WorldWideScience

Sample records for abbreviated emergency laparotomy

  1. Lessons from emergency laparotomy for abdominal tuberculosis in ...

    African Journals Online (AJOL)

    of the outcome of emergency laparotomy for abdominal TB in a population with a high prevalence of ... Committee and the Biomedical Research Ethics Committee of the. University of ... with abdominal pain, distension, vomiting and signs of ...

  2. A PROSPECTIVE STUDY OF COMPLICATIONS IN EMERGENCY LAPAROTOMY

    OpenAIRE

    Raja Bily Graham; Vijayabhasker

    2016-01-01

    Laparotomy or celiotomy is opening of the peritoneal cavity. Since the emergence of surgery, it is one of the common surgical procedure done for elective and emergency gastrointestinal and sometimes for non-gastrointestinal diseases and it is not always free from complications. The common complications associated with laparotomies are Bleeding, Haematoma, Fever, Surgical Site Infection, Wound dehiscence, Burst abdomen, Ileus, DVT, Subdiaphragmatic abscess, Stitch abscess, Enterocu...

  3. From NELA to EPOCH and beyond: enhancing the evidence base for emergency laparotomy.

    Science.gov (United States)

    Odor, Peter M; Grocott, Michael P W

    2016-01-01

    Around 35,000 patients undergo emergency laparotomy surgery in the UK each year with an in-hospital 30-day mortality estimated as between 11 and 15 %. The recent publication of the First Patient Report of the National Emergency Laparotomy Audit (NELA) has provided a detailed description of individual hospital performance against national standards of care in emergency laparotomy in England and Wales. Although the standards used for audit purposes in NELA are based upon the best currently available evidence, none of the source data derives from randomised controlled studies. This commentary explores the evidence base for the standards evaluated by NELA and highlights recent and forthcoming studies that may substantially contribute to improving the evidence base in this area, thereby improving patient care and strengthening the validity of the NELA audit standards.

  4. Analyzing intra-abdominal pressures and outcomes in patients undergoing emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Khan Shehtaj

    2010-01-01

    Full Text Available Background : Studies have documented the impact of intra-abdominal hypertension (IAH on virtually every organ. However, it still remains strangely underdiagnosed. The aims of the study were to assess, in patients undergoing emergency laparotomy, whether intra-abdominal pressure (IAP is an independent predictor of morbidity and mortality, to evaluate the effects of IAH, and to identify hidden cases of abdominal compartment syndrome (ACS. Materials and Methods : The study comprised 197 patients undergoing emergency laparotomy. IAP was measured preoperatively and then postoperatively at 0, 6, and 24 hours. Duration of hospital stay, occurrence of burst abdomen, and mortality were noted as outcomes. Results : At admission, incidence of IAH was 80%. No significant association was found between IAP and occurrence of burst abdomen (P > 0.1. IAP was found to be a significant predictor of mortality in patients undergoing laparotomy (P < 0.001. Elevated IAP was found to affect all the organ systems adversely. The incidence of post-op ACS was 3.05% in the general population and 13.16% in trauma patients. The mortality rate for this subgroup was 100%. Conclusions : IAP is a significant predictor of mortality in patients undergoing laparotomy. IAH has detrimental effects on various organ systems. A more frequent monitoring with prompt decompression may be helpful in decreasing the mortality rate. Further studies are required to establish a screening protocol in patients undergoing laparotomy to detect and manage cases of IAH and ACS.

  5. Complications after emergency laparotomy beyond the immediate postoperative period - a retrospective, observational cohort study of 1139 patients

    DEFF Research Database (Denmark)

    Toft Tengberg, Line; Cihoric, M; Foss, N B;

    2016-01-01

    %) deaths occurred between 72 h and 30 days after surgery; all of these patients had complications, indicating that there is a prolonged period with a high frequency of complications and mortality after emergency laparotomy. We conclude that peri-operative, enhanced recovery care bundles for preventing......Mortality and morbidity occur commonly following emergency laparotomy, and incur a considerable clinical and financial healthcare burden. Limited data have been published describing the postoperative course and temporal pattern of complications after emergency laparotomy. We undertook...... a retrospective, observational, multicentre study of complications in 1139 patients after emergency laparotomy. A major complication occurred in 537/1139 (47%) of all patients within 30 days of surgery. Unadjusted 30-day mortality was 20.2% and 1-year mortality was 34%. One hundred and thirty-seven of 230 (60...

  6. Transversus abdominis plane block for an emergency laparotomy in a high-risk, elderly patient

    Directory of Open Access Journals (Sweden)

    Surekha S Patil

    2010-01-01

    Full Text Available A 72-year-old male patient with gall bladder perforation and small intestinal obstruction from impacted gall stone was posted for emergency laparotomy. He had congestive heart failure, severe hypertension at admission and history of multiple other coexisting diseases. On admission, he developed pulmonary oedema from systolic hypertension which was controlled by ventilatory support, nitroglycerine and furosemide. Preoperative international normalized ratio was 2.34 and left ventricular ejection fraction was only 20%. Because of risk of exaggerated fall in blood pressure during induction of anaesthesia (general or neuraxial, a transversus abdominis plane block via combined Petit triangle and subcostal technique was administered and supplemented with Propofol sedation.

  7. Spontaneous Rupture of Primary Hepatocellular Carcinoma: Experience of Emergency Laparotomy over a 16-Year Period

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE Spontaneous rupture is an uncommon complication of primary hepatocellular carcinoma (HCC). There is no standard method of treatment, and most often treatment depends on the condition of the patient or the assessment by the surgeon. The aim of this study was to evaluate our experience of emergency laparotomy in the management of spontaneous rupture of HCC.METHODS Retrospective analysis documented 49 rupture HCC cases who received emergency laparotomy from Oct. 1990 to Oct. 2006.RESULTS Thirty-nine cases (79.6%) had a history of hepatitis and 39 cases (79.6%) were accompanied with liver cirrhosis. The most frequent manifestation which was present in 47 cases (95.9%) was sudden right hypochondrial or epigastric pain. Shock was seen in 40 cases (81.6%), and 42 cases (85.7%) had signs of peritonitis. The methods of operation were performed in the number of cases as follows: suture in 5; packing in 2; hepatic artery ligation in 4; hepatectomy in 21; microwave coagulation in 5;microwave coagulation combined with packing in 3; microwave coagulation combined with hepatic artery ligation in 9. Morbidity occurred in 11 cases (22.4%). The overall hospital mortality rate was 10.2%. The mean survival time was 8.8 months. The main causes of death were liver failure and massive variceal bleeding.CONCLUSION Spontaneous rupture of HCC represents a life-threatening condition with an overall poor prognosis. Laparotomy should be the first choice for treating HCC rupture if the proper conditions are present. Liver failure is the vital condition influencing the prognosis.

  8. CLINICAL STUDY ON FACTORS INFLUENCING WOUND DEHISCENCE IN EMERGENCY EXPLORATORY LAPAROTOMY

    Directory of Open Access Journals (Sweden)

    Mrinal

    2016-04-01

    Full Text Available BACKGROUND Wound dehiscence is a mental, financial and physical trauma to patients and has an equivalent effect on surgeon too. Wound dehiscence etches profound morbidity in a patient’s life. There arises an expanding demand in the cost of care, both in terms of increased hospital stay and manpower in nursing and managing of burst wound and its complications. Thus understanding of factors contributing to dehiscence, correctable measures and precautionary steps are very much essential in day-to-day practice of all surgeons. This ignited our thoughts to conduct a study and understand wound healing and dehiscence in a better way. AIM This study was made to find the factors that significantly contribute to wound dehiscence in midline emergency exploratory laparotomy. METHODS The study was conducted in 213 patients who underwent midline emergency exploratory laparotomy in Silchar Medical College and Hospital in Barak Valley, Assam, India, from March 2015 to February 2016. Factors such as age, preoperative albumin, body mass index, haemoglobin, post-operative pulmonary complication, diabetes mellitus, duration of surgery, time of presentation, intraabdominal sepsis/wound infection, raised intra-abdominal pressure, raised creatinine, ascites and malignancy were observed and analysed with odds ratio and P value. RESULTS AND CONCLUSION Risk factors for abdominal wound dehiscence identified in this study include anaemia, hypoalbuminemia, post-operative pulmonary complications, increased intra-abdominal pressure, intra-abdominal sepsis/wound infection, delayed presentation and malignancy.

  9. Add on dexmedetomidine in the treatment of severe alcohol withdrawal in a patient of emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Roshan Madan Shende

    2015-09-01

    Full Text Available According to American statistics 90% of people drink alcohol at some time in life. The estimated prevalence of alcohol abuse among hospitalized in patients is 20 % and 10- 33 % in patients admitted to the ICU. Approximately 18% of these patients will develop alcohol withdrawal syndrome (AWS whose symptoms can include physical and psychological manifestations that range from mild to life threatening. Although AWS has been reported in literature in post-operative periods and in intensive care unit, there is less information on treatment and preparing of a patient with AWS, coming for emergency surgical procedure. The surgical stress and deranged liver functions possess an additional challenge to the anesthesiologist. Here we are reporting the successful management of a case of delirium tremens by using Dexmedetomidine in pre, intra and post-operative period in a patient with hollow viscous perforation for emergency laparotomy. [Int J Res Med Sci 2015; 3(9.000: 2446-2449

  10. High mortality after emergency room laparotomy in haemodynamically unstable trauma patients

    DEFF Research Database (Denmark)

    Lund, Helle; Kofoed, Steen Christian; Hillingsø, Jens Georg

    2011-01-01

    Hypovolaemic shock is a major course of death in trauma patients. The mortality in patients in profound shock at the time of arrival is extremely high and we wanted to investigate the outcome of patients undergoing laparotomy at the Trauma Care Unit (TCU)....

  11. Retained Intra-Abdominal Surgical Clamp Complicating Emergency Laparotomy: Incidental Finding on Hysterosalpingogram for Evaluation of Tubal Infertility

    Directory of Open Access Journals (Sweden)

    Adebiyi Gbadebo Adesiyun

    2014-01-01

    Full Text Available The finding of intraperitoneal foreign body complicating surgical intervention broadly remains as an issue of safety in the operative room, a source of emotive concern for the patient, and an upsetting but equally embarrassing situation to the surgeon and the team. However, in the media world, it is a source of sumptuous and captivating headline on the newspaper and to the legal profession, an attractive case to prosecute. A middle age teacher presented with secondary infertility. She had emergency laparotomy fifteen years ago for ruptured tubal ectopic pregnancy in a private hospital and postoperative period was uneventful. Amongst other investigations to find out the cause of infertility, she had hysterosalpingography and a radio-opaque clamp was visualized on the films. She was counselled and had laparotomy. A pair of surgical Kocher clamps was retrieved buried in the mesentery.

  12. Evaluation of a ketamine-based anesthesia package for use in emergency cesarean delivery or emergency laparotomy when no anesthetist is available.

    Science.gov (United States)

    Burke, Thomas F; Nelson, Brett D; Kandler, Taylor; Altawil, Zaid; Rogo, Khama; Imbamba, Javan; Odenyo, Stella; Pinder, Leeya; Lozo, Svjetlana; Guha, Moytrayee; Eckardt, Melody J

    2016-12-01

    To assess the safety of a ketamine-based rescue anesthesia package to support emergency cesarean delivery and emergency laparotomy when no anesthetist was available. A prospective case-series study was conducted at seven sub-county hospitals in western Kenya between December 10, 2013, and January 20, 2016. Non-anesthetist clinicians underwent 5days of training in the Every Second Matters-Ketamine (ESM-Ketamine) program. A database captured preoperative, intraoperative, and postoperative details of all surgeries in which ESM-Ketamine was used. The primary outcome measure was the ability of ESM-Ketamine to safely support emergency operative procedures. Non-anesthetist providers trained on ESM-Ketamine supported 83 emergency cesarean deliveries and 26 emergency laparotomies. Ketamine was administered by 10 nurse-midwives and six clinical officers. Brief oxygen desaturations (Ketamine were recorded. The ESM-Ketamine package can be safely used by trained non-anesthetist providers to support emergency cesarean delivery and emergency laparotomy when no anesthetist is available. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. ANAESTHETIC MANAGEMENT OF A GERIATRIC PATIENT WITH PARKINSON`S DISEASE AND DIABETES MELLITUS POSTED FOR EMERGENCY LAPAROTOMY

    Directory of Open Access Journals (Sweden)

    Prajwal Patel

    2014-10-01

    Full Text Available Parkinson's disease (PD, one of the most common disabling neurological diseases, affects about 1% of the population over 60 years of age. It is a degenerative disease of the central nervous system caused by the loss of dopaminergic fibers in basal ganglia of the brain. PD is an important cause of perioperative morbidity and with an increasingly elderly population; it is being encountered with greater frequency in surgical patients. Here we report a case of 79year old male with Parkinsonism and diabetes mellitus posted for emergency laparotomy, which we managed successfully with general anesthesia.

  14. Intra-abdominal pressure and possible ways of its drug correction after emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Людмила Василівна Новицька-Усенко

    2015-11-01

    Full Text Available Introduction. Postoperative disorders of gastrointestinal tract (GIT motility are often after abdominal operations. Postoperative enteroparesis is usually accompanied by the raise of intra-abdominal pressure (IAP.Materials and methods. After approval of research by bioethics committee and informed consent 52 patients were prospectively divided in 2 groups depending on the type of postoperative intensive care. Patients underwent operations on abdominal cavity by laparotomy incision on the subject of peritonitis. Patient of the 1 (control group (n=27 after operation received stimulation of GIT with metoclopramide and simethicone.  In the 2 group (n=25 patients received metoclopramide and simethicone. Patients were comparable on age, sex, concomitant pathology, ASA class (IIE-IIIE and the type of operative intervention (laparotomy on the subject of peritonitis. IAP level was studied before operation and at 1,2,3 days after it. IAP was measured by indirect method trough the urinary bladder. The values recommended by the World society of abdominal compartment syndrome were considered as the normal IAP level.  Perfuse pressure (PP in abdominal cavity was calculated by formula: PP=MAP-ICP where MAP – mean arterial pressure. There were also studied indices of the central and peripheral hemodynamics, inflammation markers (leukocytes, fibrinogen level, IL-1α, TNFα, IL-10, leukocytic index of intoxication was calculated. The final point of research was 28 day after operation when we evaluated mortality and life quality on Rancho Los Amigos scale.Results and discussion. We registered the raise of IAP in 63.1% of patients. The value of intra-abdominal pressure exceeded an upper limit of the normal one by 58,5% (р <0,001. Among patients with high IAP 83% had intra-abdominal hypertension (IAH of 1 degree, 17% - of 2 degree.  The development of 3 and 4degree IAH were not observed before operation. PP remained within the normal.Correlative analysis

  15. Anesthetic management of a neonate with arthrogryposis multiplex congenita for emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Rajat Chowdhuri

    2011-01-01

    Full Text Available Arthrogryposis multiplex congenita is a rare disease, characterized by non-progressive, multiple joint contractures since birth. Anesthetic issues include difficult intravenous access, difficult airway management and regional anesthesia. We report the anesthetic management of a six-day-old neonate presenting to the emergency with features of intestinal obstruction, who was detected for the first time to have arthrogryposis multiplex congenita. General anesthesia along with caudal analgesia for peroperative and postoperative pain relief was used. There was an episode of intraoperative hyperthermia, which was tackled successfully. The child had an uneventful post-anesthesia recovery.

  16. Posterior reversible encephalopathy syndrome following an inadvertent dural puncture during an emergency laparotomy for ischemic colitis – a case report

    Directory of Open Access Journals (Sweden)

    Shah R

    2014-01-01

    Full Text Available Reena Shah, Agnieszka Kubisz-Pudelko, Jeremy Reid Yeovil District Hospital, Yeovil, UK Abstract: Posterior reversible encephalopathy syndrome (PRES is a clinico-neuroradiological syndrome characterized by various symptoms of neurological disease. It has commonly been reported in association with acute hypertension, pre-eclampsia, eclampsia, sepsis, and exposure to immunosuppressants. Here, we report on a normotensive woman who developed a severe frontal headache, visual disturbances, and hypertension 3 days after undergoing an emergency laparotomy for ischemic colitis during which she suffered an inadvertent dural puncture. Neuro-imaging revealed features consistent with PRES. The patient went on to make a good recovery, being discharged 21 days postoperatively, with only minor visual disturbances and memory problems. This case highlights the importance of awareness of PRES to all specialties. On reviewing the literature, we feel that PRES may be a potential differential diagnosis to post-procedural neurological symptoms in those patients undergoing routine procedures such as spinal anesthetics or lumbar punctures. Keywords: PRES, neurological disease, lumbar puncture, spinal anesthetic

  17. EMERGENCY LAPAROTOMY AND DEATH IN ECTOPIC PREGNANCY: A RARITY NOWADAYS? A DESCRIPTIVE STUDY OF ECTOPIC PREGNANCY CASES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Suja Mary

    2015-02-01

    Full Text Available Pregnancy implanted outside the endometrial cavity constitutes ectopic gestation. The reproductive performance can be poor following an ectopic pregnancy. The purpose of the study is to emphasize the importance of public awareness about the need for early reporting to hospital in doubtful cases, to analyze the risk factors for ectopic, to study the role of βHCG estimation and transvaginal sonography in early detection in order to preserve the fallopian tube by medical therapy and/or to do early elective surgery preventing emergency laparotomy and death from ectopic pregnancy. METHODOLOGY: All cases of ectopic gestations managed in a tertiary care hospital for a period of one year is reviewed, roughly around 70 cases. The objectives were to analyze demographic characteristics, risk factors, methods of diagnosis and to evaluate the protocol for ectopic management in the hospital. RESULTS: The study showed that the maximum number of ectopic was seen in the 26 - 30 age group and more commonly among multies. Maximum number of ectopic cases is seen between 5.1 to 6 weeks and 80% of the cases are seen in ≤8 weeks. 42/70 patients showed one or more risk factors like previous history of ectopic, LSCS, infertility treatment, sterilization and use of IUCD.82.9% patients presented either with pain alone or pain along with spotting/bleeding p/v. Earlier, majority of the cases were reported after tubal rupture resulting in shock, which sometimes even lead to death. In the present scenario, however, only 2 patients developed hypotension, 11 out of 70 alone required blood transfusion and none required laparotomy. Majority of cases of unruptured ectopic (83% showed <66% rise in βHCG in 48 hours. Pelvic ultrasound and serum βHCG estimation has revolutionized the diagnostic proce ss of ectopic pregnancy enabling detection in the unruptured stage itself in 50% of the cases and the rest in early stages of rupture. In most cases, medical line of management with

  18. Abbreviations in Maritime English

    Science.gov (United States)

    Yang, Zhirong

    2011-01-01

    Aiming at the phenomena that more and more abbreviations occur in maritime English correspondences, the composing laws of the abbreviations in maritime English correspondence are analyzed, and the correct methods to answer the abbreviations are pointed out, and the translation method of abbreviations are summarized in this article, and the…

  19. FDA Acronyms and Abbreviations

    Data.gov (United States)

    U.S. Department of Health & Human Services — The FDA Acronyms and Abbreviations database provides a quick reference to acronyms and abbreviations related to Food and Drug Administration (FDA) activities

  20. Early laparotomy after lung transplantation

    DEFF Research Database (Denmark)

    Bredahl, Pia; Zemtsovski, Mikhail; Perch, Michael;

    2014-01-01

    BACKGROUND: Gastrointestinal complications after lung transplantation have been reported with incidence rates ranging from 3% to 51%, but the reasons are poorly understood. We aimed to investigate the correlations between pulmonary diseases leading to lung transplantation and early gastrointestinal...... complications requiring laparotomy after transplantation with outcomes for patients at increased risk. METHODS: In this study we performed a retrospective analysis of data of patients who underwent lung transplantation at our institution from 2004 to 2012. The study period was limited to the first 90 days after...... for time on mechanical ventilation. Among pulmonary diseases and demographics of the patients, no other risk factors were identified for laparotomy. CONCLUSIONS: A1AD was the only significant risk factor identified for gastrointestinal complications that required laparotomy within 3 months after lung...

  1. [Laparotomy closure in advanced peritonitis].

    Science.gov (United States)

    Bensman, V M; Savchenko, Yu P; Shcherba, S N; Golikov, I V; Triandafilov, K V; Chaykin, V V; Pyatakov, S N; Saakyan, A S; Saakyan, E A

    to improve the results of advanced peritonitis management. 743 patients with advanced peritonitis were studied. Patients were divided into 2 groups depending on treatment strategy. Programmed relaparotomy combined with removable draining musculoaponeurotic seams during laparotomy closure decreased mortality from 47.8±2.7% to 24.1±2.3% (pperitonitis management. Laparotomy closure with only cutaneous seams is indicated in case of persistent abdominal hypertension. Large eventration always requires abdominal wall repair. APACHE-III scale scores have significant prognostic value in patients with advanced peritonitis.

  2. Acute Abdomen; Pre and Post-Laparotomy Diagnosis

    Directory of Open Access Journals (Sweden)

    Marjan Laal

    2009-07-01

    Full Text Available Background: Abdominal pain is a common presentation that requires almost immediate management. It is sometimes crucial to diagnose at the earliest and make a decision as to operate. Therefore it is necessary for the physician to be familiar both with the presentations of common causes of abdominal pain and the validity of diagnostic tests.  Diagnosis of acute abdomen before laparotomy is essential in reducing the morbidity and mortality while preventing from unnecessary operations especially where the diagnostic facilities are limited and clinical awareness plays an important role in the diagnosis and management. Objectives: This study attempted to compare pre and post-operative diagnosis in acute abdomen.Materials & Methods: This was an observational study, conducted from February to December 2005. The study included 139 consecutive patients referred to Sina hospital (Tehran, Iran presented with symptoms of acute abdomen, operated to see the negative laparotomy rate, the diagnostic accuracy and predictive values of different investigations in acute abdomen. Statistical analysis was performed using SPSS software version 11.5. P value of Results: All 139 patients with diagnosis of acute abdomen underwent emergency laparotomy. Acute abdomen was most common in the age group 20-29 years with male predominance. Acute appendicitis (57.6% was the most common cause of surgical condition, and then the most common causes of acute abdomen were peritonitis (14.4% and bowel obstruction (7.9% in male and ovarian cyst torsion (24.5% in female patients. The negative laparotomy rate was 12.2% (P value Conclusion: The decision to operate is based on the results of a good history and thorough physical examination(s with the guidance of investigative tools. Diagnostic modalities could guide the physician in confirming the diagnosis. An accurate diagnosis of acute abdomen can avoid from unnecessary operations so reduces the rate of negative laparotomies.

  3. The clinical analysis of the risk factor of convertion from emergency laparoscopic cholecystectomy to laparotomy%急症腹腔镜胆囊切除术中转开腹危险因素的分析

    Institute of Scientific and Technical Information of China (English)

    张立明

    2011-01-01

    time of cholecystitis, gallbladder triangle anatomical levels, gallbladder wall thickness, gallstone incarceration and gangrenous cholecystitis were extracted as the five factors. With Stata 10.0 statistical analysis software, single factor analysis was made to identify the risk factor of emergency LC convertion to open surgery, multiple logistic regression equation of factor analysis was made to predict the possibility of emergency laparoscopic cholecystectomy convertion to open operation and evaluate the effi ciency. Results: One hundred and twenty cases underwent emergency LC, of which 38 cases were converted to open cholecystectomy, conversion rate was 31.67%. Univariate analysis showed that cholecystitis attack > 72h, gallbladder triangle indistinct anatomy, gallbladder wall thickness > 0.5cm and gangrenous cholecystitis were correlate risk factor of LC conversion to open surgery. Logistic regression analysis showed that cholecystitis attack > 72h, gallbladder triangle indistinct anatomy, gallbladder wall thickness > 0.5cm and gangrenous cholecystitis were risk factors of LC convertion to open surgery. Logistic regression equation showed predictive efficiency was 0.9519. Conclusions: Cholecystitis attack > 72h, gallbladder triangle indistinct anatomy, gallbladder wall thickness > 0.5 cm, gangrenous cholecystitis are risk factors of conlversion to laparotomy. LC patients has the more risk factors,the difficulty of operation is greater, the possibility of conversion to open surgery is higher. Preoperative comprehensive evaluation of risk factor is significant for choosing operative method and decreasing conversion rate, can avoid serious complications of LC.

  4. Deciphering Journal Abbreviations with JAbbr

    OpenAIRE

    Keith Jenkins

    2009-01-01

    JAbbr is an online tool developed at Cornell University to help users decipher journal title abbreviations. This article discusses why these abbreviations are so problematic, and how traditional tools are often insufficient, and then describes the novel approach used by JAbbr. Given an abbreviation, JAbbr creates a regular expression for fuzzy matching, tests it against a list of serial titles extracted from the library catalog, and returns a list of possible matches to the user. JAbbr is ava...

  5. Decompressive laparotomy for abdominal compartment syndrome

    Science.gov (United States)

    Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.

    2016-01-01

    Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380

  6. Deciphering Journal Abbreviations with JAbbr

    Directory of Open Access Journals (Sweden)

    Keith Jenkins

    2009-06-01

    Full Text Available JAbbr is an online tool developed at Cornell University to help users decipher journal title abbreviations. This article discusses why these abbreviations are so problematic, and how traditional tools are often insufficient, and then describes the novel approach used by JAbbr. Given an abbreviation, JAbbr creates a regular expression for fuzzy matching, tests it against a list of serial titles extracted from the library catalog, and returns a list of possible matches to the user. JAbbr is available as a web site and as a web service.

  7. Laparoscopic surgery of ovarian cyst in comparison with laparotomy ...

    African Journals Online (AJOL)

    Laparoscopic surgery of ovarian cyst in comparison with laparotomy at university hospital of Brazzaville. ... Open Access DOWNLOAD FULL TEXT ... The average age of patients was 32.2 years versus 33 years in laparoscopy to laparotomy.

  8. Closed-suction drain placement at laparotomy in isolated solid organ injury is not associated with decreased risk of deep surgical site infection.

    Science.gov (United States)

    Mohseni, Shahin; Talving, Peep; Kobayashi, Leslie; Kim, Dennis; Inaba, Kenji; Lam, Lydia; Chan, Linda S; Coimbra, Raul; Demetriades, Demetrios

    2012-10-01

    The purpose of this study was to investigate the role of intra-abdominal closed-suction drainage after emergent trauma laparotomy for isolated solid organ injuries (iSOI) and to determine its association with deep surgical site infections (DSSI). All patients subjected to trauma laparotomy between January 2006 and December 2008 for an iSOI at two Level I urban trauma centers were identified. Patients with isolated hepatic, splenic, or renal injuries were included. Study variables extracted included demographics, clinical characteristics, intra-abdominal injuries, drain placement, DSSI, septic events, intensive care unit and hospital length of stay, and in-hospital mortality. Diagnosis of DSSI was based on abdominal computed tomography scan demonstrating an intra-abdominal collection combined with fever and elevated white blood cell count. For the analysis, patients were stratified based on injury severity. To identify an independent association between closed-suction drain placement and DSSI, stepwise logistic regression analysis was performed. Overall, 142 patients met the inclusion criteria with 80 per cent (n=114) having severe iSOI. In 47 per cent (n=53) of the patients with a severe injury, an intra-abdominal drain was placed. A drain was placed more often in patients with a blunt trauma with more severe injury defined by Injury Severity Score and abdominal Abbreviated Injury Scale Score and those who underwent splenectomy (Pdrain placement (odds ratio, 2.8; 95% confidence interval, 1.0 to 8.2; P=0.046). Subgroup analysis demonstrated those who sustained severe hepatic injury receiving a drain had a significantly increase risk of DSSI (P=0.02). There was no statistical difference in the rate of DSSI based on the presence or absence of an intra-abdominal drain after severe splenic injury (17 vs 18%, P=0.88). The use of intra-abdominal closed-suction drains after iSOI is not associated with decreased risk of DSSI.

  9. [Giant appendiceal mucocele during laparotomy for acute abdomen. Report of a case and brief review].

    Science.gov (United States)

    Caiazzo, P; Comentale, A; Rampone, B; Di Lascio, P; Morlino, A; Pastore, M; Del Vecchio, G; Tramutoli, P R

    2010-01-01

    The authors describe a case of giant appendiceal mucocele, secondary to a mucinous neoplasm of the appendix, diagnosed during laparotomy for acute abdomen. By a review of the literature they stress the rarity of this lesion, the particular onset in their case as acute complication of appendiceal neoplasm with rupture of the intestinal wall, the difficulties of diagnosis and management in emergency.

  10. Decompressive Abdominal Laparotomy for Abdominal Compartment Syndrome in an Unengrafted Bone Marrow Recipient with Septic Shock

    Directory of Open Access Journals (Sweden)

    Derrick J. N. Dauplaise

    2010-01-01

    Full Text Available Objective. To describe a profoundly immunocompromised (panleukopenia child with septic shock who developed abdominal compartment syndrome (ACS and was successfully treated with surgical decompression. Design. Individual case report. Setting. Pediatric intensive care unit of a tertiary children's hospital. Patient. A 32-month-old male with Fanconi anemia who underwent bone marrow transplantation (BMT 5 days prior to developing septic shock secondary to Streptococcus viridans and Escherichia coli ACS developed after massive fluid resuscitation, leading to cardiopulmonary instability. Interventions. Emergent surgical bedside laparotomy and silo placement. Measurements and Main Results. The patient's cardiopulmonary status stabilized after decompressive laparotomy. The abdomen was closed and the patient survived to hospital discharge without cardiac, respiratory, or renal dysfunction. Conclusions. The use of laparotomy and silo placement in an unengrafted BMT patient with ACS and septic shock did not result in additional complications. Surgical intervention for ACS is a reasonable option for high risk, profoundly immunocompromised patients.

  11. Global change: Acronyms and abbreviations

    Energy Technology Data Exchange (ETDEWEB)

    Woodard, C.T. [Oak Ridge National Lab., TN (United States); Stoss, F.W. [Univ. of Tennessee, Knoxville, TN (United States). Energy, Environment and Resources Center

    1995-05-01

    This list of acronyms and abbreviations is compiled to provide the user with a ready reference to dicipher the linguistic initialisms and abridgements for the study of global change. The terms included in this first edition were selected from a wide variety of sources: technical reports, policy documents, global change program announcements, newsletters, and other periodicals. The disciplinary interests covered by this document include agriculture, atmospheric science, ecology, environmental science, oceanography, policy science, and other fields. In addition to its availability in hard copy, the list of acronyms and abbreviations is available in DOS-formatted diskettes and through CDIAC`s anonymous File Transfer Protocol (FTP) area on the Internet.

  12. Will Banning Foreign Abbreviations Help?

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    @@ From early April, China's national broad-caster CCTV banned the use of borrowed English abbreviations such as NBA, GDP, WTO and CPI in all its programs. The move was launched in line with a government directive after several national legislators and political advisors called for the preservation of the Chinese language's purity.

  13. Classification and Translation of Chinese Abbreviations

    Institute of Scientific and Technical Information of China (English)

    郭颖婷

    2014-01-01

    Chinese abbreviation, containing fewer words and delivering a wealth of information, is a vital component of Chinese language. But the tremendous differences between Chinese and English make it an arduous task to translate Chinese abbreviations into English. Based on the analyses of the structure and patterns of word-formation of Chinese abbreviations, it makes a classifi-cation of Chinese abbreviations, summarize the translation methods, and point out some attention points in translation. A system-atic analysis on the structure and classification of Chinese abbreviations will be beneficial to reduce the mistakes in its translation.

  14. Abbreviations

    OpenAIRE

    2014-01-01

    CBA Cost-Benefit Analysis CBD Convention on Biological Diversity CGAPS Coordinating Group on Alien Pest Species CITES Convention on International Trade in Endangered Species of Wild Fauna and Flora CRC Cooperative Research Center for Australian Weed Management DAE Direction des affaires économiques, New Caledonia DAVAR Direction des affaires vétérinaire, alimentaire et rurale, New Caledonia DDE-E Direction du développement économique et de l’environnement, New Caledonia. DDR Direction du déve...

  15. Abbreviations

    OpenAIRE

    2013-01-01

    "AB" The official French logo for certified organic produce ("Agriculture Biologique") CF Conventional farming EF Ecological farming IFS Integrated farming systems LIF Low-input farming OF Organic farming OFgc Organic farming under group certification AFSAA Agence Française de Sécurité Sanitaire des Aliments (French food safety agency) AMAP Association pour le Maintien d'une Agriculture Paysanne (Association for the maintenance of small-scale farming – there is a network of such associations ...

  16. 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

  17. Evaluating clinical abdominal scoring system in predicting the necessity of laparotomy in blunt abdominal trauma

    Institute of Scientific and Technical Information of China (English)

    Peyman Erfantalab-Avini; Nima Hafezi-Nejad; Mojtaba Chardoli; Vafa Rahimi-Movaghar

    2011-01-01

    Objectives: Trauma is among the leading causes of death. Medical management of blunt abdominal trauma (BAT) relies on judging patients for whom laparotomy 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 hospitals 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, abdominal clinical findings, respiratory rate, temperature, hemoglobin (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 presentation 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 accuracy of diagnosis.

  18. Comparing surgical outcomes in obese women undergoing laparotomy, laparoscopy, or laparotomy with panniculectomy for the staging of uterine malignancy.

    Science.gov (United States)

    Eisenhauer, Eric L; Wypych, Kelly A; Mehrara, Babak J; Lawson, Carrie; Chi, Dennis S; Barakat, Richard R; Abu-Rustum, Nadeem R

    2007-08-01

    Limiting surgical morbidity while maintaining staging adequacy is a primary concern in obese patients with uterine malignancy. The goal of this study was to compare the surgical adequacy and postoperative morbidity of three surgical approaches to staging the disease of obese women with uterine cancer. The records of all patients with a body mass index (BMI) of >or=35 undergoing primary surgery for uterine corpus cancer at our institution from January 1993 to May 2006 were reviewed. Patients were assigned to three groups on the basis of planned surgical approach-standard laparotomy, laparoscopy, or laparotomy with panniculectomy. Standard statistical tests appropriate to group size were used to compare the three groups. In all, 206 patients with a BMI of >or=35 were grouped as follows: laparotomy, 154 patients; laparoscopy, 25 patients; and laparotomy with panniculectomy, 27 patients. Median BMI was 41 (range, 35-84). Regional lymph nodes were removed in 45% of the laparotomy patients, 40% of the laparoscopy patients, and 70% of the panniculectomy patients (P = .04). Compared with laparotomy, both laparoscopy and panniculectomy yielded higher median pelvic and total lymph node counts (P = .001). Operative time was shortest after standard laparotomy, and blood loss was greatest after panniculectomy. The incidence of all incisional complications was lower for panniculectomy (11%) and laparoscopy (8%) compared with standard laparotomy (35%) (P = .002). On multivariate analysis, a significantly lower risk of total incisional complications was seen for patients undergoing panniculectomy (risk ratio, .25; 95% confidence interval, .071-.88) and laparoscopy (risk ratio, .19; 95% confidence interval, .04-.94). Both laparoscopic staging and panniculectomy in a standardized fashion were associated with an improved lymph node count and a lower rate of incisional complications than laparotomy alone. Although definitive conclusions are limited by low patient numbers, the

  19. CLOSURE OF PERITONEUM AT LAPAROTOMY - A SURVEY OF ...

    African Journals Online (AJOL)

    There are animal and clinical trials to ... adhesion formation in animals undergOing laparotomy when peritonitis was .... women with no history of abdominal surgery (control group). ... have been documented for animal experiments and human.

  20. Neuromuscular blockade for improvement of surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Scheppan, Susanne; Kissmeyer-Nielsen, Peter

    2015-01-01

    INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep neuromus......INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep...

  1. Neuromuscular blockade for improvement of surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Scheppan, Susanne; Kissmeyer, Peter

    2015-01-01

    INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep neuromus......INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep...

  2. Acronyms, initialisms, and abbreviations: Fourth Revision

    Energy Technology Data Exchange (ETDEWEB)

    Tolman, B.J. [comp.

    1994-04-01

    This document lists acronyms used in technical writing. The immense list is supplemented by an appendix containing chemical elements, classified information access, common abbreviations used for functions, conversion factors for selected SI units, a flowcharting template, greek alphabet, metrix terminology, proofreader`s marks, signs and symbols, and state abbreviations.

  3. Abbreviation and acronym disambiguation in clinical discourse.

    Science.gov (United States)

    Pakhomov, Sergeui; Pedersen, Ted; Chute, Christopher G

    2005-01-01

    Use of abbreviations and acronyms is pervasive in clinical reports despite many efforts to limit the use of ambiguous and unsanctioned abbreviations and acronyms. Due to the fact that many abbreviations and acronyms are ambiguous with respect to their sense, complete and accurate text analysis is impossible without identification of the sense that was intended for a given abbreviation or acronym. We present the results of an experiment where we used the contexts harvested from the Internet through Google API to collect contextual data for a set of 8 acronyms found in clinical notes at the Mayo Clinic. We then used the contexts to disambiguate the sense of abbreviations in a manually annotated corpus.

  4. ISO Abbreviations for Names of Polymeric Substances

    Directory of Open Access Journals (Sweden)

    V. Jarm

    2011-04-01

    Full Text Available The use of abbreviations for the names of polymers is practical and economic in written and spoken language. Taking into consideration the several hundreds of polymers appearing in literature annually, some of them having complicated structures, it is almost impossible to derive a systematic and unique abbreviation to polymer structures. Therefore, IUPAC has taken over the well-established ISO list of abbreviated terms (about 120 items mainly selected on the basis of the scale of production. The presented ISO nomenclature is not necessarily in accord with IUPAC recommendations.

  5. 40 CFR 600.403-77 - Abbreviations.

    Science.gov (United States)

    2010-07-01

    ... ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Fuel Economy Regulations for 1977 and Later Model Year Automobiles-Dealer Availability of Fuel Economy Information § 600.403-77 Abbreviations....

  6. Body Packing: From Seizures to Laparotomy

    Directory of Open Access Journals (Sweden)

    Joanna M. Janczak

    2015-01-01

    Full Text Available Body packing is a common method for illegal drug trafficking. Complications associated with body packing can be severe and even lead to rapid death. Thus, a timely diagnosis is warranted. As most body packers initially do not show any symptoms, making a correct diagnosis can be rather challenging. We describe a case of a 41-year-old male, who was admitted with an epileptic seizure and who turned out to be a cocaine intoxicated body packer. Due to neurological and cardiovascular deterioration an emergency surgery was performed. Four bags of cocaine could be removed. We discuss the current management regimen in symptomatic and asymptomatic body packers and highlight pearls and pitfalls with diagnosis and treatment.

  7. Myasthenia Revealed Following Laparotomy - A Case Report

    Directory of Open Access Journals (Sweden)

    Abdelilah GHANNAM

    2015-06-01

    Full Text Available Myasthenia (muscle weakness is a rare neuromuscular disease of which respiratory failure is the main complication. The accidental discovery of such disease in the perioperative period is rare and potentially serious.We report a case of a woman who underwent emergency operation for appendiceal peritonitis, and failed repeatedly at weaning from postoperative mechanical ventilation. The usual etiologies such as postoperative respiratory complications, ventilator-associated pneumonia, acute respiratory distress syndrome complicating the septic shock or having no impact on it, and neuromyopathy’s resuscitation were considered, researched, examined or eliminated.Faced with the diagnostic impasse and the obvious weaning failure, another interview revealed signs of muscle fatigue which led to the diagnosis of myasthenia gravis decompensated perioperatively. Once the diagnosis was confirmed by means of a neostigmine test, the specific treatment began, particularly through plasma exchange sessions, and the process of weaning resumed. The result was complete weaning. A three-month follow-up showed a stable patient with no significant muscular disability.

  8. Decreasing the Use of Damage Control Laparotomy in Trauma: A Quality Improvement Project.

    Science.gov (United States)

    Harvin, John A; Kao, Lillian S; Liang, Mike K; Adams, Sasha D; McNutt, Michelle K; Love, Joseph D; Moore, Laura J; Wade, Charles E; Cotton, Bryan A; Holcomb, John B

    2017-08-01

    Our institution has published damage control laparotomy (DCL) rates of 30% and documented the substantial morbidity associated with the open abdomen. The purpose of this quality improvement (QI) project was to decrease the rate of DCL at a busy, Level I trauma center in the US. A prospective cohort of all emergent trauma laparotomies from November 2013 to October 2015 (QI group) was followed. The QI intervention was multifaceted and included audit and feedback for every DCL case. Morbidity and mortality of the QI patients were compared with those from a published control (control group: emergent laparotomy from January 2011 to October 2013). A significant decrease was observed immediately on beginning the QI project, from a 39% DCL rate in the control period to 23% in the QI group (p control 16% vs QI 12%; p = 0.15), fascial dehiscence (6% vs 8%; p = 0.20), unplanned relaparotomy (11% vs 10%; p = 0.58), or mortality (9% vs 10%; p = 0.69) were observed. The reduction in use resulted in a decrease of 68 DCLs over the 2-year period. There was a further reduction in the rate of DCL to 17% after completion of the QI project. A QI initiative rapidly changed the use of DCL and improved quality of care by decreasing resource use without an increase morbidity or mortality. This decrease was sustained during the QI period and further improved upon after its completion. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Hysterectomy for obese women with endometrial cancer: laparoscopy or laparotomy?

    Science.gov (United States)

    Eltabbakh, G H; Shamonki, M I; Moody, J M; Garafano, L L

    2000-09-01

    The aim of this study was to investigate the feasibility and safety of laparoscopic management of obese women with early stage endometrial cancer and to compare the surgical outcome, cost, hospital stay, recall of postoperative pain control, time to return to full activity and to work, and overall satisfaction among these women and those managed by laparotomy. We conducted a prospective study over 2 years applying laparoscopic surgery to all women with clinical stage I endometrial cancer and body mass indices (BMIs) between 28.0 and 60.0 who can tolerate such surgery. As a control, we used women with clinical stage I endometrial cancer and similar BMIs who underwent laparotomy in the previous 2 years. Both groups were compared in their characteristics, surgical outcome, cost, and hospital stay, and interviewed regarding time to recovery, recall of postoperative pain control, and overall satisfaction with their management. Forty of 42 obese women who presented with clinical stage I endometrial cancer during the study period were offered laparoscopic surgery. The procedure was converted to laparotomy in 3 (7.5%) patients. Laparoscopic surgery was thus successful in 88.1% of all obese women. There was no significant difference between women who underwent laparoscopy and those who underwent laparotomy in patient characteristics, proportion of women who underwent lymphadenectomy, complications, total cost, patients' recall of postoperative pain, and patients' satisfaction with management. Women who underwent laparoscopy had a significantly longer operative time, more pelvic lymph nodes removed, a smaller drop in postoperative hematocrit, less pain medication, and a shorter hospital stay (194.8 versus 137.7 min, P obese women with early stage endometrial cancer can be safely managed through laparoscopy with excellent surgical outcome, shorter hospitalization, and less postoperative pain than those managed through laparotomy. Copyright 2000 Academic Press.

  10. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  11. A novel abbreviation standard for organobromine, organochlorine and organophosphorus flame retardants and some characteristics of the chemicals.

    Science.gov (United States)

    Bergman, Ake; Rydén, Andreas; Law, Robin J; de Boer, Jacob; Covaci, Adrian; Alaee, Mehran; Birnbaum, Linda; Petreas, Myrto; Rose, Martin; Sakai, Shinichi; Van den Eede, Nele; van der Veen, Ike

    2012-11-15

    Ever since the interest in organic environmental contaminants first emerged 50years ago, there has been a need to present discussion of such chemicals and their transformation products using simple abbreviations so as to avoid the repetitive use of long chemical names. As the number of chemicals of concern has increased, the number of abbreviations has also increased dramatically, sometimes resulting in the use of different abbreviations for the same chemical. In this article, we propose abbreviations for flame retardants (FRs) substituted with bromine or chlorine atoms or including a functional group containing phosphorus, i.e. BFRs, CFRs and PFRs, respectively. Due to the large number of halogenated and organophosphorus FRs, it has become increasingly important to develop a strategy for abbreviating the chemical names of FRs. In this paper, a two step procedure is proposed for deriving practical abbreviations (PRABs) for the chemicals discussed. In the first step, structural abbreviations (STABs) are developed using specific STAB criteria based on the FR structure. However, since several of the derived STABs are complicated and long, we propose instead the use of PRABs. These are, commonly, an extract of the most essential part of the STAB, while also considering abbreviations previously used in the literature. We indicate how these can be used to develop an abbreviation that can be generally accepted by scientists and other professionals involved in FR related work. Tables with PRABs and STABs for BFRs, CFRs and PFRs are presented, including CAS (Chemical Abstract Service) numbers, notes of abbreviations that have been used previously, CA (Chemical Abstract) name, common names and trade names, as well as some fundamental physico-chemical constants.

  12. A novel abbreviation standard for organobromine, organochlorine and organophosphorus flame retardants and some characteristics of the chemicals

    Science.gov (United States)

    Bergman, Åke; Rydén, Andreas; Law, Robin J.; de Boer, Jacob; Covaci, Adrian; Alaee, Mehran; Birnbaum, Linda; Petreas, Myrto; Rose, Martin; Sakai, Shinichi; Van den Eede, Nele; van der Veen, Ike

    2012-01-01

    Ever since the interest in organic environmental contaminants first emerged 50 years ago, there has been a need to present discussion of such chemicals and their transformation products using simple abbreviations so as to avoid the repetitive use of long chemical names. As the number of chemicals of concern has increased, the number of abbreviations has also increased dramatically, sometimes resulting in the use of different abbreviations for the same chemical. In this article, we propose abbreviations for flame retardants (FRs) substituted with bromine or chlorine atoms or including a functional group containing phosphorus, i.e. BFRs, CFRs and PFRs, respectively. Due to the large number of halogenated and organophosphorus FRs, it has become increasingly important to develop a strategy for abbreviating the chemical names of FRs. In this paper, a two step procedure is proposed for deriving practical abbreviations (PRABs) for the chemicals discussed. In the first step, structural abbreviations (STABs) are developed using specific STAB criteria based on the FR structure. However, since several of the derived STABs are complicated and long, we propose instead the use of PRABs. These are, commonly, an extract of the most essential part of the STAB, while also considering abbreviations previously used in the literature. We indicate how these can be used to develop an abbreviation that can be generally accepted by scientists and other professionals involved in FR related work. Tables with PRABs and STABs for BFRs, CFRs and PFRs are presented, including CAS (Chemical Abstract Service) numbers, notes of abbreviations that have been used previously, CA (Chemical Abstract) name, common names and trade names, as well as some fundamental physico-chemical constants. PMID:22982223

  13. MBA: a literature mining system for extracting biomedical abbreviations

    Directory of Open Access Journals (Sweden)

    Lei YiMing

    2009-01-01

    Full Text Available Abstract Background The exploding growth of the biomedical literature presents many challenges for biological researchers. One such challenge is from the use of a great deal of abbreviations. Extracting abbreviations and their definitions accurately is very helpful to biologists and also facilitates biomedical text analysis. Existing approaches fall into four broad categories: rule based, machine learning based, text alignment based and statistically based. State of the art methods either focus exclusively on acronym-type abbreviations, or could not recognize rare abbreviations. We propose a systematic method to extract abbreviations effectively. At first a scoring method is used to classify the abbreviations into acronym-type and non-acronym-type abbreviations, and then their corresponding definitions are identified by two different methods: text alignment algorithm for the former, statistical method for the latter. Results A literature mining system MBA was constructed to extract both acronym-type and non-acronym-type abbreviations. An abbreviation-tagged literature corpus, called Medstract gold standard corpus, was used to evaluate the system. MBA achieved a recall of 88% at the precision of 91% on the Medstract gold-standard EVALUATION Corpus. Conclusion We present a new literature mining system MBA for extracting biomedical abbreviations. Our evaluation demonstrates that the MBA system performs better than the others. It can identify the definition of not only acronym-type abbreviations including a little irregular acronym-type abbreviations (e.g., , but also non-acronym-type abbreviations (e.g., .

  14. Management of Ovarian Dermoid Cysts by Laparoscopy Compared With Laparotomy

    Directory of Open Access Journals (Sweden)

    Pang Liyi

    1996-01-01

    Full Text Available Thirty patients with ovarian dermoid cysts removed by laparoscopic surgery were compared with 42 patients with ovarian dermoid cysts removed by laparotomy, with respect to the selection criteria, surgical procedures, operating time, intraoperative and postoperative complications, blood loss, and hospital stay. Although the operating time for unilateral cystectomy, unilateral salpingo-oophorectomy, and bilateral cystectomy performed by laparoscopic surgery was longer (120.3 ± 43.7 min, mean ± SD than those for the same procedures performed by laparotomy (73.9 ± 21.6 min, p < 0.01, we observed a learning curve with a remarkable declining tendency (linear regression model, p < 0.01. At the end of this study, the times taken for laparoscopic procedures were almost the same as those for laparotomy. Less blood loss (18.2 ± 1.7 ml versus 105.9 ± 84.3 ml, p < 0.01 and shorter hospital stay (5.9 ± 1.9 days versus 12.0 ± 2.9 days, p < 0.01 were also found to be advantages of laparoscopic surgery. This article discusses the technical procedures of laparoscopic surgery. The efficiency and safety of operative laparoscopy as an alternative access route for the management of ovarian dermoid cysts were recognized. We stress that strict criteria for selection of patients should always be followed and the necessity of retraining schedules for gynecologists and nursing staff in the speciality of laparoscopic surgery.

  15. Comparative Evaluation of Midventral and Flank Laparotomy Approaches in Goat

    Directory of Open Access Journals (Sweden)

    A. A. Abubakar

    2014-01-01

    Full Text Available The aim of the study was to compare two laparotomy approaches (flank and midventral. Ten (n=10 apparently healthy goats of different breeds and sex, average age of 12±2.1 months, and average weight of 13.4±2 kg were used for the investigation. The goats were randomly divided into flank and midventral groups, each group comprising five goats (n=5. Standard aseptic laparotomy was performed under lumbosacral epidural anaesthesia with mild sedation. Postsurgical wound score showed significant difference (P<0.05 in erythema at 18–24 hours and 10–14 days after surgery between the two approaches; significant difference of dehiscence between the two groups was also recorded at 10–14 days after surgery. Total white blood cells (WBC and lymphocytes counts were significantly different (P<0.05 at the first and second week after surgery. There was significant difference of platelets critical value and platelets dimension width at the first and second week after surgery. Significant difference of packed cells volume between the two approaches was also recorded one week after surgery. It was concluded that midventral laparotomy approach can be conveniently and safely performed under aseptic precautions without fear of intra- and postoperative clinical problems.

  16. 40 CFR 86.203-94 - Abbreviations.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.203-94 Section 86.203-94 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Later Model Year Gasoline-Fueled New Light-Duty Vehicles, New Light-Duty Trucks and New...

  17. 40 CFR 72.3 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 72.3 Section 72.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows...

  18. 40 CFR 96.303 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 96.303 Section 96.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBBB...

  19. 40 CFR 91.303 - Acronyms and abbreviations.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 91.303 Section 91.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS....303 Acronyms and abbreviations. (a) The acronyms and abbreviations in § 91.5 apply to this subpart. (b...

  20. 40 CFR 89.3 - Acronyms and abbreviations.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 89.3...) CONTROL OF EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES General § 89.3 Acronyms and abbreviations. The following acronyms and abbreviations apply to part 89. AECD Auxiliary emission control device...

  1. 40 CFR 60.4103 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 60.4103 Section 60.4103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR....4103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this...

  2. 40 CFR 91.4 - Acronyms and abbreviations.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 91.4...) CONTROL OF EMISSIONS FROM MARINE SPARK-IGNITION ENGINES General § 91.4 Acronyms and abbreviations. The following acronyms and abbreviations apply to this part 91. AECD—Auxiliary emission control device ASME...

  3. 40 CFR 90.5 - Acronyms and abbreviations.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 90.5...) CONTROL OF EMISSIONS FROM NONROAD SPARK-IGNITION ENGINES AT OR BELOW 19 KILOWATTS General § 90.5 Acronyms and abbreviations. The following acronyms and abbreviations apply to part 90. AECD—Auxiliary emission...

  4. The stylistic coloring of abbreviation in Business English

    Institute of Scientific and Technical Information of China (English)

    李美玲

    2011-01-01

    It is obvious to apply different vocabulary in various styles. As application of vocabulary becomes more, the distinct stylistic coloring is forming gradually. In this paper, it studies the definitions, structures, features ,of abbreviation in Business English. After that, it summarizes the stylistic coloring of abbreviation in Business English, and proves the necessity and importance to study abbreviation in Business English.

  5. The association of perioperative dexamethasone, smoking and alcohol abuse with wound complications after laparotomy

    DEFF Research Database (Denmark)

    Dahl, Rikke M; Wetterslev, Jørn; Jorgensen, Lars N;

    2014-01-01

    perioperative administration of dexamethasone, pre-operative smoking or alcohol abuse is, however, uncertain. METHODS: This study was a post hoc analysis of data from the PROXI randomized trial in 1386 patients who underwent emergency or elective laparotomy. We assessed the associations of use of dexamethasone......, smoking status and alcohol abuse with the primary outcome, being a composite of SSI, anastomotic leak, wound dehiscence, burst abdomen and 30-day mortality. RESULTS: The primary outcome occurred in 21% of patients receiving dexamethasone versus 28% of patients not receiving dexamethasone...... abdomen (3.8% vs 2.4%, P = 0.04). In alcohol abusers, the primary outcome occurred in 48%, compared with 25% in patients who did not abuse alcohol (P = 0.0006). Burst abdomen occurred more commonly in alcohol abusers (15% vs 2.3%, P 

  6. Using UMLS lexical resources to disambiguate abbreviations in clinical text.

    Science.gov (United States)

    Kim, Youngjun; Hurdle, John; Meystre, Stéphane M

    2011-01-01

    Clinical text is rich in acronyms and abbreviations, and they are highly ambiguous. As a pre-processing step before subsequent NLP analysis, we are developing and evaluating clinical abbreviation disambiguation methods. The evaluation of two sequential steps, the detection and the disambiguation of abbreviations, is reported here, for various types of clinical notes. For abbreviations detection, our result indicated the SPECIALIST Lexicon LRABR needed to be revised for better abbreviation detection. Our semi-supervised method using generated training data based on expanded form matching for 12 frequent abbreviations in our clinical notes reached over 90% accuracy in five-fold cross validation and unsupervised approach produced comparable results with the semi-supervised methods.

  7. Abbreviated guide pneumatic conveying design guide

    CERN Document Server

    Mills, David

    1990-01-01

    Abbreviated Guide: Pneumatic Conveying Design Guide describes the selection, design, and specification of conventional pneumatic conveying systems. The design procedure uses previous test data on the materials to be conveyed. The book also discusses system economics, operating costs, the choice of appropriate components or systems, system control, and system flexibility. The design system involves the type of conveying system for installation, the pipeline parameters, and also the plant components. System selection covers the properties of the material to be conveyed, plant layout, material pr

  8. Abdominal injury patterns in patients with seatbelt signs requiring laparotomy

    Directory of Open Access Journals (Sweden)

    Seema Biswas

    2014-01-01

    Full Text Available Aims: We analyzed our series of patients with seatbelt signs (bruising that underwent laparotomy in order to correlate injury pattern with clinical course and outcome. Materials and Methods: Retrospective analysis of patients with seatbelt signs presenting to the level 1 Trauma Unit between 2005 and 2010 was performed. We evaluated the nature of injuries during laparotomy associated with seatbelt signs and their treatment and complications. Results: There were 41 patients, 25 (61% male, with a median age of 26 years. Median injury severity score (ISS was 25 (range 6-66 and overall mortality was 10% (four patients. Patients were classified into three groups according to time from injury to surgery. Median time to surgery for the immediate group (n = 12 was 1.05 h, early group (n = 22 was 2.7 h, and delayed group (n = 7 was 19.5 h. Patients in the immediate group tended to have solid organ injuries; whereas, patients in the delayed group had bowel injury. Patients with solid organ injuries were found to be more seriously injured and had higher mortality (P < 0.01 and morbidity compared with patients with the "classic" bowel injury pattern associated with a typical seatbelt sign. Conclusion: Our data suggest that there is a cohort of patients with seatbelt injury who have solid organ injury requiring urgent intervention. Solid organ injuries associated with malpositioned seatbelts lying higher on the abdomen tend to result in hemodynamic instability necessitating immediate surgery. They have more postoperative complications and a greater mortality. Seatbelt signs should be accurately documented after any car crash.

  9. Predictive Potential of Heart Rate Complexity Measurement: An Indication for Laparotomy Following Solid Organ Injury

    Directory of Open Access Journals (Sweden)

    Foroutan

    2015-11-01

    Full Text Available Background Nonlinear analysis of heart rate variability (HRV has been recently used as a predictor of prognosis in trauma patients. Objectives We applied nonlinear analysis of HRV in patients with blunt trauma and intraperitoneal bleeding to assess our ability to predict the outcome of conservative management. Patients and Methods An analysis of electrocardiography (ECG from 120 patients with blunt trauma was conducted at the onset of admission to the emergency department. ECGs of 65 patients were excluded due to inadequacy of noise-free length. Of the remaining 55 patients, 47 survived (S group and eight patients died in the hospital (Non-S group. Nineteen patients were found to have intra-abdominal bleeding, eight of which ultimately underwent laparotomy to control bleeding (Op group and 11 underwent successful non-operative management (non-Op. Demographic data including vital signs, glasgow coma scale (GCS, arterial blood gas and injury severity scores (ISS were recorded. Heart rate complexity (HRC methods, including entropy, were used to analyze the ECG. Results There were no differences in age, gender, heart rate (HR and blood pressure between the S and Non-S groups. However, approximate entropy, used as a method of HRC measurement, and GCS were significantly higher in S group, compared to the Non-S group. The base deficit and ISS were significantly higher in the Non-S group. Regarding age, sex, ISS, base deficit, vital signs and GCS, no difference was found between Op and Non-Op groups. Approximate entropy was significantly lower in the Op group, compared to the Non-Op group. Conclusions The loss of HRC at the onset of admission may predict mortality in patients with blunt trauma. Lower entropy, in recently admitted patients with intra-abdominal bleeding, may indicate laparotomy when the vital signs are stable.

  10. Nasogastric intubation causes gastroesophageal reflux in patients undergoing elective laparotomy.

    LENUS (Irish Health Repository)

    Manning, B J

    2012-02-03

    BACKGROUND: The routine use of nasogastric tubes in patients undergoing elective abdominal operation is associated with an increased incidence of postoperative fever, atelectasis, and pneumonia. Previous studies have shown that nasogastric tubes have no significant effect on the incidence of gastroesophageal reflux or on lower esophageal sphincter pressure in healthy volunteers. We hypothesized that nasogastric intubation in patients undergoing laparotomy reduces lower esophageal sphincter pressure and promotes gastroesophageal reflux in the perioperative period. METHODS: A prospective randomized case-control study was undertaken in which 15 consenting patients, admitted electively for bowel surgery, were randomized into 2 groups. Group 1 underwent nasogastric intubation after induction of anesthesia, and Group 2 did not. All patients had manometry and pH probes placed with the aid of endoscopic vision at the lower esophageal sphincter and distal esophagus, respectively. Nasogastric tubes, where present, were left on free drainage, and sphincter pressures and pH were recorded continuously during a 24-hour period. Data were analyzed with 1-way analysis of variance. RESULTS: The mean number of reflux episodes (defined as pH < 4) in the nasogastric tube group was 137 compared with a median of 8 episodes in the group managed without nasogastric tubes (P =.006). The median duration of the longest episode of reflux was 132 minutes in Group 1 and 1 minute in Group 2 (P =.001). A mean of 13.3 episodes of reflux lasted longer than 5 minutes in Group 1, with pH less than 4 for 37.4% of the 24 hours. This was in contrast to Group 2 where a mean of 0.13 episodes lasted longer than 5 minutes (P =.001) and pH less than 4 for 0.2% of total time (P =.001). The mean lower esophageal sphincter pressures were lower in Group 1. CONCLUSIONS. These findings demonstrate that patients undergoing elective laparotomy with routine nasogastric tube placement have significant gastroesophageal

  11. 40 CFR 97.203 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... acronyms. 97.203 Section 97.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.203 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III are defined as follows: Btu...

  12. 40 CFR 97.103 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... acronyms. 97.103 Section 97.103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Annual Trading Program General Provisions § 97.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II are defined as...

  13. 40 CFR 97.303 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... acronyms. 97.303 Section 97.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Ozone Season Trading Program General Provisions § 97.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBBB through IIII are defined as...

  14. 40 CFR 96.3 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 96.3 Section 96.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows: Btu—British...

  15. 40 CFR 96.103 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 96.103 Section 96.103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II are...

  16. 40 CFR 97.3 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... acronyms. 97.3 Section 97.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Trading Program General Provisions § 97.3 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows: Btu-British thermal unit. CO2-carbon...

  17. 40 CFR 96.203 - Measurements, abbreviations, and acronyms.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 96.203 Section 96.203 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III are...

  18. 7 CFR 1951.852 - Definitions and abbreviations.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Definitions and abbreviations. 1951.852 Section 1951....852 Definitions and abbreviations. (a) General definitions. The following definitions are applicable...) Low-income. The level of income of a person or family which is at or below the Poverty Guidelines as...

  19. 32 CFR 516.3 - Explanation of abbreviations and terms.

    Science.gov (United States)

    2010-07-01

    ... AUTHORITIES AND PUBLIC RELATIONS LITIGATION General § 516.3 Explanation of abbreviations and terms. (a) The Glossary contains explanations of abbreviations and terms. (b) The masculine gender has been used throughout this regulation for simplicity and consistency. Any reference to the masculine gender is...

  20. 40 CFR 205.155 - Motorcycle class and manufacturer abbreviation.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Motorcycle class and manufacturer abbreviation. 205.155 Section 205.155 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Motorcycle class and manufacturer abbreviation. (a) Motorcycles must be grouped into classes determined...

  1. Laparoscopic major gynecologic surgery in patients with prior laparotomy bowel resection.

    Science.gov (United States)

    Fanning, James; Hojat, Rod; Deimling, Timothy

    2011-01-01

    To review the success and morbidity of laparoscopic major gynecologic surgery in patients with prior laparotomy bowel resection. Review of a prospective surgical database of all cases of laparoscopic major gynecologic surgery in patients with prior laparotomy bowel resection. No cases were excluded. Bowel diagnoses and procedures were total colectomy for inflammatory bowel disease (4), partial colectomy for colon cancer (6), partial small bowel resection for obstruction (1), and Whipple for pancreatic cancer (2). Two patients had 3 prior laparotomies, 8 patients had 2 prior laparotomies, and 3 patients had 1 prior laparotomy. All prior abdominal incisions were midline. Gynecologic diagnoses and procedures were laparoscopic cytoreduction for ovarian cancer (1), lsh/bso/staging for ovarian cancer (1), lavh/bso/lymphadenectomy for endometrial cancer (4), and lavh/bso, lsh/bso, or bso for large ovarian mass (7). Median patient age was 57 years, median BMI was 31kg/m(2), and all patients had medical comorbidities. All 13 laparoscopic gynecologic surgeries were successful without trocar insertion injury, conversion to laparotomy, and without enterotomy. Abdominal adhesions were present in all cases. Median operative time was 2 hours, median blood loss was 100cc, and median hospital stay was 1 day. There were no postoperative complications. Laparoscopic major gynecologic surgery in patients with prior laparotomy bowel resection is feasible for experienced laparoscopic surgeons.

  2. Abbreviations and acronyms: the case of Tlhalosi ya

    African Journals Online (AJOL)

    user

    creation of new abbreviations and acronyms because of new technologies such as mobile ... single words, as in NATO, NASA or UNESCO. Landau (1989: 27), on ..... Technology Research and Innovation); BOCRA (Botswana Communications.

  3. A chip off the old block—A case report of gallstone ileus in which identification of a facetted stone was essential in preventing re-laparotomy

    Directory of Open Access Journals (Sweden)

    James O’Kelly

    2017-01-01

    Full Text Available Gallstone ileus is a rare presentation, accounting for 0.1% of cases of mechanical small bowel obstruction. Patients are often elderly with significant comorbidity. Treatment is based upon laparotomy and enterolithotomy. We present the case of a 75 year old lady admitted as an emergency with a 4 day history of small bowel obstruction. She was found on CT scan to have an impacted gallstone in the distal ileum. At operation, her impacted stone was removed through a proximal enterostomy. The stone however was found to have a squared off edge, raising the suspicion of a second fragment within the proximal small bowel lumen. Failure to retrieve this could have led to re-obstruction requiring a return to theatre and repeat laparotomy in an elderly patient with the associated morbidity.

  4. Laparoscopy versus laparotomy for the management of endometrial carcinoma in morbidly obese patients: a prospective study.

    Science.gov (United States)

    Bige, Özgür; Demir, Ahmet; Saatli, Bahadır; Koyuncuoğlu, Meral; Saygılı, Uğur

    2015-01-01

    To compare the results of total laparoscopic hysterectomy and total abdominal hysterectomy in morbidly obese women with early stage endometrial cancer. This prospective study was conducted on 140 morbidly obese women with body mass indices ≥35 kg/m(2) and presenting with clinical stage 1 endometrial cancer. The patients underwent total laparoscopic hysterectomy (n=70) or total abdominal hysterectomy (n=70), bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and peritoneal washing. Age, parity, menopausal status, weight, height, medical problems, history of previous laparotomy, surgical procedure, operative time, estimated amount of blood loss, preoperative hematocrit, postoperative hematocrit, operative complications, conversion to laparotomy, need for intraoperative or postoperative blood transfusion, intraoperative and postoperative complications, secondary surgery, tumor stage, grade, histology, number of recovered lymph nodes, and visual pain scores of the patients were recorded. Postoperative complications were significantly higher in the laparotomy group. Hospital stay in the laparoscopy group was significantly lower than that in the laparotomy group. The visual pain scores were significantly higher in the laparotomy group on the first, second, and third postoperative days and on the day of discharge from the hospital. Resuming activity took a significantly longer time in the laparotomy group (34.70 days) than in the laparoscopic group (17.89 days). With the availability of skilled endoscopic surgeons, most obese women with early stage endometrial cancer can be safely managed by performing laparoscopy with an excellent surgical outcome, shorter hospitalization, less postoperative pain, and faster resumption of full activity.

  5. Laparoscopy versus laparotomy for the management of endometrial carcinoma in morbidly obese patients: a prospective study

    Science.gov (United States)

    Bige, Özgür; Demir, Ahmet; Saatli, Bahadır; Koyuncuoğlu, Meral; Saygılı, Uğur

    2015-01-01

    Objective To compare the results of total laparoscopic hysterectomy and total abdominal hysterectomy in morbidly obese women with early stage endometrial cancer. Material and Methods This prospective study was conducted on 140 morbidly obese women with body mass indices ≥35 kg/m2 and presenting with clinical stage 1 endometrial cancer. The patients underwent total laparoscopic hysterectomy (n=70) or total abdominal hysterectomy (n=70), bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and peritoneal washing. Age, parity, menopausal status, weight, height, medical problems, history of previous laparotomy, surgical procedure, operative time, estimated amount of blood loss, preoperative hematocrit, postoperative hematocrit, operative complications, conversion to laparotomy, need for intraoperative or postoperative blood transfusion, intraoperative and postoperative complications, secondary surgery, tumor stage, grade, histology, number of recovered lymph nodes, and visual pain scores of the patients were recorded. Results Postoperative complications were significantly higher in the laparotomy group. Hospital stay in the laparoscopy group was significantly lower than that in the laparotomy group. The visual pain scores were significantly higher in the laparotomy group on the first, second, and third postoperative days and on the day of discharge from the hospital. Resuming activity took a significantly longer time in the laparotomy group (34.70 days) than in the laparoscopic group (17.89 days). Conclusion With the availability of skilled endoscopic surgeons, most obese women with early stage endometrial cancer can be safely managed by performing laparoscopy with an excellent surgical outcome, shorter hospitalization, less postoperative pain, and faster resumption of full activity. PMID:26401110

  6. 32 CFR Attachment 1 to Part 855 - Glossary of References, Abbreviations, Acronyms, and Terms

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Glossary of References, Abbreviations, Acronyms... Attachment 1 to Part 855—Glossary of References, Abbreviations, Acronyms, and Terms Section A—References AFPD... Carriers Section B—Abbreviations and Acronyms Abbreviations and acronyms Definitions AFI Air Force...

  7. Clinical effects of laparotomy with perioperative continuous peritoneal lavage and postoperative hemofiltration in patients with severe acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Farelli Francesco

    2009-12-01

    Full Text Available Abstract Background The elevated serum and peritoneal cytokine concentrations responsible for the systemic response syndrome (SIRS and multiorgan failure in patients with severe acute pancreatitis lead to high morbidity and mortality rates. Prompted by reports underlining the importance of reducing circulating inflammatory mediators in severe acute pancreatitis, we designed this study to evaluate the efficiency of laparotomy followed by continuous perioperative peritoneal lavage combined with postoperative continuous venovenous diahemofiltration (CVVDH in managing critically ill patients refractory to intensive care therapy. As the major clinical outcome variables we measured morbidity, mortality and changes in the Acute Physiology and Chronic Health Evaluation (APACHE II score and cytokine concentrations in serum and peritoneal lavage fluid over time. Methods From a consecutive group of 23 patients hospitalized for acute pancreatitis, we studied 6 patients all with Apache II scores ≥19, who underwent emergency surgery for acute complications (5 for an abdominal compartment syndrome and 1 for septic shock followed by continuous perioperative peritoneal lavage and postoperative CVVDH. CVVDH was started within 12 hours after surgery and maintained for at least 72 hours, until the multiorgan dysfunction syndrome improved. Samples were collected from serum, peritoneal lavage fluid and CVVDH dialysate for cytokine assay. Apache II scores were measured daily and their association with cytokine levels was assessed. Results All six patients tolerated CVVDH well, and the procedure lasted a mean 6 days (range, 3-12. Five patients survived and one died of Acinetobacter infection after surgery (mortality rate 16.6%. The mean APACHE II score was ≥ 19 (range 19-22 before laparotomy and decreased significantly during peritoneal lavage and postoperative CVVDH (P = 0.013 by matched-pairs Students t-test. The decrease in cytokine concentrations in serum and

  8. LAPAROSCOPY VERSUS LAPAROTOMY IN THE REPAIR OF VENTRAL HERNIAS: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Paula Marcela Vilela CASTRO

    2014-09-01

    Full Text Available Objective To compare the laparotomy and laparoscopy techniques for correction of ventral hernia when related to perioperative complications, length of hospitalization, surgical time, and recurrence of hernia. Methods This was a systematic review of randomized controlled trials, which included studies retrieved from four databases (MEDLINE, Embase, Cochrane and LILACS, using a combination of the terms (Hernia, Ventral and (Laparoscopy and (Laparotomy. Results Six randomized trials were included, totaling 566 patients, 283 in the Laparoscopy group and 283 in the Laparotomy group. Laparoscopy reduced the risk of infection of the surgical wound (NNT = 5 and seroma formation (NNT = 13 and less length hospitalization (P = 0.02 compared to laparotomy in the correction of ventral hernias. Furthermore, laparoscopy increased the incidence of enterotomy (NNH = 25 and post operative pain (NNH = 8 and longer surgical time (P = 0.0009 when compared with laparotomy. There was no difference related to abscess (P = 0.79, hematoma (P = 0.43 and recurrency of ventral hernias (P = 0.25. Conclusions In the correction of ventral hernias, the use of laparoscopic technique is effective to reduce infections of the surgical wound and seroma formation, as well as, decrease the length hospitalization.

  9. Surgical findings during exploratory laparotomy are closely related to mortality in premature infants with necrotising enterocolitis

    DEFF Research Database (Denmark)

    Hansen, M L; Juhl, Sandra Meinich; Fonnest, G;

    2017-01-01

    AIM: This study investigated whether a correlation existed between surgical findings during the first laparotomy for necrotising enterocolitis (NEC) and death and, or, disease progression. METHODS: We included infants admitted within one day of birth to our tertiary neonatal department at Rigshos......AIM: This study investigated whether a correlation existed between surgical findings during the first laparotomy for necrotising enterocolitis (NEC) and death and, or, disease progression. METHODS: We included infants admitted within one day of birth to our tertiary neonatal department...... at Rigshospitalet, Denmark, from 2006 to 2015, who underwent a laparotomy for acute NEC. They were classified according to the locality and extent of intestinal necrosis by a paediatric surgeon, based on the surgical findings. We correlated the surgical findings with postoperative outcomes, namely death and, or...

  10. Conventional laparotomy for management of caesarean scar ectopic pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Nilesh C. Mhaske

    2015-10-01

    Full Text Available Increase in the rates of caesarean deliveries has led to a concurrent rise in the number of caesarean scar ectopic pregnancies (CSEP. With recent advances, diagnosis can be made at an early gestational age, hence facilitating a prompt intervention. With the varied treatment options available, choosing the right one may possess a clinical dilemma. However, in a low resource setting, conventional laparotomy may be the only option feasible. A case of CSEP managed with laparotomy is presented. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1581-1584

  11. 32 CFR Appendix B to Part 806 - Abbreviations and Acronyms

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Abbreviations and Acronyms B Appendix B to Part 806 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ADMINISTRATION AIR... Acronyms AFCA—Air Force Communications Agency AFCIC—Air Force Communications and Information Center AFRC...

  12. 40 CFR 87.2 - Acronyms and abbreviations.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 87.2 Section 87.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM AIRCRAFT AND AIRCRAFT ENGINES General Provisions § 87.2 Acronyms and...

  13. 7 CFR 770.2 - Abbreviations and definitions.

    Science.gov (United States)

    2010-01-01

    ... Interior pursuant to the Indian Reorganization Act. Reserve is an account established for loans approved in... AGRICULTURE SPECIAL PROGRAMS INDIAN TRIBAL LAND ACQUISITION LOANS § 770.2 Abbreviations and definitions. (a... requirements of part 761 of this chapter. Applicant is a Native American tribe or tribal corporation...

  14. 27 CFR 19.726 - Authorized abbreviations to identify spirits.

    Science.gov (United States)

    2010-04-01

    ... records: Kinds of spirits Abbreviations Alcohol A Brandy BR Bourbon Whisky BW Canadian Whisky CNW Completely Denatured Alcohol CDA Corn Whisky CW Grain Spirits GS Irish Whisky IW Light Whisky LW Malt Whisky MW Neutral Spirits NS Neutral Spirits Grain NSG Rye Whisky RW Scotch Whisky SW Specially...

  15. Abbreviated Pandemic Influenza Planning Template for Primary Care Offices

    Energy Technology Data Exchange (ETDEWEB)

    HCTT CHE

    2010-01-01

    The Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices is intended to assist primary care providers and office managers with preparing their offices for quickly putting a plan in place to handle an increase in patient calls and visits, whether during the 2009-2010 influenza season or future influenza seasons.

  16. 16 CFR 300.9 - Abbreviations, ditto marks, and asterisks.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations, ditto marks, and asterisks..., ditto marks, and asterisks. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other symbols in...

  17. Children's Text Messaging: Abbreviations, Input Methods and Links with Literacy

    Science.gov (United States)

    Kemp, N.; Bushnell, C.

    2011-01-01

    This study investigated the effects of mobile phone text-messaging method (predictive and multi-press) and experience (in texters and non-texters) on children's textism use and understanding. It also examined popular claims that the use of text-message abbreviations, or "textese" spelling, is associated with poor literacy skills. A sample of 86…

  18. 76 FR 44013 - Draft Guidance for Industry: Implementation of Acceptable Full-Length and Abbreviated Donor...

    Science.gov (United States)

    2011-07-22

    .... The Plasma Protein Therapeutics Association (PPTA) Source Plasma donor history questionnaires and... Full- Length and Abbreviated Donor History Questionnaires and Accompanying Materials for Use in... entitled ``Guidance for Industry: Implementation of Acceptable Full-Length and Abbreviated Donor History...

  19. 76 FR 13880 - Investigational New Drug Applications and Abbreviated New Drug Applications; Technical Amendment

    Science.gov (United States)

    2011-03-15

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Parts 312 and 314 Investigational New Drug Applications and Abbreviated New Drug Applications; Technical Amendment AGENCY: Food and Drug Administration... amending its investigational new drug application (IND) regulations and abbreviated new drug...

  20. Predicting Chinese Abbreviations from Definitions: An Empirical Learning Approach Using Support Vector Regression

    Institute of Scientific and Technical Information of China (English)

    Xu Sun; Hou-Feng Wang; Bo Wang

    2008-01-01

    In Chinese, phrases and named entities play a central role in information retrieval. Abbreviations, however,make keyword-based approaches less effective. This paper presents an empirical learning approach to Chinese abbreviation prediction. In this study, each abbreviation is taken as a reduced form of the corresponding definition (expanded form),and the abbreviation prediction is formalized as a scoring and ranking problem among abbreviation candidates, which are automatically generated from the corresponding definition. By employing Support Vector Regression (SVR) for scoring,we can obtain multiple abbreviation candidates together with their SVR values, which are used for candidate ranking.Experimental results show that the SVR method performs better than the popular heuristic rule of abbreviation prediction.In addition, in abbreviation prediction, the SVR method outperforms the hidden Markov model (HMM).

  1. Deferred Primary Anastomosis Versus Diversion in Patients with Severe Secondary Peritonitis Managed with Staged Laparotomies

    NARCIS (Netherlands)

    Ordonez, Carlos A.; Sanchez, Alvaro I.; Pineda, Jaime A.; Badiel, Marisol; Mesa, Rafael; Cardona, Uriel; Arias, Rafael; Rosso, Fernando; Granados, Marcela; Gutierrez-Martinez, Maria I.; Ochoa, Juan B.; Peitzman, Andrew; Puyana, Juan-Carlos

    2010-01-01

    There is inconclusive data on whether critically ill individuals with severe secondary peritonitis requiring multiple staged laparotomies may became eligible candidates for deferred primary anastomoses (DPA). We sought to compare a protocol for DPA against a protocol for diversion in severely ill cr

  2. Analysis of secondary cytoreduction for recurrent ovarian cancer by robotics, laparoscopy and laparotomy.

    Science.gov (United States)

    Magrina, Javier F; Cetta, Rachel L; Chang, Yu-Hui; Guevara, Gregory; Magtibay, Paul M

    2013-05-01

    Analysis of perioperative outcomes and survival of patients with recurrent ovarian cancer undergoing secondary cytoreduction by robotics, laparoscopy, or laparotomy. Retrospective analysis of 52 selected patients with recurrent ovarian cancer undergoing secondary cytoreduction by laparoscopy (9), laparotomy (33) or robotics (10) between January 2006 and December 2010. Comparison was made by a total of 21 factors including age, BMI, number of previous surgeries, tumor type and grade, number of procedures, and 15 types of procedures performed at secondary cytoreduction. For all patients, the mean operating time was 213.8 min, mean blood loss 657.4 ml; and mean hospital stay 7.5 days. Complete debulking was achieved in 75% of patients. Postoperative complications were noted in 36.5% of patients. Overall and progression-free survival at 3-years were 58.8% and 34.1%, respectively. Laparoscopy and robotics had reduced blood loss and hospital stay, while no differences were observed among the three groups for operating time, complications, complete debulking, and survival. Selected patients with recurrent ovarian cancer benefit from a laparoscopic or robotic secondary cytoreduction without compromising survival. Robotics and laparoscopy provide similar perioperative outcomes, and reduced blood loss and shorter hospital stay as compared to laparotomy. Laparotomy seems preferable for patients with widespread peritoneal implants, multiple sites of recurrence, and/or extensive adhesions. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Laparoscopy or laparotomy? A comparison of 240 patients with early-stage endometrial cancer.

    Science.gov (United States)

    Santi, Alessandro; Kuhn, Annette; Gyr, Thomas; Eberhard, Markus; Johann, Silke; Günthert, Andreas R; Mueller, Michael D

    2010-04-01

    This study aimed to compare the safety and efficacy of laparoscopy and laparotomy in the surgical treatment of early endometrial cancer, especially in obese women. The results obtained after laparoscopic surgical treatment of early endometrial cancer (International Federation of Gynecology and Obstetrics (FIGO) stage 1 or 2) in patients between 1996 and 2007 were compared with an age- and tumour-matched historical group of patients treated with laparotomy between 1988 and 1996. All the patients underwent hysterectomy, bilateral salpingo-oophorectomy, and pelvic + or - paraaortic lymphadenectomy. Both groups included 120 patients with a preoperative diagnosis of early endometrial cancer. The postoperative diagnosis was endometrial cancer stage 1 or 2 for 89% of the cases in both groups. The mean operating time was 170 min for the laparotomy group compared with 178 min for the laparoscopy group (nonsignificant difference). The estimated intraoperative blood loss was significantly greater in the laparotomy group, and the hospital stay was significantly shorter in the laparoscopy group. The results show that early endometrial cancer can be treated effectively by laparoscopy. Because of this study's retrospective design, the results should be interpreted with caution. However, the advantages of this method for obese patients are evident. The age and weight of these patients should not be used as a contraindication for laparoscopy.

  4. Laparotomy in mice induces blood cell expression of inflammatory and stress genes.

    Science.gov (United States)

    Ko, Fred; Isoda, Fumiko; Mobbs, Charles

    2015-04-01

    Surgical trauma induces immune and stress responses although its effects on postsurgical inflammatory and stress gene expression remain poorly characterized. This study sought to improve current scientific knowledge by investigating the effects of laparotomy on mouse blood cell inflammatory and stress gene expression. Three-month-old male C57BL/6J mice were subjected to 2% isoflurane or 2% isoflurane with laparotomy and sacrificed 4 h postintervention. Blood was collected and blood cell expression of 158 genes central to inflammatory and stress responses was assayed using quantitative polymerase chain reaction arrays. Mice subjected to isoflurane with laparotomy, compared with mice receiving isoflurane alone, had >2-fold upregulation of genes in inflammation (Osm, IL1rn, IL1b, and Csf1), oxidative stress (Hmox1), heat shock (Hspa1b), growth arrest (Cdkn1a), and DNA repair (Ugt1a2). These genes demonstrated similar expression patterns by Pearson correlation and cluster analysis. Thus, laparotomy induces coordinated, postsurgical blood cell expression of unique inflammatory and stress genes whose roles in influencing surgical outcomes need further investigation.

  5. Hoofdpijn na een laparotomie : een chronisch subduraal hematoom na epidurale anesthesie

    NARCIS (Netherlands)

    Heeman, Annelies E; Reidinga, Auke C; Groen, Rob J M; Wierda, J M K H Mark; Schiere, Sjouke

    2009-01-01

    A 63-year-old man underwent an exploratory laparotomy because of rectal carcinoma. The operation was performed under general anaesthesia in combination with epidural anaesthesia. Since the operation the patient complained of a headache. Eight weeks after the operation he was hospitalized because of

  6. Ultrasound-guided quadratus lumborum block as a postoperative analgesic technique for laparotomy.

    Science.gov (United States)

    Kadam, Vasanth Rao

    2013-10-01

    The quadratus lumborum (QL) block as a postoperative analgesic method following abdominal surgery has been described by Blanco for superficial surgeries but not used for major laparotomy. This ipsilateral QL block had low pain scores and opioid use on day one with sensory block upto T8-L1. The options of various volume used and pros and cons are discussed.

  7. Ultrasound-guided quadratus lumborum block as a postoperative analgesic technique for laparotomy

    OpenAIRE

    Vasanth Rao Kadam

    2013-01-01

    The quadratus lumborum (QL) block as a postoperative analgesic method following abdominal surgery has been described by Blanco for superficial surgeries but not used for major laparotomy. This ipsilateral QL block had low pain scores and opioid use on day one with sensory block upto T8-L1. The options of various volume used and pros and cons are discussed.

  8. Ultrasound-guided quadratus lumborum block as a postoperative analgesic technique for laparotomy

    Directory of Open Access Journals (Sweden)

    Vasanth Rao Kadam

    2013-01-01

    Full Text Available The quadratus lumborum (QL block as a postoperative analgesic method following abdominal surgery has been described by Blanco for superficial surgeries but not used for major laparotomy. This ipsilateral QL block had low pain scores and opioid use on day one with sensory block upto T8-L1. The options of various volume used and pros and cons are discussed.

  9. Minimal laparotomy management of a giant ovarian cystic teratoma in adolescence

    Directory of Open Access Journals (Sweden)

    Toshihiro Yasui

    2015-06-01

    Full Text Available Giant ovarian cysts in adolescents are very rare. Those treatment by laparotomy or laparoscopic surgery is discussed with gynecologists and pediatric surgeons because its limited working space and risk of rupture and malignancy. We present a case of minimal laparotomy management of a giant ovarian cystic teratoma in adolescent. A 13-year-old girl presented with abdominal pain and constipation. A CT scan showed a giant simple ovarian cystic tumor in her abdomen measuring 29 × 13 × 24 cm. We made a 3-cm Pfannenstiel incision and inserted an Alexis wound retractor XS. The cyst was completely aspirated without spillage in the intraperitoneal space. In total, 6L of murky brown fluid was aspirated from the cyst. There was no ovarian tissue visible on the cyst wall. The left tube and right ovary and tube were intact. The cyst wall and left ovary tube were dissected free by using a LigaSure. Postoperative recovery was uneventful. Pathological assessment revealed a mature cystic teratoma. The ovarian tissue was included in the part of the cyst wall. We were able to safely perform with minimal laparotomy. Therefore, we consider the for cases of giant ovarian tumors, minimal laparotomy surgery is useful from the safety and cosmetic perspective.

  10. 21 CFR 314.127 - Refusal to approve an abbreviated new drug application.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Refusal to approve an abbreviated new drug... HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.127 Refusal to approve an abbreviated new...

  11. [Should routine exploratory laparotomy be performed in the presence of an abdominal wound? Discussion apropos of 176 cases].

    Science.gov (United States)

    Guiberteau, B; Kohen, M; Borde, L; Sartre, J Y; Bourseau, J C; Le Neel, J C

    1992-10-01

    Management of abdominal wounds is presently the subject of discussion between the partisans of routine laparotomy and those preferring "armed" surveillance. Results of study of a series of 176 abdominal wounds subjected to surgical dogma showed: that the diagnosis of non penetrating wounds (17.6%) was not always evident, due either to their anatomical localization (frontier region wounds) or to insufficient local exploration in urgent cases (6.6% of false-negatives), that the existence of serious clinical signs (50 cases) was always associated with one or more visceral lesions, requiring urgent laparotomy with a morbidity of 20% and a mortality of 8% (4 cases), that in the case of asymptomatic penetrating wounds (96 cases), routine laparotomy did nevertheless allow the diagnosis of visceral lesions in 50 cases (including 23 major lesions) but was of no utility in 46 cases (31.5% of blind laparotomies for the total series). The elevated proportion of useless laparotomies (30% in the literature), the result of a dogmatic attitude, or the risk of a delayed intervention (5 to 8%) in the series practising the selective method, led to a modification in the authors' attitude. The existence of serious signs should obviously result in a laparotomy. In their absence, and when confronted with a penetrating or doubtful (frontier region) wound, an exploratory celioscopy is proposed to ensure complete abdominal exploration, to confirm the presence or absence of penetration, to treat minimal lesions and to perform a classical laparotomy in case of evident necessity.

  12. Leukocyte scintigraphy compared to intraoperative small bowel enteroscopy and laparotomy findings in Crohn's disease

    DEFF Research Database (Denmark)

    Almen, Sven; Granerus, Göran; Ström, Magnus

    2007-01-01

    Background: Leukocyte scintigraphy is a noninvasive investigation to assess inflammation. We evaluated the utility of labeled leukocytes to detect small bowel inflammation and disease complications in Crohn's disease and compared it to whole small bowel enteroscopy and laparotomy findings. Methods......: Scintigraphy with technetium-99m exametazime-labeled leukocytes was prospectively performed in 48 patients with Crohn's disease a few days before laparotomy; 41 also had an intraoperative small bowel enteroscopy. The same procedures were performed in 8 control patients. Independent grading of scans...... was compared with the results of enteroscopy and with surgical, histopathologic, and clinical data. Results: In the 8 control patients leukocyte scan, endoscopy, and histopathology were all negative for the small bowel. In patients with Crohn's disease and small bowel inflammation seen at enteroscopy and...

  13. Hargreaves does not evaluate nociception following a surgical laparotomy in Xenopus leavis frogs.

    Science.gov (United States)

    Vachon, P

    2014-10-01

    The present study was performed to determine the effectiveness of the Hargreaves test for the evaluation of nociception in frogs, more precisely to determine if cutaneous thresholds to a radiant heat stimulus would increase with analgesics following an abdominal laparotomy performed under general anaesthesia. Non breeding female Xenopus leavis frogs (3 groups (non-anaesthetized, anaesthetized with tricaine methanesulfonate (MS222), with or without an abdominal laparotomy) were used to evaluate the effectiveness of the Hargreaves test. Cutaneous thresholds were evaluated at baseline and following anaesthetic recovery (over 8 h) at six different body locations. Increased reaction times were observed in the gular area only at 1 h post-recovery following a MS222 bath immersion in frogs with (p leavis frogs.

  14. Laparoscopy vs. laparotomy for embryo transfer to produce transgenic goats (Capra hircus).

    Science.gov (United States)

    Shin, Sang Tae; Jang, Sung Keun; Yang, Hong Suk; Lee, Ok Keun; Shim, Yhong Hee; Choi, Won Il; Lee, Doo Soo; Lee, Gwan Sun; Cho, Jong Ki; Lee, Young Won

    2008-03-01

    This study was performed to produce transgenic Korean native goat (Capra hircus) by laparoscopic embryo transfer (ET) to overcome the limitations of ET performed by laparotomy. Transgenic embryos were produced by DNA pronuclear microinjection of in vivo zygotes. The recipient goats were synchronized for estrus by using an introvaginal progesterone devices as a controlled internal drug-releasing insert (CIDR) for 13 days and injection of 400 IU PMSG 48 h before removal of the insert. Embryos were transferred on day 3 and 4 after removal of the insert. Recipient goats were deprived of feed for 48 h, then suspended in a laparotomy cradle at an angle of 45 degrees . After obtaining a sufficient pneumoperitoneum, the laparoscope and forceps were inserted abdominally through 5 mm trocar sleeves. Examination of the ovaries and uterus was performed and then 213 embryos were transferred into the oviducts via the infundibula of 76 recipient goats. To compare pregnancy rates, ET was also performed by laparotomy in 82 recipient goats. The pregnancies in the recipient goats were diagnosed by ultrasound on day 30 after embryo transfer. The pregnancy rate with laparoscopic ET was significantly higher than with ET performed by laparotomy (46.1% vs. 28.6%, p < 0.05). In addition, the pregnancy rates were compared between ovulated and non-ovulated ovaries of the recipient goats in the laparoscopic ET group. No significant difference was observed between the pregnancy rates of ovulated and non-ovulated ovaries (41.3% vs. 33.3%, p < 0.05) suggesting that ET may also be possible in non-ovulated recipients through artificial rupture of Graafian follicles. These results suggest that laparoscopic ET is a highly efficient method for the transfer of goat embryos.

  15. Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim's technique and comparison to laparotomy.

    Science.gov (United States)

    Kim, Jeong Sook; Lee, In Ok; Eoh, Kyung Jin; Chung, Young Shin; Lee, Inha; Lee, Jung-Yun; Nam, Eun Ji; Kim, Sunghoon; Kim, Young Tae; Kim, Sang Wun

    2017-03-01

    This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim's technique and to compare the surgical outcomes with those of laparotomy. Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim's technique using a specially designed 30×30-cm(2)-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; Phuge ovarian tumors.

  16. Benefits of maltodextrin intake 2 hours before cholecystectomy by laparotomy in respiratory function and functional capacity: a prospective randomized clinical trial.

    Science.gov (United States)

    Zani, Fabiana Vieira Breijão; Aguilar-Nascimento, José Eduardo; Nascimento, Diana Borges Dock; Silva, Ageo Mário Cândido da; Caporossi, Fernanda Stephan; Caporossi, Cervantes

    2015-01-01

    To evaluate the change in respiratory function and functional capacity according to the type of preoperative fasting. Randomized prospective clinical trial, with 92 female patients undergoing cholecystectomy by laparotomy with conventional or 2 hours shortened fasting. The variables measured were the peak expiratory flow, forced expiratory volume in the first second, forced vital capacity, dominant handgrip strength, and non-dominant handgrip strength. Evaluations were performed 2 hours before induction of anesthesia and 24 hours after the operation. The two groups were similar in preoperative evaluations regarding demographic and clinical characteristics, as well as for all variables. However, postoperatively the group with shortened fasting had higher values than the group with conventional fasting for lung function tests peak expiratory flow (128.7±62.5 versus 115.7±59.9; p=0.040), forced expiratory volume in the first second (1.5±0.6 versus 1.2±0.5; p=0.040), forced vital capacity (2.3±1.1 versus 1.8±0.9; p=0.021), and for muscle function tests dominant handgrip strength (24.9±6.8 versus 18.4±7.7; p=0.001) and non-dominant handgrip strength (22.9±6.3 versus 17.0±7.8; p=0.0002). In the intragroup evaluation, there was a decrease in preoperative compared with postoperative values, except for dominant handgrip strength (25.2±6.7 versus 24.9±6.8; p=0.692), in the shortened fasting group. Abbreviation of preoperative fasting time with ingestion of maltodextrin solution is beneficial to pulmonary function and preserves dominant handgrip strength.

  17. Comparison of Robotic Surgery with Laparoscopy and Laparotomy for Treatment of Endometrial Cancer: A Meta-Analysis

    OpenAIRE

    Longke Ran; Jing Jin; Yan Xu; Youquan Bu; Fangzhou Song

    2014-01-01

    Purpose To compare the relative merits among robotic surgery, laparoscopy, and laparotomy for patients with endometrial cancer by conducting a meta-analysis. Methods The MEDLINE, Embase, PubMed, Web of Science, and Cochrane Library databases were searched. Studies clearly documenting a comparison between robotic surgery and laparoscopy or between robotic surgery and laparotomy for endometrial cancer were selected. The outcome measures included operating time (OT), number of complications, len...

  18. Results of the surgical treatment of non-advanced megaesophagus using Heller-Pinotti's surgery: Laparotomy vs. Laparoscopy

    Directory of Open Access Journals (Sweden)

    Luiz Roberto Lopes

    2011-01-01

    Full Text Available INTRODUCTION: Dysphagia is the important symptom in achalasia, and surgery is the most common treatment. The Heller-Pinotti technique is the method preferred by Brazilian surgeons. For many years, this technique was performed by laparotomy, and now the laparoscopic method has been introduced. The objective was to evaluate the immediate and long-term results of patients submitted to surgery by either laparotomy or laparoscopy. MATERIALS AND METHODS: A total of 67 patients submitted to surgery between 1994 and 2001 with at least 5 years of follow-up were evaluated retrospectively and divided into two groups: laparotomy (41 patients and laparoscopy (26 patients. Chagas was the etiology in 76.12% of cases. Dysphagia was evaluated according to the classification defined by Saeed et al. RESULTS: There were no cases of conversion to open surgery. The mean duration of hospitalization was 3.32 days for laparotomy and 2.54 days for laparoscopy (p<0.05. An improvement in dysphagia occurred with both groups reporting good or excellent results (laparotomy: 73.17% and laparoscopy: 73.08%. Mean duration of follow-up was 8 years. CONCLUSIONS: There was no difference between the two groups with respect to relief from dysphagia, thereby confirming the safety and effectiveness of the Heller-Pinotti technique, which can be performed by laparotomy or laparoscopy, depending on the surgeon's experience.

  19. Abbreviated MRI Protocols: Wave of the Future for Breast Cancer Screening.

    Science.gov (United States)

    Chhor, Chloe M; Mercado, Cecilia L

    2017-02-01

    The purpose of this article is to describe the use of abbreviated breast MRI protocols for improving access to screening for women at intermediate risk. Breast MRI is not a cost-effective modality for screening women at intermediate risk, including those with dense breast tissue as the only risk. Abbreviated breast MRI protocols have been proposed as a way of achieving efficiency and rapid throughput. Use of these abbreviated protocols may increase availability and provide women with greater access to breast MRI.

  20. Caring for critically injured children: An analysis of 56 pediatric damage control laparotomies.

    Science.gov (United States)

    Villalobos, Miguel A; Hazelton, Joshua P; Choron, Rachel L; Capano-Wehrle, Lisa; Hunter, Krystal; Gaughan, John P; Ross, Steven E; Seamon, Mark J

    2017-05-01

    Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission. Demographics, mechanism, resuscitation variables, injuries, need for DCL, and outcomes were evaluated. Independent t test, Mann-Whitney U test, Fisher's exact test, and single-factor analysis of variance assessed statistical significance. Study endpoints were hospital survival and DCL complications. Of 371 children who underwent trauma laparotomy, the median age (IQR; LQ-UQ) age was 16 (5; 11-17) years. Most (73%) were male injured by blunt mechanism (65%). Fifty-six (15%) children (Injury Severity Score [ISS], 33 (25; 17-42), pediatric trauma score 5 (6; 2-8), penetrating abdominal trauma index score [PATI] 29 (32; 12-44)) underwent DCL after major solid organ (63%), vascular (36%), thoracic (38%) and pelvic (36%) injury. DCL patients were older (16.5 (4; 14-18) vs. 16 (7; 10-17)) and were more severely injured (ISS, 33 [25; 17-42] vs. 16 [16; 9-25]), requiring greater intraoperative packed red blood cell transfusion (8 [13; 3.5-16.5] vs. 1 (0; [0-1] units) than definitive laparotomy counterparts. Nonsurvivors arrived in severe physiologic compromise (base deficit, 17 [17; 8-25] vs. 7 [4; 4-8]), requiring more frequent preoperative blood product transfusion (67% vs. 10%) after comparable injury (ISS survivors, 36 [23; 18-41] vs. nonsurvivors 26 (7; 25-32), p = 0.8880). Fifty-five percent of DCL patients survived (length of stay, 26 [21; 18-39] days) requiring 3 (2; 2-4) laparotomies during 4 (6; 2

  1. Efficacy of Sustained-Release Buprenorphine in an Experimental Laparotomy Model in Female Mice.

    Science.gov (United States)

    Kendall, Lon V; Wegenast, Daniel J; Smith, Brian J; Dorsey, Kathryn M; Kang, Sooah; Lee, Na Young; Hess, Ann M

    2016-01-01

    Mice purportedly require dosing with the opioid buprenorphine (Bup-HCl) at least every 8 to 12 h to maintain an adequate plane of analgesia. Here we used an experimental laparotomy model to determine the clinical efficacy of sustained-release formulations of buprenorphine (Bup-SR) after surgery in mice. Female CD1 mice underwent laparotomy and received either Bup-SR (0.6 mg/kg), Bup-HCl (0.1 mg/kg every 12 h), or saline (every 12 h). Pain was assessed at 1, 3, 6, 12, 24, 48, and 72 h according to the frequency of several behaviors (general activity, wheel-running activity, rearing, grooming, wound licking, orbital tightening, and percentage of integrated nest material) and daily body weight. Over time, wheel running was increased and wound licking was decreased in Bup-SR-treated mice compared with Bup-HCl- and saline-treated mice. Compared with Bup-HCl- and saline-treated mice, Bup-SR-treated mice had increased general activity and percentage of integrated nest material and decreased orbital tightening for 1 to 6 h after surgery. The Bup-HCl- and saline-treated mice had similar general activity, orbital tightening scores, and wheel running activity. Rearing activity and body weight did not differ throughout the study, and none of the observed behaviors differed between groups at 24, 48, and 72 h after surgery. These results suggest that Bup-SR at 0.6 mg/kg provides adequate analgesia after laparotomy in mice and can be used as an alternative analgesic in this context. Furthermore, Bup-HCl at 0.1 mg/kg every 12 h may be inadequate in providing analgesia for abdominal procedures in mice.

  2. Computed tomography, lymphography, and staging laparotomy: correlations in initial staging of Hodgkin disease

    Energy Technology Data Exchange (ETDEWEB)

    Castellino, R.A.; Hoppe, R.T.; Blank, N.; Young, S.W.; Neumann, C.; Rosenberg, S.A.; Kaplan, H.S.

    1984-07-01

    One hundred twenty-one patients with newly diagnosed, previously untreated Hodgkin disease underwent abdominal and pelvic computed tomographic (CT) scanning and bipedal lymphography. These studies were followed by staging laparotomy, which included biopsy of the liver, retroperitoneal and mesenteric lymph nodes, and splenectomy. Correlation of the results of the imaging studies with the histopathologic diagnoses revealed a small - but significant - increased accuracy of lymphography compared with CT in assessing the retroperitoneal lymph nodes. The theoretical advantages of CT scanning in detecting lymphomatous deposits in lymph nodes about the celiac axis and the mesentery, or in the liver and spleen, were not confirmed.

  3. Perioperative Systemic Inflammatory Response following Robot-Assisted Laparoscopic Cystectomy vs. Open Mini-Laparotomy Cystectomy

    DEFF Research Database (Denmark)

    Skjold Kingo, Pernille; Palmfeldt, Johan; Nørregaard, Rikke

    2017-01-01

    INTRODUCTION: Surgeries, such as radical cystectomy (RC), induce a systemic inflammatory response (SIR). SIR plays an important role in controlling the human immune system. This study aims at comparing the SIR in robot-assisted laparoscopic cystectomy (RALC) to open mini-laparotomy cystectomy (OMC...... with intracorporeal UD (RALC-IUD; n = 9) was performed. Blood samples were obtained preoperatively (PREOP), immediately after surgery (POD0), 24 (POD1) and 48 h (POD2) postoperatively. Clinical parameters were collected from medical records. RESULTS: Estimated blood loss and blood transfusion volume was higher in OMC...

  4. Validation of an abbreviated quality of life scale for schizophrenia.

    Science.gov (United States)

    Fervaha, Gagan; Remington, Gary

    2013-09-01

    The field of therapeutics in schizophrenia is redefining optimal outcome, moving beyond clinical remission to a more comprehensive model that also includes functional recovery. The Quality of Life Scale (QLS) has been adopted by many large clinical trials, including CATIE and CUtLASS, as a measure of functioning. The QLS is a 21-item semi-structured interview that takes approximately 45min to administer. Although the QLS is considered comprehensive, its length limits its applicability across studies. To circumvent this issue, short scales of the QLS have been created that estimate total scores with high accuracy. However, these abbreviated measures have not been adequately cross-validated in a large enough sample to allow for subsample estimations nor has its predictive ability been compared to the full scale. Here, we used data from the CATIE trial (n=1460) to demonstrate the validity and utility of an abbreviated 7-item QLS. The shortened QLS was robust in estimating total scores (r=0.953, p<0.001) across subsamples and demonstrated predictive ability similar to the full QLS in multiple regression models. The abridged QLS is recommended as a surrogate measure of psychosocial functioning, especially in cases where functioning is not the primary outcome. Copyright © 2012 Elsevier B.V. and ECNP. All rights reserved.

  5. Comparison of robotic surgery with laparoscopy and laparotomy for treatment of endometrial cancer: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Longke Ran

    Full Text Available To compare the relative merits among robotic surgery, laparoscopy, and laparotomy for patients with endometrial cancer by conducting a meta-analysis.The MEDLINE, Embase, PubMed, Web of Science, and Cochrane Library databases were searched. Studies clearly documenting a comparison between robotic surgery and laparoscopy or between robotic surgery and laparotomy for endometrial cancer were selected. The outcome measures included operating time (OT, number of complications, length of hospital stay (LOHS, estimated blood loss (EBL, number of transfusions, total lymph nodes harvested (TLNH, and number of conversions. Pooled odds ratios and weighted mean differences with 95% confidence intervals were calculated using either a fixed-effects or random-effects model.Twenty-two studies were included in the meta-analysis. These studies involved a total of 4420 patients, 3403 of whom underwent both robotic surgery and laparoscopy and 1017 of whom underwent both robotic surgery and laparotomy. The EBL (p = 0.01 and number of conversions (p = 0.0008 were significantly lower and the number of complications (p<0.0001 was significantly higher in robotic surgery than in laparoscopy. The OT, LOHS, number of transfusions, and TLNH showed no significant differences between robotic surgery and laparoscopy. The number of complications (p<0.00001, LOHS (p<0.00001, EBL (p<0.00001, and number of transfusions (p = 0.03 were significantly lower and the OT (p<0.00001 was significantly longer in robotic surgery than in laparotomy. The TLNH showed no significant difference between robotic surgery and laparotomy.Robotic surgery is generally safer and more reliable than laparoscopy and laparotomy for patients with endometrial cancer. Robotic surgery is associated with significantly lower EBL than both laparoscopy and laparotomy; fewer conversions but more complications than laparoscopy; and shorter LOHS, fewer complications, and fewer transfusions but a longer OT

  6. Robert's uterus: modern imaging techniques and ultrasound-guided hysteroscopic treatment without laparoscopy or laparotomy.

    Science.gov (United States)

    Ludwin, A; Ludwin, I; Martins, W P

    2016-10-01

    Robert's uterus is a unique malformation, described as a septate uterus with a non-communicating hemicavity, consisting of a blind uterine horn usually with unilateral hematometra, a contralateral unicornuate uterine cavity and a normally shaped external uterine fundus. The main symptom in affected young women is pelvic pain that becomes intensified near menses. We describe the case of a 22-year-old woman who was referred for diagnostic assessment and treatment of a congenital uterine anomaly. We used three-dimensional sonohysterography with volume-contrast imaging, HDLive rendering mode and automatic volume calculation (SonoHysteroAVC) for the diagnosis, surgical planning and postoperative evaluation. These imaging techniques provided a complete understanding of the internal and external uterine structures, enabling us to perform a minimally invasive hysteroscopic metroplasty, guided by transrectal ultrasound, and therefore avoiding the need for laparotomy/laparoscopy. The outcome of treatment was considered satisfactory; menstruation ceased to be painful and, after two hysteroscopic procedures, the communicating 0.3-cm(3) hemicavity was visualized as a 3.6-cm(3) normalized uterine cavity using the same imaging techniques. The findings of this case report raise questions about the embryological origin of Robert's uterus, the suitability of current classification systems, and the role of more invasive approaches (laparoscopy/laparotomy) and surgical procedures (horn resection/endometrectomy) that do not aim to improve uterine cavity shape and volume in women with this condition. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  7. Review of Subcutaneous Wound Drainage in Reducing Surgical Site Infections after Laparotomy

    Directory of Open Access Journals (Sweden)

    B. Manzoor

    2015-01-01

    Full Text Available Purpose. Surgical site infections (SSIs remain a significant problem after laparotomies. The aim of this review was to assess the evidence on the efficacy of subcutaneous wound drainage in reducing SSI. Methods. MEDLINE database was searched. Studies were identified and screened according to criteria to determine their eligibility for meta-analysis. Meta-analysis was performed using the Mantel-Haenszel method and a fixed effects model. Results. Eleven studies were included with two thousand eight hundred and sixty-four patients. One thousand four hundred and fifty patients were in the control group and one thousand four hundred and fourteen patients were in the drain group. Wound drainage in all patients shows no statistically significant benefit in reducing SSI incidence. Use of drainage in high risk patients, contaminated wound types, and obese patients appears beneficial. Conclusion. Using subcutaneous wound drainage after laparotomy in all patients is unnecessary as it does not reduce SSI risk. Similarly, there seems to be no benefit in using it in clean and clean contaminated wounds. However, there may be benefit in using drains in patients who are at high risk, including patients who are obese and/or have contaminated wound types. A well designed trial is needed which examines these factors.

  8. Quality of life in patients affected by endometrial cancer: comparison among laparotomy, laparoscopy and vaginal approach.

    Science.gov (United States)

    Berretta, Roberto; Gizzo, Salvatore; Noventa, Marco; Marrazzo, Vivienne; Franchi, Laura; Migliavacca, Costanza; Michela, Monica; Merisio, Carla; Modena, Alberto Bacchi; Patrelli, Tito Silvio

    2015-07-01

    The aim of this study is to verify if the surgical approach (laparoscopy/laparotomy/vaginal) in stage-I endometrial cancer treatment, may have effects on intra- and post-operative outcomes and on the patient's quality of life. The study group consisted of patients with histological diagnosis of type-I endometrial adenocarcinoma, stage-I. They were divided into three groups according to surgical approach chosen (laparotomic/laparoscopic/vaginal). Every patient answered a telephone health survey (SF-36) at 30 and 180 days post-surgery. Surgical-operating times, hospitalization length and short/long-term complications after surgery were also compared. The SF-36 survey revealed a better performance status in patients who underwent laparoscopy as compared to those who received laparotomy or vaginal surgery. We found significantly better results considering General Health, Physical Functioning, Role-Physical and Bodily Pain in the laparoscopy group after 30 and 180 days. Patients who underwent laparoscopy had significantly shorter hospitalization and less post-operative complications even if laparoscopy required significantly longer surgical-operating times compared to vaginal surgery. Our data confirm the superiority of the laparoscopic approach respect to the laparotomic and vaginal ones both in term of hospitalization length and post-operative complications.

  9. 78 FR 26785 - Guidance for Industry: Implementation of an Acceptable Abbreviated Donor History Questionnaire...

    Science.gov (United States)

    2013-05-08

    ...The Food and Drug Administration (FDA) is announcing the availability of a document entitled ``Guidance for Industry: Implementation of an Acceptable Abbreviated Donor History Questionnaire and Accompanying Materials for Use in Screening Frequent Donors of Blood and Blood Components'' dated May 2013. The guidance document recognizes the abbreviated donor history questionnaire and accompanying......

  10. 76 FR 65735 - Draft Guidance for Industry: Implementation of Acceptable Abbreviated Donor History Questionnaire...

    Science.gov (United States)

    2011-10-24

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft document entitled ``Guidance for Industry: Implementation of Acceptable Abbreviated Donor History Questionnaire and Accompanying Materials for Use in Screening Frequent Donors of Blood and Blood Components'' dated October 2011. The draft guidance document recognizes the abbreviated donor history questionnaire and......

  11. Automatic Word Sense Disambiguation of Acronyms and Abbreviations in Clinical Texts

    Science.gov (United States)

    Moon, Sungrim

    2012-01-01

    The use of acronyms and abbreviations is increasing profoundly in the clinical domain in large part due to the greater adoption of electronic health record (EHR) systems and increased electronic documentation within healthcare. A single acronym or abbreviation may have multiple different meanings or senses. Comprehending the proper meaning of an…

  12. 21 CFR 314.153 - Suspension of approval of an abbreviated new drug application.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Suspension of approval of an abbreviated new drug... HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG FDA... new drug application. (a) Suspension of approval. The approval of an abbreviated new drug...

  13. 21 CFR 314.101 - Filing an application and receiving an abbreviated new drug application.

    Science.gov (United States)

    2010-04-01

    ... new drug application. 314.101 Section 314.101 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.101 Filing an application and receiving an abbreviated new drug application. (a)(1) Within 60 days after FDA receives...

  14. 77 FR 50702 - Ranbaxy Laboratories Limited; Withdrawal of Approval of 27 Abbreviated New Drug Applications

    Science.gov (United States)

    2012-08-22

    ... Abbreviated New Drug Applications AGENCY: Food and Drug Administration, HHS. ACTION: Notice. ] SUMMARY: The Food and Drug Administration (FDA) is withdrawing approval of 27 abbreviated new drug applications... introduction into interstate commerce of products without approved new drug applications violates section...

  15. 16 CFR 303.5 - Abbreviations, ditto marks, and asterisks prohibited.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations, ditto marks, and asterisks... Abbreviations, ditto marks, and asterisks prohibited. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other...

  16. A comparative study of outcome of the absorbable suture polydioxanone and nonabsorbable suture polypropylene in laparotomy wound closure

    Directory of Open Access Journals (Sweden)

    Kiran Shankar H.

    2016-06-01

    Full Text Available Background: Abdominal wound closure is one of the common operations for a general surgeon. Prevention of complications is important to reduce post-operative morbidity and mortality. Post-operative wound pain, wound infection, wound dehiscence, suture sinus formation; palpable knots and incisional hernia are the parameters are to be studied. Therefore, the present study was undertaken to compare polydioxanone and polypropylene suture material for abdominal fascial closure regarding morbidity in terms of post-operative wound complications. Methods: Patients admitted in the department of surgery, who undergo laparotomy operations, with midline abdominal incisions were included in the study. The recruited subjects were divided into Group-A, whom abdominal incisions are closed with non-absorbable suture material polypropylene and Group-B whom abdominal incisions are closed with absorbable suture material polydioxanone. Data was expressed as percentages. Results: The incidence of wound pain was observed in all the patients in both immediate and delayed post-operative period in the polypropylene suture material compared to polydioxanone. The incidence of wound infection was higher in polypropylene (24% compared to PDS (2%. There were 4% cases of wound dehiscence in the present study. The incidence of suture sinus formation was higher in the polypropylene suture material (9% compared to the polydioxanone suture material (2% in the delayed postoperative period. The incidence of palpable knots was higher in the polypropylene suture material (23% compared to the polydioxanone suture material. No cases of incisional hernia were reported with polydioxanone suture material. Conclusions: The overall morbidity from abdominal closure was considerably reduced in the Polydioxanone group. We encountered reduction in wound complications like burst abdomen, wound infection, wound pain, suture sinus formation, palpable knots and incisional hernia. Therefore

  17. Enhancing acronym/abbreviation knowledge bases with semantic information.

    Science.gov (United States)

    Torii, Manabu; Liu, Hongfang

    2007-10-11

    In the biomedical domain, a terminology knowledge base that associates acronyms/abbreviations (denoted as SFs) with the definitions (denoted as LFs) is highly needed. For the construction such terminology knowledge base, we investigate the feasibility to build a system automatically assigning semantic categories to LFs extracted from text. Given a collection of pairs (SF,LF) derived from text, we i) assess the coverage of LFs and pairs (SF,LF) in the UMLS and justify the need of a semantic category assignment system; and ii) automatically derive name phrases annotated with semantic category and construct a system using machine learning. Utilizing ADAM, an existing collection of (SF,LF) pairs extracted from MEDLINE, our system achieved an f-measure of 87% when assigning eight UMLS-based semantic groups to LFs. The system has been incorporated into a web interface which integrates SF knowledge from multiple SF knowledge bases. Web site: http://gauss.dbb.georgetown.edu/liblab/SFThesurus.

  18. Compression and the origins of Zipf's law of abbreviation

    CERN Document Server

    Ferrer-i-Cancho, R; Seguin, C

    2015-01-01

    Languages across the world exhibit Zipf's law of abbreviation, namely more frequent words tend to be shorter. The generalized version of the law, namely an inverse relationship between the frequency of a unit and its magnitude, holds also for the behaviors of other species and the genetic code. The apparent universality of this pattern in human language and its ubiquity in other domains calls for a theoretical understanding of its origins. We generalize the information theoretic concept of mean code length as a mean energetic cost function over the probability and the magnitude of the symbols of the alphabet. We show that the minimization of that cost function and a negative correlation between probability and the magnitude of symbols are intimately related.

  19. Is the full version of the AUDIT really necessary? Study of the validity and internal construct of its abbreviated versions.

    Science.gov (United States)

    Meneses-Gaya, Carolina; Zuardi, Antonio W; Loureiro, Sonia R; Hallak, Jaime E C; Trzesniak, Clarissa; de Azevedo Marques, João M; Machado-de-Sousa, João P; Chagas, Marcos H N; Souza, Roberto M; Crippa, José A S

    2010-08-01

    This study was aimed at assessing the psychometric qualities of the abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT-3, AUDIT-4, AUDIT-C, AUDIT-PC, AUDIT-QF, FAST, and Five-Shot) and at comparing them to the 10-item AUDIT and the CAGE in 2 samples of Brazilian adults. The validity and internal consistency of the scales were assessed in a sample of 530 subjects attended at an emergency department and at a Psychosocial Care Center for Alcohol and Drugs. The Structured Clinical Interview for DSM-IV was used as the diagnostic comparative measure for the predictive validity assessment. The concurrent validity between the scales was analyzed by means of Pearson's correlation coefficient. The assessment of the predictive validity of the abbreviated versions showed high sensitivity (of 0.78 to 0.96) and specificity (of 0.74 to 0.94) indices, with areas under the curve as elevated as those of the AUDIT (0.89 and 0.92 to screen for abuse and 0.93 and 0.95 in the screening of dependence). The CAGE presented lower indices: 0.81 for abuse and 0.87 for dependence. The analysis of the internal consistency of the AUDIT and its versions exhibited Cronbach's alpha coefficients between 0.83 and 0.94, while the coefficient for the CAGE was 0.78. Significant correlations were found between the 10-item AUDIT and its versions, ranging from 0.91 to 0.99. Again, the results for the CAGE were satisfactory (0.77), although inferior to the other instruments. The results obtained in this study confirm the validity of the abbreviated versions of the AUDIT for the screening of alcohol use disorders and show that their psychometric properties are as satisfactory as those of the 10-item AUDIT and the CAGE.

  20. 78 FR 13071 - Guidance for Industry: Implementation of an Acceptable Full-Length and Abbreviated Donor History...

    Science.gov (United States)

    2013-02-26

    ... Plasma Protein Therapeutics Association (PPTA) Source Plasma donor history questionnaires and...- Length and Abbreviated Donor History Questionnaires and Accompanying Materials for Use in Screening... ``Guidance for Industry: Implementation of an Acceptable Full-Length and Abbreviated Donor History...

  1. 76 FR 26307 - Guidance for Industry on the Submission of Summary Bioequivalence Data for Abbreviated New Drug...

    Science.gov (United States)

    2011-05-06

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on the Submission of Summary Bioequivalence Data for Abbreviated New Drug Applications; Availability AGENCY: Food and Drug Administration, HHS... guidance for industry entitled ``Submission of Summary Bioequivalence Data for Abbreviated New...

  2. Robotic surgery compared with laparotomy for high-grade endometrial cancer.

    Science.gov (United States)

    Pant, Alok; Schink, Julian; Lurain, John

    2014-06-01

    High-grade endometrial cancer often presents with occult metastatic disease and this presentation pattern can be considered a contraindication to minimally invasive surgery. We sought to compare the surgical and oncologic outcomes of patients with high-grade endometrial cancer who underwent surgical management/staging via the robotic approach versus the traditional open approach. A retrospective analysis was performed of patients with high-grade endometrial cancer who were treated at a single institution from January 2008 through December 2011. High-grade endometrial histology was defined as FIGO grade 2 or 3 endometrioid, serous, clear cell or uterine carcinosarcoma. Pre-operatively, all patients had clinical stage I disease based on a combination of physical examination and imaging studies. Baseline patient demographics, operative results, complications and oncologic outcomes were analyzed. Eighty consecutive patients were included. Forty-seven patients underwent surgical management using the robotic approach and 33 patients underwent a traditional operation via laparotomy. The groups were well matched in terms of age, body mass index, medical co-morbidities, stage and histology. The average hospital stay for patients who underwent open surgery was significantly longer than for those who underwent a robotic approach [5.6 versus 1.4 days (p = 0.0001)]. Of the patients who underwent robotic surgery, 7/47 (15 %) experienced an operative complication versus 18/33 (55 %) in the open surgery cohort (p = 0.002). The average number of pelvic lymph nodes retrieved in each cohort was 12. The average number of para-aortic lymph nodes retrieved in each group was 4. On final pathologic analysis, 20 patients in the robotic surgery arm were found to have disease that had spread beyond the uterus (43 %), compared to 14 in the traditional surgery group (42 %). There were 11/47 (23 %) recurrences in the robotic surgery group during the study period, compared to 8/33 (24

  3. Implantation of peritoneal catheters by laparotomy: nephrologists obtained similar results to general surgeons

    Directory of Open Access Journals (Sweden)

    Restrepo CA

    2014-10-01

    Full Text Available Cesar A Restrepo, Carlos Alberto Buitrago, Cielo Holguin Division of Nephrology, Department of Health Sciences, Caldas University, Caldas, ColombiaPurpose: To analyze the complications and costs of minilaparotomies performed by a nephrologist (group A compared with conventional laparotomies performed by a surgeon (group B for peritoneal catheter implantation.Setting: Two university hospitals (Santa Sofia and Caldas in Manizales, Caldas, Colombia.Methods: The study included stage 5 chronic kidney disease patients, with indication of renal replacement therapy, who were candidates for peritoneal dialysis and gave informed consent for a peritoneal catheter implant. Minilaparotomies were performed by a nephrologist in a minor surgery room under local anesthesia. Conventional laparotomies were performed by a surgeon in an operating room under general anesthesia.Results: Two nephrologists inserted 157 peritoneal catheters, and seven general surgeons inserted 185 peritoneal catheters. The groups had similar characteristics: the mean age was 55 years, 49.5% were men, and the primary diagnoses were diabetic nephropathy, hypertensive nephropathy, and unknown etiology. The implant was successful for 98.09% of group A and 99.46% of group B. There was no procedure-related mortality. The most frequent complications in the first 30 days postsurgery in group A versus group B, respectively, were: peritonitis (6.37% versus 3.78%, exit-site infection (3.82% versus 2.16%, tunnel infection (0% versus 0.54%, catheter entrapment by omentum (1.27% versus 3.24%, peritoneal effluent spillover (1.91% versus 2.16%, draining failure (4.46% versus 6.49%, hematoma (0% versus 1.08%, catheter migration with kinking (3.18% versus 2.70%, hemoperitoneum (1.27% versus 0%, and hollow viscera accidental puncture (1.91% versus 0.54%. There were no statistically significant differences in the number of complications between groups. In 2013, the cost of a surgeon-implanted peritoneal

  4. A randomised controlled trial of the electric heating pad vs forced-air warming for preventing hypothermia during laparotomy.

    Science.gov (United States)

    Leung, K K; Lai, A; Wu, A

    2007-06-01

    A randomised controlled trial was conducted to compare the efficacy of upper body forced-air warming (Bair Hugger, Augustine Medical model 500/OR, Prairie, MN) with that of an electric heating pad (Operatherm 202, KanMed, Bromma, Sweden) for maintenance of intra-operative body temperature in 60 patients undergoing laparotomy under general anaesthesia. The nasopharyngeal temperature was recorded throughout the operative period. The mean (SD) final temperatures were 36.2 (0.4) degrees C with forced-air warming and 35.5 (1.0) degrees C with electric heating pad (p heating pad for maintenance of body temperature during laparotomy.

  5. Retrospective analysis of exploratory laparotomies in 192 Andalusian horses and 276 horses of other breeds.

    Science.gov (United States)

    Muñoz, E; Argüelles, D; Areste, L; Miguel, L San; Prades, M

    2008-03-08

    The medical records of 468 horses that underwent 490 exploratory laparotomies for the correction of gastrointestinal diseases were reviewed to search for differences between Andalusian horses and other breeds. The seasonal distribution of surgical colics and their outcome and complications were also investigated. Bivariant analysis was used to compare the horses' age, gender and breed with the type of surgery, the bowel affected and the type of colic, and all these variables were compared in relation to euthanasia during surgery, complications, short-term survival and seasonal distribution. A total of 405 horses survived the surgery and 329 were discharged from the hospital. Horses less than one year old had better short-term survival than older horses. Andalusian horses suffered more inguinal hernias than the other breeds and were more prone to suffer laminitis as a complication. Colic surgery and inguinal hernias were also more common in the summer.

  6. Surgical Treatment of Endometrial Cancer and Atypical Hyperplasia: A Trend Shift from Laparotomy to Laparoscopy

    Directory of Open Access Journals (Sweden)

    Erik Qvigstad

    2011-01-01

    Full Text Available Background. Laparoscopic hysterectomy has proved to be a safe alternative to open surgery in women with benign indications. Few studies compare laparotomy and laparoscopy in gynecologic oncology, and the objective of this study was to analyze the feasibility and development of laparoscopic surgery in endometrial cancer patients. Material and Methods. Records from all women having a hysterectomy due to premalignant or malignant endometrial changes during the years 2002–2009 were examined retrospectively. Results. A total of 521 hysterectomies were performed during the study period. Laparoscopy was performed in about 20% of the cases in the first two years, increasing to 83% in the last year of the period. Moreover, the laparoscopic technique was increasingly applied in older women, more obese women and in women with high-risk preoperative diagnosis, without increasing the complication rate. Conclusions. As for benign indications, laparoscopic hysterectomy in endometrial cancer patients should be preferred whenever possible.

  7. Echinococcosis of Iliopsoas Muscle and Anaphylaxis as the Cause of Urgent Laparotomy

    Directory of Open Access Journals (Sweden)

    A Petrić

    2014-12-01

    Full Text Available Echinococcosis is an infectious disease which in humans is caused by the larval stadium of two types of parasites (Echinococcus granulosus and Echinococcus multilocularis. It is most frequently localized in the liver, lungs and rarely in muscles. The parasite significantly affects the immune system of the host, which is why anaphylactic reactions are not rare, especially in cases of cyst rupture. This paper presents the case of a 53-year old woman who had urgent laparotomy on the presumed basis of rupture of ovarian tumour, with intra-abdominal haemorrhage and shock. It turned out to be echinococcosis of the iliopsoas muscle and anaphylactic reaction. The differential diagnosis of adnexal tumours should take into consideration echinococcosis as well. Symptoms of anaphylactic shock in the case of parasitic cyst rupture can easily be confused with the signs of haemorrhagic shock.

  8. Laparotomy enables retrograde dilatation and stent placement for malignant esophago-respiratory fistula

    Directory of Open Access Journals (Sweden)

    Iskender Özcan

    2008-01-01

    Full Text Available Abstract Background Malignant esophageal stenosis with complete obstruction and esophagorespiratory fistula (ERF is difficult to treat with standard endoscopic techniques. Case presentation We report a patient in whom with local recurrence of esophageal carcinoma an esophagotracheal fistula occurred. Initially the patient had undergone esophageal resection with interposition of a gastric tube. Due to complete obstruction of the lumen by recurrent tumor conventional transoral stent placement failed. For retrograde dilatation a laparotomy was performed. Via a duodenal incision endoscopic access to the gastric tube was achieved. Using a guidewire the esophageal obstruction was traversed and dilated. Then it was possible to place an esophageal stent via an antegrade approach. Conclusion Open surgery enables a safe access for retrograde endoscopic therapy in patients who had undergone esophageal resection with gastric interposition.

  9. 21 CFR 314.152 - Notice of withdrawal of approval of an application or abbreviated application for a new drug.

    Science.gov (United States)

    2010-04-01

    ... or abbreviated application for a new drug. 314.152 Section 314.152 Food and Drugs FOOD AND DRUG... APPROVAL TO MARKET A NEW DRUG FDA Action on Applications and Abbreviated Applications § 314.152 Notice of withdrawal of approval of an application or abbreviated application for a new drug. If the Food and...

  10. Pharmacist and Physician Interpretation of Abbreviations for Acetaminophen Intended for Use in a Consumer Icon

    Directory of Open Access Journals (Sweden)

    Saul Shiffman

    2015-10-01

    Full Text Available Concomitant use of multiple acetaminophen medications is associated with overdose. To help patients identify acetaminophen medications and thus avoid concomitant use, an icon with an abbreviation for “acetaminophen” has been proposed for all acetaminophen medications. This study assessed pharmacists’ and physicians’ use and interpretation of abbreviations for “acetaminophen”, to identify abbreviations with other meanings that might cause confusion. Physicians (n = 150 reported use and interpretation of candidate abbreviations Ac and Acm. Pharmacists (n = 150 interpretations of prescription orders using the candidate abbreviations APAP, Ac, Ace and Acm in typed, handwritten or spoken form, were judged for critical confusions likely to cause patient harm. Critical confusion was rare, except for omission by pharmacists of the acetaminophen dose for Hydrocodone/APAP prescriptions (10%. Ac was in common use to indicate “before meals”, and was interpreted as such, but some physicians (8% said they use Ac to indicate anticoagulant drugs. Most pharmacists (54% interpreted Ace as acetaminophen, and none interpreted it as referring to ACE-inhibitors. Acm was rarely used in prescriptions, had no common interfering meanings, and was often (63% interpreted as acetaminophen, especially when prescribed in combination with an opiate (85%. The data validated concerns about abbreviations in prescribing: all abbreviations resulted in some misinterpretations. However, Acm was rarely misinterpreted, was readily associated with “acetaminophen”, and seemed appropriate for use in a graphic icon to help consumers/patients identify acetaminophen medications.

  11. Processes and changes in Minas Gerais’ 18th century abbreviations: regularity and rupture

    Directory of Open Access Journals (Sweden)

    Aléxia Teles Duchowny

    2015-02-01

    Full Text Available This study analyzed 18th century abbreviations from documents written in Arraial do Tijuco, today Diamantina, in Minas Gerais, Brazil. Brachygraphic resources used in religious brotherhoods’ commitments from different social strata were compared to test two hypotheses: (i abbreviations reflect differences between strata and therefore (ii they allow identifying the degree of literacy of writing subjects. The analysis undertaken do not attest the correctness of assumptions, but the generalizations reached indicate that abbreviations, as any other linguistic phenomenon, suffer systematic, organized and multiple change processes, a different result from those that the meagre literature on the subject provides.

  12. Adaptation of abbreviated mathematics anxiety rating scale for engineering students

    Science.gov (United States)

    Nordin, Sayed Kushairi Sayed; Samat, Khairul Fadzli; Sultan, Al Amin Mohamed; Halim, Bushra Abdul; Ismail, Siti Fatimah; Mafazi, Nurul Wirdah

    2015-05-01

    Mathematics is an essential and fundamental tool used by engineers to analyse and solve problems in their field. Due to this, most engineering education programs involve a concentration of study in mathematics courses whereby engineering students have to take mathematics courses such as numerical methods, differential equations and calculus in the first two years and continue to do so until the completion of the sequence. However, the students struggled and had difficulties in learning courses that require mathematical abilities. Hence, this study presents the factors that caused mathematics anxiety among engineering students using Abbreviated Mathematics Anxiety Rating Scale (AMARS) through 95 students of Universiti Teknikal Malaysia Melaka (UTeM). From 25 items in AMARS, principal component analysis (PCA) suggested that there are four mathematics anxiety factors, namely experiences of learning mathematics, cognitive skills, mathematics evaluation anxiety and students' perception on mathematics. Minitab 16 software was used to analyse the nonparametric statistics. Kruskal-Wallis Test indicated that there is a significant difference in the experience of learning mathematics and mathematics evaluation anxiety among races. The Chi-Square Test of Independence revealed that the experience of learning mathematics, cognitive skills and mathematics evaluation anxiety depend on the results of their SPM additional mathematics. Based on this study, it is recommended to address the anxiety problems among engineering students at the early stage of studying in the university. Thus, lecturers should play their part by ensuring a positive classroom environment which encourages students to study mathematics without fear.

  13. The effect of laparotomy on hydroxyl radicals, singlet oxygen and antioxidants measured by EPR method in the tails of rats.

    Science.gov (United States)

    Fricova, Jitka; Stopka, Pavel; Krizova, Jana; Yamamotova, Anna; Rokyta, Richard

    2009-01-01

    The aim of the study was to demonstrate that direct measurement of hydroxyl radicals and singlet oxygen in the tail of living rats is possible. The basic level of hydroxyl radicals and singlet oxygen were measured and the effects of antioxidants on their levels were studied in the tail of living anaesthetized rats after acute postoperative pain. Laparotomy was performed as the source of acute abdominal pain. After closure of the abdominal cavity, the animals began to awaken within 30-60 minutes. They were left to recover for 2-3 hours; then they were reanesthetized and the effect of antioxidants was measured on the numbers of hydroxyl radicals and singlet oxygen via blood in the tail. The laparotomy was preformed under general anesthesia (Xylazin and Ketamin) using Wistar rats. After recovery and several hours of consciousness they were reanaesthetized and free radicals and singlet oxygen were measured. An antioxidant mixture (vitamins A, C, D and Selenium) was administered intramuscularly prior to the laparotomy. All measurements were done on the tail of anaesthetized animals. In this particular article, the effect of antioxidants is only reported for hydroxyl radicals. After laparotomy, which represented both somatic and visceral pain, hydroxyl radicals and singlet oxygen were increased. Antioxidant application prior to laparotomy decreased the numbers of hydroxyl radicals. Results are in agreement with our previous finding regarding the increase in hydroxyl free radicals and singlet oxygen following nociceptive stimulation, in this case a combination of both somatic and visceral pain. The administered antioxidants mitigated the increase. This is further confirmation that direct measurement of free radicals and singlet oxygen represents a very useful method for the biochemical evaluation of pain and nociception.

  14. Evaluation of sub-fascial lidocaine infusion in post-operative pain management following laparotomy

    Directory of Open Access Journals (Sweden)

    F. Eshghi

    2008-01-01

    Full Text Available  AbstractBackground and Purpose: One of the important problems of major abdominal surgery is post-operative pain control. There are different modalities to control the pain after surgery, such as oral, local or intravenous analgesic drugs, regional nerve block, epidural catheters and pain killer pumps with their own benefits and complications. The aim of this study was to evaluate the effect of continuous peritoneal infusion of lidocaine by a pain killer pump for post-operative pain management following laparotomy.Materials and Methods: This double blind randomized clinical trial was performed on 76 patients (38 cases and 38 controls who underwent laparotomy with midline incision, in Imam Hospital, Sari, Iran, in 2008. Two groups were matched in age and sex. After surgery a catheter infusion pump was prepared for all patients. In case group, 2% lidocaine (20mg/kg/day and for control, normal saline infused for 24 hours. Pain score (Visual Analog Scale, blood pressure, heart rate, respiratory rate, temperature and analgesic requirement was evaluated in 4, 10, 16 and 24 hours after surgery. Results analyzed by means of SPSS (15 software and chi-square, t test and repeated measurement. The p value less than 0.05 was considered to be significant statistically.Results: 76 patients, 39 (51.3% females and 37 (48.7% males, with mean age of 47.03±15.2 years were studied. There was no significant difference in age, sex and weight between two groups. The mean of admission days was 5.03±0.6 in case and 5.29±1.3 in control, with no significant difference between them. Mean of opiod consumption was 16.05±13.05 mg and 25.39±11.4 mg in case and control respectively (P= 0.002. Mean of VAS score, blood pressure, heart rate, respiratory rate and temperature in case group was less than control group and the difference was significant statistically. Pain severity changes during 4, 10, 16 and 24 hours following surgery were significantly different in two

  15. 75 FR 77897 - Long Walk National Historic Trail Feasibility Study, Abbreviated Final Environmental Impact...

    Science.gov (United States)

    2010-12-14

    ... trail would be designated, emphasizing the removal experiences common to both tribes. An auto tour route... National Park Service Long Walk National Historic Trail Feasibility Study, Abbreviated Final Environmental Impact Statement, National Trails Intermountain Region, NM AGENCY: National Park Service,...

  16. Modeling the structure of the attitudes and belief scale 2 using CFA and bifactor approaches: Toward the development of an abbreviated version.

    Science.gov (United States)

    Hyland, Philip; Shevlin, Mark; Adamson, Gary; Boduszek, Daniel

    2014-01-01

    The Attitudes and Belief Scale-2 (ABS-2: DiGiuseppe, Leaf, Exner, & Robin, 1988. The development of a measure of rational/irrational thinking. Paper presented at the World Congress of Behavior Therapy, Edinburg, Scotland.) is a 72-item self-report measure of evaluative rational and irrational beliefs widely used in Rational Emotive Behavior Therapy research contexts. However, little psychometric evidence exists regarding the measure's underlying factor structure. Furthermore, given the length of the ABS-2 there is a need for an abbreviated version that can be administered when there are time demands on the researcher, such as in clinical settings. This study sought to examine a series of theoretical models hypothesized to represent the latent structure of the ABS-2 within an alternative models framework using traditional confirmatory factor analysis as well as utilizing a bifactor modeling approach. Furthermore, this study also sought to develop a psychometrically sound abbreviated version of the ABS-2. Three hundred and thirteen (N = 313) active emergency service personnel completed the ABS-2. Results indicated that for each model, the application of bifactor modeling procedures improved model fit statistics, and a novel eight-factor intercorrelated solution was identified as the best fitting model of the ABS-2. However, the observed fit indices failed to satisfy commonly accepted standards. A 24-item abbreviated version was thus constructed and an intercorrelated eight-factor solution yielded satisfactory model fit statistics. Current results support the use of a bifactor modeling approach to determining the factor structure of the ABS-2. Furthermore, results provide empirical support for the psychometric properties of the newly developed abbreviated version.

  17. Results of Second-Look Laparotomy in Advanced Ovarian Cancer: One Single Center Experience

    Science.gov (United States)

    Damak, Tarak; Chargui, Riadh; Ben Hassouna, Jamel; Hechiche, Monia; Rahal, Khaled

    2012-01-01

    Objective. The goal of the study was to analyse the results of 85 cases of second-look laparotomy (SLL) and explore the influence of this procedure on survival. Patients and Methods. We reviewed retrospectively 85 cases of SLL collected and treated in our institute between 1994 and 2003. Results. Complete pathologic response (CPR) was 25.8%, microscopic disease (Rmicro) was 38.8%, and macroscopic disease (Rmacro) was 35.4%. In patients with negative SLL results, disease recurrence was diagnosed in 41%. The 3- and 5-year overall survival rates for the entire population were 91% and 87%, respectively. The 3- and 5-year disease-free survivals were, respectively, 76.3% and 58.5% in negative SLL versus 55.7% and 16% in positive SLL. The difference between the group of patients with complete response (76%) and the patients with residual microscopic disease (72%) was not significant. The tumoral residuum after initial surgery was the only prognostic factor influencing significantly the disease-free survival. On Cox regression model analysis, only initial tumoral residuum (P = 0.04) and tumoral residuum after SLL (P = 0.02) were independent prognostic factors for survival. Conclusions. The most important advantage of SLL is the early detection of recurrence and thus the early administration of consolidation treatment resulting in a better prognosis. PMID:23119177

  18. Emergency presurgical visit

    Directory of Open Access Journals (Sweden)

    Alfredo Castro Díaz

    2009-07-01

    Full Text Available The objective has been to create a Protocol of Structured Presurgical Visit applicable to the patients who are undergoing an emergency surgery, to provide the user and his family all the necessary cares on the basis of those nursing diagnosis that prevail in all the cases of surgical emergency interventions. The used method has been an analysis of the emergency surgical interventions more prevalent from February 2007 until October 2008 in our area (a regional hospital, and statistic of those nursing diagnosis that more frequently appeared in these interventions, the previous moment to the intervention and in addition common to all of them. The results were the following ones: the more frequent emergency operations were: Caesarean, ginecological curettage, laparotomy, help in risk childbirth, orthopaedic surgery and appendectomy. The more frequent nursing diagnosis in all the emergency operations at the previous moment of the intervention were: risk of falls, pain, anxiety, deficit of knowledge, risk of infection, movement stress syndrome, risk of hemorrhage, cutaneous integrity deterioration. The conclusion is that users present at the previous moment to an emergency operation several problems, which force to the emergency surgical ward nurse to the introduction of the nursing methodology, in order to identify the problems, to mark results and to indicate the interventions to achieve those results, besides in a humanitarian way and with quality. This can be obtained by performing a Structured Emergency Presurgical Visit.

  19. Reinfusion of aspirated pericardial blood during CPB. Part I. Hypothesis: laparotomy sponges are a significant part of the CPB circuit?

    Science.gov (United States)

    Bull, Brian S; Hay, Karen

    2005-01-01

    Blood accumulating in the pericardial sac is routinely reinfused during cardiopulmonary bypass (CPB) surgery. Such reinfusion has been associated with an increased incidence of serious complications such as coagulopathy, systemic inflammation, and neurologic sequelae. We hypothesize that some of these complications occur because the reinfused blood has been exposed to and activated by laparotomy sponges used to elevate the heart during vein graft emplacement. Such laparotomy sponges expose accumulating pericardial blood to a large, raw, cotton surface with an area approximately five times that of the CPB circuit (excluding the biocompatible oxygenator membrane). Because the reinfused blood has been exposed to this surface, the sponge becomes, in essence, a significant-though inapparent-part of the CPB circuit. Steps should be taken to either eliminate the sponge or to reduce the area of this foreign surface and make it more biocompatible.

  20. Assessment of post-laparotomy pain in laboratory mice by telemetric recording of heart rate and heart rate variability

    Directory of Open Access Journals (Sweden)

    Kasermann Hans P

    2007-08-01

    Full Text Available Abstract Background Pain of mild to moderate grade is difficult to detect in laboratory mice because mice are prey animals that attempt to elude predators or man by hiding signs of weakness, injury or pain. In this study, we investigated the use of telemetry to identify indicators of mild-to-moderate post-laparotomy pain. Results Adult mice were subjected to laparotomy, either combined with pain treatment (carprofen or flunixin, 5 mg/kg s/c bid, for 1 day or without pain relief. Controls received anesthesia and analgesics or vehicle only. Telemetrically measured locomotor activity was undisturbed in all animals, thus confirming that any pain experienced was of the intended mild level. No symptoms of pain were registered in any of the groups by scoring the animals' outer appearance or spontaneous and provoked behavior. In contrast, the group receiving no analgesic treatment after laparotomy demonstrated significant changes in telemetry electrocardiogram recordings: increased heart rate and decreased heart rate variability parameters pointed to sympathetic activation and pain lasting for 24 hours. In addition, core body temperature was elevated. Body weight and food intake were reduced for 3 and 2 days, respectively. Moreover, unstructured cage territory and destroyed nests appeared for 1–2 days in an increased number of animals in this group only. In controls these parameters were not affected. Conclusion In conclusion, real-time telemetric recordings of heart rate and heart rate variability were indicative of mild-to-moderate post-laparotomy pain and could define its duration in our mouse model. This level of pain cannot easily be detected by direct observation.

  1. Perioperative nutritional management of patients undergoing laparotomy Cuidados nutricionales perioperatorios en pacientes sometidos a laparotomía

    OpenAIRE

    M. I. Toulson Davisson Correia; P. Costa Fonseca; G. A. Machado Cruz

    2009-01-01

    Objectives: Lack of routine patient's nutritional assessment and prescription of long fasting periods throughout the perioperative period are still widely prevalent despite the advances in surgical care. Therefore, the aim of this study was to assess nutritional routines in two surgical wards. Methods: Adult patients undergoing laparotomy at two distinct units (gastrointestinal and gynecologic) in two public hospitals (one of them a university) were enrolled. Patients were divided in minor an...

  2. Increased mortality in the elderly after emergency abdominal surgery

    DEFF Research Database (Denmark)

    Svenningsen, Peter; Manoharan, Thukirtha; Foss, Nicolai B

    2014-01-01

    INTRODUCTION: The purpose of this study was to evaluate the relation between preoperative delay and mortality in surgical patients undergoing primary emergency laparotomy (PEL) in an unselected, well-described patient cohort in a university hospital setting. MATERIAL AND METHODS: This study was a...

  3. Increased mortality in the elderly after emergency abdominal surgery

    DEFF Research Database (Denmark)

    Svenningsen, Peter; Manoharan, Thukirtha; Foss, Nicolai B

    2014-01-01

    INTRODUCTION: The purpose of this study was to evaluate the relation between preoperative delay and mortality in surgical patients undergoing primary emergency laparotomy (PEL) in an unselected, well-described patient cohort in a university hospital setting. MATERIAL AND METHODS: This study was a...

  4. Advantages of laparoscopy versus laparotomy in extremely obese women (BMI>35) with early-stage endometrial cancer: a multicenter study.

    Science.gov (United States)

    Tinelli, Raffaele; Litta, Pietro; Meir, Yoram; Surico, Daniela; Leo, Livio; Fusco, Annarita; Angioni, Stefano; Cicinelli, Ettore

    2014-05-01

    The aim of the present study was to demonstrate the advantages of laparoscopy versus laparotomy for treatment of extremely obese women with early-stage endometrial cancer. Seventy-five extremely obese patients with Body Mass Index >35 kg/m(2) and clinical stage I endometrial cancer underwent hysterectomy and bilateral salpingo-oophorectomy, and in all cases we performed systematic pelvic lymphadenectomy by laparoscopy (mean BMI of 38±7.3 kg/m(2)) or laparotomy (mean BMI of 39±8.1 kg/m(2)). In two (4.4%) patients of the laparoscopy group we observed a port site haematoma that was resolved without a second surgery. In three patients of the laparotomy-group, we observed dehiscence of the abdominal suture with surgical site infection that was re-sutured. Laparoscopy can be considered a safe and effective therapeutic procedure for managing early-stage endometrial cancer in extremely obese women with a lower complication rate, lower surgical site infection and postoperative hospitalization.

  5. Penatalaksanaan Anestesi pada Pasien dengan Sick Sinus Syndrome yang Menjalani Laparotomi Ec Perforasi Gaster

    Directory of Open Access Journals (Sweden)

    Radian Ahmad Halimi

    2013-04-01

    Full Text Available SA node dysfunction, or known as Sick Sinus Syndrome is the common cause of disrythmia and can be caused by intrinsic and extrinsic factors of the SA node. The diagnose performed by the occurrence of bradi- takhikardia episode and the clinical symptoms, could be syncope, palpitation, or maybe asymptomatic. Some of the literature defined that the perioperative management of sick sinus syndrome is preoperative insertion of pacemaker (transcutaneal or transvenous pacing. A 75 years old man underwent laparotomy with diffuse peritonitis caused by gastric perforation. In preoperative clinical evaluation the patients revealed full awake ( compos mentis, with history of uncontrolled hypertension. In physical exammination a severe bradicardia was found with pulse of 31x/minute, and the blood pressure was 190/100 mmHg. In this rural hospital there was no fascility to insert the pace-maker. The organ perfusion was considered to be optimal from clinical evaluation ( proved by the wakefullness, SpO2 99%, and diuresis 1cc/kgBW after optimalization . The chest X’ray showed a cardiomegali without the sign of pulmonary congestion. The laboratory test were within normal limit including the renal function test ( creatinin; 0,97 mg/dl, and ureum 82,6 mg/dl. We decided to perform general anesthesia in this procedure. Before the induction while patient still awake, fentanyl 2µg/kgBW was given intravenously. Fifteen menue after fentanyl administration induction of anesthesia performed and initiated with propofol intravenous injection slowly until patients felt asleep, than intubated after muscle relaxant intravenous reached the onset After intubation the pulse / heart rate of patients rose to 44 – 90x/minute. While the pulse was 90/ minute the heart rythm of the patients became irregular, a multifocal ventricular extra systole occured, and it was reversible when the heart rate back to 44x/ minute. We decided to maintain the heart rate between 35 – 40dmitted to

  6. Abbreviated protocol for breast MRI: Are multiple sequences needed for cancer detection?

    Energy Technology Data Exchange (ETDEWEB)

    Mango, Victoria L., E-mail: vlm2125@columbia.edu [Columbia University Medical Center, Herbert Irving Pavilion, 161 Fort Washington Avenue, 10th Floor, New York, NY 10032 (United States); Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Morris, Elizabeth A., E-mail: morrise@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); David Dershaw, D., E-mail: dershawd@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Abramson, Andrea, E-mail: abramsoa@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Fry, Charles, E-mail: charles_fry@nymc.edu [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); New York Medical College, 40 Sunshine Cottage Rd, Valhalla, NY 10595 (United States); Moskowitz, Chaya S. [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Hughes, Mary, E-mail: hughesm@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Kaplan, Jennifer, E-mail: kaplanj@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Jochelson, Maxine S., E-mail: jochelsm@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States)

    2015-01-15

    Highlights: • Abbreviated breast MR demonstrates high sensitivity for breast carcinoma detection. • Time to perform/interpret the abbreviated exam is shorter than a standard MRI exam. • An abbreviated breast MRI could reduce costs and make MRI screening more available. - Abstract: Objective: To evaluate the ability of an abbreviated breast magnetic resonance imaging (MRI) protocol, consisting of a precontrast T1 weighted (T1W) image and single early post-contrast T1W image, to detect breast carcinoma. Materials and methods: A HIPAA compliant Institutional Review Board approved review of 100 consecutive breast MRI examinations in patients with biopsy proven unicentric breast carcinoma. 79% were invasive carcinomas and 21% were ductal carcinoma in situ. Four experienced breast radiologists, blinded to carcinoma location, history and prior examinations, assessed the abbreviated protocol evaluating only the first post-contrast T1W image, post-processed subtracted first post-contrast and subtraction maximum intensity projection images. Detection and localization of tumor were compared to the standard full diagnostic examination consisting of 13 pre-contrast, post-contrast and post-processed sequences. Results: All 100 cancers were visualized on initial reading of the abbreviated protocol by at least one reader. The mean sensitivity for each sequence was 96% for the first post-contrast sequence, 96% for the first post-contrast subtraction sequence and 93% for the subtraction MIP sequence. Within each sequence, there was no significant difference between the sensitivities among the 4 readers (p = 0.471, p = 0.656, p = 0.139). Mean interpretation time was 44 s (range 11–167 s). The abbreviated imaging protocol could be performed in approximately 10–15 min, compared to 30–40 min for the standard protocol. Conclusion: An abbreviated breast MRI protocol allows detection of breast carcinoma. One pre and post-contrast T1W sequence may be adequate for detecting

  7. 76 FR 64951 - Apothecon et al.; Withdrawal of Approval of 103 New Drug Applications and 35 Abbreviated New Drug...

    Science.gov (United States)

    2011-10-19

    ... HUMAN SERVICES Food and Drug Administration Apothecon et al.; Withdrawal of Approval of 103 New Drug Applications and 35 Abbreviated New Drug Applications; Correction AGENCY: Food and Drug Administration, HHS... new drug applications (NDAs) and 35 abbreviated new drug applications (ANDAs) from multiple...

  8. 78 FR 25749 - Submission of New Drug Application/Abbreviated New Drug Application Field Alert Reports: Notice...

    Science.gov (United States)

    2013-05-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Submission of New Drug Application/Abbreviated New Drug... submit new drug application (NDA) and abbreviated new drug application (ANDA) Field Alert Reports...

  9. Laparoscopic hysterectomy is preferred over laparotomy in early endometrial cancer patients, however not cost effective in the very obese.

    Science.gov (United States)

    Bijen, Claudia B M; de Bock, Geertruida H; Vermeulen, Karin M; Arts, Henriëtte J G; ter Brugge, Henk G; van der Sijde, Rob; Kraayenbrink, Arjen A; Bongers, Marlies Y; van der Zee, Ate G J; Mourits, Marian J E

    2011-09-01

    Total laparoscopic hysterectomy (TLH) is safe and cost effective in early stage endometrial cancer when compared to total abdominal hysterectomy (TAH). In non-randomised data it is often hypothesised that older and obese patients benefit most from TLH. Aim of this study is to analyse whether data support this assumption to advice patients, clinicians and policy makers. Data of 283 patients enrolled in a randomised controlled trial comparing TAH versus TLH in early stage endometrial cancer were re-analysed. Randomisation by sequential number generation was done centrally, with stratification by trial centre. Using multivariate analysis, predictors of major complications and conversions to laparotomy were assessed. For the cost effectiveness analysis, subgroups of patients were constructed based on age and body mass index (BMI). For each subgroup, costs per major complication-free patient were estimated, using incremental cost effect ratios (extra costs per additional effect). Older (odds ratio (OR): 1.05; 1.01-1.09) and obese (OR: 1.05; 1.01-1.10) patients had a higher risk to develop complications, for both groups. In obese (OR: 1.17; 1.09-1.25) patients and patients with a previous laparotomy (OR: 3.45; 1.19-10.04) a higher risk of conversion to laparotomy was found. For patients>70 years of age and patients with a BMI over 35 kg/m2, incremental costs per major complication-free patients were €16 and €54 for TLH compared to TAH, respectively. In general, TLH should be recommended as the standard surgical procedure in early stage endometrial cancer, also in patients>70 years of age. In obese patients with a BMI>35 kg/m2 TLH is not cost effective because of the high conversion rate. A careful consideration of laparoscopic treatment is needed for this subgroup. Surgeon experience level may influence this choice. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Laparotomy conversion rate of laparoscopic radical hysterectomy for early-stage cervical cancer in a consecutive series without case selection.

    Science.gov (United States)

    Park, Jeong-Yeol; Nam, Joo-Hyun

    2014-09-01

    To estimate the feasibility and conversion rate of laparoscopic radical hysterectomy (LRH) in early-stage cervical cancer. Data were collected from the medical records of 260 consecutive patients with stage IA2 to IIA2 cervical cancer who had undergone LRH, regardless of age, body mass index, prior abdominal surgery, uterus size, or tumor size. The median patient age was 48 years (range, 26-78 years), 11.9 % of whom were elderly (≥65 years), 11.2 % were obese (≥30 kg/m(2)), 15.4 % had undergone previous abdominal surgery, and 13.1 % had a tumor larger than 4 cm. Negative-margin resection was feasible in all patients except one. The median operative time and estimated blood loss were 253 min (range, 111-438 min) and 300 mL (range, 80-2000 mL), respectively. Intraoperative and postoperative complications occurred in seven (2.7 %) and 10 patients (3.8 %), respectively. Four patients (1.5 %) required intraoperative conversion to laparotomy, three of which were due to conglomerated metastatic lymph nodes surrounding the aorta (n = 2), the left external iliac vein (n = 1) or the left ureter (n = 1). LRH was still completed in the four conversion patients, and a laparotomy was required for the removal of the conglomerated metastatic lymph nodes and the repair of the injured vessels. The conversion rate to laparotomy among patients undergoing LRH for early-stage cervical cancer was 1.5 % when performed exclusively in consecutive patients. LRH showed comparable feasibility and effectiveness to open radical hysterectomy in the treatment of early-stage cervical cancer.

  11. Ovariectomy by laparotomy, a video-assisted approach or a complete laparoscopic technique in Santa Ines sheep

    OpenAIRE

    Teixeira, P. P. M; Padilha, L. C.; Motheo,T.F.; M.A.M. Silva; Oliveira, M.e.f. [UNESP; Silva, A. S. L. DA; Barros,F.F.P.C; Coutinho, L. N. [UNESP; F.N. Flores; Lopes,M.C.S.; Rodrigues, L. F. S.; W.R.R. Vicente

    2011-01-01

    The aim of the study was to compare the use of open ovariectomy, to the video-assisted laparoscopic approach or total laparoscopic ovariectomy in Santa Ines ewes. Surgical time and body weight gain/loss were recorded and post-surgical pain assessed using a behavioral scale. Laparotomy involved a longer surgical time (75 +/- 29.5 min), than the video-assisted (37.5 +/- 13.04 min; p < 0.05) or total laparoscopic approach (27.5 +/- 2.89; p < 0.01). Behavioral pain recorded score was higher for t...

  12. Abbreviated quality of life scales for schizophrenia: comparison and utility of two brief community functioning measures.

    Science.gov (United States)

    Fervaha, Gagan; Foussias, George; Siddiqui, Ishraq; Agid, Ofer; Remington, Gary

    2014-04-01

    The Heinrichs-Carpenter Quality of Life Scale (QLS) is the most extensively used real-world community functioning scale in schizophrenia research. However, the extensive time required to administer it and the inclusion of items that overlap conceptually with negative symptoms limit its use across studies. The present study examined the validity and utility of two abbreviated QLS measures against the full QLS excluding negative symptom items. The sample included 1427 patients with schizophrenia who completed the baseline visit in the CATIE study. The validity of two abbreviated QLS measures (7-item and 4-item) were examined with the full QLS, excluding the intrapsychic foundations subscale, using correlation analysis. The utility of the abbreviated measures was explored by examining associations between the functioning scales and clinical variables and longitudinal change. Both abbreviated QLS measures were highly predictive of the full QLS (both r=0.91, pschizophrenia, especially when assessment of functional outcome is not the focus. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. 77 FR 12877 - Record of Decision for the General Management Plan/Abbreviated Final Environmental Impact...

    Science.gov (United States)

    2012-03-02

    ... National Park Service Record of Decision for the General Management Plan/Abbreviated Final Environmental... Management Plan for New River Gorge National River, West Virginia. The Record of Decision selects the... the Record of Decision selecting Alternative 5 as the approved General Management Plan for New River...

  14. Automated Disambiguation of Acronyms and Abbreviations in Clinical Texts: Window and Training Size Considerations

    Science.gov (United States)

    Moon, Sungrim; Pakhomov, Serguei; Melton, Genevieve B.

    2012-01-01

    Acronyms and abbreviations within electronic clinical texts are widespread and often associated with multiple senses. Automated acronym sense disambiguation (WSD), a task of assigning the context-appropriate sense to ambiguous clinical acronyms and abbreviations, represents an active problem for medical natural language processing (NLP) systems. In this paper, fifty clinical acronyms and abbreviations with 500 samples each were studied using supervised machine-learning techniques (Support Vector Machines (SVM), Naïve Bayes (NB), and Decision Trees (DT)) to optimize the window size and orientation and determine the minimum training sample size needed for optimal performance. Our analysis of window size and orientation showed best performance using a larger left-sided and smaller right-sided window. To achieve an accuracy of over 90%, the minimum required training sample size was approximately 125 samples for SVM classifiers with inverted cross-validation. These findings support future work in clinical acronym and abbreviation WSD and require validation with other clinical texts. PMID:23304410

  15. The Maximum Entropy Approach to Record Abbreviation for Optimal Record Control.

    Science.gov (United States)

    Goyal, P.

    1983-01-01

    Tests performed on 6,260 titles from 3 machine-readable British National Bibliography files using an entropy based technique for abbreviation of text strings for use as a control code found that more than 94 percent of the titles generated a unique seven character code. Six references and an illustrative example are appended. (EJS)

  16. 21 CFR 314.150 - Withdrawal of approval of an application or abbreviated application.

    Science.gov (United States)

    2010-04-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW... that is described in the application or abbreviated application and that is essential to show that the... or contract research organization that conducted a bioavailability or bioequivalence study...

  17. Abbreviated Title of the Artwork in the System of Signs by Ch. Peirce

    Directory of Open Access Journals (Sweden)

    Grigoriy Valeryevich Tokarev

    2015-09-01

    Full Text Available The article is devoted to the semiotic aspect of the functioning of the abbreviated title of the postmodern artwork. The authors analyze the relationship of title-sign to the object which it replaces. The title is considered from the perspective of three main features peculiar of the sign in accordance with the Charles S. Peirce's theory. This fact allows us to conclude that, being a sign, the abbreviated title replaces a literary text, which is also expressed in symbolic form of the author's knowledge of reality. In this aspect the title becomes the metasign of its text. It is shown that in this connection, decoding and interpretation process take place in two stages – before reading the text and in the process of its reading and interpretation. It is alleged that the result of the interpretation of the title depends on the reader's competence which is determined by their individual literary scope, as well as by the skills of productive work with the text. On the basis of the classification of signs created by Charles Pierce, it was found that the abbreviated title has a complex semiotic nature combining the features of indexicality, conventionality, and iconicity, the latter of which may be present only in the abbreviated title.

  18. New drug applications and abbreviated new drug applications; technical amendment. Final rule; technical amendment.

    Science.gov (United States)

    2009-03-06

    The Food and Drug Administration (FDA) is amending its new drug application (NDA) and abbreviated new drug application (ANDA) regulations to update agency contacts for patent information and patent notifications and to correct an inaccurate cross-reference. This action is being taken to ensure accuracy and clarity in the agency's regulations.

  19. 75 FR 37295 - Change of Address; Abbreviated New Drug Applications; Technical Amendment

    Science.gov (United States)

    2010-06-29

    ...The Food and Drug Administration (FDA) is amending its regulations to update the address for applicants to submit abbreviated new drug applications (ANDAs) and ANDA amendments, supplements, and resubmissions. FDA is also updating the address for ANDA applicants to submit investigational new drug applications (INDs) for in vivo bioavailability and bioequivalence studies in humans that are......

  20. Evaluating an Abbreviated Version of the Hispanic Stress Inventory for Immigrants

    Science.gov (United States)

    Cavazos-Rehg, Patricia A.; Zayas, Luis H.; Walker, Mark S.; Fisher, Edwin B.

    2006-01-01

    This study evaluates an abbreviated version of the Hispanic Stress Inventory-Immigrant version (HSI-I) with a nonclinical sample of 143 adult Hispanic immigrants residing in a large midwestern city. The HSI-I consists of 73 items and 5 distinct subscales that assess psychosocial experiences on five dimensions, namely, occupational/economic,…

  1. Psychometric Properties of the Abbreviated Perceived Motivational Climate in Exercise Questionnaire

    Science.gov (United States)

    Moore, E. Whitney G.; Brown, Theresa C.; Fry, Mary D.

    2015-01-01

    The purpose of this study was to develop an abbreviated version of the Perceived Motivational Climate in Exercise Questionnaire (PMCEQ-A) to provide a more practical instrument for use in applied exercise settings. In the calibration step, two shortened versions' measurement and latent model values were compared to each other and the original…

  2. Relationship between Acceptable Noise Level and the Abbreviated Profile of Hearing Aid Benefit

    Science.gov (United States)

    Freyaldenhoven, Melinda C.; Nabelek, Anna K.; Tampas, Joanna W.

    2008-01-01

    Purpose: This study investigated the relationship between acceptable noise levels (ANLs) and the Abbreviated Profile of Hearing Aid Benefit (APHAB; R. M. Cox & G. C. Alexander, 1995). This study further examined the APHAB's ability to predict hearing aid use. Method: ANL and APHAB data were collected for 191 listeners with impaired hearing,…

  3. 78 FR 52931 - Draft Guidance for Industry on Abbreviated New Drug Applications: Stability Testing of Drug...

    Science.gov (United States)

    2013-08-27

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Abbreviated New Drug Applications: Stability Testing of Drug Substances and Products, Questions and Answers; Availability AGENCY... announcing the availability of a draft guidance for industry entitled ``ANDAs: Stability Testing of...

  4. 77 FR 58999 - Draft Guidance for Industry on Abbreviated New Drug Applications: Stability Testing of Drug...

    Science.gov (United States)

    2012-09-25

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Abbreviated New Drug... availability of a draft guidance for industry entitled ``ANDAs: Stability Testing of Drug Substances and... of a draft guidance for industry entitled ``ANDAs: Stability Testing of Drug Substances and...

  5. 75 FR 73108 - Guidance for Industry on Abbreviated New Drug Applications: Impurities in Drug Products...

    Science.gov (United States)

    2010-11-29

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Abbreviated New Drug Applications...: The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry...) guidance for industry ``Q3B(R) Impurities in New Drug Products,'' which was announced in August 2006....

  6. 78 FR 37231 - Guidance for Industry; Guidance on Abbreviated New Drug Applications: Stability Testing of Drug...

    Science.gov (United States)

    2013-06-20

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry; Guidance on Abbreviated New Drug... the availability of a guidance for industry entitled ``ANDAs: Stability Testing of Drug Substances and... generic drug review, FDA is recommending that the generic drug industry follow the approach in...

  7. Symbolic Capital in a Virtual Heterosexual Market: Abbreviation and Insertion in Italian iTV SMS

    Science.gov (United States)

    Herring, Susan C.; Zelenkauskaite, Asta

    2009-01-01

    This study analyzes gender variation in nonstandard typography--specifically, abbreviations and insertions--in mobile phone text messages (SMS) posted to a public Italian interactive television (iTV) program. All broadcast SMS were collected for a period of 2 days from the Web archive for the iTV program, and the frequency and distribution of…

  8. Text-Message Abbreviations and Language Skills in High School and University Students

    Science.gov (United States)

    De Jonge, Sarah; Kemp, Nenagh

    2012-01-01

    This study investigated the use of text-message abbreviations (textisms) in Australian adolescents and young adults, and relations between textism use and literacy abilities. Fifty-two high school students aged 13-15 years, and 53 undergraduates aged 18-24 years, all users of predictive texting, translated conventional English sentences into…

  9. Symbolic Capital in a Virtual Heterosexual Market: Abbreviation and Insertion in Italian iTV SMS

    Science.gov (United States)

    Herring, Susan C.; Zelenkauskaite, Asta

    2009-01-01

    This study analyzes gender variation in nonstandard typography--specifically, abbreviations and insertions--in mobile phone text messages (SMS) posted to a public Italian interactive television (iTV) program. All broadcast SMS were collected for a period of 2 days from the Web archive for the iTV program, and the frequency and distribution of…

  10. The Use of Abbreviations in English-Medium Astrophysics Research Paper Titles: A Problematic Issue

    Science.gov (United States)

    Méndez, David I.; Alcaraz, M. Ángeles

    2015-01-01

    In this study, we carry out a qualitative and quantitative analysis of abbreviations in 300 randomly collected research paper titles published in the most prestigious European and US-based Astrophysics journals written in English. Our main results show that the process of shortening words and groups of words is one of the most characteristic and…

  11. Supra-transumbilical laparotomy (STL approach for small bowel atresia repair: Our experience and review of the literature

    Directory of Open Access Journals (Sweden)

    Ernesto Leva

    2013-01-01

    Full Text Available Background: Supra-Transumbilical Laparotomy (STL has been used in paediatric surgery for a broad spectrum of abdominal procedures. We report our experience with STL approach for small bowel atresia repair in newborns and review previous published series on the topic. Patients and Methods: Fourteen patients with small bowel atresia were treated via STL approach at our Institution over a 5-year period and their charts were retrospectively reviewed. Results: STL procedure was performed at mean age of 3.1 day. No malrotation disorders were detected with pre-operative contrast enema. Eight patients (54.1% presented jejunal atresia, five (35.7% ileal atresia, and one (7.1% multiple ileal and jejunal atresias. Standard repair with primary end-to-back anastomosis was performed in all but one patient. In the newborn with multiple atresia, STL incision was converted in supra-umbilical transverse incision due to difficulty of exposition. After surgery, one patient developed anastomotic stricture, and another developed occlusion due to adhesions: Both infants required second laparotomy. No infections of the umbilical site were recorded, and cosmetic results were excellent in all patients. Conclusions: Increasing evidence suggests that STL approach for small bowel atresia is feasible, safe and provides adequate exposure for small bowel atresia surgery. When malrotation and colonic/multiple atresia are pre-operatively ruled out, STL procedure can be choosen as first approach.

  12. Perbandingan Pemulihan Bising Usus pada Pasien Pascaoperasi Histerektomi per Laparotomi Menggunakan Analgetik Kombinasi Ketamin-Morfin dengan Morfin Intravena

    Directory of Open Access Journals (Sweden)

    Irvan Setiawan

    2015-03-01

    Full Text Available Gastrointestinal dysfunction is the most common post anaesthesia complication. The aim of this study is to compare the recovery of bowel sounds between combination of ketamine-morphine analgesia to morphine alone. This is a randomized controlled study on 36 patients with American Society of Anesthesiologist (ASA physical status I and II who underwent hysterectomy per laparotomy at Dr. Hasan Sadikin Bandung during April–August 2012. Both groups received an initial dose of morphine 0.03 mg/kgBW, while K group received intravenous ketamine 4 μg/kgBW/min, and the M group received morphine 10 μg/kgBW/hr. The results were analyzed using t-test and Mann Whitney test with a confidence level of 95% and were considered significant if p<0.05. The results of this study showed that the recovery time of bowel sounds in K group was significantly faster than in the M group (p<0.05. In conclusion, recovery of bowel sounds is faster in analgesia using combination of ketamine-morphine than morphine in postoperative hysterectomy per laparotomy patients.

  13. Effects of xylazine-ketamine anesthesia on plasma levels of cortisol and vital signs during laparotomy in dogs

    Directory of Open Access Journals (Sweden)

    H. Naddaf

    2014-09-01

    Full Text Available This study was designed to evaluate effects of xylazine-ketamine anesthesia on plasma levels of cortisol and vital signs during and after laparotomy in dogs. Eight clinically healthy, adult male dogs, weighing 20 kg were used. All dogs were initially sedated by acepromazine. Thirty minutes later, ketamine plus xylazine was used to induce anesthesia. Surgical incision of laparotomy was done. After a 5 min manipulation of the abdominal organs, the incision was sutured. Vital signs including heart rate, respiratory rate and rectal temperature (RT were recorded at the times of -30: premedication, 0: induction and Surgical incision, 30: End of surgery, 60, 90 and 120 min. Blood was sampled at the above mentioned times and analyzed using a commercial ELISA kit for cortisol. A significant decreasing trend in RT was observed during the studied times. No significant changes were observed in heart rate and respiratory rate (p>0.05, except at the time of 60 respiratory rate significantly decreased when compared to the time of 90 (p=0.026 and 120 (p=0.041. A non-significant but increasing trend in plasma levels of cortisol was observed.

  14. Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass

    Science.gov (United States)

    Sussenbach, Samanta Pereira; Silva, Everton Nunes; Pufal, Milene Amarante; Casagrande, Daniela Shan; Padoin, Alexandre Vontobel; Mottin, Cláudio Corá

    2014-01-01

    Background Because of the high prevalence of obesity, there is a growing demand for bariatric surgery worldwide. The objective of this systematic review was to analyze the difference in relation to cost-effectiveness of access route by laparoscopy versus laparotomy of Roux en-Y gastric bypass (RYGB). Methods A systematic review was conducted in the electronic databases MEDLINE, Embase, Scopus, Cochrane and Lilacs in order to identify economic evaluation studies that compare the cost-effectiveness of laparoscopic and laparotomic routes in RYGB. Results In a total of 494 articles, only 6 fulfilled the eligibility criteria. All studies were published between 2001 and 2008 in the United States (USA). Three studies fulfilled less than half of the items that evaluated the results quality; two satisfied 5 of the required items, and only 1 study fulfilled 7 of 10 items. The economic evaluation of studies alternated between cost-effectiveness and cost-consequence. Five studies considered the surgery by laparoscopy the dominant strategy, because it showed greater clinical benefit (less probability of post-surgical complications, less hospitalization time) and lower total cost. Conclusion This review indicates that laparoscopy is a safe and well-tolerated technique, despite the costs of surgery being higher when compared with laparotomy. However, the additional costs are compensated by the lower probability of complications after surgery and, consequently, avoiding their costs. PMID:24945704

  15. RESULTS OF SECOND-LOOK LAPAROTOMY WITH EXTENSIVE DISSECTION OF RETROPERITONEAL LYMPH NODE IN OVARIAN CANCER PATIENTS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To evaluate retrospectively the results of extensive lymphadenectomy during second-look laparotomy on patients with ovarian cancer. Methods: A total of 63 patients with ovarian malignancies received second-look laparotomy (SLL). Retroperitoneal lymph nodes, including pelvic and para-aortic lymph nodes below the level of left renal vein, were extensively dissected. Results: Of the 63 patients, residual tumor was found in 24 (38.0%) on SLL. The frequency of residual tumor was positively correlated with the clinical stage and with the amount of tumor left after initial debulking but not with degree of differentiation of tumor cells. Lymph node metastasis(LNM) was pathologically confirmed in 19 cases (30.2%), of which no residual tumor was found in 8 patients. Tumor recurred in only 4 of the 39 patients (10.3%) with negative SLL. The overall 3- and 5-year survival rate were 75.0% and 68.0%, respectively. Conclusion: Extensive retroperitoneal lymph node dissection was recommended during SLL. It favored a decrease in recurrence rate in ovarian cancer patients negative on SLL.

  16. Rectosigmoid gallstone coleus: a rare emergency presentation.

    Science.gov (United States)

    Ball, William Robert; Elshaieb, Mohamed; Hershman, Michael Jeremy

    2013-11-12

    An elderly woman presented with abdominal pain and vomiting, was known to have gallstones. A CT scan was arranged identifying gallstone ileus and cholecystitis. Ensuing sepsis precipitated fast atrial fibrillation delaying the planned laparotomy. Her symptoms subsequently resolved with conservative management. Ten days following admission her abdomen became distended. A repeat CT scan showed large bowel dilation with intramural air suggestive of obstruction and bowel ischaemia. Emergency laparotomy was performed identifying a large 23 mm gallstone impacted at the rectosigmoid junction (gallstone coleus). The stone was milked back to the transverse colon where it was retrieved and a transverse loop colostomy was formed. Gallstone ileus is rare; gallstone coleus is even rarer. On review of the published literature both entities have not been seen in the same patient during the same admission or indeed caused by the same gallstone.

  17. Gonococcal peritonitis diagnosed post laparotomy in a 38-year-old woman: a case report

    OpenAIRE

    Wilmore, Stephanie MS; Reynolds, Carl J

    2009-01-01

    A 38-year-old South African lady with a background history of cervical intra-epithelial neoplasia and recent colposcopy presented to the emergency department with severe abdominal pain. Initial investigations were non-diagnostic and despite empirical antibiotic therapy the patient developed peritonism. Post-laprotomy the diagnosis of severe pelvic inflammatory disease and peritonitis secondary to infection with Neisseria Gonorrhoea was made.

  18. Gonococcal peritonitis diagnosed post laparotomy in a 38-year-old woman: a case report.

    Science.gov (United States)

    Wilmore, Stephanie Ms; Reynolds, Carl J

    2009-09-01

    A 38-year-old South African lady with a background history of cervical intra-epithelial neoplasia and recent colposcopy presented to the emergency department with severe abdominal pain. Initial investigations were non-diagnostic and despite empirical antibiotic therapy the patient developed peritonism. Post-laprotomy the diagnosis of severe pelvic inflammatory disease and peritonitis secondary to infection with Neisseria Gonorrhoea was made.

  19. Effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. A randomized, placebo controlled pilot study

    Directory of Open Access Journals (Sweden)

    Jusset Teresa García-Navia

    2016-01-01

    Full Text Available Background and goal of study: there is evidence that perioperative intravenous ketamine and lidocaine reduce postoperative pain, postoperative opioids consumption, shortens hospital stay and accelerates intestinal function recovery. However, it has not been studied the beneficial effects in the intraoperative period. The aim of this study was to evaluate the effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. Materials and methods: we performed a single-centre, prospective, randomized, double-blinded, placebo-controlled study. We included 33 patients (11 in the ketamine group, 11 in the lidocaine group and 11 in the placebo group. Postoperative analgesia was accomplished by patient-controlled morphine. Patients were randomly assigned to receive either a 1.5 mg/kg of 2% lidocaine, 0.5 mg/kg of 5% ketamine or 0.9% saline bolus. The primary outcome was the opioids consumption during surgery. The secondary outcomes included: emergence time, pain scores, opioids consumption within 24 h after surgery and side effects. Results: decreased intraoperative opioids requirements were noted in the experimental groups (ketamine: 402.3 } 106.3 and lidocaine: 397.7 } 107.5, compared with saline: 561.4 } 97.1; p = 0.001. We found a positive correlation between intraoperative opioids consumption and emergence time (r = 0.864, p < 0.001. There was no significant difference between the groups in VAS pain scores at rest within the first 24 postoperative hours. Total morphine consumption within 24 h after surgery did not differ significantly among the groups (placebo: 27.54 } 11.75; ketamine: 30.95 } 7.88; lidocaine 34.77 } 10.25; p = 0.26. Postoperative nausea and vomiting were more common in placebo group (it was observed in 3 subjects in ketamine group, in 5 subjects in lidocaine group and in 9 subjects in placebo group; p = 0

  20. Effective Municipal Emergency Planning for People With Disabilities and Others With Access and Functional Needs

    Science.gov (United States)

    2012-09-01

    LIST OF ACRONYMS AND ABBREVIATIONS ADA Americans with Disabilities Act AFN Access and Functional Needs CEMA California Emergency Management...Needs Support Services (“FNSS”), planning against risks identified in the City.”46 Additionally, the California Emergency Management Agency ( CEMA

  1. McArthur-Bates Communicative Development Inventory (CDI: Proposal of an abbreviate version

    Directory of Open Access Journals (Sweden)

    Chamarrita Farkas Klein

    2011-01-01

    Full Text Available The McArthur-Bates Communicative Development Inventories (CDI assesses language development en children, through a significant caregiver report. The first inventory assesses verbal and non verbal language in infants who are from 8 to 18 months old and it is composed of 949 items distributed in 6 scales. This study proposes an abbreviate form of this instrument, and was tested on families and educators of 130 Chilean children of 11-15 months old. Analyses related to the items, reliability and validity of the instrument and factorial analyses of subscales were realized. The abbreviate version consider 241 items distributed in 4 scales. The evaluation of the psychometric properties of the instrument was acceptable, demonstrating adequate reliability and validity.

  2. A woman presenting with postabortal pyomyoma and treated with exploratory laparotomy with myomectomy and fistulectomy: a case report

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    Saravanan M. Rajalakshmi

    2016-10-01

    Full Text Available Pyomyoma (suppurative leiomyoma of the uterus is a rare condition resulting from infarction and infection of a leiomyoma. It is more usual in pregnant women or postmenopausal women who have vascular disease. The condition is usually fatal unless treated with appropriate antibiotics and surgical intervention. We report a case of a 42-year-old woman who presented with abdominal pain and lump abdomen for 6 months with fever over a period of one month with anaemia for which she was readmitted. She had a history of incomplete abortion with fibroid with red degeneration for which check evacuation was done one and half months before readmission. During the course of treatment in hospital she developed an umbilical fistula with continuous drainage of pus. Her clinical presentation proved to be a diagnostic dilemma mimicking other clinical entities including Tuberculosis and ovarian cancer. Her blood culture and urine culture were sterile. She was widal (dilution positive and Mantoux negative. Her pus culture from umbilical wound and vaginal swab culture revealed growth of E- coli sensitive to gentamicin and amoxicillin clavulanic acid. An ultrasound scan suggested uterine fibroid with mixed echogenic collection in pelvic cavity with fistulous communication to the umbilicus, but a Magnetic resonance imaging scan suggested a big mass that appeared heterogeneous with fluid filled areas in posterior wall. She was treated with several courses of antibiotics and finally had to undergo laparotomy. During laparotomy, it was found that a large pyomyoma came into view which was successfully removed followed by fistulectomy by surgeon. The patient had uneventful recovery till discharge from hospital. The diagnosis of pyomyoma should be considered in perimenopausal women with large fibroids and pyrexia of unknown origin. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3626-3629

  3. Financial reporting by small companies in the UK: the demand for abbreviated accounts

    OpenAIRE

    Collis, Jill

    2003-01-01

    The aim of the study is to provide generalisble evidence of the utility of the statutory financial statements of small companies to the directors. It took the form of a postal questionnaire survey of the directors of a tranche of 385 companies meeting the EC size criteria for a small company. This paper focuses on the factors that influence the filing choices of the directors of these small companies and the demand for abbreviated accounts.

  4. Abbreviated epitaxial growth mode (AGM) method for reducing cost and improving quality of LEDs and lasers

    Science.gov (United States)

    Tansu, Nelson; Chan, Helen M; Vinci, Richard P; Ee, Yik-Khoon; Biser, Jeffrey

    2013-09-24

    The use of an abbreviated GaN growth mode on nano-patterned AGOG sapphire substrates, which utilizes a process of using 15 nm low temperature GaN buffer and bypassing etch-back and recovery processes during epitaxy, enables the growth of high-quality GaN template on nano-patterned AGOG sapphire. The GaN template grown on nano-patterned AGOG sapphire by employing abbreviated growth mode has two orders of magnitude lower threading dislocation density than that of conventional GaN template grown on planar sapphire. The use of abbreviated growth mode also leads to significant reduction in cost of the epitaxy. The growths and characteristics of InGaN quantum wells (QWs) light emitting diodes (LEDs) on both templates were compared. The InGaN QWs LEDs grown on the nano-patterned AGOG sapphire demonstrated at least a 24% enhancement of output power enhancement over that of LEDs grown on conventional GaN templates.

  5. Abbreviated epitaxial growth mode (AGM) method for reducing cost and improving quality of LEDs and lasers

    Energy Technology Data Exchange (ETDEWEB)

    Tansu, Nelson; Chan, Helen M; Vinci, Richard P; Ee, Yik-Khoon; Biser, Jeffrey

    2013-09-24

    The use of an abbreviated GaN growth mode on nano-patterned AGOG sapphire substrates, which utilizes a process of using 15 nm low temperature GaN buffer and bypassing etch-back and recovery processes during epitaxy, enables the growth of high-quality GaN template on nano-patterned AGOG sapphire. The GaN template grown on nano-patterned AGOG sapphire by employing abbreviated growth mode has two orders of magnitude lower threading dislocation density than that of conventional GaN template grown on planar sapphire. The use of abbreviated growth mode also leads to significant reduction in cost of the epitaxy. The growths and characteristics of InGaN quantum wells (QWs) light emitting diodes (LEDs) on both templates were compared. The InGaN QWs LEDs grown on the nano-patterned AGOG sapphire demonstrated at least a 24% enhancement of output power enhancement over that of LEDs grown on conventional GaN templates.

  6. An Investigation into the Impact of Abbreviated Didactic Texting on Language Learning

    Directory of Open Access Journals (Sweden)

    Seyyed Reza Mousavinia

    2014-03-01

    Full Text Available This study aimed to investigate whether application of abbreviations in instructional texting (SMS plays any role in promoting students’ performance in learning English through reducing distance and language anxiety. Parallel with examining elliptical features and abbreviations in creating SMS advertisements for addressing their special customers around the world with informal style, to borrow some of the features for the compass of language teaching, 120 participants in two groups at Isfahan university of technology were presented with the same type of content, namely, English grammar notes. They used directions with different lexemes and grammars. To compare the participants’ grammar learning, t-test was run. Results indicated that the difference between the performance of learners of the groups was statistically significant. Analyses showed that the didactic SMS with abbreviations and elliptical forms was significantly more effective than the SMS without such features in reducing learners’ anxiety, thereby enhancing their language learning. The findings of this study can have implications for both designing texting for advertisements and didactic SMS.

  7. BUSINESS ENGLISH OUTSIDE THE BOX. BUSINESS JARGON AND ABBREVIATIONS IN BUSINESS COMMUNICATION

    Directory of Open Access Journals (Sweden)

    Pop Anamaria-Mirabela

    2014-12-01

    Full Text Available Business English is commonly understood language, yet Harvard Business Review called business jargon “The Silent Killer of Big Companies”. As we all have been taught in school, we are aware of the fact that in communication we must comply with linguistic rules so that our message gets across succinctly. Yet, there is one place where all these rules can be omitted (at least in the recent decades: the corporate office. Here, one can use euphemisms and clichés, can capitalize any word that is considered important, the passive voice is used wherever possible and abbreviations occur in every sentence. The worst part is that all of these linguistic enormities are carried out deliberately. The purpose of this paper is to analyse to what extent business jargon and abbreviations have affected business communication (which most of the time, it is filled with opaque language to mask different activities and operations and the reasons for which these linguistic phenomena have become so successful in the present. One of the reasons for the research is that in business English, jargon can be annoying because it overcomplicates. It is frequently unnecessary and it can transform a simple idea or instruction into something very confusing. It is true that every field has its jargon. Education, journalism, law, politics, medicine, urban planning – no filed is immune. Yet, it seems that business jargon has been described as “the most annoying”. Another reason is that jargon tends to be elitist. Those who do not understand the terms feel confused and uncertain. The paper starts with defining these two concepts, business jargon and abbreviations, and then it attempts to explain the “unusual” pervasion of these, both in business communication and in everyday communication. For this, the paper includes a list with the most common business jargon and abbreviations. In this view, the authors have accessed different economic blogs and specialty journals

  8. Molecular mechanisms underlying postoperative peritoneal tumor dissemination may differ between a laparotomy and carbon dioxide pneumoperitoneum: a syngeneic mouse model with controlled respiratory support.

    Science.gov (United States)

    Matsuzaki, Sachiko; Bourdel, Nicolas; Darcha, Claude; Déchelotte, Pierre J; Bazin, Jean-Etienne; Pouly, Jean-Luc; Mage, Gérard; Canis, Michel

    2009-04-01

    The mechanisms promoting postoperative peritoneal tumor dissemination are unclear. This study aimed to investigate postoperative tumor dissemination over time on both tissue and molecular levels. For this study, C57BL6 mice were randomized into four groups: anesthesia alone (control), carbon dioxide (CO(2)) pneumoperitoneum at low (2 mmHg) or high (8 mmHg) intraperitoneal pressure (IPP), and laparotomy. A mouse ovarian cancer cell line (ID8) was injected intraperitoneally just before surgery. The groups were further subdivided into three groups, and a laparotomy was performed to evaluate tumor dissemination on postoperative day (POD) 7, 14, or 42. The incidence of cancer cell invasion into the muscle layers of the abdominal wall was significantly higher in the laparotomy and high-IPP groups than in the low-IPP and control groups on PODs 7 and 42. Expression levels of beta 1 integrin, cMet, urokinase-type plasminogen activator (uPA), urokinase-type plasminogen activator receptor (uPAR), and type-1 plasminogen activator inhibitor (PAI-1) mRNA in the disseminated nodules were not significantly different among the four groups on POD 7. However, the expression levels of all these genes in the disseminated nodules in the laparotomy group were significantly higher on POD 14 than on POD 7. They then returned to control levels on POD 42. There were no significant differences in the expression levels of any of these genes among the groups on POD 42. The current study suggests that the molecular mechanisms underlying postoperative peritoneal tumor dissemination may differ between a laparotomy and CO(2) pneumoperitoneum. Therefore, strategies targeting postoperative tumor dissemination likely will need to account for the surgical environment.

  9. Late radiation injuries of the gastrointestinal tract in the H2 and H5 EORTC Hodgkin's disease trials: emphasis on the role of exploratory laparotomy and fractionation.

    Science.gov (United States)

    Cosset, J M; Henry-Amar, M; Burgers, J M; Noordijk, E M; Van der Werf-Messing, B; Meerwaldt, J H; van der Schueren, E

    1988-09-01

    Out of 516 patients who entered in the two successive EORTC trials H2 and H5 for supra-diaphragmatic stages I and II Hodgkin's disease (HD), and who received an infra-diaphragmatic irradiation, 36 (7%) developed late radiation injuries of the gastrointestinal tract (GIT). Twenty-five patients presented with ulcers (stomach or duodenum), 2 with severe gastritis, 6 with small bowel obstruction or perforation and 3 patients had both an ulcer and bowel obstruction. A previous laparotomy played an important role. While the complication rate was 2.7% without any previous abdominal surgery, it was 11.5% after laparotomy (p less than 0.001). Fractionation was also found to be of importance in the occurrence of complications: three different weekly schedules were used -5 x 2 Gy, 4 x 2.5 Gy and 3 x 3.3 Gy; the GIT complication rates were 4, 9 and 22%, respectively (p less than 0.001). When combining laparotomy and fractionation, we found that the patients who were treated using 5 weekly fractions of 2 Gy without any prior laparotomy had a very low rate of late digestive complications (1%), whereas the patients who received 3 weekly fractions of 3.3 Gy after laparotomy presented a 39% complication rate. The other subgroups of patients were at an intermediate risk (from 5 to 13%) of late digestive injuries. Since most patients received 40 Gy with only very small variations, the influence of the radiation dose could not be investigated.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Use of laparotomy in a staged approach for resolution of bilateral or complicated perineal hernia in 41 dogs.

    Science.gov (United States)

    Brissot, Hervé N; Dupré, Gilles P; Bouvy, Bernard M

    2004-01-01

    To evaluate the value of laparotomy as the initial step in the treatment of bilateral or complicated perineal hernia (PH) in dogs. Retrospective study. Forty-one dogs with PH. Dogs with bilateral or complicated PH treated by a 2-step approach between November 1997 and December 2001 were studied. Inclusion criteria for complicated PH were: recurrence of PH, unilateral PH with a major rectal dilatation, PH with a concurrent surgical prostatic disease, and PH with retroflexed bladder. Colopexy, vas deferens pexy, cystopexy, and prostatic omentalization were performed during laparotomy as needed. Later, PH was performed by internal obturator muscle flap (IOMF) or if there was a perineal rent or weakness on the contralateral side, appositional herniorrhaphy was performed. Outcome was followed for >/=6 months. PH were bilateral (20 dogs) or unilateral (21). Twenty-one (51%) dogs had prostatic disease (clinical or ultrasonography diagnosis; 17 confirmed histologically) and 12 (29%) had urinary bladder retroflexion. Forty-one colopexies, 32 vas deferens pexies, 6 cystopexies, and 9 prostatic surgeries (omentalization or perineal cyst resection) were performed. PH was performed 2-20 days (median, 6 days) later: 61 IOMF transpositions, 13 appositional. Mean follow-up time was 26.6 months (range, 6-54 months, median, 27 months). PH was resolved in 37 (90%) dogs; 4 dogs had recurrence, and all occurred within 6 months. Thirty-eight (92%) dogs had an improved quality of life (good in 34 dogs, fair in 4 dogs). Wound complications occurred in 7 dogs (17%). Postoperative urine dribbling occurred in 15 dogs (37%) and was irreversible in 7 dogs (17%). Postoperative fecal straining persisted in 18 dogs (44%), and was permanent in 4 dogs (10%). Fecal incontinence did not occur. In bilateral or complicated PH, fixation of the urinary bladder and colon, and treatment of prostatic disease increase the chances of resolution. Emptying of the perineal space by organ pexy allows improved

  11. Local and systemic chemotherapy with taurolidine and taurolidine/heparin in colon cancer-bearing rats undergoing laparotomy.

    Science.gov (United States)

    Braumann, Chris; Ordemann, Jürgen; Kilian, Maik; Wenger, Frank A; Jacobi, Christoph A

    2003-01-01

    Experimental studies in the therapy of malignant abdominal tumors have shown that different cytotoxic agents suppress the intraperitoneal tumor growth. Nevertheless, a general accepted approach to prevent tumor recurrences does not exist. Following subcutaneous and intraperitoneal injection of 10(4) colon adenocarcinoma cells (DHD/K12/TRb), the influences of both taurolidine or taurolidine/heparin on intraperitoneal and subcutaneous tumor growth was investigated in 105 rats undergoing midline laparotomy. The animals were randomized into 7 groups and operated on during 30 min. To investigate the intraperitoneal (local) influence of either taurolidine or heparin on tumor growth, the substances were applied intraperitoneally. Systemic and intraperitoneal effects were evaluated after intravenous injection of the substances. Both application forms were also combined to analyze synergistic effects. Tumor weights, as well as the incidence of abdominal wound metastases, were determined four weeks after the intervention. In order to evaluate the effects of the agents, blood was taken to determine the peripheral leukocytes counts. Intraperitoneal tumor growth in rats receiving intraperitoneal application of taurolidine (median 7.0 mg, P = 0.05) and of taurolidine/heparin (median 0 mg, P = 0.02) was significantly reduced when compared to the control group (median 185 mg). The simultaneous instillation of both agents also reduced the intraperitoneal tumor growth (median 4 mg, P = 0.04), while the intravenous injection of the substances caused no local effect. In contrast, the subcutaneous tumor growth did not differ among all groups. In all groups, abdominal wound recurrences were rare and did not differ. Independent of the agents and the application form, the operation itself caused a slight leukopenia shortly after the operation and a leukocytosis in the following course. Intraperitoneal therapy of either taurolidine or in combination with heparin inhibits local tumor growth

  12. Lung Emergencies

    Science.gov (United States)

    ... Emergencies Cardiac Emergencies Eye Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at ... should be considered an emergency. Symptoms of sudden lung collapse (pneumothorax) Symptoms of a sudden lung collapse ...

  13. Trichobezoar - A hair-raising surgical emergency

    Directory of Open Access Journals (Sweden)

    Elizabeth Tan

    2017-06-01

    Full Text Available A trichobezoar is a mass of undigested hair in the proximal gastrointestinal tract. It is a rare condition seen in young females with psychiatric disorders of trichotillomania and trichophagia or mental retardation. We present a case of an intellectually impaired 14-year-old girl with a gastric trichobezoar discovered during an emergency laparotomy. We will discuss the limited but salient findings on history and examination. Through a review of the literature, imaging modalities and treatment options for the early versus late stage of trichobezoar presentations will be identified. Through our case, subsequent holistic management will also be highlighted to prevent recurrence.

  14. Abbreviations, acronyms, and initialisms frequently used by Martin Marietta Energy Systems, Inc.. Second edition

    Energy Technology Data Exchange (ETDEWEB)

    Miller, J.T.

    1994-09-01

    Guidelines are given for using abbreviations, acronyms, and initialisms (AAIs) in documents prepared by US Department of Energy facilities managed by Martin Marietta Energy Systems, Inc., in Oak Ridge, Tennessee. The more than 10,000 AAIs listed represent only a small portion of those found in recent documents prepared by contributing editors of the Information Management Services organization of Oak Ridge National Laboratory, the Oak Ridge K-25 Site, and the Oak Ridge Y-12 Plant. This document expands on AAIs listed in the Document Preparation Guide and is intended as a companion document

  15. An abbreviated version of the brief assessment of cognition in schizophrenia (BACS

    Directory of Open Access Journals (Sweden)

    MD Yasuhiro Kaneda

    2015-06-01

    Full Text Available Background and Objectives: A short version of the Brief Assessment of Cognition in Schizophrenia (BACS was derived. Methods: We calculated the corrected item-total correlation (CITC for each test score relative to the composite score, and then computed the proportion of variance that each test shares with the global score excluding that test (Rt² = CITCt² and the variance explained per minute of administration time for each test (Rt²/mint. Results and Conclusions: The 3 tests with the highest Rt²/mint, Symbol Coding, Digit Sequencing, and Token Motor, were selected for the Abbreviated BACS.

  16. Attenuation by phentolamine of hypoxia and levcromakalim-induced abbreviation of the cardiac action potential.

    OpenAIRE

    Tweedie, D.; Boachie-Anash, G.; Henderson, C. G.; Kane, K. A.

    1993-01-01

    1. The effects of phentolamine (5-30 microM) and glibenclamide (10 microM) on action potential characteristics were examined in guinea-pig papillary muscle exposed to either hypoxia or levcromakalim (20 microM). 2. The hypoxia-induced abbreviation of action potential duration (APD) and effective refractory period (ERP) were attenuated but not abolished by glibenclamide (10 microM). Hypoxia reduced APD by 24 +/- 2 vs 65 +/- 4% in glibenclamide- and vehicle-treated tissue, respectively. 3. Phen...

  17. Perioperative Systemic Inflammatory Response following Robot-Assisted Laparoscopic Cystectomy vs. Open Mini-Laparotomy Cystectomy: A Prospective Study.

    Science.gov (United States)

    Skjold Kingo, Pernille; Palmfeldt, Johan; Nørregaard, Rikke; Borre, Michael; Jensen, Jørgen Bjerggaard

    2017-07-01

    Surgeries, such as radical cystectomy (RC), induce a systemic inflammatory response (SIR). SIR plays an important role in controlling the human immune system. This study aims at comparing the SIR in robot-assisted laparoscopic cystectomy (RALC) to open mini-laparotomy cystectomy (OMC) with a urinary diversion (UD). Comparison was based on immunologic markers of SIR, thus quantifying the degree of tissue trauma. Forty-two male patients underwent RC with an ileal conduit. Either OMC RC (OMC; n = 20), RALC with extracorporeal UD (RALC-EUD; n = 13), or RALC with intracorporeal UD (RALC-IUD; n = 9) was performed. Blood samples were obtained preoperatively (PREOP), immediately after surgery (POD0), 24 (POD1) and 48 h (POD2) postoperatively. Clinical parameters were collected from medical records. Estimated blood loss and blood transfusion volume was higher in OMC (p's OMC (p = 0.016). IL-10 level was higher at POD0 (p = 0.029) and POD1 (p = 0.038) in OMC vs. RALC-EUD. MCP-1 levels for RALC-IUD were significantly lower compared to RALC-EUD (p = 0.027). This study found that postoperative SIR was overall less pronounced in RALC, thus depicting reduced tissue trauma. No major clinical differences between RALC-IUD and -EUD were found. © 2017 S. Karger AG, Basel.

  18. The impact of listening to music on analgesic use and length of hospital stay while recovering from laparotomy.

    Science.gov (United States)

    Vaajoki, Anne; Kankkunen, Päivi; Pietilä, Anna-Maija; Kokki, Hannu; Vehviläinen-Julkunen, Katri

    2012-01-01

    Postoperative pain management is based on the use of analgesics; however, music may alleviate pain either by direct analgesic effects or by relaxing and distracting the mind from pain and unpleasant feelings. Conflicting results have been presented about how listening to music affects analgesic use and length of hospital stay after surgery. We assessed the effect of music listening on analgesic use, length of hospital stay, and adverse effects in adult patients having laparotomy, using a prospective design with two parallel groups. Patients undergoing elective abdominal surgery (n = 168) were assigned to either a music group (n = 83) operated on odd weeks or a control group (n = 85) operated on even weeks. The music group listened to music 7 times for 30 minutes at a time during the first 3 postoperative days. The control group did not listen to the music. The hypotheses that patients in the music group will need less analgesic, have a shorter length of hospital stay, and experience less adverse effects than those in the control group were not supported by the data, although patients recovering from surgery enjoyed listening to music. Music listening may enhance quality of hospital stay and recovery in patients undergoing major abdominal surgery and could be a useful tool to relieve the patient's pain experience.

  19. Acceptance and commitment therapy for chronic pain: evidence of mediation and clinically significant change following an abbreviated interdisciplinary program of rehabilitation.

    Science.gov (United States)

    Vowles, Kevin E; Witkiewitz, Katie; Sowden, Gail; Ashworth, Julie

    2014-01-01

    There is an emerging body of evidence regarding interdisciplinary acceptance and commitment therapy in the rehabilitative treatment of chronic pain. This study evaluated the reliability and clinical significance of change following an open trial that was briefer than that examined in previous work. In addition, the possible mediating effect of psychological flexibility, which is theorized to underlie the acceptance and commitment therapy model, was examined. Participants included 117 completers of an interdisciplinary program of rehabilitation for chronic pain. Assessment took place at treatment onset and conclusion, and at a 3-month follow-up when 78 patients (66.7%) provided data. At the 3-month follow-up, 46.2% of patients achieved clinically significant change, and 58.9% achieved reliable change, in at least 1 key measure of functioning (depression, pain anxiety, and disability). Changes in measures of psychological flexibility significantly mediated changes in disability, depression, pain-related anxiety, number of medical visits, and the number of classes of prescribed analgesics. These results add to the growing body of evidence supporting interdisciplinary acceptance and commitment therapy for chronic pain, particularly with regard to the clinical significance of an abbreviated course of treatment. Further, improvements appear to be mediated by changes in the processes specified within the theoretical model. Outcomes of an abbreviated interdisciplinary treatment for chronic pain based on a particular theoretical model are presented. Analyses indicated that improvements at follow-up mediated change in the theorized treatment process. Clinically significant change was indicated in just under half of participants. These data may be helpful to clinicians and researchers interested in intervention approaches and mechanisms of change. Copyright © 2014 American Pain Society. All rights reserved.

  20. Development of Abbreviated Eight-Item Form of the Penn Verbal Reasoning Test

    Science.gov (United States)

    Bilker, Warren B.; Wierzbicki, Michael R.; Brensinger, Colleen M.; Gur, Raquel E.; Gur, Ruben C.

    2014-01-01

    The ability to reason with language is a highly valued cognitive capacity that correlates with IQ measures and is sensitive to damage in language areas. The Penn Verbal Reasoning Test (PVRT) is a 29-item computerized test for measuring abstract analogical reasoning abilities using language. The full test can take over half an hour to administer, which limits its applicability in large-scale studies. We previously described a procedure for abbreviating a clinical rating scale and a modified procedure for reducing tests with a large number of items. Here we describe the application of the modified method to reducing the number of items in the PVRT to a parsimonious subset of items that accurately predicts the total score. As in our previous reduction studies, a split sample is used for model fitting and validation, with cross-validation to verify results. We find that an 8-item scale predicts the total 29-item score well, achieving a correlation of .9145 for the reduced form for the model fitting sample and .8952 for the validation sample. The results indicate that a drastically abbreviated version, which cuts administration time by more than 70%, can be safely administered as a predictor of PVRT performance. PMID:24577310

  1. [A study on the abbreviated form of the Eysenck Personality Questionnaire Revised-Abbreviated (EPQR-A) in a student population].

    Science.gov (United States)

    Bouvard, M; Aulard-Jaccod, J; Pessonneaux, S; Hautekeete, M; Rogé, B

    2010-12-01

    The aim of this paper is to examine the short questionnaire of the Eysenck Personality Questionnaire Revised (the Eysenck Personality Questionnaire Revised-Abbreviated [EPQR-A]) among a student population. University students were invited, in groups, to fill in the forms proposed. Three sites were compared, representing a sample of 346 participants (Chambéry=118 subjects [44 males and 74 females]; Lille=110 subjects [50 males and 60 females] and Toulouse=118 subjects [60 males and 58 females]). The three groups of students have comparable scores on the EPQR-A wherever they live (Chambéry, Lille or Toulouse). Moreover, neither the age nor the gender allowed the detection of differences between subjects. Our sample of students is situated in the range of a "normal" group of students. Regarding the internal consistency coefficients, the French version we used of the neuroticism and the extraversion scales of the EPQR-A obtained a satisfactory result. The internal consistency coefficient of psychoticism was rather low (<70). This unsatisfactory level of internal reliability for the psychoticism is also found in the English version [7]. The four-factor model of the EPQR-A is judged to be an adequate explanation of the data. In the end, self-esteem correlated positively with extraversion and negatively with neuroticism. On the other hand, there is no link between psychoticism and self-esteem.

  2. Effects of SK-896, a new human motilin analogue ([Leu13]motilin-Hse), on postoperative ileus in dogs after laparotomy.

    Science.gov (United States)

    Furuta, Yoshiyuki; Takeda, Motohiro; Nakayama, Yukiharu; Ito, Mikio; Suzuki, Yoshio

    2002-08-01

    The effects of SK-896, a new human motilin analogue ([Leu13]motilin-Hse), on digestive tract motility in postoperative ileus were evaluated in a dog model of ileus after laparotomy. SK-896 was intravenously administered at 0.17, 0.33 and 0.67 microg/kg starting soon after operation and then at 6-h intervals, for a total of 9 times. SK-896 progressively, dose-dependently and significantly increased the duodenal motility from 1 h after operation. The recovery time of the gastrointestinal-interdigestive migrating complex (GI-IMC) activity, which is an indicator of normal gastrointestinal tract activity after laparotomy, was 56.5 +/- 5.0 h in the control group. SK-896 significantly shortened this recovery time. On the other hand, the plasma SK-896 concentrations declined diexponentially after administration, and can be described by a linear pharmacokinetic model within the dose range used. In addition, the pharmacokinetics of SK-896 did not change significantly at any postoperative time. There was no correlation between the plasma SK-896 concentrations and the intensity of duodenal motility, because the activity in the duodenum decreased transiently 13 h after laparotomy and increased with time thereafter. The changes in the activity are considered to reflect the progressive changes in the state of ileus. In conclusion, SK-896 increased the duodenal motility significantly, shortening the recovery time of GI-IMC-like activity in dogs with post-laparotomy ileus. Therefore, it is expected from these results that SK-896 would be useful and effective for the treatment of gastroparalysis after abdominal surgery.

  3. Laparoscopy versus mini-laparotomy peritoneal catheter insertion of ventriculoperitoneal shunts: a systematic review and meta-analysis.

    Science.gov (United States)

    He, Mingliang; Ouyang, Leping; Wang, Shengwen; Zheng, Meiguang; Liu, Anmin

    2016-09-01

    OBJECTIVE Ventriculoperitoneal (VP) shunt treatment is the main treatment method for hydrocephalus. The traditional operative approach for peritoneal catheter insertion is mini-laparotomy. In recent years, laparoscopy-assisted insertion has become increasingly popular. It seems likely that use of an endoscope could lower the incidence of shunt malfunction. However, there is no consensus about the benefits of laparoscopy-assisted peritoneal catheter insertion. METHODS A systematic search was performed using the PubMed, Embase, ScienceDirect, and Cochrane Library databases. A manual search for reference lists was conducted. The protocol was prepared according to the interventional systematic reviews of the Cochrane Handbook, and the article was written on the basis of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. RESULTS Eleven observational trials and 2 randomized controlled trials were included. Seven operation-related outcome measures were analyzed, and 3 of these showed no difference between operative techniques. The results of the meta-analysis are as follows: in the laparoscopy group, the rate of distal shunt failure was lower (OR 0.41, 95% CI 0.25-0.67; p = 0.0003), the absolute effect is 7.11% for distal shunt failure, the number needed to treat is 14 (95% CI 8-23), operative time was shorter (mean difference [MD], -12.84; 95% CI -20.68 to -5.00; p = 0.001), and blood loss was less (MD -9.93, 95% CI -17.56 to -2.31; p = 0.01). In addition, a borderline statistically significant difference tending to laparoscopic technique was observed in terms of hospital stay (MD -1.77, 95% CI -3.67 to 0.13; p = 0.07). CONCLUSIONS To some extent, a laparoscopic insertion technique could yield a better prognosis, mainly because it is associated with a lower distal failure rate and shorter operative time, which would be clinically relevant.

  4. Quality of life and sexuality in disease-free survivors of cervical cancer after radical hysterectomy alone: A comparison between total laparoscopy and laparotomy.

    Science.gov (United States)

    Xiao, Meizhu; Gao, Huiqiao; Bai, Huimin; Zhang, Zhenyu

    2016-09-01

    The aim of the present study was to evaluate the possible differences between total laparoscopy and laparotomy regarding their impact on postoperative quality of life and sexuality in disease-free cervical cancer survivors who received radical hysterectomy (RH) and/or lymphadenectomy alone and were followed for >1 year.We reviewed all patients with cervical cancer who had received surgical treatment in our hospital between January 2001 and March 2014. Consecutive sexually active survivors who received RH and/or lymphadenectomy for early stage cervical cancer were enrolled and divided into 2 groups based on surgical approach. Survivors were interviewed and completed validated questionnaires, including the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items, the Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI).In total, 273 patients with histologically confirmed cervical cancer were retrospectively reviewed. However, only 64 patients had received RH and/or lymphadenectomy alone; 58 survivors meeting the inclusion criteria were enrolled, including 42 total laparoscopy cases and 16 laparotomy cases, with an average follow-up of 46.1 and 51.2 months, respectively. The survivors in the 2 groups obtained good and similar scores on all items of the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items and Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items, without significant differences after controlling for covariate background characteristics. To the date of submission, 21.4% (9/42) of cases in the total laparoscopy group and 31.2% (5/16) of cases in the laparotomy group had not resumed sexual behavior after RH. Additionally

  5. Abbreviated bibliography on energy development—A focus on the Rocky Mountain Region

    Science.gov (United States)

    Montag, Jessica M.; Willis, Carolyn J.; Glavin, Levi W.

    2011-01-01

    Energy development of all types continues to grow in the Rocky Mountain Region of the western United States. Federal resource managers increasingly need to balance energy demands, effects on the natural landscape and public perceptions towards these issues. To assist in efficient access to valuable information, this abbreviated bibliography provides citations to relevant information for myriad of issues for which resource managers must contend. The bibliography is organized by seven large topics with various sup-topics: broad energy topics (energy crisis, conservation, supply and demand, etc.); energy sources (fossil fuel, nuclear, renewable, etc.); natural landscape effects (climate change, ecosystem, mitigation, restoration, and reclamation, wildlife, water, etc.); human landscape effects (attitudes and perceptions, economics, community effects, health, Native Americans, etc.); research and technology; international research; and, methods and modeling. A large emphasis is placed on the natural and human landscape effects.

  6. Densitometric properties of rapid manual processing solutions: abbreviated versus complete rapid processing.

    Science.gov (United States)

    Geist, J R; Gleason, M J

    1995-04-01

    Rapid manual processing solutions produce wet, readable radiographs in 1 to 2 min. However, some manufacturers permit time reductions for various processing steps to obtain images even more quickly. Differences in densitometric characteristics and spatial resolution between abbreviated rapid processing (ARP) and complete rapid processing were examined in four rapid manual processing systems on D- and E-speed film. When compared with films processed conventionally in an automatic processor, films processed in rapid manual processing chemistries had more fog and generally lower levels of speed and contrast. ARP radiographs were excessively stained unless they were washed for at least 60 s after fixing. The most severe depreciation in ARP film quality occurred when developing time was reduced by 50%; the complete rapid processing developing time should always be used. E-speed films produced radiographs with comparable densitometric and resolution characteristics to D-speed films for ARP and complete rapid processing techniques while requiring 40% less radiation.

  7. Salvage of relapse of patients with Hodgkin's disease in clinical stages I or II who were staged with laparotomy and initially treated with radiotherapy alone. A report from the international database on Hodgkin's disease

    DEFF Research Database (Denmark)

    Specht, L; Horwich, A; Ashley, S

    1994-01-01

    To analyze presentation variables that might indicate a high or low likelihood of success of the treatment of patients relapsing after initial radiotherapy of Hodgkin's disease in clinical Stages I or II who were staged with laparotomy....

  8. Performance of an Abbreviated Version of the Lubben Social Network Scale among Three European Community-Dwelling Older Adult Populations

    Science.gov (United States)

    Lubben, James; Blozik, Eva; Gillmann, Gerhard; Iliffe, Steve; von Renteln-Kruse, Wolfgang; Beck, John C.; Stuck, Andreas E.

    2006-01-01

    Purpose: There is a need for valid and reliable short scales that can be used to assess social networks and social supports and to screen for social isolation in older persons. Design and Methods: The present study is a cross-national and cross-cultural evaluation of the performance of an abbreviated version of the Lubben Social Network Scale…

  9. Matching Element Symbols with State Abbreviations: A Fun Activity for Browsing the Periodic Table of Chemical Elements

    Science.gov (United States)

    Woelk, Klaus

    2009-01-01

    A classroom activity is presented in which students are challenged to find matches between the United States two-letter postal abbreviations for states and chemical element symbols. The activity aims to lessen negative apprehensions students might have when the periodic table of the elements with its more than 100 combinations of letters is first…

  10. Matching Element Symbols with State Abbreviations: A Fun Activity for Browsing the Periodic Table of Chemical Elements

    Science.gov (United States)

    Woelk, Klaus

    2009-01-01

    A classroom activity is presented in which students are challenged to find matches between the United States two-letter postal abbreviations for states and chemical element symbols. The activity aims to lessen negative apprehensions students might have when the periodic table of the elements with its more than 100 combinations of letters is first…

  11. 21 CFR 314.430 - Availability for public disclosure of data and information in an application or abbreviated...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Availability for public disclosure of data and... APPROVAL TO MARKET A NEW DRUG Miscellaneous Provisions § 314.430 Availability for public disclosure of data... acknowledged, no data or information in the application or abbreviated application is available for...

  12. The Revised Junior Eysenck Personality Questionnaire (JEPQ-R): Dutch replications of the full length, short, and abbreviated forms

    NARCIS (Netherlands)

    Scholte, R.H.J.; Bruyn, E.E.J. De

    2001-01-01

    This study examines the full-length, short and abbreviated forms of the Revised Junior Eysenck Personality Questionnaire (JEPQ-R) in a Dutch sample of 215 boys and 207 girls, aged 12–14. The reliability and concurrent validity of the scales of the full-length form (JEPQ-R, 81 items), short form (JEP

  13. 78 FR 60292 - Draft Guidance for Industry on Abbreviated New Drug Application Submissions-Refuse-to-Receive...

    Science.gov (United States)

    2013-10-01

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Abbreviated New Drug Application Submissions--Refuse-to-Receive Standards; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of a...

  14. Txt Msg N School Literacy: Does Texting and Knowledge of Text Abbreviations Adversely Affect Children's Literacy Attainment?

    Science.gov (United States)

    Plester, Beverly; Wood, Clare; Bell, Victoria

    2008-01-01

    This paper reports on two studies which investigated the relationship between children's texting behaviour, their knowledge of text abbreviations and their school attainment in written language skills. In Study One, 11-12-year-old children provided information on their texting behaviour. They were also asked to translate a standard English…

  15. Development of an Abbreviated Social Phobia and Anxiety Inventory (SPAI) Using Item Response Theory: The SPAI-23

    Science.gov (United States)

    Roberson-Nay, Roxann; Strong, David R.; Nay, William T.; Beidel, Deborah C.; Turner, Samuel M.

    2007-01-01

    An abbreviated version of the Social Phobia and Anxiety Inventory (SPAI) was developed using methods based in nonparametric item response theory. Participants included a nonclinical sample of 1,482 undergraduates (52% female, mean age = 19.4 years) as well as a clinical sample of 105 individuals (56% female, mean age = 36.4 years) diagnosed with…

  16. Effect of Ultrasound Guided Rectus Sheath Block on Postoperative Analgesia after Laparotomy with Transverse Incision in Children

    Directory of Open Access Journals (Sweden)

    Aydin Halefoglu

    2015-09-01

    Material and Methods: Forty patients with ASA I-II physical status, aged 3-7 years and undergoing laparotomy with transverse incision were randomly allocated into two groups. Patients were administered general anesthesia and before the beginning of surgery ultrasound guided RSB with 0.2 mL/kg, 0.25% of levobupivacaine and thirty minutes before the surgery the loading dose of morphine of 0.1 mg/kg intravenously were received in group RSB and group M, respectively. Analgesic drug pump with 0.01 mg/kg bolus doses of morphine and 30 minutes lockout interval was set up postoperatively in both groups. Concentrations (% and consumed amounts (mL/h of sevoflurane during the surgery and systolic and diastolic blood pressure, heart rate, and peripheral oxygen saturation values were recorded both intraoperative and postoperative period in each groups. Analgesic consumption with postoperative analgesic drug pump, FLACC pain scores, sedation level, nausea, vomiting, supplemental analgesic requirement and side effects were also recorded. Results: Demographic data and hemodynamic parameters were similar in both groups excepting that systolic arterial pressure values were reduced in group RSB than in group M. Inhaled concentration and consumed amounts of sevoflurane were decreased in group RSB compared with group M. Averages of consumptions of sevoflurane were 18.7+/-2.1 mL/h and 21.5 +/-2.9 mL/h in group RSB and group M, respectively (p<0.001. Postoperative FLACC scores, sedation scores, and morphine consumption for 24 hours were lower in group RSB than in group M (p<0.001. Three patients had nausea in group M, however no nausea and vomiting was observed in group RSB and any patients did not need supplemental analgesia postoperatively. Conclusions: Ultrasound guided RSB is superior to intravenous morphine according to intraoperative anesthetic gas consumption and postoperative pain control in children undergoing abdominal surgery using transverse incision. [Cukurova Med J 2015; 40

  17. Comparison between computed tomography with oral oil-based contrast and laparotomy for gastric cancer staging; Tomografia computerizada con contraste oral graso frente a lapartomia en la estadificacion del cancer gastrico

    Energy Technology Data Exchange (ETDEWEB)

    Marco, S. F.; Garcia-Vila, J. H.; Cervera, J.; Gomez, R.; Piqueras, R. M.; Perona, I.; Escrig, J.; Salvador, J. L. [Hospital General de Castello. Castellon (Spain)

    2000-07-01

    To compare the utility of conventional computed tomography (CT) with oral oil-based contrast with that of laparotomy in the preoperative staging of gastric cancer. We prospectively studied 41 patients diagnosed as having gastric adenocarcinoma according to the results of endoscopy and biopsy. Applying the TNM classification for gastric cancer staging, we compared the findings in CT associated with oral oil-based contrast and intraoperative staging with definitive postoperative pathological staging. Definitive pathological studies demonstrated that there were 7 stage T1-T2 lesions, 26 stage T3 and 8 stage T4. The assessment of lymph node involvement showed that 10 patients presented stage N0 and 31 stage N1-N3. Ten patients had metastases. The diagnostic reliability for tumor staging according to CT was 56% versus 80% for laparotomy. In the determination of nodal involvement CT had a diagnostic yield of 71% versus 6% for laparotomy. Metastatic disease was correctly diagnosed by CT in 83% of cases versus 88% by laparotomy. There were no statistically significant differences between CT with oral oil-based contrast and laparotomy for the staging of nodal involvement and metastases. However, the CT diagnosis was significantly more reliable than laparotomy for the determination of tumor infiltration. (Author) 21 refs.

  18. Diabetic Emergencies

    Science.gov (United States)

    ... Emergencies A-Z Share this! Home » Emergency 101 Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  19. Childhood Emergencies

    Science.gov (United States)

    ... emergency physicians. They receive comprehensive training in treating childhood emergencies and have more training in pediatric emergencies than other physicians, including pediatricians. Does Your Child's School Know About Food Allergies? - 8/10/2015 The nation's emergency physician ...

  20. Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs.

    Science.gov (United States)

    Birettoni, Francesco; Caivano, Domenico; Rishniw, Mark; Moretti, Giulia; Porciello, Francesco; Giorgi, Maria Elena; Crovace, Alberto; Bianchini, Erika; Bufalari, Antonello

    2017-02-14

    Migrating plant material is often suspected clinically to be the underlying cause of iliopsoas myositis in the dog, but cannot always be found pre- or intraoperatively. In most cases, recurrence of clinical signs is related to failure to remove the plant material. Preoperative ultrasonography can be useful to visualize migrating plant material and to determine anatomical landmarks that can assist in planning a surgical approach. The purpose of the present study was to report the role of intraoperative (intra-abdominal) ultrasonography for visualizing and removing the plant material from iliopsoas abscesses using a ventral midline laparotomy approach. A retrospective case series of 22 dogs with iliopsoas muscle abnormalities and suspected plant material was reported. Preoperative visualization and subsequent retrieval of the plant material was performed during a single hospitalization. In all 22 dogs, the plant material (including complete grass awns, grass awn fragments and a bramble twig) was successfully removed via ventral midline laparotomy in which intraoperative ultrasonography was used to direct the grasping forceps tips to the foreign body and guide its removal. In 11 of these 22 dogs, the plant material was not completely removed during prior surgery performed by the referring veterinarians without pre- or intraoperative ultrasonography. Clinical signs resolved in all dogs and all dogs resumed normal activity after successful surgical removal of the plant material. Intraoperative ultrasonography is a safe and readily available tool that improves success of surgical removal of plant material within the iliopsoas abscesses via ventral midline laparotomy. Moreover, ultrasonographic findings of unusual plant material can be useful in planning and guiding surgical removal, by providing information about the size and shape of the foreign body.

  1. Randomized comparison of polyglycolic acid and polyglyconate sutures for abdominal fascial closure after laparotomy in patients with suspected impaired wound healing

    DEFF Research Database (Denmark)

    Osther, P J; Gjøde, P; Mortensen, Sophie Berit Bondegaard

    1995-01-01

    A randomized study of abdominal fascial closure using interrupted polyglyconate and polyglycolic acid sutures after laparotomy was carried out in 204 consecutive patients with suspected impaired wound healing. There were no statistically significant differences between the two sutures with regard...... to the development of fascial disruption and incisional hernia. Wound infection demanding surgical intervention was found in 7 per cent of patients with polyglyconate sutures and in 16 per cent of those with polyglycolic acid sutures (P = 0.04). Monofilament polyglyconate suture does not reduce the incidence...

  2. Surgical management and outcome of blunt major liver injuries: experience of damage control laparotomy with perihepatic packing in one trauma centre.

    Science.gov (United States)

    Lin, Being-Chuan; Fang, Jen-Feng; Chen, Ray-Jade; Wong, Yon-Cheong; Hsu, Yu-Pao

    2014-01-01

    This retrospective study aimed to assess the clinical experience and outcome of damage control laparotomy with perihepatic packing in the management of blunt major liver injuries. From January 1998 to December 2006, 58 patients of blunt major liver injury, American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) equal or greater than III, were operated with perihepatic packing at our institute. Demographic data, intra-operative findings, operative procedures, adjunctive managements and outcome were reviewed. To determine whether there was statistical difference between the survivor and non-survivor groups, data were compared by using Mann-Whitney U test for continuous variables, either Pearson's chi-square test or with Yates continuity correction for contingency tables, and results were considered statistically significant if p<0.05. Of the 58 patients, 20 (35%) were classified as AAST-OIS grade III, 24 (41%) as grade IV, and 14 (24%) as grade V. At laparotomy, depending on the severity of injuries, all 58 patients underwent various liver-related procedures and perihepatic packing. The more frequent liver-related procedures included debridement hepatectomy (n=21), hepatorrhaphy (n=19), selective hepatic artery ligation (n=11) and 7 patients required post-laparotomy hepatic transarterial embolization. Of the 58 patients, 28 survived and 30 died with a 52% mortality rate. Of the 30 deaths, uncontrolled liver bleeding in 24-h caused 25 deaths and delayed sepsis caused residual 5 deaths. The mortality rate versus OIS was grade III: 30% (6/20), grade IV: 54% (13/24), and grade V: 79% (11/14), respectively. On univariate analysis, the significant predictors of mortality were OIS grade (p=0.019), prolonged initial prothrombin time (PT) (p=0.004), active partial thromboplastin time (APTT) (p<0.0001) and decreased platelet count (p=0.005). The mortality rate of surgical blunt major liver injuries remains high even with perihepatic packing. Since

  3. [Anesthetic management of exploratory laparotomy for a patient with panperitonitis with hyperkalemia: a case report of spontaneous rupture of the urinary bladder].

    Science.gov (United States)

    Kotani, Kohei; Takaki, Osamu

    2006-07-01

    A 71-year-old woman was admitted with panperitonitis, hyperkalemia and acute renal failure. Immediately after a large amount of ascites had been drained by laparotomy, hyperkalemia and acidosis were remarkably improved. During the operation, rupture of the urinary bladder was detected and repaired. The level of potassium and renal function became normal the next morning, and it seemed that peritoneal-self-dialysis had been related to hyperkalemia and acute renal failure. Rupture of the urinary bladder is very rare but should be considered in any cases of acute abdomen with hyperkalemia and acute renal failure.

  4. The Convergent, Discriminant, and Concurrent Validity of Scores on the Abbreviated Self-Leadership Questionnaire

    Directory of Open Access Journals (Sweden)

    Faruk Şahin

    2015-10-01

    Full Text Available The present study reports the psychometric properties of a short measure of self-leadership in the Turkish context: the Abbreviated Self-Leadership Questionnaire (ASLQ. The ASLQ was examined using two samples and showed sound psychometric properties. Confirmatory factor analysis showed that nine-item ASLQ measured a single construct of self-leadership. The results supported the convergent and discriminant validity of the one-factor model of the ASLQ in relation to the 35-item Revised Self-Leadership Questionnaire and General Self-Efficacy scale, respectively. With regard to internal consistency and test-retest reliability, the ASLQ showed acceptable results. Furthermore, the results provided evidence that scores on the ASLQ positively predicted individual's self-reported task performance and self-efficacy mediated this relationship. Taken together, these findings suggest that the Turkish version of the ASLQ is a reliable and valid measure that can be used to measure self-leadership as one variable of interest in the future studies.

  5. Reliability and validity of the Farsi version of the standardized assessment of personality-abbreviated scale

    Directory of Open Access Journals (Sweden)

    Maryam Sepehri

    2017-06-01

    Full Text Available Introduction: A short screening tool for high-risk individuals with personality disorder (PD is useful both for clinicians and researchers. The aim of this study was to assess the validity and reliability of the Farsi version of the Standardized Assessment of Personality-Abbreviated Scale (SAPAS. Methods: The original English version of the SAPAS questionnaire was translated into Farsi, and then, translated back into English by two professionals. A survey was then conducted using the questionnaire on 150 clients of primary health care centers in Tabriz, Iran. A total of 235 medical students were also studied for the reliability assessment of the questionnaire. The SAPAS was compared to the short form of Minnesota Multiphasic Personality Inventory (MMPI. The data analysis was performed using receiver operating characteristic (ROC curve technique, operating characteristic for diagnostic efficacy, Cronbach's alpha, and test-retest for reliability evaluation. Results: We found an area under the curve (AUC of 0.566 [95% confidence intervals (CI: 0.455-0.677]; sensitivity of 0.89 and specificity of 0.26 at the cut-off score of 2 and higher. The total Cronbach's alpha coefficient was 0.38 and Cohen's kappa ranged between 0.5 and 0.8. Conclusion: The current study showed that the Farsi version of the SAPAS was relatively less efficient, in term of validity and reliability, in the screening of PD in the population.

  6. The Modified Abbreviated Math Anxiety Scale: A Valid and Reliable Instrument for Use with Children.

    Science.gov (United States)

    Carey, Emma; Hill, Francesca; Devine, Amy; Szűcs, Dénes

    2017-01-01

    Mathematics anxiety (MA) can be observed in children from primary school age into the teenage years and adulthood, but many MA rating scales are only suitable for use with adults or older adolescents. We have adapted one such rating scale, the Abbreviated Math Anxiety Scale (AMAS), to be used with British children aged 8-13. In this study, we assess the scale's reliability, factor structure, and divergent validity. The modified AMAS (mAMAS) was administered to a very large (n = 1746) cohort of British children and adolescents. This large sample size meant that as well as conducting confirmatory factor analysis on the scale itself, we were also able to split the sample to conduct exploratory and confirmatory factor analysis of items from the mAMAS alongside items from child test anxiety and general anxiety rating scales. Factor analysis of the mAMAS confirmed that it has the same underlying factor structure as the original AMAS, with subscales measuring anxiety about Learning and Evaluation in math. Furthermore, both exploratory and confirmatory factor analysis of the mAMAS alongside scales measuring test anxiety and general anxiety showed that mAMAS items cluster onto one factor (perceived to represent MA). The mAMAS provides a valid and reliable scale for measuring MA in children and adolescents, from a younger age than is possible with the original AMAS. Results from this study also suggest that MA is truly a unique construct, separate from both test anxiety and general anxiety, even in childhood.

  7. Abbreviated New Drug Applications and 505(b)(2) Applications. Final rule.

    Science.gov (United States)

    2016-10-06

    The Food and Drug Administration (FDA, the Agency, or we) is issuing a final rule to implement Title XI of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), which amended provisions of the Federal Food, Drug, and Cosmetic Act (the FD&C Act) that govern the approval of 505(b)(2) applications and abbreviated new drug applications (ANDAs). This final rule implements portions of Title XI of the MMA that pertain to provision of notice to each patent owner and the new drug application (NDA) holder of certain patent certifications made by applicants submitting 505(b)(2) applications or ANDAs; the availability of 30-month stays of approval on 505(b)(2) applications and ANDAs that are otherwise ready to be approved; submission of amendments and supplements to 505(b)(2) applications and ANDAs; and the types of bioavailability and bioequivalence data that can be used to support these applications. This final rule also amends certain regulations regarding 505(b)(2) applications and ANDAs to facilitate compliance with and efficient enforcement of the FD&C Act.

  8. Effectiveness of abbreviated CBT for insomnia in psychiatric outpatients: sleep and depression outcomes.

    Science.gov (United States)

    Wagley, J Nile; Rybarczyk, Bruce; Nay, William T; Danish, Steven; Lund, Hannah G

    2013-10-01

    To test the efficacy of cogntive-behavioral therapy for insomnia (CBT-I) as a supplement treatment for psychiatric outpatients. Comorbid insomnia is prevalent among individuals with varied psychiatric disorders and evidence indicates that CBT-I may be effective for reducing insomnia and other psychiatric symptoms. The present study randomly assigned 30 psychiatric outpatients (mean duration of treatment = 3.6 years) with low sleep quality and residual depressive symptoms to two sessions of CBT-I or a treatment as usual control group. Assessment included the Pittsburgh Sleep Quality Index (PSQI) for insomnia and the Patient Health Questionnaire (PHQ-9) for depression at pretreatment and 4 and 8 weeks posttreatment. Patients who received CBT-I demonstrated within group changes in PSQI and the PHQ-9 scores at both 4 and 8 weeks posttreatment, but did not show between-group differences. Additionally, 38% of the treatment participants achieved normal sleep at follow-up compared with none in the control condition. This study provides preliminary evidence that abbreviated behavioral treatment has beneficial effects on residual insomnia and depression in long-term psychiatric outpatients. © 2012 Wiley Periodicals, Inc.

  9. Development of an abbreviated version of the delirium motor subtyping scale (DMSS-4).

    Science.gov (United States)

    Meagher, D; Adamis, D; Leonard, M; Trzepacz, P; Grover, S; Jabbar, F; Meehan, K; O'Connor, M; Cronin, C; Reynolds, P; Fitzgerald, J; O'Regan, N; Timmons, S; Slor, C; de Jonghe, J; de Jonghe, A; van Munster, B C; de Rooij, S E; Maclullich, A

    2014-04-01

    Delirium is a common neuropsychiatric syndrome with considerable heterogeneity in clinical profile. Identification of clinical subtypes can allow for more targeted clinical and research efforts. We sought to develop a brief method for clinical subtyping in clinical and research settings. A multi-site database, including motor symptom assessments conducted in 487 patients from palliative care, adult and old age consultation-liaison psychiatry services was used to document motor activity disturbances as per the Delirium Motor Checklist (DMC). Latent class analysis (LCA) was used to identify the class structure underpinning DMC data and also items for a brief subtyping scale. The concordance of the abbreviated scale was then compared with the original Delirium Motor Subtype Scale (DMSS) in 375 patients having delirium as per the American Psychiatric Association's Diagnostic and Statistical Manual (4th edition) criteria. Latent class analysis identified four classes that corresponded closely with the four recognized motor subtypes of delirium. Further, LCA of items (n = 15) that loaded >60% to the model identified four features that reliably identified the classes/subtypes, and these were combined as a brief motor subtyping scale (DMSS-4). There was good concordance for subtype attribution between the original DMSS and the DMSS-4 (κ = 0.63). The DMSS-4 allows for rapid assessment of clinical subtypes in delirium and has high concordance with the longer and well-validated DMSS. More consistent clinical subtyping in delirium can facilitate better delirium management and more focused research effort.

  10. Increasing body mass index portends abbreviated survival following pancreatoduodenectomy for pancreatic adenocarcinoma.

    Science.gov (United States)

    Mathur, Abhishek; Luberice, Kenneth; Paul, Harold; Franka, Co; Rosemurgy, Alexander

    2015-06-01

    Body mass index (BMI), a common surrogate marker for grading obesity, does not differentiate between metabolically active visceral fat and the relatively inert subcutaneous fat. We aim to determine the utility of BMI as a prognostic marker for the impact of obesity on outcomes and survival following pancreatoduodenectomy for pancreatic adenocarcinoma. From a database of over 1,000 patients who had undergone pancreatoduodenectomy, 228 patients with a diagnosis of pancreatic adenocarcinoma were identified. Demographic data including BMI and perioperative parameters-operative time, estimated blood loss, length of stay, survival, nodal status, and American Joint Committee on Cancer stage-were obtained. Data are presented as median. One hundred ninety-two patients had a BMI less than or equal to 29 and 36 patients had a BMI greater than or equal to 30 (24 vs. 34, P obese patients had positive nodes (69% vs. 62%, P pancreatic adenocarcinoma undergoing pancreatoduodenectomy, obesity does not impact operative complexity or length of stay but results in a shortened survival. Therefore, we conclude that BMI is an important prognostic marker that portends an abbreviated survival following pancreatoduodenectomy for pancreatic adenocarcinoma. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Validity and Reliability of the Abbreviated Barratt Impulsiveness Scale in Spanish (BIS-15S)*

    Science.gov (United States)

    Orozco-Cabal, Luis; Rodríguez, Maritza; Herin, David V.; Gempeler, Juanita; Uribe, Miguel

    2010-01-01

    Objective This study determined the validity and reliability of a new, abbreviated version of the Spanish Barratt Impulsiveness Scale (BIS-15S) in Colombian subjects. Method The BIS-15S was tested in non-clinical (n=283) and clinical (n=164) native Spanish-speakers. Intra-scale reliability was calculated using Cronbach’s α, and test-retest reliability was measured with Pearson correlations. Psychometric properties were determined using standard statistics. A factor analysis was performed to determine BIS-15S factor structure. Results 447 subjects participated in the study. Clinical subjects were older and more educated compared to non-clinical subjects. Impulsivity scores were normally distributed in each group. BIS-15S total, motor, non-planning and attention scores were significantly lower in non-clinical vs. clinical subjects. Subjects with substance-related disorders had the highest BIS-15S total scores, followed by subjects with bipolar disorders and bulimia nervosa/binge eating. Internal consistency was 0.793 and test-retest reliability was 0.80. Factor analysis confirmed a three-factor structure (attention, motor, non-planning) accounting for 47.87% of the total variance in BIS-15S total scores. Conclusions The BIS-15S is a valid and reliable self-report measure of impulsivity in this population. Further research is needed to determine additional components of impulsivity not investigated by this measure. PMID:21152412

  12. A Confirmatory Factor Analysis of the Structure of Abbreviated Math Anxiety Scale

    Directory of Open Access Journals (Sweden)

    Farahman Farrokhi

    2011-06-01

    Full Text Available "nObjective: The aim of this study is to explore the confirmatory factor analysis results of the Persian adaptation of Abbreviated Math Anxiety Scale (AMAS, proposed by Hopko, Mahadevan, Bare & Hunt. "nMethod: The validity and reliability assessments of the scale were performed on 298 college students chosen randomly from Tabriz University in Iran. The confirmatory factor analysis (CFA was carried out to determine the factor structures of the Persian version of AMAS. "nResults: As expected, the two-factor solution provided a better fit to the data than a single factor. Moreover, multi-group analyses showed that this two-factor structure was invariant across sex. Hence, AMAS provides an equally valid measure for use among college students. "nConclusions:  Brief AMAS demonstrates adequate reliability and validity. The AMAS scores can be used to compare symptoms of math anxiety between male and female students. The study both expands and adds support to the existing body of math anxiety literature.

  13. Development of an abbreviated Career Indecision Profile-65 using item response theory: The CIP-Short.

    Science.gov (United States)

    Xu, Hui; Tracey, Terence J G

    2017-03-01

    The current study developed an abbreviated version of the Career Indecision Profile-65 (CIP-65; Hacker, Carr, Abrams, & Brown, 2013) by using item response theory. In order to improve the efficiency of the CIP-65 in measuring career indecision, the individual item performance of the CIP-65 was examined with respect to the ordering of response occurrence and gender differential item functioning. The best 5 items of each scale of the CIP-65 (i.e., neuroticism/negative affectivity, choice/commitment anxiety, lack of readiness, and interpersonal conflicts) were retained in the CIP-Short using a sample of 588 college students. A validation sample (N = 174) supported the reliability and structural validity of the CIP-Short. The convergent and divergent validity of the CIP-Short was additionally supported in the findings of a hypothesized differential relational pattern in a separate sample (N = 360). While the current study supported the CIP-Short being a sound brief measure of career indecision, the limitations of this study and suggestions for future research were discussed as well. (PsycINFO Database Record

  14. Proposal for a revised taxonomy of the family Filoviridae: classification, names of taxa and viruses, and virus abbreviations

    OpenAIRE

    Jens H. Kuhn; Becker, Stephan (Prof. Dr.); Ebihara, Hideki; Geisbert, Thomas W.; Johnson, Karl M.; Kawaoka, Yoshihiro; Lipkin, W. Ian; Negredo, Ana I.; Netesov, Sergey V.; Stuart T Nichol; Palacios, Gustavo; Peters, Clarence J.; Tenorio, Antonio; Volchkov, Viktor E.; Jahrling, Peter B.

    2010-01-01

    The taxonomy of the family Filoviridae (marburgviruses and ebolaviruses) has changed several times since the discovery of its members, resulting in a plethora of species and virus names and abbreviations. The current taxonomy has only been partially accepted by most laboratory virologists. Confusion likely arose for several reasons: species names that consist of several words or which (should) contain diacritical marks, the current orthographic identity of species and virus names, and the sim...

  15. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Groen, Aard J.; Sijde, van der Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies an

  16. Decompressive laparotomy in the treatment of severe acute pancreatitis complicated with abdominal compartment syndrome%开腹减压治疗重症急性胰腺炎并发腹腔间室综合征

    Institute of Scientific and Technical Information of China (English)

    朱维铭; 龚剑峰

    2008-01-01

    Abdominal compartment syndrome(ACS)is an important factor contributing to the multiple organ dysfunction syndrome which is commonly seen in patients with severe acute pancreatitis(SAP).As a life-saving procedure,decompressive laparotomy is widely applied to patients with SAP complicated with ACS,especially to patients with edema of the visceral tissues caused by massive fluid resuscitation at the early stage of the disease.However,decompressive laparotomy should be adopted with caution since it is associated with enteroatmospherie fistula,intraabdominal infection,postoperative ileus,third space losses,hypothermia and hemia.Therefore,decompressive laparotomy should only be considered after conservative management had failed.The indications for decompressive laparotomy are as follows:(1)intraabdominal pressure>25 nnn Hg;(2)adequate ventilation of the patient is difficult;(3)pereutaneous drainage of ascites is not helpful.Timely temporal abdominal closure is helpful in preventing complications.Infected peripanereatie necrosis is the indication for peripancreatic exploration or necroseetomy.A thorough knowledge of decompressive laparotomy is essential for individualized management of patients with SAP complicated with ACS.

  17. Perioperative nutritional management of patients undergoing laparotomy Cuidados nutricionales perioperatorios en pacientes sometidos a laparotomía

    Directory of Open Access Journals (Sweden)

    M. I. Toulson Davisson Correia

    2009-08-01

    Full Text Available Objectives: Lack of routine patient's nutritional assessment and prescription of long fasting periods throughout the perioperative period are still widely prevalent despite the advances in surgical care. Therefore, the aim of this study was to assess nutritional routines in two surgical wards. Methods: Adult patients undergoing laparotomy at two distinct units (gastrointestinal and gynecologic in two public hospitals (one of them a university were enrolled. Patients were divided in minor and major (groups A and B procedures and were nutritionally assessed at admission. Daily diet intake and a 24 hour recall were performed. Patients rated the quality of the meals, as well asregistered the reasons for not ingesting it fully. Results: Patients in group B presented with poorer nutritional status. Group A patients resumed oral diets on the first post operative day and most of them received regular diets (85.5%. In group B, only 4.7% were allowed a regular diet on the first PO day, 7.0% received soft diets, 30.2% full liquid diets, 27.9% clear liquids and the remaining 30.2% were on NPO. Patients in this group had a slower progression of diets from liquid to regular solid meals, with 7% of them still on NPO on the fifth PO day. Contrary to group B, patients in group A did not present with cumulative caloric and protein deficits throughout the postoperative period. Overall tolerance of the early diet was good. Conclusion: Malnutrition is still high among major surgical patients. Early oral nutrition can be feasible and well tolerated with few side effects, when prescribed.Objetivos: La falta de la valoración nutricional rutinaria del paciente y la prescripción de largos periodos de ayuno durante el periodo perioperatorio siguen siendo muy prevalentes a pesar de los avances en los cuidados quirúrgicos. Por lo tanto, el objetivo de este estudio fue evaluar las rutinas de valoración nutricional en dos guardias quirúrgicas. Métodos: Se reclutaron

  18. Abbreviated injury scale unification: the case for a unified injury system for global use.

    Science.gov (United States)

    Garthe, E; States, J D; Mango, N K

    1999-08-01

    The Abbreviated Injury Scale (AIS), developed by the Association for the Advancement of Automotive Medicine is the most widely used anatomic injury severity scale in the world (Association for the Advancement of Automotive Medicine. The Abbreviated Injury Scale; 1985 and 1990 revisions. Des Plaines, IL: Association for the Advancement of Automotive Medicine). However, different user groups have modified the AIS system to fit their needs, and these modifications prevent ready comparison and trending of data collected in these systems in the United States and throughout the world. The United States currently has five AIS-based severity systems and two AIS-based impairment systems in use, with additional revisions forthcoming. Other modified AIS systems are known to be in use in the United Kingdom and Japan. The data collected in these systems cannot be accurately combined or compared without re-coding or the use of complex "mapping" methodologies. Furthermore, the expanding use of data linked from multiple databases to answer complex medical, engineering, or policy issues emphasizes the need for coordination between severity and other injury systems. Linkage of state-wide motor vehicle crash data with data from hospital injury classification systems, mortality files, trauma registry, and national crash databases brings into immediate focus the lack of well defined relationships between the severity coding systems and these other widely used injury systems (Mango N, Garthe E. SAE Congress, February, 1998; Johnson, S, Walker, J. NHTSA Technical Report. DOT HS 808 338, Washington, DC: NHTSA; January, 1996). With the expanding use of linked data in state and national policy decisions, it is vital that consistent standards for injury descriptions, severities, and impairments be available for clinical, engineering, and policy users. This paper compares five anatomic severity systems and two impairment systems in terms of purpose, code structure, and use and discusses the

  19. Abbreviated MRI protocols for detecting breast cancer in women with dense breasts

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Shung Qing; Huang, Min; Shen, Yu Ying; Liu, Chen Lu; Xu, Chuan Xiao [The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou (China)

    2017-06-15

    To evaluate the validity of two abbreviated protocols (AP) of MRI in breast cancer screening of dense breast tissue. This was a retrospective study in 356 participants with dense breast tissue and negative mammography results. The study was approved by the Nanjing Medical University Ethics Committee. Patients were imaged with a full diagnostic protocol (FDP) of MRI. Two APs (AP-1 consisting of the first post-contrast subtracted [FAST] and maximum-intensity projection [MIP] images, and AP-2 consisting of AP-1 combined with diffusion-weighted imaging [DWI]) and FDP images were analyzed separately, and the sensitivities and specificities of breast cancer detection were calculated. Of the 356 women, 67 lesions were detected in 67 women (18.8%) by standard MR protocol, and histological examination revealed 14 malignant lesions and 53 benign lesions. The average interpretation time of AP-1 and AP-2 were 37 seconds and 54 seconds, respectively, while the average interpretation time of the FDP was 3 minutes and 25 seconds. The sensitivities of the AP-1, AP-2, and FDP were 92.9, 100, and 100%, respectively, and the specificities of the three MR protocols were 86.5, 95.0, and 96.8%, respectively. There was no significant difference among the three MR protocols in the diagnosis of breast cancer (p > 0.05). However, the specificity of AP-1 was significantly lower than that of AP-2 (p = 0.031) and FDP (p = 0.035), while there was no difference between AP-2 and FDP (p > 0.05). The AP may be efficient in the breast cancer screening of dense breast tissue. FAST and MIP images combined with DWI of MRI are helpful to improve the specificity of breast cancer detection.

  20. Towards a Theory and View of Teaching Compressed and Abbreviated Research Methodology and Statistics Courses

    Directory of Open Access Journals (Sweden)

    James Carifio

    2007-01-01

    Full Text Available One of the highly questionable effects of educational reform and other curriculum reshaping factors at both the high school, post-secondary and graduate levels has been the shift to teaching compressed, pared-down or abbreviated courses in still needed or required subject-matter that became de-emphasized in the current educational reformation. Research methodology, particularly the highly quantitative and experimental kind and statistics, are two still needed to some degree subject matters that has been especially affected by this demotion and compression movement at the pre-service, in-service, professional development, undergraduate, continuing education and graduate levels, even though the professional areas of education, science, business, politics and most other areas (including history have become far more quantitative and objective research oriented than in the past. Until there are more enlightened policy shifts, effective means of teaching such compressed courses need to be devised and tested, if only to lessen the negative outcomes of such critical courses. This article, therefore, analyzes compressed courses from the point of view of cognitive learning and then describes 5 methods and approaches that were tested to improve the effectiveness of research methodology and statistics courses taught in these formats. Each of the formats helped to reduce student stress and anxiety about the content and its compressed presentation and improved understanding and achievement. The theory and view developed in this article is also applicable to similar compressed courses for scientific and/or technical content which are currently prevalent in allied health and biotechnology areas.

  1. The Modified Abbreviated Math Anxiety Scale: A Valid and Reliable Instrument for Use with Children

    Science.gov (United States)

    Carey, Emma; Hill, Francesca; Devine, Amy; Szűcs, Dénes

    2017-01-01

    Mathematics anxiety (MA) can be observed in children from primary school age into the teenage years and adulthood, but many MA rating scales are only suitable for use with adults or older adolescents. We have adapted one such rating scale, the Abbreviated Math Anxiety Scale (AMAS), to be used with British children aged 8–13. In this study, we assess the scale's reliability, factor structure, and divergent validity. The modified AMAS (mAMAS) was administered to a very large (n = 1746) cohort of British children and adolescents. This large sample size meant that as well as conducting confirmatory factor analysis on the scale itself, we were also able to split the sample to conduct exploratory and confirmatory factor analysis of items from the mAMAS alongside items from child test anxiety and general anxiety rating scales. Factor analysis of the mAMAS confirmed that it has the same underlying factor structure as the original AMAS, with subscales measuring anxiety about Learning and Evaluation in math. Furthermore, both exploratory and confirmatory factor analysis of the mAMAS alongside scales measuring test anxiety and general anxiety showed that mAMAS items cluster onto one factor (perceived to represent MA). The mAMAS provides a valid and reliable scale for measuring MA in children and adolescents, from a younger age than is possible with the original AMAS. Results from this study also suggest that MA is truly a unique construct, separate from both test anxiety and general anxiety, even in childhood. PMID:28154542

  2. Salvage of relapse of patients with Hodgkin's disease in clinical stages I or II who were staged with laparotomy and initially treated with radiotherapy alone. A report from the international database on Hodgkin's disease

    DEFF Research Database (Denmark)

    Specht, L.; Horwich, A.; Ashley, S.

    1994-01-01

    PURPOSE: To analyze presentation variables that might indicate a high or low likelihood of success of the treatment of patients relapsing after initial radiotherapy of Hodgkin's disease in clinical Stages I or II who were staged with laparotomy. METHODS AND MATERIALS: Data were analyzed on 681...... patients in the International Database on Hodgkin's Disease who were initially in clinical Stages I or II, who were staged with laparotomy, and who relapsed after initial treatment with irradiation alone. Factors analyzed for outcome after first relapse included initial stage, age, sex, histology...

  3. Development of abdominal compartment syndrome secondary to tumor lysis in an infant with disseminated stage 4 neuroblastoma despite decompressive laparotomy

    Directory of Open Access Journals (Sweden)

    Grigoriy V. Klimovich

    2016-01-01

    Full Text Available A 7-week-old girl presented with disseminated stage 4 neuroblastoma complicated with massive hepatomegaly and signs of liver failure. She underwent wedge liver biopsy and decompressive laparotomy with GORE-TEX® patch placement prior to the administration of chemotherapy. Her fluid losses during chemotherapy were so severe that her GORE-TEX® patch became tense and filled with ascites resulting in abdominal compartment syndrome (ACS. A negative pressure dressing system was applied after opening the patch to assist in the quantification of the fluid losses and to allow decompression. Unfortunately, in spite of favorable histology, the patient failed to adequately respond to chemotherapy resulting in persistent hepatomegaly. Soon after, she developed respiratory, renal insufficiency and disseminated intravascular coagulation, leading to her death 12 days after the initiation of treatment.

  4. Jejunal diverticulosis presenting as an acute emergency.

    Science.gov (United States)

    Khan, Huma Sabir; Ayyaz, Mahmood

    2015-04-01

    Diverticulosis of jejunum is a relatively rare disease of bowel. Jejunal diverticula are false diverticula with projections of mucosa and serosa without the muscular layer. These manifest as diverticulitis, bleeding, perforation or intestinal obstruction. There should be a high index of suspicion when patients present with chronic central abdominal pain, malabsorption and anaemia. Sometimes they are just incidentally picked up on investigations. Laparoscopy can be valuable in diagnosis and treatment as most of the times jejunal diverticulosis can be treated conservatively with surgery required for generalized peritonitis and massive gastrointestinal bleeding. A 33-year man repeatedly presented to emergency with abdominal pain which resolved with analgesics until he developed constipation, vomiting, fever and severe abdominal pain. He had to undergo laparotomy which revealed multiple jejunal diverticula. Resection of the involved gut portion was done. The patient did fine postoperatively.

  5. Fatores predisponentes das complicações incisionaisde laparotomias medianas em eqüinos Predisposal factors to incisional complications of ventral midline laparotomies in horses

    Directory of Open Access Journals (Sweden)

    Geane Maciel Pagliosa

    2004-10-01

    Full Text Available As complicações incisionais após laparotomia mediana em eqüinos têm prevalência de 35 a 87,5% e levam a aumento no período de convalescença ou mesmo ao óbito. Os fatores predisponentes destas complicações são pouco abordados na literatura médica eqüina e são inerentes ao paciente, ao ato cirúrgico, à anestesia e ao período pós-operatório. Considerações sobre os cuidados no pré-operatório, tamanho da incisão, roupa do cirurgião, escolha do fio cirúrgico e as condições clínicas e comportamentais do eqüino são salientadas entre os fatores predisponentes que, quando bem conhecidos, podem ser melhor administrados, no sentido de minimizar as complicações incisionais na laparotomia mediana.Incisional complications after equine midline laparotomy have an incidence of 35 to 87.5% and lead an increase in the convalescence period or to death. Predisposed factors to these complications are little approached in the equine medicine literature and consist of inherent factors to the patient, surgery, anesthesia and postoperative period. Preoperative cares, size of the incision, surgeon clothes, the choice of the suture material and equine clinical and behaviour conditions may be considered and well known in order to decrease the incisional complications after the midline laparotomy.

  6. Management of postoperative arterial hemorrhage after pancreato-biliary surgery according to the site of bleeding: re-laparotomy or interventional radiology.

    Science.gov (United States)

    Miura, Fumihiko; Asano, Takehide; Amano, Hodaka; Yoshida, Masahiro; Toyota, Naoyuki; Wada, Keita; Kato, Kenichiro; Yamazaki, Eriko; Kadowaki, Susumu; Shibuya, Makoto; Maeno, Sawako; Furui, Shigeru; Takeshita, Koji; Kotake, Yutaka; Takada, Tadahiro

    2009-01-01

    Intra-abdominal arterial hemorrhage is still one of the most serious complications after pancreato-biliary surgery. We retrospectively analyzed our experiences with 15 patients in order to establish a therapeutic strategy for postoperative arterial hemorrhage following pancreato-biliary surgery. Between August 1981 and November 2007, 15 patients developed massive intra-abdominal arterial bleeding after pancreato-biliary surgery. The initial surgery of these 15 patients were pylorus-preserving pancreatoduodenectomy (PPPD) (7 patients), hemihepatectomy and caudate lobectomy with extrahepatic bile duct resection or PPPD (4 patients), Whipple's pancreatoduodenectomy (PD) (3 patients), and total pancreatectomy (1 patient). Twelve patients were managed by transcatheter arterial embolization and three patients underwent re-laparotomy. Patients were divided into two groups according to the site of bleeding: SMA group, superior mesenteric artery (4 patients); HA group, stump of gastroduodenal artery, right hepatic artery, common hepatic artery, or proper hepatic artery (11 patients). In the SMA group, re-laparotomy and coil embolization for pseudoaneurysm were performed in three and one patients, respectively, but none of the patients survived. In the HA group, all 11 patients were managed by transcatheter arterial embolization. None of four patients who had major hepatectomy with extrahepatic bile duct resection survived. Six of seven patients (85.7%) who had pancreatectomy survived, although hepatic infarction occurred in four. Management of postoperative arterial hemorrhage after pancreato-biliary surgery should be done according to the site of bleeding and the initial operative procedure. Careful consideration is required for indication of interventional radiology for bleeding from SMA after pancreatectomy and hepatic artery after major hepatectomy with bilioenteric anastomosis.

  7. The use of an algorithm for prophylactic mesh use in high risk patients reduces the incidence of incisional hernia following laparotomy for colorectal cancer resection.

    Science.gov (United States)

    Argudo, Núria; Iskra, M Pilar; Pera, Miguel; Sancho, Juan J; Grande, Luis; López-Cano, Manuel; Pereira, José Antonio

    2017-04-01

    Incisional hernia (IH) after colorectal surgery is highly prevalent. The objective of this study is to assess the utility of an algorithm to decide on mesh augmentation after a midline laparotomy for colorectal resection to prevent IH in high-risk patients. A prospective study was conducted including all patients undergoing a midline laparotomy for colorectal resection between January 2011 and June 2014, after the implementation of a decision algorithm for prophylactic mesh augmentation in selected high-risk patients. Intention-to-treat analyses were conducted between patients in which the algorithm was correctly applied and those in which it was not. From the 235 patients analysed, the algorithm was followed in 166 patients, the resting 69 cases were used as a control group. From an initial adherence to the algorithm of 40% in the first semester, a 90.3% adherence was achieved in the seventh semester. The incidence of IH decreased as the adherence to the algorithm increased (from 28 to 0%) with a time-related correlation (R(2)=0.781). A statistically significant reduction in IH incidence was demonstrated in high-risk groups in which the algorithm was correctly applied (10,2 vs. 46,3%; p=0,0001; OR: 7,58;95%; CI: 3,8-15). Survival analysis showed that the differences remained constant during follow-up. The implementation of the algorithm reduces the incidence of IH in high-risk patients. The adherence to the algorithm also correlates with a decrease in the incidence of IH. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... prevents pregnancy in the same way as regular birth control pills: By preventing or delaying the release of an ...

  9. Emerging Hopes

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    China looks to strategically important emerging industries for innovation-driven economic growthc hina will soon announce a decision to rev up seven strategically impor- tant emerging industries,said the National

  10. [The role of laparoscopy in emergency abdominal surgery].

    Science.gov (United States)

    Balén, E; Herrera, J; Miranda, C; Tarifa, A; Zazpe, C; Lera, J M

    2005-01-01

    Abdominal emergencies can also be operated on through the laparoscopic approach: the approach can be diagnostic laparoscopy, surgery assisted by laparoscopy or laparotomy directed according to the findings of the laparoscopy. The general contraindications refer above all to the state of haemodynamic instability of the patient and to seriously ill patients (ASA IV). In the absence of any specific counter-indications for the specific laparoscopic procedure to be carried out, many abdominal diseases requiring emergency surgery can be performed with the laparoscopic approach. The most frequent indications are appendicitis, acute colecistitis, gastroduodenal perforation, occlusion of the small intestine, and some abdominal traumas. With a correct selection of patients and the appropriate experience of the surgeon, the results are excellent and better than open surgery (less infection of the wound, complications, hospital stay and postoperative pain). A detailed explanation is given of the basic aspects of the surgical technique in the most frequent procedures of emergency laparoscopy.

  11. Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9 among patients on antihypertensive medications

    Directory of Open Access Journals (Sweden)

    Desrosiers Marie-Pierre

    2009-04-01

    Full Text Available Abstract Background The 14-item Treatment Satisfaction Questionnaire for Medication (TSQM Version 1.4 is a reliable and valid instrument to assess patients' satisfaction with medication, providing scores on four scales – side effects, effectiveness, convenience and global satisfaction. In naturalistic studies, administering the TSQM with the side effects domain could provoke the physician to assess the presence or absence of adverse events in a way that is clinically atypical, carrying the potential to interfere with routine medical care. As a result, an abbreviated 9-item TSQM (TSQM-9, derived from the TSQM Version 1.4 but without the five items of the side effects domain was created. In this study, an interactive voice response system (IVRS-administered TSQM-9 was psychometrically evaluated among patients taking antihypertensive medication. Methods A total of 3,387 subjects were invited to participate in the study from an online panel who self-reported taking a prescribed antihypertensive medication. The subjects were asked to complete the IVRS-administered TSQM-9 at the start of the study, along with the modified Morisky scale, and again within 7 to 14 days. Standard psychometric analyses were conducted; including Cronbach's alpha, intraclass correlation coefficients, structural equation modeling, Spearman correlation coefficients and analysis of covariance (ANCOVA. Results A total of 396 subjects completed all the study procedures. Approximately 50% subjects were male with a good racial/ethnic mix: 58.3% white, 18.9% black, 17.7% Hispanic and 5.1% either Asian or other. There was evidence of construct validity of the TSQM-9 based on the structural equation modeling findings of the observed data fitting the Decisional Balance Model of Treatment Satisfaction even without the side effects domain. TSQM-9 domains had high internal consistency as evident from Cronbach's alpha values of 0.84 and greater. TSQM-9 domains also demonstrated good test

  12. The utility of abbreviated patient-reported outcomes for predicting survival in early stage colorectal cancer.

    Science.gov (United States)

    Hsu, Tina; Speers, Caroline H; Kennecke, Hagen F; Cheung, Winson Y

    2017-05-15

    Patient-reported outcomes (PROs) are increasingly used in clinical settings. Prior research suggests that PROs collected at baseline may be associated with cancer survival, but most of those studies were conducted in patients with breast or lung cancer. The objective of this study was to determine the correlation between prospectively collected PROs and cancer-specific outcomes in patients with early stage colorectal cancer. Patients who had newly diagnosed stage II or III colorectal cancer from 2009 to 2010 and had a consultation at the British Columbia Cancer Agency completed the brief Psychosocial Screen for Cancer (PSSCAN) questionnaire, which collects data on patients' perceived social supports, quality of life (QOL), anxiety and depression, and general health. PROs from the PSSCAN were linked with the Gastrointestinal Cancers Outcomes Database, which contains information on patient and tumor characteristics, treatment details, and cancer outcomes. Cox regression models were constructed for overall survival (OS), and Fine and Gray regression models were developed for disease-specific survival (DSS). In total, 692 patients were included. The median patient age was 67 years (range, 26-95 years), and the majority had colon cancer (61%), were diagnosed with stage III disease (54%), and received chemotherapy (58%). In general, patients felt well supported and reported good overall health and QOL. On multivariate analysis, increased fatigue was associated with worse OS (hazard ratio [HR], 1.99; P = .00007) and DSS (HR, 1.63; P = .03), as was lack of emotional support (OS: HR, 4.36; P = .0003; DSS: HR, 1.92; P = .02). Although most patients described good overall health and QOL and indicated that they were generally well supported, patients who experienced more pronounced fatigue or lacked emotional support had a higher likelihood of worse OS and DSS. These findings suggest that abbreviated PROs can inform and assist clinicians to identify patients who have a worse

  13. Does a booster intervention augment the preventive effects of an abbreviated version of the coping power program for aggressive children?

    Science.gov (United States)

    Lochman, John E; Baden, Rachel E; Boxmeyer, Caroline L; Powell, Nicole P; Qu, Lixin; Salekin, Karen L; Windle, Michel

    2014-01-01

    Booster interventions have been presumed to be important methods for maintaining the effects of evidence-based programs for children with behavioral problems, but there has been remarkably little empirical attention to this assumption. The present study examines the effect of a child-oriented booster preventive intervention with children who had previously received an abbreviated version (24 child sessions, 10 parent sessions) of the Coping Power targeted prevention program. Two hundred and forty-one children (152 boys, 89 girls) were screened as having moderate to high levels of aggressive behavior in 4th grade, then half were randomly assigned to receive the abbreviated Coping Power program in 5th grade, and half of the preventive intervention children were then randomly assigned to a Booster condition in 6th grade. The Booster sessions consisted of brief monthly individual contacts, and were primarily with the children. Five assessments across 4 years were collected from teachers, providing a three-year follow-up for all children who participated in the project. Results indicated that the abbreviated Coping Power program (one-third shorter than the full intervention) had long-term effects in reducing children's externalizing problem behaviors, proactive and reactive aggression, impulsivity traits and callous-unemotional traits. The Booster intervention did not augment these prevention effects. These findings indicate that a briefer and more readily disseminated form of an evidence-based targeted preventive intervention was effective. The findings have potential implications for policy and guidelines about possible intervention length and booster interventions.

  14. Emergent Expertise?

    Science.gov (United States)

    McGivern, Patrick

    2014-01-01

    The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

  15. Portal and systemic serum growth factor and acute-phase response after laparotomy or partial hepatectomy in patients with colorectal liver metastases : A prognostic role for C-reactive protein and hepatocyte growth factor

    NARCIS (Netherlands)

    de Jong, KP; Hoedemakers, RMJ; Fidler, [No Value; Bijzet, J; Limburg, PC; Peeters, PMJG; de Vries, EGE; Slooff, MJH

    2004-01-01

    Background: Growth factors play a role in wound healing and tumour growth. The aim of this study was to compare the effect of partial hepatectomy (PH) and laparotomy on serum levels of growth factors and acute-phase proteins in patients with colorectal liver metastases and to correlate these levels

  16. Emergency Endoscopy

    Directory of Open Access Journals (Sweden)

    Dariusz Apel

    2000-01-01

    Full Text Available The need for emergency endoscopy is a matter of debate. The time interval for emergency procedures remains to be defined. Most authors propose a time span of 24 h as emergency time, while some define a period of 72 h (especially in acute pancreatitis. Several studies have shown a possible benefit for a select group of patients. Four main indications are established for emergency endoscopy: acute gastrointestinal bleeding (variceal and nonvariceal, acute biliary pancreatitis and acute cholangitis. In the case of upper gastrointestinal bleeding, emergency endoscopy enables exact diagnosis and appropiate therapy, and provides important prognostic information. There is some evidence that emergent endoscopic injection therapy improves clinical outcome and reduces mortality in patients with acute ulcer bleeding. Patients do not benefit if endoscopy is performed only as a diagnostic procedure. Controversial results were published recently for emergency endoscopy in acute biliary pancreatitis. There is good evidence that emergency endoscopic retrograde cholangiopancreatography is helpful in patients with severe pancreatitis and stone impaction if performed within the first 24 h after onset of symptoms. However, emergency endoscopic retrograde cholangiopancreatography is not benefical for patients with mild pancreatitis if performed later than 72 h (or 24 h after onset of symptoms. There is a limited number of well established evidence-based indications for emergency endoscopy. Some other indications are still a matter of debate, and controversial opinions have been published.

  17. Zipf's Law of Abbreviation and the Principle of Least Effort: Language users optimise a miniature lexicon for efficient communication.

    Science.gov (United States)

    Kanwal, Jasmeen; Smith, Kenny; Culbertson, Jennifer; Kirby, Simon

    2017-08-01

    The linguist George Kingsley Zipf made a now classic observation about the relationship between a word's length and its frequency; the more frequent a word is, the shorter it tends to be. He claimed that this "Law of Abbreviation" is a universal structural property of language. The Law of Abbreviation has since been documented in a wide range of human languages, and extended to animal communication systems and even computer programming languages. Zipf hypothesised that this universal design feature arises as a result of individuals optimising form-meaning mappings under competing pressures to communicate accurately but also efficiently-his famous Principle of Least Effort. In this study, we use a miniature artificial language learning paradigm to provide direct experimental evidence for this explanatory hypothesis. We show that language users optimise form-meaning mappings only when pressures for accuracy and efficiency both operate during a communicative task, supporting Zipf's conjecture that the Principle of Least Effort can explain this universal feature of word length distributions. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Coelomogenesis during the abbreviated development of the echinoid Heliocidaris erythrogramma and the developmental origin of the echinoderm pentameral body plan.

    Science.gov (United States)

    Morris, Valerie B

    2011-01-01

    The development of the coeloms is described in an echinoid with an abbreviated larval development and shows the early morphogenesis of the coeloms of the adult stage. The development is described from images obtained by laser scanning confocal microscopy. The development in Heliocidaris erythrogramma is asymmetric with a larger left coelom forming on the larval-left side and a smaller right coelom forming on the larval-right side. The right coelom forms after the development of the left coelom is well advanced. The hydrocoele forms from the anterior part of the left coelom. The five lobes of the hydrocoele from which the pentamery of the adult derives take shape on the outer, distal wall of the anterior part of the left coelom. The hydrocoele separates from the more posterior part of the left coelom, which becomes the left posterior coelom. The lobes of the hydrocoele are named, based on the site of the connexion of the stone canal to the hydrocoele. The mouth is assumed to form by penetration through only the outer, distal wall of the hydrocoele and the ectoderm. Both larval and adult polarities are evident in this larva. A comparison with coelomogenesis in the asteroid Parvulastra exigua, which also has an abbreviated development, leads to predictions of homology between the echinoderm and chordate phyla that do not require the hypothesis of a dorsoventral inversion event in chordates.

  19. Self efficacy for fruit, vegetable and water intakes: Expanded and abbreviated scales from item response modeling analyses

    Directory of Open Access Journals (Sweden)

    Cullen Karen W

    2010-03-01

    Full Text Available Abstract Objective To improve an existing measure of fruit and vegetable intake self efficacy by including items that varied on levels of difficulty, and testing a corresponding measure of water intake self efficacy. Design Cross sectional assessment. Items were modified to have easy, moderate and difficult levels of self efficacy. Classical test theory and item response modeling were applied. Setting One middle school at each of seven participating sites (Houston TX, Irvine CA, Philadelphia PA, Pittsburg PA, Portland OR, rural NC, and San Antonio TX. Subjects 714 6th grade students. Results Adding items to reflect level (low, medium, high of self efficacy for fruit and vegetable intake achieved scale reliability and validity comparable to existing scales, but the distribution of items across the latent variable did not improve. Selecting items from among clusters of items at similar levels of difficulty along the latent variable resulted in an abbreviated scale with psychometric characteristics comparable to the full scale, except for reliability. Conclusions The abbreviated scale can reduce participant burden. Additional research is necessary to generate items that better distribute across the latent variable. Additional items may need to tap confidence in overcoming more diverse barriers to dietary intake.

  20. Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study.

    Science.gov (United States)

    Fortney, Luke; Luchterhand, Charlene; Zakletskaia, Larissa; Zgierska, Aleksandra; Rakel, David

    2013-01-01

    Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influence on health care. Interventions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and compassion among primary care clinicians. A total of 30 primary care clinicians participated in an abbreviated mindfulness course. We used a single-sample, pre-post design. At 4 points in time (baseline, and 1 day, 8 weeks, and 9 months postintervention), participants completed a set of online measures assessing burnout, anxiety, stress, resilience, and compassion. We used a linear mixed-effects model analysis to assess changes in outcome measures. Participants had improvements compared with baseline at all 3 follow-up time points. At 9 months postintervention, they had significantly better scores (1) on all Maslach Burnout Inventory burnout subscales-Emotional Exhaustion (P =.009), Depersonalization (P = .005), and Personal Accomplishment (P job burnout, depression, anxiety, and stress. Modified mindfulness training may be a time-efficient tool to help support clinician health and well-being, which may have implications for patient care.

  1. Bacterial toxins activation of abbreviated urea cycle in porcine cerebral vascular smooth muscle cells.

    Science.gov (United States)

    Mishra, Rajesh G; Tseng, Tzu-Ling; Chen, Mei-Fang; Chen, Po-Yi; Lee, Tony J-F

    2016-12-01

    Nitric oxide (NO) overproduction via induction of inducible nitric oxide synthase (iNOS) is implicated in vasodilatory shock in sepsis, leading to septic encephalopathy and accelerating cerebral ischemic injury. An abbreviated urea-cycle (l-citrulline-l-arginine-NO cycle) has been demonstrated in cerebral perivascular nitrergic nerves and endothelial cells but not in normal cerebral vascular smooth muscle cell (CVSMC). This cycle indicates that argininosuccinate synthase (ASS) catalyzes l-citrulline (l-cit) conversion to form argininosuccinate (AS), and subsequent AS cleavage by argininosuccinate lyase (ASL) forms l-arginine (l-arg), the substrate for NO synthesis. The possibility that ASS enzyme in this cycle was induced in the CVSMC in sepsis was examined. Blood-vessel myography technique was used for measuring porcine isolated basilar arterial tone. NO in cultured CVSMC and in condition mediums were estimated by diaminofluorescein (DAF)-induced fluorescence and Griess reaction, respectively. Immunohistochemical and immunoblotting analyses were used to examine iNOS and ASS induction. l-cit and l-arg, which did not relax endothelium-denuded normal basilar arteries precontracted by U-46619, induced significant vasorelaxation with increased NO production in these arteries and the CVSMCs following 6-hour exposure to 20μg/ml lipopolysaccharide (LPS) or lipoteichoic acid (LTA). Pre-treatment with pyrrolidine dithiocarbamate (PDTC) and salicylate (SAL) (NFκB inhibitors), aminoguanidine (AG, an iNOS inhibitor), and nitro-l-arg (NLA, a non-specific NOS inhibitor) blocked NO synthesis in the CVSMC and attenuated l-cit- and l-arg-induced relaxation of LPS- and LTA-treated arteries. Furthermore, immunohistochemical and immunoblotting studies demonstrated that expression of basal iNOS and ASS in the smooth muscle cell of arterial segments denuded of endothelium and the cultured CVSMCs was significantly increased following 6-hour incubation with LPS or LTA. This increased i

  2. Cyclosporine therapy monitored with abbreviated area under curve in nephrotic syndrome.

    Science.gov (United States)

    Rinaldi, Stefano; Sesto, Antonella; Barsotti, Paola; Faraggiana, Tullio; Sera, Francesco; Rizzoni, Gianfranco

    2005-01-01

    Cyclosporin A (CsA) is an effective therapy for children with long-lasting nephrotic syndrome (NS). Long-term treatment can result in chronic CsA nephropathy (CsAN) and there is controversy concerning its incidence and severity. Trough levels are commonly used to monitor the drug concentration. We report a retrospective clinical and histological analysis of 18 children (12 males, 6 females) with steroid-dependent nephrotic syndrome (15 patients) and partially steroid-sensitive nephrotic syndrome (3 patients) treated with CsA for a long-term period (mean 4.9 years, range 2.2-6.9). Before CsA treatment all patients had normal creatinine clearance. CsA was started at a dose of 5 mg/kg per day administered orally in two divided doses and adjusted to maintain the mean CsA blood concentration between 250 and 350 ng/ml obtained from abbreviated area under the curve (AUC). A renal biopsy was performed after a mean period of 3.9 years (range 2.2-6.2) from the start of CsA treatment. Tubular, interstitial, and arteriolar lesions were evaluated in order to assess CsAN. The mean CsA dose and the mean CsA blood concentration were 4.4 mg/kg per day (range 3.6-5.8) and 276.6 ng/ml (range 162-346), respectively. No child had a worsening creatinine clearance during CsA treatment and follow-up after CsA discontinuation. If compared with the year before the start of CsA treatment, NS relapses and prednisone (PDN) dose significantly decreased during CsA treatment, 4/year versus 0.8/year (P <0.0001) and 0.9 mg/kg per day versus 0.2 mg/kg per day (P <0.0001), respectively. Histological analysis showed 15 patients with minimal change disease and 3 with focal segmental glomerulosclerosis. Clear-cut lesions diagnostic of CsAN were never found and only mild lesions were observed in 5 children (suggestive of CsAN in 2 patients and consistent with CsAN in 3 patients). Long-term CsA treatment is confirmed to be effective in preventing NS relapses and reducing PDN dose. Renal function is not a

  3. Maintenance of anaesthesia with sevoflurane and oxygen in mechanically-ventilated horses subjected to exploratory laparotomy treated with intra- and post operative anaesthetic adjuncts.

    Science.gov (United States)

    Carroll, G L; Hooper, R N; Rains, C B; Martinez, E A; Matthews, N S; Hartsfield, S M; Beleau, M H

    1998-09-01

    Eight healthy horses premedicated with xylazine and induced with ketamine were used to evaluate sevoflurane in oxygen for maintenance of anaesthesia during elective exploratory laparotomy. After orotracheal intubation, horses were hoisted, placed in dorsal recumbency on a padded surgery table, and received sevoflurane in oxygen for maintenance of anaesthesia. The horses were allowed to breathe spontaneously until instrumented; then, they were mechanically ventilated to maintain the PaCO2 between 35 and 45 mmHg. Systolic (SAP), diastolic (DAP), and mean (MAP) arterial blood pressures, heart rate (HR), ECG, respiratory rate, an estimation of the saturation of haemoglobin with oxygen in peripheral arterial blood (S(p)O2), nasal temperature, end-tidal CO2(ET(CO2)), end-tidal sevoflurane (ET(SEVO)), and vaporiser concentration were recorded every 5 min post induction; arterial blood samples were obtained soon after induction, at 30 min after induction, and every hour thereafter until surgery was completed. Recovery data including times from the sevoflurane vaporiser being turned off to first movement, to sternal recumbency, and to standing, number of attempts to stand, and recovery score (between 1 = safe, smooth and 6 = stormy, major injury to horse) were collected. Analysis of variance was performed using physiological data collected over 195 min of anaesthesia, the longest time period during which all 8 horses were instrumented. Time effects (P<0.05) for HR, SAP, DAP, MAP, and nasal temperature were identified. Heart rate peaked at 45 min and declined over the course of the procedure. Arterial blood pressure generally decreased over time. Body temperature decreased over time. From 15 to 195 min mean ET(SEVO)concentration ranged from 2.0 to 3.3%, while mean vaporiser settings ranged from 3.7 to 5.5%. Three horses received intra-operative ketamine; all horses received dobutamine infusions; and 2 horses received intra-operative calcium-dextrose. Total anaesthesia time

  4. Mini-laparotomy with abdominal wall lifting for partial gastrectomy in patients with early gastric mucosal cancer at lesser curvature of the middle stomach.

    Science.gov (United States)

    Tomita, Ryouichi; Fujisak, Shigeru; Park, Yeong Ji

    2009-01-01

    Partial gastrectomy (PG) is the most frequently adopted minimally invasive procedure for early gastric cancer (EGC), especially mucosal cancer (MC). The aim of this study was to introduce a minimally invasive procedure, i.e., minilaparotomy with abdominal wall lifting for PG in patients with early mucosal gastric cancer at the lesser curvature of the middle stomach. Well differentiated adenocarcionoma in MC at the lesser curvature of the middle stomach was selected, where no lymph node metastasis (NO) was confirmed using ultrasonic endoscopy, CT, and MRI during the preoperative examinations. PG was also chosen for patients with a tumor size of 2cm or less and non-depressive type in whom endoscopic mucosal resection (EMR) or endoscopic submucosal resection (ESD) was not possible. Five MC patients (3 men and 2 women, aged 44-62 years, mean age 53.3 years) underwent mini-laparotomy with abdominal wall lifting for PG. Our procedure involved a 6 cm upper abdominal median incision made at the beginning of the operation. The upper abdominal wall was lifted by a subcutaneous Kirshner wire. The small wound was also pulled upward and/or laterally by Kent retractors and conventional surgical instruments were used through the wound. The middle stomach could be detected through the small wound and partially resected, approximately 1 cm from the tumor edge under the guide of the endoscope. The resected stomach margin was stitched layer-to-layer. In this way, PG was easily completed. The total surgical time was 71.8 +/- 12.9 min and the mean estimated blood loss was 30.8 +/- 20.5 ml. Day of starting diet was 3 +/- 0.7 days after operation. Post-operative hospitalization was 8.2 +/- 1.3 days. There was no surgical mortality. All subjects were satisfied with this procedure. Mini-laparotomy with abdominal wall lifting is a safe and efficient technique in the treatment of PG for MC with NO at the lesser curvature of the middle stomach when EMR or ESD is impossible.

  5. Linfoma de Burkitt: informe de un caso diagnosticado por laparotomía Burkitt's lymphoma: report of a case diagnosed by laparotomy

    Directory of Open Access Journals (Sweden)

    Rafael Pinilla González

    2008-12-01

    Full Text Available El linfoma de Burkitt no endémico es un tumor de frecuente localización abdominal, por lo que se debe tener presente ante cualquier masa intraabdominal. Aunque el tratamiento de elección es la quimioterapia, existe controversia respecto del papel que debe desempeñar la cirugía, especialmente en casos donde el diagnóstico se establece durante una laparotomía exploradora. Este fue el caso de una adolescente de 14 años que presentó una masa hipogástrica y otra menor en la fosa ilíaca derecha. Algunos autores no aceptan la cirugía y añaden que puede retrasar y complicar el tratamiento quimioterápeutico, mientras que otros autores defienden la cirugía reductora de masa tumoral asociada a la quimioterapia. Esta controversia es especialmente importante cuando el diagnóstico se establece en el curso de una laparotomía exploradora, durante la cual hay que decidir si extirpar la masa tumoral o no hacerlo. En nuestro caso decidimos extirpar todo el tumor macroscópico. La buena evolución de nuestra paciente y los resultados comunicados apoyan esta postura.Non-endemic Burkitt's lymphoma is a tumor of frequent abdominal localization that should be taken into consideration before any intraabdominal mass. Although chemotherapy is the election treatment, there is controversy as regards the role surgery should play, specially in those cases where the diagnosis is established by explorative laparotomy. This was the case of a 14-year-old adolescent that presented a hypogastric mass and another lower mass in the right iliac fossa. Some authors do not accept surgery and state that it may delay and complicate chemotherapy, whereas other authors defend the tumoral mass-reducing surgery associated with chemotherapy. This controversy is particularly important when the diagnosis is made in the course of an explorative laparotomy and it should be decided wether to remove the tumoral mass or not. In our case, it was decided to remove the whole macroscopic

  6. P.O.P.A. study: prevention of postoperative abdominal adhesions by icodextrin 4% solution after laparotomy for adhesive small bowel obstruction. A prospective randomized controlled trial.

    Science.gov (United States)

    Catena, Fausto; Ansaloni, Luca; Di Saverio, Salomone; Pinna, Antonio D

    2012-02-01

    Adhesive small bowel obstruction (ASBO) is an important cause of hospital admission, is associated with significant morbidity and mortality, and therefore is a substantial burden for healthcare systems worldwide. Icodextrin 4% solution (Adept, Shire Pharmaceuticals, UK) is a high-molecular-weight a-1,4 glucose polymer approved in Europe for use as intraoperative lavage and postoperative instillation to reduce the occurrence of post-surgery intra-abdominal adhesions. The present clinical study aimed to evaluate the safety and effectiveness of icodextrin 4% in decreasing the incidence, extent, and severity of adhesions in patients after abdominal surgery for ASBO. The study was a single-center prospective, randomized investigation. The study is designed and conducted in compliance with the principles of Good Clinical Practice regulations. Safety and efficacy of icodextrin 4% in the study group are compared to no anti-adhesion treatment in a parallel control group with blinded evaluation of primary endpoints. Primary endpoints are the evaluation of the therapeutic role of icodextrin 4% in reducing ASBO recurrence incidence and the need of laparotomies for ASBO recurrence, as well as adhesion formation (with evaluation of their incidence, extent, and severity). A sum of 181 patients with ASBO and surgical indication to laparotomy were enrolled and randomized in two groups. Patients were submitted to adhesiolysis with bowel resection if required with or without anastomosis. The first group received traditional treatment (control group), whereas the second group was treated with the addition of icodextrin 4% solution before the abdominal closure. Ninety-one patients were randomized to have icodextrin 4% solution administered intraperitoneally, and 90 patients were randomized to have the traditional treatment. The two study groups were homogeneous regarding their baseline characteristics. The ASBO recurrence rate was 2.19% (2/91) in the icodextrin groups vs 11.11% (10

  7. Dental Emergencies

    OpenAIRE

    Domb, Ivor

    1982-01-01

    Emergency dental problems can result from trauma, dental pathology, or from dental treatment itself. While the physician can treat many instances of dental trauma, the patient should see a dentist as soon as possible so that teeth can be saved. Emergency treatment of dental pathology usually involves relief of pain and/or swelling. Bleeding is the most frequent post-treatment emergency. The physician should be able to make the patient comfortable until definitive dental treatment can be avail...

  8. Mensuração da gravidade do trauma com as versões 1998 e 2005 da Abbreviated Injury Scale

    OpenAIRE

    Maria Carolina Barbosa Teixeira Lopes; Iveth Yamaguchi Whitaker

    2014-01-01

    Objetivo: Comparar a gravidade das lesões e do trauma mensurada pelas versões da Abbreviated Injury Scale 1998 e 2005 e verificar a mortalidade nos escores Injury Severity Score e New Injury Severity Score nas duas versões.Método: Estudo transversal e retrospectivo analisou lesões de pacientes de trauma, de três hospitais universitários do município de São Paulo, Brasil. Cada lesão foi codificada com Abbreviated Injury Scale 1998 e 2005. Os testes estatísticos aplicados foram Wilcoxon, McNema...

  9. Impact of an Abbreviated Cardiac Enzyme Protocol to Aid Rapid Discharge of Patients with Cocaine-associated Chest Pain in the Clinical Decision Unit

    Directory of Open Access Journals (Sweden)

    Faheem W. Guirgis

    2014-03-01

    Full Text Available Introduction: In 2007 there were 64,000 visits to the emergency department (ED for possible myocardial infarction (MI related to cocaine use. Prior studies have demonstrated that low- to intermediate-risk patients with cocaine-associated chest pain can be safely discharged after 9-12 hours of observation. The goal of this study was to determine the safety of an 8-hour protocol for ruling out MI in patients who presented with cocaine-associated chest pain. Methods: We conducted a retrospective review of patients treated with an 8-hour cocaine chest pain protocol between May 1, 2011 and November 30, 2012 who were sent to the clinical decision unit (CDU for observation. The protocol included serial cardiac biomarker testing with Troponin-T, CK-MB (including delta CK-MB, and total CK at 0, 2, 4, and 8 hours after presentation with cardiac monitoring for the observation period. Patients were followed up for adverse cardiac events or death within 30 days of discharge. Results: There were 111 admissions to the CDU for cocaine chest pain during the study period. One patient had a delta CK-MB of 1.6 ng/ml, but had negative Troponin-T at all time points. No patient had a positive Troponin-T or CK-MB at 0, 2, 4 or 8 hours, and there were no MIs or deaths within 30 days of discharge. Most patients were discharged home (103 and there were 8 inpatient admissions from the CDU. Of the admitted patients, 2 had additional stress tests that were negative, 1 had additional cardiac biomarkers that were negative, and all 8 patients were discharged home. The estimated risk of missing MI using our protocol is, with 99% confidence, less than 5.1% and with 95% confidence, less than 3.6% (99% CI, 0-5.1%; 95% CI, 0-3.6%. Conclusion: Application of an abbreviated cardiac enzyme protocol resulted in the safe and rapid discharge of patients presenting to the ED with cocaine-associated chest pain. [West J Emerg Med. 2014;15(2:180–183.

  10. Emergency Shelters

    DEFF Research Database (Denmark)

    Popovic Larsen, Olga; Lee, Daniel Sang-Hoon; Eskemose Andersen, Jørgen;

    2013-01-01

    The report gives all the research, teaching, seminars carried in the duration of the shelter cluster. It concludes with proposing relevant research agendas in the field of emergency architecture......The report gives all the research, teaching, seminars carried in the duration of the shelter cluster. It concludes with proposing relevant research agendas in the field of emergency architecture...

  11. Vascular emergencies.

    Science.gov (United States)

    Semashko, D C

    1997-01-01

    This article reviews the initial assessment and emergent management of several common as well as uncommon vascular emergencies. Aortic dissection, aneurysms, and arterial occlusive disease are familiar but challenging clinical entities. Less frequently encountered conditions are also discussed including an aortic enteric fistula, mesenteric venous thrombosis, phlegmasia alba dolens, and subclavian vein thrombosis.

  12. Predictive and prognostic values of cancer-associated serum antigen (CASA) and cancer antigen 125 (CA 125) levels prior to second-look laparotomy for ovarian cancer.

    Science.gov (United States)

    Kierkegaard, O; Mogensen, O; Mogensen, B; Jakobsen, A

    1995-11-01

    CA 125 and cancer-associated serum antigen (CASA) were measured prior to second-look laparotomy (SLL) to investigate their predictive and prognostic values in 93 patients treated for epithelial ovarian cancer FIGO stage II, III, or IV. Residual tumor was diagnosed at the SLL in 58 patients (62%). The optimal cutoff level was 15 U/ml for CA 125 and 8 U/ml for CASA. Using these levels, the sensitivity for detection of residual tumor was 40% for CA 125 and 22% for CASA. The combined use of the markers resulted in a sensitivity of 47% (diagnostic gain 6.9%; 95% confidence interval (CI), 0.14-13.44%). Microscopic tumor volumes were equally diagnosed by CASA and CA 125. The independent prognostic value of CA 125 (RR = 2.6; 95% CI, 2.0-3.2) and CASA (RR = 2.2; CI, 1.5-2.9) was established by means of Cox regression analysis of the covariation between survival, age, FIGO stage, histopathology, tumor grade, and bulk of residual tumor at the primary operation and CA 125 and CASA before the SLL. In conclusion, we found that CASA could supplement CA 125 measurement prior to SLL and reduce the number of SLLs. Furthermore, CASA had an independent prognostic value for survival which may be used together with other information in the planning of further treatment of the individual patient.

  13. Proposal for a revised taxonomy of the family Filoviridae: classification, names of taxa and viruses, and virus abbreviations.

    Science.gov (United States)

    Kuhn, Jens H; Becker, Stephan; Ebihara, Hideki; Geisbert, Thomas W; Johnson, Karl M; Kawaoka, Yoshihiro; Lipkin, W Ian; Negredo, Ana I; Netesov, Sergey V; Nichol, Stuart T; Palacios, Gustavo; Peters, Clarence J; Tenorio, Antonio; Volchkov, Viktor E; Jahrling, Peter B

    2010-12-01

    The taxonomy of the family Filoviridae (marburgviruses and ebolaviruses) has changed several times since the discovery of its members, resulting in a plethora of species and virus names and abbreviations. The current taxonomy has only been partially accepted by most laboratory virologists. Confusion likely arose for several reasons: species names that consist of several words or which (should) contain diacritical marks, the current orthographic identity of species and virus names, and the similar pronunciation of several virus abbreviations in the absence of guidance for the correct use of vernacular names. To rectify this problem, we suggest (1) to retain the current species names Reston ebolavirus, Sudan ebolavirus, and Zaire ebolavirus, but to replace the name Cote d'Ivoire ebolavirus [sic] with Taï Forest ebolavirus and Lake Victoria marburgvirus with Marburg marburgvirus; (2) to revert the virus names of the type marburgviruses and ebolaviruses to those used for decades in the field (Marburg virus instead of Lake Victoria marburgvirus and Ebola virus instead of Zaire ebolavirus); (3) to introduce names for the remaining viruses reminiscent of jargon used by laboratory virologists but nevertheless different from species names (Reston virus, Sudan virus, Taï Forest virus), and (4) to introduce distinct abbreviations for the individual viruses (RESTV for Reston virus, SUDV for Sudan virus, and TAFV for Taï Forest virus), while retaining that for Marburg virus (MARV) and reintroducing that used over decades for Ebola virus (EBOV). Paying tribute to developments in the field, we propose (a) to create a new ebolavirus species (Bundibugyo ebolavirus) for one member virus (Bundibugyo virus, BDBV); (b) to assign a second virus to the species Marburg marburgvirus (Ravn virus, RAVV) for better reflection of now available high-resolution phylogeny; and (c) to create a new tentative genus (Cuevavirus) with one tentative species (Lloviu cuevavirus) for the recently

  14. Proposal for a revised taxonomy of the family Filoviridae: classification, names of taxa and viruses, and virus abbreviations

    Science.gov (United States)

    Kuhn, Jens H.; Becker, Stephan; Ebihara, Hideki; Geisbert, Thomas W.; Johnson, Karl M.; Kawaoka, Yoshihiro; Lipkin, W. Ian; Negredo, Ana I.; Netesov, Sergey V.; Nichol, Stuart T.; Palacios, Gustavo; Peters, Clarence J.; Tenorio, Antonio; Volchkov, Viktor E.; Jahrling, Peter B.

    2011-01-01

    The taxonomy of the family Filoviridae (marburgviruses and ebolaviruses) has changed several times since the discovery of its members, resulting in a plethora of species and virus names and abbreviations. The current taxonomy has only been partially accepted by most laboratory virologists. Confusion likely arose for several reasons: species names that consist of several words or which (should) contain diacritical marks, the current orthographic identity of species and virus names, and the similar pronunciation of several virus abbreviations in the absence of guidance for the correct use of vernacular names. To rectify this problem, we suggest (1) to retain the current species names Reston ebolavirus, Sudan ebolavirus, and Zaire ebolavirus, but to replace the name Cote d'Ivoire ebolavirus [sic] with Taï Forest ebolavirus and Lake Victoria marburgvirus with Marburg marburgvirus; (2) to revert the virus names of the type marburgviruses and ebolaviruses to those used for decades in the field (Marburg virus instead of Lake Victoria marburgvirus and Ebola virus instead of Zaire ebolavirus); (3) to introduce names for the remaining viruses reminiscent of jargon used by laboratory virologists but nevertheless different from species names (Reston virus, Sudan virus, Taï Forest virus), and (4) to introduce distinct abbreviations for the individual viruses (RESTV for Reston virus, SUDV for Sudan virus, and TAFV for Taï Forest virus), while retaining that for Marburg virus (MARV) and reintroducing that used over decades for Ebola virus (EBOV). Paying tribute to developments in the field, we propose (a) to create a new ebolavirus species (Bundibugyo ebolavirus) for one member virus (Bundibugyo virus, BDBV); (b) to assign a second virus to the species Marburg marburgvirus (Ravn virus, RAVV) for better reflection of now available high-resolution phylogeny; and (c) to create a new tentative genus (Cuevavirus) with one tentative species (Lloviu cuevavirus) for the recently

  15. Abbreviated breast dynamic contrast-enhanced MR imaging for lesion detection and characterization: the experience of an Italian oncologic center.

    Science.gov (United States)

    Petrillo, Antonella; Fusco, Roberta; Sansone, Mario; Cerbone, Marilena; Filice, Salvatore; Porto, Annamaria; Rubulotta, Maria Rosaria; D'Aiuto, Massimiliano; Avino, Franca; Di Bonito, Maurizio; Botti, Gerardo

    2017-07-01

    To evaluate the performance of an abbreviated dynamic contrast-enhanced MR imaging (MRI) protocol for breast cancer detection; a comparison with the complete diagnostic protocol has been conducted. A retrospective analysis on 508 patients was performed. Abbreviated protocol (AP) included one pre-contrast and the first post-contrast T1-weighted series. Complete protocol (CP) consisted of four post-contrast and one pre-contrast T1-weighted series. Diagnostic performance was assessed for AP and CP. Performance comparison was made using McNemar's test for sensitivity and specificity and Moskowitz and Pepe's method as regards negative predictive value (NPV) and positive predictive value (PPV). AP has been realized in two different ways (AP1 and AP2) and they were compared by means of Cohen's κ. Both CP and AP revealed 206 of 207 cancers. There were no statistically significant differences between AP and CP diagnostic performance (P > 0.05). NPVs of CP and both versions of AP (99.57 vs. 99.56%, P = 0.39), as well as the specificity (77.08 vs. 75.42%, P = 0.18), were substantially equivalent. Relative predictive value method did not reveal the presence of a statistically significant difference between the PPV of CP and both versions of AP (74.91 vs. 73.57%, P = 0.099). Analysis for single lesion confirmed that both CP and AP had equivalent results: CP and AP revealed 280 of 281 malignancies. NPVs of CP and both AP versions, as well as the specificity (P > 0.05), were substantially equivalent. Relative predictive value method did not reveal the presence of a significant difference between the PPV of CP and both AP versions (70.89 vs. 70.18%, P = 0.25; 70.89 vs. 70.00%, P = 0.13). Abbreviated approach to breast MRI examination reduces the image acquisition and the reading time associated with MR substantially without influencing the diagnostic accuracy (high sensitivity and NPV >99.5%). AP could translate into cost-savings and could enable a higher number of

  16. Emergency contraception.

    Science.gov (United States)

    Van Look, P F; von Hertzen, H

    1993-01-01

    The term 'emergency contraception', as employed in this paper, refers to methods that are used as emergency procedures to prevent pregnancy following unprotected intercourse. Alternative, less appropriate, terms are postcoital and 'morning-after' contraception. References to postcoital preparations can be found as far back as 1500 BC in Egyptian papyri, but it was not until fairly recently that contraceptive research has been able to at least partially fulfill that need. The development of hormonal methods of emergency contraception goes back to the 1960s when the first human trials of postcoitally administered high-dose oestrogens were undertaken. Combined oestrogen- progestogen combination therapy (the so-called Yuzpe regimen) was introduced in the early 1970s, while the postcoital insertion of an intrauterine contraceptive device (IUD) for emergency contraception was first reported in 1976. Other compounds that have been tested more recently include levonorgestrel, the antiprogestogen mifepristone, and danazol. Although there is some debate about the magnitude of the protective effect, few people question the important role that emergency contraception can play in preventing unwanted pregnancy and hence maternal mortality and morbidity resulting from unsafe abortion. Given that the most often used methods of emergency contraception, namely the Yuzpe regimen and postcoital insertion of an IUD, rely on technology that has been available for some 30 years, family planning programmes that claim to be concerned with improving women's reproductive health, cannot really be excused if they do not provide emergency contraception as part of their routine services.

  17. Validation of an abbreviated version of the structured interview of reported symptoms in outpatient psychiatric and community settings.

    Science.gov (United States)

    Green, Debbie; Rosenfeld, Barry; Dole, Tia; Pivovarova, Ekaterina; Zapf, Patricia A

    2008-04-01

    This study examined the effectiveness of an abbreviated version of the Structured Interview of Reported Symptoms (SIRS-A) in identifying malingered mental illness. The SIRS-A is comprised of 69 items drawn from the SIRS (R. Rogers et al. 1992, SIRS: Structured Interview of Reported Symptoms: Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc.), substantially reducing the administration time. A simulation design was used with three samples; 87 psychiatric outpatients who responded honestly were compared to 29 community-dwelling adults and 24 psychiatric patients instructed to malinger psychopathology. The SIRS-A generated sensitivity comparable to or exceeding that of the SIRS normative data, but specificity was poorer; many genuinely impaired patients were misclassified as malingering. Although these findings suggest the SIRS-A may be an effective means to assess malingering in psychiatric populations, further research assessing the reasons for the elevated false positive rates is necessary.

  18. An Abbreviated Protocol for In Vitro Generation of Functional Human Embryonic Stem Cell-Derived Beta-Like Cells

    DEFF Research Database (Denmark)

    Massumi, Mohammad; Pourasgari, Farzaneh; Nalla, Amarnadh

    2016-01-01

    developed an abbreviated five-stage protocol (25-30 days) to generate human Embryonic Stem Cell-Derived Beta-like Cells (ES-DBCs). We showed that Geltrex, as an extracellular matrix, could support the generation of ES-DBCs more efficiently than that of the previously described culture systems......The ability to yield glucose-responsive pancreatic beta-cells from human pluripotent stem cells in vitro will facilitate the development of the cell replacement therapies for the treatment of Type 1 Diabetes. Here, through the sequential in vitro targeting of selected signaling pathways, we have...... positive cells, 1% insulin and glucagon positive cells and 30% insulin and NKX6.1 co-expressing cells. Functionally, ES-DBCs were responsive to high glucose in static incubation and perifusion studies, and could secrete insulin in response to successive glucose stimulations. Mitochondrial metabolic flux...

  19. Screening for personality disorder with the Standardised Assessment of Personality: Abbreviated Scale (SAPAS: further evidence of concurrent validity

    Directory of Open Access Journals (Sweden)

    Moran Paul

    2010-01-01

    Full Text Available Abstract Background The assessment of personality disorders (PD is costly and time-consuming. There is a need for a brief screen for personality disorders that can be used in routine clinical settings and epidemiological surveys. Aims: To test the validity of the Standardised Assessment of Personality: Abbreviated Scale (SAPAS as a screen for PD in a clinical sample of substance abusers. Methods Convergent validity of the SAPAS with both categorical and dimensional representations of personality disorders was estimated. Results In this sample, the SAPAS correlated well with dimensional representations of cluster A and C personality disorders, even after controlling for ADHD symptoms, anxiety/depression symptoms and recent substance use. The SAPAS was also significantly associated with total number of PD criteria, although correlation with categorical measures of PD was weak. Conclusions The SAPAS is an valid brief screen for PD as assessed dimensionally.

  20. Measuring health outcomes of a multidisciplinary care approach in individuals with chronic environmental conditions using an abbreviated symptoms questionnaire

    Directory of Open Access Journals (Sweden)

    Roy Fox

    2008-12-01

    Full Text Available Roy Fox1, Tara Sampalli1, Jonathan Fox11Nova Scotia Environmental Health Centre, Fall River, NS, CanadaAbstract: The Nova Scotia Environmental Health Centre is a treatment facility for individuals with chronic environmental conditions such as multiple chemical sensitivity, chronic fatigue syndrome, fibromyalgia, chronic respiratory conditions and in some cases chronic pain. The premise of care is to provide a patient-centred multidisciplinary care approach leading to self-management strategies. In order to measure the outcome of the treatment in these complex problems, with overlapping diagnoses, symptoms in many body systems and suspected environmental triggers, a detailed symptoms questionnaire was developed specifically for this patient population and validated. Results from a pilot study in which an abbreviated symptoms questionnaire based on the top reported symptoms captured in previous research was used to measure the efficacy of a multidisciplinary care approach in individuals with multiple chemical sensitivity are presented in this paper. The purpose of this study was to examine the extent, type and patterns of changes over time in the top reported symptoms with treatment measured using the abbreviated symptoms questionnaire. A total of 183 active and 109 discharged patients participated in the study where the health status was measured at different time periods of follow up since the commencement of treatment at the Centre. The findings from this study were successful in generating an initial picture of the nature and type of changes in these symptoms. For instance, symptoms such as difficulty concentrating, sinus conditions and tiredness showed early improvement, within the first 6 months of being in treatment, while others, such as fatigue, hoarseness or loss of voice, took longer while others showed inconsistent changes warranting further enquiry. A controlled longitudinal study is planned to confirm the findings of the pilot study

  1. Impact of abbreviated lecture with interactive mini-cases vs traditional lecture on student performance in the large classroom.

    Science.gov (United States)

    Marshall, Leisa L; Nykamp, Diane L; Momary, Kathryn M

    2014-12-15

    To compare the impact of 2 different teaching and learning methods on student mastery of learning objectives in a pharmacotherapy module in the large classroom setting. Two teaching and learning methods were implemented and compared in a required pharmacotherapy module for 2 years. The first year, multiple interactive mini-cases with inclass individual assessment and an abbreviated lecture were used to teach osteoarthritis; a traditional lecture with 1 inclass case discussion was used to teach gout. In the second year, the same topics were used but the methods were flipped. Student performance on pre/post individual readiness assessment tests (iRATs), case questions, and subsequent examinations were compared each year by the teaching and learning method and then between years by topic for each method. Students also voluntarily completed a 20-item evaluation of the teaching and learning methods. Postpresentation iRATs were significantly higher than prepresentation iRATs for each topic each year with the interactive mini-cases; there was no significant difference in iRATs before and after traditional lecture. For osteoarthritis, postpresentation iRATs after interactive mini-cases in year 1 were significantly higher than postpresentation iRATs after traditional lecture in year 2; the difference in iRATs for gout per learning method was not significant. The difference between examination performance for osteoarthritis and gout was not significant when the teaching and learning methods were compared. On the student evaluations, 2 items were significant both years when answers were compared by teaching and learning method. Each year, students ranked their class participation higher with interactive cases than with traditional lecture, but both years they reported enjoying the traditional lecture format more. Multiple interactive mini-cases with an abbreviated lecture improved immediate mastery of learning objectives compared to a traditional lecture format, regardless of

  2. Eye emergencies

    Science.gov (United States)

    ... eds. Duane's Foundations of Clinical Ophthalmology . Philadelphia, PA: Lippincott Williams and Wilkins; 2013:vol. 3, chap 6. ... Practice of Emergency Medicine . 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009:chap 54-61. Sharma R, ...

  3. Emergency Contraception

    Science.gov (United States)

    ... the pill that contains ulipristal acetate reduces the risk of pregnancy more effectively than pills that contain levonorgestrel.It is important to remember that emergency contraceptive pills will not prevent pregnancy if you have ...

  4. Myeloproliferative neoplasm (MPN) symptom assessment form total symptom score: Prospective international assessment of an abbreviated symptom burden scoring system among patients with MPNs

    NARCIS (Netherlands)

    R.M. Emanuel (Robyn); A.C. Dueck (Amylou); H.L. Geyer (Holly); J.J. Kiladjian; S. Slot (Stefanie); S. Zweegman (Sonja); P.A.W. te Boekhorst (Peter); S. Commandeur (Suzan); H. Schouten (Harry); F. Sackmann (Federico); A.K. Fuentes (Ana Kerguelen); D. Hernández-Maraver (Dolores); C. Pahl (Clemens); M. Griesshammer (Martin); F. Stegelmann (Frank); K. Doehner (Konstanze); T. Lehmann (Thomas); K. Bonatz (Karin); A. Reiter (Alfred); F. Boyer (Francoise); J. Etienne (Jerome); J.-C. Ianotto (Jean-Christophe); D. Ranta (Dana); L. Roy (Lydia); J.-Y. Cahn (Jean-Yves); C.N. Harrison (Claire); D. Radia (Deepti); P. Muxi (Pablo); N. Maldonado (Norman); C. Besses (Carlos); F. Cervantes (Francisco); P.L. Johansson (Peter); T. Barbui (Tiziano); G. Barosi (Giovanni); A.M. Vannucchi (Alessandro); F. Passamonti (Francesco); B. Andreasson (Bjorn); M.L. Ferarri (Maria); A. Rambaldi (Alessandro); J. Samuelsson (Jan); G. Birgegard (Gunnar); A. Tefferi (Ayalew); A.A. Mesa

    2012-01-01

    textabstractPurpose: Myeloproliferative neoplasm (MPN) symptoms are troublesome to patients, and alleviation of this burden represents a paramount treatment objective in the development of MPN-directed therapies. We aimed to assess the utility of an abbreviated symptom score for the most pertinent a

  5. 21 CFR 314.107 - Effective date of approval of a 505(b)(2) application or abbreviated new drug application under...

    Science.gov (United States)

    2010-04-01

    ... introduction into interstate commerce when approval of the application or abbreviated application for the drug... for 5 years of exclusive marketing under § 314.108(b)(2) and the patent owner or its representative or... application first commences commercial marketing of its drug product; or (ii) The date of a decision of...

  6. The Self-report Standardized Assessment of Personality-abbreviated Scale: Preliminary results of a brief screening test for personality disorders

    NARCIS (Netherlands)

    Germans, S.; Heck, G.L. van; Moran, P.; Hodiamont, P.P.G.

    2009-01-01

    Objective The internal consistency, test-retest reliability and validity of the Self-report Standardized Assessment of Personality-abbreviated Scale (SAPAS-SR) as a screening instrument for personality disorders were studied in a random sample of 195 Dutch psychiatric outpatients, using the Structu

  7. Myeloproliferative neoplasm (MPN) symptom assessment form total symptom score: Prospective international assessment of an abbreviated symptom burden scoring system among patients with MPNs

    NARCIS (Netherlands)

    R.M. Emanuel (Robyn); A.C. Dueck (Amylou); H.L. Geyer (Holly); J.J. Kiladjian; S. Slot (Stefanie); S. Zweegman (Sonja); P.A.W. te Boekhorst (Peter); S. Commandeur (Suzan); H. Schouten (Harry); F. Sackmann (Federico); A.K. Fuentes (Ana Kerguelen); D. Hernández-Maraver (Dolores); C. Pahl (Clemens); M. Griesshammer (Martin); F. Stegelmann (Frank); K. Doehner (Konstanze); T. Lehmann (Thomas); K. Bonatz (Karin); A. Reiter (Alfred); F. Boyer (Francoise); J. Etienne (Jerome); J.-C. Ianotto (Jean-Christophe); D. Ranta (Dana); L. Roy (Lydia); J.-Y. Cahn (Jean-Yves); C.N. Harrison (Claire); D. Radia (Deepti); P. Muxi (Pablo); N. Maldonado (Norman); C. Besses (Carlos); F. Cervantes (Francisco); P.L. Johansson (Peter); T. Barbui (Tiziano); G. Barosi (Giovanni); A.M. Vannucchi (Alessandro); F. Passamonti (Francesco); B. Andreasson (Bjorn); M.L. Ferarri (Maria); A. Rambaldi (Alessandro); J. Samuelsson (Jan); G. Birgegard (Gunnar); A. Tefferi (Ayalew); A.A. Mesa

    2012-01-01

    textabstractPurpose: Myeloproliferative neoplasm (MPN) symptoms are troublesome to patients, and alleviation of this burden represents a paramount treatment objective in the development of MPN-directed therapies. We aimed to assess the utility of an abbreviated symptom score for the most pertinent

  8. Emerging boundaries

    DEFF Research Database (Denmark)

    Løvschal, Mette

    2014-01-01

    This article proposes a processual ontology for the emergence of man-made, linear boundaries across northwestern Europe, particularly in the first millennium BC. Over a significant period of time, these boundaries became new ways of organizing the landscape and settlements—a phenomenon that has...... of this phenomenon emerged along equivalent trajectories. At the same time, variation in the regional incorporation of these linear phenomena points toward situation-specific applications and independent development....

  9. Dermatologic emergencies

    Directory of Open Access Journals (Sweden)

    M.P. Simón Díaz

    2016-01-01

    Full Text Available Dermatologic emergencies represent about 8–20% of the diseases seen in the Emergency Department of hospitals. It is often a challenge for primary care physicians to differentiate mundane skin ailments from more serious, life threatening conditions that require immediate intervention. In this review we included the following conditions: Stevens-Johnson syndrome/toxic epidermal necrosis, pemphigus vulgaris, toxic shock syndrome, fasciitis necrotising, angioedema/urticaria, meningococcemia, Lyme disease and Rocky Mountain spotted fever.

  10. Emerging images

    KAUST Repository

    Mitra, Niloy J.

    2009-01-01

    Emergence refers to the unique human ability to aggregate information from seemingly meaningless pieces, and to perceive a whole that is meaningful. This special skill of humans can constitute an effective scheme to tell humans and machines apart. This paper presents a synthesis technique to generate images of 3D objects that are detectable by humans, but difficult for an automatic algorithm to recognize. The technique allows generating an infinite number of images with emerging figures. Our algorithm is designed so that locally the synthesized images divulge little useful information or cues to assist any segmentation or recognition procedure. Therefore, as we demonstrate, computer vision algorithms are incapable of effectively processing such images. However, when a human observer is presented with an emergence image, synthesized using an object she is familiar with, the figure emerges when observed as a whole. We can control the difficulty level of perceiving the emergence effect through a limited set of parameters. A procedure that synthesizes emergence images can be an effective tool for exploring and understanding the factors affecting computer vision techniques. © 2009 ACM.

  11. EMERGENCY CALLS

    CERN Multimedia

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  12. Anorectal emergencies.

    Science.gov (United States)

    Lohsiriwat, Varut

    2016-07-14

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up.

  13. Surgical and clinical safety and effectiveness of robot-assisted laparoscopic hysterectomy compared to conventional laparoscopy and laparotomy for cervical cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Park, D A; Yun, J E; Kim, S W; Lee, S H

    2017-06-01

    This study aimed to evaluate the surgical safety and clinical effectiveness of RH versus LH and laparotomy for cervical cancer. We searched Ovid-Medline, Ovid-EMBASE, and the Cochrane library through May 2015, and checked references of relevant studies. We selected the comparative studies reported the surgical safety (overall; peri-operative; and post-operative complications; death within 30 days; and specific morbidities), and clinical effectiveness (survival; recurrence; length of stay [LOS]; estimated blood loss [EBL]; operative time [OT]) and patient-reported outcomes. Fifteen studies comparing RH with OH and 11 comparing RH with LH were identified. No significant differences were found in survival outcomes. The LOS was shorter and transfusion rate was lower with RH compared to OH or LH. EBL was significantly reduced with RH compared to OH. Compared to OH, overall complications, urinary infection, wound infection, and fever were significantly less frequent with RH. The overall, peri-operative, and post-operative complications were similar in other comparisons. Several patient-reported outcomes were improved with RH, though each outcome was reported in only one study. RH appears to have a positive effect in reducing overall complications, individual adverse events including wound infection, fever, urinary tract infection, transfusion, LOS, EBL, and time to diet than OH for cervical cancer patients. Compared to LH, the current evidence is not enough to clearly determine its clinical safety and effectiveness. Further rigorous prospective studies with long-term follow-up that overcome the many limitations of the current evidence are needed. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  14. Physiologic mastectomy via flank laparotomy.

    Science.gov (United States)

    Allen, Andrew J; Barrington, George M; Parish, Steve M

    2008-11-01

    Physiologic mastectomy can be used as a salvage procedure in cases of chronic suppurative mastitis, gangrenous mastitis, or chronic, severe mastitis associated with organisms liberating endotoxin or exotoxin. The surgical technique involves ligation of the major arterial blood supply (external pudendal artery) to the corresponding half of the mammary gland, which results in decreased systemic absorption of toxins and gland atrophy. The technique is performed with the cow standing, and it is relatively atraumatic. This procedure is a simple, yet effective alternative to radical mastectomy for unresponsive mastitis cases in genetically or otherwise valuable cattle.

  15. Hematologic emergencies

    Directory of Open Access Journals (Sweden)

    Daniele Vallisa

    2012-01-01

    Full Text Available In recent years, the surprising progress made in other areas of hematology (advances in the understanding of leukemogenesis, improved transplant techniques has been conspicuously absent in the management of hematologic emergencies. And yet, every step toward greater knowledge, every new treatment option will be of little value unless we are able to manage the acute complications of hematologic diseases. These complications are better defined as hematologic emergencies, and they are characterized by a high rate of mortality. This review is based on a search of the literature that was initially confined to articles published in the journal Hematology from 2000 to 2009. The search was then extended to the Cochrane Library and to Pub Med in February 2010 with the following Keywords emergencies; urgencies; hematology. The same key words were employed in a search of the archives of Blood and the New England Journal of Medicine from 2000 to 2010. The results confirm that hematologic emergencies can be caused by hematologic malignancies as well as by non-neoplastic hematologic diseases. Within the former category; this review examines the causes; manifestations; treatment and prevention of disseminated intravascular coagulation; superior vena caval syndrome; spinal cord compression; tumor lysis syndrome; hyperleukocytosis; and hypercalcemia. We also review emergency situations associated with non-neoplatic haematological diseases; such as thrombotic thrombocytopenic purpura; drug-induced hemolytic anemia; and acute sickle-cell crisis.

  16. Emergency management of complicated jejunal diverticulosis.

    Science.gov (United States)

    Johnson, Kevin N; Fankhauser, Grant T; Chapital, Alyssa B; Merritt, Marianne V; Johnson, Daniel J

    2014-06-01

    Jejunal diverticulosis is a rare condition that is usually found incidentally. It is most often asymptomatic but presenting symptoms are nonspecific and include abdominal pain, nausea, diarrhea, malabsorption, bleeding, obstruction, and/or perforation. A retrospective review of medical records between 1999 and 2012 at a tertiary referral center was conducted to identify patients requiring emergency management of complicated jejunal diverticulosis. Complications were defined as those that presented with inflammation, bleeding, obstruction, or perforation. Eighteen patients presented to the emergency department with acute complications of jejunal diverticulosis. Ages ranged from 47 to 86 years (mean, 72 years). Seven patients presented with evidence of free bowel perforation. Six had either diverticulitis or a contained perforation. The remaining five were found to have gastrointestinal bleeding. Fourteen of the patients underwent surgical management. Four patients were successfully managed nonoperatively. As a result of the variety of presentations, complications of jejunal diverticulosis present a diagnostic and therapeutic challenge for the acute care surgeon. Although nonoperative management can be successful, most patients should undergo surgical intervention. Traditional management dictates laparotomy and segmental jejunal resection. Diverticulectomy is not recommended as a result of the risk of staple line breakdown. The entire involved portion of jejunum should be resected when bowel length permits.

  17. Emergency preparedness

    CERN Document Server

    Cennini, E; Oortman Gerlings, P

    2009-01-01

    On September 19th 2008, a technical fault was at the centre of a sequence of events which hampered the performance of certain equipments of the LHC 3-4 sector. Once the first effects of this sequence of events were detected, the behaviour of the CERN staff confronted to this complex and critical situation became the centre of the risk control process. During such a downward spiral the preparation of all stakeholders is essential and should respect the (apparently) basic principles of emergency preparedness. Preparedness towards normal operation of CERN facilities towards minor up to major emergency situations will be presented. The main technical, organisational and legal frameworks of the CERN emergency preparedness will be recalled, highlighting the CERN risk management and risk control strategy. Then, the sequence of events experienced by different stakeholders on September 19th will be reported, thus starting the learned lessons process.

  18. EMERGING MARKETS

    Directory of Open Access Journals (Sweden)

    GHEORGHE CARALICEA-MĂRCULESCU

    2012-03-01

    Full Text Available The emerging markets are winning the currency war, because at this very moment its the battle of global financial institutions , as to who is more vulnerable and more exposed to the debt crisis and have their hands in more risky assets. US and Euro with their intertwining the financial stuff of the nation, the banks and the corporations are in a deep mess. One goes down, takes the other ones too. Right now , they all are struggling and getting beaten up , while the emerging markets are quiet and not really expressing their stands on the current situation except are reacting by all only putting their own houses in order.

  19. Emerging Materiality

    DEFF Research Database (Denmark)

    Bertelsen, Olav Wedege; Breinbjerg, Morten; Pold, Søren

    2009-01-01

    The authors examine how materiality emerges from complex chains of mediation in creative software use. The primarily theoretical argument is inspired and illustrated by interviews with two composers of electronic music. The authors argue that computer mediated activity should not primarily...

  20. Emergency control

    Energy Technology Data Exchange (ETDEWEB)

    Di Caprio, U.

    1982-01-01

    The main trends in the development of techniques presently used for emergency control of electric power systems are illustrated, from load-shedding to islanding, generator control, automatic reclosure of circuits, reactive power control and auxiliary aids in the control centers. Methods for improving the design criteria are reviewed. 61 refs.

  1. Emergency Preparedness

    CERN Document Server

    2001-01-01

    The trends of RPC work in the area of preparedness for nuclear and radiological accidents are listed. RPC in cooperation with Swedish Government developed the project on preparation for iodine prophylaxis in case of accident at Ignalina NPP and arranged seminar on emergency preparedness issues in 2001.

  2. Emergency Contraception

    Science.gov (United States)

    ... It works because the copper prevents sperm from swimming or functioning well. While more expensive than ECPs, an IUD is the most effective type of emergency contraception. It also can prevent future pregnancies for up to 12 years after insertion. How ...

  3. Thyroid emergencies.

    Science.gov (United States)

    Klubo-Gwiezdzinska, Joanna; Wartofsky, Leonard

    2012-03-01

    This review presents current knowledge about the thyroid emergencies known as myxedema coma and thyrotoxic storm. Understanding the pathogenesis of these conditions, appropriate recognition of the clinical signs and symptoms, and their prompt and accurate diagnosis and treatment are crucial in optimizing survival.

  4. Studying Emerge

    DEFF Research Database (Denmark)

    Davies, Sarah Rachael; Selin, Cynthia; Rodegher, Sandra

    2015-01-01

    The Emerge event, held in Tempe, AZ in March 2012, brought together a range of scientists, artists, futurists, engineers and students in order to experiment with innovative methods for thinking about the future. These methodological techniques were tested through nine workshops, each of which made...

  5. Emergence delirium

    DEFF Research Database (Denmark)

    Munk, Louise; Andersen, Lars Peter Holst; Gögenur, Ismail

    2013-01-01

    Emergence delirium (ED) is a well-known phenomenon in the postoperative period. However, the literature concerning this clinical problem is limited. This review evaluates the literature with respect to epidemiology and risk factors. Treatment strategies are discussed. The review concludes...

  6. Postmodern Emergence

    Science.gov (United States)

    Somerville, Margaret

    2007-01-01

    This paper is a work-in-progress in which the author will begin to articulate the elements of a new methodology that she is calling, for the moment, a methodology of postmodern emergence. She explores this approach through examples from her own research journals that follow her research-in-process and from observing student work-in-progress. She…

  7. APRENDIZAJE EN CIRUGÍA MEDIANTE LAPARATOMÍA EXPLORATORIA POR TRAUMA PENETRANTE. EXPERIENCIA EN EL HOSPITAL GENERAL DE CIUDAD JUÁREZ Learning in laparotomy-based abdominal surgery for managinf penetrating trauma: experience in the Ciudad Juárez General Hospital

    Directory of Open Access Journals (Sweden)

    Lenin Enríquez-Domínguez

    2011-01-01

    abdominal trauma over the course of a year. The variables analysed were cause of the lesion, type of laparotomy, the role played by the resident assistant / surgeon, damaged organs, established treatment, complications and mortality. This was a cross-sectional descriptive study. Analysis was done with percentages as means of summary and Pearson’s chi-square test for obtaining significant differences. Results. 203 patients underwent laparotomy, 109 were wounded by firearms and 105 had knife wounds. 139 therapeutic laparotomies were performed, 49 nontherapeutic ones and 15 damage-control surgeries. 24 were attended by first-year residents, 85 by second-year ones and 94 by residents in their third year. 184 of the 272 wounds were in hollow viscera, 78 in solid organs and 10 were vascular wounds; 28 post-surgical complications occurred, the most common ones being sepsis (8 patients and surgical site infection (5 cases. Conclusions. An important part of a surgeon’s training concerns acquiring technical abilities in the operating room and the integral management of patients suffering abdominal trauma from the time of their being admitted to the emergency room. Clear parameters have not been established regarding the number of patients who should be evaluated or the number of surgical procedures which must be performed during a resident’s formation

  8. Development and validation of a complementary map to enhance the existing 1998 to 2008 Abbreviated Injury Scale map

    Directory of Open Access Journals (Sweden)

    McLellan Susan

    2011-05-01

    Full Text Available Abstract Introduction Many trauma registries have used the Abbreviated Injury Scale 1990 Revision Update 98 (AIS98 to classify injuries. In the current AIS version (Abbreviated Injury Scale 2005 Update 2008 - AIS08, injury classification and specificity differ substantially from AIS98, and the mapping tools provided in the AIS08 dictionary are incomplete. As a result, data from different AIS versions cannot currently be compared. The aim of this study was to develop an additional AIS98 to AIS08 mapping tool to complement the current AIS dictionary map, and then to evaluate the completed map (produced by combining these two maps using double-coded data. The value of additional information provided by free text descriptions accompanying assigned codes was also assessed. Methods Using a modified Delphi process, a panel of expert AIS coders established plausible AIS08 equivalents for the 153 AIS98 codes which currently have no AIS08 map. A series of major trauma patients whose injuries had been double-coded in AIS98 and AIS08 was used to assess the maps; both of the AIS datasets had already been mapped to another AIS version using the AIS dictionary maps. Following application of the completed (enhanced map with or without free text evaluation, up to six AIS codes were available for each injury. Datasets were assessed for agreement in injury severity measures, and the relative performances of the maps in accurately describing the trauma population were evaluated. Results The double-coded injuries sustained by 109 patients were used to assess the maps. For data conversion from AIS98, both the enhanced map and the enhanced map with free text description resulted in higher levels of accuracy and agreement with directly coded AIS08 data than the currently available dictionary map. Paired comparisons demonstrated significant differences between direct coding and the dictionary maps, but not with either of the enhanced maps. Conclusions The newly

  9. Emerging Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter

    South Korean and Taiwanese brands have long been household names. Today, however, the names of transnational companies (TNCs) from an increasingly diverse set of emerging and developing economies are regularly making if not the dinner table conversation then at least the headlines of the internat......South Korean and Taiwanese brands have long been household names. Today, however, the names of transnational companies (TNCs) from an increasingly diverse set of emerging and developing economies are regularly making if not the dinner table conversation then at least the headlines......859 billion in 2003, up from USD129 billion in 1990, and has increased 11 times since 1985. A limited number of recent studies do exist, though (e.g. Cai 1999; Lecraw 1993; van Hoesel 1999; Tolentino 1993; Andreff 2003; Chudnovsky and López 2000; Bulatov 1998, Yeung 2000). Furthermore, academic...

  10. Emergency Contraception

    Directory of Open Access Journals (Sweden)

    Gemzell-Danielsson K

    2010-01-01

    Full Text Available There have been numerous attempts to control fertility after unprotected sexual intercourse. From very bizarre methods like the vaginal application of Coca Cola to the more serious attempts using calcium antagonists influencing fertility parameters in sperm to hormonal methods or intrauterine devices. So far, hormonal methods preventing or delaying ovulation have proved to be the most popular starting with the combination of ethinyl estradiol and levonorgestrel, known as the Yuzpe regimen. The first dose had to be taken within 72 hours of unprotected intercourse, a second one 12 hours later. Later on, levonorgestrel alone, at first in a regimen similar to the Yuzpe method (2 × 0.75 mg 12 hours apart showed to be more successful, eventually resulting in the development of a 1.5 mg levonorgestrel pill that combined good efficacy with a high ease of use. It has become the standard method used up to this day in most countries. Since the mid 1970s copper IUDs have been used for emergency contraception, which show a high efficacy. Their disadvantages lie in the fact that emergency contraception is considered an off label use and that they might not be acceptable for every patient. Mifepristone in doses of 10 or 25 mg is being used successfully as an emergency contraceptive in China, but has never received any significant consideration in Western countries. The most recent development is the approval of the selective progesterone receptor modulator ulipristal acetate in the dosage of 30 mg for emergency contraception up to 5 days after unprotected intercourse, combining the safe and easy application of the single dose levonorgestrel pill with an even higher efficacy. Several efficacious and easy to use methods for emergency contraception are available on the market today with the most widely spread being levonorgestrel in a single dose of 1.5 mg (given as one tablet of 1.5 mg or 2 tablets of 0.75 mg each for administration up to 3 days after

  11. Emerging Technologies

    OpenAIRE

    Salgar, S. M.

    2004-01-01

    Phenomenal advancements have taken place in the field of Information and communication technologies in the last decade. Spectacular and innovative changes are expected to take place in these fields in coming decade. Networking technologies are going through a sea change. This paper enumerates the likely networking technologies which are emerging, particularly WLANs. Most of the personal communication in the country will be through cellular/ mobile technologies, which are also covered in the p...

  12. Emerging jets

    Energy Technology Data Exchange (ETDEWEB)

    Schwaller, Pedro; Stolarski, Daniel [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Weiler, Andreas [European Organization for Nuclear Research (CERN), Geneva (Switzerland). TH-PH Div.; Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2015-02-15

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilities for discovery at LHCb are also discussed.

  13. Emerging Jets

    CERN Document Server

    Schwaller, Pedro; Weiler, Andreas

    2015-01-01

    In this work, we propose a novel search strategy for new physics at the LHC that utilizes calorimeter jets that (i) are composed dominantly of displaced tracks and (ii) have many different vertices within the jet cone. Such emerging jet signatures are smoking guns for models with a composite dark sector where a parton shower in the dark sector is followed by displaced decays of dark pions back to SM jets. No current LHC searches are sensitive to this type of phenomenology. We perform a detailed simulation for a benchmark signal with two regular and two emerging jets, and present and implement strategies to suppress QCD backgrounds by up to six orders of magnitude. At the 14 TeV LHC, this signature can be probed with mediator masses as large as 1.5 TeV for a range of dark pion lifetimes, and the reach is increased further at the high-luminosity LHC. The emerging jet search is also sensitive to a broad class of long-lived phenomena, and we show this for a supersymmetric model with R-parity violation. Possibilit...

  14. Nano Revolution--Big Impact: How Emerging Nanotechnologies Will Change the Future of Education and Industry in America (and More Specifically in Oklahoma). An Abbreviated Account

    Science.gov (United States)

    Holley, Steven E.

    2009-01-01

    Scientists are creating new and amazing materials by manipulating molecules at the ultra-small scale of 0.1 to 100 nanometers. Nanosize super particles demonstrate powerful and unprecedented electrical, chemical, and mechanical properties. This study examines how nanotechnology, as the multidisciplinary engineering of novel nanomaterials into…

  15. Testing the Abbreviated Food Technology Neophobia Scale and its relation to satisfaction with food-related life in university students.

    Science.gov (United States)

    Schnettler, Berta; Grunert, Klaus G; Miranda-Zapata, Edgardo; Orellana, Ligia; Sepúlveda, José; Lobos, Germán; Hueche, Clementina; Höger, Yesli

    2017-06-01

    The aims of this study were to test the relationships between food neophobia, satisfaction with food-related life and food technology neophobia, distinguishing consumer segments according to these variables and characterizing them according to willingness to purchase food produced with novel technologies. A survey was conducted with 372 university students (mean aged=20.4years, SD=2.4). The questionnaire included the Abbreviated version of the Food Technology Neophobia Scale (AFTNS), Satisfaction with Life Scale (SWLS), and a 6-item version of the Food Neophobia Scale (FNS). Using confirmatory factor analysis, it was confirmed that SWFL correlated inversely with FNS, whereas FNS correlated inversely with AFTNS. No relationship was found between SWFL and AFTNS. Two main segments were identified using cluster analysis; these segments differed according to gender and family size. Group 1 (57.8%) possessed higher AFTNS and FNS scores than Group 2 (28.5%). However, these groups did not differ in their SWFL scores. Group 1 was less willing to purchase foods produced with new technologies than Group 2. The AFTNS and the 6-item version of the FNS are suitable instruments to measure acceptance of foods produced using new technologies in South American developing countries. The AFTNS constitutes a parsimonious alternative for the international study of food technology neophobia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Math Anxiety Assessment with the Abbreviated Math Anxiety Scale: Applicability and usefulness: insights from the Polish adaptation

    Directory of Open Access Journals (Sweden)

    Krzysztof eCipora

    2015-11-01

    Full Text Available Math anxiety has an important impact on mathematical development and performance. However, although math anxiety is supposed to be a transcultural trait, assessment instruments are scarce and are validated mainly for Western cultures so far. Therefore, we aimed at examining the transcultural generality of math anxiety by a thorough investigation of the validity of math anxiety assessment in Eastern Europe. We investigated the validity and reliability of a Polish adaptation of the Abbreviated Math Anxiety Scale (AMAS, known to have very good psychometric characteristics in its original, American-English version as well as in its Italian and Iranian adaptations.We also observed high reliability, both for internal consistency and test-retest stability of the AMAS in the Polish sample. The results also show very good construct, convergent and discriminant validity: The factorial structure in Polish adult participants (n = 857 was very similar to the one previously found in other samples; AMAS scores correlated moderately in expected directions with state and trait anxiety, self-assessed math achievement and skill as well temperamental traits of emotional reactivity, briskness, endurance and perseverance. Average scores obtained by participants as well as gender differences and correlations with external measures were also similar across cultures. Beyond the cultural comparison, we used path model analyses to show that math anxiety relates to math grades and self-competence when controlling for trait anxiety.The current study shows transcultural validity of math anxiety assessment with the AMAS.

  17. Selecting an optimal abbreviated ICF set for clinical practice among rehabilitants with subacute stroke: retrospective analysis of patient records.

    Science.gov (United States)

    Saltychev, Mikhail; Tarvonen-Schröder, Sinikka; Eskola, Merja; Laimi, Katri

    2013-06-01

    To evaluate the adequacy of abbreviated versions of International Classification of Functioning, Disability and Health (ICF) (the WHO ICF Checklist and the ICF Comprehensive Core Set for Stroke) with respect to the specific clinical needs of a stroke rehabilitation unit before their implementation at a practical level. Common descriptions of functional limitations were identified from patient records of 10 subsequent subacute stroke patients referred to an inpatient multiprofessional rehabilitation unit of a university hospital. These descriptions were then converted into ICF categories, and the list was compared with the ICF Checklist of the WHO and the ICF Comprehensive and Brief Core Sets for Stroke developed by the ICF Research Branch. From the study population (50% women), 71 different, second-level ICF categories were identified, averaging 36.4 categories/patient (SD 5.8, range 28-46). Except for one category, all of the categories identified were also found in the ICF Comprehensive Core Set for Stroke. Of the categories identified, 49 (69%) were found in the WHO ICF Checklist. All except one category included in the ICF Brief Core Set for Stroke were also in our list. The Comprehensive Core Set for Stroke was found to be a good potential starting point for the practical implementation of the ICF in a stroke rehabilitation unit.

  18. Math Anxiety Assessment with the Abbreviated Math Anxiety Scale: Applicability and Usefulness: Insights from the Polish Adaptation

    Science.gov (United States)

    Cipora, Krzysztof; Szczygieł, Monika; Willmes, Klaus; Nuerk, Hans-Christoph

    2015-01-01

    Math anxiety has an important impact on mathematical development and performance. However, although math anxiety is supposed to be a transcultural trait, assessment instruments are scarce and are validated mainly for Western cultures so far. Therefore, we aimed at examining the transcultural generality of math anxiety by a thorough investigation of the validity of math anxiety assessment in Eastern Europe. We investigated the validity and reliability of a Polish adaptation of the Abbreviated Math Anxiety Scale (AMAS), known to have very good psychometric characteristics in its original, American-English version as well as in its Italian and Iranian adaptations. We also observed high reliability, both for internal consistency and test-retest stability of the AMAS in the Polish sample. The results also show very good construct, convergent and discriminant validity: The factorial structure in Polish adult participants (n = 857) was very similar to the one previously found in other samples; AMAS scores correlated moderately in expected directions with state and trait anxiety, self-assessed math achievement and skill as well temperamental traits of emotional reactivity, briskness, endurance, and perseverance. Average scores obtained by participants as well as gender differences and correlations with external measures were also similar across cultures. Beyond the cultural comparison, we used path model analyses to show that math anxiety relates to math grades and self-competence when controlling for trait anxiety. The current study shows transcultural validity of math anxiety assessment with the AMAS. PMID:26648893

  19. Math Anxiety Assessment with the Abbreviated Math Anxiety Scale: Applicability and Usefulness: Insights from the Polish Adaptation.

    Science.gov (United States)

    Cipora, Krzysztof; Szczygieł, Monika; Willmes, Klaus; Nuerk, Hans-Christoph

    2015-01-01

    Math anxiety has an important impact on mathematical development and performance. However, although math anxiety is supposed to be a transcultural trait, assessment instruments are scarce and are validated mainly for Western cultures so far. Therefore, we aimed at examining the transcultural generality of math anxiety by a thorough investigation of the validity of math anxiety assessment in Eastern Europe. We investigated the validity and reliability of a Polish adaptation of the Abbreviated Math Anxiety Scale (AMAS), known to have very good psychometric characteristics in its original, American-English version as well as in its Italian and Iranian adaptations. We also observed high reliability, both for internal consistency and test-retest stability of the AMAS in the Polish sample. The results also show very good construct, convergent and discriminant validity: The factorial structure in Polish adult participants (n = 857) was very similar to the one previously found in other samples; AMAS scores correlated moderately in expected directions with state and trait anxiety, self-assessed math achievement and skill as well temperamental traits of emotional reactivity, briskness, endurance, and perseverance. Average scores obtained by participants as well as gender differences and correlations with external measures were also similar across cultures. Beyond the cultural comparison, we used path model analyses to show that math anxiety relates to math grades and self-competence when controlling for trait anxiety. The current study shows transcultural validity of math anxiety assessment with the AMAS.

  20. Reliability and diagnostic efficiency of the abbreviated-diagnostic interview for borderlines in an adolescent clinical population.

    Science.gov (United States)

    Guilé, Jean Marc; Greenfield, Brian; Berthiaume, Claude; Chapdelaine, Cimon; Bergeron, Lise

    2009-09-01

    Examine the reliability as well as the concurrent validity and diagnostic efficiency of the Abbreviated version of the diagnostic interview for borderlines revised (Ab-DIB) as a screening measure of borderline psychopathology in an adolescent clinical population. The Ab-DIB is a DIB-R-derived self-report covering the impulsiveness as well as the affect and cognitive components of the borderline construct. Its administration lasts 10 min. The Ab-DIB was tested on 139 suicidal youths for reliability and concurrent validity against the DIB-R and the Columbia Impairment Scale (CIS). Internal consistencies and test-retest Intra-Class-Correlations ranged from 0.80 to 0.86 and 0.77 to 0.95, respectively. ROC analysis yielded an area under the curve of 0.87 (p < 0.001). Sensitivity was 0.88 and specificity ranged from 0.82 to 0.73 depending on the age-range. Correlation of the Ab-DIB's continuous score with the CIS was 0.42 (p < 0.001). In conclusion, The Ab-DIB's brief duration and psychometric properties suggest its utility in time-limited settings.

  1. Consequences of peritonism in an emergency department setting

    DEFF Research Database (Denmark)

    Bjørsum-Meyer, Thomas; Schmidt, Thomas A.

    2013-01-01

    Background: In patients who were referred to the emergency department (ED) with abdominal pain, it is crucial to determine the presence of peritonism to allow for appropriate handling and subsequent referral to stationary departments. We aimed to assess the incidence of perceived peritonism...... on the patients with abdominal pain. Following a physical examination, the patients with abdominal pain were divided into those who had clinical signs of peritonism and those who did not. Results: Among the 1,270 patients admitted to the ED, 10% had abdominal pain. In addition, 41% of these patients were found...... to have signs indicative of peritonism, and 90% were admitted to the Department of Surgery (DS). Also, 24% of those patients with signs of peritonism and admission to the DS underwent surgical intervention in terms of laparotomy/laparoscopy. Five of the patients without peritonism underwent surgery...

  2. Management of Hepatic Rupture Diagnosed after an Emergency Cesarean Section

    Directory of Open Access Journals (Sweden)

    Gianluca Raffaello Damiani

    2014-01-01

    Full Text Available A careful management of hepatic capsular rupture, with massive hemoperitoneum which occurred 14 hours after an emergency cesarean section at 36 weeks of gestation, is meticulously reported. The grade of hepatic involvement varies from minor capsular laceration to extensive parenchymal rupture. Our management involved a combination of surgical interventions and aggressive supportive care. The patient was discharged after 53 days and 4 laparotomies and an unsuccessful attempt of superselective artery embolization. Ultrasound after 40 days from the last surgery showed uniform hepatic parenchyma free of focal lesions. Due to the rarity and the unpredictability nature of this devastating event we believe necessary to report our experience, reinforcing the importance of the postsurgery management.

  3. Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref) in north Indian patients with bronchial asthma: an evaluation using Rasch analysis

    OpenAIRE

    Aggarwal, Ashutosh N.; Agarwal, Ritesh; Gupta, Dheeraj

    2014-01-01

    Background: There is no disease-specific instrument to describe health-related quality of life (HRQoL) in Indian patients with asthma. However, an abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref), a generic Hindi HRQoL measure, has been developed and validated in India. Aims: To evaluate the WHOQOL-Bref in adult patients with asthma and to test possible modifications to the instrument to improve its psychometric adequacy. Methods: Sixty-seven patients with ast...

  4. 腹腔镜与开腹手术治疗胆总管囊肿的临床对比研究%Clinical comparison of laparoscope and laparotomy in treatment of chole-dochocyst

    Institute of Scientific and Technical Information of China (English)

    王朝晖; 杜志勇; 全昌银

    2015-01-01

    Objective:To explore the clinical efficacy and safety of laparoscope and laparotomy in the treatment of choledocho-cyst.Methods:A total of 98 infants with congenital choledochocyst were randomly divided into laparoscope group treated with laparo-scope and laparotomy group with laparotomy to incise the cyst.The differences of surgical duration,intra-operative hemorrhagic vol-ume,postoperative evacuation time,feeding time and hospital stays between two groups were observed and complications were recor-ded.Results:Both group had no intra-operative death.Only 1 infant in laparoscope group was transferred to laparotomy due to severe adhesion,whereas all infants in laparotomy group finished the surgery successfully.Laparoscope group was evidently longer in surgical duration but significantly lower in intra-operative hemorrhagic volume and markedly shorter in postoperative evacuation time,feeding time and hospital stays than laparotomy group (P 0.05).Conclusion:Compared with laparomoty,laparoscope is longer in surgical duration but smaller in trauma and quicker in postoperative recovery without increasing the development of complications in treating choledochocyst,so selection of proper surgical method based on the real conditions of patients can improve their clinical benefits.%目的:探讨腹腔镜与开腹手术治疗胆总管囊肿的临床疗效与安全性。方法:先天性胆总管囊肿患儿98例随机分为腹腔镜组(腹腔镜下切除囊肿)和开腹组(开腹手术切除囊肿),观察两组手术时间、术中出血量、术后排气时间、进食时间以及住院时间差异,并记录并发症。结果:两组均未发生围术期死亡病例。腹腔镜组有1例因粘连较重,中转开腹手术;开腹组患儿均顺利完成手术。腹腔镜组手术时间长于开腹组,但术中出血少于开腹组,术后排气时间、进食时间及住院时间均短于开腹组(P <0.01)。两组术后主要并发症为胆漏

  5. Is it an Emergency?

    Science.gov (United States)

    ... Emergency 101 Share this! Home » Emergency 101 Is it an Emergency? Medical emergencies can be frightening and ... situation. Here you can find information about emergencies. It is essential to know how to recognize the ...

  6. 两种不同类型的缩略词语:用语缩略与造词缩略——兼论海峡两岸缩略词语的类型差异%Two kinds of Abbreviations:Abbreviations about Using and Abbreviation about Coinages——On Different Types across the Taiwan Strait

    Institute of Scientific and Technical Information of China (English)

    刁晏斌

    2011-01-01

    Abbreviations in Modern Chinese are a very complex set which can be divided as abbreviations about using and abbreviation about coinages,depending on their generated motivations and generative process.The former focuses on the convenient form of language use about the relatively fixed form of language.The latter is a kind of combination which is not associated with a relatively fixed strictly corresponded to the original style,using the abbreviated form of word-building materials.They have different focuses and correspond to different issues.The mechanism and procedure of generating and the surface meanings are also different.In the framework of dichotomy,there are significant difference between abbreviations in Taiwan Mandarin and mainland Mandarin: as to abbreviations about using,it includes less Numeral Compact Expressions,more common names and more compaction of Three-syllable words;as to abbreviation about coinages,it includes less fixed terms but more temporary words.%现代汉语缩略词语是一个非常复杂的集合,可以根据其产生动机和生成过程等的差异,分为"用语的缩略"和"造词的缩略",前者因着眼于对已有相对固定语言形式的便捷使用而生,后者则是不与某一相对固定的原式严格对应的、利用缩略性构词材料构成的组合形式。二者的着眼点不同,对应物不同,产生机制和过程不同,在表义上也有差异。在这个二分的框架下,可以看到台湾"国语"缩略词语与普通话的明显差异:就用语缩略来说,是数字略语少、合称多、三音节词的简缩多;就造词缩略来看,则是固定词少而临时词多。

  7. Emerging Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter

    South Korean and Taiwanese brands have long been household names. Today, however, the names of transnational companies (TNCs) from an increasingly diverse set of emerging and developing economies are regularly making if not the dinner table conversation then at least the headlines...... of the international business press. This reflects that companies such as Mittal and Tata (India), China National Offshore Oil Corporation (CNOOC), Haier and Lenovo (PRC), Embraer (Brazil), SAPMiller (South Africa), and Cemex (Mexico) are foraying ever deeper into the international economy and increasingly investing...

  8. Laparoscopy in major abdominal emergency surgery seems to be a safe procedure

    DEFF Research Database (Denmark)

    Nielsen, Liv Bjerre Juul; Tengberg, Line Toft; Bay-Nielsen, Morten

    2017-01-01

    INTRODUCTION: Laparoscopy is well established in the majority of elective procedures in abdominal surgery. In contrast, it is primarily used in minor surgery such as appendectomy or cholecystectomy in the emergent setting. This study aimed to analyze the safety and effectiveness of a laparoscopic...... approach in a large cohort of major abdominal emergencies. METHODS: A population-based cohort from the Region of Copenhagen, Denmark, including n = 1,139 patients undergoing major abdominal emergency surgery in 2012. RESULTS: A total of 313 patients were operated with an initial laparoscopic approach; 37......% were laparoscopically completed and 63% of the operations were converted to a laparotomy. Most conversions (40%) were for performing a bowel resection, 35% were due to inadequate exposure, 2% were converted due to accidental bleeding and 7% due to iatrogenic injuries. The reoperation rate was 17...

  9. Avaliação muscular respiratória nas toracotomias e laparotomias superiores eletivas Respiratory muscle evaluation in elective thoracotomies and laparotomies of the upper abdomen

    Directory of Open Access Journals (Sweden)

    Laryssa Milenkovich Bellinetti

    2006-04-01

    Full Text Available OBJETIVO: Verificar se existe associação entre a função muscular respiratória pré-operatória abaixo dos valores previstos e a incidência de complicações pós-operatórias e o óbito, nas laparotomias superiores e toracotomias eletivas. MÉTODOS: Estudo de coorte prospectivo, no qual 70 pacientes acima de dezoito anos foram acompanhados, em dois hospitais similares. A avaliação durante a internação pré-operatória classificou-os em não expostos (50 ou expostos (20, estes quando os valores das pressões respiratórias máximas foram abaixo de 75% dos valores previstos. O acompanhamento foi feito até a alta hospitalar, verificando-se a incidência de pneumonia, insuficiência respiratória aguda, broncoespasmo, ventilação mecânica prolongada, atelectasia, derrame pleural, pneumotórax e óbito nos dois grupos. Realizou-se análise comparativa entre os grupos e cálculo do risco relativo. RESULTADOS: A incidência total de complicações pós-operatórias da amostra foi de 22,86% (16/70; no grupo exposto foi de 55% (11/20 e no grupo não exposto de 10% (5/50. Os pacientes expostos apresentaram risco relativo de 5,5 (intervalo de confiança de 95% entre 2,19 e 13,82. CONCLUSÃO: Os resultados indicaram que a função muscular respiratória pré-operatória abaixo do valor previsto esteve associada a um risco relativo maior de complicações pós-operatórias nas cirurgias pesquisadas.OBJECTIVE: To identify any possible relation between lower than predicted preoperative respiratory muscle function and the incidence of postoperative respiratory complications and death in elective thoracotomies and laparotomies of the upper abdomen. METHODS: A prospective cohort study was conducted, in which 70 patients over the age of 18 were monitored in two similar hospitals. In the preoperative evaluation performed at admission, patients were classified as presenting respiratory muscle function (as determined by measurement of maximal respiratory

  10. Abbreviation of larval development and extension of brood care as key features of the evolution of freshwater Decapoda.

    Science.gov (United States)

    Vogt, Günter

    2013-02-01

    The transition from marine to freshwater habitats is one of the major steps in the evolution of life. In the decapod crustaceans, four groups have colonized fresh water at different geological times since the Triassic, the freshwater shrimps, freshwater crayfish, freshwater crabs and freshwater anomurans. Some families have even colonized terrestrial habitats via the freshwater route or directly via the sea shore. Since none of these taxa has ever reinvaded its environment of origin the Decapoda appear particularly suitable to investigate life-history adaptations to fresh water. Evolutionary comparison of marine, freshwater and terrestrial decapods suggests that the reduction of egg number, abbreviation of larval development, extension of brood care and lecithotrophy of the first posthatching life stages are key adaptations to fresh water. Marine decapods usually have high numbers of small eggs and develop through a prolonged planktonic larval cycle, whereas the production of small numbers of large eggs, direct development and extended brood care until the juvenile stage is the rule in freshwater crayfish, primary freshwater crabs and aeglid anomurans. The amphidromous freshwater shrimp and freshwater crab species and all terrestrial decapods that invaded land via the sea shore have retained ocean-type planktonic development. Abbreviation of larval development and extension of brood care are interpreted as adaptations to the particularly strong variations of hydrodynamic parameters, physico-chemical factors and phytoplankton availability in freshwater habitats. These life-history changes increase fitness of the offspring and are obviously favoured by natural selection, explaining their multiple origins in fresh water. There is no evidence for their early evolution in the marine ancestors of the extant freshwater groups and a preadaptive role for the conquest of fresh water. The costs of the shift from relative r- to K-strategy in freshwater decapods are traded

  11. An Abbreviated Protocol for In Vitro Generation of Functional Human Embryonic Stem Cell-Derived Beta-Like Cells

    Science.gov (United States)

    Massumi, Mohammad; Pourasgari, Farzaneh; Nalla, Amarnadh; Batchuluun, Battsetseg; Nagy, Kristina; Neely, Eric; Gull, Rida; Nagy, Andras; Wheeler, Michael B.

    2016-01-01

    The ability to yield glucose-responsive pancreatic beta-cells from human pluripotent stem cells in vitro will facilitate the development of the cell replacement therapies for the treatment of Type 1 Diabetes. Here, through the sequential in vitro targeting of selected signaling pathways, we have developed an abbreviated five-stage protocol (25–30 days) to generate human Embryonic Stem Cell-Derived Beta-like Cells (ES-DBCs). We showed that Geltrex, as an extracellular matrix, could support the generation of ES-DBCs more efficiently than that of the previously described culture systems. The activation of FGF and Retinoic Acid along with the inhibition of BMP, SHH and TGF-beta led to the generation of 75% NKX6.1+/NGN3+ Endocrine Progenitors. The inhibition of Notch and tyrosine kinase receptor AXL, and the treatment with Exendin-4 and T3 in the final stage resulted in 35% mono-hormonal insulin positive cells, 1% insulin and glucagon positive cells and 30% insulin and NKX6.1 co-expressing cells. Functionally, ES-DBCs were responsive to high glucose in static incubation and perifusion studies, and could secrete insulin in response to successive glucose stimulations. Mitochondrial metabolic flux analyses using Seahorse demonstrated that the ES-DBCs could efficiently metabolize glucose and generate intracellular signals to trigger insulin secretion. In conclusion, targeting selected signaling pathways for 25–30 days was sufficient to generate ES-DBCs in vitro. The ability of ES-DBCs to secrete insulin in response to glucose renders them a promising model for the in vitro screening of drugs, small molecules or genes that may have potential to influence beta-cell function. PMID:27755557

  12. SLAM-enriched hematopoietic stem cells maintain long-term repopulating capacity after lentiviral transduction using an abbreviated protocol.

    Science.gov (United States)

    Laje, P; Zoltick, P W; Flake, A W

    2010-03-01

    Gene transfer to long-term repopulating hematopoietic stem cells (HSCs) using integrating viral vectors is an important goal in gene therapy. The SLAM (signaling lymphocyte activation molecule)-family receptors have recently been used for the isolation of highly enriched murine HSCs. This HSC enrichment protocol is relatively simple, and results in an HSC population with comparable repopulating capacity to c-kit(+)lin(-)Sca-1(+) (KSL) HSCs. The capacity to withstand genetic manipulation and, most importantly, to maintain long-term repopulating capacity of SLAM-enriched HSC populations has not been reported. In this study, SLAM-enriched HSCs were assessed for transduction efficiency and in vivo long-term repopulating capacity after lentiviral transduction using an abbreviated transduction protocol and KSL-enriched HSCs as a reference population. SLAM- and KSL-enriched HSCs were efficiently transduced by lentiviral vector using a simple protocol that involves minimal in vitro manipulation and no pre-stimulation. SLAM-HSCs are at least equal to KSL-HSCs with respect to efficiency of transduction and maintenance of long-term repopulating capacity. Although there was a reduction in repopulating capacity related to enrichment and culture manipulations relative to freshly isolated bone marrow (BM) cells, no detrimental effects were identified on long-term competitive capacity related to transduction, as transduced cells maintained stable levels of chimerism in competition with non-transduced cells and freshly isolated BM cells. These results support the SLAM-HSC enrichment protocol as a simple and efficient method for HSC enrichment for gene transfer studies.

  13. Use of an abbreviated neuroscience education approach in the treatment of chronic low back pain: a case report.

    Science.gov (United States)

    Louw, Adriaan; Puentedura, Emilio Louie; Mintken, Paul

    2012-01-01

    Chronic low back pain (CLBP) remains prevalent in society, and conservative treatment strategies appear to have little effect. It is proposed that patients with CLBP may have altered cognition and increased fear, which impacts their ability to move, perform exercise, and partake in activities of daily living. Neuroscience education (NE) aims to change a patient's cognition regarding their pain state, which may result in decreased fear, ultimately resulting in confrontation of pain barriers and a resumption of normal activities. A 64-year-old female with history of CLBP was the patient for this case report. A physical examination, the Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire (FABQ), and Zung Depression Scale were assessed during her initial physical therapy visit, immediately after her first physical therapy session, and at 7-month follow-up. Treatment consisted of an abbreviated NE approach, exercises (range of motion, stretches, and cardiovascular), and aquatic therapy. She attended twice a week for 4 weeks, or 8 visits total. Pre-NE, the patient reported NPRS = 9/10; ODI = 54%; FABQ-W = 25/42,; FABQ-PA = 20/24, and Zung = 58. Immediately following the 75-minute evaluation and NE session, the patient reported improvement in all four outcome measures, most notably a reduction in the FABQ-W score to 2/42 and the FABQ-PA to 1/24. At a 7-month follow-up, all outcome measures continued to be improved. NE aimed at decreasing fear associated with movement may be a valuable adjunct to movement-based therapy, such as exercise, for patients with CLBP.

  14. [Urological emergencies].

    Science.gov (United States)

    Danuser, H; Ackermann, D K; Studer, U E

    1993-04-17

    Every general practitioner has to deal with urologic emergencies. The most frequent illnesses are urinary retention, acute scrotum, priapism, macrohematuria, nephritic colic, obstructive pyelonephritis and pyonephrosis. Whereas urinary retention, as well as acute ureteric stone colic must generally be treated by the practitioner, the urologist must often be consulted in case of an acute scrotum or for priapism. Testicular torsion is one situation, where surgical treatment needs to be performed within 6 hours. Of utmost importance is his timely assistance with the obstructive pyelonephritis and pyonephrosis. These are initially often not recognized, especially because the first ultrasound examination of the intrarenal pyelone may not show a dilatation of the collecting system despite obstruction. If the adequate treatment with drainage and antibiotics is applied too late, this can result in serious and potentially lethal consequences.

  15. A rare case of mature cystic teratoma in the emergency department

    Directory of Open Access Journals (Sweden)

    Zeynep Konyar

    2016-05-01

    Full Text Available Teratomas are the most common germ cell tumors among pediatric and female patients, which originates from germ cells layers and can be located everywhere in bodies. They are diagnosed by ultrasonography (US, which was characterized by calcification and cystic anechoic view. Our aim is to attract attention to a 21-year-old female patient with complaint of acute abdominal pain diagnosed with teratoma by early radiological imaging. The female patient admitted to the emergency department with a new onset of abdominal pain at the lower and left sides of the abdomen for a week. The suprapubic and left costovertebral angle tenderness were found in her physical examination. We firstly chose US for imaging. The US of the abdomen showed multiple cystic masses around uterus. Heterogeneous cystic and calcified lesions were detected on the patients computerized tomography scan, and considered as teratoma. A laparotomy was performed by gynecologists. At laparotomy, lobulated cystic masses were removed and the left ovary had been detorsioned. She has been discharged after two days of postoperative observation. For patients of young females with abdominal pain such as rare gynecological diseases, teratoma and ovarian torsion, in the emergency department should be considered and early imaging should be performed.

  16. A rare case of mature cystic teratoma in the emergency department

    Institute of Scientific and Technical Information of China (English)

    Zeynep Konyar; Gokhan Eyupoglu; Mehmet Tatli; Ozlem Guneysel

    2016-01-01

    Teratomas are the most common germ cell tumors among pediatric and female patients, which originates from germ cells layers and can be located everywhere in bodies. They are diagnosed by ultrasonography (US), which was characterized by calcification and cystic anechoic view. Our aim is to attract attention to a 21-year-old female patient with complaint of acute abdominal pain diagnosed with teratoma by early radiological im-aging. The female patient admitted to the emergency department with a new onset of abdominal pain at the lower and left sides of the abdomen for a week. The suprapubic and left costovertebral angle tenderness were found in her physical examination. We firstly chose US for imaging. The US of the abdomen showed multiple cystic masses around uterus. Heterogeneous cystic and calcified lesions were detected on the patients computerized tomography scan, and considered as teratoma. A laparotomy was per-formed by gynecologists. At laparotomy, lobulated cystic masses were removed and the left ovary had been detorsioned. She has been discharged after two days of postoperative observation. For patients of young females with abdominal pain such as rare gyneco-logical diseases, teratoma and ovarian torsion, in the emergency department should be considered and early imaging should be performed.

  17. Postoperative Complications Leading to Death after Coagulum Pyelolithotomy in a Tetraplegic Patient: Can We Prevent Prolonged Ileus, Recurrent Intestinal Obstruction due to Adhesions Requiring Laparotomies, Chest Infection Warranting Tracheostomy, and Mechanical Ventilation?

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2013-01-01

    Full Text Available A 22-year-old male sustained C-6 tetraplegia in 1992. In 1993, intravenous pyelography revealed normal kidneys. Suprapubic cystostomy was performed. He underwent open cystolithotomy in 2004 and 2008. In 2009, computed tomography revealed bilateral renal calculi. Coagulum pyelolithotomy of left kidney was performed. Pleura and peritoneum were opened. Peritoneum could not be closed. Following surgery, he developed pulmonary atelectasis; he required tracheostomy and mechanical ventilation. He did not tolerate nasogastric feeding. CT of abdomen revealed bilateral renal calculi and features of proximal small bowel obstruction. Laparotomy revealed small bowel obstruction due to dense inflammatory adhesions involving multiple small bowel loops which protruded through the defect in sigmoid mesocolon and fixed posteriorly over the area of previous intervention. All adhesions were divided. The wide defect in mesocolon was not closed. In 2010, this patient again developed vomiting and distension of abdomen. Laparotomy revealed multiple adhesions. He developed chest infection and required ventilatory support again. He developed pressure sores and depression. Later abdominal symptoms recurred. This patient’s general condition deteriorated and he expired in 2011. Conclusion. Risk of postoperative complications could have been reduced if minimally invasive surgery had been performed instead of open surgery to remove stones from left kidney. Suprapubic cystostomy predisposed to repeated occurrence of stones in urinary bladder and kidneys. Spinal cord physicians should try to establish intermittent catheterisation regime in tetraplegic patients.

  18. Clinical analysis on conversion to laparotomy during laparoscopic cholecystectomy:report of 30 cases%腹腔镜胆囊切除术中转开腹30例临床分析

    Institute of Scientific and Technical Information of China (English)

    黄鑫; 洪建文; 詹泽锋; 谢志伟; 王森辉

    2014-01-01

    Objective To investigate the causes and prevention of conversion to laparotomy during laparoscopic cholecystectomy. Methods Clinical data of 30 out of 770 patients converting to laparotomy during laparoscopic cholecystectomy in Guangdong Chaozhou Central Hospital from February 2007 to January 2013 were analyzed retrospectively. There were 13 males and 17 females with age ranging from 25 to 81 years old and a median age of 48 years old. The informed consents of all patients were obtained and the ethical committee approval was received. Laparoscopic cholecystectomy was performed in the patients under endotracheal general anesthesia using the conventional 4-port approach. The causes of conversion to laparotomy during laparoscopic cholecystectomy and the incidence of postoperative complications of the patients were observed. Results The incidence of conversion to laparotomy during laparoscopic cholecystectomy was 3.9%(30/770). The causes of conversion to laparotomy were adhesion at Calot's triangle (n=12), gallbladder bed bleeding (n=6), gallbladder artery bleeding (n=4), dense adhesion around the gallbladder with difficult dissecting (n=4), dissatisfactory treatment of the gallbladder stump (n=1), liver surface laceration (n=1), gallbladder carcinoma (n=1). All the converted laparotomies were completed at one time. No complication was observed in all patients after operation. Conclusions The common causes for conversion to laparotomy during laparoscopic cholecystectomy were unclear dissection at Calot's triangle and around the gallbladder, gallbladder bed or gallbladder artery bleeding, dissatisfactory treatment of gallbladder stump, liver surface laceration, gallbladder cancer, etc. Improving the preoperative evaluation, intraoperative appropriate treatment of the Calot's triangle and gallbladder bed are the keys to prevent conversion to laparotomy during laparoscopic cholecystectomy.%目的探讨腹腔镜胆囊切除术中转开腹的原因及预防

  19. CLINICAL AND ERITROLEUCOMETRIC EVALUATION OF COLIC HORSES SUBMITTED TO LAPAROTOMY AND SURVIVED OR NOT AVALIAÇÃO CLÍNICA E ERITROLEUCOGRAMA DE EQÜINOS COM CÓLICA SUBMETIDOS À LAPAROTOMIA, SOBREVIVENTES E NÃO SOBREVIVENTES

    Directory of Open Access Journals (Sweden)

    Aureo Evangelista Santana

    2009-12-01

    Full Text Available

    Seventy horses were utilized, twenty healthy horses (GI and fifty colic horses which survived (GII, n=25 or not (GIII, n=25 after laparotomy. Clinical examination was carried out and blood samples were collected before laparotomy (T0 and after laparotomy (T24h-T240h. Animals from GII, at T0 and animals from GIII, at T0, T24h, T48h, T72h, T96h, T120h, T168h and T240h after laparotomy presented increase of respiratory and heart rates, tissue perfusion time, red blood cell, leukocyte, and packed cell volume. In the same moments the animals from GII and GIII presented decrease of concentration of total plasmatic proteins. The intensity and persistence of theses alterations relates negatively to the animals recuperation and were attributed the time, localization and, severity of obstruction. Laboratorial and clinical analysis in series can be useful for the prognosis of post-operative recovery after laparotomy.

    KEY WORDS: Acute abdomen, equine, haemogram. 
    Utilizaram-se setenta equinos, vinte sadios (GI e cinquenta com cólica, submetidos à laparotomia, sobreviventes (GII, n=25 e não sobreviventes (GIII, n=25. O exame clínico e a colheita das amostras de sangue foram realizados antes da laparotomia (T0 e diariamente, a partir da cirurgia, até o décimo dia após a intervenção (T24h - T10o dia. No T0, observou-se aumento dos valores da frequência cardíaca e respiratória, do tempo de perfusão tecidual, do número de hemácias, do volume globular e do número de leucócitos nos equinos dos grupos GII e GIII, que ainda se mantiveram até o décimo dia pós-operatório nos animais do grupo GIII. Nesses mesmos momentos e animais verificou-se diminuição na concentração das proteínas plasmáticas totais. A intensidade e a persistência das alterações relacionaram-se negativamente com a recuperação dos animais e foram atribuídas ao tempo, à localização e à gravidade do processo obstrutivo. A

  20. Analysis of risk factors for conversion of laparoscopic cholecystectomy to laparotomy%腹腔镜胆囊切除术中转开腹的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    朱建华; 韩江; 陈益鸣; 王炜; 乔弟; 马大喜; 汪运节; 高书平

    2012-01-01

    目的 探讨腹腔镜胆囊切除术(LC)中转开腹的危险因素.方法 1020例LC患者,选取其中36例中转开腹患者作为病例组,108例LC成功患者作为对照组,采用单因素分析和非条件Loistic回归模型分析LC中转开腹的危险因素.结果 年龄>65岁(OR=3.234,95% CI:0.532~6.853),病程>72 h(OR=2.342,95% CI:0.568~5.656),上腹部手术史(OR=2.453,95% CI:0.345~7.453),胆囊壁厚度≥6 mm(OR=2.453,95% CI:0.453~6.343),白细胞计数≥15.0×109/L(OR=4.532,95% CI:0.535~8.329)是LC中转开腹的危险因素.结论 术前综合评估患者具有的危险因素进而选择手术方案,对降低LC中转开腹率具有重要的临床意义.%Objective To investigate the risk factors for conversion of laparoscopic cholecystectomy (LC) to laparotomy.Methods In 1020 LC patients,36 patients with conversion of LC to laparotomy were chosen as the case group,108 patients with successful LC were chosen as the control group.Univariate analysis and Logistic multivariate regression model were used to analyze the risk factors for conversion of LC to laparotomy.Results Age > 65 years (0R=3.234,95% CI:0.532-6.853),course of disease > 72h (OR =2.342,95% CI:0.568 ~ 5.656),history of upper abdominal operation (OR =2.453,95% CI:0.345-7.453),thickness of gallbladder wall ≥ 6 mm (OR =2.453,95% CI:0.453-6.343),white bloodcell count > 15.0 × 109/L (OR =4.532,95% CI:0.535-8.329) were risk factors for conversion of LC to laparotomy.Conclusion Preoperative comprehensive evaluation the risk factors and selecting suitable program have important clinical significant in reducing the rate of conversion LC to laparotomy.

  1. Emerging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Shin-yee

    1993-03-01

    The mission of the Emerging Technologies thrust area at Lawrence Livermore National Laboratory is to help individuals establish technology areas that have national and commercial impact, and are outside the scope of the existing thrust areas. We continue to encourage innovative ideas that bring quality results to existing programs. We also take as our mission the encouragement of investment in new technology areas that are important to the economic competitiveness of this nation. In fiscal year 1992, we have focused on nine projects, summarized in this report: (1) Tire, Accident, Handling, and Roadway Safety; (2) EXTRANSYT: An Expert System for Advanced Traffic Management; (3) Odin: A High-Power, Underwater, Acoustic Transmitter for Surveillance Applications; (4) Passive Seismic Reservoir Monitoring: Signal Processing Innovations; (5) Paste Extrudable Explosive Aft Charge for Multi-Stage Munitions; (6) A Continuum Model for Reinforced Concrete at High Pressures and Strain Rates: Interim Report; (7) Benchmarking of the Criticality Evaluation Code COG; (8) Fast Algorithm for Large-Scale Consensus DNA Sequence Assembly; and (9) Using Electrical Heating to Enhance the Extraction of Volatile Organic Compounds from Soil.

  2. Choice of Operative Technique for Emergency Cases of Sigmoid Volvulus in a Tertiary Care Hospital of Gujarat

    Directory of Open Access Journals (Sweden)

    Patel Upendra

    2012-04-01

    Full Text Available Introduction: Sigmoid volulus is by far the most common type of volvulus, accounting for 75 to 90 % of all volvulus. Most common presenting symptom is abdominal pain and constipation. . It may be initially managed by sigmoidoscopy or rectal tube insertion but where fear of compromised vascular supply of the sigmoid colon is associated, immediate laparotomy after resuscitation must be undertaken to avoid gangrene and septic shock. The primary objective of the study is to demonstrate the most suitable procedure for management of patients with sigmoid volvulus needing emergency surgery. Methodology: All patients presenting with volvulus and needing emergency operative intervention during 1 years duration from January 2010 to December 2011 were included in this study. Total 41 patients were included in the study of which 25 presented with gangrenous sigmoid colon on laparotomy and viable sigmoid colon was present in the remaining 16 cases. Comparison is done with respect to mortality and early morbidity associated with different operative procedures. Results: Highest mortality i.e. 33.3% observed among patients who underwent primary resection and anastomosis without proximal colostomy. Wound infection was more common following all forms of stoma procedure. Conclusion: Hartmann’s procedure goes a long way in decreasing mortality due to sigmoid volvulus in the emergency setting. [National J of Med Res 2012; 2(2.000: 226-228

  3. Comparative study on the impact of laparoscopy and abdominal laparotomy to maternal-fetal at gestation period%妊娠期腹腔镜与开腹手术对母胎影响的对比研究

    Institute of Scientific and Technical Information of China (English)

    黄晓晖; 范保维; 罗喜平; 金文艳; 曾俐琴; 陈丹

    2014-01-01

    Objective To compare and analyze the impact on maternal-fetal of laparoscopy and abdominal laparotomy and evaluate the safety of laparoscopy during pregnancy.Methods In this prospective controlled study,20 pregnant patients underwent a laparoscopy,and the other 20 pregnant patients underwent an exploratory laparotomy during the same period of time.The parameters including anesthesia time,operative time,blood loss,arterial blood gas analysis in the fifteen minute after surgery,uterine artery blood flow,postoperative pain,postoperative recovery and pregnancy outcomes were collected.Results The anesthesia time and the operative time in laparoscopic group were significantly shorter than those in laparotomy group [(18.91 ± 8.76) min vs (35.28 ± 14.67) min,t=4.28,P < 0.05,(17.85 ± 6.32) min vs (30.27 ± 10.41) min,t=4.56,P < 0.05].The blood loss was significantly different during laparoscopic group and laparotomy group [(15.48 ± 10.24) ml vs (25.48 ± 15.56) ml,t=2.40,P < 0.05].The stubbs catheter time,postoperative ambulation time,postoperative discharge time in the laparoscopic group were (6.58 ± 0.92) h,(6.98 ± 1.69) h and (18.52 ± 3.45) h respectively,while those were (24.63 ± 3.85) h,(25.37 ± 5.34) h,(23.67 ± 7.81) h in the laparotomy group (t=2.70,14.68,20.39; all P < 0.05).The postoperative pain by laparoscopy was significantly lighter than that by laparotomy (P < 0.05).There was no statistical significant difference between arterial blood gas analysis and uterine artery blood flow in two groups (P > 0.05),and we didn't see any difference from abortion rate,premature birth rate,term delivery rate,the rate of birth defects,neonatal Apgar score and full-term birth weight.Conclusion Compared with laparotomy,laparoscopy has relatively less impact on maternal-fetal,and it won't increase the risk of adverse pregnancy outcomes.%目的 对比分析妊娠期腹腔镜与开腹手术对母胎影响的情况,评估妊娠期腹腔镜的安全性.方法

  4. Emergent Endotracheal Intubation and Mortality in Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Fine, Philip R

    2008-11-01

    Full Text Available Objective: To determine the relationship between emergent intubation (emergency department and field intubation cases combined and mortality in patients with traumatic brain injury (TBI while controlling for injury severity.Methods: Retrospective observational study of 981 (35.2% intubated, 64.8% not intubated patients with TBI evaluating the association between intubation status and mortality. Logistic regression was used to analyze the data. Injury severity measures included Head/Neck Abbreviated Injury Scale (H-AIS, systolic blood pressure, type of head injury (blunt vs. penetrating, and a propensity score combining the effects of several other potential confounding variables. Age was also included in the model.Results: The simple association of emergent endotracheal intubation with death had an odds ratio (OR of 14.3 (95% CI = 9.4 – 21.9. The logistic regression model including relevant covariates and a propensity score that adjusted for injury severity and age yielded an OR of 5.9 (95% CI = 3.2 – 10.9.Conclusions: This study indicates that emergent intubation is associated with increased risk of death after controlling for a number of injury severity indicators. We discuss the need for optimal paramedic training, and an understanding of the factors that guide patient selection and the decision to intubate in the field. [WestJEM.2008;9:184-189

  5. DESENVOLVIMENTO DE MODELO DE PERITONITE BACTERIANA PARA AVALIAÇÃO DO TRATAMENTO MEDIANTE ACESSO LAPAROTÔMICO E VIDEO-LAPAROSCÓPICO DEVELOPMENT A MODEL OF BACTERIAL PERITONITES FOR THE EVALUATION OF THE TREATMENTS THROUGH LAPAROTOMY AND LAPAROSCOPY

    Directory of Open Access Journals (Sweden)

    W. Salgado Jr

    2001-01-01

    Full Text Available Introdução: O emprego do acesso videolaparoscópico no tratamento das afecções digestivas que cursam com peritonite generalizada é motivo de controvérsia. Objetivo: Desenvolver um modelo de peritonite bacteriana para avaliação do tratamento mediante acesso laparotômico e videolaparoscópico. Métodos: Ratos machos Wistar foram submetidos à ligadura de ceco (CLP sob molde rígido de 3mm de diâmetro; na seqüência foram feitas 14 punções no ceco com agulha 15X10. Após 6 horas de indução da peritonite, os animais foram tratados mediante laparotomia ou videolaparoscopia e avaliados com base nas hemoculturas e na taxa de mortalidade. O tratamento consistiu de tiflectomia seguida ou não de lavagem da cavidade peritoneal com solução fisiológica. Resultado: A mortalidade após CLP sem tratamento foi de 90% em uma semana. As hemoculturas positivas para bactérias após 3 horas variaram de 80 a 100% e após 24 horas de 60 a 80%, nos animais tratados com laparotomia sem lavagem do peritôneo e com videolaparoscopia seguida ou não de lavagem peritoneal. Todavia, a mortalidade após laparotomia foi de 20% e após videolaparoscopia foi de 80%. Conclusão: O modelo experimental desenvolvido induz a peritonite grave, e a bacteremia associada ao tratamento videolaparoscópico tem alta letalidade.Introduction: The use of videolaparoscopy in the treatment of digestive diseases, associated with generalized peritonitis, is controverted. Objective: To develop a model of bacterial peritonitis for the evaluation of the treatments through laparotomy and through videolaparoscopy. Methods: Male Wistar rats were submitted to occlusion of the ceacum (CLP on a rigid mold of 3mm diameter, followed by 14 punctures of the ceacum with a 15 x 10 needle. Six hours after the induction of peritonitis, the animals were treated by laparotomy or videolaparoscopy, while analysing blood cultures and the mortality rates. The treatment involved typhlectomy followed or

  6. Mortality Risk in Pediatric Motor Vehicle Crash Occupants: Accounting for Developmental Stage and Challenging Abbreviated Injury Scale Metrics.

    Science.gov (United States)

    Doud, Andrea N; Weaver, Ashley A; Talton, Jennifer W; Barnard, Ryan T; Schoell, Samantha L; Petty, John K; Stitzel, Joel D

    2015-01-01

    Survival risk ratios (SRRs) and their probabilistic counterpart, mortality risk ratios (MRRs), have been shown to be at odds with Abbreviated Injury Scale (AIS) severity scores for particular injuries in adults. SRRs have been validated for pediatrics but have not been studied within the context of pediatric age stratifications. We hypothesized that children with similar motor vehicle crash (MVC) injuries may have different mortality risks (MR) based upon developmental stage and that these MRs may not correlate with AIS severity. The NASS-CDS 2000-2011 was used to define the top 95% most common AIS 2+ injuries among MVC occupants in 4 age groups: 0-4, 5-9, 10-14, and 15-18 years. Next, the National Trauma Databank 2002-2011 was used to calculate the MR (proportion of those dying with an injury to those sustaining the injury) and the co-injury-adjusted MR (MRMAIS) for each injury within 6 age groups: 0-4, 5-9, 10-14, 15-18, 0-18, and 19+ years. MR differences were evaluated between age groups aggregately, between age groups based upon anatomic injury patterns and between age groups on an individual injury level using nonparametric Wilcoxon tests and chi-square or Fisher's exact tests as appropriate. Correlation between AIS and MR within each age group was also evaluated. MR and MRMAIS distributions of the most common AIS 2+ injuries were right skewed. Aggregate MR of these most common injuries varied between the age groups, with 5- to 9-year-old and 10- to 14-year-old children having the lowest MRs and 0- to 4-year-old and 15- to 18-year-old children and adults having the highest MRs (all P injuries imparted the greatest mortality risk in all age groups with median MRMAIS ranging from 0 to 6% and 0 to 4.5%, respectively. Injuries to particular body regions also varied with respect to MR based upon age. For example, thoracic injuries in adults had significantly higher MRMAIS than such injuries among 5- to 9-year-olds and 10- to 14-year-olds (P =.04; P injuries

  7. Emergency teams in Danish emergency departments

    DEFF Research Database (Denmark)

    Lafrenz, Thomas; Lindberg, Søren Østergaard; La Cour, Jeppe Lerche;

    2012-01-01

    The use of designated emergency teams for cardiac arrest and trauma patients is widely implemented. However, the use of designated teams in Danish emergency departments (EDs) has not been investigated. Our aim was to investigate the use and staffing of emergency teams in Danish EDs....

  8. Emergency, anaesthetic and essential surgical capacity in the Gambia.

    Science.gov (United States)

    Iddriss, Adam; Shivute, Nestor; Bickler, Stephen; Cole-Ceesay, Ramou; Jargo, Bakary; Abdullah, Fizan; Cherian, Meena

    2011-08-01

    To assess the resources for essential and emergency surgical care in the Gambia. The World Health Organization's Tool for Situation Analysis to Assess Emergency and Essential Surgical Care was distributed to health-care managers in facilities throughout the country. The survey was completed by 65 health facilities - one tertiary referral hospital, 7 district/general hospitals, 46 health centres and 11 private health facilities - and included 110 questions divided into four sections: (i) infrastructure, type of facility, population served and material resources; (ii) human resources; (iii) management of emergency and other surgical interventions; (iv) emergency equipment and supplies for resuscitation. Questionnaire data were complemented by interviews with health facility staff, Ministry of Health officials and representatives of nongovernmental organizations. Important deficits were identified in infrastructure, human resources, availability of essential supplies and ability to perform trauma, obstetric and general surgical procedures. Of the 18 facilities expected to perform surgical procedures, 50.0% had interruptions in water supply and 55.6% in electricity. Only 38.9% of facilities had a surgeon and only 16.7% had a physician anaesthetist. All facilities had limited ability to perform basic trauma and general surgical procedures. Of public facilities, 54.5% could not perform laparotomy and 58.3% could not repair a hernia. Only 25.0% of them could manage an open fracture and 41.7% could perform an emergency procedure for an obstructed airway. The present survey of health-care facilities in the Gambia suggests that major gaps exist in the physical and human resources needed to carry out basic life-saving surgical interventions.

  9. [Pediatric emergencies in the emergency medical service].

    Science.gov (United States)

    Silbereisen, C; Hoffmann, F

    2015-01-01

    Out-of-hospital pediatric emergencies occur rarely but are feared among medical personnel. The particular characteristics of pediatric cases, especially the unaccustomed anatomy of the child as well as the necessity to adapt the drug doses to the little patient's body weight, produce high cognitive and emotional pressure. In an emergency standardized algorithms can facilitate a structured diagnostic and therapeutic approach. The aim of this article is to provide standardized procedures for the most common pediatric emergencies. In Germany, respiratory problems, seizures and analgesia due to trauma represent the most common emergency responses. This article provides a practical approach concerning the diagnostics and therapy of emergencies involving children.

  10. Emergency Medical Services

    Science.gov (United States)

    ... and need help right away, you should use emergency medical services. These services use specially trained people and specially equipped facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  11. Emergency care toolkits.

    Science.gov (United States)

    Black, Steven

    2004-06-01

    Emergency care services are the focus of a series of toolkits developed by the NHS National electronic Library for Health to provide resources for emergency care leads and others involved in modernising emergency care, writes Steven Black.

  12. Emerging Pathogens Initiative (EPI)

    Data.gov (United States)

    Department of Veterans Affairs — The Emerging Pathogens Initiative (EPI) database contains emerging pathogens information from the local Veterans Affairs Medical Centers (VAMCs). The EPI software...

  13. Necessity of immediate cardiopulmonary resuscitation in trauma emergency

    Directory of Open Access Journals (Sweden)

    Luciano Baitello

    2010-08-01

    Full Text Available Abstract The ability to respond quickly and effectively to a cardiac arrest situation rests on nurses being competent in the emergency life-saving procedure of cardiopulmonary resuscitation. The objective of the current study was to evaluate the types of trauma and survival of patients that require immediate cardiopulmonary resuscitation in trauma emergencies. A total of 13301 patients treated as accident victims between July 2004 and December 2006 were evaluated in a prospective study. Patients requiring immediate cardiopulmonary resuscitation at admission were identified. The type of injury and the survival of these patients were evaluated. Of the 65 patients included in the study, 30% had suffered from gunshot wounds, 19% had been run over, 18% had been involved in car crashes, 13% in motor cycle accidents, 9% stabbings, 1% by cycle accidents and 10% other types of accidents including burns, hangings and falls. In only 12 of these patients, immediate resuscitation was successful and procedure such as chest drainage, exploratory laparotomy and interventions in the surgical center were performed. However all patients evolved to death; eight within 24 hours, two between 24 and 48 hours and the other 2 after 48 hours. Immediate cardiopulmonary resuscitation after accidents is a sign of high mortality requiring further studies to review indication and the ethical aspects involved.

  14. Emergency care of raptors.

    Science.gov (United States)

    Graham, Jennifer E; Heatley, J Jill

    2007-05-01

    Raptors may present with a variety of conditions, such as trauma, debilitation, and disease, that necessitate emergency care. Emergency treatment should prioritize stabilization of the patient. Diagnostic testing should be delayed until feasible based on patient status. This article reviews emergency medicine in raptors, including appropriate handling and restraint, hospitalization, triage and patient assessment, sample collection, supportive care, and common emergency presentations.

  15. Clinical studies of laparoscopic repair and laparotomy surgery in the treatment of gastric or duodenal ulcer%腹腔镜与开腹胃十二指肠溃疡穿孔修补手术临床研究

    Institute of Scientific and Technical Information of China (English)

    代学峰; 崔海燕

    2015-01-01

    Objective:To observe the curative effect of laparoscopic repair and laparotomy surgery in the treatment of gastric or duodenal ulcer.Methods:The clinical data of 75 cases with gastric or duodenal ulcer from February 2012 to May 2014 were analyzed retrospectively.38 cases were treated with laparoscopic repair in perforated gastric or duodenal ulcer(the laparoscope group).37 cases were treated with laparotomy gastric or duodenal ulcer perforation repair(the open group).We observed the intraoperative and postoperative general index,the recovery time of the postoperative intestinal function and the incidence of postoperative complications and etc in the two groups.Results:The operation time,the hospitalization time,the recovery time of the postoperative intestinal function and the leaving bed time in the laparoscopic group were all shorter than those of the open group, and there were statistical significant differences(P<0.05).The incidence of postoperative complications in the laparoscopic group was 5.26% (2/38);that of the open group was 24.32% (9/37);there was statistical significant difference( χ 2=4.03,P<0.05).The postoperative VAS scores of the laparoscopic patients were significantly lower than that of the open group(t=9.50,P<0.05). Conclusion:Laparoscopic repair in perforated gastric or duodenal ulcer has the advantages of shorter surgery time,quick recovery and lower complication rates comparing with the traditional laparotomy,which is a kind of safe and effective treatment.%目的:观察腹腔镜与开腹行胃十二指肠溃疡穿孔修补术的临床疗效。方法:回顾性分析2012年2月-2014年5月收治胃十二指肠溃疡穿孔患者75例的临床资料,其中38例行腹腔镜胃十二指肠溃疡穿孔修补术(腹腔镜组),37例行胃十二指肠溃疡穿孔修补术(开腹组),观察两组术中、术后一般指标、术后肠道功能恢复时间及术后并发症发生率等。结果:腹腔镜组手术时间

  16. Comparison on the effect of laparoscopic and laparotomy in treatment of peptic ulcer perforation%腹腔镜与开腹手术治疗消化性溃疡穿孔的效果对比

    Institute of Scientific and Technical Information of China (English)

    于青松

    2014-01-01

    目的:对比分析腹腔镜与开腹手术治疗消化性溃疡穿孔的手术效果。方法选取2011年1月~2013年1月在本院行腹腔镜穿孔修补术的患者40例作为腹腔镜组,另选择同期在本院行开腹子穿孔修补术的40例患者作为对照组,比较两组患者的手术时间、术中出血量、术后排气时间、住院时间及并发症发生情况。结果腹腔镜组患者的术中出血量明显少于对照组(P<0.01);术后排气时间明显短于对照组(P<0.01)、住院时间短于对照组(P<0.05),腹腔镜组的并发症发生率仅为5.0%,明显低于对照组(P<0.05)。结论腹腔镜胃十二指肠溃疡穿孔修补术较开腹手术能减少术中出血量、降低术后发症发生率、缩短住院时间、促进患者术后的恢复,值得临床推广应用。%Objective To compare the effect of laparoscopic and laparotomy in treatment of peptic ulcer perforation. Methods 40 patients with underwent laparoscopic perforation repair from January 2011 to January 2013 in our hospital were selected as the laparoscopic group,and another 40 patients underwent laparotomy perforation repair were selected as the control group at the same period,the amount of bleeding,operation time,postoperative exhaust time, hospitalization time and incidence rate of complication were compared between the two groups. Results The amount of bleeding in the laparoscopic group was significantly less than that in the control group (P<0.01),the exhaust time of laparoscopic group was significantly shorter than the control group (P<0.01),the hospitalization time of the laparoscopic group was shorter than the control group (P<0.05).The incidence rate of complication of the laparoscopic group (5.0%) was significantly lower than that in the control group (P<0.05). Conclusion Laparoscopic in treatment of peptic ulcer perforation compared with la-parotomy can reduce the amount of bleeding,reduce the complications incidence,shorten the

  17. A Non-Inferiority Trial of an Evidence-Based Secondary HIV Prevention Behavioral Intervention Compared to an Adapted, Abbreviated Version: Rationale and Intervention Description

    Science.gov (United States)

    Shrestha, Roman; Krishnan, Archana; Altice, Frederick L.; Copenhaver, Michael

    2015-01-01

    Background Real-world clinical settings like addiction treatment programs are ill-equipped to deploy and sustain the existing-resource-demanding evidence-based interventions (EBIs) that target HIV-infected people who use drugs (PWUDs), and this has left a critical void in current HIV prevention efforts. In response to this unmet need, we have conducted formative research in addiction treatment settings that has resulted in Holistic Health for HIV (3H+) – an empirically adapted, substantially abbreviated version of Holistic Health Recovery Program (HHRP+), a CDC-recommended EBI targeting HIV-infected PWUDs. Methods Using a non-inferiority randomized controlled trial design, we will determine whether the abbreviated 3H+ intervention is comparable (i.e., within a 10% margin) and cost-effective relative to the original HHRP+ intervention in terms of reducing HIV risk behaviors and improving antiretroviral therapy (ART) adherence among HIV-infected PWUDs in addiction treatment who report drug- or sex-related HIV risk behaviors. Conclusions This article provides a description of the development and adaptation of the 3H+ intervention, the innovative non-inferiority comparative experimental design for testing the 3H+ to the HHRP+. Furthermore, it provides empirical evidence from a formal cost-effectiveness analysis justifying the cost-effectiveness of the 3H+ intervention when compared to the HHRP+ intervention. If confirmed to be comparable and more cost-effective, as hypothesized, the 3H+ intervention has the potential to be readily and immediately integrated within common clinical settings where large numbers of HIV-infected PWUDs receive clinical services. PMID:26253181

  18. Detecting malingering in traumatic brain injury and chronic pain with an abbreviated version of the Meyers Index for the MMPI-2.

    Science.gov (United States)

    Aguerrevere, Luis E; Greve, Kevin W; Bianchini, Kevin J; Meyers, John E

    2008-01-01

    Meyers, Millis, and Volkert [Meyers, J. E., Millis, S. R., & Volkert, K. (2002). A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169] developed a method to detect malingering in chronic pain patients using seven scales from the Minnesota Multiphasic Inventory-2 (MMPI-2). This method may be impractical because two of the scales (Obvious minus Subtle and Dissimulation-revised) are not reported by the commercially available Pearson computerized scoring system. The current study recalculated the Meyers Index using the five Pearson-provided scales in the chronic pain data sets of Meyers et al. [Meyers, J. E., Millis, S. R., & Volkert, K. (2002). A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169] and Bianchini, Etherton, Greve, Heinly, and Meyers [Bianchini, K. J., Etherton, J. L., Greve, K. W., Heinly, M. T., & Meyers, J. E. (in press). Classification accuracy of MMPI-2 validity scales in the detection of pain-related malingering: A known-groups approach. Assessment], and the traumatic brain injury data of Greve, Bianchini, Love, Brennan, and Heinly [Greve, K. W., Bianchini, K. J., Love, J. M., Brennan, A., & Heinly, M. T. (2006). Sensitivity and specificity of MMPI-2 validity scales and indicators to malingered neurocognitive dysfunction in traumatic brain injury. The Clinical Neuropsychologist, 20, 491-512]. Classification accuracy of the abbreviated Meyers Index was comparable to the original. These findings demonstrate that the abbreviated Meyers Index can be used as a substitute of the original Meyers Index without decrements in classification accuracy.

  19. The abbreviated impactor measurement (AIM) concept: part 1--Influence of particle bounce and re-entrainment-evaluation with a "dry" pressurized metered dose inhaler (pMDI)-based formulation.

    Science.gov (United States)

    Mitchell, J P; Nagel, M W; Avvakoumova, V; MacKay, H; Ali, R

    2009-01-01

    The abbreviated impactor measurement concept is a potential improvement to the labor-intensive full-resolution cascade impactor methodology for inhaler aerosol aerodynamic particle size distribution (APSD) measurement by virtue of being simpler and therefore quicker to execute. At the same time, improved measurement precision should be possible by eliminating stages upon which little or no drug mass is collected. Although several designs of abbreviated impactor systems have been developed in recent years, experimental work is lacking to validate the technique with aerosols produced by currently available inhalers. In part 1 of this two-part article that focuses on aerosols produced by pressurized metered dose inhalers (pMDIs), the evaluation of two abbreviated impactor systems (Copley fast screening Andersen impactor and Trudell fast screening Andersen impactor), based on the full-resolution eight-stage Andersen nonviable cascade impactor (ACI) operating principle, is reported with a formulation producing dry particles. The purpose was to investigate the potential for non-ideal collection behavior associated with particle bounce in relation to internal losses to surfaces from which particles containing active pharmaceutical ingredient are not normally recovered. Both abbreviated impactors were found to be substantially equivalent to the full-resolution ACI in terms of extra-fine and fine particle and coarse mass fractions used as metrics to characterize the APSD of these pMDI-produced aerosols when sampled at 28.3 L/min, provided that precautions are taken to coat collection plates to minimize bounce and entrainment.

  20. The operation techniques of distal pancreatectomy: laparotomy, laparoscopy or robotic surgery%开腹还是腹腔镜或机器人:胰体尾肿瘤切除方式的选择

    Institute of Scientific and Technical Information of China (English)

    彭承宏; 李花

    2016-01-01

    胰腺外科因其本身手术的复杂性,微创手术的应用一直晚于其他外科.但随着微创外科的逐渐发展,尤其是机器人辅助手术系统问世以来,胰腺外科在微创领域取得了巨大成就.腹腔镜及机器人技术广泛应用于胰腺外科,同时开腹手术技术也在发展,三者各有优劣,如何选择术式成了胰腺外科医师面临的新问题.微创胰体尾切除手术尤其是机器入辅助手术的安全性和可行性已得到多方证实.但即使有诸多优点,腹腔镜手术和机器人辅助手术均无法完全替代开腹手术,胰腺外科医师熟练掌握三种手术方式有助于其得心应手地处理复杂的临床问题.%Due to the operational complexity,the application of minimally invasive surgery in pancreatic procedure has been delayed than other departments.But with the gradual development of minimally invasive surgery,especially since the introduction of robotic surgery system,pancreatic surgery in this field has seen a great number of achievement.Laparoscopic and robotic technology is being widely adopted,while the technique of laparotomy is also developing.These three operation techniques have their advantages and disadvantages.Which method to option for became a new problem for pancreatic surgeons.The safety and feasibility of minimally invasive surgery especially robotic procedure for distal pancreatectomy have been confirmed by many agencies.But even with these advantages,laparoscopic and robotic surgery can not completely replace laparotomy.Pancreatic surgeons need to master these three operation methods to be able to handle complicated clinical situations.

  1. Emerging and re-emerging infections.

    Science.gov (United States)

    Lim, V K

    1999-06-01

    An emerging infection is defined as an infection which has newly appeared in a population while a re-emerging infection is one which has existed in the past but its incidence is rapidly increasing. The reasons for the emergence and re-emergence of infections are not well understood but appear to be associated with factors that involve the pathogen, the host and the environment. These factors are often inter-related and act together in a complex manner to bring about changes in patterns of infection. Pathogens are extremely resourceful and possess mechanisms to adapt to new hosts and environments as well as to acquire new virulence traits. Host factors include herd immunity, social behaviour and demographics. Environmental factors like the climate, deforestation and new technologies have an impact on the emergence of infections. The challenge is to contain an infection when it emerges but more importantly to prevent its emergence in the first place. As the emergence of an infection is complex and multifactorial, a multidisciplinary approach is required. Health based strategies alone are insufficient. Social, economic and environmental measures and the political will to implement appropriate policies are equally important.

  2. Vasovagal reflex emergency caused by Riedel's thyroiditis: A case report and review of the literature.

    Science.gov (United States)

    Cai, Wei; Kang, Hua; Hai, Tao

    2016-01-01

    Riedel's thyroiditis is a rare type of chronic thyroiditis, associated with fibroinflammatory process and invasion into surrounding tissues, leading to compressive symptoms. A 45-year-old man had a left thyroid mass, presenting with hypotension and bradycardia many times. He was diagnosed with vasovagal reflex caused by cervical vessel compression due to a thyroid lesion. We performed the emergency operation, and most of the left thyroid was removed to relieve the compression on cervical vessels. The result of pathology proved to be Riedel's thyroiditis. The vasovagal reflex did not occur any more during the 28-month follow up, except on the 3(rd) day after the surgery. Six months after the thyroidectomy, the patient was found to have retroperitoneal fibrosis, diagnosed by biopsy during a laparotomy for biliary disease. Riedel's thyroiditis can lead to a vasovagal episode and might not be a primary thyroid disease but rather a manifestation of the systemic disorder, multifocal fibrosclerosis.

  3. Dissemination of bacteria labeled with technetium-99m after laparotomy and abdominal insufflation with different CO2 pressures on rats; Disseminacao de bacterias marcadas com tecnecio-99m apos laparotomia e insuflacao com diferentes pressoes de CO2 em ratos

    Energy Technology Data Exchange (ETDEWEB)

    Pitombo, Marcos Bettini; Faria, Clarice Abreu dos Santos Albuquerque de; Steinbruck, Klaus [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Escola de Medicina]. E-mail: mpitombo@urbi.com.br; Bernardo, Luciana Camargo; Bernardo Filho, Mario[Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes (IBRAG). Lab. de Radiofarmacia Experimental

    2008-01-15

    Purpose: To asses the dissemination of bacteria labeled with technetium-99m (99mTc) from peritoneal cavity after different surgical procedures. Methods: Bacteria of the Escherichia coli species labeled with 99mTc were used in a concentration of 108 units of colony-makers for ml (UFC/ml) and 1 ml was inoculated through intra-peritoneal via. Forty-eight rats were divided into four groups: control, laparotomy, pneumoperitoneum with 10 mmHg and pneumoperitoneum with 20 mmHg of CO2. Procedures were performed 20 min after injection of the inoculum and lasted 30 min. Animals were sacrificed after six hours (Group 1) and 24 hours (Group 2). Samples of blood, liver and spleen were collected for radioactivity counting. Results: After six hours, indirect detection of the bacteria in different organs was uniform in all groups. After 24 hours, a larger detection of technetium was observed in the livers of animals of the group insufflated with 20 mmHg of CO2, when compared with those of control group (p<0.01). The other groups did not present statistically significant variations. Conclusions: The use of a higher intra-abdominal pressure was associated with a higher bacterial dissemination to the liver. The application of lower intra-abdominal pressures may be associated with a lower dissemination of the infectious status during laparoscopic approach of peritonitis status. (author)

  4. Damage control laparotomy in multiple trauma care: a report of 33 cases%多发伤救治中损害控制性剖腹术33例

    Institute of Scientific and Technical Information of China (English)

    李培源; 孙士锦; 张连阳

    2016-01-01

    目的 探讨损害控制性剖腹术在多发伤救治中的应用及效果. 方法 回顾性分析2009年1月-2015年6月应用损害控制性剖腹术救治的33例多发伤患者的临床资料,其中男24例,女9例;年龄19~68岁,平均41.0岁.致伤原因:交通伤21例,高处坠落伤6例,重物砸伤5例,雷管爆炸伤1例.损伤严重度评分(ISS)14 ~64分,平均27.0分.患者均有腹部创伤;合并脑伤10例次,胸伤23例次,骨盆四肢伤21例次.33例均实施损害控制性剖腹术,完成腹腔内手术后均行暂时性腹腔关闭.观察并统计患者腹腔关闭时间,腹腔高压症(IAH)或腹腔间隙综合征(ACS)的发生及治疗方法,总住院时间和并发症发生情况. 结果 33例中29例在术后5~12 d行早期确定性腹腔关闭,4例植皮覆盖创面形成计划性腹疝.12例出现IAH或ACS,行负压封闭引流(VSD)辅助的腹腔扩容术.患者总住院时间21 ~70 d,平均31.4 d.2例开放性骨折术后创面感染;4例出现腹壁切口感染,经清创+ VSD引流后愈合;腹腔内脓肿1例,经腹腔穿刺引流后治愈.所有患者均顺利出院. 结论 对于合并腹部创伤的多发伤救治,合理应用损害控制性剖腹术安全有效.%Objective To investigate the effect of damage control laparotomy in multiple trauma care.Methods A retrospective review was made on clinical data of 33 multiple trauma cases who received damage control laparotomy from January 2009 to June 2015.Twenty-four cases were males and 9 females, with the age range of 19-68 years(mean, 41.0 years).The trauma causes included traffic injury in 21 cases, high fall injury in 6 cases, falling object injury in 5 cases, and detonator blast injury in 1 case.Injury severity score (ISS) ranged from 14 to 64 points (mean, 27.0 points).All cases presented abdominal injury.Complicated injuries included brain injury in 10 cases, chest injury in 23 cases, and pelvic limb injury in 21 cases.All cases underwent damage control laparotomy

  5. The GP as first responder in a major medical emergency.

    Science.gov (United States)

    Somers, G T; Drinkwater, E J; Torcello, N

    1997-12-01

    While there have been many articles and seminars on the Ash Wednesday bushfire and Port Arthur shooting disasters, the role, responsibility and support structure of general practitioners (GPs) and the effect of the disaster on them, have received little attention. This paper looks at the role of the GP as the first responder in a disaster in rural and semi-rural Australia. Hopefully, a structured involvement, with adequate preparation and recovery, will minimise harm to these respondents. This article was written after a local GP response to disasters had been incorporated into the local Displan of one region. This response was successfully activated by Victorian State Displan during the Dandenong Ranges bushfire disaster of January, 1997. A disaster is said to have occurred when normal community and organisational arrangements are overwhelmed by an event, and extraordinary responses need to be instituted. First responder has become the generic term for those who arrive at the scene during the early phase of the response, that is, before centralised coordination is in place. Displan is the abbreviation for the State Emergency Response Plan. The phases of emergency management consist of: prevention; preparation; response; and recovery.

  6. Dog Bite Emergencies

    Science.gov (United States)

    ... Emergency Care Animal Welfare Veterinary Careers Public Health Dog bite emergencies What do I do if I’ ... vaccination records. What do I do if my dog bites someone? Dog bites are scary for everyone ...

  7. OEM Emergency Preparedness Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management compiles a wide variety of information in support of Emergency Preparedness, including certain elements of the System for Risk...

  8. HANARO radiation emergency plan

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tai

    1997-10-15

    The emergency plan of HANARO (High-flux advanced Neutron Application Reactor) is prepared based on the Korea Atomic Law, the Civil Defence Law, Disaster Protection Law and the emergency related regulation guides such as the NUREG series from USNRC to ensure adequate response capabilities to the emergency event which would cause a significant risk to the KAERI staffs and the public near to the site. Periodic training and exercise for the reactor operators and emergency staffs will reduce accident risks and the release of radioactivities to the environment. The plan describes the organization and staff's duties in the radiation emergency, classification on the radiation accidents, urgent actions of reactor operators in the early state, emergency response activities, maintenance of emergency equipment, training and exercise to improve response capabilities against emergency accidents. (author). 1 tab., 5 figs.

  9. Emergency peripartum hysterectomy

    DEFF Research Database (Denmark)

    Jakobsson, Maija; Tapper, Anna Maija; Colmorn, Lotte Berdiin

    2015-01-01

    OBJECTIVE: To assess the prevalence and risk factors of emergency peripartum hysterectomy. DESIGN: Nordic collaborative study. POPULATION: 605 362 deliveries across the five Nordic countries. METHODS: We collected data prospectively from patients undergoing emergency peripartum hysterectomy withi...

  10. [Emerging noninfectious diseases].

    Science.gov (United States)

    Consiglio, Ezequiel

    2008-11-01

    In recent years, emerging diseases were defined as being infectious, acquiring high incidence, often suddenly, or being a threat or an unexpected phenomenon. This study discusses the hallmarks of emerging diseases, describing the existence of noninfectious emerging diseases, and elaborating on the advantages of defining noninfectious diseases as emerging ones. From the discussion of various mental health disorders, nutritional deficiencies, external injuries and violence outcomes, work injuries and occupational health, and diseases due to environmental factors, the conclusion is drawn that a wide variety of noninfectious diseases can be defined as emergent. Noninfectious emerging diseases need to be identified in order to improve their control and management. A new definition of "emergent disease" is proposed, one that emphasizes the pathways of emergence and conceptual traits, rather than descriptive features.

  11. Emergency Management Offices - Emergency Management Region (polygon)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — Data available online through GeoStor at http://www.geostor.arkansas.gov. This file contains location information for Emergency Management Regions in the State of...

  12. Planning for School Emergencies.

    Science.gov (United States)

    Della-Giustina, Daniel E.

    This document is designed to provide civil leaders and school administrators with a resource that will enable them to develop comprehensive contingency plans for specific emergency situations. A discussion of disaster and emergency management planning includes an outline of the objectives of emergency planning that were established for this guide.…

  13. [Emergent viral infections

    NARCIS (Netherlands)

    Galama, J.M.D.

    2001-01-01

    The emergence and re-emergence of viral infections is an ongoing process. Large-scale vaccination programmes led to the eradication or control of some viral infections in the last century, but new viruses are always emerging. Increased travel is leading to a rise in the importation of exotic infecti

  14. Wireless Emergency Alerts

    Science.gov (United States)

    ... through your mobile carrier. 3. What types of alerts will I receive?  Extreme weather, and other threatening emergencies in your area  AMBER ... you receive emergency alerts. Other sources include NOAA Weather Radio, ... the Emergency Alert System on radio and TV programs, outdoor sirens, and ...

  15. Emerging technology and ethics

    CERN Document Server

    Wakunuma, Kutoma

    2011-01-01

    This e-book on Emerging Technologies and Ethics includes a collection of essays which explore the future and ethics of emerging information and communication technologies. Articles in the collection include an overview of the legal implications which may be relevant to the ethical aspects of emerging technologies and also ethical issues arising from the mass-take up of mobile technologies.

  16. Medical emergencies in Goa

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo

    2010-01-01

    Full Text Available Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa′s roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%, which were mainly of the nature of accidents or assaults (17% and fever related (17%. Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa.

  17. Encountering Meckel's diverticulum in emergency surgery for ascaridial intestinal obstruction

    Directory of Open Access Journals (Sweden)

    Amin Abid

    2010-06-01

    Full Text Available Abstract Background Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract. In children with intestinal ascariasis, the diverticulum remains asymptomatic or rarely the Ascaris lumbricoides may lead to its complications in the presence of massive intestinal roundworm load. Given that preoperative diagnosis is seldom carried out, when Meckel's diverticulum is found at laparotomy for obstructive intestinal complications of roundworm, the diverticulum should be removed as complications may occur at any time. The aim of this study was to describe the findings of concomitant presence of Meckel's diverticulum who had surgical intervention in symptomatic intestinal ascariasis in children. Methods A retrospective case review study of 14 children who had surgical intervention for symptomatic intestinal ascariasis having the presence of concomitant Meckel's diverticulum was done. The study was done at SMHS Hospital Srinagar, Kashmir. Results A total of the 14 children who had ascaridial intestinal obstruction with concomitant presence of Meckel's diverticulum were studied. Age of children ranged from 4-12 years, male:female ratio was 1.8:1. Nine patients had asymptomatic Meckel's diverticulum, whereas 5 patients with symptomatic signs were found in the course of emergency surgery for ascaridial intestinal obstruction. Conclusion Meckel's diverticulum in intestinal ascariasis may pursue silent course or may be accompanied with complications of the diverticulitis, perforation or the gangrene. Incidental finding of the Meckel's diverticulum in the intestinal ascariasis should have removal.

  18. Train operation in emergencies

    CERN Document Server

    Jia, Limin; Qin, Yong

    2017-01-01

    This book presents the latest findings on train operation theories and methods in the context of emergencies. It examines and assesses a range of aspects—including the definition of a railway emergency, transport organization modes in emergencies, calculating railway transport capacity in emergencies, line planning in emergencies, train re-pathing in emergencies and train re-scheduling in emergencies—that are urgently needed in the railway transportation field, which faces the serious challenge of dealing with emergencies worldwide. The book highlights the latest research results in an integrated and systematic way, and the methodology presented is oriented on real-world problems, allowing it to be used not only directly in railway operational management, but also as the point of departure for further applications or theoretical research. As such, the book will be of considerable interest to graduate students and researchers in the field of traffic and transportation engineering.>.

  19. Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model Influência da laparoscopia e laparotomia na gasometria, leucócitos e citocinas em modelo de sepse abdominal em ratos

    Directory of Open Access Journals (Sweden)

    Irami Araújo Filho

    2006-04-01

    Full Text Available PURPOSE: Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. METHODS: Wistar rats were randomly assigned to five groups: control (anesthesia only, laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFalpha, IL-1beta, IL-6 were determined in intraperitoneal fluid (by ELISA. Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. RESULTS: Peritoneal TNFalpha, IL-1beta and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (pOBJETIVO: A cirurgia laparoscópica está associada com trauma reduzido e baixa resposta na fase aguda do trauma, quando comparada com a cirurgia aberta. As citocinas e o balanço ácido-base são fatores importantes da resposta biológica ao trauma cirúrgico-anestésico. O objetivo deste estudo foi determinar se o pneumoperitôneo com CO2 altera a expressão das citocinas, a gasometria e a contagem diferencial de leucócitos em ratos com sepse abdominal. MÉTODOS: Ratos Wistar foram aleatoriamente distribuídos em 5 grupos: controle (somente anestesia, laparotomia, pneumoperitôneo com CO2, ligadura e punção do ceco por laparotomia, ligadura e punção do ceco por laparoscopia. Após 30 minutos dos procedimentos, sangue arterial foi colhido para leucometria diferencial em hemocitômetro. TNFalfa, IL-1beta e IL-6 foram dosadas no líquido intraperitoneal (por ELISA. Os parâmetros gasosos foram medidos no sangue arterial e nos exsudatos

  20. Comparative study of laparoscope and laparotomy D2 radical gastrectomy in the treatment of distal gastric cancer%腹腔镜与开腹远端胃癌D2根治术的对比研究

    Institute of Scientific and Technical Information of China (English)

    何洪生; 曾文龙; 朱柏炼; 杜永御; 赖扬城

    2014-01-01

    目的:通过对比腹腔镜与开腹远端胃癌D2根治术的疗效及安全性,探讨腹腔镜辅助远端胃癌D2根治术的临床价值。方法221例行远端胃癌D2根治术患者,分为两组。其中腹腔镜组115例,开腹组106例,对两组手术时间、术中出血量、术后排气时间、首次进流质时间、淋巴结清扫数目、术后住院天数、并发症进行比较。结果腹腔镜组手术时间、淋巴结清扫数与开腹组差异无统计学意义(P>0.05),而腹腔镜组术中出血量少,术后肛门排气时间早,首次进流质时间早,术后住院时间短,并发症发生率低(P0.05). However, the laparoscope group had fewer intraoperative bleeding volumes, earlier postoperative anal exhaust time, earlier first time of liquid diet, shorter postoperative hospital stays and lower incidence of complications (P<0.05). Conclusion Laparoscope assisted D2 radical gastrectomy in the treatment of distal gastric cancer has small trauma, few bleeding, quick recovery and less complications. The recent curative effect is similar as that of laparotomy, and the treatment is safe and feasible, and worthy of clinical promotion.

  1. Emergency in Burn; Burn in Emergency

    Directory of Open Access Journals (Sweden)

    Yalcin Bayram

    2012-06-01

    Full Text Available Physicians who first meet with burned patients are often emergency service employees. When the patient was admitted to emergency service, especially in patients with major burn injury, is a matter should be dealt with strongly. Before sending the patients to a burn center, some interventions could became life saving which should be done as a first line treatment. Herein, review of the literature related to emergency burn treatment was performed and presented to all physicians as a summary guide. In addition, some questions such as how should be physician, who first meet with the burned patient, evaluated the patient, what should be physician paid attention, which principles should be employed for fluid replacement, how should be approached to burn wound are tried to be addressed. [TAF Prev Med Bull 2012; 11(3.000: 365-368

  2. Emergências hipertensivas Hypertensive emergencies

    OpenAIRE

    Gilson Soares Feitosa-Filho; Renato Delascio Lopes; Nilson Tavares Poppi; Hélio Penna Guimarães

    2008-01-01

    As urgências e as emergências hipertensivas são ocorrências clínicas que podem representar mais de 25% dos atendimentos a urgências médicas. O médico deverá estar habilitado a diferenciá-las, pois o prognóstico e o tratamento são distintos. Estima-se que 3% de todas as visitas às salas de emergência decorrem de elevações significativas da pressão arterial. Nos quadros relacionados a estes atendimentos, a emergência hipertensiva é a entidade clínica mais grave que merece cuidados intensivos. É...

  3. SUPERVASMOL POISONING: AN EMERGING ENT EMERGENCY

    Directory of Open Access Journals (Sweden)

    Mitta

    2016-05-01

    Full Text Available Poisoning is one of the commonest modes of suicide in India. Supervasmol poisoning is one of the commonest modes of suicidal attempt in our region. The common cause for consumption of hair dye is by suicidal intent or accidental oral ingestion. There is no specific antidote for Supervasmol poisoning. Management is only symptomatic and supportive with emergency tracheostomy in majority of cases. Hence, we conducted this study to emphasize the role of ENT surgeon in Supervasmol poisoning. STUDY DESIGN Prospective study. MATERIALS AND METHODS We present a total of 79 cases of Supervasmol poisoning who attended the Emergency Department of Narayana Medical College and General Hospital, Nellore. RESULTS All patients were between age group 15-35 yrs. Females are more than males. More patients were in second decade; 55 cases presented in acute phase, 51 patients underwent tracheostomy and four patients were brought dead. CONCLUSION Emergency tracheostomy is a life saving measure in severe stridor

  4. Wound Failure in Laparotomy: New insights

    NARCIS (Netherlands)

    G.H. van Ramshorst (Gabrielle)

    2014-01-01

    markdownabstract__Abstract__ Wound failure is a common complication of abdominal surgery. Its clinical presentation can vary from superficial wound dehiscence to burst abdomen with intraabdominal organs protruding through the wound. In long term, incisional hernia can be considered a representation

  5. Wound Failure in Laparotomy: New insights

    NARCIS (Netherlands)

    G.H. van Ramshorst (Gabrielle)

    2014-01-01

    markdownabstract__Abstract__ Wound failure is a common complication of abdominal surgery. Its clinical presentation can vary from superficial wound dehiscence to burst abdomen with intraabdominal organs protruding through the wound. In long term, incisional hernia can be considered a

  6. Patterns of Flux Emergence

    Science.gov (United States)

    Title, A.; Cheung, M.

    2008-05-01

    The high spatial resolution and high cadence of the Solar Optical Telescope on the JAXA Hinode spacecraft have allowed capturing many examples of magnetic flux emergence from the scale of granulation to active regions. The observed patterns of emergence are quite similar. Flux emerges as a array of small bipoles on scales from 1 to 5 arc seconds throughout the region that the flux eventually condenses. Because the fields emerging from the underlying flux rope my appear many in small segments and the total flux (absolute sum) is not a conserved quantity the amount of total flux on the surface may vary significantly during the emergence process. Numerical simulations of flux emergence exhibit patterns similar to observations. Movies of both observations and numerical simulations will be presented.

  7. Thermodynamics and emergent universe

    CERN Document Server

    Ghosh, Saumya

    2016-01-01

    We show that in the isentropic scenario the first order thermodynamical particle creation model gives an emergent universe solution even when the chemical potential is non-zero. However there exists no emergent universe scenario in the second order non-equilibrium theory for the particle creation model. We then point out a correspondence between the particle creation model with barotropic equation of state and the equation of state giving rise to an emergent universe without particle creation in spatially flat FRW cosmology.

  8. Handbook of pulmonary emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Spaquolo, S.V.; Medinger, A

    1986-01-01

    This book presents information on the following topics: clinical assessment of the patient with pulmonary disease; interpretation of arterial blood gases in the emergency patient; life-threatening pneumonia; extrapulmonic ventilatory failure; acute inhalation lung disease; pulmonary edema; near drowning; chest trauma; upper airway emergencies; chronic lung disease with acute respiratory decompensation; acute respiratory failure in the patient with chronic airflow obstruction; asthma; hemoptysis; embolic pulmonary disease; superior vena cava syndrome; catastrophic pleural disease; ventilatory assistance and its complications; and ventilator emergencies.

  9. Emerging Equity Market Volatility

    OpenAIRE

    Geert Bekaert; Harvey, Campbell R.

    1995-01-01

    Returns in emerging capital markets are very different from returns in developed markets. While most previous research has focused on average returns, we analyze the volatility of the returns in emerging equity markets. We characterize the time-series of volatility in emerging markets and explore the distributional foundations of the variance process. Of particular interest is evidence of asymmetries in volatility and the evolution of the variance process after periods of capital market refor...

  10. Flux Emergence (Theory)

    Science.gov (United States)

    Cheung, Mark C. M.; Isobe, Hiroaki

    2014-12-01

    Magnetic flux emergence from the solar convection zone into the overlying atmosphere is the driver of a diverse range of phenomena associated with solar activity. In this article, we introduce theoretical concepts central to the study of flux emergence and discuss how the inclusion of different physical effects (e.g., magnetic buoyancy, magnetoconvection, reconnection, magnetic twist, interaction with ambient field) in models impact the evolution of the emerging field and plasma.

  11. Energy emergency handbook

    Energy Technology Data Exchange (ETDEWEB)

    1979-01-01

    This Handbook identifies selected state and federal measures available to mitigate the impact of an energy emergency, and provides a comprehensive energy emergency communications directory. In the case of state remedial actions, particular emphasis has been placed on typical implementation procedures and likely impacts. The discussions of federal actions focus on initation and implementation procedures. The directory is designed to facilitate communications of all types (telephone, Telex, TWX, or facsimile) among key energy emergency officials in the federal and state governments.

  12. Theoretical magnetic flux emergence

    OpenAIRE

    MacTaggart, David

    2011-01-01

    Magnetic flux emergence is the subject of how magnetic fields from the solar interior can rise and expand into the atmosphere to produce active regions. It is the link that joins dynamics in the convection zone with dynamics in the atmosphere. In this thesis, we study many aspects of magnetic flux emergence through mathematical modelling and computer simulations. Our primary aim is to understand the key physical processes that lie behind emergence. The first chapter intro...

  13. Emergency Medical Service

    Science.gov (United States)

    1980-01-01

    Lewis Research Center helped design the complex EMS Communication System, originating from space operated telemetry, including the telemetry link between ambulances and hospitals for advanced life support services. In emergency medical use telemetry links ambulances and hospitals for advanced life support services and allows transmission of physiological data -- an electrocardiogram from an ambulance to a hospital emergency room where a physician reads the telemetered message and prescribes emergency procedures to ambulance attendants.

  14. Flux Emergence (Theory

    Directory of Open Access Journals (Sweden)

    Mark C. M. Cheung

    2014-07-01

    Full Text Available Magnetic flux emergence from the solar convection zone into the overlying atmosphere is the driver of a diverse range of phenomena associated with solar activity. In this article, we introduce theoretical concepts central to the study of flux emergence and discuss how the inclusion of different physical effects (e.g., magnetic buoyancy, magnetoconvection, reconnection, magnetic twist, interaction with ambient field in models impact the evolution of the emerging field and plasma.

  15. Nonneurologic emergencies in boxing.

    Science.gov (United States)

    Coletta, Domenic F

    2009-10-01

    Professional boxing has done an admirable job in promoting safety standards in its particular sport. However, injuries occur during the normal course of competition and, unfortunately, an occasional life-threatening emergency may arise. Although most common medical emergencies in boxing are injuries from closed head trauma, in this article those infrequent but potentially catastrophic nonneurologic conditions are reviewed along with some less serious emergencies that the physician must be prepared to address.

  16. Delayed emergence after anesthesia.

    Science.gov (United States)

    Tzabazis, Alexander; Miller, Christopher; Dobrow, Marc F; Zheng, Karl; Brock-Utne, John G

    2015-06-01

    In most instances, delayed emergence from anesthesia is attributed to residual anesthetic or analgesic medications. However, delayed emergence can be secondary to unusual causes and present diagnostic dilemmas. Data from clinical studies is scarce and most available published material is comprised of case reports. In this review, we summarize and discuss less common and difficult to diagnose reasons for delayed emergence and present cases from our own experience or reference published case reports/case series. The goal is to draw attention to less common reasons for delayed emergence, identify patient populations that are potentially at risk and to help anesthesiologists identifying a possible cause why their patient is slow to wake up.

  17. Radiological Emergency Response Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — Quality Data Asset includes all current and historical emergency radiological response event and incident of national significance data and surveillance, monitoring,...

  18. Historicism and Industry Emergence

    DEFF Research Database (Denmark)

    Kirsch, David; Moeen, Mahka; Wadhwani, Dan

    2014-01-01

    Management and organization scholars have increasingly turned to historical sources to examine the emergence and evolution of industries over time. This scholarship has typically used historical evidence as observations for testing theoretically relevant processes of industry emergence....... In this chapter, an alternative approach is explored that focuses on reconstructing causes and processes that time and theory have erased. The emergence of three industries—plant biotechnology, savings banking, and the automobile—shows how time, along with prevailing functional models of industry evolution, leads...... excluded phenomena and explanations, reconstructing uncertainty and alternative paths of industry emergence, and studying the processes of information elision and exclusion in the formation of industry knowledge....

  19. EMERGE-ing from the Shadows

    Science.gov (United States)

    Grier, Terry B.

    2014-01-01

    Houston school officials noticed their best performing low-income students weren't applying to Ivy League and selective colleges. In response, they created EMERGE, a program that develops and guides talented youths toward a top-college path.

  20. Emergências hipertensivas Hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Gilson Soares Feitosa-Filho

    2008-09-01

    Full Text Available As urgências e as emergências hipertensivas são ocorrências clínicas que podem representar mais de 25% dos atendimentos a urgências médicas. O médico deverá estar habilitado a diferenciá-las, pois o prognóstico e o tratamento são distintos. Estima-se que 3% de todas as visitas às salas de emergência decorrem de elevações significativas da pressão arterial. Nos quadros relacionados a estes atendimentos, a emergência hipertensiva é a entidade clínica mais grave que merece cuidados intensivos. É caracterizada por pressão arterial marcadamente elevada e sinais de lesões de órgãos-alvo (encefalopatia, infarto agudo do miocárdio, angina instável, edema agudo de pulmão, eclâmpsia, acidente vascular encefálico. O objetivo deste estudo foi apresentar os principais pontos sobre o seu apropriado diagnóstico e tratamento. Foi realizada busca por artigos originais com os unitermos "crise hipertensiva" e "emergência hipertensiva" nas bases de dados Pubmed e MedLine nos últimos dez anos. As referências disponíveis destes artigos foram verificadas. Os artigos foram identificados e revisados e o presente estudo condensa os principais resultados descritos. Para esta revisão foram considerados ensaios clínicos em língua inglesa, estudos retrospectivos e artigos de revisão. A crise hipertensiva é a entidade clínica com aumento súbito da PA (> 180 x 120 mmHg, acompanhada por sintomas, que podem ser leves (cefaléia, tontura, zumbido ou graves (dispnéia, dor precordial, coma e até morte, com ou sem lesão aguda de órgãos-alvo. Se os sintomas forem leves e sem lesão aguda de órgãos alvos, define-se a urgência hipertensiva. Se o quadro clínico apresentar risco de vida e refletir lesão aguda de órgãos-alvo têm-se, então, a emergência hipertensiva. Muitos pacientes também apresentam uma PA elevada demais, por não usarem suas medicações, tratando-se apenas de hipertensão arterial sistêmica crônica n

  1. Emerging patient safety issues under health care reform: follow-on biologics and immunogenicity

    Directory of Open Access Journals (Sweden)

    Liang BA

    2011-12-01

    Full Text Available Bryan A Liang1-3, Timothy Mackey1,41Institute of Health Law Studies, California Western School of Law, 2Department of Anesthesiology, University of California, San Diego School of Medicine, 3San Diego Center for Patient Safety, University of California, San Diego School of Medicine,4Joint Program in Global Health, University of California San Diego-San Diego State University, San Diego, CA, USAAbstract: US health care reform includes an abbreviated pathway for follow-on biologics, also known as biosimilars, in an effort to speed up access to these complex therapeutics. However, a key patient safety challenge emerges from such an abbreviated pathway: immunogenicity reactions. Yet immunogenicity is notoriously difficult to predict, and even cooperative approaches in licensing between companies have resulted in patient safety concerns, injury, and death. Because approval pathways for follow-on forms do not involve cooperative disclosure of methods and manufacturing processes by innovator companies and follow-on manufacturers, the potential for expanded immunogenicity must be taken into account from a risk management and patient safety perspective. The US Institute of Safe Medication Practices (ISMP has principles of medication safety that have been applied in the past to high-risk drugs. We propose adapting ISMP principles to follow-on biologic forms and creating systems approaches to warn, rapidly identify, and alert providers regarding this emerging patient safety risk. This type of system can be built upon and provide lessons learned as these new drug forms are developed and marketed more broadly.Keywords: biosimilars, follow-on biologics, immunogenicity, patient safety, law, health care reform

  2. Emerging wind energy technologies

    DEFF Research Database (Denmark)

    Rasmussen, Flemming; Grivel, Jean-Claude; Faber, Michael Havbro

    2014-01-01

    This chapter will discuss emerging technologies that are expected to continue the development of the wind sector to embrace new markets and to become even more competitive.......This chapter will discuss emerging technologies that are expected to continue the development of the wind sector to embrace new markets and to become even more competitive....

  3. Preparing for Emergency

    DEFF Research Database (Denmark)

    Melchiors, Jacob; Todsen, Tobias; Nilsson, Philip

    2015-01-01

    OBJECTIVE: Emergency cricothyrodotomy (EC) is a lifesaving procedure. Evidence-based assessment of training effects and competency levels is relevant to all departments involved in emergency airway management. As most training uses low-fidelity models, the predictive value of good performance on ...

  4. Emergency Notification Strategy

    Science.gov (United States)

    Katsouros, Mark

    2014-01-01

    In higher education, the IT department is often the service provider for the institution's emergency notification system (ENS). For many institutions, the complexity of providing emergency notification to students, faculty, and staff makes using a local, on-premise solution unrealistic. But finding the right commercially hosted technical solution…

  5. Quantization of Emergent Gravity

    CERN Document Server

    Yang, Hyun Seok

    2013-01-01

    Emergent gravity is based on a novel form of the equivalence principle known as the Darboux theorem or the Moser lemma in symplectic geometry stating that the electromagnetic force can always be eliminated by a local coordinate transformation as far as spacetime admits a symplectic structure, in other words, a microscopic spacetime becomes noncommutative (NC). If gravity emerges from U(1) gauge theory on NC spacetime, this picture of emergent gravity suggests a completely new quantization scheme where quantum gravity is defined by quantizing spacetime itself, leading to a dynamical NC spacetime. Therefore the quantization of emergent gravity is radically different from the conventional approach trying to quantize a phase space of metric fields. This approach for quantum gravity allows a background independent formulation where spacetime as well as matter fields is equally emergent from a universal vacuum of quantum gravity.

  6. Quantization of emergent gravity

    Science.gov (United States)

    Yang, Hyun Seok

    2015-02-01

    Emergent gravity is based on a novel form of the equivalence principle known as the Darboux theorem or the Moser lemma in symplectic geometry stating that the electromagnetic force can always be eliminated by a local coordinate transformation as far as space-time admits a symplectic structure, in other words, a microscopic space-time becomes noncommutative (NC). If gravity emerges from U(1) gauge theory on NC space-time, this picture of emergent gravity suggests a completely new quantization scheme where quantum gravity is defined by quantizing space-time itself, leading to a dynamical NC space-time. Therefore the quantization of emergent gravity is radically different from the conventional approach trying to quantize a phase space of metric fields. This approach for quantum gravity allows a background-independent formulation where space-time and matter fields are equally emergent from a universal vacuum of quantum gravity.

  7. Electric power emergency handbook

    Energy Technology Data Exchange (ETDEWEB)

    Labadie, J.R.

    1980-09-01

    The Emergency Electric Power Administration's Emergency Operations Handbook is designed to provide guidance to the EEPA organization. It defines responsibilities and describes actions performed by the government and electric utilities in planning for, and in operations during, national emergencies. The EEPA Handbook is reissued periodically to describe organizational changes, to assign new duties and responsibilities, and to clarify the responsibilities of the government to direct and coordinate the operations of the electric utility industry under emergencies declared by the President. This Handbook is consistent with the assumptions, policies, and procedures contained in the National Plan for Emergency Preparedness. Claimancy and restoration, communications and warning, and effects of nuclear weapons are subjects covered in the appendices.

  8. Efficacy and safety of laparoscopy and laparotomy in the treatment of acute cholecystitis%腹腔镜术和开腹术治疗急性胆囊炎的疗效及安全性分析

    Institute of Scientific and Technical Information of China (English)

    佘明杰; 刘小虎

    2014-01-01

    Objective:To investigate the clinical application value of laparoscopy and laparotomy in the treatment of acute cholecystitis.Methods:129 cases with acute cholecystitis who had been treated by operation from June 2010 to December 2013.We retrospectively analyzed their clinical datas.They were divided into the laparoscopy group(69 cases were treated with laparoscopic cholecystectomy) and the open group(60 cases were treated with conventional open operation) according to the different surgical treatment.We analyzed the operation related index and postoperative condition of the two groups.Results:The operation time, amount of bleeding during operation and postoperative anal exhaust time for the first time of the laparoscopic group were significantly shorter than those of the open group(P<0.01).The postoperative incision infection,bile leakage rate of the laparoscopic group were significantly lower than those in the open group(P<0.05).Conclusion:The laparoscopic cholecystectomy in the treatment of acute cholecystitis with less bleeding,less postoperative complications and other advantages,so it is worthy of clinical application.%目的:探讨腹腔镜胆囊切除术治疗急性胆囊炎的临床应用价值。方法:2010年6月-2013年12月收治行手术治疗的急性胆囊炎患者129例,回顾性分析其临床资料,按照所行治疗术式不同分为腔镜组69例,行腹腔镜下胆囊切除术治疗和开腹组60例,行常规开腹手术治疗,对两组患者手术相关指标及术后情况进行对比分析。结果:腔镜组手术耗时、术中出血量及术后首次肛门排气时间均明显短于开腹组(P<0.01);腔镜组患者术后切口感染、胆汁漏发生率明显低于开腹组(P<0.05)。结论:腹腔镜微创胆囊切除术治疗急性胆囊炎具有出血少、术后并发症少等优势,值得临床推广应用。

  9. Munchausen syndrome in the emergency department mostly difficult, sometimes easy to diagnose: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Vanderbruggen Nathalie

    2009-11-01

    Full Text Available Abstract Munchausen syndrome is a rare psychiatric disorder in which patients inflict on themselves an illness or injury for the primary purpose of assuming the sick role. Because these patients can present with many different complaints and clinical symptoms, diagnosis is often made at a later stage of hospitalisation. In contrast we report a case of a 40-year old woman very easy to diagnose with Munchausen syndrome. This trained nurse presented at our emergency department (ED complaining of abdominal pain. Interviewed by the medical trainee, she immediately confessed having put a knitting needle into her urethra four days earlier. She was not able to remove it anymore because it was beyond her reach. Abdominal X-ray confirmed the presence of the needle and a median laparotomy was performed to remove it. The diagnosis of Munchausen syndrome seemed immediately obvious in this case.

  10. Risk adapted transmission prophylaxis to prevent vertical HIV–1 transmission: Effectiveness and safety of an abbreviated regimen of postnatal oral Zidovudine

    Directory of Open Access Journals (Sweden)

    Neubert Jennifer

    2013-01-01

    Full Text Available Abstract Background Antiretroviral drugs including zidovudine (ZDV are effective in reducing HIV mother to child transmission (MTCT, however safety concern remains. The optimal duration of postnatal ZDV has not been established in clinical studies and there is a lack of consensus regarding optimal management. The objective of this study was to investigate the effectiveness and safety of a risk adapted two week course of oral postnatal ZDV as part of a combined intervention to reduce MTCT. Methods 118 mother infant pairs were treated according to the German-Austrian recommendations for HIV therapy in pregnancy and in HIV exposed newborns between 2000–2010. In the absence of factors associated with an increased HIV–1 transmission risk, children were assigned to the low risk group and treated with an abbreviated postnatal regimen with oral ZDV for 2 weeks. In the presence of risk factors, postnatal ZDV was escalated accordingly. Results Of 118 mother-infant pairs 79 were stratified to the low risk group, 27 to the high risk group and 11 to the very high risk group for HIV–1 MTCT. 4 children were lost to follow up. Overall Transmission risk in the group regardless of risk factors and completion of prophylaxis was 1.8% (95% confidence interval (CI 0.09–6.6. If transmission prophylaxis was complete, transmission risk was 0.9% (95% CI 0.01-5.7. In the low risk group receiving two week oral ZDV transmission risk was 1.4% (95% CI 0.01–8.4 Conclusion These data demonstrate the effectiveness of a short neonatal ZDV regimen in infants of women on stable ART and effective HIV–1 suppression. Further evaluation is needed in larger studies.

  11. Screening for personality disorder in incarcerated adolescent boys: preliminary validation of an adolescent version of the standardised assessment of personality – abbreviated scale (SAPAS-AV

    Directory of Open Access Journals (Sweden)

    Kongerslev Mickey

    2012-07-01

    Full Text Available Abstract Background Personality disorder (PD is associated with significant functional impairment and an elevated risk of violent and suicidal behaviour. The prevalence of PD in populations of young offenders is likely to be high. However, because the assessment of PD is time-consuming, it is not routinely assessed in this population. A brief screen for the identification of young people who might warrant further detailed assessment of PD could be particularly valuable for clinicians and researchers working in juvenile justice settings. Method We adapted a rapid screen for the identification of PD in adults (Standardised Assessment of Personality – Abbreviated Scale; SAPAS for use with adolescents and then carried out a study of the reliability and validity of the adapted instrument in a sample of 80 adolescent boys in secure institutions. Participants were administered the screen and shortly after an established diagnostic interview for DSM-IV PDs. Nine days later the screen was readministered. Results A score of 3 or more on the screening interview correctly identified the presence of DSM-IV PD in 86% of participants, yielding a sensitivity and specificity of 0.87 and 0.86 respectively. Internal consistency was modest but comparable to the original instrument. 9-days test-retest reliability for the total score was excellent. Convergent validity correlations with the total number of PD criteria were large. Conclusion This study provides preliminary evidence of the validity, reliability, and usefulness of the screen in secure institutions for adolescent male offenders. It can be used in juvenile offender institutions with limited resources, as a brief, acceptable, staff-administered routine screen to identify individuals in need of further assessment of PD or by researchers conducting epidemiological surveys.

  12. Associations between performance on an abbreviated CogState battery, other measures of cognitive function, and biomarkers in people at risk for Alzheimer’s disease

    Science.gov (United States)

    Racine, Annie M.; Clark, Lindsay R.; Berman, Sara E.; Koscik, Rebecca L.; Mueller, Kimberly D.; Norton, Derek; Nicholas, Christopher R.; Blennow, Kaj; Zetterberg, Henrik; Jedynak, Bruno; Bilgel, Murat; Carlsson, Cynthia M.; Christian, Bradley T.; Asthana, Sanjay; Johnson, Sterling C.

    2016-01-01

    It is not known whether computerized cognitive assessments, like the CogState battery, are sensitive to preclinical cognitive changes or pathology in people at risk for Alzheimer’s disease (AD). In 469 late middle-aged participants from the Wisconsin Registry for Alzheimer’s Prevention (mean age 63.8±7 years at testing; 67% female; 39% APOE4+), we examined relationships between a CogState abbreviated battery (CAB) of seven tests and demographic characteristics, traditional paper-based neuropsychological tests as well as a composite cognitive impairment index, cognitive impairment status (determined by consensus review); and biomarkers for amyloid and tau (CSF phosphorylated-tau/Aβ42 and global PET-PiB burden) and neural injury (CSF neurofilament light protein). CSF and PET-PiB were collected in n=71 and n=91 participants, respectively, approximately four years prior to CAB testing. For comparison, we examined three traditional tests of delayed memory in parallel. Similar to studies in older samples, the CAB was less influenced by demographic factors than traditional tests. CAB tests were generally correlated with most paper-based cognitive tests examined and mapped onto the same cognitive domains. Greater composite cognitive impairment index was associated with worse performance on all CAB tests. Cognitively impaired participants performed significantly worse compared to normal controls on all but one CAB test. Poorer One Card Learning test performance was associated with higher levels of CSF phosphorylated-tau/Aβ42. These results support the use of the CogState battery as measures of early cognitive impairment in studies of people at risk for AD. PMID:27589532

  13. Emergent cosmology revisited

    Energy Technology Data Exchange (ETDEWEB)

    Bag, Satadru; Sahni, Varun [Inter-University Centre for Astronomy and Astrophysics, Pune 411007 (India); Shtanov, Yuri [Bogolyubov Institute for Theoretical Physics, Kiev 03680 (Ukraine); Unnikrishnan, Sanil, E-mail: satadru@iucaa.ernet.in, E-mail: varun@iucaa.ernet.in, E-mail: shtanov@bitp.kiev.ua, E-mail: sanil@lnmiit.ac.in [Department of Physics, The LNM Institute of Information Technology, Jaipur 302031 (India)

    2014-07-01

    We explore the possibility of emergent cosmology using the effective potential formalism. We discover new models of emergent cosmology which satisfy the constraints posed by the cosmic microwave background (CMB). We demonstrate that, within the framework of modified gravity, the emergent scenario can arise in a universe which is spatially open/closed. By contrast, in general relativity (GR) emergent cosmology arises from a spatially closed past-eternal Einstein Static Universe (ESU). In GR the ESU is unstable, which creates fine tuning problems for emergent cosmology. However, modified gravity models including Braneworld models, Loop Quantum Cosmology (LQC) and Asymptotically Free Gravity result in a stable ESU. Consequently, in these models emergent cosmology arises from a larger class of initial conditions including those in which the universe eternally oscillates about the ESU fixed point. We demonstrate that such an oscillating universe is necessarily accompanied by graviton production. For a large region in parameter space graviton production is enhanced through a parametric resonance, casting serious doubts as to whether this emergent scenario can be past-eternal.

  14. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  15. Emergency Call Reform

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    China merges several hotline call services in an effort to streamline the urban emergency system Chances are that if you find yourself in a crisis situation in China, dialing the correct emergency number could be a problem. Not because there isn't one, but quite the opposite. China has four main emergency response numbers-110 summons police help in a life-threatening situation, 119 brings out firefighters, 122 gets police activated to sort out traffic accidents and 120 ensures medical help. Along with th...

  16. [Emerging parasitic diseases].

    Science.gov (United States)

    Weibel Galluzzo, C; Wagner, N; Michel, Y; Jackson, Y; Chappuis, F

    2014-05-07

    Travels, migration and circulation of goods facilitate the emergence of new infectious diseases often unrecognized outside endemic areas. Most of emerging infections are of viral origin. Muscular Sarcocystis infection, an acute illness acquired during short trips to Malaysia, and Chagas disease, a chronic illness with long incubation period found among Latin American migrants, are two very different examples of emerging parasitic diseases. The former requires a preventive approach for travelers going to Malaysia and must be brought forth when they return with fever, myalgia and eosinophilia, while the latter requires a proactive attitude to screen Latin American migrant populations that may face difficulties in accessing care.

  17. Emergency Nurses Association

    Science.gov (United States)

    ... TNCC TNCC 1-Day Renewal ENPC CEN Online Review Course ADVANTICE Free CE Emergency Nursing 2017 CNE Application and Approval Process Partner Products Government Relations Public Policy Agenda Federal News EN411 Practice Resources Resource ...

  18. Household Chemical Emergencies

    Science.gov (United States)

    ... order to provide requested information. Follow the emergency operator or dispatcher’s first aid instructions carefully. The first ... many hazardous materials throughout your home. Take a tour of your home to see where these materials ...

  19. OEM Emergency Response Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management retains records of all incident responses in which it participates. This data asset includes three major sources of information:...

  20. Emerging topics in FXTAS

    DEFF Research Database (Denmark)

    Hall, Deborah A; Birch, Rachael C; Anheim, Mathieu

    2014-01-01

    This paper summarizes key emerging issues in fragile X-associated tremor/ataxia syndrome (FXTAS) as presented at the First International Conference on the FMR1 Premutation: Basic Mechanisms & Clinical Involvement in 2013....

  1. Football emergency medicine

    African Journals Online (AJOL)

    With the planning and preparation for effective and efficient medical service provision ... Medical management limitations and adaptations .... so that emergency medical management may be .... sudden cardiac death in high school and college.

  2. Emerging Targets in Photopharmacology

    NARCIS (Netherlands)

    Lerch, Michael M; Hansen, Mickel J; van Dam, Gooitzen M; Szymanski, Wiktor; Feringa, Ben L

    2016-01-01

    The field of photopharmacology uses molecular photoswitches to establish control over the action of bioactive molecules. It aims to reduce systemic drug toxicity and the emergence of resistance, while achieving unprecedented precision in treatment. By using small molecules, photopharmacology provide

  3. Emergency abdominoplasty following trauma

    Directory of Open Access Journals (Sweden)

    Suliman M

    2006-01-01

    Full Text Available We report a case of modified abdominoplasty done on emergency basis to a 37 years old male with acute abdominal wall injury due to road traffic accident. We discuss the case and review the literature.

  4. EMERGENCY PERIPARTUM HYSTERECTOMY

    African Journals Online (AJOL)

    2001-02-02

    Feb 2, 2001 ... complications that give rise to emergency hysterectomy should decrease maternal and fetal morbidity ... labour and early recourse to Caesarean section, the clinical ... insertion of prostaglandin, the patient was found to be in.

  5. Clustering of Emerging Flux

    Science.gov (United States)

    Ruzmaikin, A.

    1997-01-01

    Observations show that newly emerging flux tends to appear on the Solar surface at sites where there is flux already. This results in clustering of solar activity. Standard dynamo theories do not predict this effect.

  6. Emergency airway puncture - slideshow

    Science.gov (United States)

    ... presentations/100113.htm Emergency airway puncture - series—Normal anatomy To ... larynx is a tubular structure in the neck, through which air passes to the lungs. The thryoid and cricoid cartilage form the narrowest ...

  7. Emerging Market Multinationals

    DEFF Research Database (Denmark)

    Gammeltoft, Peter; Hobdari, Bersant

    2017-01-01

    International knowledge flows and innovation are becoming ever more important to the competitiveness of multinational corporations. Emerging market multinationals (EMNCs) in specific are deploying increasingly activist measures to harness foreign sources of knowledge and innovation as a strategy...

  8. Winter Weather Emergencies

    Science.gov (United States)

    Severe winter weather can lead to health and safety challenges. You may have to cope with Cold related health problems, including ... there are no guarantees of safety during winter weather emergencies, you can take actions to protect yourself. ...

  9. Emergency Notification System

    Data.gov (United States)

    US Agency for International Development — The USAID ENS provides quick and effective notification messages during any emergency affecting the Ronald Reagan Building, SA-44, Potomac Yards and USAID Washington...

  10. Emergency Preparedness at NCI

    Science.gov (United States)

    Information to help prepare for an emergency. Includes resources for patients and health care providers to continue cancer care, NCI contacts for grantees, and resources to prepare and update NCI employees and contractors.

  11. [Emerging viral diseases].

    Science.gov (United States)

    Bricaire, François; Bossi, Philippe

    2006-03-01

    Emerging and re-emerging infectious diseases have again entered the public arena in recent years. This is due to factors such as evolving lifestyles, ecological and socio-political upheavals, and recent diagnostic advances. Numerous pathogens, including viruses like West Nile, Chikungunya and Japanese encephalitis on the one hand, and hemorrhagic fever viruses like Ebola and Maburg, are particular concerns. Recently, the Corona virus responsible for SARS, which caused an epidemic sufficiently worrisome to challenge crisis management concepts, was successfully isolated. It is in this context that so-called "bird flu'", may be on the verge of causing a human pandemic. Pox and Monkeypox are "virtually emerging" viruses that have potential for use in bioterrorism. The management and treatment of these emerging infectious diseases calls for new approaches, organizations and infrastructures.

  12. LARYNGEAL MYXOMA : EMERGENCY MANAGEMENT

    OpenAIRE

    Budhram Singh; Santosh K Uddesh

    2014-01-01

    A sixty five years male presented with stridor and dysphonia in emergency clinic of Govt. CIMS medical college, Bilaspur. Indirect laryngoscopic examination revealed a polypoidal lesion in glottic chink. CT scan evaluation confirmed the findings of clinical examination. Patient was relived of symptoms after emergency tracheostomy followed by surgical removal of polypoidal lesion from right vocal cord by microlaryngeal surgery. Histopathological examination revealed myxoma. Clinical examinatio...

  13. Emerging zoonotic viral diseases.

    Science.gov (United States)

    Wang, L-F; Crameri, G

    2014-08-01

    Zoonotic diseases are infectious diseases that are naturally transmitted from vertebrate animals to humans and vice versa. They are caused by all types of pathogenic agents, including bacteria, parasites, fungi, viruses and prions. Although they have been recognised for many centuries, their impact on public health has increased in the last few decades due to a combination of the success in reducing the spread of human infectious diseases through vaccination and effective therapies and the emergence of novel zoonotic diseases. It is being increasingly recognised that a One Health approach at the human-animal-ecosystem interface is needed for effective investigation, prevention and control of any emerging zoonotic disease. Here, the authors will review the drivers for emergence, highlight some of the high-impact emerging zoonotic diseases of the last two decades and provide examples of novel One Health approaches for disease investigation, prevention and control. Although this review focuses on emerging zoonotic viral diseases, the authors consider that the discussions presented in this paper will be equally applicable to emerging zoonotic diseases of other pathogen types.

  14. Investigate of cause and opportunity of alternative laparotomy in laparoscopic cholecystectomy for ;cholecystitis complicated with gallbladder stone patients%胆囊炎合并胆囊结石患者行腹腔镜胆囊切除术中转开腹的原因及时机探讨

    Institute of Scientific and Technical Information of China (English)

    孔锡根; 万里鹏; 王继阳

    2015-01-01

    Objective To investigate cause and opportunity of alternative laparotomy in laparoscopic cholecystectomy(LC) for cholecystitis complicated with gallbladder stone patients. Methods Clinical data of 83 cholecystitis complicated with gallbladder stone patients were retrospectively analyzed. The patients were divided by surgery condition into laparoscopic cholecystectomy group (group A, n=30), active alternative laparotomy group (group B, n=26), and passive alternative laparotomy group (group C, n=27). Differences of risk factors for alternative laparotomy were compared in the three groups, and their operation process, intraoperative bleeding volume, postoperative exhaust time, and hospital stay were recorded. Results ①Groups B and C had much higher white blood cell count, thickness of gallbladder wall, and history of epigastrium operation than the group A. Their difference had statistical significance (P<0.05). ②After treatment, group A had the shortest operation process, intraoperative bleeding volume, postoperative exhaust time, and hospital stay among the three groups. Those were in middle levels in group B, and those of group C were the longest ones. Their differences had statistical significance (P<0.05). Conclusion Thickness of gallbladder wall, history of epigastrium operation, and white blood cell count are the risk factors of alternative laparotomy in laparoscopic cholecystectomy for cholecystitis complicated with gallbladder stone patients. Active alternative laparotomy according to intraoperative probing status is helpful for improving prognosis quality of patients.%目的:探讨胆囊炎合并胆囊结石患者行腹腔镜胆囊切除术(LC)中转开腹的原因及时机。方法回顾性分析83例胆囊炎合并胆囊结石患者临床病历资料,根据其实际手术情况分成成功完成腹腔镜胆囊切除术组(A组, n=30)、主动中转开腹组(B组, n=26)和被动中转开腹组(C组, n=27)三组。分析三组患者中转开腹危险

  15. Monitoring equine visceral pain with a composite pain scale score and correlation with survival after emergency gastrointestinal surgery.

    Science.gov (United States)

    van Loon, Johannes P A M; Jonckheer-Sheehy, Valerie S M; Back, Willem; van Weeren, P René; Hellebrekers, Ludo J

    2014-04-01

    Recognition and management of equine pain have been studied extensively in recent decades and this has led to significant advances. However, there is still room for improvement in the ability to identify and treat pain in horses that have undergone emergency gastrointestinal surgery. This study assessed the validity and clinical application of the composite pain scale (CPS) in horses after emergency gastrointestinal surgery. Composite pain scores were determined every 4h over 3 days following emergency gastrointestinal surgery in 48 horses. Inter-observer reliability was determined and another composite visceral pain score (numerical rating scale, NRS) was determined simultaneously with CPS scores. CPS scores had higher inter-observer reliability (r=0.87, K=0.84, Pscores (r=0.68, K=0.72, Pscores compared to horses that were euthanased or had to undergo re-laparotomy (Pscores. In conclusion, the use of the CPS improved objectivity of pain scoring in horses following emergency gastrointestinal surgery. High inter-observer reliability allows for comparisons between different observers. This will be of great benefit in larger veterinary hospitals where several attending clinicians are often involved in the care of each case.

  16. Assessment of the effects and limitations of the 1998 to 2008 Abbreviated Injury Scale map using a large population-based dataset

    Directory of Open Access Journals (Sweden)

    Franklyn Melanie

    2011-01-01

    Full Text Available Abstract Background Trauma systems should consistently monitor a given trauma population over a period of time. The Abbreviated Injury Scale (AIS and derived scores such as the Injury Severity Score (ISS are commonly used to quantify injury severities in trauma registries. To reflect contemporary trauma management and treatment, the most recent version of the AIS (AIS08 contains many codes which differ in severity from their equivalents in the earlier 1998 version (AIS98. Consequently, the adoption of AIS08 may impede comparisons between data coded using different AIS versions. It may also affect the number of patients classified as major trauma. Methods The entire AIS98-coded injury dataset of a large population based trauma registry was retrieved and mapped to AIS08 using the currently available AIS98-AIS08 dictionary map. The percentage of codes which had increased or decreased in severity, or could not be mapped, was examined in conjunction with the effect of these changes to the calculated ISS. The potential for free text information accompanying AIS coding to improve the quality of AIS mapping was explored. Results A total of 128280 AIS98-coded injuries were evaluated in 32134 patients, 15471 patients of whom were classified as major trauma. Although only 4.5% of dictionary codes decreased in severity from AIS98 to AIS08, this represented almost 13% of injuries in the registry. In 4.9% of patients, no injuries could be mapped. ISS was potentially unreliable in one-third of patients, as they had at least one AIS98 code which could not be mapped. Using AIS08, the number of patients classified as major trauma decreased by between 17.3% and 30.3%. Evaluation of free text descriptions for some injuries demonstrated the potential to improve mapping between AIS versions. Conclusions Converting AIS98-coded data to AIS08 results in a significant decrease in the number of patients classified as major trauma. Many AIS98 codes are missing from the

  17. Studies on health in elderly observation centers (abbreviated from Italian: COSA): a multidimensional evaluation (MDE) of an elderly population frequenting a diurnal center in Catania.

    Science.gov (United States)

    Santangelo, Antonino; Testai', Manuela; Castelli, Roberta; Albani, Salvatore; Cappello, Antonella; Primavera, Grazia; Tomarchio, Marcello; Maugeri, Domenico

    2012-01-01

    The worldwide progressive aging of the population forces us to reconsider the strategies of evaluation the effects of the geriatric "tsunami" on the health politics. The present study on the COSA (abbreviated from the Italian name: "Centro Osservazione Salute Anziani") has the aim to investigate the effects of a new form called Specialistic Geriatric Assistance on the already existing geriatric services in our territory, like UVG (Unità Valutazione Geriatrica), ADI (Assistenza Domiciliare Integrata), MMG (Medici di Medicina Generale). The present preliminary studies were carried out a group of elderly people frequenting the elderly day center "Villa Angela" located in Catania. We enrolled 42 subjects, 29 females and 13 males, in the age-range of 65-89 years (mean=73.6 years). An evaluation protocol was used for the participants, having two parts. The first part was a general one performing an accurate anamnestic examination, while the second part evaluated the cognitive and affective spheres, and the levels of autonomy and autosufficiency. The data obtained show that that the elderly population of the daily center "Villa Angela" in Catania is affected by numerous pathologies and comorbidities, which all increase the total risk of disabilities. The subjects use a high number of medicines (sometimes more than 10), which is not always justified by the pathologies found in them. Considering the functional profiles of the patients, the sanitary services offered to them are appropriate, because almost all of the elderly people were autonomous and autosufficient, having still adequate physical performances. The higher cognitive performance seemed to be reduced in more than 50% of the patients, showing almost always a slight or moderate deterioration. The depressive state measured by the GDS seemed to reach the deflection of joy of life 54.8%, while the established depression was detected in 12%. These results emphasize the importance of the functional psychogeriatric

  18. Myeloproliferative Neoplasm (MPN) Symptom Assessment Form Total Symptom Score: Prospective International Assessment of an Abbreviated Symptom Burden Scoring System Among Patients With MPNs

    Science.gov (United States)

    Emanuel, Robyn M.; Dueck, Amylou C.; Geyer, Holly L.; Kiladjian, Jean-Jacques; Slot, Stefanie; Zweegman, Sonja; te Boekhorst, Peter A.W.; Commandeur, Suzan; Schouten, Harry C.; Sackmann, Federico; Kerguelen Fuentes, Ana; Hernández-Maraver, Dolores; Pahl, Heike L.; Griesshammer, Martin; Stegelmann, Frank; Doehner, Konstanze; Lehmann, Thomas; Bonatz, Karin; Reiter, Andreas; Boyer, Francoise; Etienne, Gabriel; Ianotto, Jean-Christophe; Ranta, Dana; Roy, Lydia; Cahn, Jean-Yves; Harrison, Claire N.; Radia, Deepti; Muxi, Pablo; Maldonado, Norman; Besses, Carlos; Cervantes, Francisco; Johansson, Peter L.; Barbui, Tiziano; Barosi, Giovanni; Vannucchi, Alessandro M.; Passamonti, Francesco; Andreasson, Bjorn; Ferarri, Maria L.; Rambaldi, Alessandro; Samuelsson, Jan; Birgegard, Gunnar; Tefferi, Ayalew; Mesa, Ruben A.

    2012-01-01

    Purpose Myeloproliferative neoplasm (MPN) symptoms are troublesome to patients, and alleviation of this burden represents a paramount treatment objective in the development of MPN-directed therapies. We aimed to assess the utility of an abbreviated symptom score for the most pertinent and representative MPN symptoms for subsequent serial use in assessing response to therapy. Patients and Methods The Myeloproliferative Neoplasm Symptom Assessment Form total symptom score (MPN-SAF TSS) was calculated as the mean score for 10 items from two previously validated scoring systems. Questions focus on fatigue, concentration, early satiety, inactivity, night sweats, itching, bone pain, abdominal discomfort, weight loss, and fevers. Results MPN-SAF TSS was calculable for 1,408 of 1,433 patients with MPNs who had a mean score of 21.2 (standard deviation [SD], 16.3). MPN-SAF TSS results significantly differed among MPN disease subtypes (P < .001), with a mean of 18.7 (SD, 15.3), 21.8 (SD, 16.3), and 25.3 (SD, 17.2) for patients with essential thrombocythemia, polycythemia vera, and myelofibrosis, respectively. The MPN-SAF TSS strongly correlated with overall quality of life (QOL; r = 0.59; P < .001) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) functional scales (all P < .001 and absolute r ≥ 0.50 except social functioning r = 0.48). No significant trends were present when comparing therapy subgroups. The MPN-SAF TSS had excellent internal consistency (Cronbach's α = .83). Factor analysis identified a single underlying construct, indicating that the MPN-SAF TSS is an appropriate, unified scoring method. Conclusion The MPN-SAF TSS is a concise, valid, and accurate assessment of MPN symptom burden with demonstrated clinical utility in the largest prospective MPN symptom study to date. This new prospective scoring method may be used to assess MPN symptom burden in both clinical practice and trial settings. PMID

  19. Evidence-based nursing radical psychological impact on patients undergoing colon cancer with laparotomy%循证护理对开腹结肠癌根治术患者术前心理的影响

    Institute of Scientific and Technical Information of China (English)

    米卫华

    2014-01-01

    Objective To investigate the psychological impact of evidence-based care in patients undergoing colon cancer with laparotomy. Methods 80 cases were divided into two groups, each 40 cases, the observation group were implemented evidence-based nursing interventions in this study, the control group were implemented routine care, such as general care, general psychological care, health education, fears, depression, self-assessment, then patients with nursing intervention tables and Self-Rating Anxiety scale score and intraoperative vital signs during the night before 20:00were compared in the two groups. Results The observation group without fear of proportion was higher than control group (P<0.05), the proportion of moderate fear was more than control group (P<0.05), Self-Rating Depression Scale and the Self-Rating Anxiety Scale scores were lower than control group (P<0.05), systolic blood pressure, diastolic blood pressure were lower than control group (P<0.05), heart rate was slower than control group (P < 0.05). Conclusion The evidence-based psychological interventions for reducing pre-nursing patients undergoing abdominal cancer treatment anxiety and fear has a positive meaning, it can stable the preoperative vital signs.%目的:探讨循证护理对开腹结肠癌根治术患者术前的心理影响。方法选择患者80例,分为两组,各40例,观察组实施本研究循证护理干预方法,对照组则实施常规护理,如一般护理、普通心理护理,健康教育等,比较两组患者护理干预后恐惧情绪、抑郁自评量表和焦虑自评量表得分以及,术前晚20点时的生命体征。结果观察组术前无恐惧比例高于对照组(P<0.05),中度以上恐惧比例低于对照组(P<0.05),抑郁自评量表和焦虑自评量表得分低于对照组(P<0.05),收缩压、舒张压低于对照组(P<0.05),心率慢于对照组(P<0.05)。结论循证护理心理

  20. Transumbilical laparotomy: a cosmetic and minimally invasive operative route in pediatric patients%经脐入路--一种美观与微创的儿童腹部手术径路

    Institute of Scientific and Technical Information of China (English)

    李爱武; 张文同; 李福海; 崔新海; 刘月忠; 庄岩

    2006-01-01

    目的:探讨婴幼儿腹部手术经脐入路这一微创方法的可行性与实用性.方法:沿肚脐右侧环形皱襞作半环形切开,最大不超过270,经腹直肌或中线剪开腹膜,拖出病变或在切口处直视下进行手术操作,可吸收线皮内缝合脐部切口.结果:2001年1月~2005年1月,57例患儿经脐行58项手术,手术时间20~170min,无1例需扩大皮肤切口或转为传统开腹术.除术后1例小肠闭锁新生儿出现吻合口瘘,无其他并发症.术后5~7d愈痊出院,随访3月~4年,切口美观,无脐疝发生.结论:婴幼儿腹部手术经脐入路安全、简便、微创、美观、实用,适用于多种腹部疾病,在其它手术范围年龄及其他系统疾病都有很好的应用前景.%Objective:The feasibility of a minimally invasive cosmetic transbilical laparotomy was studied in fifty-seven pediatric patients.The advantages of this technique will be discussed.Methods:The circumferential incision was made following the ring fold of the right umblilicus,which was less than 2700.The peritoneum was opened in the midline via rectus abdominis.Intra-peritoneal lesions were detected and explored.The surgical procedures were able to be carried out either inside or outside of the peritoneum.After closure of peritoneum,the umbilical incision was closed subcutaneously with an absorbable suture.Results:From January 2001 to January 2005,58 procedures via transumbilical route have been done in 57 pediatric patients.None of those cases required conversion to a traditional abdominal incision.The duration of surgery was from 20 to 170 minutes.All patients were discharged five days postoperatively and follow-up was conducted from 3 months to 4 years.No complications were observed in all but one patient.This patient had a leaking anastamosis.No visible scars were present and the cosmetic results were excellent.All patients had shorter hospital stay and lower operating cost.Conclusion:Transumbilical approach is a

  1. Exame do fluido peritoneal e hemograma de eqüinos submetidos à laparotomia e infusão intraperitoneal de carboximetilcelulose Peritoneal fluid exam and hemogram of horses submited to laparotomy and carboxymethylcellulose intraperitoneal infusion

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Ferreira Lopes

    1999-03-01

    Full Text Available A aplicação intraperitoneal de carboximetilcelulose (CMC tem sido utilizada na prevenção de aderências peritoneais em animais e em humanos. Os objetivos deste trabalho foram avaliar a resposta do peritônio ao trauma cirúrgico e à aplicação de CMC e estudar como se processa a metabolização da CMC. Dezenove eqüinos mestiços foram submetidos à laparotomia, quando se produziram lesões no jejuno distal por abrasão da serosa e isquemia. Nos 9 eqüinos do grupo tratamento, antes da síntese da parede abdominal, foi instilada, na cavidade peritoneal, uma solução estéril de CMC, a 1% na dose de 7ml/kg. Nos eqüinos do grupo controle, nenhum medicamento foi aplicado na cavidade peritoneal. Após a cirurgia, colheram-se sangue e fluido peritoneal em 9 momentos: 4 horas após o fim da cirurgia, nos 3 primeiros dias pós-operatórios, pela manhã e a cada 48 horas nos dias subseqüentes (no 5º, 7º, 9º, 11º e 13º dias pós-operatórios. Os exames laboratoriais demonstraram que todos os animais desenvolveram inflamação peritoneal. Entretanto, nos animais do grupo tratamento, esta inflamação foi mais intensa e com um curso mais longo. Observou-se também que a excreção da CMC ocorreu por fagocitose.Intraperitoneal application of carboxymethylcellulose (CMC has been used for peritoneal adhesions prevention in animals and humans. The objectives of this research was to study the peritoneal response to surgical trauma and application of CMC and also to study how CMC excretion occurs. Nineteen healthy mixed breed horses were submited to laparotomy to produce lesions in distal jejunum by serosal abrasion and ischemia. In the nine horses of the treatment group, 7ml/kg of a 1% CMC sterile solution were instilated in peritoneal cavity before abdominal wall syntesis. No medication was instiled in peritoneal cavitiy of the control group horses. After surgery, blood and peritoneal fluid were colected in 9 postoperative moments: 4 hours after

  2. 开腹及腹腔镜手术切除胆囊治疗结石性胆囊炎对比观察%Comparison observation laparotomy and laparoscopic cholecystectomy treating calculous cholecystitis

    Institute of Scientific and Technical Information of China (English)

    仲杨

    2016-01-01

    ABSTRAC:Objective To compare the effect of open and laparoscopic cholecystectomy in the treatment of gallstone cholecystitis. Methods in our hospital in January 2013 and 2015 January 100 cases of calculus cholecystitis patients were studied with different surgery were randomly divided into open surgery grouPand the laparoscopic group, there were 50 cases of patients in the laparotomy grouPunderwent conventional open cholecystectomy surgery, the laparoscopic grouPunderwent laparoscopic cholecystectomy, of two groups of patients with operation time, incision length, intraoperative bleeding and hospitalization time and other factors compared. Results compared with the open group, the operation time, incision length, blood loss and postoperative pain time of the laparoscopic grouPwere more ideal,P< 0.05, the difference was statistically significant. And, the proportion of complications of open surgery grouPwas 24%, compared with the open group, the probability of complications of laparoscopic grouPwas 12%, significantly lower,P< 0.05, the difference between the two groups was statistically significant.Conclusion laparoscopic cholecystectomy for gallstone cholecystitis can achieve good clinical results, it is worthy of clinical application in the future.%目的:将开腹及腹腔镜手术切除胆囊治疗结石性胆囊炎的效果进行对比。方法选取本院2013年1月至2015年1月收治的100例结石性胆囊炎患者进行研究,以手术方式的不同随机分为开腹组与腹腔镜组,两组均有50例患者,开腹组行传统开腹胆囊切除手术,腹腔镜组行腹腔镜胆囊切除术,对两组患者的手术时间、切口长度、术中出血量以及住院时间等因素进行比较。结果与开腹组相比,腹腔镜组的手术时间、切口长度、术中出血量以及术后疼痛时间等更为理想,P<0.05,差异具有统计学意义。并且,开腹组并发症所占比例为24.0%,与开腹组相比,腹

  3. 腹腔镜胆囊切除术与开腹胆囊切除术疗效比较%Clinical effect of laparoscopic cholecystectomy and laparotomy surgical treatment with cholecystolithiasis

    Institute of Scientific and Technical Information of China (English)

    张全轴

    2015-01-01

    目的:比较腹腔镜胆囊切除术与开腹胆囊切除术的临床治疗效果。方法收治胆囊结石患者102例,其中采取四孔法腹腔镜胆囊切除术(腔镜组)50例,采取传统开腹胆囊切除术(对照组)52例,比较两组患者的手术时间、术中出血量、术后首次下床时间、术后通气时间、引流管拔除时间、术后住院时间以及术后并发症发生率。结果腔镜组手术时间平均(61.36±10.23) min,术中出血量(21.04±5.44)ml,术后通气时间(1.70±0.64) d,引流管拔除时间(2.26±0.44) d,术后平均住院时间(3.26± 0.44)d。对照组手术时间平均为(80.08±8.44) min,术中出血量为(76.12±7.43) ml,术后通气时间为(3.08±0.75)d,腔镜组上述指标均优于对照组,差异均有统计学意义(P<0.05)。结论在具备良好的腹腔镜手术技术的基础上行腹腔镜胆囊切除术是安全有效的,值得在基层医院推广。%Objective To compare the clinical effect of laparoscopic cholecystectomy and laparotomy surgical treatment with cholecystolithiasis.Methods A total of 102 patients diagnosed as gallbladder stone in our hospital were selected and randomly divided into experimental group and control group.50 cases in experimental group were treated with four-hole laparoscopic cholecystectomy, 52 cases in control group were received conventional open cholecystectomy.The clinical effect were observed and compared by the two groups.Results In the experimental group, the mean operative time (61.36 ±10.23) min, the bleeding amount (21.04 ±5.44) ml, postoperative ventilation time (1.70 ±0.64) d, drainage tube removal time (2.26 ±0.44) d, the mean postoperative hospital stay time (3.26 ±0.44) d, the results were better than the control group, the difference was statistically significant(P<0.05).Postoperative complications had no statistically significant

  4. [Nurse-performed FAST ultrasound in the emergency department: a systematic review].

    Science.gov (United States)

    Storti, Matteo; Musella, Lorenzo; Cianci, Vito

    2013-01-01

    Focused Assessment with Sonography for Trauma (commonly abbreviated as FAST) is considered for patients with blunt abdominal trauma as the gold standard for accident assessment in site. This method is increasingly used even by not radiologists professionals, as well as by nurses who works in emergency settings. This systematic review is aimed at evaluating the effectiveness of ultrasound FAST performed by nurses in emergencies department. Seven databases of primary and secondary literature as well as three national journals relevant to the field were consulted. The review was conducted between March and August 2011 developing 9 search strings. Articles have been critically reviewed by two authors independently. No restriction on language or time of publication have been used. A total of 4767 documents were displayed, of those only 4 were considered to be reviewed. A total of 1035 FAST ultrasound performed by nurses were included. The results show that the use of ultrasound FAST performed by trained nurses is very effective, with a sensitivity of 84% (95% CI 72.1-92.2) and a specificity of 97.37% (95% CI 92.55-99.10) . Practice execution time was an average of 156 seconds (2.6 minutes), median time of 138 seconds (range = 76 to 357). Just one study specified the training course that nurses were required to attend. To sum up, FAST ultrasound performed by nurses have an important role in emergencies management as well as in triage setting as valid screening tool.

  5. Fatal pancreatic pseudocyst co-infected by Raoultella planticola: an emerging pathogen.

    Science.gov (United States)

    de Campos, Fernando Peixoto Ferraz; Guimarães, Tiago Borges; Lovisolo, Silvana Maria

    2016-01-01

    Raoultella planticola is an aerobic Gram-negative bacterium belonging to the Enterobacteriaceae family. Initially identified in the 1980s, its pathogenic potential was further recognized when the first case of bacteremia was reported. Since then, only a few infections caused by this pathogen have been described. Although considered an opportunistic agent, fatal outcomes are associated with the infection by this pathogen, since it is more prevalent among the patients with immunodeficiency. The authors report the case of a middle-aged man diagnosed with end-stage renal disease and alcoholic pancreatitis, who was admitted to the emergency department with septic shock. Physical examination disclosed peritoneal irritation and a laparotomy was undertaken. Purulent peritonitis was found as well as a retroperitoneal abscess, which was drained. The postoperative period was troublesome, and the patient died. The autopsy showed a ruptured, infected pancreatic cyst and purulent peritonitis, among other findings. The culture of the peritoneal fluid and two blood sample sets were positive for R. planticola. The authors call attention to the importance of this emerging pathogen associated with severe gastrointestinal infections.

  6. Emergências hipertensivas

    OpenAIRE

    Feitosa-Filho, Gilson Soares; Lopes,Renato Delascio; Poppi, Nilson Tavares; Guimarães,Hélio Penna

    2008-01-01

    As urgências e as emergências hipertensivas são ocorrências clínicas que podem representar mais de 25% dos atendimentos a urgências médicas. O médico deverá estar habilitado a diferenciá-las, pois o prognóstico e o tratamento são distintos. Estima-se que 3% de todas as visitas às salas de emergência decorrem de elevações significativas da pressão arterial. Nos quadros relacionados a estes atendimentos, a emergência hipertensiva é a entidade clínica mais grave que merece cuidados intensivos. É...

  7. Hanford Emergency Response Plan

    Energy Technology Data Exchange (ETDEWEB)

    Wagoner, J.D.

    1994-04-01

    The Hanford Emergency Response Plan for the US Department of Energy (DOE), Richland Operations Office (RL), incorporates into one document an overview of the emergency management program for the Hanford Site. The program has been developed in accordance with DOE orders, and state and federal regulations to protect worker and public health and safety and the environment in the event of an emergency at or affecting the Hanford Site. This plan provides a description of how the Hanford Site will implement the provisions of DOE 5500 series and other applicable Orders in terms of overall policies and concept of operations. It should be used as the basis, along with DOE Orders, for the development of specific contractor and RL implementing procedures.

  8. Emergence and Phase Transitions

    Science.gov (United States)

    Sikkema, Arnold

    2006-05-01

    Phase transitions are well defined in physics through concepts such as spontaneous symmetry breaking, order parameter, entropy, and critical exponents. But emergence --- also exhibiting whole-part relations (such as top-down influence), unpredictability, and insensitivity to microscopic detail --- is a loosely-defined concept being used in many disciplines, particularly in psychology, biology, philosophy, as well as in physics[1,2]. I will review the concepts of emergence as used in the various fields and consider the extent to which the methods of phase transitions can clarify the usefulness of the concept of emergence both within the discipline of physics and beyond.1. Robert B. Laughlin, A Different Universe: Reinventing Physics from the Bottom Down (New York: Basic Books, 2005). 2. George F.R. Ellis, ``Physics and the Real World'', Physics Today, vol. 58, no. 7 (July 2005) pp. 49-54.

  9. The Emerging World Order

    Directory of Open Access Journals (Sweden)

    PETER COLLECOTT

    2014-05-01

    Full Text Available It is common ground amongst almost all commentators that the world has changed radically over the past 25 years – the 25 years since the fall of the Berlin Wall heralded the ending of the Cold War, the reunification of a tragically divided Europe, and the acceleration of the process of globalisation which has its only comparable period in the decades leading up to the First World War in 1914. When analyzing the Emerging World Order it is important to cover more than Brazil economy or any other individual BRICs or other Emerging Powers. Instead, our analysis will provide a global view about the economic and political global power structures which are evolving and forming before our eyes, and then to talk about the challenges these emerging realities pose for us in Europe, and in the West in general.

  10. [Emergency Triage. An Overview].

    Science.gov (United States)

    Christ, Michael; Bingisser, Roland; Nickel, Christian Hans

    2016-03-01

    In emergency departments, patients present with different severities of diseases and traumatic injuries. However, patients with severe and life-threatening conditions compete for the same resources such as personal and structure. As a general rule, each patient should receive immediate diagnostic and treatment, independent of his or her severity of disease or traumatic injury. However, an unexpected number of patients presenting to the emergency department at the same time may exceed available resources. Thus, waiting times will occur and management of patients may be impeded. As a consequence, patients with diseases or traumatic injuries with a need for time-critical management, have to be detected at the time of presentation. After categorization, patients have to be prioritized and guided to the correct place of treatment ("triage"). Starting in Australia and the United States, nurse-driven triage systems have been introduced in the emergency departments. Aim of triage is to correctly identify at increased risk of death and guide them to rapid and correct treatment. In Germany, two five-level triage systems have been introduced: Manchester Triage System (MTS) and Emergency Severity Index (ESI). We give an overview of these risk assessment tools and discuss pros and cons. In addition, new options such as "team triage" and a combination with "Early Warning Scores" are reported. In summary, nurse-driven triage is an instrument to improve patient safety in emergency medicine. A structured and systematic triage of patients using validated triage assessment tools are recommended from national and international societies of emergency medicine. Therefore, nurse-driven triage is also a must in Germany.

  11. Emergent technologies: 25 years

    Science.gov (United States)

    Rising, Hawley K.

    2013-03-01

    This paper will talk about the technologies that have been emerging over the 25 years since the Human Vision and Electronic Imaging conference began that the conference has been a part of, and that have been a part of the conference, and will look at those technologies that are emerging today, such as social networks, haptic technologies, and still emerging imaging technologies, and what we might look at for the future.Twenty-five years is a long time, and it is not without difficulty that we remember what was emerging in the late 1980s. Yet to be developed: The first commercial digital still camera was not yet on the market, although there were hand held electronic cameras. Personal computers were not displaying standardized images, and image quality was not something that could be talked about in a standardized fashion, if only because image compression algorithms were not standardized yet for several years hence. Even further away were any standards for movie compression standards, there was no personal computer even on the horizon which could display them. What became an emergent technology and filled many sessions later, image comparison and search, was not possible, nor the current emerging technology of social networks- the world wide web was still several years away. Printer technology was still devising dithers and image size manipulations which would consume many years, as would scanning technology, and image quality for both was a major issue for dithers and Fourier noise.From these humble beginnings to the current moves that are changing computing and the meaning of both electronic devices and human interaction with them, we will see a course through the changing technology that holds some features constant for many years, while others come and go.

  12. Efficiency of emergency exercises

    Energy Technology Data Exchange (ETDEWEB)

    Zander, N. [Bundesamt fuer Strahlenschutz (BfS), Oberschleissheim/Neuherberg (Germany); Sogalla, M. [Gesellschaft fuer Anlagen- und Reaktorsicherheim (GRS) mbH, Koeln (Germany)

    2011-12-15

    In order to cope with accidents beyond the design basis within German nuclear power plants which possibly lead to relevant radiological consequences, the utilities as well as the competent authorities exist emergency organisations. The efficiency, capacity for teamwork and preparedness of such organisations should be tested by regular, efficient exercise activities. Such activities can suitably be based on scenarios which provide challenging tasks for all units of the respective emergency organisation. Thus, the demonstration and further development of the efficiency of the respective organisational structures, including their ability to collaborate, is promoted. (orig.)

  13. Identifying oncological emergencies.

    Science.gov (United States)

    Guddati, Achuta K; Kumar, Nilay; Segon, Ankur; Joy, Parijat S; Marak, Creticus P; Kumar, Gagan

    2013-01-01

    Prompt identification and treatment of life-threatening oncological conditions is of utmost importance and should always be included in the differential diagnosis. Oncological emergencies can have a myriad of presentations ranging from mechanical obstruction due to tumor growth to metabolic conditions due to abnormal secretions from the tumor. Notably, hematologic and infectious conditions may complicate the presentation of oncological emergencies. Advanced testing and imaging is generally required to recognize these serious presentations of common malignancies. Early diagnosis and treatment of these conditions can significantly affect the patient's clinical outcome.

  14. LARYNGEAL MYXOMA : EMERGENCY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Budhram Singh

    2014-04-01

    Full Text Available A sixty five years male presented with stridor and dysphonia in emergency clinic of Govt. CIMS medical college, Bilaspur. Indirect laryngoscopic examination revealed a polypoidal lesion in glottic chink. CT scan evaluation confirmed the findings of clinical examination. Patient was relived of symptoms after emergency tracheostomy followed by surgical removal of polypoidal lesion from right vocal cord by microlaryngeal surgery. Histopathological examination revealed myxoma. Clinical examination after eight months showed significant improvement in hoarseness of voice with no evidence of recurrence of lesion. [Natl J Med Res 2014; 4(2.000: 175-177

  15. Rethinking emergency department visits.

    Science.gov (United States)

    Resar, Roger K; Griffin, Frances A

    2010-01-01

    Efforts to date have been unable to reverse the trend of increased emergency department utilization. The Institute for Healthcare Improvement has developed a framework for reducing avoidable emergency department visits on the basis of the formation of local coalitions. These coalitions include interested partners approaching improvement by integrating community resources and nonmedical solutions. Targeted patient populations are identified via homogeneous characteristics. Open-ended interview questions are used to identify possible community and nonmedical solutions to complement medical strategies. This article describes the framework and process of testing. If validated, this approach will have significant policy implications.

  16. Historicism and Industry Emergence

    DEFF Research Database (Denmark)

    Kirsch, David; Moeen, Mahka; Wadhwani, Dan

    2014-01-01

    . In this chapter, an alternative approach is explored that focuses on reconstructing causes and processes that time and theory have erased. The emergence of three industries—plant biotechnology, savings banking, and the automobile—shows how time, along with prevailing functional models of industry evolution, leads...

  17. CT of Gastric Emergencies.

    Science.gov (United States)

    Guniganti, Preethi; Bradenham, Courtney H; Raptis, Constantine; Menias, Christine O; Mellnick, Vincent M

    2015-01-01

    Abdominal pain, nausea, and vomiting are common presenting symptoms among adult patients seeking care in the emergency department, and, with the increased use of computed tomography (CT) to image patients with these complaints, radiologists will more frequently encounter a variety of emergent gastric pathologic conditions on CT studies. Familiarity with the CT appearance of emergent gastric conditions is important, as the clinical presentation is often nonspecific and the radiologist may be the first to recognize gastric disease as the cause of a patient's symptoms. Although endoscopy and barium fluoroscopy remain important tools for evaluating patients with suspected gastric disease in the outpatient setting, compared with CT these modalities enable less comprehensive evaluation of patients with nonspecific complaints and are less readily available in the acute setting. Endoscopy is also more invasive than CT and has greater potential risks. Although the mucosal detail of CT is relatively poor compared with barium fluoroscopy or endoscopy, CT can be used with the appropriate imaging protocols to identify inflammatory conditions of the stomach ranging from gastritis to peptic ulcer disease. In addition, CT can readily demonstrate the various complications of gastric disease, including perforation, obstruction, and hemorrhage, which may direct further clinical, endoscopic, or surgical management. We will review the normal anatomy of the stomach and discuss emergent gastric disease with a focus on the usual clinical presentation, typical imaging appearance, and differentiating features, as well as potential imaging pitfalls.

  18. Emergency Nurses Association

    Science.gov (United States)

    ... Marketplace Emerging Infectious Diseases Contact Us Sponsorship and Advertising ENA Conferences Exhibitors Job Center ENA provides opportunity ... Public Policy Agenda ​​​​​​ Contact ENA Find us on Facebook Join our conversation on Twitter Add us on ...

  19. LNG - emergency control

    Energy Technology Data Exchange (ETDEWEB)

    Berardinelli, Ricardo Porto; Correa, Kleber Macedo; Moura Filho, Nelson Barboza de; Fernandez, Carlos Antonio [TRANSPETRO, Rio de Janeiro, RJ (Brazil); Matos, Jose Eduardo Nogueira de [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2009-07-01

    The operation of liquefied natural gas (LNG) is pioneering within the PETROBRAS System. PETROBRAS Transporte - TRANSPETRO is going to operate two flexible LNG terminals, located in Ceara and Rio de Janeiro. In accordance with the Corporate Health, Safety and Environmental (HSE) Directive - Training, Education and Awareness, PETROBRAS Transporte S.A. - TRANSPETRO has prepared an action plan with the objective of ensuring the operational safety of the undertaking. Among other actions a training program for the emergency control of LNG will be inserted into the timetable. The above mentioned training program was held over a period of 20 hours, and was divided between theory and practice. In the theoretical part, the characteristics of the product, the history of accidents and the emergency response procedures were covered. In the practical part, 3000 gallons of LNG were utilized where the behavior of the product could be confirmed following a confined leak, thereby verifying the efficacy of the emergency control resources. The teaching process of the course was developed in the company through the preparation of specific procedures, emergency plans and the formation of internal instructors. (author)

  20. National Emergency Communications Plan

    Science.gov (United States)

    2008-07-01

    Integration Center’s ( NIC ) Incident Management Systems Integration Division (IMSID) promotes plain- language standards and associated guidance. o Within...and Command and Control Centers Coordination Centers Lead Agency Supporting/Participating Departments and Agencies National Operations Center ( NOC ...National Guard Bureau NGO Nongovernmental Organization NIC National Integration Center NIEM National Information Exchange Model National Emergency

  1. Emergence of regional clusters

    DEFF Research Database (Denmark)

    Dahl, Michael S.; Østergaard, Christian Richter; Dalum, Bent

    2010-01-01

    The literature on regional clusters has increased considerably during the last decade. The emergence and growth patterns are usually explained by such factors as unique local culture, regional capabilities, tacit knowledge or the existence of location-specific externalities (knowledge spillovers,...

  2. Supervising Emergency Credentialed Teachers.

    Science.gov (United States)

    Neu, Beverly; Hale, Walt

    2000-01-01

    Teachers assigned to teach on an emergency credential are severely challenged by inadequate understanding of classroom management techniques and instructional methods. Also, California's Beginning Teacher Support and Assessment Program is not available to these teachers. This article outlines criteria for principals to include in an inservice…

  3. Common paediatric cardiac emergencies

    African Journals Online (AJOL)

    presentations in older infants and children that are essential to recognise early in order to institute ... spell constitutes an emergency, as there is a high risk of hypoxic brain injury, stroke and even death. Clinical features. The clinical features ...

  4. [Medical emergency teams

    DEFF Research Database (Denmark)

    Bunkenborg, G.; Lund, C.; Petersen, John Asger

    2008-01-01

    The aim of medical emergency teams (MET) is to identify and treat deteriorating patients on general wards, and to avoid cardiac arrest, unplanned intensive care unit admission and death. The effectiveness of METs has yet to be proven, as the only two randomised, controlled trials on the subject...

  5. Fire Department Emergency Response

    Energy Technology Data Exchange (ETDEWEB)

    Blanchard, A. [Westinghouse Savannah River Company, AIKEN, SC (United States); Bell, K.; Kelly, J.; Hudson, J.

    1997-09-01

    In 1995 the SRS Fire Department published the initial Operations Basis Document (OBD). This document was one of the first of its kind in the DOE complex and was widely distributed and reviewed. This plan described a multi-mission Fire Department which provided fire, emergency medical, hazardous material spill, and technical rescue services.

  6. Emergent Gauge Fields

    CERN Document Server

    Freund, Peter G O

    2010-01-01

    Erik Verlinde's proposal of the emergence of the gravitational force as an entropic force is extended to abelian and non-abelian gauge fields and to matter fields. This suggests a picture with no fundamental forces or forms of matter whatsoever.

  7. Emerging Presidential Styles.

    Science.gov (United States)

    Stanton, Thomas C.; Pitsvada, Bernard T.

    1993-01-01

    A study of the state of the college presidency revealed that five broad management issues have emerged: conflict resolution, coping with change, achieving continuity, need for increased collaboration, and justice and ethics in the education enterprise. Implications for managerial practice in the future are analyzed. (MSE)

  8. The Emerging Scholarly Brain

    CERN Document Server

    Kurtz, Michael J

    2010-01-01

    It is now a commonplace observation that human society is becoming a coherent super-organism, and that the information infrastructure forms its emerging brain. Perhaps, as the underlying technologies are likely to become billions of times more powerful than those we have today, we could say that we are now building the lizard brain for the future organism.

  9. Emerging Presidential Styles.

    Science.gov (United States)

    Stanton, Thomas C.; Pitsvada, Bernard T.

    1993-01-01

    A study of the state of the college presidency revealed that five broad management issues have emerged: conflict resolution, coping with change, achieving continuity, need for increased collaboration, and justice and ethics in the education enterprise. Implications for managerial practice in the future are analyzed. (MSE)

  10. Emergency medicine in Vietnam.

    Science.gov (United States)

    Richards, J R

    1997-04-01

    The Socialist Republic of Vietnam is one of the poorest countries in the world. Recent economic developments, as the country attempts to start a market economy, have had a profound impact on its health care system. This report describes the state of prehospital and emergency medical care in Vietnam and possibilities for the future.

  11. Emerging supercomputer architectures

    Energy Technology Data Exchange (ETDEWEB)

    Messina, P.C.

    1987-01-01

    This paper will examine the current and near future trends for commercially available high-performance computers with architectures that differ from the mainstream ''supercomputer'' systems in use for the last few years. These emerging supercomputer architectures are just beginning to have an impact on the field of high performance computing. 7 refs., 1 tab.

  12. Emergency medicine: beyond the basics.

    Science.gov (United States)

    Malamed, S F

    1997-07-01

    Medical emergencies can arise in the dental office. Preparedness for these emergencies is predicated on an ability to rapidly recognize a problem and to effectively institute prompt and proper management. In all emergency situations, management is based on implementation of basic life support, as needed. The author describes the appropriate management of two common emergency situations: allergy and chest pain.

  13. The difficult medical emergency call

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Kjærulff, Thora Majlund; Viereck, Søren

    2017-01-01

    BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories and the ......BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories...... and the effect of categorization on mortality. METHODS: Register-based study in a 2-year period based on emergency call data from the emergency medical dispatch center in Copenhagen combined with nationwide register data. Logistic regression analysis (N = 78,040 individuals) was used for identification...

  14. The difficult medical emergency call

    DEFF Research Database (Denmark)

    Møller, Thea Palsgaard; Kjærulff, Thora Majlund; Viereck, Søren

    2017-01-01

    BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories and the ......BACKGROUND: Pre-hospital emergency care requires proper categorization of emergency calls and assessment of emergency priority levels by the medical dispatchers. We investigated predictors for emergency call categorization as "unclear problem" in contrast to "symptom-specific" categories...... and the effect of categorization on mortality. METHODS: Register-based study in a 2-year period based on emergency call data from the emergency medical dispatch center in Copenhagen combined with nationwide register data. Logistic regression analysis (N = 78,040 individuals) was used for identification...

  15. 认知语义学视角下汉语网络缩略词语规范化研究%The Standardization of Chinese Net Abbreviations from the Perspective of Cognitive Semantic Theory

    Institute of Scientific and Technical Information of China (English)

    史小平; 张懂

    2016-01-01

    This paper makes a study of the standardization of Chinese net abbreviations by means of cognitive semantic theory, and it has the following findings:the standardization can be made from two dimensions;one is that it can not go beyond people’s conceptual knowledge structure of Chinese language, the other is that the conceptualization mechanisms of Chinese net abbreviations can not be over complicated.%采用认知语义学理论,对汉语网络缩略词语的规范化进行了研究,研究发现:可以从两个维度对汉语网络缩略词语进行规范化:一是不能超出人们现有关于汉语的概念知识结构;二是对汉语网络缩略词语识解中涉及的概念化机制不能过于复杂。

  16. Emergent Complex Network Geometry

    CERN Document Server

    Wu, Zhihao; Rahmede, Christoph; Bianconi, Ginestra

    2014-01-01

    Networks are mathematical structures that are universally used to describe a large variety of complex systems such as the brain or the Internet. Characterizing the geometrical properties of these networks has become increasingly relevant for routing problems, inference and data mining. In real growing networks, topological, structural and geometrical properties emerge spontaneously from their dynamical rules. Nevertheless we still miss a model in which networks develop an emergent complex geometry. Here we show that a single two parameter network model, the growing geometrical network, can generate complex network geometries with non-trivial distribution of curvatures, combining exponential growth and small-world properties with finite spectral dimensionality. In one limit, the non-equilibrium dynamical rules of these networks can generate scale-free networks with clustering and communities, in another limit planar random geometries with non-trivial modularity. Finally we find that these properties of the geo...

  17. Hantaviruses as emergent zoonoses

    Directory of Open Access Journals (Sweden)

    LS Ullmann

    2008-01-01

    Full Text Available Hantaviruses belong to the Bunyaviridae family, which consists of vector-borne viruses. These viruses can provoke two infection types: hemorrhagic fever with renal syndrome (HFRS - which occurs in the Old World - and hantavirus cardiopulmonary syndrome (HCPS - an emergent zoonosis that can be found in many countries of the western hemisphere. Rodents are hantavirus reservoirs and each species seems to host a different virus type. Humans acquire the infection by inhaling contaminated aerosol particles eliminated by infected animals. The factors involved in the emergence of hantavirus infections in the human population include ecological modifications and changes in human activities. The most important risk factor is contact between man and rodents, as a result of agricultural, forestry or military activities. Rodent control remains the primary strategy for preventing hantavirus diseases, including via health education and hygienic habits.

  18. Emerging and Disruptive Technologies

    Science.gov (United States)

    2016-01-01

    Several emerging or disruptive technologies can be identified that might, at some point in the future, displace established laboratory medicine technologies and practices. These include increased automation in the form of robots, 3-D printing, technology convergence (e.g., plug-in glucose meters for smart phones), new point-of-care technologies (e.g., contact lenses with sensors, digital and wireless enabled pregnancy tests) and testing locations (e.g., Retail Health Clinics, new at-home testing formats), new types of specimens (e.g., cell free DNA), big biology/data (e.g., million genome projects), and new regulations (e.g., for laboratory developed tests). In addition, there are many emerging technologies (e.g., planar arrays, mass spectrometry) that might find even broader application in the future and therefore also disrupt current practice. One interesting source of disruptive technology may prove to be the Qualcomm Tricorder XPrize, currently in its final stages. PMID:27683538

  19. Effectively Emergent Quantum Mechanics

    CERN Document Server

    Exirifard, Qasem

    2008-01-01

    We consider non minimal coupling between matters and gravity in modified theories of gravity. In contrary to the current common sense, we report that quantum mechanics can effectively emerge when the space-time geometry is sufficiently flat. In other words, quantum mechanics might play no role when and where the space-time geometry is highly curved. We study the first two simple models of Effectively Emergent Quantum Mechanics(EEQM): R-dependent EEQM and G-dependent EEQM where R is the Ricci scalar and G is the Gauss-Bonnet Lagrangian density. We discuss that these EEQM theories might be fine tuned to remain consistent with all the implemented experiments and performed observations. In particular, we observe that G-dependent EEQM softens the problem of quantum gravity.

  20. Emerging and Disruptive Technologies.

    Science.gov (United States)

    Kricka, Larry J

    2016-08-01

    Several emerging or disruptive technologies can be identified that might, at some point in the future, displace established laboratory medicine technologies and practices. These include increased automation in the form of robots, 3-D printing, technology convergence (e.g., plug-in glucose meters for smart phones), new point-of-care technologies (e.g., contact lenses with sensors, digital and wireless enabled pregnancy tests) and testing locations (e.g., Retail Health Clinics, new at-home testing formats), new types of specimens (e.g., cell free DNA), big biology/data (e.g., million genome projects), and new regulations (e.g., for laboratory developed tests). In addition, there are many emerging technologies (e.g., planar arrays, mass spectrometry) that might find even broader application in the future and therefore also disrupt current practice. One interesting source of disruptive technology may prove to be the Qualcomm Tricorder XPrize, currently in its final stages.