Platelet Rich Plasma- mechanism of action and clinical applications

Directory of Open Access Journals (Sweden)

Cristina N. Cozma

2016-11-01

Full Text Available Platelet-rich plasma (PRP is a blood-derived fraction containing high level of platelets, a high concentration of leukocytes and growth factors. PRP therapy has been growing as a viable treatment alternative for a number of clinical applications and has a potential benefit for use in wound healing. Nowadays platelet rich plasma is used in stimulating wound healing in skin and soft tissue ulcerations, accelerating wound healing in diabetic patients and facilitating bone proliferation in orthopedic and trauma surgery. It has also applications in maxillofacial surgery, spinal surgery, plastic and esthetic surgery, heart surgery and burns. This review of the literature shows a limited number of studies realized on humans that sustain PRP applications in orthopedic and plastic surgery. As the use of PRP increases, more properly structured clinical studies are necessary to confirm the results and to establish clearly the techniques of preparing, the conditions and the clinical indications of applying this therapy.

Microneedle delivery: clinical studies and emerging medical applications.

Science.gov (United States)

Pettis, Ronald J; Harvey, Alfred J

2012-03-01

The concept of microneedle drug delivery was described three decades ago; however, effective clinical demonstration has only occurred within the past 10-15 years. Substantial progress in microneedle design and fabrication including extensive in vitro, ex vivo, and in vivo preclinical evaluation with various drugs, vaccines and other agents has transpired over the last decade. In contrast with this large volume of preclinical data, there are relatively few published microneedle clinical studies. To date, the clinical investigative focus has included testing to reduce dermal barrier properties and enhance transdermal delivery; evaluation of enhanced vaccine antigenicity, including development of the first commercial microneedle product for intradermal influenza vaccination; evaluation of altered microneedle protein pharmacokinetics and pharmacodynamics, especially for insulin; and evaluation of the pain and other perceptions associated with microneedle usage. This review summarizes the various aspects of microneedle clinical evaluation to date and identifies areas requiring further clinical evaluation.

Medical imaging in clinical applications algorithmic and computer-based approaches

CERN Document Server

Bhateja, Vikrant; Hassanien, Aboul

2016-01-01

This volume comprises of 21 selected chapters, including two overview chapters devoted to abdominal imaging in clinical applications supported computer aided diagnosis approaches as well as different techniques for solving the pectoral muscle extraction problem in the preprocessing part of the CAD systems for detecting breast cancer in its early stage using digital mammograms. The aim of this book is to stimulate further research in medical imaging applications based algorithmic and computer based approaches and utilize them in real-world clinical applications. The book is divided into four parts, Part-I: Clinical Applications of Medical Imaging, Part-II: Classification and clustering, Part-III: Computer Aided Diagnosis (CAD) Tools and Case Studies and Part-IV: Bio-inspiring based Computer Aided diagnosis techniques. .

Practical clinical applications of the computer in nuclear medicine

International Nuclear Information System (INIS)

Price, R.R.; Erickson, J.J.; Patton, J.A.; Jones, J.P.; Lagan, J.E.; Rollo, F.D.

1978-01-01

The impact of the computer on the practice of nuclear medicine has been felt primarily in the area of rapid dynamic studies. At this time it is difficult to find a clinic which routinely performs computer processing of static images. The general purpose digital computer is a sophisticated and flexible instrument. The number of applications for which one can use the computer to augment data acquisition, analysis, or display is essentially unlimited. In this light, the purpose of this exhibit is not to describe all possible applications of the computer in nuclear medicine but rather to illustrate those applications which have generally been accepted as practical in the routine clinical environment. Specifically, we have chosen examples of computer augmented cardiac, and renal function studies as well as examples of relative organ blood flow studies. In addition, a short description of basic computer components and terminology along with a few examples of non-imaging applications are presented

Clinical nuclear medicine applications in Turkey and specific renal studies

International Nuclear Information System (INIS)

Erbas, B.

2004-01-01

Full text: Nuclear cardiology, nuclear oncology, pediatric nuclear medicine and nuclear endocrinology are the main application areas of clinical nuclear medicine in Turkey. Not only imaging studies, but also therapeutic application of radiopharmaceuticals is also performed at many institutes, such as hyperthyroidism treatment with radioiodine, thyroid cancer ablation and metastases treatment with radioiodine, radio synovectomy, metastatic pain therapy, and recently radioimmunotherapy of lymphomas. Almost all radionuclides and radiopharmaceuticals are obtained commercially from European countries, except 18-FDG which is obtained from two cyclotrons in Turkey. More than 30.000 renal procedures are performed at the University hospitals in a year. Pediatric age groups is approximately % 55 of patients. 99mTc-DTPA (%44), 99mTc-DMSA (%37), 99mTc-MAG3 (%17) and 99mTc-EC (%2) are the most commonly used radiopharmaceuticals for renal imaging. More than 6.000 vials of several pharmaceuticals are used for renal cortical scintigraphy (%35), dynamic renal imaging (%34), renal scintigraphy with diuretic (%27) and captopril scintigraphy (%4). Most common indication for renal cortical scintigraphy is detection of cortical scarring (%53). In addition, using single plasma sample method or gamma-camera method renal clearance measurements with 99mTc-MAG3 99mTc-DTPA have been used at some institutions

Clinical nuclear medicine applications in Turkey and specific renal studies

International Nuclear Information System (INIS)

Erbas, B.

2004-01-01

Nuclear cardiology, nuclear oncology, pediatric nuclear medicine and nuclear endocrinology are the main application areas of clinical nuclear medicine in Turkey. Not only imaging studies, but also therapeutic application of radiopharmaceuticals is also performed at many institutes, such as hyperthyroidism treatment with radioiodine, thyroid cancer ablation and metastases treatment with radioiodine, radio synovectomy, metastatic pain therapy, and recently radioimmunotherapy of lymphomas. Almost all radionuclides and radiopharmaceuticals are obtained commercially from European countries, except 18-FDG which is obtained from two cyclotrons in Turkey. More than 30.000 renal procedures are performed at the University hospitals in a year. Pediatric age groups is approximately % 55 of patients. 99m Tc-DTPA (%44), 99m Tc-DMSA (%37), 99m Tc-MAG3 (%17) and 99m Tc-EC (%2) are the most commonly used radiopharmaceuticals for renal imaging. More than 6.000 vials of several pharmaceuticals are used for renal cortical scintigraphy (%35), dynamic renal imaging (%34), renal scintigraphy with diuretic (%27) and captopril scintigraphy (%4). Most common indication for renal cortical scintigraphy is detection of cortical scarring (%53). In addition, using single plasma sample method or gamma-camera method renal clearance measurements with 99m Tc-MAG3 99m Tc-DTPA have been used at some institutions. (author)

Clinical applications of iterative reconstruction

International Nuclear Information System (INIS)

Eberl, S.

1998-01-01

Expectation maximisation (EM) reconstruction largely eliminates the hot and cold streaking artifacts characteristic of filtered-back projection (FBP) reconstruction around localised hot areas, such as the bladder. It also substantially reduces the problem of decreased inferior wall counts in MIBI myocardial perfusion studies due to ''streaking'' from high liver uptake. Non-uniform attenuation and scatter correction, resolution recovery, anatomical information, e.g. from MRI or CT tracer kinetic modelling, can all be built into the EM reconstruction imaging model. The properties of ordered subset EM (OSEM) have also been used to correct for known patient motion as part of the reconstruction process. These uses of EM are elaborated more fully in some of the other abstracts of this meeting. Currently we use OSEM routinely for: (i) studies where streaking is a problem, including all MIBI myocardial perfusion studies, to avoid hot liver inferior wall artifact, (ii) all whole body FDG PET, all lung V/Q SPECT (which have a short acquisition time) and all gated 201 TI myocardial perfusion studies due to improved noise characteristics of OSEM in these studies; (iii) studies with measured, non-uniform attenuation correction. With the accelerated OSEM algorithm, iterative reconstruction is practical for routine clinical applications and we have found OSEM to provide clearly superior reconstructions for the areas listed above and are investigating its application to other studies. In clinical use, we have not found OSEM to introduce artifacts which would not also occur with FBP, e.g. uncorrected patient motion will cause artifacts with both OSEM and FBP

Application of ion chromatography in clinical studies and pharmaceutical industry.

Science.gov (United States)

Michalski, Rajmund

2014-01-01

Ion chromatography is a well-established regulatory method for analyzing anions and cations in environmental, food and many other samples. It offers an enormous range of possibilities for selecting stationary and mobile phases. Additionally, it usually helps to solve various separation problems, particularly when it is combined with different detection techniques. Ion chromatography can also be used to determine many ions and substances in clinical and pharmaceutical samples. It provides: availability of high capacity stationary phases and sensitive detectors; simple sample preparation; avoidance of hazardous chemicals; decreased sample volumes; flexible reaction options on a changing sample matrix to be analyzed; or the option to operate a fully-automated system. This paper provides a short review of the ion chromatography applications for determining different inorganic and organic substances in clinical and pharmaceutical samples.

Application and Exploration of Big Data Mining in Clinical Medicine

Science.gov (United States)

Zhang, Yue; Guo, Shu-Li; Han, Li-Na; Li, Tie-Ling

2016-01-01

Objective: To review theories and technologies of big data mining and their application in clinical medicine. Data Sources: Literatures published in English or Chinese regarding theories and technologies of big data mining and the concrete applications of data mining technology in clinical medicine were obtained from PubMed and Chinese Hospital Knowledge Database from 1975 to 2015. Study Selection: Original articles regarding big data mining theory/technology and big data mining's application in the medical field were selected. Results: This review characterized the basic theories and technologies of big data mining including fuzzy theory, rough set theory, cloud theory, Dempster–Shafer theory, artificial neural network, genetic algorithm, inductive learning theory, Bayesian network, decision tree, pattern recognition, high-performance computing, and statistical analysis. The application of big data mining in clinical medicine was analyzed in the fields of disease risk assessment, clinical decision support, prediction of disease development, guidance of rational use of drugs, medical management, and evidence-based medicine. Conclusion: Big data mining has the potential to play an important role in clinical medicine. PMID:26960378

Clinical applications of immunoglobulin: update

Directory of Open Access Journals (Sweden)

Marcia Cristina Zago Novaretti

2011-06-01

Full Text Available Human immunoglobulin is the most used blood product in the clinical practice. Immunoglobulin applications have increased quickly since the elucidation of its immunomodulatory and antiinflammatory properties which turned this blood product into a precious tool in the treatment of numerous diseases that present with humoral immune deficiency or that cause immune system dysfunction. Currently, the approved indications for Ig are: primary immunodeficiencies, secondary immunodeficiencies (multiple myeloma or chronic lymphoid leukemia, Kawasaki syndrome, immune thrombocytopenic purpura, Guillain Barré syndrome, graft-versus-host disease following bone marrow transplantation and repeat infections in HIV children. On the other hand, there are numerous "off-label" indications of immunoglobulin, which represent 20-60% of all clinical applications of this drug. It is important to study all these indications and, above all, the scientific evidence for its use, in order to provide patients with a new therapeutic option without burdening the health system. This review results from a wide selection of papers identified in the Pubmed and Lilacs scientific electronic databases. A group of descriptors were used from human immunoglobulin to the names of each disease that immunoglobulin is clinically applied. Our main objective is to list the numerous indications of immunoglobulin, both authorized and "off-label" and to analyze these indications in the light of the most recent scientific evidence.

Clinical applications of nuclear magnetic resonance spectroscopy: a review

Energy Technology Data Exchange (ETDEWEB)

Newman, R.J. (Glasgow Western Infirmary (UK))

1984-09-01

The advantages and present limitations of the clinical applications of nuclear magnetic resonance spectroscopy are reviewed in outline, with passing references to skeletal muscular studies, in particular a group of children with advanced Duchenne dystrophy, and the applications to the study of cerebral metabolism of neonates, excised kidneys, biopsy studies of breast and axillary lymph node samples, and NMR spectroscopy performed during chemotherapy of a secondary rhabdomyosarcoma in the skin.

fMRI. Basics and clinical applications

Energy Technology Data Exchange (ETDEWEB)

Ulmer, Stephan; Jansen, Olav (eds.) [University Hospital of Schleswig-Holstein, Kiel (Germany). Inst. of Neuroradiology, Neurocenter

2010-07-01

Functional MRI (fMRI) and the basic method of BOLD imaging were introduced in 1993 by Seiji Ogawa. From very basic experiments, fMRI has evolved into a clinical application for daily routine brain imaging. There have been various improvements in both the imaging technique as such as well as in the statistical analysis. In this volume, experts in the field share their knowledge and point out possible technical barriers and problems explaining how to solve them. Starting from the very basics on the origin of the BOLD signal, the book covers technical issues, anatomical landmarks, presurgical applications, and special issues in various clinical fields. Other modalities for brain mapping such as PET, TMS, and MEG are also compared with fMRI. This book is intended to give a state-of-the-art overview and to serve as a reference and guide for clinical applications of fMRI. (orig.)

Clinical applications of nuclear magnetic resonance spectroscopy: a review

International Nuclear Information System (INIS)

Newman, R.J.

1984-01-01

The advantages and present limitations of the clinical applications of nuclear magnetic resonance spectroscopy are reviewed in outline, with passing references to skeletal muscular studies, in particular a group of children with advanced Duchenne dystrophy, and the applications to the study of cerebral metabolism of neonates, excised kidneys, biopsy studies of breast and axillary lymph node samples, and NMR spectroscopy performed during chemotherapy of a secondary rhabdomyosarcoma in the skin. (U.K.)

Clinical application of dendritic cells in cancer vaccination therapy

DEFF Research Database (Denmark)

Svane, Inge Marie; Soot, Mette Line; Buus, Søren

2003-01-01

During the last decade use of dendritic cells (DC) has moved from murine and in vitro studies to clinical trials as adjuvant in cancer immunotherapy. Here they function as delivery vehicles for exogenous tumor antigens, promoting an efficient antigen presentation. The development of protocols...... for large-scale generation of dendritic cells for clinical applications has made possible phase I/II studies designed to analyze the toxicity, feasibility and efficacy of this approach. In clinical trials, DC-based vaccination of patients with advanced cancer has in many cases led to immunity...

Magnetic Nanoparticles From Fabrication to Clinical Applications

CERN Document Server

Thanh, Nguyen TK

2012-01-01

Offering the latest information in magnetic nanoparticle (MNP) research, Magnetic Nanoparticles: From Fabrication to Clinical Applications provides a comprehensive review, from synthesis, characterization, and biofunctionalization to clinical applications of MNPs, including the diagnosis and treatment of cancers. This book, written by some of the most qualified experts in the field, not only fills a hole in the literature, but also bridges the gaps between all the different areas in this field. Translational research on tailored magnetic nanoparticles for biomedical applications spans a variet

Possibility of clinical applications of forest medicine.

Science.gov (United States)

Li, Qing; Kawada, Tomoyuki

2014-01-01

Since 2004, we have conducted a series of studies of the effect of forest therapy on human health and established forest therapy as a new preventive strategy. We have found that forest therapy has many beneficial effects on human health. However, there is almost no study dealing with the possibility of clinical applications of forest therapy. In this review, we discuss the possibility of clinical applications of forest therapy from the following viewpoints: 1. Forest therapy can decrease blood pressure, heart rate, sympathetic nerve activity, and levels of stress hormones, such as urinary adrenaline and noradrenaline, and can increase parasympathetic nerve activity, suggesting its preventive effect on hypertension. 2. Forest therapy can also decreace the scores for anxiety, depression, anger, fatigue, and confusion and increase the score for vigor in the Profile of Mood States (POMS) test, suggesting its preventive effect on mental depression. 3. Forest therapy can increase the activity and number of human natural killer (NK) cells and the intracellular levels of anticancer proteins, suggesting its preventive effect on cancers. 4. These findings suggest that forest therapy may have preventive effects on lifestyle-related diseases. However, the above preventive effects of forest therapy should be confirmed in clinical research.

Clinical applications of PET/CT

International Nuclear Information System (INIS)

Le Ngoc Ha

2011-01-01

The purpose of this article is to review the evolution of PET, PET/CT focusing on the technical aspects, PET radiopharmaceutical developments and current clinical applications as well. The newest technologic advances have been reviewed, including improved crystal design, acquisition modes, reconstruction algorithms, etc. These advancements will continue to improve contrast, decrease noise, and increase resolution. Combined PET/CT system provides faster attenuation correction and useful anatomic correlation to PET functional information. A number of new radiopharmaceuticals used for PET imaging have been developed, however, FDG have been considered as the principal PET radiotracer. The current clinical applications of PET and PET/CT are widespread and include oncology, cardiology and neurology. (author)

Nursing Students' Opinion on the Use of Smartphone Applications (Apps) in Clinical Education and Training: A Study Protocol.

Science.gov (United States)

O'Connor, Siobhan; Andrews, Tom

2016-01-01

Nurse educators are exploring different mobile technologies to provide additional support to nursing students in clinical practice. However, the view of nursing students on the use of smartphone applications (apps) to enhance clinical education has not been explored. This proposed study will use a self-reported questionnaire to examine the opinions of nursing students on the current and potential use of smartphone apps when training in clinical settings. Descriptive and inferential statistics will be performed on the quantitative data. Qualitative data from open ended questions will be thematically analysed using the framework approach. This will be the first study to examine the use of smartphone apps as a support in clinical teaching from a students' perspective. Their opinion is vital if the right mobile technology is to be designed and implemented.

Use of an android phone application for automated text messages in international settings: A case study in an HIV clinical trial in St. Petersburg, Russia.

Science.gov (United States)

Forman, Leah S; Patts, Gregory J; Coleman, Sharon M; Blokhina, Elena; Lu, John; Yaroslavtseva, Tatiana; Gnatienko, Natalia; Krupitsky, Evgeny; Samet, Jeffrey H; Chaisson, Christine E

2018-02-01

Reproducible outcomes in clinical trials depend on adherence to study protocol. Short message service (also known as text message) reminders have been shown to improve clinical trial adherence in the United States and elsewhere. However, due to systematic differences in mobile data plans, languages, and technology, these systems are not easily translated to international settings. To gauge technical capabilities for international projects, we developed SMSMessenger, an automated Android application that uses a US server to send medication reminders to participants in a clinical trial in St. Petersburg, Russia (Zinc for HIV disease among alcohol users-a randomized controlled trial in the Russia Alcohol Research Collaboration on HIV/AIDS cohort). The application is downloaded once onto an Android study phone. When it is time for the text message reminders to be sent, study personnel access the application on a local phone, which in turn accesses the existing clinical trial database hosted on a US web server. The application retrieves a list of participants with the following information: phone number, whether a message should be received at that time, and the appropriate text of the message. The application is capable of storing multiple outgoing messages. With a few clicks, text messages are sent to study participants who can reply directly to the message. Study staff can check the local phone for incoming messages. The SMSMessenger application uses an existing clinical trial database and is able to receive real-time updates. All communications between the application and server are encrypted, and phone numbers are stored in a secure database behind a firewall. No sensitive data are stored on the phone, as outgoing messages are sent through the application and not by messaging features on the phone itself. Messages are sent simultaneously to study participants, which reduces the burden on local study staff. Costs and setup are minimal. The only local requirements

Clinical applications of resting state functional connectivity

Directory of Open Access Journals (Sweden)

Michael D Fox

2010-06-01

Full Text Available During resting conditions the brain remains functionally and metabolically active. One manifestation of this activity that has become an important research tool is spontaneous fluctuations in the blood oxygen level dependent (BOLD signal of fMRI. The identification of correlation patterns in these spontaneous fluctuations has been termed resting state functional connectivity (fcMRI and has the potential to greatly increase the translation of fMRI into clinical care. In this article we review the advantages of the resting state signal for clinical applications including detailed discussion of signal to noise considerations. We include guidelines for performing resting state research on clinical populations, outline the different areas for clinical application, and identify important barriers to be addressed to facilitate the translation of resting state fcMRI into the clinical realm.

Criteria for selection and application of molecular markers for clinical studies of osteoarthritis.

Science.gov (United States)

Otterness, I G; Swindell, A C

2003-03-01

To develop criteria for the selection and application of molecular markers for the study of osteoarthritis (OA). Statistical criteria for marker selection for OA are developed. After studying more than 20 different molecular markers for monitoring OA, procedures for choosing markers for clinical studies have been developed. For a particular study, the process starts with the markers showing 'face-validity' for monitoring OA. They are next required to successfully distinguish OA patients from controls. This necessitates definition of the distribution of marker values in OA patients and controls. So far, they have been consistently log-normal. The difference (Delta) in marker values between OA and controls defines the opportunity for marker improvement. The between-visit standard deviation (S) in patients puts limits on the detection of marker changes. The two variables can be combined to estimate the practicality of a marker using a modified power analysis. The number of patients (N*) required to observe a 50% improvement with an alpha level of P=0.05 and with 80% certainty is estimated as 50(S/Delta)(2). N*, S and Delta should be used to characterize and compare markers. Marker efficiency can be refined by regressing on secondary variables, such as age, sex, BMI, severity, etc. Finally, the use of two or more markers may be required to improve marker prediction of clinical outcome. Correlated markers can be used to reinforce conclusions by essentially adding replicative data. Independent, complementary markers can be used to develop associations with clinical parameters, and perhaps diagnose and monitor disease status, activities that so far have not been possible with single markers.

Outpatient Tinnitus Clinic, Self-Help Web Platform, or Mobile Application to Recruit Tinnitus Study Samples?

Directory of Open Access Journals (Sweden)

Thomas Probst

2017-04-01

Full Text Available For understanding the heterogeneity of tinnitus, large samples are required. However, investigations on how samples recruited by different methods differ from each other are lacking. In the present study, three large samples each recruited by different means were compared: N = 5017 individuals registered at a self-help web platform for tinnitus (crowdsourcing platform Tinnitus Talk, N = 867 users of a smart mobile application for tinnitus (crowdsensing platform TrackYourTinnitus, and N = 3786 patients contacting an outpatient tinnitus clinic (Tinnitus Center of the University Hospital Regensburg. The three samples were compared regarding age, gender, and duration of tinnitus (month or years perceiving tinnitus; subjective report using chi-squared tests. The three samples significantly differed from each other in age, gender and tinnitus duration (p < 0.05. Users of the TrackYourTinnitus crowdsensing platform were younger, users of the Tinnitus Talk crowdsourcing platform had more often female gender, and users of both newer technologies (crowdsourcing and crowdsensing had more frequently acute/subacute tinnitus (<3 months and 4–6 months as well as a very long tinnitus duration (>20 years. The implications of these findings for clinical research are that newer technologies such as crowdsourcing and crowdsensing platforms offer the possibility to reach individuals hard to get in contact with at an outpatient tinnitus clinic. Depending on the aims and the inclusion/exclusion criteria of a given study, different recruiting strategies (clinic and/or newer technologies offer different advantages and disadvantages. In general, the representativeness of study results might be increased when tinnitus study samples are recruited in the clinic as well as via crowdsourcing and crowdsensing.

Generalizing the Arden Syntax to a Common Clinical Application Language.

Science.gov (United States)

Kraus, Stefan

2018-01-01

The Arden Syntax for Medical Logic Systems is a standard for encoding and sharing knowledge in the form of Medical Logic Modules (MLMs). Although the Arden Syntax has been designed to meet the requirements of data-driven clinical event monitoring, multiple studies suggest that its language constructs may be suitable for use outside the intended application area and even as a common clinical application language. Such a broader context, however, requires to reconsider some language features. The purpose of this paper is to outline the related modifications on the basis of a generalized Arden Syntax version. The implemented prototype provides multiple adjustments to the standard, such as an option to use programming language constructs without the frame-like MLM structure, a JSON compliant data type system, a means to use MLMs as user-defined functions, and native support of restful web services with integrated data mapping. This study does not aim to promote an actually new language, but a more generic version of the proven Arden Syntax standard. Such an easy-to-understand domain-specific language for common clinical applications might cover multiple additional medical subdomains and serve as a lingua franca for arbitrary clinical algorithms, therefore avoiding a patchwork of multiple all-purpose languages between, and even within, institutions.

Multi-disciplinary data organization and visualization models for clinical and pre-clinical studies: A case study in the application of proton beam radiosurgery for treating spinal cord injury related pain

Science.gov (United States)

Verma, Sneha K.; Liu, Brent J.

2016-03-01

An increasing adoption of electronic medical records has made information more accessible to clinicians and researchers through dedicated systems such as HIS, RIS and PACS. The speed and the amount at which information are generated in a multi-institutional clinical study make the problem complicated compared to day-to-day hospital workflow. Often, increased access to the information does not translate into the efficient use of that information. Therefore, it becomes crucial to establish models which can be used to organize and visualize multi-disciplinary data. Good visualization in turn makes it easy for clinical decision-makers to reach a conclusion within a small span of time. In a clinical study involving multi-disciplinary data and multiple user groups who need access to the same data and presentation states based on the stage of the clinical trial or the task are crucial within the workflow. Therefore, in order to demonstrate the conceptual system design and system workflow, we will be presenting a clinical trial based on application of proton beam for radiosurgery which will utilize our proposed system. For demonstrating user role and visualization design purposes, we will be focusing on three different user groups which are researchers involved in patient enrollment and recruitment, clinicians involved in treatment and imaging review and lastly the principle investigators involved in monitoring progress of clinical study. Also datasets for each phase of the clinical study including preclinical and clinical data as it related to subject enrollment, subject recruitment (classifier), treatment (DICOM), imaging, and pathological analysis (protein staining) of outcomes.

Review and classification of variability analysis techniques with clinical applications

Science.gov (United States)

2011-01-01

Analysis of patterns of variation of time-series, termed variability analysis, represents a rapidly evolving discipline with increasing applications in different fields of science. In medicine and in particular critical care, efforts have focussed on evaluating the clinical utility of variability. However, the growth and complexity of techniques applicable to this field have made interpretation and understanding of variability more challenging. Our objective is to provide an updated review of variability analysis techniques suitable for clinical applications. We review more than 70 variability techniques, providing for each technique a brief description of the underlying theory and assumptions, together with a summary of clinical applications. We propose a revised classification for the domains of variability techniques, which include statistical, geometric, energetic, informational, and invariant. We discuss the process of calculation, often necessitating a mathematical transform of the time-series. Our aims are to summarize a broad literature, promote a shared vocabulary that would improve the exchange of ideas, and the analyses of the results between different studies. We conclude with challenges for the evolving science of variability analysis. PMID:21985357

Review and classification of variability analysis techniques with clinical applications.

Science.gov (United States)

Bravi, Andrea; Longtin, André; Seely, Andrew J E

2011-10-10

Analysis of patterns of variation of time-series, termed variability analysis, represents a rapidly evolving discipline with increasing applications in different fields of science. In medicine and in particular critical care, efforts have focussed on evaluating the clinical utility of variability. However, the growth and complexity of techniques applicable to this field have made interpretation and understanding of variability more challenging. Our objective is to provide an updated review of variability analysis techniques suitable for clinical applications. We review more than 70 variability techniques, providing for each technique a brief description of the underlying theory and assumptions, together with a summary of clinical applications. We propose a revised classification for the domains of variability techniques, which include statistical, geometric, energetic, informational, and invariant. We discuss the process of calculation, often necessitating a mathematical transform of the time-series. Our aims are to summarize a broad literature, promote a shared vocabulary that would improve the exchange of ideas, and the analyses of the results between different studies. We conclude with challenges for the evolving science of variability analysis.

fMRI. Basics and clinical applications. 2. ed.

Energy Technology Data Exchange (ETDEWEB)

Ulmer, Stephan [Medizinisch Radiologisces Institut (MRI), Zuerich (Switzerland); Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Inst. fuer Neuroradiologie; Jansen, Olav (eds.) [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Inst. fuer Neuroradiologie

2013-11-01

State of the art overview of fMRI. Covers technical issues, methods of statistical analysis, and the full range of clinical applications. Revised and expanded edition including discussion of novel aspects of analysis and further important applications. Includes comparisons with other brain mapping techniques and discussion of potential combined uses. Since functional MRI (fMRI) and the basic method of BOLD imaging were introduced in 1993 by Seiji Ogawa, fMRI has evolved into an invaluable clinical tool for routine brain imaging, and there have been substantial improvements in both the imaging technique itself and the associated statistical analysis. This book provides a state of the art overview of fMRI and its use in clinical practice. Experts in the field share their knowledge and explain how to overcome diverse potential technical barriers and problems. Starting from the very basics on the origin of the BOLD signal, the book covers technical issues, anatomical landmarks, the full range of clinical applications, methods of statistical analysis, and special issues in various clinical fields. Comparisons are made with other brain mapping techniques, such as DTI, PET, TMS, EEG, and MEG, and their combined use with fMRI is also discussed. Since the first edition, original chapters have been updated and new chapters added, covering both novel aspects of analysis and further important clinical applications.

Tooth apatite as a bone substitute: an experimental study and clinical applications

International Nuclear Information System (INIS)

Eun-Seok Kim; Pill-Hoon Choung

1999-01-01

The purpose of this study is to evaluate the usefulness of calcined teeth powder as biological apatite. The animal experiment was performed in 36 rabbits aging 6 weeks and weighing 1.6 kg. In experimental group, tooth apatite powder was implanted to 10 mm bony defects in diameter made on the cranial bone of the rabbits. As control groups, synthetic porous hydroxyapatite and resorbable type calcium carbonate were implanted to the defects of same size. Each group was sacrificed in 1, 2, 4, 6, 8, 12 weeks after the surgery. Specimens were prepared for decalcified samples and observed by a light microscope. And we also performed quantitative analysis of new bone formation through image analysis using computer. In clinical applications, we used tooth apatite alone or mixed with decalcified freeze-dried bone for reconstruction of bony defects in 15 patients undergone enucleation of cyst or ameloblastoma. The obtained results were as follows; 1) The powder of the calcined teeth was called as 'tooth apatite' and it seemed to have biocompatibility in rabbits and human. 2) In group of tooth apatite, after 4 weeks of operation, new bone directly bonded to the particles was observed. And in 12 weeks of it, new bone occupied most of the bony defects. In 6 weeks, resorption of the tooth apatite particles was observed. Thus the tooth apatite was regarded as one of resorbable apatite. 3) The group of tooth apatite showed new bone formation similar to the group of porous hydroxyapatite, but they were inferior to the group of resorbable calcium carbonate. 4) In clinical application, tooth apatite had biocompatibility and new bone formation was observed without any complication except for 1 case. So we think it is a useful bone substitute with osteoconductivity

Dental student attitudes towards communication skills instruction and clinical application.

Science.gov (United States)

McKenzie, Carly T

2014-10-01

This study investigated dental students' attitudes towards communication skills instruction and clinical application and explored the impact of a one-semester course and year in school on students' attitudes, measured by the Communication Skills Attitude Scale. Demographic characteristics and self-assessment of communication skills were also analyzed. The study employed a pretest-posttest survey design combined with cross-sectional data. Participants were first- and fourth-year students at a U.S. dental school. Out of a possible 120 students, 106 (fifty-seven D1 and forty-nine D4) participated in the pretest, an 88 percent response rate; out of a possible 121 students, 115 (fifty-seven D1 and fifty-eight D4) participated in the posttest, a 95 percent response rate. In the results, D4 students consistently demonstrated less positive attitudes towards communication skills instruction and more negative attitudes regarding the importance of interpersonal skills in clinical encounters than did their D1 counterparts. A single communications course had no discernible effect on attitudes or self-assessments for either cohort. Females reported more positive attitudes towards clinical application of interpersonal skills than did males. Gender significantly interacted with two demographic variables: primary language and parent as health care professional. Female children of health care professionals reported poorer attitudes towards clinical communication skills training and application than did their male counterparts. Generally, parental occupation in health care moderated the decrease in positive attitudes over time towards clinical usefulness of communication skills. The D4 students rated their communication skills higher than did the D1 students. Students who demonstrated more positive attitudes towards communication skills training and application were more likely to say their own skills needed improvement.

Clinical Application Projects (CAPs) for Health Science Students in Introductory Microbiology.

Science.gov (United States)

Halyard, Rebecca A.

Clinical Application Projects (CAPs) have been developed that allow dental hygiene and nursing students to apply introductory microbiology principles and skills learned in lecture and laboratory to a problem in an appropriate clinical situation. CAPs therefore substitute for the traditional study of "unknowns". Principles and processes emphasized…

Clinical applications of SONIALVISION 100 digital diagnostic table system

International Nuclear Information System (INIS)

Shiomi, Takeshi; Shimizu, Tatsuya; Iinuma, Masao; Takemoto, Hajime; Tanaka, Shuji

2003-01-01

This report refers to the clinical applications of our newly developed SONIALVISION 100 fully digitalized X-ray diagnostic table system. The main design concept of the SONIALVISION 100 system is the improvement of workflow in various clinical fields. The development of digital imaging technologies has come to allow fully digitalized X-ray diagnostic table systems to be widely utilized in various clinical applications, including interventional radiology (IVR) and examinations using contrast medium. This report mainly refers to the clinical applications of the Shimadzu SONIALVISION 100 digitalized X-ray diagnostic table system, also presenting some typical image data demonstrating the high efficiency, made available through the use of this new system, in high-speed spot imaging and digital tomography. (author)

[Progress of midfacial fat compartments and related clinical applications].

Science.gov (United States)

Wen, Lihong; Wang, Jinhuang; Li, Yang; Liu, Dalie

2018-02-01

To review the research progress of midfacial fat compartments, and to thoroughly understand its current state of the anatomy and the aging morphologic characters of midfacial fat compartments, as well as the current status of clinical applications. The recent literature concerning the midfacial fat compartments and related clinical applications were extensively reviewed and analyzed. Midfacial fat layer has been considered as a fusion and a continuous layer, experiencing a global atrophy when aging. As more anatomical researches have done, recent studies have shown that midfacial fat layer is broadly divided into superficial and deep layers, which are both divided into different fat compartments by fascia, ligaments, or muscles. Midfacial fat compartments tend to atrophy with age, specifically in the deep fat compartments while hypertrophy in the superficial fat compartments. Clinical applications show that fat volumetric restoration with deep medial cheek fat and Ristow's space can restore the appearance of midface effectively. In recent years, the researches of midfacial fat compartments have achieved obvious progress, which will provide new ideas and basis for fat volumetric restoration. Corresponding treatments are selected based on different sites and different layers with different aging changes, reshaping a more youthful midface.

Applicable or non-applicable: investigations of clinical heterogeneity in systematic reviews

Directory of Open Access Journals (Sweden)

Laura E. Chess

2016-02-01

characteristics they initially chose as potential for clinical heterogeneity. Very few studies mentioned clinician training, compliance, brand, co-interventions, dose route, ethnicity, prognostic markers and psychosocial variables as covariates to investigate as potentially clinically heterogeneous. Addressing aspects of clinical heterogeneity was not different between Cochrane and non-Cochrane reviews. Conclusions The ability to quantify and compare the clinical differences of trials within a meta-analysis is crucial to determining its applicability and use in clinical practice. Despite Cochrane Collaboration emphasis on methodology, the proportion of reviews that assess clinical heterogeneity is less than those of non-Cochrane reviews. Our assessment reveals that there is room for improvement in assessing clinical heterogeneity in both Cochrane and non-Cochrane reviews.

Applications of stable isotopes in clinical pharmacology

NARCIS (Netherlands)

Schellekens, Reinout C A; Stellaard, Frans; Woerdenbag, Herman J; Frijlink, Henderik W; Kosterink, Jos G W

2011-01-01

This review aims to present an overview of the application of stable isotope technology in clinical pharmacology. Three main categories of stable isotope technology can be distinguished in clinical pharmacology. Firstly, it is applied in the assessment of drug pharmacology to determine the

Clinical applications of 7 T MRI in the brain

International Nuclear Information System (INIS)

Kolk, Anja G. van der; Hendrikse, Jeroen; Zwanenburg, Jaco J.M.; Visser, Fredy; Luijten, Peter R.

2013-01-01

This review illustrates current applications and possible future directions of 7 Tesla (7 T) Magnetic Resonance Imaging (MRI) in the field of brain MRI, in clinical studies as well as clinical practice. With its higher signal-to-noise (SNR) and contrast-to-noise ratio (CNR) compared to lower field strengths, high resolution, contrast-rich images can be obtained of diverse pathologies, like multiple sclerosis (MS), brain tumours, aging-related changes and cerebrovascular diseases. In some of these diseases, additional pathophysiological information can be gained compared to lower field strengths. Because of clear depiction of small anatomical details, and higher lesion conspicuousness, earlier diagnosis and start of treatment of brain diseases may become possible. Furthermore, additional insight into the pathogenesis of brain diseases obtained with 7 T MRI could be the basis for new treatment developments. However, imaging at high field comes with several limitations, like inhomogeneous transmit fields, a higher specific absorption rate (SAR) and, currently, extensive contraindications for patient scanning. Future studies will be aimed at assessing the advantages and disadvantages of 7 T MRI over lower field strengths in light of clinical applications, specifically the additional diagnostic and prognostic value of 7 T MRI

Clinical applications of 7 T MRI in the brain

Energy Technology Data Exchange (ETDEWEB)

Kolk, Anja G. van der, E-mail: A.G.vanderKolk@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Hendrikse, Jeroen, E-mail: J.Hendrikse@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Zwanenburg, Jaco J.M., E-mail: J.J.M.Zwanenburg@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Image Sciences Institute, University Medical Center Utrecht (Netherlands); Visser, Fredy, E-mail: F.Visser-2@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands); Philips Healthcare, Best (Netherlands); Luijten, Peter R., E-mail: P.Luijten@umcutrecht.nl [Department of Radiology, University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht (Netherlands)

2013-05-15

This review illustrates current applications and possible future directions of 7 Tesla (7 T) Magnetic Resonance Imaging (MRI) in the field of brain MRI, in clinical studies as well as clinical practice. With its higher signal-to-noise (SNR) and contrast-to-noise ratio (CNR) compared to lower field strengths, high resolution, contrast-rich images can be obtained of diverse pathologies, like multiple sclerosis (MS), brain tumours, aging-related changes and cerebrovascular diseases. In some of these diseases, additional pathophysiological information can be gained compared to lower field strengths. Because of clear depiction of small anatomical details, and higher lesion conspicuousness, earlier diagnosis and start of treatment of brain diseases may become possible. Furthermore, additional insight into the pathogenesis of brain diseases obtained with 7 T MRI could be the basis for new treatment developments. However, imaging at high field comes with several limitations, like inhomogeneous transmit fields, a higher specific absorption rate (SAR) and, currently, extensive contraindications for patient scanning. Future studies will be aimed at assessing the advantages and disadvantages of 7 T MRI over lower field strengths in light of clinical applications, specifically the additional diagnostic and prognostic value of 7 T MRI.

Clinical applications of cells labelling

International Nuclear Information System (INIS)

Gonzalez, B.M.

1994-01-01

Blood cells labelled with radionuclides are reviewed and main applications are described. Red blood cell labelling by both random and specific principle. A table with most important clinical uses, 99mTc labelling of RBC are described pre tinning and in vivo reduction of Tc, in vitro labelling and administration of labelled RBC and in vivo modified technique. Labelled leucocytes with several 99mTc-complex radiopharmaceuticals by in vitro technique and specific monoclonal s for white cells(neutrofiles). Labelled platelets for clinical use and research by in vitro technique and in vivo labelling

Studies on the clinical application of MR perfusion image using arterial spin labeling method

International Nuclear Information System (INIS)

Miyasaka, Kenji

1999-01-01

A new technique for imaging brain perfusion, arterial spin labeling method was applied in clinic. Brain perfusion was imaged by FAIR and EPISTAR both of which using arterial spin labeling (ASL) method. Suitable parameters for small contamination were examined using a imaging phantom. Then normal volunteers were examined for imaging timing. Suitable time between labeling pulse and imaging pulse for brain capillary and parenchyma was 1.0 sec. For clinical application study, total 48 patients with brain diseases were examined by FAIR and/or EPISTAR. A lesion/white matter signal intensity ratio was calculated in all clinical cases. Average of signal intensity ratio in infarction, tumor and arteriovenous malformation (AVM) were 0.8, 2.2 and 18.6 at FAIR, and 0.6, 2.2 and 12.8 at EPISTAR, respectively. Low perfusion diseases such as cerebral infarction have low signal intensity ratio and high perfusion diseases such as AVM have high signal intensity ratio in both FAIR and EPISTAR. Brain lesions were imaged similarly in FAIR and EPISTAR, and no remarkable difference was found between FAIR and EPISTAR. As a result of diagnostic trial by signal intensity ratio in operated tumor, hemorrhagic cases could be diagnosed by accuracies of 75% in FAIR and 100% in EPISTAR, respectively. (author)

Clinical applications of SPECT-CT

Energy Technology Data Exchange (ETDEWEB)

Ahmadzadehfar, Hojjat; Biersack, Hans-Juergen (eds.) [University Hospital Bonn (Germany). Dept. of Nuclear Medicine

2014-06-01

Covers the full spectrum of clinical applications of SPECT/CT in diagnosis of benign and malignant diseases. Includes chapters on the use of SPECT/CT for dosimetry and for therapy planning. Completely up to date. Many helpful illustrations. SPECT/CT cameras have considerably improved diagnostic accuracy in recent years. Such cameras allow direct correlation of anatomic and functional information, resulting in better localization and definition of scintigraphic findings. In addition to this anatomic referencing, CT coregistration provides superior quantification of radiotracer uptake based on the attenuation correction capabilities of CT. Useful applications of SPECT/CT have been identified not only in oncology but also in other specialties such as orthopedics and cardiology. This book covers the full spectrum of clinical applications of SPECT/CT in diagnosis and therapy planning of benign and malignant diseases. Opening chapters discuss the technology and physics of SPECT/CT and its use for dosimetry. The role of SPECT/CT in the imaging of a range of pathologic conditions is then addressed in detail. Applications covered include, among others, imaging of the thyroid, bone, and lungs, imaging of neuroendocrine tumors, cardiac scintigraphy, and sentinel node scintigraphy. Individual chapters are also devoted to therapy planning in selective internal radiation therapy of liver tumors and bremsstrahlung SPECT/CT. Readers will find this book to be an essential and up-to-date source of information on this invaluable hybrid imaging technique.

Study on human chondrocyte culture viability for autologous transplantation in clinical application

Directory of Open Access Journals (Sweden)

Christiane Lombello

2003-06-01

Full Text Available Objective: The limited regenerative capacity of the cartilage tissuemakes the treatment of chondral lesions difficult. The techniquescurrently available to treat cartilage lesions may relieve symptoms,but do not regenerate the injured tissue. Autologous chondrocytetransplantation uses cell biology and cell culture techniques toregenerate the hyaline cartilage. Methods: In this study, we analyzechondrocyte biopsy collection and culture for autologoustransplantation. Ultrastructural analyses of hyaline cartilage biopsieswere performed 0, 6, 24 and 48 hours after collection. The tissue evenafter 48 hours. Eleven cell culture assays were performed to evaluateisolation, viability, morphology, proliferation and absence ofcontaminants. Results: The cell culture techniques used allowedchondrocyte proliferation. Rates on cell viability were maintained abovethe acceptable patterns (above 90. Control of cell culture laboratoryconditions showed absence of contaminants, assuring safety of theprocess. The chondrocytes obtained presented the morphology typicalof cultured cell monolayers. Conclusion: The results indicate viabilityof chondrocyte culture technique for clinical application in autologoustransplantation.

Application of virtual reality technology in clinical medicine.

Science.gov (United States)

Li, Lan; Yu, Fei; Shi, Dongquan; Shi, Jianping; Tian, Zongjun; Yang, Jiquan; Wang, Xingsong; Jiang, Qing

2017-01-01

The present review discusses the application of virtual reality (VR) technology in clinical medicine, especially in surgical training, pain management and therapeutic treatment of mental illness. We introduce the common types of VR simulators and their operational principles in aforementioned fields. The clinical effects are also discussed. In almost every study that dealt with VR simulators, researchers have arrived at the same conclusion that both doctors and patients could benefit from this novel technology. Moreover, advantages and disadvantages of the utilization of VR technology in each field were discussed, and the future research directions were proposed.

Non-commercial vs. commercial clinical trials: a retrospective study of the applications submitted to a research ethics committee.

Science.gov (United States)

Fuentes Camps, Inmaculada; Rodríguez, Alexis; Agustí, Antonia

2018-02-15

There are many difficulties in undertaking independent clinical research without support from the pharmaceutical industry. In this retrospective observational study, some design characteristics, the clinical trial public register and the publication rate of noncommercial clinical trials were compared to those of commercial clinical trials. A total of 809 applications of drug-evaluation clinical trials were submitted from May 2004 to May 2009 to the research ethics committee of a tertiary hospital, and 16.3% of trials were noncommercial. They were mainly phase IV, multicentre national, and unmasked controlled trials, compared to the commercial trials that were mainly phase II or III, multicentre international, and double-blind masked trials. The commercial trials were registered and published more often than noncommercial trials. More funding for noncommercial research is still needed. The results of the research, commercial or noncommercial, should be disseminated in order not to compromise either its scientific or its social value. © 2018 The British Pharmacological Society.

Analysis of Biological Interactions by Affinity Chromatography: Clinical and Pharmaceutical Applications.

Science.gov (United States)

Hage, David S

2017-06-01

The interactions between biochemical and chemical agents in the body are important in many clinical processes. Affinity chromatography and high-performance affinity chromatography (HPAC), in which a column contains an immobilized biologically related binding agent, are 2 methods that can be used to study these interactions. This review presents various approaches that can be used in affinity chromatography and HPAC to characterize the strength or rate of a biological interaction, the number and types of sites that are involved in this process, and the interactions between multiple solutes for the same binding agent. A number of applications for these methods are examined, with an emphasis on recent developments and high-performance affinity methods. These applications include the use of these techniques for fundamental studies of biological interactions, high-throughput screening of drugs, work with modified proteins, tools for personalized medicine, and studies of drug-drug competition for a common binding agent. The wide range of formats and detection methods that can be used with affinity chromatography and HPAC for examining biological interactions makes these tools attractive for various clinical and pharmaceutical applications. Future directions in the development of small-scale columns and the coupling of these methods with other techniques, such as mass spectrometry or other separation methods, should continue to increase the flexibility and ease with which these approaches can be used in work involving clinical or pharmaceutical samples. © 2016 American Association for Clinical Chemistry.

Surgery planning and navigation by laser lithography plastic replica. Features, clinical applications, and advantages

International Nuclear Information System (INIS)

Kihara, Tomohiko; Tanaka, Yuuko; Furuhata, Kentaro

1995-01-01

The use of three-dimensional replicas created using laserlithography has recently become popular for surgical planning and intraoperative navigation in plastic surgery and oral maxillofacial surgery. In this study, we investigated many clinical applications that we have been involved in regarding the production of three-dimensional replicas. We have also analyzed the features, application classes, and advantages of this method. As a result, clinical applications are categorized into three classes, which are 'three-dimensional shape recognition', 'simulated surgery', and 'template'. The distinct features of three-dimensional replicas are 'direct recognition', 'fast manipulation', and 'free availability'. Meeting the requirements of surgical planning and intraoperative navigation, they have produced satisfactory results in clinical applications. (author)

[Clinical application evaluation of Guidelines for Diagnosis and Treatment of Internal Diseases in Traditional Chinese Medicine].

Science.gov (United States)

Han, Xue-Jie; Liu, Meng-Yu; Lian, Zhi-Hua; Wang, Li-Ying; Shi, Nan-Nan; Zhao, Jun

2017-09-01

To evaluate the applicability and clinical applications of Guidelines for Diagnosis and Treatment of Internal Diseases in Traditional Chinese Medicine, so as to provide the basis for the revision of the guidelines. This study was completed by the research and promotion base for traditional Chinese medicine(TCM) standard. The methods of applicability evaluation and application evaluation were used in the study. The questionnaires were filled out to evaluate applicability of the guideline, including doctor's familiarity with the guideline,the quality of the guideline, applicable conditions and clinical applications. The prospective case study analysis method was used to evaluate application of the guideline, including evaluation of clinical application compliance and application results(such as clinical effects, safety and economy). There were two parts in the guideline, which were TCM guideline and Western medicine guideline. The results of applicability evaluation showed that there were no obvious differences between TCM guideline and Western medicine guideline in doctor's familiarity with guideline(85.43%, 84.57%) and the use of the guideline(52.10%, 54.47%); the guidelines with good quality, and higher scores in the scope of application and the use of the term rationality(91.94%, 93.35%); the rationality scores of relevant contents in syndrome differentiation and treatment were more than 75%; the applicable conditions were better, and the safety score was the the highest. The comprehensive applicability evaluation showed that the proportion of the application of TCM guideline and Western medicine guideline were 77.73%, 75.46%, respectively. The results of application evaluation showed that there was high degree coincidence between the guideline with its clinical application; except for "other treatment" and "recuperation and prevention" in TCM, other items got high scores which were more than 90%; in the evaluation of application effects, safety of the guideline

XML, Ontologies, and Their Clinical Applications.

Science.gov (United States)

Yu, Chunjiang; Shen, Bairong

2016-01-01

The development of information technology has resulted in its penetration into every area of clinical research. Various clinical systems have been developed, which produce increasing volumes of clinical data. However, saving, exchanging, querying, and exploiting these data are challenging issues. The development of Extensible Markup Language (XML) has allowed the generation of flexible information formats to facilitate the electronic sharing of structured data via networks, and it has been used widely for clinical data processing. In particular, XML is very useful in the fields of data standardization, data exchange, and data integration. Moreover, ontologies have been attracting increased attention in various clinical fields in recent years. An ontology is the basic level of a knowledge representation scheme, and various ontology repositories have been developed, such as Gene Ontology and BioPortal. The creation of these standardized repositories greatly facilitates clinical research in related fields. In this chapter, we discuss the basic concepts of XML and ontologies, as well as their clinical applications.

Application and Exploration of Big Data Mining in Clinical Medicine.

Science.gov (United States)

Zhang, Yue; Guo, Shu-Li; Han, Li-Na; Li, Tie-Ling

2016-03-20

To review theories and technologies of big data mining and their application in clinical medicine. Literatures published in English or Chinese regarding theories and technologies of big data mining and the concrete applications of data mining technology in clinical medicine were obtained from PubMed and Chinese Hospital Knowledge Database from 1975 to 2015. Original articles regarding big data mining theory/technology and big data mining's application in the medical field were selected. This review characterized the basic theories and technologies of big data mining including fuzzy theory, rough set theory, cloud theory, Dempster-Shafer theory, artificial neural network, genetic algorithm, inductive learning theory, Bayesian network, decision tree, pattern recognition, high-performance computing, and statistical analysis. The application of big data mining in clinical medicine was analyzed in the fields of disease risk assessment, clinical decision support, prediction of disease development, guidance of rational use of drugs, medical management, and evidence-based medicine. Big data mining has the potential to play an important role in clinical medicine.

[Up-to-date research for clinical application in breast cancer].

Science.gov (United States)

Koyama, Hiroki

2006-03-01

Breast cancer is still increasing in number of patients affected annually, with a peak incidence between 40-50 years of age. Various researches to control the disease have been attracting much attention scientifically and socially. Clinical application of trastuzumab (Herceptin), sentinel node biopsy to avoid unnecessary axillary dissection and individualized use of chemo-endocrine therapy as indicated by large scale clinical trials are among the recent successful results by pre-clinical and early clinical studies. In this context, the present special edition deals with articles on recent progress in breast cancer researches by leading scientists in this field. Hoping readers to understand, digest, and also to be stimulated by the updates for daily clinical practice.

Radiosensitizing efficacy of iso-metronidazole after intravesical application in bladder cancer. A clinical phase II study

International Nuclear Information System (INIS)

Kob, D.; Lilienthal, A.; Bauhardt, H.; Merkle, K.; Schroeder, E.; Schroeder, E.; Hentschel, M.

1991-01-01

The radiosensitizing efficacy of iso-Metronidazole, a 4-Nitroimidazole derivative, was evaluated in a prospective clinical phase II study. The results of combined radiotherapy of 25 patients with bladder cancer were compared with those of a control group of 25 patients treated with radiotherapy only. Tumor regression six months after radiotherapy was used as an endpoint. The surgical procedure was performed as double TUR. Evaluating the local tumor control after additional application of iso-Metronidazole a gain factor of 1.2 is obtained. (orig.) [de

Calculating Clinically Significant Change: Applications of the Clinical Global Impressions (CGI) Scale to Evaluate Client Outcomes in Private Practice

Science.gov (United States)

Kelly, Peter James

2010-01-01

The Clinical Global Impressions (CGI) scale is a therapist-rated measure of client outcome that has been widely used within the research literature. The current study aimed to develop reliable and clinically significant change indices for the CGI, and to demonstrate its application in private psychological practice. Following the guidelines…

[Literature survey on botanical origin and clinical application of traditional Tibetan medicine "Shengdeng"].

Science.gov (United States)

Chen, De-Dao; Meng, Xian-Hua; Zhang, Ying-Shan; Chen, Gen-Ping; Huang, Yu-Lan

2012-10-01

"Shengdeng" is its Tibetan transliteration referring to many medicines. Tibetan doctors and pharmacists in different areas use different drugs in formulation and clinical application, which are easily confused. In order to grasp the formula and clinical application accurately, we conduct a literature survey on history and current state of botanical origin and clinical application of "Shengdeng", making clear the application of various herbs named "Shengdeng" and providing reference to all Tibetan researchers and clinical workers in formulation and clinical application.

[Application of Delphi method in traditional Chinese medicine clinical research].

Science.gov (United States)

Bi, Ying-fei; Mao, Jing-yuan

2012-03-01

In recent years, Delphi method has been widely applied in traditional Chinese medicine (TCM) clinical research. This article analyzed the present application situation of Delphi method in TCM clinical research, and discussed some problems presented in the choice of evaluation method, classification of observation indexes and selection of survey items. On the basis of present application of Delphi method, the author analyzed the method on questionnaire making, selection of experts, evaluation of observation indexes and selection of survey items. Furthermore, the author summarized the steps of application of Delphi method in TCM clinical research.

Clinical reasoning and its application to nursing: concepts and research studies.

Science.gov (United States)

Banning, Maggi

2008-05-01

Clinical reasoning may be defined as "the process of applying knowledge and expertise to a clinical situation to develop a solution" [Carr, S., 2004. A framework for understanding clinical reasoning in community nursing. J. Clin. Nursing 13 (7), 850-857]. Several forms of reasoning exist each has its own merits and uses. Reasoning involves the processes of cognition or thinking and metacognition. In nursing, clinical reasoning skills are an expected component of expert and competent practise. Nurse research studies have identified concepts, processes and thinking strategies that might underpin the clinical reasoning used by pre-registration nurses and experienced nurses. Much of the available research on reasoning is based on the use of the think aloud approach. Although this is a useful method, it is dependent on ability to describe and verbalise the reasoning process. More nursing research is needed to explore the clinical reasoning process. Investment in teaching and learning methods is needed to enhance clinical reasoning skills in nurses.

Radiolabeled amino acids : Basic aspects and clinical applications in oncology

NARCIS (Netherlands)

Jager, PL; Vaalburg, W; Pruim, J; de Vries, EGE; Langen, KJ; Piers, DA

As the applications of metabolic imaging are expanding, radiolabeled amino acids may gain increased clinical interest, This review first describes the basic aspects of amino acid metabolism, then continues with basic aspects of radiolabeled amino acids, and finally describes clinical applications,

Challenges in the Implementation of a Mobile Application in Clinical Practice: Case Study in the Context of an Application that Manages the Daily Interventions of Nurses

Science.gov (United States)

Wipfli, Rolf; Teodoro, Douglas; Sarrey, Everlyne; Walesa, Magali; Lovis, Christian

2013-01-01

Background Working in a clinical environment requires unfettered mobility. This is especially true for nurses who are always on the move providing patients’ care in different locations. Since the introduction of clinical information systems in hospitals, this mobility has often been considered hampered by interactions with computers. The popularity of personal mobile assistants such as smartphones makes it possible to gain easy access to clinical data anywhere. Objective To identify the challenges involved in the deployment of clinical applications on handheld devices and to share our solutions to these problems. Methods A team of experts underwent an iterative development process of a mobile application prototype that aimed to improve the mobility of nurses during their daily clinical activities. Through the process, challenges inherent to mobile platforms have emerged. These issues have been classified, focusing on factors related to ensuring information safety and quality, as well as pleasant and efficient user experiences. Results The team identified five main challenges related to the deployment of clinical mobile applications and presents solutions to overcome each of them: (1) Financial: Equipping every care giver with a new mobile device requires substantial investment that can be lowered if users use their personal device instead, (2) Hardware: The constraints inherent to the clinical environment made us choose the mobile device with the best tradeoff between size and portability, (3) Communication: the connection of the mobile application with any existing clinical information systems (CIS) is insured by a bridge formatting the information appropriately, (4) Security: In order to guarantee the confidentiality and safety of the data, the amount of data stored on the device is minimized, and (5) User interface: The design of our user interface relied on homogeneity, hierarchy, and indexicality principles to prevent an increase in data acquisition errors

Models to Study NK Cell Biology and Possible Clinical Application.

Science.gov (United States)

Zamora, Anthony E; Grossenbacher, Steven K; Aguilar, Ethan G; Murphy, William J

2015-08-03

Natural killer (NK) cells are large granular lymphocytes of the innate immune system, responsible for direct targeting and killing of both virally infected and transformed cells. NK cells rapidly recognize and respond to abnormal cells in the absence of prior sensitization due to their wide array of germline-encoded inhibitory and activating receptors, which differs from the receptor diversity found in B and T lymphocytes that is due to the use of recombination-activation gene (RAG) enzymes. Although NK cells have traditionally been described as natural killers that provide a first line of defense prior to the induction of adaptive immunity, a more complex view of NK cells is beginning to emerge, indicating they may also function in various immunoregulatory roles and have the capacity to shape adaptive immune responses. With the growing appreciation for the diverse functions of NK cells, and recent technological advancements that allow for a more in-depth understanding of NK cell biology, we can now begin to explore new ways to manipulate NK cells to increase their clinical utility. In this overview unit, we introduce the reader to various aspects of NK cell biology by reviewing topics ranging from NK cell diversity and function, mouse models, and the roles of NK cells in health and disease, to potential clinical applications. © 2015 by John Wiley & Sons, Inc. Copyright © 2015 John Wiley & Sons, Inc.

Clinical applications of cobalt-radionuclides in neuro-imaging

Energy Technology Data Exchange (ETDEWEB)

Jansen, H.M.L

1998-04-01

The aim of the studies embodied in this thesis was to investigate the clinical applicability of Co in euro-imaging using positron emission tomography (PET). To this purpose, a set of closely related pilot studies were performed in patients suffering from several neurological diseases affecting the brain. Chapter 2 discusses the physiological role of Co and both indications and complications of Co-administration in the past. The probable deposition mechanism of Co is described, potential (absence of) evidence of Co mimicking Ca in vivo is discussed, a comparison is made with other tracer-analogues (Ga, TI, Rb) and several hypotheses with respect to the pharmacokinetic behaviour of Co and the role of (inflammatory) proteins and cells are forwarded. The etiologic mechanism(s), clinical symptoms, Ca-related pathophysiology and (most recent) imaging techniques are reviewed of Multiple Sclerosis, cerebrovascular stroke, traumatic brain injury and primary brain tumours. The major goal of these respective reviews is both a rough outline of present insights and near-future developments and an assessment of the (im)possibilities in visualising the actual substrate of disease. Since Co is assumed to reflect (the common pathway of) Ca, an application of Co (based on cell-decay and inflammation) may be hypothesised in all of the diseases mentioned. These considerations served as a theoretical basis for our further studies in clinical practice. Chapter 3 (Original reprints) presents the actual results, whil Chapter 4 (General discussion) reflects on lessons that can be learned from the present work and consequently formulates some suggestions for future (extended) studies. The contours of possible new emerging areas of interest (dementia of the Alzheimer type; vascular dementia; stunned myocardium) are drawn in continuation of the foregoing studies. 47 refs.

Functional MRI in children: clinical and research applications

International Nuclear Information System (INIS)

Leach, James L.; Holland, Scott K.

2010-01-01

Functional MRI has become a critical research tool for evaluating brain function and developmental trajectories in children. Its clinical use in children is becoming more common. This presentation will review the basic underlying physiologic and technical aspects of fMRI, review research applications that have direct clinical relevance, and outline the current clinical uses of this technology. (orig.)

Single cell analysis contemporary research and clinical applications

CERN Document Server

Cossarizza, Andrea

2017-01-01

This book highlights the current state of the art in single cell analysis, an area that involves many fields of science – from clinical hematology, functional analysis and drug screening, to platelet and microparticle analysis, marine biology and fundamental cancer research. This book brings together an eclectic group of current applications, all of which have a significant impact on our current state of knowledge. The authors of these chapters are all pioneering researchers in the field of single cell analysis. The book will not only appeal to those readers more focused on clinical applications, but also those interested in highly technical aspects of the technologies. All of the technologies identified utilize unique applications of photon detection systems.

Balancing the Need for Clinical Photography With Patient Privacy Issues: The Search for a Secure SmartPhone Application to Take and Store Clinical Photographs.

Science.gov (United States)

Dumestre, Danielle O; Fraulin, Frankie O G

2017-11-01

Physicians are increasingly using smartphones to take clinical photographs. This study evaluates a smartphone application for clinical photography that prioritizes and facilitates patient security. Ethics approval was obtained to trial a smartphone clinical photography application, PicSafe Medi. Calgary plastic surgeons and residents used the application to obtain informed consent and photograph patients. Surveys gauging the application's usability, consent process, and photograph storage/sharing were then sent to surgeons and patients. Over a 6-month trial period, 15 plastic surgeons and residents used the application to photograph 86 patients. Over half of the patients (57%) completed the survey. The majority of patients (96%) were satisfied with the application's consent process, and all felt their photographs were secure. The majority (93%) of surgeons/residents completed the survey. The application was felt to overcome issues with current photography practices: inadequate consent and storage of photographs (100%), risk to patient confidentiality (92%), and unsecure photograph sharing (93%). Barriers to regular use of the application included need for cellphone service/Internet (54%), sanitary concerns due to the need for patients to sign directly on the phone (46%), inability to obtain proactive/retroactive consent (85%), and difficulty viewing photographs (80%). The majority of surgeons (85%) believe a smartphone application would be suitable for clinical patient photography, but due to its limitations, only 23% would use the trialed application. A smartphone clinical photography application addresses the patient confidentiality risks of current photography methods; however, limitations of the trialed application prevent its broad implementation.

Clinical applications of nuclear cardiology studies in the reforms epoch of health systems

International Nuclear Information System (INIS)

Mut, Fernando; Beretta, Mario

2003-01-01

The appropriate evaluation of the ischemic heart disease due to it seriousness and high prevalence, limited by the expenses that arise from the illness, constitutes a challenge in our times for the daily practice. At the present time, nuclear cardiology competes with several non invasive techniques in the evaluation of the perfusion and the myocardial viability, being this requested in function of the real necessity of each patient. The applications that nuclear cardiology offers for the study of the myocardial perfusion are multiple. Clinical situations are reviewed in this article, such as the coronary illness, states previous to the non cardiac surgery, states after cardiac catheterization, coronary angioplasty, revascularization surgery, and evaluation of patient under long term medical treatment. The study of the myocardial perfusion allows that the coronary illness can be classified according to a low, intermediate or high probability, providing a wide prognosis information in relation to the extension and severity of the ischemia. In this study there are also remarked practical limits as for the selection of patients in order to achieve that the studies of nuclear cardiology offer an appropriate evaluation of the well-known or suspected coronary illness. (The author)

Clinical Application of Diode Laser (980 nm) in Maxillofacial Surgical Procedures.

Science.gov (United States)

Aldelaimi, Tahrir N; Khalil, Afrah A

2015-06-01

For many procedures, lasers are now becoming the treatment of choice by both clinicians and patients, and in some cases, the standard of care. This clinical study was carried out at Department of Maxillofacial Surgery, Ramadi Teaching Hospital, Rashid Private Hospital and Razi Private Hospital, Anbar Health Directorate, Anbar Province, Iraq. A total of 32 patients including 22 (≈ 70%) male and 10 (≈ 30%) female with age range from 5 months to 34 years old. Chirolas 20 W diode laser emitting at 980 nm was used. Our preliminary clinical findings include sufficient hemostasis, coagulation properties, precise incision margin, lack of swelling, bleeding, pain, scar tissue formation and overall satisfaction were observed in the clinical application. The clinical application of the diode (980 nm) laser in maxillofacial surgery proved to be of beneficial effect for daily practice and considered practical, effective, easy to used, offers a safe, acceptable, and impressive alternative for conventional surgical techniques.

Non-clinical studies in the process of new drug development - Part II: Good laboratory practice, metabolism, pharmacokinetics, safety and dose translation to clinical studies.

Science.gov (United States)

Andrade, E L; Bento, A F; Cavalli, J; Oliveira, S K; Schwanke, R C; Siqueira, J M; Freitas, C S; Marcon, R; Calixto, J B

2016-12-12

The process of drug development involves non-clinical and clinical studies. Non-clinical studies are conducted using different protocols including animal studies, which mostly follow the Good Laboratory Practice (GLP) regulations. During the early pre-clinical development process, also known as Go/No-Go decision, a drug candidate needs to pass through several steps, such as determination of drug availability (studies on pharmacokinetics), absorption, distribution, metabolism and elimination (ADME) and preliminary studies that aim to investigate the candidate safety including genotoxicity, mutagenicity, safety pharmacology and general toxicology. These preliminary studies generally do not need to comply with GLP regulations. These studies aim at investigating the drug safety to obtain the first information about its tolerability in different systems that are relevant for further decisions. There are, however, other studies that should be performed according to GLP standards and are mandatory for the safe exposure to humans, such as repeated dose toxicity, genotoxicity and safety pharmacology. These studies must be conducted before the Investigational New Drug (IND) application. The package of non-clinical studies should cover all information needed for the safe transposition of drugs from animals to humans, generally based on the non-observed adverse effect level (NOAEL) obtained from general toxicity studies. After IND approval, other GLP experiments for the evaluation of chronic toxicity, reproductive and developmental toxicity, carcinogenicity and genotoxicity, are carried out during the clinical phase of development. However, the necessity of performing such studies depends on the new drug clinical application purpose.

Analysis of the Chemical, Pharmacological and Clinical Applications of Polygonum Cuspidatum

Science.gov (United States)

Guo, Chenyang; Bai, Ming; Miao, Mingsan; Miao, Yanyan

2018-01-01

Traditional Chinese medicine Polygonum cuspidatum widely used, the larger production, and in the clinical application of more, but the role played by the role of different roles are also different. By reviewing the relevant literatures in recent years, the chemical constituents and pharmacological effects of Polygonum cuspidatum were sorted and summarized, and the role of Polygonum cuspidatum was analyzed, and the function of Polygonum cuspidatum was explored to find out the role of Polygonum cuspidatum in compatibility. Application law. Which can not only study the medicinal mechanism of Polygonum cuspidatum, but also provide the theoretical basis for the medicinal development, clinical treatment and comprehensive utilization of Polygonum cuspidatum.

Mineralized Collagen: Rationale, Current Status, and Clinical Applications

Directory of Open Access Journals (Sweden)

Zhi-Ye Qiu

2015-07-01

Full Text Available This paper presents a review of the rationale for the in vitro mineralization process, preparation methods, and clinical applications of mineralized collagen. The rationale for natural mineralized collagen and the related mineralization process has been investigated for decades. Based on the understanding of natural mineralized collagen and its formation process, many attempts have been made to prepare biomimetic materials that resemble natural mineralized collagen in both composition and structure. To date, a number of bone substitute materials have been developed based on the principles of mineralized collagen, and some of them have been commercialized and approved by regulatory agencies. The clinical outcomes of mineralized collagen are of significance to advance the evaluation and improvement of related medical device products. Some representative clinical cases have been reported, and there are more clinical applications and long-term follow-ups that currently being performed by many research groups.

An overview of PET/MR, focused on clinical applications.

Science.gov (United States)

Catalano, Onofrio Antonio; Masch, William Roger; Catana, Ciprian; Mahmood, Umar; Sahani, Dushyant Vasudeo; Gee, Michael Stanley; Menezes, Leon; Soricelli, Andrea; Salvatore, Marco; Gervais, Debra; Rosen, Bruce Robert

2017-02-01

Hybrid PET/MR scanners are innovative imaging devices that simultaneously or sequentially acquire and fuse anatomical and functional data from magnetic resonance (MR) with metabolic information from positron emission tomography (PET) (Delso et al. in J Nucl Med 52:1914-1922, 2011; Zaidi et al. in Phys Med Biol 56:3091-3106, 2011). Hybrid PET/MR scanners have the potential to greatly impact not only on medical research but also, and more importantly, on patient management. Although their clinical applications are still under investigation, the increased worldwide availability of PET/MR scanners, and the growing published literature are important determinants in their rising utilization for primarily clinical applications. In this manuscript, we provide a summary of the physical features of PET/MR, including its limitations, which are most relevant to clinical PET/MR implementation and to interpretation. Thereafter, we discuss the most important current and emergent clinical applications of such hybrid technology in the abdomen and pelvis, both in the field of oncologic and non-oncologic imaging, and we provide, when possible, a comparison with clinically consolidated imaging techniques, like for example PET/CT.

Status and headway of the clinical application of artificial ligaments

Directory of Open Access Journals (Sweden)

Tianwu Chen

2015-01-01

Full Text Available The authors first reviewed the history of clinical application of artificial ligaments. Then, the status of clinical application of artificial ligaments was detailed. Some artificial ligaments possessed comparable efficacy to, and fewer postoperative complications than, allografts and autografts in ligament reconstruction, especially for the anterior cruciate ligament. At the end, the authors focused on the development of two types of artificial ligaments: polyethylene glycol terephthalate artificial ligaments and tissue-engineered ligaments. In conclusion, owing to the advancements in surgical techniques, materials processing, and weaving methods, clinical application of some artificial ligaments so far has demonstrated good outcomes and will become a trend in the future.

Clinical applications of functional MRI at 1.0 T: motor and language studies in healthy subjects and patients

International Nuclear Information System (INIS)

Papke, K.; Hellmann, T.; Renger, B.; Schuierer, G.; Reimer, P.; Morgenroth, C.; Knecht, S.

1999-01-01

In this article we describe clinical applications of functional MRI (fMRI) at 1.0 T. All experiments were performed on a commercially available 1.0-T system (Magnetom Impact Expert, Siemens AG, Erlangen, Germany) using a blood oxygen level-dependent (BOLD)-sensitive multi-slice EPI technique (TE 66 ms, 4 mm slice thickness, 210 mm field of view, 64 x 64 acquisition matrix). Different paradigms for localization of the motor cortex and for language lateralization were tested in healthy subjects and patients. Methodological considerations concerning the development of the paradigms are also described. In all healthy subjects, motor activation elicited BOLD signal changes in the sensorimotor cortex, permitting identification of primary motor and sensory cortical areas. Furthermore, focal activation of different cortical areas by a language task was possible in 6 of 10 subjects. Nineteen motor studies were performed in 18 patients with supratentorial lesions, in most cases prior to neurosurgical procedures. In 14 studies, fMRI results demonstrated the localization of the motor hand areas relative to the lesion. The results proved valuable for preoperative planning and contributed to therapeutical decisions. We conclude that functional MRI for clinically relevant applications, such as localization of motor and language function, is feasible even at a field strength of 1.0 T without dedicated equipment. (orig.)

[Polyetheretherketone (PEEK). Part II: application in clinical practice].

Science.gov (United States)

Pokorný, D; Fulín, P; Slouf, M; Jahoda, D; Landor, I; Sosna, A

2010-01-01

Polyetheretherketone (PEEK) is one of the up-to-date organic polymer thermoplastics with applications in orthopaedics and trauma medicine. This study presents a detailed analysis of its tests and applications in clinical medicine. A wide range of PEEK modifications and composites are commercially available, e.g., PEEK-Classix, PEEK-Optima, Endolign and Motis. They differ in their physical properties, which makes them suitable for different applications. Other forms, so-called PEEK bioactive composites, contain beta-tricalcium phosphate and hydroxyapatite. Research in this field is also concerned with the surface finish of this polymer thermoplastic and involves macroporous titanium and hydroxyapatite layers, or treatment with laser for an exactly defined surface structure. The clinical applications of PEEK and its composites include, in addition to components for spinal surgery, osteosynthesis plates, screws, intramedullary nails or external fixators, which are implants still at the stage of prototypes. In this review, attention is paid to the use of PEEK thermoplastics for joint replacement. Mid-term studies involving hundreds of patients have shown that, for instance, the VerSys Epoch Fullcoat Hip System (Zimmer) has a markedly lower stress-shielding effect. Carbon fibre-reinforced (CFR-PEEK) composites are used to make articulating components for total hip replacement. Their convenient properties allow for production of much thinner liners and an enlargement of the femoral head diameter, thus reducing the wear of joint implants. CFR-PEEK composites are particularly effective for hip resurfacing in which the Mitch PCR (Stryker) acetabular component has been used with good results. The MOTIS polymer acetabular cup (Invibio Ltd.) is another example. Further PEEK applications include the construction of finger-joint prostheses (Mathys AG), suture anchors (Stryker) and various kinds of augmentations (Medin). Based on the information obtained, the authors suggest

Potential consequences of clinical application of artificial gametes: a systematic review of stakeholder views.

Science.gov (United States)

Hendriks, Saskia; Dondorp, Wybo; de Wert, Guido; Hamer, Geert; Repping, Sjoerd; Dancet, Eline A F

2015-01-01

Recent progress in the formation of artificial gametes, i.e. gametes generated from progenitors or somatic cells, has led to scientific and societal discussion about their use in medically assisted reproduction. In animals, live births have already been achieved using artificial gametes of varying (cell type) sources and biological research seems to be progressing steadily toward clinical application in humans. Artificial gametes could potentially help not only infertile heterosexual couples of reproductive age of which one or both partners lacks functional gametes, but also post-menopausal women and same-sex couples, to conceive a child who will be genetically related to them. But as clinical application of these new technologies may have wider societal consequences, a proactive consideration of the possible impact seems timely and important. This review aims to contribute to this by providing a systematic overview of the potential consequences of clinical application of artificial gametes anticipated by different stakeholders. The electronic database 'Medline/Pubmed' was systematically searched with medical subject heading terms (MesH) for articles published in English between January 1970 and December 2013. Articles were selected based on eligibility and reference lists of eligible studies were hand searched. The reported potential consequences of clinical application of artificial gametes were extracted from the articles and were grouped into categories by content analysis. Per category, we noted which stakeholders referred to which potential consequences, based on author affiliations and, if applicable, study participants. The systematic search yielded 2424 articles, and 84 studies were included after screening. Nine positive consequences, 21 specific consequences requiring consideration and 22 recommendations referring to clinical application of artificial gametes were documented. All positive consequences, consequences requiring consideration and

[Clinical evaluation of female pelvic tumors : Application fields of integrated PET/MRI].

Science.gov (United States)

Grueneisen, J; Umutlu, L

2016-07-01

Integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) scanning has recently become established in clinical imaging. Various studies have demonstrated the great potential of this new hybrid imaging procedure for applications in the field of oncology and the diagnostics of inflammatory processes. With initial studies demonstrating the feasibility and high diagnostic potential of PET/MRI comparable to PET-computed tomography (CT), the focus of future studies should be on the identification of application fields with a potential diagnostic benefit of PET/MRI over other established diagnostic tools. Both MRI and PET/CT are widely used in the diagnostic algorithms for malignancies of the female pelvis. A simultaneous acquisition of PET and MRI data within a single examination provides complementary information which can be used for a more comprehensive evaluation of the primary tumor as well as for whole body staging. Therefore, the aim of this article is to outline potential clinical applications of integrated PET/MRI for the diagnostic work-up of primary or recurrent gynecological neoplasms of the female pelvis.

The progress and clinical application of radionuclide neuroimaging

International Nuclear Information System (INIS)

Chen Wenxin; He Pinyu

2008-01-01

Development of site-specific brain radiopharmaceuticals extends the the functional neuroimaging applications in the diagnosis and monitoring treatments of various neurologic and psychiatric disorders. This article highlights recent advances and clinical applications of the functional neuroimaging in Parkinson disease, epilepsy, dementia, substance abuse, psychiatric disorders and brain functional research. (authors)

Impact assessment of the European Clinical Trials Directive: a longitudinal, prospective, observational study analyzing patterns and trends in clinical drug trial applications submitted since 2001 to regulatory agencies in six EU countries

Directory of Open Access Journals (Sweden)

Hartmann Markus

2012-04-01

Full Text Available Abstract Background Shifts in clinical trial application rates over time indicate if the attractiveness of a country or region for the conduct of clinical trials is growing or decreasing. The purpose of this observational study was to track changes in drug trial application patterns across several EU countries in order to analyze the medium-term impact of the EU Clinical Trials Directive 2001/20/EC on the conduct of drug trials. Methods Rates of Clinical Trial Applications (CTA for studies with medicinal products in those six countries in the EU, which authorize on average more than 500 trials per year, were analyzed. Publicly available figures on the number of annually submitted CTA, the distribution of trials per phase and the type of sponsorship were tracked; missing data were provided by national drug agencies. Results Since 2001, the number of CTA in Italy and Spain increased significantly (5.0 and 2.5% average annual growth. For Italy, the gain was driven by a strong increase of applications from academic trial sponsors; Spain's growth was due to a rise in trials run by commercial sponsors. The Netherlands, Germany, France and the UK saw a decline (1.9, 2.3, 3.0 and 5.3% average annual diminution; significant (P Conclusions The EU Clinical Trials Directive 2001/20/EC did not achieve the harmonization of clinical trial requirements across Europe. Rather, it resulted in the leveling of clinical trial activities caused by a continuing decrease in CTA rates in the Netherlands, Germany, France and the UK. Southern European countries, Italy and Spain, benefited to some extent from policy changes introduced by the Directive. In Italy's case, national funding measures helped to considerably promote the conduct of non-commercial trials. On the other hand, the EU Directive-driven transition from liberal policy environments, based on non-explicit trial approval through notifications, towards red-taped processes of trial authorization, contributed to

Complement inhibition in pre-clinical models of periodontitis and prospects for clinical application.

Science.gov (United States)

Hajishengallis, George; Hajishengallis, Evlambia; Kajikawa, Tetsuhiro; Wang, Baomei; Yancopoulou, Despina; Ricklin, Daniel; Lambris, John D

2016-06-01

Periodontitis is a dysbiotic inflammatory disease leading to the destruction of the tooth-supporting tissues. Current therapies are not always effective and this prevalent oral disease continues to be a significant health and economic burden. Early clinical studies have associated periodontitis with elevated complement activity. Consistently, subsequent genetic and pharmacological studies in rodents have implicated the central complement component C3 and downstream signaling pathways in periodontal host-microbe interactions that promote dysbiosis and inflammatory bone loss. This review discusses these mechanistic advances and moreover focuses on the compstatin family of C3 inhibitors as a novel approach to treat periodontitis. In this regard, local application of the current lead analog Cp40 was recently shown to block both inducible and naturally occurring periodontitis in non-human primates. These promising results from non-human primate studies and the parallel development of Cp40 for clinical use highlight the feasibility for developing an adjunctive, C3-targeted therapy for human periodontitis. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Evaluation of Web-based software applications for administrating and organising an ophthalmological clinical trial site].

Science.gov (United States)

Kortüm, K; Reznicek, L; Leicht, S; Ulbig, M; Wolf, A

2013-07-01

The importance and complexity of clinical trials is continuously increasing, especially in innovative specialties like ophthalmology. Therefore an efficient clinical trial site organisational structure is essential. In modern internet times, this can be accomplished by web-based applications. In total, 3 software applications (Vibe on Prem, Sharepoint and open source software) were evaluated in a clinical trial site in ophthalmology. Assessment criteria were set; they were: reliability, easiness of administration, usability, scheduling, task list, knowledge management, operating costs and worldwide availability. Vibe on Prem customised by the local university met the assessment criteria best. Other applications were not as strong. By introducing a web-based application for administrating and organising an ophthalmological trial site, studies can be conducted in a more efficient and reliable manner. Georg Thieme Verlag KG Stuttgart · New York.

Clinical application of cerebral dynamic perfusion studies

International Nuclear Information System (INIS)

DeLand, F.H.

1975-01-01

Radionuclide cerebral perfusion studies are assuming a far greater importance in the detection and differential diagnosis of cerebral lesions. Perfusion studies not only contribute to the differential diagnosis of lesions but in certain cases are the preferred methods by which more accurate clinical interpretations can be made. The characteristic blood flow of arterio-venous malformations readily differentiates this lesion from neoplasms. The decreased perfusion or absent perfusion observed in cerebral infarctions is diagnostic without concurrent evidence from static images. Changes in rates and direction of blood flow contribute fundamental information to the status of stenosis and vascular occlusion and, in addition, offer valuable information on the competency and routes of collateral circulation. The degree of cerebral perfusion after cerebral vascular accidents appears to be directly related to patient recovery, particularly muscular function. Cerebral perfusion adds a new parameter in the diagnosis of subdural haematomas and concussion and in the differentiation of obscuring radioactivity from superficial trauma. Although pictorial displays of perfusion blood flow will offer information in most cerebral vascular problems, the addition of computer analysis better defines temporal relationships of regional blood flow, quantitative changes in flow and the detection of the more subtle increases or decreases in cerebral blood flow. The status of radionuclide cerebral perfusion studies has taken on an importance making it the primary modality for the diagnosis of cerebral lesions. (author)

Clinical Studies

DEFF Research Database (Denmark)

Pallesen, Ulla

universities and practicing dentists restore millions of teeth throughout the World with composite resin materials. Do we know enough about the clinical performance of these restorations over time? Numerous in vitro studies are being published on resin materials and adhesion, some of them attempting to imitate...... in vivo conditions. But real life is different and in vitro studies cannot include all variables. Only clinical studies can provide valid information on the clinical performance of restorations over time. What do we know about longevity of posterior resin restorations? What are the reasons for replacement...... and results from own up to 30-year prospective clinical university studies and practice based studies from Public Dental Health Service on the clinical performance of posterior composite resin restorations....

Clinical Use of the Utrecht Applicator for Combined Intracavitary/Interstitial Brachytherapy Treatment in Locally Advanced Cervical Cancer

International Nuclear Information System (INIS)

Nomden, Christel N.; Leeuw, Astrid A.C. de; Moerland, Marinus A.; Roesink, Judith M.; Tersteeg, Robbert J.H.A.; Jürgenliemk-Schulz, Ina Maria

2012-01-01

Purpose: The aims of this study were to investigate the benefit of the Utrecht interstitial CT/MR applicator for combined intracavitary/interstitial (IC/IS) approach, using magnetic resonance imaging—guided brachytherapy, over the intracavitary approach alone in patients with locally advanced cervical cancer and to analyze the clinical use of needles. Methods and Materials: This study includes the first 20 patients treated with the new applicator. Brachytherapy consisted of two pulsed dose rate applications, and the second application was performed with the IC/IS approach. The number of needles, chosen guiding holes through the ovoids, and insertion depths were based on the dose distribution and dosimetric shortcomings of the first application (IC alone). We investigated the dosimetric gain by comparing the clinical interstitial optimized plan (IC/IS clinical ) with an additionally generated optimized plan without needle use (IC study ). Furthermore, we studied the relation of the inserted needles and their source loading patterns with the high-risk clinical target volume (HR-CTV). Results: A total of 54 needles (range, 1–6 per application) were applied with an average depth of 25 mm. The chosen needle positions corresponded with the location of the HR-CTV extensions. The total and individual needle treatment times per application were on average 19% (range, 4–35%) and 7% (range, 2–14%) of the implant treatment time, respectively. The total (external-beam radiotherapy + brachytherapy) D90 HR-CTV for the IC study and the IC/IS clinical were on average 79.5 (SD 7.4) Gy α/β10 and 83.9 (SD 6.7) Gy α/β10 , respectively, with an average gain of 4.4 (SD 2.3) Gy α/β10 for the second application. Conclusions: Needle placement was feasible in all patients and resulted in a gain in dose and better coverage of HR-CTV. Defining the location of HR-CTV protrusions and analyzing the associated needles has given us deeper understanding of the possibilities in magnetic

PET measurements of myocardial blood flow post myocardial infarction: Relationship to invasive and cardiac magnetic resonance studies and potential clinical applications.

Science.gov (United States)

Gewirtz, Henry

2017-12-01

This review focuses on clinical studies concerning assessment of coronary microvascular and conduit vessel function primarily in the context of acute and sub acute myocardial infarction (MI). The ability of quantitative PET measurements of myocardial blood flow (MBF) to delineate underlying pathophysiology and assist in clinical decision making in this setting is discussed. Likewise, considered are physiological metrics fractional flow reserve, coronary flow reserve, index of microvascular resistance (FFR, CFR, IMR) obtained from invasive studies performed in the cardiac catheterization laboratory, typically at the time of PCI for MI. The role both of invasive studies and cardiac magnetic resonance (CMR) imaging in assessing microvascular function, a key determinant of prognosis, is reviewed. The interface between quantitative PET MBF measurements and underlying pathophysiology, as demonstrated both by invasive and CMR methodology, is discussed in the context of optimal interpretation of the quantitative PET MBF exam and its potential clinical applications.

Prostate specific antigen and its clinical application

International Nuclear Information System (INIS)

Xu Yang

2000-01-01

Prostate-Specific Antigen (PSA), a serine proteases, is a glycoprotein consisting of a single polypeptide chain. Secreted exclusively by epithelial cells of the prostate gland, PSA is found largely in seminal plasma. Only a small amount of PSA can be found in normal serum. Serum PSA levels are found to be, considerably increased in prostate cancer patients. A number of studies on PSA have made great achievement on its biochemistry, analytical method and clinical application. PSA as one of the most important tumor marker, is used to help diagnosis and monitor the therapeutic efficacy of prostate cancer

[Advances of Molecular Diagnostic Techniques Application in Clinical Diagnosis.

Science.gov (United States)

Ying, Bin-Wu

2016-11-01

Over the past 20 years,clinical molecular diagnostic technology has made rapid development,and became the most promising field in clinical laboratory medicine.In particular,with the development of genomics,clinical molecular diagnostic methods will reveal the nature of clinical diseases in a deeper level,thus guiding the clinical diagnosis and treatments.Many molecular diagnostic projects have been routinely applied in clinical works.This paper reviews the advances on application of clinical diagnostic techniques in infectious disease,tumor and genetic disorders,including nucleic acid amplification,biochip,next-generation sequencing,and automation molecular system,and so on.

Basics concepts and clinical applications of oxygen-enhanced MR imaging

International Nuclear Information System (INIS)

Ohno, Yoshiharu; Hatabu, Hiroto

2007-01-01

Oxygen-enhanced MR imaging is a new technique, and its physiological significance has not yet been fully elucidated. This review article covers (1) the theory of oxygen enhancement and its relationship with respiratory physiology; (2) design for oxygen-enhanced MR imaging sequencing; (3) a basic study of oxygen-enhanced MR imaging in animal models and humans; (4) a clinical study of oxygen-enhanced MR imaging; and (5) a comparison of advantages and disadvantages of this technique with those of hyperpolarized noble gas MR ventilation imaging. Oxygen-enhanced MR imaging provides not only the ventilation-related, but also respiration-related information. Oxygen-enhanced MR imaging has the potential to replace nuclear medicine studies for the identification of regional pulmonary function, and many investigators are now attempting to adapt this technique for routine clinical studies. We believe that further basic studies as well as clinical applications of this new technique will define the real significance of oxygen-enhanced MR imaging for the future of pulmonary functional imaging and its usefulness for diagnostic radiology and pulmonary medicine

Teleultrasound: Historical Perspective and Clinical Application

Directory of Open Access Journals (Sweden)

Adilson Cunha Ferreira

2015-01-01

Full Text Available The health care of patients in rural or isolated areas is challenged by the scarcity of local resources, limited patient access to doctors and hospitals, and the lack of specialized professionals. This has led to a new concept in telemedicine: teleultrasonography (or teleultrasound, which permits ultrasonographic diagnoses to be performed remotely. Telemedicine and teleultrasonography are effective in providing diagnostic imaging services to these populations and reduce health care costs by decreasing the number and duration of hospitalizations and reducing unnecessary surgical procedures. This is a narrative review to present the potential clinical applications of teleultrasonography in clinical practice. The results indicate that although barriers persist for implementing teleultrasonography in a more universal and routine way, advances in telecommunications, Internet bandwidth, and the high resolution currently available for portable ultrasonography suggest teleultrasonography applications will continue to expand. Teleultrasound appears to be a valuable addition to remote medical care for isolated populations with limited access to tertiary healthcare facilities and also a useful tool for education and training.

Implementation of a Mobile Clinical Decision Support Application to Augment Local Antimicrobial Stewardship.

Science.gov (United States)

Hoff, Brian M; Ford, Diana C; Ince, Dilek; Ernst, Erika J; Livorsi, Daniel J; Heintz, Brett H; Masse, Vincent; Brownlee, Michael J; Ford, Bradley A

2018-01-01

Medical applications for mobile devices allow clinicians to leverage microbiological data and standardized guidelines to treat patients with infectious diseases. We report the implementation of a mobile clinical decision support (CDS) application to augment local antimicrobial stewardship. We detail the implementation of our mobile CDS application over 20 months. Application utilization data were collected and evaluated using descriptive statistics to quantify the impact of our implementation. Project initiation focused on engaging key stakeholders, developing a business case, and selecting a mobile platform. The preimplementation phase included content development, creation of a pathway for content approval within the hospital committee structure, engaging clinical leaders, and formatting the first version of the guide. Implementation involved a media campaign, staff education, and integration within the electronic medical record and hospital mobile devices. The postimplementation phase required ongoing quality improvement, revision of outdated content, and repeated staff education. The evaluation phase included a guide utilization analysis, reporting to hospital leadership, and sustainability and innovation planning. The mobile application was downloaded 3056 times and accessed 9259 times during the study period. The companion web viewer was accessed 8214 times. Successful implementation of a customizable mobile CDS tool enabled our team to expand beyond microbiological data to clinical diagnosis, treatment, and antimicrobial stewardship, broadening our influence on antimicrobial prescribing and incorporating utilization data to inspire new quality and safety initiatives. Further studies are needed to assess the impact on antimicrobial utilization, infection control measures, and patient care outcomes.

Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

Energy Technology Data Exchange (ETDEWEB)

Rim, Chai Hong; Seong, Jin Sil [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2016-09-15

In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy.

Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

International Nuclear Information System (INIS)

Rim, Chai Hong; Seong, Jin Sil

2016-01-01

In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy

Hazard report. Don't use industrial-grade gases for clinical applications.

Science.gov (United States)

2010-01-01

The use of industrial-grade gases instead of medical-grade gases for clinical applications increases the risk of introducing undesirable and even toxic contaminants into the clinical environment. Hospitals should have policies in place to ensure that gases of the appropriate type and grade are used for the intended application.

Mass Spectrometry in Clinical Laboratory: Applications in Therapeutic Drug Monitoring and Toxicology.

Science.gov (United States)

Garg, Uttam; Zhang, Yan Victoria

2016-01-01

Mass spectrometry (MS) has been used in research and specialized clinical laboratories for decades as a very powerful technology to identify and quantify compounds. In recent years, application of MS in routine clinical laboratories has increased significantly. This is mainly due to the ability of MS to provide very specific identification, high sensitivity, and simultaneous analysis of multiple analytes (>100). The coupling of tandem mass spectrometry with gas chromatography (GC) or liquid chromatography (LC) has enabled the rapid expansion of this technology. While applications of MS are used in many clinical areas, therapeutic drug monitoring, drugs of abuse, and clinical toxicology are still the primary focuses of the field. It is not uncommon to see mass spectrometry being used in routine clinical practices for those applications.

Comparison of smartphone application-based vital sign monitors without external hardware versus those used in clinical practice: a prospective trial.

Science.gov (United States)

Alexander, John C; Minhajuddin, Abu; Joshi, Girish P

2017-08-01

Use of healthcare-related smartphone applications is common. However, there is concern that inaccurate information from these applications may lead patients to make erroneous healthcare decisions. The objective of this study is to study smartphone applications purporting to measure vital sign data using only onboard technology compared with monitors used routinely in clinical practice. This is a prospective trial comparing correlation between a clinically utilized vital sign monitor (Propaq CS, WelchAllyn, Skaneateles Falls, NY, USA) and four smartphone application-based monitors Instant Blood Pressure, Instant Blood Pressure Pro, Pulse Oximeter, and Pulse Oximeter Pro. We performed measurements of heart rate (HR), systolic blood pressures (SBP), diastolic blood pressure (DBP), and oxygen saturation (SpO 2 ) using standard monitor and four smartphone applications. Analysis of variance was used to compare measurements from the applications to the routine monitor. The study was completed on 100 healthy volunteers. Comparison of routine monitor with the smartphone applications shows significant differences in terms of HR, SpO 2 and DBP. The SBP values from the applications were not significantly different from those from the routine monitor, but had wide limits of agreement signifying a large degree of variation in the compared values. The degree of correlation between monitors routinely used in clinical practice and the smartphone-based applications studied is insufficient to recommend clinical utilization. This lack of correlation suggests that the applications evaluated do not provide clinically meaningful data. The inaccurate data provided by these applications can potentially contribute to patient harm.

Nanomedicine, microarrays and their applications in clinical microbiology

Directory of Open Access Journals (Sweden)

Özcan Deveci

2010-12-01

Full Text Available Growing interest in the future medical applications of nanotechnology is leading to the emergence of a new scientific field that called as “nanomedicine”. Nanomedicine may be defined as the investigating, treating, reconstructing and controlling human biology and health at the molecular level, using engineered nanodevices and nanostructures. Microarray technology is a revolutionary tool for elucidating roles of genes in infectious diseases, shifting from traditional methods of research to integrated approaches. This technology has great potential to provide medical diagnosis, monitor treatment and help in the development of new tools for infectious disease prevention and/or management. The aim of this paper is to provide an overview of the current application of microarray platforms and nanomedicine in the study of experimental microbiology and the impact of this technology in clinical settings.

[The development of clinical application of the rejuvenator and a study of its mechanism for the treatment of functional erectile dysfunction].

Science.gov (United States)

Meng, Z; Zou, Y; Luo, E; Zou, L

2001-12-01

In this paper, we describe the development and clinical application of the Rejuvenator and report the result of our study on its mechanism for the treatment of functional erectile dysfunction (FED). The Rejuvenator, which can be used both at home and in hospitals to treat patients with FED, was developed on the basis of our clinical practice in the light of the modern theory of traditional Chinese medicine and by integrating multiple techniques of engineering science. It works by means of the paraoral use of the special herbal medicine, electro-magnetic effects, thermal moxibustion and drug-ingression. 2250 patients with FED received the treatment. Using combined electro-neurophysiological techniques, pulsed ultrasound Doppler and microcomputer image-scanning, we further studied the mechanism of the Rejuvenator for the treatment of FED. The total effective rate was 92%. The clinical data and result of study indicate that the Rejuvenator for the patients with functional erectile dysfunction is a safe, effective and scientific new method.

Are the MDS-UPDRS-based composite scores clinically applicable?

Science.gov (United States)

Makkos, Attila; Kovács, Márton; Aschermann, Zsuzsanna; Harmat, Márk; Janszky, József; Karádi, Kázmér; Kovács, Norbert

2018-02-28

The International Parkinson and Movement Disorder Society-sponsored UPDRS (MDS-UPDRS) is a powerful clinical outcome measure. To evaluate the feasibility of various MDS-UPDRS-based composite scores and determine their minimal clinically important difference threshold values. Overall, 1,113 paired investigations of 452 patients were reviewed implementing three different techniques simultaneously. Based on the ordinal regression modeling, the MDS-UPDRS II+III, MDS-UPDRS I+II+III, and the total score of MDS-UPDRS are clinically applicable outcome measures. Any improvement greater than 4.9 points or any worsening more than 4.2 points on MDS-UPDRS II+III represent a minimal, yet clinically meaningful, change. In reference to MDS-UPDRS I+II+III, the smallest changes considered clinically relevant were 6.7 and 5.2 points for improvement and deterioration, respectively. The thresholds for the total score of MDS-UPDRS were 7.1 points for improvement and 6.3 points for worsening. Our findings support the application of various MDS-UPDRS-based composite scores. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

PET/MRI. Methodology and clinical applications

Energy Technology Data Exchange (ETDEWEB)

Carrio, Ignasi [Autonomous Univ. of Barcelona, Hospital Sant Pau (Spain). Dept. Medicina Nuclear; Ros, Pablo (ed.) [Univ. Hospitals Case, Medical Center, Cleveland, OH (United States). Dept. of Radiology

2014-04-01

Provides detailed information on the methodology and equipment of MRI-PET. Covers a wide range of clinical applications in oncology, cardiology, and neurology. Written by an international group of experts in MRI and PET. PET/MRI is an exciting novel diagnostic imaging modality that combines the precise anatomic and physiologic information provided by magnetic resonance imaging (MRI) with the molecular data obtained with positron emission tomography (PET). PET/MRI offers the promise of a simplified work flow, reduced radiation, whole-body imaging with superior soft tissue contrast, and time of flight physiologic information. It has been described as the pathway to molecular imaging in medicine. In compiling this textbook, the editors have brought together a truly international group of experts in MRI and PET. The book is divided into two parts. The first part covers methodology and equipment and comprises chapters on basic molecular medicine, development of specific contrast agents, MR attenuation and validation, quantitative MRI and PET motion correction, and technical implications for both MRI and PET. The second part of the book focuses on clinical applications in oncology, cardiology, and neurology. Imaging of major neoplasms, including lymphomas and tumors of the breast, prostate, and head and neck, is covered in individual chapters. Further chapters address functional and metabolic cardiovascular examinations and major central nervous system applications such as brain tumors and dementias. Risks, safety aspects, and healthcare costs and impacts are also discussed. This book will be of interest to all radiologists and nuclear medicine physicians who wish to learn more about the latest developments in this important emerging imaging modality and its applications.

[The clinical application of three dimention printing technology].

Science.gov (United States)

Zhong, S Z; Fang, C H

2016-09-01

In recent years, the three-dimentional(3D)printing technology is gradually applied in medicine.Now, the 3D printing has already play an important role in medical education, surgical device development, prosthesis implantation and so on.There are still many challenges and difficulties in the clinical overall application of 3D printing for some time, but it also contains a huge application prospect.Once with appropriate applications of this technology, it will be a major breakthrough in iatrical history once more.

Optical coherence tomography angiography: Technical principles and clinical applications in ophthalmology

Directory of Open Access Journals (Sweden)

Ahmed M Hagag

2017-01-01

Full Text Available Optical coherence tomography angiography (OCTA is a functional extension of OCT that provides information on retinal and choroidal circulations without the need for dye injections. With the recent development of high-speed OCT systems and efficient algorithms, OCTA has become clinically feasible. In this review article, we discuss the technical principles of OCTA, including image processing and artifacts, and its clinical applications in ophthalmology. We summarize recent studies which qualitatively or quantitatively assess disease presentation, progression, and/or response to treatment.

[Latest development in mass spectrometry for clinical application].

Science.gov (United States)

Takino, Masahiko

2013-09-01

Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has seen enormous growth in special clinical chemistry laboratories. It significantly increases the analytic potential in clinical chemistry, especially in the field of low molecular weight biomarker analysis. This review summarizes the state of the art in mass spectrometry and related techniques for clinical application with a main focus on recent developments in LC-MS. Current trends in ionization techniques, automated online sample preparation techniques coupled with LC-MS, and ion mobility spectrometry are discussed. Emerging mass spectrometric approaches complementary to LC-MS are discussed as well.

From Diagnosis to Treatment: Clinical Applications of Nanotechnology in Thoracic Surgery

Science.gov (United States)

Digesu, Christopher S.; Hofferberth, Sophie C.; Grinstaff, Mark W.; Colson, Yolonda L.

2016-01-01

Synopsis Nanotechnology is an emerging field of medicine with significant potential to become a powerful adjunct to cancer therapy, and in particular, thoracic surgery. Using the unique properties of several different nanometer-sized platforms, therapy can be delivered to tumors in a more targeted fashion, with less of the systemic toxicity associated with traditional chemotherapeutics. In addition to the packaged delivery of chemotherapeutic drugs, nanoparticles show potential to aid in the diagnosis, pre-operative characterization, and intraoperative localization of thoracic tumors and their lymphatics. With increasing interest in their clinical application, there is a rapid expansion of in vitro and in vivo studies being conducted that provide a better understanding of potential toxicities and hopes of broader clinical translation. Focused research into nanotechnology’s ability to deliver both diagnostics and therapeutics has led to the development of a field known as nanotheranostics which promises to improve the treatment of thoracic malignancies through enhanced tumor targeting, controlled drug delivery, and therapeutic monitoring. This article reviews the various types of nanoplatforms, their unique properties, and the potential for clinical application in thoracic surgery. PMID:27112260

MALDI-TOF-mass spectrometry applications in clinical microbiology.

Science.gov (United States)

Seng, Piseth; Rolain, Jean-Marc; Fournier, Pierre Edouard; La Scola, Bernard; Drancourt, Michel; Raoult, Didier

2010-11-01

MALDI-TOF-mass spectrometry (MS) has been successfully adapted for the routine identification of microorganisms in clinical microbiology laboratories in the past 10 years. This revolutionary technique allows for easier and faster diagnosis of human pathogens than conventional phenotypic and molecular identification methods, with unquestionable reliability and cost-effectiveness. This article will review the application of MALDI-TOF-MS tools in routine clinical diagnosis, including the identification of bacteria at the species, subspecies, strain and lineage levels, and the identification of bacterial toxins and antibiotic-resistance type. We will also discuss the application of MALDI-TOF-MS tools in the identification of Archaea, eukaryotes and viruses. Pathogenic identification from colony-cultured, blood-cultured, urine and environmental samples is also reviewed.

Clinical Utilization of Repeated Open Application Test Among American Contact Dermatitis Society Members.

Science.gov (United States)

Brown, Gabrielle E; Botto, Nina; Butler, Daniel C; Murase, Jenny E

2015-01-01

The repeated open application test (ROAT) provides useful information regarding allergens in suspected cases of allergic contact dermatitis; however, standardized methodology has not been established. The aim of this study was to assess how ROAT is used in clinical and research settings. We distributed a survey regarding ROAT practice to the American Contact Dermatitis Society and conducted a literature review of ROAT utilization in research. A total of 67 American Contact Dermatitis Society members participated in the survey. Respondents most frequently recommend application of leave-on products twice daily (46.0%) and rinse-off products once daily (43.5%). The most commonly used anatomical sites include the forearm (38.7%) and antecubital fossa (32.3%). Most respondents continue ROAT for 1 (49.2%) or 2 weeks (31.7%). Literature review of 32 studies (26 leave-on, 6 rinse-off) revealed that application frequency is most common at twice daily for both leave-on (96.2%) and rinse-off (50.0%) products. The most common anatomical site is the forearm (62.5%), with an overall study duration of 3 to 4 weeks (65.6%). When comparing ROAT clinical and research practice, the majority trend was consistent for leave-on product application frequency and anatomical site, but not for rinse-off product application frequency, or overall duration. Further research is needed to determine best practice recommendations.

Clinical application of helical CT colonography

International Nuclear Information System (INIS)

Zeng Huiliang; Zhu Xinjin; Liang Rujian; Liang Jianhao; Ou Weiqian; Wen Haomao

2009-01-01

Objective: To investigate the clinical value of 16-slice helical CT colonography in the diagnosis of colon tumor and polypus. Methods: 16-slice helical CT volumetric scanning was performed in 18 patients with colonic disease, including colonic tumor (n=16) and colonic polypus (n=2). 3D images, virtual endoscopy and multiplanar reformation were obtained in the AW4.1 workstation. CT appearances were compared with operation and fiberoptic colonoscopy. Results: Satisfied results were achieved from 18 patients, no difference found in results between CT colonography and operation in 16 patients with colonic tumor. Conclusion: 16-slice helical CT colonography is of great value in preoperative staging of colonic tumor and have a high value in clinical application. (authors)

Virtual reality for mobility devices: training applications and clinical research: a review

NARCIS (Netherlands)

Erren-Wolters, Cathelijne V.; van Dijk, Henk; de Kort, Alexander C.; IJzerman, Maarten Joost; Jannink, M.J.A.

2007-01-01

Virtual reality technology is an emerging technology that possibly can address the problems encountered in training (elderly) people to handle a mobility device. The objective of this review was to study different virtual reality training applications as well as their clinical implication for

Clinical Application of Three-Dimensional Printing Technology in Craniofacial Plastic Surgery

Science.gov (United States)

Kim, Namkug

2015-01-01

Three-dimensional (3D) printing has been particularly widely adopted in medical fields. Application of the 3D printing technique has even been extended to bio-cell printing for 3D tissue/organ development, the creation of scaffolds for tissue engineering, and actual clinical application for various medical parts. Of various medical fields, craniofacial plastic surgery is one of areas that pioneered the use of the 3D printing concept. Rapid prototype technology was introduced in the 1990s to medicine via computer-aided design, computer-aided manufacturing. To investigate the current status of 3D printing technology and its clinical application, a systematic review of the literature was conducted. In addition, the benefits and possibilities of the clinical application of 3D printing in craniofacial surgery are reviewed, based on personal experiences with more than 500 craniofacial cases conducted using 3D printing tactile prototype models. PMID:26015880

Clinical Application of Three-Dimensional Printing Technology in Craniofacial Plastic Surgery

Directory of Open Access Journals (Sweden)

Jong Woo Choi

2015-05-01

Full Text Available Three-dimensional (3D printing has been particularly widely adopted in medical fields. Application of the 3D printing technique has even been extended to bio-cell printing for 3D tissue/organ development, the creation of scaffolds for tissue engineering, and actual clinical application for various medical parts. Of various medical fields, craniofacial plastic surgery is one of areas that pioneered the use of the 3D printing concept. Rapid prototype technology was introduced in the 1990s to medicine via computer-aided design, computer-aided manufacturing. To investigate the current status of 3D printing technology and its clinical application, a systematic review of the literature was conducted. In addition, the benefits and possibilities of the clinical application of 3D printing in craniofacial surgery are reviewed, based on personal experiences with more than 500 craniofacial cases conducted using 3D printing tactile prototype models.

Preconditioning, postconditioning and their application to clinical cardiology.

Science.gov (United States)

Kloner, Robert A; Rezkalla, Shereif H

2006-05-01

Ischemic preconditioning is a well-established phenomenon first described in experimental preparations in which brief episodes of ischemia/reperfusion applied prior to a longer coronary artery occlusion reduce myocardial infarct size. There are ample correlates of ischemic preconditioning in the clinical realm. Preconditioning mimetic agents that stimulate the biochemical pathways of ischemic preconditioning and protect the heart without inducing ischemia have been examined in numerous experimental studies. However, despite the effectiveness of ischemic preconditioning and preconditioning mimetics for protecting ischemic myocardium, there are no preconditioning-based therapies that are routinely used in clinical medicine at the current time. Part of the problem is the need to administer therapy prior to the known ischemic event. Other issues are that percutaneous coronary intervention technology has advanced so far (with the development of stents and drug-eluting stents) that ischemic preconditioning or preconditioning mimetics have not been needed in most interventional cases. Recent clinical trials such as AMISTAD I and II (Acute Myocardial Infarction STudy of ADenosine) suggest that some preconditioning mimetics may reduce myocardial infarct size when given along with reperfusion or, as in the IONA trial, have benefit on clinical events when administered chronically in patients with known coronary artery disease. It is possible that some of the benefit described for adenosine in the AMISTAD 1 and 2 trials represents a manifestation of the recently described postconditioning phenomenon. It is probable that postconditioning--in which reperfusion is interrupted with brief coronary occlusions and reperfusion sequences--is more likely than preconditioning to be feasible as a clinical application to patients undergoing percutaneous coronary intervention for acute myocardial infarction.

Clinical application of Assessment of Parenting Competencies (APC)

DEFF Research Database (Denmark)

Jacobsen, Stine Lindahl

This paper is part of a symposium on music therapy with families with Kirsi Tuomi as Chair. It revolves around the clinical application of a new music therapy assessment model on parent-child interaction and parenting competencies. APC was developed for emotional neglected children and their pare......This paper is part of a symposium on music therapy with families with Kirsi Tuomi as Chair. It revolves around the clinical application of a new music therapy assessment model on parent-child interaction and parenting competencies. APC was developed for emotional neglected children......, child somatic hospitals, centers for refuges and other populations where it would be clinical relevant to assess the parent-child interaction. APC is an observational and improvisational based assessment model evaluating dyads of parent and child (child age range is 5-12). It produces information...... (numbers, graphs, and descriptions) of parent-child interaction and parenting competencies including nonverbal communication, level of attunement in the dyad, and level of emotional support from the parent. It is based on video analysis and a fixed assessment protocol. It was developed through a completed...

Distributed user interfaces for clinical ubiquitous computing applications.

Science.gov (United States)

Bång, Magnus; Larsson, Anders; Berglund, Erik; Eriksson, Henrik

2005-08-01

Ubiquitous computing with multiple interaction devices requires new interface models that support user-specific modifications to applications and facilitate the fast development of active workspaces. We have developed NOSTOS, a computer-augmented work environment for clinical personnel to explore new user interface paradigms for ubiquitous computing. NOSTOS uses several devices such as digital pens, an active desk, and walk-up displays that allow the system to track documents and activities in the workplace. We present the distributed user interface (DUI) model that allows standalone applications to distribute their user interface components to several devices dynamically at run-time. This mechanism permit clinicians to develop their own user interfaces and forms to clinical information systems to match their specific needs. We discuss the underlying technical concepts of DUIs and show how service discovery, component distribution, events and layout management are dealt with in the NOSTOS system. Our results suggest that DUIs--and similar network-based user interfaces--will be a prerequisite of future mobile user interfaces and essential to develop clinical multi-device environments.

Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

Science.gov (United States)

Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S.

2015-01-01

Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods: A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results: The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. Conclusion: There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA

Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals.

Science.gov (United States)

Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S

2015-05-20

Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, and the application of

Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

Directory of Open Access Journals (Sweden)

Asgar Aghaei Hashjin

2015-10-01

Full Text Available Background Iran has a widespread diagnostics and clinical support services (DCSS network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%, pharmacopoeia availability (92%, equipment calibration (87% and identifying responsibilities (86%. Least reported was external auditing of the DCSS (57%. The clinical chemistry and microbiology laboratories (84%, pharmacies, blood bank services (83% reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%. There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO and private-for-profit hospitals than in governmental hospitals. Conclusion There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits can be improved. Both the effectiveness of QA

Clinical application of noninvasive diagnosis of liver fibrosis

Directory of Open Access Journals (Sweden)

ZHU Chuanlong

2015-03-01

Full Text Available Hepatic fibrosis is the common outcome of chronic liver diseases of various causes. At present, liver biopsy is the “gold standard” for the diagnosis of liver fibrosis, but it has limitations and is invasive, which leads to the development of noninvasive assessment of liver fibrosis. The article mainly introduces the technology and application of noninvasive diagnosis of liver fibrosis from the aspects of clinical manifestation, serology, and radiology. It has pointed out the clinical value of these noninvasive diagnosis techniques, and it discusses the progress in clinical research and its limitations for noninvasive diagnosis of liver fibrosis.

[Applications of MALDI-TOF technology in clinical microbiology].

Science.gov (United States)

Suarez, S; Nassif, X; Ferroni, A

2015-02-01

Until now, the identification of micro-organisms has been based on the cultural and biochemical characteristics of bacterial and fungal species. Recently, Mass Spectrometry type Matrix-Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF MS) was developed in clinical microbiology laboratories. This new technology allows identification of micro-organisms directly from colonies of bacteria and fungi within few minutes. In addition, it can be used to identify germs directly from positive blood culture bottles or directly from urine samples. Other ways are being explored to expand the use of MALDI-TOF in clinical microbiology laboratories. Indeed, some studies propose to detect bacterial antibiotic resistance while others compare strains within species for faster strain typing. The main objective of this review is to update data from the recent literature for different applications of MALDI-TOF technique in microbiological diagnostic routine. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Routine clinical application of virtual reality in abdominal surgery.

Science.gov (United States)

Sampogna, Gianluca; Pugliese, Raffaele; Elli, Marco; Vanzulli, Angelo; Forgione, Antonello

2017-06-01

The advantages of 3D reconstruction, immersive virtual reality (VR) and 3D printing in abdominal surgery have been enunciated for many years, but still today their application in routine clinical practice is almost nil. We investigate their feasibility, user appreciation and clinical impact. Fifteen patients undergoing pancreatic, hepatic or renal surgery were studied realizing a 3D reconstruction of target anatomy. Then, an immersive VR environment was developed to import 3D models, and some details of the 3D scene were printed. All the phases of our workflow employed open-source software and low-cost hardware, easily implementable by other surgical services. A qualitative evaluation of the three approaches was performed by 20 surgeons, who filled in a specific questionnaire regarding a clinical case for each organ considered. Preoperative surgical planning and intraoperative guidance was feasible for all patients included in the study. The vast majority of surgeons interviewed scored their quality and usefulness as very good. Despite extra time, costs and efforts necessary to implement these systems, the benefits shown by the analysis of questionnaires recommend to invest more resources to train physicians to adopt these technologies routinely, even if further and larger studies are still mandatory.

The clinical applicability of music therapy research

DEFF Research Database (Denmark)

Wigram, Anthony Lewis

in lengthy and complex theses is seldom accessible to the practitioner working ‘at the coal-face’; and sometimes lacks clear direction on how the results are applicable in everyday therapy. For results to be implemented in clinical practice and disseminated to colleagues in related fields as well as senior...

Is medical perspective on clinical governance practices associated with clinical units’ performance and mortality? A cross-sectional study through a record-linkage procedure

Directory of Open Access Journals (Sweden)

Guido Sarchielli

2016-07-01

Full Text Available Objective: Assessment of the knowledge and application as well as perceived utility by doctors of clinical governance tools in order to explore their impact on clinical units’ performance measured through mortality rates and efficiency indicators. Methods: This research is a cross-sectional study with a deterministic record-linkage procedure. The sample includes n = 1250 doctors (n = 249 chiefs of clinical units; n = 1001 physicians working in six public hospitals located in the Emilia-Romagna Region in Italy. Survey instruments include a checklist and a research-made questionnaire which were used for data collection about doctors’ knowledge and application as well as perceived utility of clinical governance tools. The analysis was based on clinical units’ performance indicators which include patients’ mortality, extra-region active mobility rate, average hospital stay, bed occupancy, rotation and turnover rates, and the comparative performance index as efficiency indicators. Results: The clinical governance tools are known and applied differently in all the considered clinical units. Significant differences emerged between roles and organizational levels at which the medical leadership is carried out. The levels of knowledge and application of clinical governance practices are correlated with the clinical units’ efficiency indicators (bed occupancy rate, bed turnover interval, and extra-region mobility. These multiple linear regression analyses highlighted that the clinical governance knowledge and application is correlated with clinical units’ mortality rates (odds ratio, −8.677; 95% confidence interval, −16.654, −0.700. Conclusion: The knowledge and application, as well as perceived utility by medical professionals of clinical governance tools, are associated with the mortality rates of their units and with some efficiency indicators. However, the medical frontline staff seems to not consider homogeneously useful

Application of Next-generation Sequencing in Clinical Molecular Diagnostics

Directory of Open Access Journals (Sweden)

Morteza Seifi

2017-05-01

Full Text Available ABSTRACT Next-generation sequencing (NGS is the catch all terms that used to explain several different modern sequencing technologies which let us to sequence nucleic acids much more rapidly and cheaply than the formerly used Sanger sequencing, and as such have revolutionized the study of molecular biology and genomics with excellent resolution and accuracy. Over the past years, many academic companies and institutions have continued technological advances to expand NGS applications from research to the clinic. In this review, the performance and technical features of current NGS platforms were described. Furthermore, advances in the applying of NGS technologies towards the progress of clinical molecular diagnostics were emphasized. General advantages and disadvantages of each sequencing system are summarized and compared to guide the selection of NGS platforms for specific research aims.

Clinical application of noninvasive diagnosis of liver fibrosis

OpenAIRE

ZHU Chuanlong

2015-01-01

Hepatic fibrosis is the common outcome of chronic liver diseases of various causes. At present, liver biopsy is the “gold standard” for the diagnosis of liver fibrosis, but it has limitations and is invasive, which leads to the development of noninvasive assessment of liver fibrosis. The article mainly introduces the technology and application of noninvasive diagnosis of liver fibrosis from the aspects of clinical manifestation, serology, and radiology. It has pointed out the clinical value o...

In vivo confocal microscopy in dermatology: from research to clinical application

Science.gov (United States)

Ulrich, Martina; Lange-Asschenfeldt, Susanne

2013-06-01

Confocal laser scanning microscopy (CLSM) represents an emerging technique for the noninvasive histomorphological analysis of skin in vivo and has shown its applicability for dermatological research as well as its value as an adjunct tool in the clinical management of skin cancer patients. Herein, we aim to give an overview on the current clinical indications for CLSM in dermatology and also highlight the diverse applications of CLSM in dermatological research.

Study of liver volume measurement and its clinical application for liver transplantation using multiple-slice spiral CT

International Nuclear Information System (INIS)

Peng Zhiyi; Yu Zhefeng; Kuang Pingding; Xiao Shengxiang; Huang Dongsheng; Zheng Shusen; Wu Jian

2004-01-01

Objective: To study the accuracy of liver volume measurement using MSCT and its application in liver transplantation. Methods: (1) Experimental study. Ten pig livers were scanned using MSCT with two collimations (3.2 mm and 6.5 mm) and pitch 1.25. Semi-automatic method was used to reconstruct 3D liver models to measure the liver volume. (2) Clinical study. Twenty-three patients received MSCT scan with collimation of 6.5 mm before liver transplantation. Same method was used to calculate the liver volume and the measurement was repeated by the same observer after 1 month. Results: (1) Experimental study. Actual liver volumes were (1134.1 ± 288.0) ml. Liver volumes by MSCT with two collimations were (1125.0 ± 282.5) ml (3.2 mm) and (1101.6 ± 277.6) ml (6.5 mm). The accuracy was (99.5 ± 0.8)% and (97.4 ± 0.8)%, respectively. Both showed same good agreement with actual liver volume: r=0.999, P<0.01 (2) Clinical study. Actual liver volumes were (1455.7±730.0) ml. Liver volume by MSCT was (1462.7 ± 774.1) ml. The accuracy was (99.5±9.6)%, r=0.986, P<0.01. Liver volume measured again was (1449.4 ± 768.9) ml, r=0.991 (P<0.01). Conclusion: MSCT can assess the liver volume correctly, and could be used as a routine step for evaluations before liver transplantation

MO-FG-207-03: Maximizing the Utility of Integrated PET/MRI in Clinical Applications

Energy Technology Data Exchange (ETDEWEB)

Behr, S. [University of California (United States)

2015-06-15

The use of integrated PET/MRI systems in clinical applications can best benefit from understanding their technological advances and limitations. The currently available clinical PET/MRI systems have their own characteristics. Thorough analyses of existing technical data and evaluation of necessary performance metrics for quality assurances could be conducted to optimize application-specific PET/MRI protocols. This Symposium will focus on technical advances and limitations of clinical PET/MRI systems, and how this exciting imaging modality can be utilized in applications that can benefit from both PET and MRI. Learning Objectives: To understand the technological advances of clinical PET/MRI systems To correctly identify clinical applications that can benefit from PET/MRI To understand ongoing work to further improve the current PET/MRI technology Floris Jansen is a GE Healthcare employee.

MO-FG-207-03: Maximizing the Utility of Integrated PET/MRI in Clinical Applications

International Nuclear Information System (INIS)

Behr, S.

2015-01-01

The use of integrated PET/MRI systems in clinical applications can best benefit from understanding their technological advances and limitations. The currently available clinical PET/MRI systems have their own characteristics. Thorough analyses of existing technical data and evaluation of necessary performance metrics for quality assurances could be conducted to optimize application-specific PET/MRI protocols. This Symposium will focus on technical advances and limitations of clinical PET/MRI systems, and how this exciting imaging modality can be utilized in applications that can benefit from both PET and MRI. Learning Objectives: To understand the technological advances of clinical PET/MRI systems To correctly identify clinical applications that can benefit from PET/MRI To understand ongoing work to further improve the current PET/MRI technology Floris Jansen is a GE Healthcare employee

Mobile clinical decision support systems and applications: a literature and commercial review.

Science.gov (United States)

Martínez-Pérez, Borja; de la Torre-Díez, Isabel; López-Coronado, Miguel; Sainz-de-Abajo, Beatriz; Robles, Montserrat; García-Gómez, Juan Miguel

2014-01-01

The latest advances in eHealth and mHealth have propitiated the rapidly creation and expansion of mobile applications for health care. One of these types of applications are the clinical decision support systems, which nowadays are being implemented in mobile apps to facilitate the access to health care professionals in their daily clinical decisions. The aim of this paper is twofold. Firstly, to make a review of the current systems available in the literature and in commercial stores. Secondly, to analyze a sample of applications in order to obtain some conclusions and recommendations. Two reviews have been done: a literature review on Scopus, IEEE Xplore, Web of Knowledge and PubMed and a commercial review on Google play and the App Store. Five applications from each review have been selected to develop an in-depth analysis and to obtain more information about the mobile clinical decision support systems. Ninety-two relevant papers and 192 commercial apps were found. Forty-four papers were focused only on mobile clinical decision support systems. One hundred seventy-one apps were available on Google play and 21 on the App Store. The apps are designed for general medicine and 37 different specialties, with some features common in all of them despite of the different medical fields objective. The number of mobile clinical decision support applications and their inclusion in clinical practices has risen in the last years. However, developers must be careful with their interface or the easiness of use, which can impoverish the experience of the users.

[Manufacture and clinical application of 215 IPS-Empress casting ceramic restorations].

Science.gov (United States)

Zhao, Na; Zhou, Jian

2008-08-01

To explore the manufacture and clinical application of IPS-Empress casting ceramic restorations. The problems in manufacture and clinical operation of 215 casting ceramic restorations were analyzed. In 215 casting ceramic restorations, 12 (5.58%) casting ceramic restorations were affected by clinical design or application, 15 (6.98%) casting ceramic restorations were affected by some manufacture problems, and 14 (6.51%) casting ceramic restorations were affected by clinical try-in. Through 2-3 years' follow-up, the achievement ratio of 215 IPS-Empress casting ceramic restorations was 94.88%, and 11 casting ceramic restorations were affected by some problems. Beauty and simultaneous enamel wear are the characteristics of casting ceramic restorations. But because of its brittle, the indications should be strictly selected.

Human reporter genes: potential use in clinical studies

Energy Technology Data Exchange (ETDEWEB)

Serganova, Inna [Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Ponomarev, Vladimir [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Blasberg, Ronald [Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States)], E-mail: blasberg@neuro1.mskcc.org

2007-10-15

The clinical application of positron-emission-tomography-based reporter gene imaging will expand over the next several years. The translation of reporter gene imaging technology into clinical applications is the focus of this review, with emphasis on the development and use of human reporter genes. Human reporter genes will play an increasingly more important role in this development, and it is likely that one or more reporter systems (human gene and complimentary radiopharmaceutical) will take leading roles. Three classes of human reporter genes are discussed and compared: receptors, transporters and enzymes. Examples of highly expressed cell membrane receptors include specific membrane somatostatin receptors (hSSTrs). The transporter group includes the sodium iodide symporter (hNIS) and the norepinephrine transporter (hNET). The endogenous enzyme classification includes human mitochondrial thymidine kinase 2 (hTK2). In addition, we also discuss the nonhuman dopamine 2 receptor and two viral reporter genes, the wild-type herpes simplex virus 1 thymidine kinase (HSV1-tk) gene and the HSV1-tk mutant (HSV1-sr39tk). Initial applications of reporter gene imaging in patients will be developed within two different clinical disciplines: (a) gene therapy and (b) adoptive cell-based therapies. These studies will benefit from the availability of efficient human reporter systems that can provide critical monitoring information for adenoviral-based, retroviral-based and lenteviral-based gene therapies, oncolytic bacterial and viral therapies, and adoptive cell-based therapies. Translational applications of noninvasive in vivo reporter gene imaging are likely to include: (a) quantitative monitoring of gene therapy vectors for targeting and transduction efficacy in clinical protocols by imaging the location, extent and duration of transgene expression; (b) monitoring of cell trafficking, targeting, replication and activation in adoptive T-cell and stem/progenitor cell therapies

Human reporter genes: potential use in clinical studies

International Nuclear Information System (INIS)

Serganova, Inna; Ponomarev, Vladimir; Blasberg, Ronald

2007-01-01

The clinical application of positron-emission-tomography-based reporter gene imaging will expand over the next several years. The translation of reporter gene imaging technology into clinical applications is the focus of this review, with emphasis on the development and use of human reporter genes. Human reporter genes will play an increasingly more important role in this development, and it is likely that one or more reporter systems (human gene and complimentary radiopharmaceutical) will take leading roles. Three classes of human reporter genes are discussed and compared: receptors, transporters and enzymes. Examples of highly expressed cell membrane receptors include specific membrane somatostatin receptors (hSSTrs). The transporter group includes the sodium iodide symporter (hNIS) and the norepinephrine transporter (hNET). The endogenous enzyme classification includes human mitochondrial thymidine kinase 2 (hTK2). In addition, we also discuss the nonhuman dopamine 2 receptor and two viral reporter genes, the wild-type herpes simplex virus 1 thymidine kinase (HSV1-tk) gene and the HSV1-tk mutant (HSV1-sr39tk). Initial applications of reporter gene imaging in patients will be developed within two different clinical disciplines: (a) gene therapy and (b) adoptive cell-based therapies. These studies will benefit from the availability of efficient human reporter systems that can provide critical monitoring information for adenoviral-based, retroviral-based and lenteviral-based gene therapies, oncolytic bacterial and viral therapies, and adoptive cell-based therapies. Translational applications of noninvasive in vivo reporter gene imaging are likely to include: (a) quantitative monitoring of gene therapy vectors for targeting and transduction efficacy in clinical protocols by imaging the location, extent and duration of transgene expression; (b) monitoring of cell trafficking, targeting, replication and activation in adoptive T-cell and stem/progenitor cell therapies

Clinical application of bio ceramics

Energy Technology Data Exchange (ETDEWEB)

Anu, Sharma, E-mail: issaranu@gmail.com; Gayatri, Sharma, E-mail: sharmagayatri@gmail.com [Department of Chemistry, Govt. College of Engineering & Technology, Bikaner, Rajasthan (India)

2016-05-06

Ceramics are the inorganic crystalline material. These are used in various field such as biomedical, electrical, electronics, aerospace, automotive and optical etc. Bio ceramics are the one of the most active areas of research. Bio ceramics are the ceramics which are biocompatible. The unique properties of bio ceramics make them an attractive option for medical applications and offer some potential advantages over other materials. During the past three decades, a number of major advances have been made in the field of bio ceramics. This review focuses on the use of these materials in variety of clinical scenarios.

Clinical application of bio ceramics

International Nuclear Information System (INIS)

Anu, Sharma; Gayatri, Sharma

2016-01-01

Ceramics are the inorganic crystalline material. These are used in various field such as biomedical, electrical, electronics, aerospace, automotive and optical etc. Bio ceramics are the one of the most active areas of research. Bio ceramics are the ceramics which are biocompatible. The unique properties of bio ceramics make them an attractive option for medical applications and offer some potential advantages over other materials. During the past three decades, a number of major advances have been made in the field of bio ceramics. This review focuses on the use of these materials in variety of clinical scenarios.

Telerehabilitation Clinical and Vocational Applications for Assistive Technology: Research, Opportunities, and Challenges

Directory of Open Access Journals (Sweden)

Mark R. Schmeler

2009-09-01

Full Text Available Rehabilitation service providers in rural or underserved areas are often challenged in meeting the needs of their complex patients due to limited resources in their geographical area. Recruitment and retention of the rural clinical workforce are beset by the ongoing problems associated with limited continuing education opportunities, professional isolation, and the challenges inherent in coordinating rural community healthcare. People with disabilities who live in rural communities also face challenges accessing healthcare. Traveling long distances to a specialty clinic for necessary expertise may be troublesome due to inadequate or unavailable transportation, disability specific limitations, and financial limitations. Distance and lack of access are just two threats to quality of care that now being addressed by the use of videoconferencing, information exchange, and other telecommunication technologies that facilitate telerehabilitation. This white paper illustrates and summarizes clinical and vocational applications of telerehabilitation. We provide definitions related to the fields of telemedicine, telehealth, and telerehabilitation, and consider the impetus for telerehabilitation. We review the telerehabilitation literature for assistive technology applications; pressure ulcer prevention; virtual reality applications; speech-language pathology applications; seating and wheeled mobility applications; vocational rehabilitation applications; and cost effectiveness. We then discuss external telerehabilitation influencers, such as the positions of professional organizations. Finally, we summarize clinical and policy issues in a limited context appropriate to the scope of this paper. Keywords: Telerehabilitation, Telehealth, Telemedicine, Telepractice

Telerehabilitation clinical and vocational applications for assistive technology: research, opportunities, and challenges.

Science.gov (United States)

Schmeler, Mark R; Schein, Richard M; McCue, Michael; Betz, Kendra

2009-01-01

Rehabilitation service providers in rural or underserved areas are often challenged in meeting the needs of their complex patients due to limited resources in their geographical area. Recruitment and retention of the rural clinical workforce are beset by the ongoing problems associated with limited continuing education opportunities, professional isolation, and the challenges inherent in coordinating rural community healthcare. People with disabilities who live in rural communities also face challenges accessing healthcare. Traveling long distances to a specialty clinic for necessary expertise may be troublesome due to inadequate or unavailable transportation, disability specific limitations, and financial limitations. Distance and lack of access are just two threats to quality of care that now being addressed by the use of videoconferencing, information exchange, and other telecommunication technologies that facilitate telerehabilitation. This white paper illustrates and summarizes clinical and vocational applications of telerehabilitation. We provide definitions related to the fields of telemedicine, telehealth, and telerehabilitation, and consider the impetus for telerehabilitation. We review the telerehabilitation literature for assistive technology applications; pressure ulcer prevention; virtual reality applications; speech-language pathology applications; seating and wheeled mobility applications; vocational rehabilitation applications; and cost-effectiveness. We then discuss external telerehabilitation influencers, such as the positions of professional organizations. Finally, we summarize clinical and policy issues in a limited context appropriate to the scope of this paper.

Clinical applications of 3-dimensional printing in radiation therapy

International Nuclear Information System (INIS)

Zhao, Yizhou; Moran, Kathryn; Yewondwossen, Mammo; Allan, James; Clarke, Scott; Rajaraman, Murali; Wilke, Derek; Joseph, Paul; Robar, James L.

2017-01-01

Three-dimensional (3D) printing is suitable for the fabrication of complex radiotherapy bolus. Although investigated from dosimetric and feasibility standpoints, there are few reports to date of its use for actual patient treatment. This study illustrates the versatile applications of 3D printing in clinical radiation oncology through a selection of patient cases, namely, to create bolus for photon and modulated electron radiotherapy (MERT), as well as applicators for surface high-dose rate (HDR) brachytherapy. Photon boluses were 3D-printed to treat a recurrent squamous cell carcinoma (SCC) of the nasal septum and a basal cell carcinoma (BCC) of the posterior pinna. For a patient with a mycosis fungoides involving the upper face, a 3D-printed MERT bolus was used. To treat an SCC of the nose, a 3D-printed applicator for surface brachytherapy was made. The structures' fit to the anatomy and the radiotherapy treatment plans were assessed. Based on the treatment planning computed tomography (CT), the size of the largest air gap at the interface of the 3D-printed structure was 3 mm for the SCC of the nasal septum, 3 mm for the BCC of the pinna, 2 mm for the mycosis fungoides of the face, and 2 mm for the SCC of the nose. Acceptable treatment plans were obtained for the SCC of the nasal septum (95% isodose to 99.8% of planning target volume [PTV]), the BCC of the pinna (95% isodose to 97.7% of PTV), and the mycosis fungoides of the face (90% isodose to 92.5% of PTV). For the latter, compared with a plan with a uniform thickness bolus, the one featuring the MERT bolus achieved relative sparing of all the organs at risk (OARs) distal to the target volume, while maintaining similar target volume coverage. The surface brachytherapy plan for the SCC of the nose had adequate coverage (95% isodose to 95.6% of clinical target volume [CTV]), but a relatively high dose to the left eye, owing to its proximity to the tumor. 3D printing can be implemented effectively in

Clinical applications of 3-dimensional printing in radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Zhao, Yizhou, E-mail: yizhou.zhao@dal.ca [Department of Radiation Oncology, Dalhousie University, Queen Elizabeth II Health Sciences Centre, 5820 University Avenue, Halifax, Nova Scotia B3H 2Y9 (Canada); Moran, Kathryn [Department of Radiation Oncology, Dalhousie University, Queen Elizabeth II Health Sciences Centre, 5820 University Avenue, Halifax, Nova Scotia B3H 2Y9 (Canada); Yewondwossen, Mammo; Allan, James; Clarke, Scott [Department of Medical Physics, Dalhousie University, Queen Elizabeth II Health Sciences Centre, 5820 University Avenue, Halifax, Nova Scotia B3H 2Y9 (Canada); Rajaraman, Murali; Wilke, Derek; Joseph, Paul [Department of Radiation Oncology, Dalhousie University, Queen Elizabeth II Health Sciences Centre, 5820 University Avenue, Halifax, Nova Scotia B3H 2Y9 (Canada); Robar, James L. [Department of Medical Physics, Dalhousie University, Queen Elizabeth II Health Sciences Centre, 5820 University Avenue, Halifax, Nova Scotia B3H 2Y9 (Canada)

2017-07-01

Three-dimensional (3D) printing is suitable for the fabrication of complex radiotherapy bolus. Although investigated from dosimetric and feasibility standpoints, there are few reports to date of its use for actual patient treatment. This study illustrates the versatile applications of 3D printing in clinical radiation oncology through a selection of patient cases, namely, to create bolus for photon and modulated electron radiotherapy (MERT), as well as applicators for surface high-dose rate (HDR) brachytherapy. Photon boluses were 3D-printed to treat a recurrent squamous cell carcinoma (SCC) of the nasal septum and a basal cell carcinoma (BCC) of the posterior pinna. For a patient with a mycosis fungoides involving the upper face, a 3D-printed MERT bolus was used. To treat an SCC of the nose, a 3D-printed applicator for surface brachytherapy was made. The structures' fit to the anatomy and the radiotherapy treatment plans were assessed. Based on the treatment planning computed tomography (CT), the size of the largest air gap at the interface of the 3D-printed structure was 3 mm for the SCC of the nasal septum, 3 mm for the BCC of the pinna, 2 mm for the mycosis fungoides of the face, and 2 mm for the SCC of the nose. Acceptable treatment plans were obtained for the SCC of the nasal septum (95% isodose to 99.8% of planning target volume [PTV]), the BCC of the pinna (95% isodose to 97.7% of PTV), and the mycosis fungoides of the face (90% isodose to 92.5% of PTV). For the latter, compared with a plan with a uniform thickness bolus, the one featuring the MERT bolus achieved relative sparing of all the organs at risk (OARs) distal to the target volume, while maintaining similar target volume coverage. The surface brachytherapy plan for the SCC of the nose had adequate coverage (95% isodose to 95.6% of clinical target volume [CTV]), but a relatively high dose to the left eye, owing to its proximity to the tumor. 3D printing can be implemented effectively in

Topical Vitamin C and the Skin: Mechanisms of Action and Clinical Applications.

Science.gov (United States)

Al-Niaimi, Firas; Chiang, Nicole Yi Zhen

2017-07-01

OBJECTIVE: This review article details the main mechanisms of action and clinical applications of topical vitamin C on the skin, including its antioxidative, photoprotective, antiaging, and antipigmentary effects. DESIGN: A PubMed search for the relevant articles on vitamin C and the skin was conducted using the following key words: "vitamin C," "ascorbic acid," "ascorbyl-6-palmitate,"and "magnesium ascorbyl phosphate." RESULTS: As one of the most powerful antioxidants in the skin, vitamin C has been shown to protect against photoaging, ultraviolet-induced immunosuppression, and photocarcinogenesis. It also has an antiaging effect by increasing collagen synthesis, stabilizing collagen fibers, and decreasing collagen degradation. It decreases melanin formation, thereby reducing pigmentation. Vitamin C is the primary replenisher of vitamin E and works synergistically with vitamin E in the protection against oxidative damage. CONCLUSION: Topical vitamin C has a wide range of clinical applications, from antiaging and antipigmentary to photoprotective. Currently, clinical studies on the efficacy of topical formulations of vitamin C remain limited, and the challenge lies in finding the most stable and permeable formulation in achieving the optimal results.

The epigenetics of prostate cancer diagnosis and prognosis: update on clinical applications.

Science.gov (United States)

Blute, Michael L; Damaschke, Nathan A; Jarrard, David F

2015-01-01

There is a major deficit in our ability to detect and predict the clinical behavior of prostate cancer (PCa). Epigenetic changes are associated with PCa development and progression. This review will focus on recent results in the clinical application of diagnostic and prognostic epigenetic markers. The development of high throughput technology has seen an enormous increase in the discovery of new markers that encompass epigenetic changes including those in DNA methylation and histone modifications. Application of these findings to urine and other biofluids, but also cancer and noncancerous prostate tissue, has resulted in new biomarkers. There has been a recent commercial development of a DNA methylation-based assay for identifying PCa risk from normal biopsy tissue. Other biomarkers are currently in the validation phase and encompass combinations of multiple genes. Epigenetic changes improve the specificity and sensitivity of PCa diagnosis and have the potential to help determine clinical prognosis. Additional studies will not only provide new and better biomarker candidates, but also have the potential to inform new therapeutic strategies given the reversibility of these processes.

Clinical Application of Earlobe Augmentation with Hyaluronic Acid Filler in the Chinese Population.

Science.gov (United States)

Qian, Wei; Zhang, Yan-Kun; Cao, Qian; Hou, Ying; Lv, Wei; Fan, Ju-Feng

2017-02-01

Larger earlobes, which are a symbol of "richness" in traditional Chinese culture, are favored by Chinese patients. The objective of this paper is to investigate the application of earlobe augmentation with hyaluronic acid (HA) filler injection and its clinical effects in the Chinese population. A total of 19 patients (38 ears) who received earlobe augmentation with HA filler injections between March 2013 and March 2015 were included. The clinical effects, duration, and complications of these cases were investigated. All patients who received earlobe HA injections showed immediate postoperative effects with obvious morphological improvement of their earlobes. The volume of HA filler injected into each ear was 0.3-0.5 ml. The duration of the effect was 6-9 months. Two of the 19 cases (3 ears) demonstrated mild bruising at the injection site, but the bruising completely disappeared within 7 days after the injection. No vascular embolism, infection, nodule, or granuloma complications were observed in the studied group. The application of earlobe augmentation with HA filler injection is a safe, effective, simple procedure for earlobe shaping. It has an easy clinical application with good clinical prospects. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Clinical Applications of 3D Printing: Primer for Radiologists.

Science.gov (United States)

Ballard, David H; Trace, Anthony Paul; Ali, Sayed; Hodgdon, Taryn; Zygmont, Matthew E; DeBenedectis, Carolynn M; Smith, Stacy E; Richardson, Michael L; Patel, Midhir J; Decker, Summer J; Lenchik, Leon

2018-01-01

Three-dimensional (3D) printing refers to a number of manufacturing technologies that create physical models from digital information. Radiology is poised to advance the application of 3D printing in health care because our specialty has an established history of acquiring and managing the digital information needed to create such models. The 3D Printing Task Force of the Radiology Research Alliance presents a review of the clinical applications of this burgeoning technology, with a focus on the opportunities for radiology. Topics include uses for treatment planning, medical education, and procedural simulation, as well as patient education. Challenges for creating custom implantable devices including financial and regulatory processes for clinical application are reviewed. Precedent procedures that may translate to this new technology are discussed. The task force identifies research opportunities needed to document the value of 3D printing as it relates to patient care. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Non-interventional (observational study of application of the tamsulosin (Proflosin® in patients with benign prostatic hyperplasia in routine clinical practice

Directory of Open Access Journals (Sweden)

L. G. Spivak

2014-01-01

Full Text Available The problem of therapy of benign prostatic hyperplasia has not lost its relevance today due to the high prevalence rate of this pathologyamong the male population. The article provides the results of non-interventional (observational study of application of the tamsulosin(Proflosin® drug or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno of patients with benign prostatic hyperplasia in routine clinical practice. 1,000 practicing urology experts from 100 cities and towns of Russia took part in the study as well as 23 492 patients with the established diagnosis of benign prostatic hyperplasia, which were prescribed with tamsulosin (Proflosin® monotherapy or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno in conditions of outpatient clinical practice. As a result of the study, improvement of the life standard and subjective symptoms were stated with patients with the absence of significant side effects directly associated with intake of the drug studies.

Non-interventional (observational study of application of the tamsulosin (Proflosin® in patients with benign prostatic hyperplasia in routine clinical practice

Directory of Open Access Journals (Sweden)

L. G. Spivak

2015-02-01

Full Text Available The problem of therapy of benign prostatic hyperplasia has not lost its relevance today due to the high prevalence rate of this pathologyamong the male population. The article provides the results of non-interventional (observational study of application of the tamsulosin(Proflosin® drug or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno of patients with benign prostatic hyperplasia in routine clinical practice. 1,000 practicing urology experts from 100 cities and towns of Russia took part in the study as well as 23 492 patients with the established diagnosis of benign prostatic hyperplasia, which were prescribed with tamsulosin (Proflosin® monotherapy or combined therapy with tamsulosin (Proflosin® + Serenoa repens (Prostamol® Uno in conditions of outpatient clinical practice. As a result of the study, improvement of the life standard and subjective symptoms were stated with patients with the absence of significant side effects directly associated with intake of the drug studies.

Application of Standard Project Management Tools to Research--A Case Study from a Multi-National Clinical Trial

Science.gov (United States)

Gist, Peter; Langley, David

2007-01-01

PRINCE2, which stands for Projects in Controlled Environments, is a project management method covering the organisation, management, and control of projects and is widely used in both government and commercial IT and building projects in the UK. This paper describes the application of PRINCE2 to the management of large clinical trials…

Disease models of chronic inflammatory airway disease : applications and requirements for clinical trials

NARCIS (Netherlands)

Diamant, Zuzana; Clarke, Graham W.; Pieterse, Herman; Gispert, Juan

Purpose of reviewThis review will discuss methodologies and applicability of key inflammatory models of respiratory disease in proof of concept or proof of efficacy clinical studies. In close relationship with these models, induced sputum and inflammatory cell counts will be addressed for

The development of a clinical outcomes survey research application: Assessment Center.

Science.gov (United States)

Gershon, Richard; Rothrock, Nan E; Hanrahan, Rachel T; Jansky, Liz J; Harniss, Mark; Riley, William

2010-06-01

The National Institutes of Health sponsored Patient-Reported Outcome Measurement Information System (PROMIS) aimed to create item banks and computerized adaptive tests (CATs) across multiple domains for individuals with a range of chronic diseases. Web-based software was created to enable a researcher to create study-specific Websites that could administer PROMIS CATs and other instruments to research participants or clinical samples. This paper outlines the process used to develop a user-friendly, free, Web-based resource (Assessment Center) for storage, retrieval, organization, sharing, and administration of patient-reported outcomes (PRO) instruments. Joint Application Design (JAD) sessions were conducted with representatives from numerous institutions in order to supply a general wish list of features. Use Cases were then written to ensure that end user expectations matched programmer specifications. Program development included daily programmer "scrum" sessions, weekly Usability Acceptability Testing (UAT) and continuous Quality Assurance (QA) activities pre- and post-release. Assessment Center includes features that promote instrument development including item histories, data management, and storage of statistical analysis results. This case study of software development highlights the collection and incorporation of user input throughout the development process. Potential future applications of Assessment Center in clinical research are discussed.

Family Environments and Adaptation: A Clinically Applicable Typology.

Science.gov (United States)

Billings, Andrew G.; Moos, Rudolf H.

1982-01-01

Presents a typology of family environments based on multidimensional assessments of a representative sample of community families. Identified seven family types. Found family differences in environmental stressors and coping resources affected family members' levels of functioning. Discusses clinical and research applications of the typology.…

Experimental application of Business Process Management technology to manage clinical pathways: a pediatric kidney transplantation follow up case.

Science.gov (United States)

Andellini, Martina; Fernandez Riesgo, Sandra; Morolli, Federica; Ritrovato, Matteo; Cosoli, Piero; Petruzzellis, Silverio; Rosso, Nicola

2017-11-03

To test the application of Business Process Management technology to manage clinical pathways, using a pediatric kidney transplantation as case study, and to identify the benefits obtained from using this technology. Using a Business Process Management platform, we implemented a specific application to manage the clinical pathway of pediatric patients, and monitored the activities of the coordinator in charge of the case management during a 6-month period (from June 2015 to November 2015) using two methodologies: the traditional procedure and the one under study. The application helped physicians and nurses to optimize the amount of time and resources devoted to management purposes. In particular, time reduction was close to 60%. In addition, the reduction of data duplication, the integrated event management and the efficient data collection improved the quality of the service. The use of Business Process Management technology, usually related to well-defined processes with high management costs, is an established procedure in multiple environments; its use in healthcare, however, is innovative. The use of already accepted clinical pathways is known to improve outcomes. The combination of these two techniques, well established in their respective areas of application, could represent a revolution in clinical pathway management. The study has demonstrated that the use of this technology in a clinical environment, using a proper architecture and identifying a well-defined process, leads to real benefits in terms of resources optimization and quality improvement.

Hydroxyurea revisited: a decade of clinical effects studies

International Nuclear Information System (INIS)

Sinclair, W.K.

1981-01-01

Over a decade ago hydroxyurea was shown to selectively kill cells in the S phase in a proliferating cell population and to block cells at the G 1 -S border. Consequently, blocked cells became sensitized to irradiation and were further sensitized when the drug was present after exposure. In the ensuing decade, many in vivo studies on hydroxyurea have confirmed that the main properties of hydroxyurea identified in the dish are also evident in vivo. During a period of about ten years, a considerable number of clinical studies have been performed, the results of which have been mixed, ranging from indeterminate to encouraging, depending to some extent on the site treated and whether careful randomized studies were done. The question arises whether the clinical studies have represented adequate tests, by laboratory standards, of the likely effectiveness of the drug in clinical circumstances. The clinical studies with hydroxyurea have been examined in this light, since the results might also bear on the use of many other such agents in combination therapy. This examination revealed that no attempts have been made to determine the concentration of hydroxyurea in the tumor and other relevant tissues as a function of time or to assess the cell kinetic features of the tumor and thus estimate the appropriate dose regimen. It would seem that a wide gap still exists between laboratory research and clinical application

Clinical application of urodilatin in Type 2 diabetic nephropathy

International Nuclear Information System (INIS)

Zhu Yihua; Cao Xingjian; Chen Yuxiang; Zhang Kexia; Jin Yan

2011-01-01

Objective: To investigate the clinical application of urodilatin (URO) in tubular injury of DM2. Methods: 41 healthy controls, 33 type 2 diabetics without nephropathy, 37 patients with early stage of diabetic nephropathy and 26 patients with clinical diabetic nephropathy were enrolled in the study and categorized into four groups. Urodilatin was measured by radioimmunoassay (RIA). The changes of urodilatin levels among four groups were analyzed, and correlation analyses were performed between urodilatin and urinary micro-albumin/urine creatinine(mA/UCr). The efficiency index of URO were evaluated by receiver operation characteristic (ROC). Results: Compared with those in the controls,diabetics without nephropathy, early stage of diabetic nephropathy and clinical diabetic nephropathy, the urodilatin level decreased significantly in the course of diabetic nephropathy (P<0.001). The value of URO was significantly correlated with mA/UCr (r=-0.626, P<0.01). In early phase of DM2, The area under curve was 0.759. When the cut-off vaule of URO was ≤51.5 pg/ml, The sensitivity and specificity were 67.14% and 70.29%, respectively. Furthermore, Urodilatin had similar diagnosis efficiency with mA/UCr. Conclusion: The decrease of urodilatin level had clinical value in pristine tubular injury of DM2 and can serve as an evaluation parameter. (authors)

The clinical application of mobile technology to disaster medicine.

Science.gov (United States)

Case, Timothy; Morrison, Cecily; Vuylsteke, Alain

2012-10-01

Mobile health care technology (mHealth) has the potential to improve communication and clinical information management in disasters. This study reviews the literature on health care and computing published in the past five years to determine the types and efficacy of mobile applications available to disaster medicine, along with lessons learned. Five types of applications are identified: (1) disaster scene management; (2) remote monitoring of casualties; (3) medical image transmission (teleradiology); (4) decision support applications; and (5) field hospital information technology (IT) systems. Most projects have not yet reached the deployment stage, but evaluation exercises show that mHealth should allow faster processing and transport of patients, improved accuracy of triage and better monitoring of unattended patients at a disaster scene. Deployments of teleradiology and field hospital IT systems to disaster zones suggest that mHealth can improve resource allocation and patient care. The key problems include suitability of equipment for use in disaster zones and providing sufficient training to ensure staff familiarity with complex equipment. Future research should focus on providing unbiased observations of the use of mHealth in disaster medicine.

Clinical applications of Gallium-68

International Nuclear Information System (INIS)

Banerjee, Sangeeta Ray; Pomper, Martin G.

2013-01-01

Gallium-68 is a positron-emitting radioisotope that is produced from a 68 Ge/ 68 Ga generator. As such it is conveniently used, decoupling radiopharmacies from the need for a cyclotron on site. Gallium-68-labeled peptides have been recognized as a new class of radiopharmaceuticals showing fast target localization and blood clearance. 68 Ga-DOTATOC, 8 Ga-DOTATATE, 68 Ga-DOTANOC, are the most prominent radiopharmaceuticals currently in use for imaging and differentiating lesions of various somatostatin receptor subtypes, overexpressed in many neuroendocrine tumors. There has been a tremendous increase in the number of clinical studies with 68 Ga over the past few years around the world, including within the United States. An estimated ∼10,000 scans are being performed yearly in Europe at about 100 centers utilizing 68 Ga-labeled somatostatin analogs within clinical trials. Two academic sites within the US have also begun to undertake human studies. This review will focus on the clinical experience of selected, well-established and recently applied 68 Ga-labeled imaging agents used in nuclear medicine. - Highlights: ► A summary of the emerging clinical uses of 68 Ga-based radiopharmaceuticals is provided. ► 68 Ga-PET may prove as or more clinically robust than the corresponding 18 F-labeled agents. ► 68 Ga-radiopeptides were studied for targeting of somatostatin receptors subtypes. ► 68 Ga-DOTATOC, 68 Ga-DOTATATE, 68 Ga-DOTANOC, are currently in clinical trials

Approaches using molecular imaging technology -- use of PET in clinical microdose studies.

Science.gov (United States)

Wagner, Claudia C; Langer, Oliver

2011-06-19

Positron emission tomography (PET) imaging uses minute amounts of radiolabeled drug tracers and thereby meets the criteria for clinical microdose studies. The advantage of PET, when compared to other analytical methods used in microdose studies, is that the pharmacokinetics (PK) of a drug can be determined in the tissue targeted for drug treatment. PET microdosing already offers interesting applications in clinical oncology and in the development of central nervous system pharmaceuticals and is extending its range of application to many other fields of pharmaceutical medicine. Although requirements for preclinical safety testing for microdose studies have been cut down by regulatory authorities, radiopharmaceuticals increasingly need to be produced under good manufacturing practice (GMP) conditions, which increases the costs of PET microdosing studies. Further challenges in PET microdosing include combining PET with other ultrasensitive analytical methods, such as accelerator mass spectrometry (AMS), to gain plasma PK data of drugs, beyond the short PET examination periods. Finally, conducting clinical PET studies with radiolabeled drugs both at micro- and therapeutic doses is encouraged to answer the question of dose linearity in clinical microdosing. Copyright © 2010 Elsevier B.V. All rights reserved.

Diffusion weighted imaging of female pelvic cancers: Concepts and clinical applications

International Nuclear Information System (INIS)

Punwani, Shonit

2011-01-01

Early applications of diffusion weighted magnetic resonance imaging (DWI) were limited to neuroimaging, concentrating either on stroke or brain tumours. With recent advances in MRI hardware and software DWI is now increasingly being investigated for cancer assessment throughout the body. Clinical applications of DWI relating to female pelvic cancers have largely concentrated on detection, localisation and staging of disease. More recently investigators have started to evaluate the ability of DWI for determining tumour histology and even predicting the outcome of chemoradiation treatment. This article reviews the physical concepts of MR diffusion weighting, illustrates the biophysical basis of diffusion contrast and reports the clinical applications of DWI for cervical, endometrial, ovarian, rectal and bladder tumours.

Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

Science.gov (United States)

Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

2018-04-20

Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

CT colonography after colostomy - clinical application and technical feasibility

International Nuclear Information System (INIS)

Nedevska, A.

2013-01-01

Full text:Introduction: The aim of this study was to evaluate the clinical application and technical implementation of computed tomographic (CT ) colonoscopy in patients undergoing sigmoid or rectal resection and following sigmoid colostomy in the course of standard diagnostic postoperative follow-up and prior to the reconstructive colon surgery. Materials and Methods: The study included 48 patients who underwent anterior abdomen-perineal or rectal resection and subsequent sigmoid colostomy in case of sigma or rectum carcinoma. The pre-procedure bowel preparation included a full colon cleansing and barium-based fecal tagging. The balloon catheter (18 F) is placed in the colonic stoma. The balloon is insufflated with 15-30 ml saline or air. The balloon was gently pulled until opening of the stoma has been closed completely. In 15 patients, a second catheter was placed in the remaining rectum. Contrast scanning in supination was done for all patients. An additional scanning in left and right lateral position was necessary for 9 patients. Results: All studies were carried out without any major complications. All patients tolerated the intubation and insufflation of air into the intestinal lumen. Two patients (4%) have evaluated the examination as uncomfortable. In 6 patients (12.5 %) it was impossible to evaluate the intestinal segments because due to a collapse of the wall. Five of them were localized in the descending colon. In 5 patients there was a significant amount of residual intestinal contents. The fecal tagging and intravenous contrast enhancing allowed the assessment of these intestinal segments. The rectal residue was correctly assessed in all patients in terms of length, position and wall changes. Conclusion: CT colonoscopy is applicable after sigmostoma in patients with abdomen-perineal and anterior rectal resection. Further in-depth studies are needed to determine the clinical indications and reliability of the method

Incorporating uncertainty regarding applicability of evidence from meta-analyses into clinical decision making.

Science.gov (United States)

Kriston, Levente; Meister, Ramona

2014-03-01

Judging applicability (relevance) of meta-analytical findings to particular clinical decision-making situations remains challenging. We aimed to describe an evidence synthesis method that accounts for possible uncertainty regarding applicability of the evidence. We conceptualized uncertainty regarding applicability of the meta-analytical estimates to a decision-making situation as the result of uncertainty regarding applicability of the findings of the trials that were included in the meta-analysis. This trial-level applicability uncertainty can be directly assessed by the decision maker and allows for the definition of trial inclusion probabilities, which can be used to perform a probabilistic meta-analysis with unequal probability resampling of trials (adaptive meta-analysis). A case study with several fictitious decision-making scenarios was performed to demonstrate the method in practice. We present options to elicit trial inclusion probabilities and perform the calculations. The result of an adaptive meta-analysis is a frequency distribution of the estimated parameters from traditional meta-analysis that provides individually tailored information according to the specific needs and uncertainty of the decision maker. The proposed method offers a direct and formalized combination of research evidence with individual clinical expertise and may aid clinicians in specific decision-making situations. Copyright © 2014 Elsevier Inc. All rights reserved.

Clinical applications of SPECT/CT: advantages and limitations

International Nuclear Information System (INIS)

Rigo, P.

2006-01-01

The application of hybrid SPECT cameras in Nuclear Medicine follows the revolutionary introduction of PET/CT. This review focuses on the advantages and limitations of SPECT/CT in its various clinical indications. It appears that SPECT/CT will be a clear factor of progress for Nuclear Medicine. (author)

Leverage hadoop framework for large scale clinical informatics applications.

Science.gov (United States)

Dong, Xiao; Bahroos, Neil; Sadhu, Eugene; Jackson, Tommie; Chukhman, Morris; Johnson, Robert; Boyd, Andrew; Hynes, Denise

2013-01-01

In this manuscript, we present our experiences using the Apache Hadoop framework for high data volume and computationally intensive applications, and discuss some best practice guidelines in a clinical informatics setting. There are three main aspects in our approach: (a) process and integrate diverse, heterogeneous data sources using standard Hadoop programming tools and customized MapReduce programs; (b) after fine-grained aggregate results are obtained, perform data analysis using the Mahout data mining library; (c) leverage the column oriented features in HBase for patient centric modeling and complex temporal reasoning. This framework provides a scalable solution to meet the rapidly increasing, imperative "Big Data" needs of clinical and translational research. The intrinsic advantage of fault tolerance, high availability and scalability of Hadoop platform makes these applications readily deployable at the enterprise level cluster environment.

Coleopteran Antimicrobial Peptides: Prospects for Clinical Applications

Directory of Open Access Journals (Sweden)

Monde Ntwasa

2012-01-01

Full Text Available Antimicrobial peptides (AMPs are activated in response to septic injury and have important roles in vertebrate and invertebrate immune systems. AMPs act directly against pathogens and have both wound healing and antitumor activities. Although coleopterans comprise the largest and most diverse order of eukaryotes and occupy an earlier branch than Drosophila in the holometabolous lineage of insects, their immune system has not been studied extensively. Initial research reports, however, indicate that coleopterans possess unique immune response mechanisms, and studies of these novel mechanisms may help to further elucidate innate immunity. Recently, the complete genome sequence of Tribolium was published, boosting research on coleopteran immunity and leading to the identification of Tribolium AMPs that are shared by Drosophila and mammals, as well as other AMPs that are unique. AMPs have potential applicability in the development of vaccines. Here, we review coleopteran AMPs, their potential impact on clinical medicine, and the molecular basis of immune defense.

Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility.

Science.gov (United States)

da Silva, Marcos Barragan; Almeida, Miriam de Abreu; Panato, Bruna Paulsen; Siqueira, Ana Paula de Oliveira; da Silva, Mariana Palma; Reisderfer, Letícia

2015-01-01

to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context.

Approaches using molecular imaging technology - use of PET in clinical microdose studies§

Science.gov (United States)

Wagner, Claudia C; Langer, Oliver

2013-01-01

Positron emission tomography (PET) imaging uses minute amounts of radiolabeled drug tracers and thereby meets the criteria for clinical microdose studies. The advantage of PET, when compared to other analytical methods used in microdose studies, is that the pharmacokinetics (PK) of a drug can be determined in the tissue targeted for drug treatment. PET microdosing already offers interesting applications in clinical oncology and in the development of central nervous system pharmaceuticals and is extending its range of application to many other fields of pharmaceutical medicine. Although requirements for preclinical safety testing for microdose studies have been cut down by regulatory authorities, radiopharmaceuticals increasingly need to be produced under good manufacturing practice (GMP) conditions, which increases the costs of PET microdosing studies. Further challenges in PET microdosing include combining PET with other ultrasensitive analytical methods, such as accelerator mass spectrometry (AMS), to gain plasma PK data of drugs, beyond the short PET examination periods. Finally, conducting clinical PET studies with radiolabeled drugs both at micro- and therapeutic doses is encouraged to answer the question of dose linearity in clinical microdosing. PMID:20887762

Nuclear medicine imaging in clinical practice: Current applications and future trends

International Nuclear Information System (INIS)

Galli, G.; Maini, C.L.

1985-01-01

The following conclusions can be drawn: 1) Even though developments in data digitalization enable also other imaging techniques to extract functional information, it is likely that nuclear medicine will keep and possibly increase its key role for functional studies requiring quantitative data analyses. This statement is true at present and it will probably remain true for a long time to come. 2) Nuclear medicine is and will remain an important clinical tool also for morphological or morphodynamic studies in selected situations. Of course the integration of nuclear medicine studies with other diagnostic procedures is highly desirable. The highest clinical yield of multi-test diagnostic protocols will be anyway obtained by the wisest physician as sophysticated technology is no substitution for intelligent clinical judgment. 3) The development of new radiopharmaceuticals with well characterized biokinetic features allowing precise tissue characterization opens new frontiers to be exploited by nuclear medicine centers equipped with conventional technology (digital gammacameras, SPECT). 4) Positron emission tomography is the most important new development of nuclear medicine imaging. Not only PET has already shown its enormous possibilities for physiological and pathophysiological studies, but the clinical relevance of selected applications has been proved. More experience is however needed to assess systematically the whole impact of PET studies in clinical practice and to perform dependable cost/benefit studies. 5) Among all other imaging techniques NMR is the closest to nuclear medicine because of a strict ''compatibility of aptitudes, training and methodology'' (4). Accordingly future improvements of both methods will be better achieved if they could be integrated and the results compared with the same institutions

Platelet Immunology in China: Research and Clinical Applications.

Science.gov (United States)

Wu, Guoguang; Zhou, Yan; Li, Lilan; Zhong, Zhoulin; Li, Hengchong; Li, Haiyan; Yu, Mei; Shen, Weidong; Ni, Heyu

2017-04-01

Immunization against human platelet alloantigens (HPAs) is associated with a number of clinical complications. The detection and identification of clinically relevant platelet antibodies are important for the diagnosis and management of patients affected with immune-mediated thrombocytopenias. Human platelet alloantigen frequencies and the characteristics of antiplatelet antibodies vary widely between ethnic groups. Since 2008, the importance of platelet immunology in the field of transfusion medicine has gained greater recognition by clinical laboratories in China. Laboratories in China have established and improved methods for platelet antibody detection and HPA genotyping techniques, which are used for the diagnosis of alloimmune platelet disorders in clinic and research environments. Research has revealed the frequencies of HPA alleles in different Chinese ethnic groups and compared the differences in HPA gene frequencies between the Chinese Han and other ethnic groups of the world. Production of anti-CD36 isoantibodies is an important risk factor for immune-mediated thrombocytopenia in the Chinese population. Advances in research and clinical application of platelet immunology have significantly improved the clinical diagnosis, treatment including transfusion support, and prevention of alloimmune platelet disorders in the Chinese population. Copyright © 2017. Published by Elsevier Inc.

Closing the gap between knowledge and clinical application: challenges for genomic translation.

Science.gov (United States)

Burke, Wylie; Korngiebel, Diane M

2015-01-01

Despite early predictions and rapid progress in research, the introduction of personal genomics into clinical practice has been slow. Several factors contribute to this translational gap between knowledge and clinical application. The evidence available to support genetic test use is often limited, and implementation of new testing programs can be challenging. In addition, the heterogeneity of genomic risk information points to the need for strategies to select and deliver the information most appropriate for particular clinical needs. Accomplishing these tasks also requires recognition that some expectations for personal genomics are unrealistic, notably expectations concerning the clinical utility of genomic risk assessment for common complex diseases. Efforts are needed to improve the body of evidence addressing clinical outcomes for genomics, apply implementation science to personal genomics, and develop realistic goals for genomic risk assessment. In addition, translational research should emphasize the broader benefits of genomic knowledge, including applications of genomic research that provide clinical benefit outside the context of personal genomic risk.

The Need for Clinical Decision Support Integrated with the Electronic Health Record for the Clinical Application of Whole Genome Sequencing Information

Directory of Open Access Journals (Sweden)

Brandon M. Welch

2013-12-01

Full Text Available Whole genome sequencing (WGS is rapidly approaching widespread clinical application. Technology advancements over the past decade, since the first human genome was decoded, have made it feasible to use WGS for clinical care. Future advancements will likely drive down the price to the point wherein WGS is routinely available for care. However, were this to happen today, most of the genetic information available to guide clinical care would go unused due to the complexity of genetics, limited physician proficiency in genetics, and lack of genetics professionals in the clinical workforce. Furthermore, these limitations are unlikely to change in the future. As such, the use of clinical decision support (CDS to guide genome-guided clinical decision-making is imperative. In this manuscript, we describe the barriers to widespread clinical application of WGS information, describe how CDS can be an important tool for overcoming these barriers, and provide clinical examples of how genome-enabled CDS can be used in the clinical setting.

TU-AB-207-03: Tomosynthesis: Clinical Applications

Energy Technology Data Exchange (ETDEWEB)

Maidment, A. [Univ Pennsylvania (United States)

2015-06-15

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis.

TU-AB-207-03: Tomosynthesis: Clinical Applications

International Nuclear Information System (INIS)

Maidment, A.

2015-01-01

Digital Tomosynthesis (DT) is becoming increasingly common in breast imaging and many other applications. DT is a form of computed tomography in which a limited set of projection images are acquired over a small angular range and reconstructed into a tomographic data set. The angular range and number of projections is determined both by the imaging task and equipment manufacturer. For example, in breast imaging between 9 and 25 projections are acquired over a range of 15° to 60°. It is equally valid to treat DT as the digital analog of classical tomography - for example, linear tomography. In fact, the name “tomosynthesis” is an acronym for “synthetic tomography”. DT shares many common features with classical tomography, including the radiographic appearance, dose, and image quality considerations. As such, both the science and practical physics of DT systems is a hybrid between CT and classical tomographic methods. This lecture will consist of three presentations that will provide a complete overview of DT, including a review of the fundamentals of DT, a discussion of testing methods for DT systems, and a description of the clinical applications of DT. While digital breast tomosynthesis will be emphasized, analogies will be drawn to body imaging to illustrate and compare tomosynthesis methods. Learning Objectives: To understand the fundamental principles behind tomosynthesis, including the determinants of image quality and dose. To learn how to test the performance of tomosynthesis imaging systems. To appreciate the uses of tomosynthesis in the clinic and the future applications of tomosynthesis

Clinical applications of contrast echocardiography

International Nuclear Information System (INIS)

Jorge, Leon Galindo

2005-01-01

The echocardiography is the technique more used for the diagnosis and pursuit of the cardiovascular illnesses; therefore, their diagnostic precision has acquired a vital importance in the handling of the patients with cardiovascular pathologies. However, with relative frequency, the diagnostic capacity of the echocardiography exam is diminished by limitations of the acoustic window, mainly in-patient with obesity, lung illnesses and alterations of the thoracic wall. This can be obviated with the use of the intra-esophagus echocardiography, although this it is a procedure semi-invasive and not very practical of carrying out in all the patients with problems of acoustic window. In this article the clinical applications are revised more common of the contrast echocardiography

Bioethics of Clinical Applications of Stem Cells.

Science.gov (United States)

Petrini, Carlo

2017-04-12

The clinical applications of stem cells pose a multitude of problems, including safety, efficacy, information and consent, the right to unproven treatments, the "right to try", costs, access, sustainability, scientific scrupulousness, patents and regulatory aspects, to name but a few. This article does not address individual issues, but rather introduces and discusses some of the possible approaches to solving the problems. The first part compares the consequentialist and deontological approaches, offering an overview of "top-down" and "bottom-up" models and proposing the principles of personalism as applied in clinical settings. The second part of the article suggests practical frameworks for organising the ethical issues, focusing in particular on the medical indications, patient preferences, quality of life, and contextual features.

Immunoregulation by Mesenchymal Stem Cells: Biological Aspects and Clinical Applications

Science.gov (United States)

Castro-Manrreza, Marta E.; Montesinos, Juan J.

2015-01-01

Mesenchymal stem cells (MSCs) are multipotent cells capable of differentiation into mesenchymal lineages and that can be isolated from various tissues and easily cultivated in vitro. Currently, MSCs are of considerable interest because of the biological characteristics that confer high potential applicability in the clinical treatment of many diseases. Specifically, because of their high immunoregulatory capacity, MSCs are used as tools in cellular therapies for clinical protocols involving immune system alterations. In this review, we discuss the current knowledge about the capacity of MSCs for the immunoregulation of immunocompetent cells and emphasize the effects of MSCs on T cells, principal effectors of the immune response, and the immunosuppressive effects mediated by the secretion of soluble factors and membrane molecules. We also describe the mechanisms of MSC immunoregulatory modulation and the participation of MSCs as immune response regulators in several autoimmune diseases, and we emphasize the clinical application in graft versus host disease (GVHD). PMID:25961059

Clinical application of Chamomilla recutita in phlebitis: dose response curve study.

Science.gov (United States)

Reis, Paula Elaine Diniz Dos; Carvalho, Emilia Campos de; Bueno, Paula Carolina Pires; Bastos, Jairo Kenupp

2011-01-01

This experimental and dose-response curve study aimed to carry out the quality control of the Chamomilla recutita sample, as well as to estimate the ideal dose, for anti-inflammatory effect, of the extract of its capitula, in patients with phlebitis due to peripheral intravenous infusion of antineoplastic chemotherapy and to evaluate the toxicity of this extract in human beings. The therapeutic efficacy, concerning the anti-inflammatory potential, of different doses of Chamomilla recutita extract were analyzed and compared in 25 patients. The time of regression of phlebitis was shorter for groups with 2.5% concentration (mean=29.2h, standard deviation = 8.98) and 5% concentration (mean = 38.8h, standard deviation = 17.47). Local toxicity was almost not observed. This research contributes to the innovation of the nursing clinical practice, since it suggests an alternative for the treatment of phlebitis through the clinical use of phytotherapeutic drugs.

Radio sterilized human ligaments and their clinical application

International Nuclear Information System (INIS)

Luna Z, D.; Reyes F, M. L.; Diaz M, I.; Hernandez R, G.

2009-10-01

The ligaments are human tissues that are used in the transplantation area. A ligament is an anatomical structure in band form, composed by resistant fibers that connect the tissues that unite the bones with the articulations. In an articulation, the ligaments allow and facilitate the movement inside the natural anatomical directions, while it restricts those movements that are anatomically abnormal, impeding lesions that could arise of this type of movements. The kneecap ligament is a very important tissue in the knee mobility and of walking in the human beings. This ligament can injure it because of automobile accidents, for sport lesions or illnesses, and in many cases the only form of recovering the knee movement is carried out a transplant with the purpose of replacing the damage ligament by allo gen kneecap ligament processed in specialized Tissue Banks where the tissue is sterilized with gamma radiation of 60 Co at very low temperatures, obtaining high quality ligaments for clinical application in injured patients. The kneecap ligaments are processed in the Tissue Banks with a segment of kneecap bone, a segment of tibial bone, the contained ligament between both bones and in some cases a fraction of the quadriceps tendon. In this work is given a description of the selection method of the tissue that includes the donor's serologic control, the kneecap ligament processing in the Radio Sterilized Tissues Bank, its sterilization with gamma radiation of 60 Co, also it is indicated like the clinical application of the allo gen ligament was realized in a hasty patient and whose previous crossed ligament was injured. Finally the results are presented from the tissue obtaining until the clinical application of it is, and in this case is observed a favorable initial evolution of the transplantation patient. (Author)

[Clinical applications of dosing algorithm in the predication of warfarin maintenance dose].

Science.gov (United States)

Huang, Sheng-wen; Xiang, Dao-kang; An, Bang-quan; Li, Gui-fang; Huang, Ling; Wu, Hai-li

2011-12-27

To evaluate the feasibility of clinical application for genetic based dosing algorithm in the predication of warfarin maintenance dose in Chinese population. The clinical data were collected and blood samples harvested from a total of 126 patients undergoing heart valve replacement. The genotypes of VKORC1 and CYP2C9 were determined by melting curve analysis after PCR. They were divided randomly into the study and control groups. In the study group, the first three doses of warfarin were prescribed according to the predicted warfarin maintenance dose while warfarin was initiated at 2.5 mg/d in the control group. The warfarin doses were adjusted according to the measured international normalized ratio (INR) values. And all subjects were followed for 50 days after an initiation of warfarin therapy. At the end of a 50-day follow-up period, the proportions of the patients on a stable dose were 82.4% (42/51) and 62.5% (30/48) for the study and control groups respectively. The mean durations of reaching a stable dose of warfarin were (27.5 ± 1.8) and (34.7 ± 1.8) days and the median durations were (24.0 ± 1.7) and (33.0 ± 4.5) days in the study and control groups respectively. Significant differences existed in the durations of reaching a stable dose between the two groups (P = 0.012). Compared with the control group, the hazard ratio (HR) for the duration of reaching a stable dose was 1.786 in the study group (95%CI 1.088 - 2.875, P = 0.026). The predicted dosing algorithm incorporating genetic and non-genetic factors may shorten the duration of achieving efficiently a stable dose of warfarin. And the present study validates the feasibility of its clinical application.

Genome Editing with Crispr-Cas9 Systems: Basic Research and Clinical Applications

Directory of Open Access Journals (Sweden)

Anna Meiliana

2017-04-01

Full Text Available BACKGROUND: Recently established genome editing technologies will open new avenues for biological research and development. Human genome editing is a powerful tool which offers great scientific and therapeutic potential. CONTENT: Genome editing using the clustered regularly interspaced short palindromic repeats (CRISPR/CRISPRassociated protein 9 (Cas9 technology is revolutionizing the gene function studies and possibly will give rise to an entirely new degree of therapeutics for a large range of diseases. Prompt advances in the CRISPR/Cas9 technology, as well as delivery modalities for gene therapy applications, are dismissing the barriers to the clinical translation of this technology. Many studies conducted showed promising results, but as current available technologies for evaluating off-target gene modification, several elements must be addressed to validate the safety of the CRISPR/Cas9 platform for clinical application, as the ethical implication as well. SUMMARY: The CRISPR/Cas9 system is a powerful genome editing technology with the potential to create a variety of novel therapeutics for a range of diseases, many of which are currently untreatable. KEYWORDS: genome editing, CRISPR-Cas, guideRNA, DSB, ZFNs, TALEN

DEVELOPING AN IPAD® APPLICATION FOR DATA COLLECTION IN A RHEUMATOLOGY RESEARCH CLINIC.

Science.gov (United States)

Kaka, Hussam; Ayearst, Renise; Tran, Maithy; Touma, Zahi; Bagovich, Maria; Vinik, Ophir; Somaily, Mansour; Haddad, Amir; Gladman, Dafna D; Chandran, Vinod

2015-01-01

Clinical research data are often collected on paper and later inputted onto an electronic database. This method is time consuming and potentially introduces errors. Therefore, to make primary data collection more efficient and less error prone we aimed to develop a touch-screen application for data collection in a psoriatic arthritis research clinic and compared it with the pre-existing paper-based system. We developed a Web application using Java and optimized it for the iPad®. It highlights missing fields for physicians in real time, and only permits submission of data collection form after corrections are made. For its evaluation, seven physicians participated, and before each patient visit they were randomly assigned paper or iPad® data entry. Number of errors, length of visit, and time between clinic visit and completion of data entry were measured. A total of 106 patients seen in the clinic who agreed to participate were randomly assigned to be evaluated by clinic physicians using the iPad® (fifty-three patients) or a paper protocol (fifty-three patients). On average, 3.34 omissions were found per paper form, of which 2.24 would have been detected on the iPad®. The iPad® increased the mean patient encounter time from 37.2 minutes to 46.5 minutes, but eliminated delay between a clinic visit and its data entry. Entering data using the iPad® application makes the patient encounter slightly longer, but reduces "missing fields." It also eliminates the delay between clinic visit and data entry thus improving the efficiency of clinical data capture in a research setting.

There’s an App for That? Highlighting the Difficulty in Finding Clinically Relevant Smartphone Applications

Directory of Open Access Journals (Sweden)

Warren Wiechmann, MD, MBA

2016-03-01

Full Text Available Introduction: The use of personal mobile devices in the medical field has grown quickly, and a large proportion of physicians use their mobile devices as an immediate resource for clinical decisionmaking, prescription information and other medical information. The iTunes App Store (Apple, Inc. contains approximately 20,000 apps in its “Medical” category, providing a robust repository of resources for clinicians; however, this represents only 2% of the entire App Store. The App Store does not have strict criteria for identifying content specific to practicing physicians, making the identification of clinically relevant content difficult. The objective of this study is to quantify the characteristics of existing medical applications in the iTunes App Store that could be used by emergency physicians, residents, or medical students. Methods: We found applications related to emergency medicine (EM by searching the iTunes App Store for 21 terms representing core content areas of EM, such as “emergency medicine,” “critical care,” “orthopedics,” and “procedures.” Two physicians independently reviewed descriptions of these applications in the App Store and categorized each as the following: Clinically Relevant, Book/ Published Source, Non-English, Study Tools, or Not Relevant. A third physician reviewer resolved disagreements about categorization. Descriptive statistics were calculated. Results: We found a total of 7,699 apps from the 21 search terms, of which 17.8% were clinical, 9.6% were based on a book or published source, 1.6% were non-English, 0.7% were clinically relevant patient education resources, and 4.8% were study tools. Most significantly, 64.9% were considered not relevant to medical professionals. Clinically relevant apps make up approximately 6.9% of the App Store’s “Medical” Category and 0.1% of the overall App Store. Conclusion: Clinically relevant apps represent only a small percentage (6.9% of the total App

Neurorestorative clinical application standards for the culture and quality control of olfactory ensheathing cells

Directory of Open Access Journals (Sweden)

Xiao J

2017-09-01

Full Text Available Juan Xiao,1,2 Lin Chen,3 Gengsheng Mao,1 Wenyong Gao,1,2 Ming Lu,4 Xijing He,5 Hongyun Huang1,2 On behalf of the Neurorestoratology Professional Committee of Chinese Medical Doctors Association (Chinese Association of Neurorestoratology 1Institute of Neurorestoratology, The General Hospital of Chinese People’s Armed Police Forces, Beijing, People’s Republic of China; 2Cell Therapy Center, Beijing Hongtianji Neuroscience Academy, Beijing, People’s Republic of China; 3Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing, People’s Republic of China; 4Department of Neurosurgery, 163 Hospital of PLA (Second Affiliated Hospital of Hunan Normal University, Changsha, Hunan Province, People’s Republic of China; 5Department of Orthopedics, Second Affiliated Hospital of Xi’an Jiaotong University, Xian, Shanxi Provine, People’s Republic of China Abstract: Olfactory ensheathing cells (OECs are a novel type of glial cell that can perform and promote many neurorestorative processes in vivo after transplant. To date, dozens of preclinical and clinical studies have confirmed that OECs have unique restoring effects in animal models and human subjects with neurological degeneration or damage, such as spinal cord injury, stroke, cerebral palsy, traumatic brain injury, and motor neuron disease (amyotrophic lateral sclerosis. To ensure the safety and effectiveness of clinical applications utilizing this type of cell, it is important to standardize cell-culture and quality-control processes. Based on a comprehensive review of published clinical studies, as well as existing methods of OEC culture and quality control currently utilized by hospitals and biomedical enterprises, the Chinese Association of Neurorestoratology has developed a set of standards for the culture and quality control of olfactory ensheathing cells for use in clinical applications. These guidelines include standardized training and management procedures for

Depth dose curves from 90Sr+90Y clinical applicators using the thermoluminescent technique

International Nuclear Information System (INIS)

Antonio, Patricia L.; Caldas, Linda V.E.; Oliveira, Mercia L.

2009-01-01

The 90 Sr+ 90 Y beta-ray sources widely used in brachytherapy applications were developed in the 1950's. Many of these sources, called clinical applicators, are still routinely used in several Brazilian radiotherapy clinics for the treatment of superficial lesions in the skin and eyes, although they are not commercialized anymore. These applicators have to be periodically calibrated, according to international recommendations, because these sources have to be very well specified in order to reach the traceability of calibration standards. In the case of beta-ray sources, the recommended quantity is the absorbed dose rate in water at a reference distance from the source. Moreover, there are other important quantities, as the depth dose curves and the source uniformity for beta-ray plaque sources. In this work, depth dose curves were obtained and studied of five dermatological applicators, using thin thermoluminescent dosimeters of CaSO 4 :Dy and phantoms of PMMA with different thicknesses (between 1.0 mm and 5.0 mm) positioned between each applicator and the TL pellets. The depth dose curves obtained presented the expected attenuation response in PMMA, and the results were compared with data obtained for a 90 Sr+ 90 Y standard source reported by the IAEA, and they were considered satisfactory. (author)

[Application of the Smoking Scale for Primary Care (ETAP) in clinical practice].

Science.gov (United States)

González Romero, M P; Cuevas-Fernández, F J; Marcelino-Rodríguez, I; Covas, V J; Rodríguez Pérez, M C; Cabrera de León, A; Aguirre-Jaime, A

2017-08-23

To determine if the ETAP smoking scale, which measures accumulated exposure to tobacco, both actively and passively, is applicable and effective in the clinical practice of Primary Care for the prevention of acute myocardial infarction (AMI). Location Barranco Grande Health Centre in Tenerife, Spain. A study of 61 cases (AMI) and 144 controls. Sampling with random start, without matching. COR-II curves were analysed, and effectiveness was estimated using sensitivity and negative predictive value (NPV). A questionnaire was provided to participating family physicians on the applicability of ETAP in the clinic. The opinion of the participating physicians was unanimously favourable. ETAP was easy to use in the clinic, required less than 3min per patient, and was useful to reinforce the preventive intervention. The ETAP COR-II curve showed that 20years of exposure was the best cut-off point, with an area under the curve of 0.70 (95%CI: 0.62-0.78), and a combination of sensitivity (98%) and NPV (96%) for AMI. When stratifying age and gender, all groups achieved sensitivities and NPVs close to 100%, except for men aged ≥55years, in whom the NPV fell to 75%. The results indicate that ETAP is a valid tool that can be applied and be effective in the clinical practice of Primary Care for the prevention of AMI related to smoking exposure. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

[Application of three compartment model and response surface model to clinical anesthesia using Microsoft Excel].

Science.gov (United States)

Abe, Eiji; Abe, Mari

2011-08-01

With the spread of total intravenous anesthesia, clinical pharmacology has become more important. We report Microsoft Excel file applying three compartment model and response surface model to clinical anesthesia. On the Microsoft Excel sheet, propofol, remifentanil and fentanyl effect-site concentrations are predicted (three compartment model), and probabilities of no response to prodding, shaking, surrogates of painful stimuli and laryngoscopy are calculated using predicted effect-site drug concentration. Time-dependent changes in these calculated values are shown graphically. Recent development in anesthetic drug interaction studies are remarkable, and its application to clinical anesthesia with this Excel file is simple and helpful for clinical anesthesia.

Applications of stable isotopes of 2H, 13C and 15N to clinical problems

International Nuclear Information System (INIS)

Klein, P.D.; Szczepanik, P.A.; Hachey, D.L.

1974-01-01

The function of the Argonne Program is to provide synthetic, analytical instrumental capability in a core facility for the clinical investigator who needs to use 2 H, 13 C, or 15 N labelled compounds for metabolic or clinical research on pregnant women, newborn infants, young children, or for mass screening. To carry out such application development, there were six stages which were recurrent steps in every application. Five fundamental strategies should be adopted to establish the use of stable isotopes in clinical work. The instrument required for measurements was a combined gas chromatograph-mass spectrometer, and its use was schematically illustrated. Some of the successful experiences with compounds labelled by stable isotopes, such as deuterium labelled chenodeoxycholic acid, and respective 13 C and 15 N-labelled glycine were described. Deutrium labelled bile acid enabled easy and safe determination of the size of the bile acid pool and the replacement rate, providing clearer diagnoses for cholestatic liver disease and gallstones. 13 C and 15 N labelled compounds were used in clinical studies, of children with genetic disorders of amino acid metabolism, i.e., non ketotic hyperflycinemia, B 12 -responsive methyl malonic acidemia, and Lesch-Nyhan syndrome. 15 N-labelled glycine was also studied in a child with Lesch-Nyhan syndrome. (Mukohata, S.)

Dentin biomodification: strategies, renewable resources and clinical applications.

Science.gov (United States)

Bedran-Russo, Ana K; Pauli, Guido F; Chen, Shao-Nong; McAlpine, James; Castellan, Carina S; Phansalkar, Rasika S; Aguiar, Thaiane R; Vidal, Cristina M P; Napotilano, José G; Nam, Joo-Won; Leme, Ariene A

2014-01-01

The biomodification of dentin is a biomimetic approach, mediated by bioactive agents, to enhance and reinforce the dentin by locally altering the biochemistry and biomechanical properties. This review provides an overview of key dentin matrix components, targeting effects of biomodification strategies, the chemistry of renewable natural sources, and current research on their potential clinical applications. The PubMed database and collected literature were used as a resource for peer-reviewed articles to highlight the topics of dentin hierarchical structure, biomodification agents, and laboratorial investigations of their clinical applications. In addition, new data is presented on laboratorial methods for the standardization of proanthocyanidin-rich preparations as a renewable source of plant-derived biomodification agents. Biomodification agents can be categorized as physical methods and chemical agents. Synthetic and naturally occurring chemical strategies present distinctive mechanism of interaction with the tissue. Initially thought to be driven only by inter- or intra-molecular collagen induced non-enzymatic cross-linking, multiple interactions with other dentin components are fundamental for the long-term biomechanics and biostability of the tissue. Oligomeric proanthocyanidins show promising bioactivity, and their chemical complexity requires systematic evaluation of the active compounds to produce a fully standardized intervention material from renewable resource, prior to their detailed clinical evaluation. Understanding the hierarchical structure of dentin and the targeting effect of the bioactive compounds will establish their use in both dentin-biomaterials interface and caries management. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Guidelines for the Design and Conduct of Clinical Studies in Knee Articular Cartilage Repair

Science.gov (United States)

Mithoefer, Kai; Saris, Daniel B.F.; Farr, Jack; Kon, Elizaveta; Zaslav, Kenneth; Cole, Brian J.; Ranstam, Jonas; Yao, Jian; Shive, Matthew; Levine, David; Dalemans, Wilfried; Brittberg, Mats

2011-01-01

Objective: To summarize current clinical research practice and develop methodological standards for objective scientific evaluation of knee cartilage repair procedures and products. Design: A comprehensive literature review was performed of high-level original studies providing information relevant for the design of clinical studies on articular cartilage repair in the knee. Analysis of cartilage repair publications and synopses of ongoing trials were used to identify important criteria for the design, reporting, and interpretation of studies in this field. Results: Current literature reflects the methodological limitations of the scientific evidence available for articular cartilage repair. However, clinical trial databases of ongoing trials document a trend suggesting improved study designs and clinical evaluation methodology. Based on the current scientific information and standards of clinical care, detailed methodological recommendations were developed for the statistical study design, patient recruitment, control group considerations, study endpoint definition, documentation of results, use of validated patient-reported outcome instruments, and inclusion and exclusion criteria for the design and conduct of scientifically sound cartilage repair study protocols. A consensus statement among the International Cartilage Repair Society (ICRS) and contributing authors experienced in clinical trial design and implementation was achieved. Conclusions: High-quality clinical research methodology is critical for the optimal evaluation of current and new cartilage repair technologies. In addition to generally applicable principles for orthopedic study design, specific criteria and considerations apply to cartilage repair studies. Systematic application of these criteria and considerations can facilitate study designs that are scientifically rigorous, ethical, practical, and appropriate for the question(s) being addressed in any given cartilage repair research project

Diffusion Tensor Imaging: Application to the Study of the Developing Brain

Science.gov (United States)

Cascio, Carissa J.; Gerig, Guido; Piven, Joseph

2007-01-01

Objective: To provide an overview of diffusion tensor imaging (DTI) and its application to the study of white matter in the developing brain in both healthy and clinical samples. Method: The development of DTI and its application to brain imaging of white matter tracts is discussed. Forty-eight studies using DTI to examine diffusion properties of…

Prospect for application of umbilical cord blood to clinical treatment of radiation sickness

International Nuclear Information System (INIS)

Jia Tingzhen; Ke Xiaoyan

1998-01-01

Objective: To look forward to the prospect for application of umbilical cord blood to clinical treatment of radiation sickness by analyzing the results using umbilical cord blood in laboratory experiments and clinical research. Method: The data on umbilical cord blood published in literature are reviewed. Results: The umbilical blood is rich in hematopoietic stem/progenitor cells, low in immunological activity of lymphocytes, expanded significantly ex vivo under selected culture condition readily available and collected easily. Conclusion: With the above advantages, the prospect for application of umbilical cord blood is encouraging, particularly in the clinical treatment of radiation sickness

Clinical application of removable partial dentures using thermoplastic resin. Part II: Material properties and clinical features of non-metal clasp dentures.

Science.gov (United States)

Fueki, Kenji; Ohkubo, Chikahiro; Yatabe, Masaru; Arakawa, Ichiro; Arita, Masahiro; Ino, Satoshi; Kanamori, Toshikazu; Kawai, Yasuhiko; Kawara, Misao; Komiyama, Osamu; Suzuki, Tetsuya; Nagata, Kazuhiro; Hosoki, Maki; Masumi, Shin-ichi; Yamauchi, Mutsuo; Aita, Hideki; Ono, Takahiro; Kondo, Hisatomo; Tamaki, Katsushi; Matsuka, Yoshizo; Tsukasaki, Hiroaki; Fujisawa, Masanori; Baba, Kazuyoshi; Koyano, Kiyoshi; Yatani, Hirofumi

2014-04-01

This position paper reviews physical and mechanical properties of thermoplastic resin used for non-metal clasp dentures, and describes feature of each thermoplastic resin in clinical application of non-metal clasp dentures and complications based on clinical experience of expert panels. Since products of thermoplastic resin have great variability in physical and mechanical properties, clinicians should utilize them with careful consideration of the specific properties of each product. In general, thermoplastic resin has lower color-stability and higher risk for fracture than polymethyl methacrylate. Additionally, the surface of thermoplastic resin becomes roughened more easily than polymethyl methacrylate. Studies related to material properties of thermoplastic resin, treatment efficacy and follow-up are insufficient to provide definitive conclusions at this time. Therefore, this position paper should be revised based on future studies and a clinical guideline should be provided. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Clinical applications of cardiovascular magnetic resonance imaging

International Nuclear Information System (INIS)

Marcu, C.B.; Beek, A.M.; Van Rossum, A.C.

2006-01-01

Cardiovascular magnetic resonance imaging (MRI) has evolved from an effective research tool into a clinically proven, safe and comprehensive imaging modality. It provides anatomic and functional information in acquired and congenital heart disease and is the most precise technique for quantification of ventricular volumes, function and mass. Owing to its excellent interstudy reproducibility, cardiovascular MRI is the optimal method for assessment of changes in ventricular parameters after therapeutic intervention. Delayed contrast enhancement is an accurate and robust method used in the diagnosis of ischemic and nonischemic cardiomyopathies and less common diseases, such as cardiac sarcoidosis and myocarditis. First-pass magnetic contrast myocardial perfusion is becoming an alternative to radionuclide techniques for the detection of coronary atherosclerotic disease. In this review we outline the techniques used in cardiovascular MRI and discuss the most common clinical applications. (author)

Implementing a low-cost web-based clinical trial management system for community studies: a case study.

Science.gov (United States)

Geyer, John; Myers, Kathleen; Vander Stoep, Ann; McCarty, Carolyn; Palmer, Nancy; DeSalvo, Amy

2011-10-01

Clinical trials with multiple intervention locations and a single research coordinating center can be logistically difficult to implement. Increasingly, web-based systems are used to provide clinical trial support with many commercial, open source, and proprietary systems in use. New web-based tools are available which can be customized without programming expertise to deliver web-based clinical trial management and data collection functions. To demonstrate the feasibility of utilizing low-cost configurable applications to create a customized web-based data collection and study management system for a five intervention site randomized clinical trial establishing the efficacy of providing evidence-based treatment via teleconferencing to children with attention-deficit hyperactivity disorder. The sites are small communities that would not usually be included in traditional randomized trials. A major goal was to develop database that participants could access from computers in their home communities for direct data entry. Discussed is the selection process leading to the identification and utilization of a cost-effective and user-friendly set of tools capable of customization for data collection and study management tasks. An online assessment collection application, template-based web portal creation application, and web-accessible Access 2007 database were selected and customized to provide the following features: schedule appointments, administer and monitor online secure assessments, issue subject incentives, and securely transmit electronic documents between sites. Each tool was configured by users with limited programming expertise. As of June 2011, the system has successfully been used with 125 participants in 5 communities, who have completed 536 sets of assessment questionnaires, 8 community therapists, and 11 research staff at the research coordinating center. Total automation of processes is not possible with the current set of tools as each is loosely

Instructional Storytelling: Application of the Clinical Judgment Model in Nursing.

Science.gov (United States)

Timbrell, Jessica

2017-05-01

Little is known about the teaching and learning implications of instructional storytelling (IST) in nursing education or its potential connection to nursing theory. The literature establishes storytelling as a powerful teaching-learning method in the educational, business, humanities, and health sectors, but little exploration exists that is specific to nursing. An example of a story demonstrating application of the domains of Tanner's clinical judgment model links storytelling with learning outcomes appropriate for the novice nursing student. Application of Tanner's clinical judgment model offers consistency of learning experience while preserving the creativity inherent in IST. Further research into student learning outcomes achievement using IST is warranted as a step toward establishing best practices with IST in nursing education. [J Nurs Educ. 2017;56(5):305-308.]. Copyright 2017, SLACK Incorporated.

Clinical application analysis of 3D-CRT methods using tomography

Energy Technology Data Exchange (ETDEWEB)

Cho, Kang Chul; Kyum, Hun Kyum; Kim, Joo Ho; Ahn, Seung Kwon; Lee, Sang Kyoo; Yoon, Jong Won; Cho, Jeong Hee [Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul (Korea, Republic of); Lee, Jong Seok; Yoo, Beong Gyu [Dept. of Radiotechnology, Wonkwang Health Science University, Iksan (Korea, Republic of)

2013-12-15

This study investigates the case of clinical application for TomoDirect 3D-CRT(TD-3D) and TomoHelical 3D-CRT(TH-3D) with evaluating dose distribution for clinical application in each case. Treatment plans were created for 8 patients who had 3 dimensional conformal radiation therapy using TD-3D and TH-3D mode. Each patients were treated for sarcoma, CSI(craniospinal irradiation), breast, brain, pancreas, spine metastasis, SVC syndrome and esophagus. DVH(dose volume histogram) and isodose curve were used for comparison of each treatment modality. TD-3D shows better dose distribution over the irradiation field without junction effect because TD-3D was not influenced by target length for sarcoma and CSI case. In breast case, dosimetric results of CTV, the average value of D 99%, D 95% were 49.2±0.4 Gy, 49.9±0.4 Gy and V 105%, V 110% were 0%, respectively. TH-3D with the dosimetric block decreased dose of normal organ in brain, pancreas, spine metastasis case. SCV syndrome also effectively decreased dose of normal organ by using dose block to the critical organs(spinal cord <38 Gy). TH-3D combined with other treatment modalities was possible to boost irradiation and was total dose was reduced to spinal cord in esophagus case(spinal cord <45 Gy, lung V 20 <20%). 3D-CRT using Tomotherapy could overcomes some dosimetric limitations, when we faced Conventional Linac based CRT and shows clinically proper dose distribution. In conclusion, 3D-CRT using Tomotherapy will be one of the effective 3D-CRT techniques.

Medical Device Integrated Vital Signs Monitoring Application with Real-Time Clinical Decision Support.

Science.gov (United States)

Moqeem, Aasia; Baig, Mirza; Gholamhosseini, Hamid; Mirza, Farhaan; Lindén, Maria

2018-01-01

This research involves the design and development of a novel Android smartphone application for real-time vital signs monitoring and decision support. The proposed application integrates market available, wireless and Bluetooth connected medical devices for collecting vital signs. The medical device data collected by the app includes heart rate, oxygen saturation and electrocardiograph (ECG). The collated data is streamed/displayed on the smartphone in real-time. This application was designed by adopting six screens approach (6S) mobile development framework and focused on user-centered approach and considered clinicians-as-a-user. The clinical engagement, consultations, feedback and usability of the application in the everyday practices were considered critical from the initial phase of the design and development. Furthermore, the proposed application is capable to deliver rich clinical decision support in real-time using the integrated medical device data.

Clinical relevance of liquid chromatography tandem mass spectrometry as an analytical method in microdose clinical studies.

Science.gov (United States)

Yamane, Naoe; Tozuka, Zenzaburo; Kusama, Makiko; Maeda, Kazuya; Ikeda, Toshihiko; Sugiyama, Yuichi

2011-08-01

To investigate the potency of LC-MS/MS by means of sensitivity and the applicability for cassette dosing in microdose clinical trials. Thirty one top-selling 31 drugs were spiked to human plasma, extracted, and analyzed by LC-MS/MS. The lower limits of quantification for each drug varied from 0.08 to 50 pg/mL, and were lower than one eighth of the assumed maximum plasma concentration at microdose in all drugs except for losartan, indicating the high performance in acquisition of full pharmacokinetic profiles at microdose. We also succeeded in simultaneous analysis of multiple compounds, assuming a situation of cassette dosing in which multiple drug candidates would be administrated simultaneously. Together with the features of LC-MS/MS, such as immediate verification, the utilization of non-radiolabeled drugs and no special facilities, we suppose that LC-MS/MS analysis would be widely applicable in conducting microdose clinical studies.

Clinical application of positron emission tomography for diagnosis of dementia

International Nuclear Information System (INIS)

Ishii, Kazunari

2002-01-01

Clinical applications of PET studies for dementia are reviewed in this paper. At the mild and moderate stages of Alzheimer's disease (AD), glucose metabolism is reduced not only in the parietotemporal region but also in the posterior cingulate and precuneus. At the advanced stage of AD, there is also a metabolic reduction in the frontal region. In AD patients, glucose metabolism is relatively preserved in the pons, sensorimotor cortices, primary visual cortices, basal ganglia, thalamus and cerebellum. In patients with dementia with Lewy bodies, glucose metabolism in the primary visual cortices is reduced, and this reduction appears to be associated with the reduction pattern in AD patients. In patients with frontotemporal dementia, reduced metabolism in the frontotemporal region is the main feature of this disease, but reduced metabolism in the basal ganglia, and/or parietal metabolic reduction can be associated with the frontotemporal reduction. When corticobasal degeneration is associated with dementia, the reduction pattern of dementia is similar to the reduction pattern in AD and the hallmarks of diagnosing corticobasal degeneration associated with dementia are a reduced metabolism in the primary sensorimotor region and/or basal ganglia and an asymmetric reduction in the two hemispheres. FDG-PET is a very useful tool for the diagnosis of early AD and for the differential diagnosis of dementia. I also describe clinical applications of PET for the diagnosis of dementia in Japan. (author)

Some aspects of cancer biomarkers and their clinical application in solid tumors – revisited

Directory of Open Access Journals (Sweden)

Isaac D

2017-07-01

Full Text Available Cancer biomarkers can be used for a variety of purposes related to screening, prediction, stratification, detection, diagnosis, prognosis, treatment design, and monitoring of a therapeutic response. One of the most important characteristics of a given biomarker includes ease of collection allowing for a non-invasive approach and frequent sampling. Such samples may be obtained from serum or plasma, sputum, bronchoalveolar lavage, saliva, nipple discharge, pleural, or peritoneal effusions. Validation of different biomarkers is considered a mandatory method for useful evaluation. In this review, we highlight the clinical applicability of some cancer biomarkers, as well as future approaches for their development and collection, which may help guide clinicians and researchers. The role of liquid biopsies will also be summarized. Further studies using liquid biopsies are needed to elucidate the significance of various sources of biomarkers suitable for clinical application.

Study on veterinary stem cells advances and applications

OpenAIRE

Ribalaiga Pinyol, Núria

2016-01-01

Regenerative medicine refers to therapies that seek to restore the form and function of normal cells using the body's own biological machinery, as are stem cells. Since the first study succeeded in achieving pluripotent stem cells in 1981, the aim of the research has been changing diversely, from preclinical model in experimental studies for human diseases to clinical therapeutic applications in animals.

Epigenetics and allergy: from basic mechanisms to clinical applications.

Science.gov (United States)

Potaczek, Daniel P; Harb, Hani; Michel, Sven; Alhamwe, Bilal Alashkar; Renz, Harald; Tost, Jörg

2017-04-01

Allergic diseases are on the rise in the Western world and well-known allergy-protecting and -driving factors such as microbial and dietary exposure, pollution and smoking mediate their influence through alterations of the epigenetic landscape. Here, we review key facts on the involvement of epigenetic modifications in allergic diseases and summarize and critically evaluate the lessons learned from epigenome-wide association studies. We show the potential of epigenetic changes for various clinical applications: as diagnostic tools, to assess tolerance following immunotherapy or possibly predict the success of therapy at an early time point. Furthermore, new technological advances such as epigenome editing and DNAzymes will allow targeted alterations of the epigenome in the future and provide novel therapeutic tools.

On-site preparation of technetium-99m labeled human serum albumin for clinical application

International Nuclear Information System (INIS)

Wang Yuhfeng; Chuang Meihua; Cham Thauming; Chung Meiing; Chiu Jainnshiun

2007-01-01

Technetium-99m labeled human serum albumin (Tc-99m HSA) is an important radiopharmaceutical for clinical applications, such as cardiac function tests or protein-losing gastroenteropathy assessment. However, because of transfusion-induced infectious diseases, the safety of serum products is a serious concern. In this context, serum products acquired from patients themselves are the most ideal tracer. However, the development of rapid separation and easy clinical labeling methods is not yet well established. Under such situation, products from the same ethnic group or country are now recommended by the World Health Organization as an alternative preparation. This article describes the on-site preparation of Tc-99m HSA from locally supplied serum products. Different formulations were prepared and the labeling efficiency and stability were examined. Radio-labeling efficiencies were more than 90% in all preparation protocols, except for one that omitted the stannous solution. The most cost-effective protocol contained HSA 0.1 mg, treated with stannous fluoride 0.2 mg, and mixed with Tc-99m pertechnetate 30 mCi. A biodistribution study was performed in rats using a gamma camera immediately after intravenous administration of radiolabeled HSA. Tissue/organ uptake was obtained by measuring the radioactivity in organs after sacrificing the rats at timed intervals. The biologic half-life was about 32 min, determined from sequential venous blood collections. These data indicate that our preparation of Tc-99m HSA is useful and potentially applicable clinically. In addition, this on-site preparation provides the possibility of labeling a patient's own serum for subsequent clinical application. (author)

VARK Learning Preferences and Mobile Anatomy Software Application Use in Pre-Clinical Chiropractic Students

Science.gov (United States)

Meyer, Amanda J.; Stomski, Norman J.; Innes, Stanley I.; Armson, Anthony J.

2016-01-01

Ubiquitous smartphone ownership and reduced face-to-face teaching time may lead to students making greater use of mobile technologies in their learning. This is the first study to report on the prevalence of mobile gross anatomy software applications (apps) usage in pre-clinical chiropractic students and to ascertain if a relationship exists…

[Development of Diagrammatic Recording System for Choledochoscope and Its Clinical Application].

Science.gov (United States)

Xue, Zhao; Hu, Liangshuo; Tang, Bo; Zhang, Xiaogang; Lyu, Yi

2017-11-30

To develop a diagrammatic recording system for choledochoscopy and evaluate the system with clinical application. To match the real-time image and procedure illustration during choledochoscopy examination, we combined video-image capture and speech recognition technology to quickly generate personalized choledochoscopy images and texts records. The new system could be used in sharing territorial electronic medical records, telecommuting, scientific research and education, et al. In the clinical application of 32 patients, the choledochoscopy diagrammatic recording system could significantly improve the surgeons' working efficiency and patients' satisfaction. It could also meet the design requirement of remote information interaction. The choledochoscopy diagrammatic recording system which is recommended could elevate the quality of medical service and promote academic exchange and training.

Human Amniotic Membrane-Derived Products in Sports Medicine: Basic Science, Early Results, and Potential Clinical Applications.

Science.gov (United States)

Riboh, Jonathan C; Saltzman, Bryan M; Yanke, Adam B; Cole, Brian J

2016-09-01

Amniotic membrane (AM)-derived products have been successfully used in ophthalmology, plastic surgery, and wound care, but little is known about their potential applications in orthopaedic sports medicine. To provide an updated review of the basic science and preclinical and clinical data supporting the use of AM-derived products and to review their current applications in sports medicine. Systematic review. A systematic search of the literature was conducted using the Medline, EMBASE, and Cochrane databases. The search term amniotic membrane was used alone and in conjunction with stem cell, orthopaedic, tissue engineering, scaffold, and sports medicine. The search identified 6870 articles, 80 of which, after screening of the titles and abstracts, were considered relevant to this study. Fifty-five articles described the anatomy, basic science, and nonorthopaedic applications of AM-derived products. Twenty-five articles described preclinical and clinical trials of AM-derived products for orthopaedic sports medicine. Because the level of evidence obtained from this search was not adequate for systematic review or meta-analysis, a current concepts review on the anatomy, physiology, and clinical uses of AM-derived products is presented. Amniotic membranes have many promising applications in sports medicine. They are a source of pluripotent cells, highly organized collagen, antifibrotic and anti-inflammatory cytokines, immunomodulators, and matrix proteins. These properties may make it beneficial when applied as tissue engineering scaffolds, improving tissue organization in healing, and treatment of the arthritic joint. The current body of evidence in sports medicine is heavily biased toward in vitro and animal studies, with little to no human clinical data. Nonetheless, 14 companies or distributors offer commercial AM products. The preparation and formulation of these products alter their biological and mechanical properties, and a thorough understanding of these

Finite element modelling of the foot for clinical application: A systematic review.

Science.gov (United States)

Behforootan, Sara; Chatzistergos, Panagiotis; Naemi, Roozbeh; Chockalingam, Nachiappan

2017-01-01

Over the last two decades finite element modelling has been widely used to give new insight on foot and footwear biomechanics. However its actual contribution for the improvement of the therapeutic outcome of different pathological conditions of the foot, such as the diabetic foot, remains relatively limited. This is mainly because finite element modelling has only been used within the research domain. Clinically applicable finite element modelling can open the way for novel diagnostic techniques and novel methods for treatment planning/optimisation which would significantly enhance clinical practice. In this context this review aims to provide an overview of modelling techniques in the field of foot and footwear biomechanics and to investigate their applicability in a clinical setting. Even though no integrated modelling system exists that could be directly used in the clinic and considerable progress is still required, current literature includes a comprehensive toolbox for future work towards clinically applicable finite element modelling. The key challenges include collecting the information that is needed for geometry design, the assignment of material properties and loading on a patient-specific basis and in a cost-effective and non-invasive way. The ultimate challenge for the implementation of any computational system into clinical practice is to ensure that it can produce reliable results for any person that belongs in the population for which it was developed. Consequently this highlights the need for thorough and extensive validation of each individual step of the modelling process as well as for the overall validation of the final integrated system. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

Laboratory and software applications for clinical trials: the global laboratory environment.

Science.gov (United States)

Briscoe, Chad

2011-11-01

The Applied Pharmaceutical Software Meeting is held annually. It is sponsored by The Boston Society, a not-for-profit organization that coordinates a series of meetings within the global pharmaceutical industry. The meeting generally focuses on laboratory applications, but in recent years has expanded to include some software applications for clinical trials. The 2011 meeting emphasized the global laboratory environment. Global clinical trials generate massive amounts of data in many locations that must be centralized and processed for efficient analysis. Thus, the meeting had a strong focus on establishing networks and systems for dealing with the computer infrastructure to support such environments. In addition to the globally installed laboratory information management system, electronic laboratory notebook and other traditional laboratory applications, cloud computing is quickly becoming the answer to provide efficient, inexpensive options for managing the large volumes of data and computing power, and thus it served as a central theme for the meeting.

Scattered radiation from applicators in clinical electron beams

International Nuclear Information System (INIS)

Battum, L J van; Zee, W van der; Huizenga, H

2003-01-01

In radiotherapy with high-energy (4-25 MeV) electron beams, scattered radiation from the electron applicator influences the dose distribution in the patient. In most currently available treatment planning systems for radiotherapy this component is not explicitly included and handled only by a slight change of the intensity of the primary beam. The scattered radiation from an applicator changes with the field size and distance from the applicator. The amount of scattered radiation is dependent on the applicator design and on the formation of the electron beam in the treatment head. Electron applicators currently applied in most treatment machines are essentially a set of diaphragms, but still do produce scattered radiation. This paper investigates the present level of scattered dose from electron applicators, and as such provides an extensive set of measured data. The data provided could for instance serve as example input data or benchmark data for advanced treatment planning algorithms which employ a parametrized initial phase space to characterize the clinical electron beam. Central axis depth dose curves of the electron beams have been measured with and without applicators in place, for various applicator sizes and energies, for a Siemens Primus, a Varian 2300 C/D and an Elekta SLi accelerator. Scattered radiation generated by the applicator has been found by subtraction of the central axis depth dose curves, obtained with and without applicator. Scattered radiation from Siemens, Varian and Elekta electron applicators is still significant and cannot be neglected in advanced treatment planning. Scattered radiation at the surface of a water phantom can be as high as 12%. Scattered radiation decreases almost linearly with depth. Scattered radiation from Varian applicators shows clear dependence on beam energy. The Elekta applicators produce less scattered radiation than those of Varian and Siemens, but feature a higher effective angular variance. The scattered

Development and clinical application of In Vivo dosimetry for radiotherapy

International Nuclear Information System (INIS)

Honda, Hirofumi; Oita, Masataka; Tominaga, Masahide; Oto, Yoshihiro

2016-01-01

In practical radiotherapy, it is important to deliver radiation to the target correctly and safely according to the treatment planning. The control of radiation dose delivered to each patient in radiotherapy mainly relies on the prediction based on the result of pre-treatment verification and irradiation accuracy of treatment machines. In Vivo dosimetry in radiotherapy is the procedure of quality assurance by the way of direct measurement for the patient whether the calculated prescribed dose in the treatment planning is delivered precisely. The history of In Vivo dosimetry is relatively long, and the TLD dosimetry for clinical radiotherapy started in early 1970's. After 1980's, owing to the development of semiconductor devices such as diode detectors, semiconductor arrays, the clinical applications for the dosimetry and diagnostic radiation imaging devices which contributed to the development of electric portal imaging devices and 2D semiconductor detectors were introduced. In recent years, these radiation measurement devices and non-invasive methods have been developed, they are becoming widespread as clinical practice. In this paper, we reviewed the In Vivo dosimetry devices and their characteristics, and technical application for radiotherapy. (author)

Factors Influencing the Application of a Biopsychosocial Perspective in Clinical Judgement of Chronic Pain: Interactive Management with Medical Students.

Science.gov (United States)

Dwyer, Christopher P; McKenna-Plumley, Phoebe E; Durand, Hannah; Gormley, Emer M; Slattery, Brian W; Harney, Owen M; MacNeela, Padraig; McGuire, Brian E

2017-09-01

Though there is wide support for the application of biopsychosocial perspectives in clinical judgement of chronic pain cases, such perspectives are often overlooked due to either inadequate training or attitudes favoring a biomedical approach. Recent research has indicated that despite such explanations, both established general practitioners (GP) and medical students account for some psychosocial factors when making clinical judgements regarding chronic pain cases, but report not being likely to apply these in real-world, clinical settings due to numerous factors, including available time with patients. Thus, it is evident that a greater understanding of clinical judgement-making processes and the factors that affect application of these processes is required, particularly regarding chronic pain. The aims of the current study were to investigate medical students' conceptualizations of the factors that influence application of a biopsychosocial approach to clinical judgement-making in cases of chronic pain using interactive management (IM), model the relationships among these factors, and make recommendations to chronic pain treatment policy in light of the findings. The current study used IM to identify and model factors that influence the application of a biopsychosocial approach to clinical judgement-making in cases of chronic pain, based on medical students' conceptualizations of these factors. Two university classrooms. IM is a systems thinking and action mapping strategy used to aid groups in developing outcomes regarding complex issues, through integrating contributions from individuals with diverse views, backgrounds, and perspectives. IM commonly utilizes the nominal group technique and interpretive structural modeling, which in this context were employed to help medical students identify, clarify, and model influences on the application of biopsychosocial perspectives in treating chronic pain patients. Results of IM group work revealed 7 core

Linked Data Applications Through Ontology Based Data Access in Clinical Research.

Science.gov (United States)

Kock-Schoppenhauer, Ann-Kristin; Kamann, Christian; Ulrich, Hannes; Duhm-Harbeck, Petra; Ingenerf, Josef

2017-01-01

Clinical care and research data are widely dispersed in isolated systems based on heterogeneous data models. Biomedicine predominantly makes use of connected datasets based on the Semantic Web paradigm. Initiatives like Bio2RDF created Resource Description Framework (RDF) versions of Omics resources, enabling sophisticated Linked Data applications. In contrast, electronic healthcare records (EHR) data are generated and processed in diverse clinical subsystems within hospital information systems (HIS). Usually, each of them utilizes a relational database system with a different proprietary schema. Semantic integration and access to the data is hardly possible. This paper describes ways of using Ontology Based Data Access (OBDA) for bridging the semantic gap between existing raw data and user-oriented views supported by ontology-based queries. Based on mappings between entities of data schemas and ontologies data can be made available as materialized or virtualized RDF triples ready for querying and processing. Our experiments based on CentraXX for biobank and study management demonstrate the advantages of abstracting away from low level details and semantic mediation. Furthermore, it becomes clear that using a professional platform for Linked Data applications is recommended due to the inherent complexity, the inconvenience to confront end users with SPARQL, and scalability and performance issues.

Computational models of the pulmonary circulation: Insights and the move towards clinically directed studies

Science.gov (United States)

Tawhai, Merryn H.; Clark, Alys R.; Burrowes, Kelly S.

2011-01-01

Biophysically-based computational models provide a tool for integrating and explaining experimental data, observations, and hypotheses. Computational models of the pulmonary circulation have evolved from minimal and efficient constructs that have been used to study individual mechanisms that contribute to lung perfusion, to sophisticated multi-scale and -physics structure-based models that predict integrated structure-function relationships within a heterogeneous organ. This review considers the utility of computational models in providing new insights into the function of the pulmonary circulation, and their application in clinically motivated studies. We review mathematical and computational models of the pulmonary circulation based on their application; we begin with models that seek to answer questions in basic science and physiology and progress to models that aim to have clinical application. In looking forward, we discuss the relative merits and clinical relevance of computational models: what important features are still lacking; and how these models may ultimately be applied to further increasing our understanding of the mechanisms occurring in disease of the pulmonary circulation. PMID:22034608

78 FR 60885 - Proposed Collection; 60-Day Notice Request: Application Process for Clinical Research Training...

Science.gov (United States)

2013-10-02

... Notice Request: Application Process for Clinical Research Training and Medical Education at the Clinical... Research Training and Medical Education, NIH Clinical Center, 10 Center Drive, MSC 1158, Bethesda, MD 20892... Process for Clinical Research Training and Medical Education at the Clinical Center and its Impact on...

42 CFR 447.321 - Outpatient hospital and clinic services: Application of upper payment limits.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital and clinic services... SERVICES Payment Methods for Other Institutional and Noninstitutional Services Outpatient Hospital and Clinic Services § 447.321 Outpatient hospital and clinic services: Application of upper payment limits...

The effect of music video exposure on students' perceived clinical applications of popular music in the field of music therapy: a pilot study.

Science.gov (United States)

Gooding, Lori F; Mori-Inoue, Satoko

2011-01-01

The purpose of this study was to examine the effect of video exposure on music therapy students' perceptions of clinical applications of popular music in the field of music therapy. Fifty-one participants were randomly divided into two groups and exposed to a popular song in either audio-only or music video format. Participants were asked to indicate clinical applications; specifically, participants chose: (a) possible population(s), (b) most appropriate population(s), (c) possible age range(s), (d) most appropriate age ranges, (e) possible goal area(s) and (f) most appropriate goal area. Data for each of these categories were compiled and analyzed, with no significant differences found in the choices made by the audio-only and video groups. Three items, (a) selection of the bereavement population, (b) selection of bereavement as the most appropriate population and (c) selection of the age ranges of pre teen/mature adult, were additionally selected for further analysis due to their relationship to the video content. Analysis results revealed a significant difference between the video and audio-only groups for the selection of these specific items, with the video group's selections more closely aligned to the video content. Results of this pilot study suggest that music video exposure to popular music can impact how students choose to implement popular songs in the field of music therapy.

Advanced MR methods at ultra-high field (7 Tesla) for clinical musculoskeletal applications

Energy Technology Data Exchange (ETDEWEB)

Trattnig, Siegfried [Medical University of Vienna/Vienna General Hospital, MR Centre - High Field MR, Department of Radiology, Vienna (Austria); Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Austrian Cluster for Tissue Regeneration, Vienna (Austria); Zbyn, Stefan; Schmitt, Benjamin; Friedrich, Klaus; Bogner, Wolfgang [Medical University of Vienna/Vienna General Hospital, MR Centre - High Field MR, Department of Radiology, Vienna (Austria); Juras, Vladimir; Szomolanyi, Pavol [Medical University of Vienna/Vienna General Hospital, MR Centre - High Field MR, Department of Radiology, Vienna (Austria); Slovak Academy of Sciences, Department of Imaging Methods, Institute of Measurement Science, Bratislava (Slovakia)

2012-11-15

This article provides an overview of the initial clinical results of musculoskeletal studies performed at 7 Tesla, with special focus on sodium imaging, new techniques such as chemical exchange saturation transfer (CEST) and T2* imaging, and multinuclear MR spectroscopy. Sodium imaging was clinically used at 7 T in the evaluation of patients after cartilage repair procedures because it enables the GAG content to be monitored over time. Sodium imaging and T2* mapping allow insights into the ultra-structural composition of the Achilles tendon and help detect early disease. Chemical exchange saturation transfer was, for the first time, successfully applied in the clinical set-up at 7 T in patients after cartilage repair surgery. The potential of phosphorus MR spectroscopy in muscle was demonstrated in a comparison study between 3 and 7 T, with higher spectral resolution and significantly shorter data acquisition times at 7 T. These initial clinical studies demonstrate the potential of ultra-high field MR at 7 T, with the advantage of significantly improved sensitivity for other nuclei, such as {sup 23}Na (sodium) and {sup 31}P (phosphorus). The application of non-proton imaging and spectroscopy provides new insights into normal and abnormal physiology of musculoskeletal tissues, particularly cartilage, tendons, and muscles. (orig.)

Approaches using molecular imaging technology - use of PET in clinical microdose studies§

OpenAIRE

Wagner, Claudia C.; Langer, Oliver

2011-01-01

Positron emission tomography (PET) imaging uses minute amounts of radiolabeled drug tracers and thereby meets the criteria for clinical microdose studies. The advantage of PET, when compared to other analytical methods used in microdose studies, is that the pharmacokinetics (PK) of a drug can be determined in the tissue targeted for drug treatment. PET microdosing already offers interesting applications in clinical oncology and in the development of central nervous system pharmaceuticals and ...

Kinetic chains: a review of the concept and its clinical applications.

Science.gov (United States)

Karandikar, Ninad; Vargas, Oscar O Ortiz

2011-08-01

During the past decade, our understanding of biomechanics and its importance in rehabilitation has advanced significantly. The kinetic chain, a concept borrowed from engineering, has helped us better understand the underlying physiology of human movement. This understanding, in turn, has facilitated the development of new and more rational rehabilitation strategies. The kinetic chain concept has application in a wide spectrum of clinical conditions, including musculoskeletal medicine, sports medicine, and neurorehabilitation, as well as prosthetics and orthotics. The purpose of this review is to provide insights into the biomechanics related to the concept of kinetic chains, with a specific focus on closed kinetic chains and its clinical applications in rehabilitation. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Application of Higuchi's fractal dimension from basic to clinical neurophysiology: A review.

Science.gov (United States)

Kesić, Srdjan; Spasić, Sladjana Z

2016-09-01

For more than 20 years, Higuchi's fractal dimension (HFD), as a nonlinear method, has occupied an important place in the analysis of biological signals. The use of HFD has evolved from EEG and single neuron activity analysis to the most recent application in automated assessments of different clinical conditions. Our objective is to provide an updated review of the HFD method applied in basic and clinical neurophysiological research. This article summarizes and critically reviews a broad literature and major findings concerning the applications of HFD for measuring the complexity of neuronal activity during different neurophysiological conditions. The source of information used in this review comes from the PubMed, Scopus, Google Scholar and IEEE Xplore Digital Library databases. The review process substantiated the significance, advantages and shortcomings of HFD application within all key areas of basic and clinical neurophysiology. Therefore, the paper discusses HFD application alone, combined with other linear or nonlinear measures, or as a part of automated methods for analyzing neurophysiological signals. The speed, accuracy and cost of applying the HFD method for research and medical diagnosis make it stand out from the widely used linear methods. However, only a combination of HFD with other nonlinear methods ensures reliable and accurate analysis of a wide range of neurophysiological signals. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Retrieval of diagnostic and treatment studies for clinical use through PubMed and PubMed's Clinical Queries filters.

Science.gov (United States)

Lokker, Cynthia; Haynes, R Brian; Wilczynski, Nancy L; McKibbon, K Ann; Walter, Stephen D

2011-01-01

Clinical Queries filters were developed to improve the retrieval of high-quality studies in searches on clinical matters. The study objective was to determine the yield of relevant citations and physician satisfaction while searching for diagnostic and treatment studies using the Clinical Queries page of PubMed compared with searching PubMed without these filters. Forty practicing physicians, presented with standardized treatment and diagnosis questions and one question of their choosing, entered search terms which were processed in a random, blinded fashion through PubMed alone and PubMed Clinical Queries. Participants rated search retrievals for applicability to the question at hand and satisfaction. For treatment, the primary outcome of retrieval of relevant articles was not significantly different between the groups, but a higher proportion of articles from the Clinical Queries searches met methodologic criteria (p=0.049), and more articles were published in core internal medicine journals (p=0.056). For diagnosis, the filtered results returned more relevant articles (p=0.031) and fewer irrelevant articles (overall retrieval less, p=0.023); participants needed to screen fewer articles before arriving at the first relevant citation (p<0.05). Relevance was also influenced by content terms used by participants in searching. Participants varied greatly in their search performance. Clinical Queries filtered searches returned more high-quality studies, though the retrieval of relevant articles was only statistically different between the groups for diagnosis questions. Retrieving clinically important research studies from Medline is a challenging task for physicians. Methodological search filters can improve search retrieval.

MO-A-BRC-00: TG167: Clinical Recommendations for Innovative Brachytherapy Devices and Applicators

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved. The physicist’s role, along with physician colleagues, in this process is highlighted for innovative products or applications and includes evaluation of 1) dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use, 2) risks and benefits from regulatory and safety perspectives, and 3) resource assessment and preparedness. Further, calibration methods should be traceable to a primary standards dosimetry laboratory such as NIST in the U.S. or to other primary standards dosimetry laboratory located elsewhere. Clinical users should follow standards as approved by their country’s regulatory agencies that approved such a brachytherapy device. Integration of this system into the medical source calibration infrastructure of secondary standard dosimetry laboratories such as the ADCLs is encouraged before a source is introduced into widespread routine clinical use. The AAPM and GEC-ESTRO have developed guidelines for the safe and consistent application of brachytherapy using innovative brachytherapy devices and applications. The current report covers regulatory approvals, calibration, dose calculations, radiobiological issues, and overall safety concerns that should be addressed during the commissioning stage preceding clinical use. These guidelines are based on review of

MO-A-BRC-00: TG167: Clinical Recommendations for Innovative Brachytherapy Devices and Applicators

International Nuclear Information System (INIS)

2016-01-01

Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved. The physicist’s role, along with physician colleagues, in this process is highlighted for innovative products or applications and includes evaluation of 1) dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use, 2) risks and benefits from regulatory and safety perspectives, and 3) resource assessment and preparedness. Further, calibration methods should be traceable to a primary standards dosimetry laboratory such as NIST in the U.S. or to other primary standards dosimetry laboratory located elsewhere. Clinical users should follow standards as approved by their country’s regulatory agencies that approved such a brachytherapy device. Integration of this system into the medical source calibration infrastructure of secondary standard dosimetry laboratories such as the ADCLs is encouraged before a source is introduced into widespread routine clinical use. The AAPM and GEC-ESTRO have developed guidelines for the safe and consistent application of brachytherapy using innovative brachytherapy devices and applications. The current report covers regulatory approvals, calibration, dose calculations, radiobiological issues, and overall safety concerns that should be addressed during the commissioning stage preceding clinical use. These guidelines are based on review of

Clinical application of positron emission tomography for diagnosis of dementia

Energy Technology Data Exchange (ETDEWEB)

Ishii, Kazunari [Hyogo Brain and Heart Center, Himeji (Japan)

2002-12-01

Clinical applications of PET studies for dementia are reviewed in this paper. At the mild and moderate stages of Alzheimer's disease (AD), glucose metabolism is reduced not only in the parietotemporal region but also in the posterior cingulate and precuneus. At the advanced stage of AD, there is also a metabolic reduction in the frontal region. In AD patients, glucose metabolism is relatively preserved in the pons, sensorimotor cortices, primary visual cortices, basal ganglia, thalamus and cerebellum. In patients with dementia with Lewy bodies, glucose metabolism in the primary visual cortices is reduced, and this reduction appears to be associated with the reduction pattern in AD patients. In patients with frontotemporal dementia, reduced metabolism in the frontotemporal region is the main feature of this disease, but reduced metabolism in the basal ganglia, and/or parietal metabolic reduction can be associated with the frontotemporal reduction. When corticobasal degeneration is associated with dementia, the reduction pattern of dementia is similar to the reduction pattern in AD and the hallmarks of diagnosing corticobasal degeneration associated with dementia are a reduced metabolism in the primary sensorimotor region and/or basal ganglia and an asymmetric reduction in the two hemispheres. FDG-PET is a very useful tool for the diagnosis of early AD and for the differential diagnosis of dementia. I also describe clinical applications of PET for the diagnosis of dementia in Japan. (author)

Prehospital Ultrasound in Trauma: A Review of Current and Potential Future Clinical Applications

Directory of Open Access Journals (Sweden)

Tharwat El Zahran

2018-01-01

Full Text Available Ultrasound (US is an essential tool for evaluating trauma patients in the hospital setting. Many previous in-hospital studies have been extrapolated to out of hospital setting to improve diagnostic accuracy in prehospital and austere environments. This review article presents the role of prehospital US in blunt and penetrating trauma management with emphasis on its current clinical applications, challenges, and future implications of such use.

Challenges of the Unknown: Clinical Application of Microbial Metagenomics

Directory of Open Access Journals (Sweden)

Graham Rose

2015-01-01

Full Text Available Availability of fast, high throughput and low cost whole genome sequencing holds great promise within public health microbiology, with applications ranging from outbreak detection and tracking transmission events to understanding the role played by microbial communities in health and disease. Within clinical metagenomics, identifying microorganisms from a complex and host enriched background remains a central computational challenge. As proof of principle, we sequenced two metagenomic samples, a known viral mixture of 25 human pathogens and an unknown complex biological model using benchtop technology. The datasets were then analysed using a bioinformatic pipeline developed around recent fast classification methods. A targeted approach was able to detect 20 of the viruses against a background of host contamination from multiple sources and bacterial contamination. An alternative untargeted identification method was highly correlated with these classifications, and over 1,600 species were identified when applied to the complex biological model, including several species captured at over 50% genome coverage. In summary, this study demonstrates the great potential of applying metagenomics within the clinical laboratory setting and that this can be achieved using infrastructure available to nondedicated sequencing centres.

[Bibliometrics study on indications of acupuncture therapy based on foreign acupuncture clinical trials].

Science.gov (United States)

He, Wei; Tong, Yuan-Yuan; Zhao, Ying-Kai; Rong, Pei-Jing; Wang, Hong-Cai

2012-10-01

In the present paper, the authors make a bibliometrics study on clinical indications of acupuncture therapy based on the published foreign articles about acupuncture clinical trials collected from PubMed database and Excerpta Medica database (EMbase). In 1996, 64 acupuncture indications were declared by WHO in Milan conference. But in recent 15 years, clinical trials have been conducted extensively in the foreign countries. Till now, 77 new indications for acupuncture therapy have been found in the foreign journals. The authors recommended that 29 indications (knee osteoarthritis, critique age problems, muscular fasciae ache, anxiety, etc.) should be added to the first class, 4 indications (irritable bowel syndrome, malposition, backache, simple obesity) should be upgraded from the second class to the first class, and the other 3 indications (childbirth pain, male and female barren) should be upgraded from the third class to the first class due to their application frequency in clinical trials. Increase of clinical indications reflects extensive application of acupuncture therapy and may help providing a better service for people's health.

FDA Regulation of Clinical Applications of CRISPR-CAS Gene-Editing Technology.

Science.gov (United States)

Grant, Evita V

Scientists have repurposed an adaptive immune system of single cell organisms to create a new type of gene-editing tool: CRISPR (clustered regularly interspaced short palindromic repeats)-Cas technology. Scientists in China have reported its use in the genome modification of non-viable human embryos. This has ignited a spirited debate about the moral, ethical, scientific, and social implications of human germline genome engineering. There have also been calls for regulations; however, FDA has yet to formally announce its oversight of clinical applications of CRISPR-Cas systems. This paper reviews FDA regulation of previously controversial biotechnology breakthroughs, recombinant DNA and human cloning. It then shows that FDA is well positioned to regulate CRISPR-Cas clinical applications, due to its legislative mandates, its existing regulatory frameworks for gene therapies and assisted reproductive technologies, and other considerations.

Clinical application of radiotherapy combined with chemotherapy

International Nuclear Information System (INIS)

Morita, Kozo

1978-01-01

In clinical application of radiation therapy combined with chemotherapy, it is important to gain the maximal therapeutic benefit. At present we have no agents that improve the therapeutic ratio by enhancing the effect of radiation on the tumor cell selectively. Therefore, it is necessary to use combining some or all of following procedures: (1) the intraarterial infusion of the agents, (2) the selective localization by reason of the biological affinity of the agents, (3) the surgical removal of the non-sensitized tumor residue and (4) the selective sensitization of the tumor due to its shorter cell cycle. (author)

Clinical application of PET in abdominal cancers

International Nuclear Information System (INIS)

Choi, Chang Woon

2002-01-01

Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studies performed with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FG). Although FDG PET cannot match the anatomic resolution of conventional imaging techniques in the liver and the other abdominal organs, it is particularly useful for identification and characterization of the entire body simultaneously. FDG PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterizing of indeterminate soft-tissue masses. Most abdominal cancer requires surgical management. FGD PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. The abdominal cancers, such as gastroesophageal cancer, colorectal cancer, liver cancer and pancreatic cancer, are common malignancies in Korea, and PET is one of the most promising and useful methodologies for the management of abdominal cancers

Report of the consultants' meeting on radioimmunometric assays for non-clinical applications

International Nuclear Information System (INIS)

2000-01-01

A meeting between three experts and various Agency staff with specific areas of expertise was convened to review present status of radiolabelled immunoassays i.e. radioimmunoassay (RIA) and immunradiometric assay (IRMA) and their relevance to non- clinical applications. For many years, the Agency has been active in supporting the devolution of RIA and IRMA expertise in clinical applications, particularly in the field of thyroid disease and its management. The Agency's strategy was based on a perceived need to reduce the high cost of imported reagents and the poor working practices that this encouraged. This has been achieved through the use of bulk reagents (rather than 'kits') and the transfer of existing technology. The success of the Agency's approach is evident from the high degree of self- sufficiency now available in many developing countries. In recent years, the increasing workload for clinical analyses has necessitated an increase in automation, which in turn has required a change to more non-isotopic alternatives. This change seen in the more developed countries, and beginning to be introduced elsewhere, is likely lo continue. However, RIA/IRMA will continue to be used in many parts of the world for some time to come. In recent years there has been an increasing interest in the use of immunoassay technology in non-clinical applications, e.g., environmental monitoring, quality control in food production and livestock management. RIA and IRMA continue to play a major role in research

Clinical Applications of CO2 and H2 Breath Test

Directory of Open Access Journals (Sweden)

ZHAO Si-qian;CHEN Bao-jun;LUO Zhi-fu

2016-08-01

Full Text Available Breath test is non-invasive, high sensitivity and high specificity. In this article, CO2 breath test, H2 breath test and their clinical applications were elaborated. The main applications of CO2 breath test include helicobacter pylori test, liver function detection, gastric emptying test, insulin resistance test, pancreatic exocrine secretion test, etc. H2 breath test can be applied in the diagnosis of lactose malabsorption and detecting small intestinal bacterial overgrowth. With further research, the breath test is expected to be applied in more diseases diagnosis.

Stimulation of collateral artery growth: travelling further down the road to clinical application

OpenAIRE

Schirmer, S.H.; van Nooijen, F.C.; Piek, J.J.; van Royen, N.

2009-01-01

Collateral artery growth is a potent natural defence mechanism to prevent death and myocardial infarction in occlusive artery disease. Given the high prevalence of arterial obstructive disease, a therapeutic compound stimulating collateral vessel growth could have a major impact on morbidity and mortality world wide. Although experimental studies on the stimulation of arteriogenesis have been promising, not a single drug has been proved to be applicable in clinical practice, either because of...

The Current Status of The Clinical Application of Radioisotope in Korea

International Nuclear Information System (INIS)

Lee, Myung Chul

1987-01-01

The medical application of radioisotope started in the western countries in the 1920's but the first successful clinical use of Nuclear Medicine in Korea was made in June, 1959, through the treatment of a patient with hyperthyroidism using radioactive iodine. However, keeping pace with the brilliant international development of nuclear medicine, nuclear medicine in Korea has remarkably grown scientifically; The Korean Society of Nuclear Medicine was organized in 1961, The Radiology Science Institute attached to the Korea Atomic Energy Research Institute, the predecessor of the Korea Cancer Center Hospital, was established in 1963, and The Korean Journal of Nuclear Medicine published its first issue in 1967. Furthermore, the active studies using radioisotopes and the vigorous interchanges of information with foreign countries had increased so steadily and remarkably that we could hold the 3rd Asia and Oceania Congress of Nuclear Medicine in 1984. In Korea, Nuclear Medicine has now settled as a field of a science which interests lots of medical doctors and scientists. However, I cannot deny the fact that the progress of the development of Nuclear Medicine in Korea tends to defer relatively to that of the western countries, which is naturally a very active one, in many respects. I here would like to analyze the current status of clinical application of radioisotope in Korea, find the problems and present their solutions

Some comments on clinical studies in orthodontics and their applications to orthodontic treatment.

Science.gov (United States)

Baumrind, S

1999-06-01

This article indicates the origins and background of the current series of National Institute of Dental and Craniofacial Research-funded, university-based clinical studies of orthodontic treatment. It suggests that future studies should be less focused on refining our estimates of mean changes during treatment and concentrate research on the systematic analysis of individual differences among patients' responses to treatment, and study how skilled clinicians make in-course corrections in response to unexpected changes in treatment conditions. Finally, some suggestions are made concerning optimization of decision making in the presence of uncertainty.

78 FR 79703 - Submission for OMB Review; 30-Day Comment Request: Application Process for Clinical Research...

Science.gov (United States)

2013-12-31

...; 30-Day Comment Request: Application Process for Clinical Research Training and Medical Education at..., MD, Deputy Director, Office of Clinical Research Training and Medical Education, NIH Clinical Center... Clinical Research Training and Medical Education at the Clinical Center and its Impact on Course and...

Study on the clinical application of pulsed DC magnetic technology for tracking of intraoperative head motion during frameless stereotaxy

Directory of Open Access Journals (Sweden)

Stendel Rüdiger

2006-04-01

Full Text Available Abstract Background Tracking of post-registration head motion is one of the major problems in frameless stereotaxy. Various attempts in detecting and compensating for this phenomenon rely on a fixed reference device rigidly attached to the patient's head. However, most of such reference tools are either based on an invasive fixation technique or have physical limitations which allow mobility of the head only in a restricted range of motion after completion of the registration procedure. Methods A new sensor-based reference tool, the so-called Dynamic Reference Frame (DRF which is designed to allow an unrestricted, 360° range of motion for the intraoperative use in pulsed DC magnetic navigation was tested in 40 patients. Different methods of non-invasive attachment dependent on the clinical need and type of procedure, as well as the resulting accuracies in the clinical application have been analyzed. Results Apart from conventional, completely rigid immobilization of the head (type A, four additional modes of head fixation and attachment of the DRF were distinguished on clinical grounds: type B1 = pin fixation plus oral DRF attachment; type B2 = pin fixation plus retroauricular DRF attachment; type C1 = free head positioning with oral DRF; and type C2 = free head positioning with retroauricular DRF. Mean fiducial registration errors (FRE were as follows: type A interventions = 1.51 mm, B1 = 1.56 mm, B2 = 1.54 mm, C1 = 1.73 mm, and C2 = 1.75 mm. The mean position errors determined at the end of the intervention as a measure of application accuracy were: 1.45 mm in type A interventions, 1.26 mm in type B1, 1.44 mm in type B2, 1.86 mm in type C1, and 1.68 mm in type C2. Conclusion Rigid head immobilization guarantees most reliable accuracy in various types of frameless stereotaxy. The use of an additional DRF, however, increases the application scope of frameless stereotaxy to include e.g. procedures in which rigid pin fixation of the cranium is

[Clinical application evaluation of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine].

Science.gov (United States)

Liu, Meng-Yu; Yang, Wei; Wang, Li-Ying; Zhao, Xue-Yao; Wang, Yue-Xi; Liu, Yu-Qi; Han, Xue-Jie; Lv, Ai-Ping

2017-09-01

Clinical application evaluation research of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine intends to evaluate the quality level and clinical application of the guideline. A questionnaire and prospective case survey methods were used to evaluate the applicability evaluation based on the clinician questionnaire and the application evaluation based on clinical case observation. The applicability evaluation, familiarity and utilization rate of doctors' guidelines were 85.06%, 62.76%; Sort by technical grade, intermediate grade doctors have a higher familiarity rate and utilization rate, while the junior grade doctor's is lower; Guide quality level of applicability evaluation, other items' rational percentage are better than 96% except the items of health preserving and prevention and other treatment is relatively low; Items' applicable percentage of applicability evaluation are more than 91% except the item of guide simplicity. Comprehensive applicability evaluation, The percentage of the guideline applicable to clinical practice accounted for 94.94%. The consistency rate of syndrome differentiation and clinical application is more than 96% in addition to prescription medication, other treatments and health preserving and prevention of the guidelines apply consistency of application evaluation. The percentage of good treatment effect accounted for 92.96% of application effect evaluation. The safety percentage is 99.89% and economy is 97.45%. The research shows that of Guidelines for the Diagnosis and Treatment of Common Diseases of Pediatrics in Traditional Chinese Medicine quality level is good and is basically applicable to pediatric clinical practice which can be used as a standardized recommendation of pediatric common diseases' treatment specification. A small part of the guidelines are not applicable and need to be further consummated. Health preserving and prevention and other treatment of the

Stem cell technology using bioceramics: hard tissue regeneration towards clinical application

Directory of Open Access Journals (Sweden)

Hiroe Ohnishi, Yasuaki Oda and Hajime Ohgushi

2010-01-01

Full Text Available Mesenchymal stem cells (MSCs are adult stem cells which show differentiation capabilities toward various cell lineages. We have already used MSCs for treatments of osteoarthritis, bone necrosis and bone tumor. For this purpose, culture expanded MSCs were combined with various ceramics and then implanted. Because of rejection response to allogeneic MSC implantation, we have utilized patients' own MSCs for the treatment. Bone marrow is a good cell source of MSCs, although the MSCs also exist in adipose tissue. When comparing osteogenic differentiation of these MSCs, bone marrow MSCs show more extensive bone forming capability than adipose MSCs. Thus, the bone marrow MSCs are useful for bone tissue regeneration. However, the MSCs show limited proliferation and differentiation capabilities that hindered clinical applications in some cases. Recent advances reveal that transduction of plural transcription factors into human adult cells results in generation of new type of stem cells called induced pluripotent stem cells (iPS cells. A drawback of the iPS cells for clinical applications is tumor formation after their in vivo implantation; therefore it is difficult to use iPS cells for the treatment. To circumvent the problem, we transduced a single factor of either SOX2 or NANOG into the MSCs and found high proliferation as well as osteogenic differentiation capabilities of the MSCs. The stem cells could be combined with bioceramics for clinical applications. Here, we summarize our recent technologies using adult stem cells in viewpoints of bone tissue regeneration.

[Clinical application evaluation of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine].

Science.gov (United States)

Liu, Yu-Qi; Liu, Meng-Yu; Li, Chun; Shi, Nan-Nan; Wang, Yue-Xi; Wang, Li-Ying; Zhao, Xue-Yao; Kou, Shuang; Han, Xue-Jie; Wang, Yan-Ping

2017-09-01

This study is to assess the Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine in clinical application and provide evidence for further guideline revision. The assessment was divided into applicability assessment and practicability assessment. The applicability assessment based on questionnaire survey and the traditional Chinese medicine (TCM) practitioners were asked to independently fill the Questionnaire for Applicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The practicability assessment was based on prospective case investigation and analysis method and the TCM practitioners-in-charge filled the Case Investigation Questionnaire for Practicability Assessment on the Guidelines for Diagnosis and Treatment in Traditional Chinese Medicine. The data were analyzed in descriptive statistics. 151 questionnaires were investigated for applicability assessment and 1 016 patients were included for practicability assessment. The results showed that 88.74% of them were familiar with the guidelines and 45.70% used them. The guidelines quality and related items were similar in applicability assessment and practicability assessment, and scored highly as more than 85.00% except the "recuperating and prevention". The results suggested that the quality of Guidelines for Diagnosis and Treatment of Common Diseases of Otolaryngology in Traditional Chinese Medicine was high and could better guide the clinical practice. The "recuperating and prevention" part should be improved and the evidence data should be included in future guideline revision, so that the clinical utilization rate could be increased. Copyright© by the Chinese Pharmaceutical Association.

Flat detectors and their clinical applications

International Nuclear Information System (INIS)

Spahn, Martin

2005-01-01

Diagnostic and interventional flat detector X-ray systems are penetrating the market in all application segments. First introduced in radiography and mammography, they have conquered cardiac and general angiography and are getting increasing attention in fluoroscopy. Two flat detector technologies prevail. The dominating method is based on an indirect X-ray conversion process, using cesium iodide scintillators. It offers considerable advantages in radiography, angiography and fluoroscopy. The other method employs a direct converter such as selenium which is particularly suitable for mammography. Both flat detector technologies are based on amorphous silicon active pixel matrices. Flat detectors facilitate the clinical workflow in radiographic rooms, foster improved image quality and provide the potential to reduce dose. This added value is based on their large dynamic range, their high sensitivity to X-rays and the instant availability of the image. Advanced image processing is instrumental in these improvements and expand the range of conventional diagnostic methods. In angiography and fluoroscopy the transition from image intensifiers to flat detectors is facilitated by ample advantages they offer, such as distortion-free images, excellent coarse contrast, large dynamic range and high X-ray sensitivity. These characteristics and their compatibility with strong magnetic fields are the basis for improved diagnostic methods and innovative interventional applications. (orig.)

NONINVASIVE METHODS ASSESSMENT BLOOD FLOW IN ANTERIOR SEGMENT AND CLINICAL APPLICATION PERSPECTIVE

Directory of Open Access Journals (Sweden)

T. N. Kiseleva

2017-01-01

Full Text Available The literature review contains information on the anatomical and physiological features of the vessels of the conjunctiva, iris, ciliary body. There are data on the development and application of new non-invasive methods for the study of hemodynamics in the microvessels of anterior eye segment. To study the blood flow of the anterior segment of the eye, biomycroscopy, photography and videobiomicroscopy, television biomicroscopy of vessels, darkfield visualization, application fluorescence angiography, photoacoustic angiography, orthogonal polarization spectroscopy, laser Doppler flowmetry and OCT-angiography were used in recent years. These methods allow to determine the qualitative and quantitative characteristics of conjunctiva, iris, ciliary body microcirculation. They are highly informative for assess of various drugs effect on the vascular eye system. Investigation of hemodynamics in the eye microvessels is necessary for a fundamental approach to the study of the pathophysiology of systemic circulatory pathologies (with arterial hypertension, diabetes, etc. and changes in regional blood flow in organ of vision disease. Monitoring of anterior segment microcirculation in clinical practice makes possible to monitor the effectiveness of drug and surgical treatment.

Clinical applications of SPECT/CT: New hybrid nuclear medicine imaging system

International Nuclear Information System (INIS)

2008-08-01

Interest in multimodality imaging shows no sign of subsiding. New tracers are spreading out the spectrum of clinical applications and innovative technological solutions are preparing the way for yet more modality marriages: hybrid imaging. Single photon emission computed tomography (SPECT) has enabled the evaluation of disease processes based on functional and metabolic information of organs and cells. Integration of X ray computed tomography (CT) into SPECT has recently emerged as a brilliant diagnostic tool in medical imaging, where anatomical details may delineate functional and metabolic information. SPECT/CT has proven to be valuable in oncology. For example, in the case of a patient with metastatic thyroid cancer, neither SPECT nor CT alone could identify the site of malignancy. SPECT/CT, a hybrid image, precisely identified where the surgeon should operate. However SPECT/CT is not just advantageous in oncology. It may also be used as a one-stop-shop for various diseases. Clinical applications with SPECT/CT have started and expanded in developed countries. It has been reported that moving from SPECT alone to SPECT/CT could change diagnoses in 30% of cases. Large numbers of people could therefore benefit from this shift all over the world. This report presents an overview of clinical applications of SPECT/CT and a relevant source of information for nuclear medicine physicians, radiologists and clinical practitioners. This information may also be useful for decision making when allocating resources dedicated to the health care system, a critical issue that is especially important for the development of nuclear medicine in developing countries. In this regard, the IAEA may be heavily involved in the promotion of programmes aimed at the IAEA's coordinated research projects and Technical Cooperation projects

CBF-measurement of Xe-133 inhalation. Validity and clinical applications in psychiatry

International Nuclear Information System (INIS)

Risberg, J.

1980-01-01

Some methodological questions are dealt with, especially elimination of influence from non-cerebral sources of radiation. Experience from clinical applications of the method in psychiatry are briefly reviewed. (Auth.)

Clinical applications of single photon emission tomography in neuromedicine. Pt. 2. Dementia, psychotic disorders, inflammation, trauma

International Nuclear Information System (INIS)

Bartenstein, P.; Gruenwald, F.; Kuwert, T.; Tatsch, K.; Sabri, O.; Benkert, O.; Fahlbusch, R.; Gruender, G.; Herholz, K.; Weiller, C.

2000-01-01

This article gives in his second part a critical review of the clinical applications of SPECT with perfusion markers and receptor ligands in dementing disorders and psychosis. In addition this review discusses clinical applications of SPECT investigations with perfusion markers in inflammatory diseases of the central nervous system and in brain trauma. (orig.) [de

WE-D-BRB-04: Clinical Applications of CBCT for Proton Therapy

Energy Technology Data Exchange (ETDEWEB)

Teo, B. [University of Pennsylvania (United States)

2016-06-15

The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

WE-D-BRB-04: Clinical Applications of CBCT for Proton Therapy

International Nuclear Information System (INIS)

Teo, B.

2016-01-01

The goal of this session is to review the physics of proton therapy, treatment planning techniques, and the use of volumetric imaging in proton therapy. The course material covers the physics of proton interaction with matter and physical characteristics of clinical proton beams. It will provide information on proton delivery systems and beam delivery techniques for double scattering (DS), uniform scanning (US), and pencil beam scanning (PBS). The session covers the treatment planning strategies used in DS, US, and PBS for various anatomical sites, methods to address uncertainties in proton therapy and uncertainty mitigation to generate robust treatment plans. It introduces the audience to the current status of image guided proton therapy and clinical applications of CBCT for proton therapy. It outlines the importance of volumetric imaging in proton therapy. Learning Objectives: Gain knowledge in proton therapy physics, and treatment planning for proton therapy including intensity modulated proton therapy. The current state of volumetric image guidance equipment in proton therapy. Clinical applications of CBCT and its advantage over orthogonal imaging for proton therapy. B. Teo, B.K Teo had received travel funds from IBA in 2015.

Evaluation of the clinical process in a critical care information system using the Lean method: a case study

Directory of Open Access Journals (Sweden)

Yusof Maryati Mohd

2012-12-01

Full Text Available Abstract Background There are numerous applications for Health Information Systems (HIS that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS, known as IntelliVue Clinical Information Portfolio (ICIP, and recommends solutions to the problems that were identified during the study. Methods We conducted a case study under actual clinical settings, to investigate how the Lean method can be used to improve the clinical process. We used observations, interviews, and document analysis, to achieve our stated goal. We also applied two tools from the Lean methodology, namely the Value Stream Mapping and the A3 problem-solving tools. We used eVSM software to plot the Value Stream Map and A3 reports. Results We identified a number of problems related to inefficiency and waste in the clinical process, and proposed an improved process model. Conclusions The case study findings show that the Value Stream Mapping and the A3 reports can be used as tools to identify waste and integrate the process steps more efficiently. We also proposed a standardized and improved clinical process model and suggested an integrated information system that combines database and software applications to reduce waste and data redundancy.

Challenges in cryopreservation of regulatory T cells (Tregs) for clinical therapeutic applications.

Science.gov (United States)

Golab, Karolina; Leveson-Gower, Dennis; Wang, Xiao-Jun; Grzanka, Jakub; Marek-Trzonkowska, Natalia; Krzystyniak, Adam; Millis, J Michael; Trzonkowski, Piotr; Witkowski, Piotr

2013-07-01

Promising results of initial studies applying ex-vivo expanded regulatory T cell (Treg) as a clinical intervention have increased interest in this type of the cellular therapy and several new clinical trials involving Tregs are currently on the way. Methods of isolation and expansion of Tregs have been studied and optimized to the extent that such therapy is feasible, and allows obtaining sufficient numbers of Tregs in the laboratory following Good Manufacturing Practice (GMP) guidelines. Nevertheless, Treg therapy could even more rapidly evolve if Tregs could be efficiently cryopreserved and stored for future infusion or expansions rather than utilization of only freshly isolated and expanded cells as it is preferred now. Currently, our knowledge regarding the impact of cryopreservation on Treg recovery, viability, and functionality is still limited. Based on experience with cryopreserved peripheral blood mononuclear cells (PBMCs), cryopreservation may have a detrimental effect on Tregs, can decrease Treg viability, cause abnormal cytokine secretion, and compromise expression of surface markers essential for proper Treg function and processing. Therefore, optimal strategies and conditions for Treg cryopreservation in conjunction with cell culture, expansion, and processing for clinical application still need to be investigated and defined. Copyright © 2013 Elsevier B.V. All rights reserved.

An application of business process method to the clinical efficiency of hospital.

Science.gov (United States)

Leu, Jun-Der; Huang, Yu-Tsung

2011-06-01

The concept of Total Quality Management (TQM) has come to be applied in healthcare over the last few years. The process management category in the Baldrige Health Care Criteria for Performance Excellence model is designed to evaluate the quality of medical services. However, a systematic approach for implementation support is necessary to achieve excellence in the healthcare business process. The Architecture of Integrated Information Systems (ARIS) is a business process architecture developed by IDS Scheer AG and has been applied in a variety of industrial application. It starts with a business strategy to identify the core and support processes, and encompasses the whole life-cycle range, from business process design to information system deployment, which is compatible with the concept of healthcare performance excellence criteria. In this research, we apply the basic ARIS framework to optimize the clinical processes of an emergency department in a mid-size hospital with 300 clinical beds while considering the characteristics of the healthcare organization. Implementation of the case is described, and 16 months of clinical data are then collected, which are used to study the performance and feasibility of the method. The experience gleaned in this case study can be used a reference for mid-size hospitals with similar business models.

Real-time three-dimensional speckle tracking echocardiography: technical aspects and clinical applications

Directory of Open Access Journals (Sweden)

Sorrentino R

2016-11-01

Full Text Available Regina Sorrentino, Roberta Esposito, Enrica Pezzullo, Maurizio Galderisi Department of Advanced Biomedical Sciences, Interdepartmental Laboratory of Cardiac Imaging, Federico II University Hospital, Naples, Italy Abstract: Three-dimensional speckle tracking echocardiography (3D STE is a novel technique for the quantification of cardiac deformation based on tracking of ultrasonic speckles in gray scale full-volume 3D images. Developments in ultrasound technologies have made 3D speckle tracking widely available. Two-dimensional echocardiography has intrinsic limitations regarding estimation of left ventricular (LV volumes, ejection fraction, and LV mechanics, due to its inherent foreshortening errors and dependency on geometric models. The development of 3D echocardiography has improved reproducibility and accuracy. Data regarding the feasibility, accuracy, and clinical applications of 3D STE are rapidly assembling. From the tracking results, 3D STE derives several parameters, including longitudinal, circumferential and radial strain, as well as a combined assessment of longitudinal and circumferential strain, termed area strain. 3D STE can also quantify LV rotational movements such as rotation, twist, and torsion. 3D STE provides a better insight on global and regional myocardial deformation. Main applications include detection of subclinical myocardial involvement in heart failure, arterial hypertension, dyssynchrony, and ischemic heart disease. Emerging areas of application include a large spectrum of heart-involving systemic conditions, such as prediction of rejection in heart transplant patients, early detection of cardiotoxicity in patients receiving chemotherapy for cancer, and deeper physiological understanding of LV contraction mechanics in different types of athletes. Aim of this review is to discuss background, technical acquisition and processing aspects as well as recognized and developing clinical applications of this emerging

The role of hybrid SPECT-CT in oncology: current and emerging clinical applications

International Nuclear Information System (INIS)

Chowdhury, F.U.; Scarsbrook, A.F.

2008-01-01

Single photon emission computed tomography - computed tomography (SPECT-CT) is an emerging dual-modality imaging technique with many established and potential clinical applications in the field of oncology. To date, there has been a considerable emphasis on the benefits of integrated positron emission tomography - computed tomography (PET-CT) in oncology, but relatively little focus on the clinical utility of SPECT-CT. As with PET-CT, accurate co-registration of anatomical and functional data from a combined SPECT-CT camera often provides complementary diagnostic information. Both sensitivity (superior disease localization) and specificity (exclusion of false-positives due to physiological tracer uptake) are improved, and the functional significance of indeterminate lesions detected on cross-sectional imaging can be defined. This article will review the scope of hybrid SPECT-CT in oncology and illustrate both current and emerging clinical applications

UPLC-based metabonomic applications for discovering biomarkers of diseases in clinical chemistry.

Science.gov (United States)

Zhao, Ying-Yong; Cheng, Xian-Long; Vaziri, Nosratola D; Liu, Shuman; Lin, Rui-Chao

2014-10-01

Metabonomics is a powerful and promising analytic tool that allows assessment of global low-molecular-weight metabolites in biological systems. It has a great potential for identifying useful biomarkers for early diagnosis, prognosis and assessment of therapeutic interventions in clinical practice. The aim of this review is to provide a brief summary of the recent advances in UPLC-based metabonomic approach for biomarker discovery in a variety of diseases, and to discuss their significance in clinical chemistry. All the available information on UPLC-based metabonomic applications for discovering biomarkers of diseases were collected via a library and electronic search (using Web of Science, Pubmed, ScienceDirect, Springer, Google Scholar, etc.). Metabonomics has been used in clinical chemistry to identify and evaluate potential biomarkers and therapeutic targets in various diseases affecting the liver (hepatocarcinoma and liver cirrhosis), lung (lung cancer and pneumonia), gastrointestinal tract (colorectal cancer) and urogenital tract (prostate cancer, ovarian cancer and chronic kidney disease), as well as metabolic diseases (diabetes) and neuropsychiatric disorders (Alzheimer's disease and schizophrenia), etc. The information provided highlights the potential value of determination of endogenous low-molecular-weight metabolites and the advantages and potential drawbacks of the application of UPLC-based metabonomics in clinical setting. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Clinical Research on Treatment of Hyperkinetic Syndrome of Childhood by Electroacupuncture plus Acupoint Application

Institute of Scientific and Technical Information of China (English)

WU Yao-chi; KUAI Le

2003-01-01

Objective To observe the clinical therapeu tic effect of hyperkinetic syndrome of childhood treated by electroacupuncture plus acupoint application. Method Sixty-five cases with hyperkinetic syndrome of childhood were treated by electroacupuncture plus acupoint application (electroacupuncture group); 53 cases were treated by acupuncture (acupuncture group) and 53 cases were treated by Ritalin (west drug group). The above three groups were compared with each other in therapeutic effect. Results The effective rate of treating hyperkinetic syndrome of childhood by electroacupuncture plus acupoint application was 87.7%; the effective rate in west drug group was 86.8% and in acupuncture group was 77.4%. A comparison among the three groups showed there was no significant difference in clinical ther apeutic effect ( P > 0.05 ). Conclusion Electroacupuncture plus acupoint application was an effective therapy of hyperkinetic syndrome of childhood.

Cranial MRI: Current clinical applications

International Nuclear Information System (INIS)

Bradley, W.G. Jr.; Kortman, K.E.

1987-01-01

Human MR images were first published by the Nottingham group in 1980. Since that time, there have been steady improvements in image quality and significant reductions in imaging time. After initial studies by the Hammersmith group in London, investigators at UCSF published studies comparing CT with MR, clearly demonstrating the higher sensitivity of MR to pathologic intracranial processes. Since that time, several investigators have demonstrated the efficacy of MR in the evaluation of a wide range of intracranial pathologic processes, including neoplasms, demyelinating disease, trauma, and congenital abnormalities. In the authors' studies comparing MR with CT in 400 consecutive cases of suspected CNS pathology, MR detected abnormalities which were not seen on CT in 30 percent of these cases. MR has become established as the imaging modality of choice in the evaluation of a broad range of CNS abnormalities and is rapidly being implemented not only at university medical centers but also in community hospitals and free-standing clinics. This chapter deals with fundamental principles of MR image interpretation and provides insight into current clinical indications for MR in intracranial disorders

Autogenic therapy: Techniques, foundations, health and clinical applications, and empirical support

Directory of Open Access Journals (Sweden)

Manuel R. Abuín

2016-12-01

Full Text Available Autogenic therapy emerges from the "autogenic training" method created by Schultz, and its development incorporates different therapeutic methods based on a psychophysiological approach. All these methods promote homeostatic self-regulatory brain processes. The aims of this paper are to describe and analyse the autogenic methods, the psychophysiological and neurophysiological processes involved, and their effective applications in both health and clinical fields. For these purposes, beside reviewing the earlier work by Schultz and Luthe, an electronic search of literature was conducted in order to find relevant contributions on these topics. Results show a big development of autogenic methods until the 80s, with an enormous amount of applications and studies on the psychophysiological and neurophysiological changes related to the practice of autogenic training. However, their expansion during the last 25 years has been much lower in comparison with other methods such as mindfulness and hypnosis. Possible causes are discussed and new challenges are suggested

Clinical Application of Three-Dimensional Printing Technology in Craniofacial Plastic Surgery

OpenAIRE

Choi, Jong Woo; Kim, Namkug

2015-01-01

Three-dimensional (3D) printing has been particularly widely adopted in medical fields. Application of the 3D printing technique has even been extended to bio-cell printing for 3D tissue/organ development, the creation of scaffolds for tissue engineering, and actual clinical application for various medical parts. Of various medical fields, craniofacial plastic surgery is one of areas that pioneered the use of the 3D printing concept. Rapid prototype technology was introduced in the 1990s to m...

A clinically applicable six-segmented foot model.

Science.gov (United States)

De Mits, Sophie; Segers, Veerle; Woodburn, Jim; Elewaut, Dirk; De Clercq, Dirk; Roosen, Philip

2012-04-01

We describe a multi-segmented foot model comprising lower leg, rearfoot, midfoot, lateral forefoot, medial forefoot, and hallux for routine use in a clinical setting. The Ghent Foot Model describes the kinematic patterns of functional units of the foot, especially the midfoot, to investigate patient populations where midfoot deformation or dysfunction is an important feature, for example, rheumatoid arthritis patients. Data were obtained from surface markers by a 6 camera motion capture system at 500 Hz. Ten healthy subjects walked barefoot along a 12 m walkway at self-selected speed. Joint angles (rearfoot to shank, midfoot to rearfoot, lateral and medial forefoot to midfoot, and hallux to medial forefoot) in the sagittal, frontal, and transverse plane are reported according to anatomically based reference frames. These angles were calculated and reported during the foot rollover phases in stance, detected by synchronized plantar pressure measurements. Repeated measurements of each subject revealed low intra-subject variability, varying between 0.7° and 2.3° for the minimum values, between 0.5° and 2.1° for the maximum values, and between 0.8° and 5.8° for the ROM. The described movement patterns were repeatable and consistent with biomechanical and clinical knowledge. As such, the Ghent Foot model permits intersegment, in vivo motion measurement of the foot, which is crucial for both clinical and research applications. Copyright © 2011 Orthopaedic Research Society.

[Clinical application of "categorization by analogy" in acupuncture for pain syndromes].

Science.gov (United States)

Chen, Xiaojun

2018-03-12

The"categorization by analogy"is one of the most primitive thinking methods for ancient people to explore the world, which has exerted far-reaching impact on the origin and development of TCM. With examples of Sanjian (LI 3) for neck pain, Chize (LU 5) for low back pain and Chengshan (BL 57) for dysmenorrhea, the clinical application of"categorization by analogy"in acupuncture for pain syndromes was discussed, hoping more acupuncturists will pay attention to the guiding role of"categorization by analogy"in acupuncture clinical treatment.

Investigation of the Study Characteristics Affecting Clinical Trial Quality Using the Protocol Deviations Leading to Exclusion of Subjects From the Per Protocol Set Data in Studies for New Drug Application: A Retrospective Analysis.

Science.gov (United States)

Kohara, Norihito; Kaneko, Masayuki; Narukawa, Mamoru

2018-01-01

The concept of the risk-based approach has been introduced as an effort to secure the quality of clinical trials. In the risk-based approach, identification and evaluation of risk in advance are considered important. For recently completed clinical trials, we investigated the relationship between study characteristics and protocol deviations leading to the exclusion of subjects from Per Protocol Set (PPS) efficacy analysis. New drugs approved in Japan in the fiscal year 2014-2015 were targeted in the research. The reasons for excluding subjects from the PPS efficacy analysis were described in 102 trials out of 492 in the summary of new drug application documents, which was publicly disclosed after the drug's regulatory approval. The author extracted these reasons along with the numbers of the cases and the study characteristics of each clinical trial. Then, the direct comparison, univariate regression analysis, and multivariate regression analysis was carried out based on the exclusion rate. The study characteristics for which exclusion of subjects from the PPS efficacy analysis were frequently observed was multiregional clinical trials in study region; inhalant and external use in administration route; Anti-infective for systemic use; Respiratory system, Dermatologicals, and Nervous system in therapeutic drug under the Anatomical Therapeutic Chemical Classification. In the multivariate regression analysis, the clinical trial variables of inhalant, Respiratory system, or Dermatologicals were selected as study characteristics leading to a higher exclusion rate. The characteristics of the clinical trial that is likely to cause protocol deviations that will affect efficacy analysis were suggested. These studies should be considered for specific attention and priority observation in the trial protocol or its monitoring plan and execution, such as a clear description of inclusion/exclusion criteria in the protocol, development of training materials to site staff, and

Environmental pollution and DNA methylation: carcinogenesis, clinical significance, and practical applications.

Science.gov (United States)

Cao, Yi

2015-09-01

Environmental pollution is one of the main causes of human cancer. Exposures to environmental carcinogens result in genetic and epigenetic alterations which induce cell transformation. Epigenetic changes caused by environmental pollution play important roles in the development and progression of environmental pollution-related cancers. Studies on DNA methylation are among the earliest and most conducted epigenetic research linked to cancer. In this review, the roles of DNA methylation in carcinogenesis and their significance in clinical medicine were summarized, and the effects of environmental pollutants, particularly air pollutants, on DNA methylation were introduced. Furthermore, prospective applications of DNA methylation to environmental pollution detection and cancer prevention were discussed.

Clinical applications of single photon emission tomography in neuromedicine. Part 1. Neuro-oncology, epilepsy, movement disorders, cerebrovascular disease

International Nuclear Information System (INIS)

Bartenstein, P.; Gruenwald, F.; Kuwert, T.; Tatsch, K.; Sabri, O.; Benkert, O.; Fahlbusch, R.; Gruender, G.; Herzholz, K.; Weiller, C.

2000-01-01

Single photon emission tomography is, because of its availability and the relatively low costs, the functional imaging modality currently most widely used for clinical applications in the brain. Beside the application of radiopharmaceuticals for the assessment of regional cerebral blood flow there is an increasing clinical use of more selective SPECT-radiopharmaceuticals, like amino acid analogs or receptor ligands. This article gives in its first part a critical review of the clinical applications of SPECT in neuro-oncology, epilepsy, basal ganglia disorders and cerebrovascular disease. (orig.) [de

Dynamic Studies with Radioisotopes in Medicine. Proceedings of the Symposium on Dynamics Studies with Radioisotopes in Clinical Medicine and Research

International Nuclear Information System (INIS)

1971-01-01

Observations on the temporal patterns of uptake, metabolism, clearance or excretion of administered radioactive materials form the basis of many important applications of radioisotopes in clinical medicine and research. Such applications include studies of organ function, of regional blood flow and of the turnover of various substances in the human body. Newly available radioisotopes, new instruments such as gamma came ras, new techniques and new methods of data analysis based on the use of analogue and digital computers are continually enlarging the scope of the applications. Progress in these matters was discussed at the Symposium on Dynamic Studies with Radioisotopes in Clinical Medicine and Research, organized by the lnternational Atomic Energy Agency and held in Rotterdam, The Netherlands, from 31 August to 4 September 1970. A total of 315 participants nominated by 39 countries and 4 international organizations attended, and the 70 papers presented cove r the theoretical aspects of dynamic studies, the development of techniques and instruments for such studies, and specific applications in studies of thyroid, renal, hepatic and splenic function, mineral metabolism, regional blood flow, and cardiac and pulmonary function. The proceedings include the full texts of all the papers presented together with the edited discussions. Invited review papers deal with the general aspects of the various main groups of applications covered. Many of the applications described have already reached the stage of routine use; others are still in the developmental stage. Of particular note in the latter connection are applications based on the quantitative analysis of scintillation camera data. The many papers presented on these topics and the ensuing discussions indicate the great interest now shown in this promising area of development. It is hoped that the proceedings will provide a valuable guide to the present status of the subject

Citrus bergamia essential oil: from basic research to clinical application

Directory of Open Access Journals (Sweden)

Michele eNavarra

2015-03-01

Full Text Available Citrus bergamia Risso et Poiteau, also known as Bergamot, is a plant belonging to the Rutaceae family, defined as a hybrid of bitter orange and lemon. It is an endemic plant of the Calabria region (Italy. Bergamot fruit is primarily used for the extraction of its essential oil (bergamot essential oil: BEO, employed in perfume, cosmetics, food and confections.The aim of this review was to collect recent data from the literature on Citrus bergamia essential oil and, through a critical analysis, focus on safety and the beneficial effects on human health. Clinical studies on the therapeutic applications of BEO exclusively focus on the field of aromatherapy, suggesting that its use can be useful for reducing anxiety and stress.

Preventing pressure sores of the nasal ala after nasotracheal tube intubation: from animal model to clinical application.

Science.gov (United States)

Huang, Tze-Ta; Tseng, Chih-En; Lee, Tsan-Mu; Yeh, Jen-Ying; Lai, Yu-Yung

2009-03-01

Nasal-ala pressure sores induced by nasotracheal intubation are common complications of oral and maxillofacial surgery, but are easily ignored. To determine whether such sores could be prevented, we studied the effects of a combination of cushioning material in an animal model, and then analyzed the efficacy of this combination clinically. Four pigs received nasotracheal intubation. Each pig received intubation for 4, 8, 12, or 16 hours. Outcomes from pigs undergoing 500-gram-weight compression on each nostril were compared: one nostril received an application of cushioning materials, and the contralateral nostril did not. After the required study period, clinical assessment and further evaluation were performed by measuring pressure-sore dimensions and performing incisional biopsies. Clinical applications of this protective technique were then undertaken. Eight patients who underwent intubation without Soft Liner (GC Co, Tokyo, Japan) and DuoDERM CGF (ConvaTec, Inc, Princeton, NJ) protection, and 10 patients with Soft Liner and DuoDERM protection, were evaluated. The protective efficacy of the cushioning materials was significant in the animal model as well as in clinical practice. Pressure sores were avoided on the protected side, with severe tissue necrosis documented on the control side. We found that the combined use of Soft Liner and DuoDERM reduced the size and severity of nasal-ala pressure sores attributable to nasotracheal intubation during oral and maxillofacial surgery.

Clinical multiphoton tomography and clinical two-photon microendoscopy

Science.gov (United States)

König, Karsten; Bückle, Rainer; Weinigel, Martin; Elsner, Peter; Kaatz, Martin

2009-02-01

We report on applications of high-resolution clinical multiphoton tomography based on the femtosecond laser system DermaInspectTM with its flexible mirror arm in Australia, Asia, and Europe. Applications include early detection of melanoma, in situ tracing of pharmacological and cosmetical compounds including ZnO nanoparticles in the epidermis and upper dermis, the determination of the skin aging index SAAID as well as the study of the effects of anti-aging products. In addition, first clinical studies with novel rigid high-NA two-photon 1.6 mm GRIN microendoscopes have been conducted to study the effect of wound healing in chronic wounds (ulcus ulcera) as well as to perform intrabody imaging with subcellular resolution in small animals.

77 FR 67396 - Importer of Controlled Substances; Notice of Application, Fisher Clinical Services, Inc.

Science.gov (United States)

2012-11-09

... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application, Fisher Clinical Services, Inc. Pursuant to Title 21 Code of Federal Regulations 1301.34(a), this is notice that on August 20, 2012, Fisher Clinical Services, Inc., 7554 Schantz Road, [[Page 67397...

77 FR 60143 - Importer of Controlled Substances; Notice of Application; Fisher Clinical Services, Inc.

Science.gov (United States)

2012-10-02

... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application; Fisher Clinical Services, Inc. Pursuant to Title 21 Code of Federal Regulations 1301.34(a), this is notice that on July 18, 2012, Fisher Clinical Services, Inc., 7554 Schantz Road, Allentown...

77 FR 72409 - Importer of Controlled Substances; Notice of Application; Fisher Clinical Services, Inc.

Science.gov (United States)

2012-12-05

... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application; Fisher Clinical Services, Inc. Pursuant to Title 21 Code of Federal Regulations 1301.34 (a), this is notice that on October 16, 2012, Fisher Clinical Services, Inc., 7554 Schantz Road, Allentown...

78 FR 59064 - Importer of Controlled Substances; Notice of Application; Fisher Clinical Services, Inc.

Science.gov (United States)

2013-09-25

... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application; Fisher Clinical Services, Inc. Pursuant to Title 21 Code of Federal Regulations (CFR) 1301.34 (a), this is notice that on June 21, 2013, Fisher Clinical Services, Inc., 7554 Schantz Road, Allentown...

76 FR 28990 - Ultra High Throughput Sequencing for Clinical Diagnostic Applications-Approaches To Assess...

Science.gov (United States)

2011-05-19

... Web cast of the public meeting, you must register online at http://www.fda.gov/MedicalDevices/News... technologies are currently extensively used in research and are entering clinical diagnostic use; they are... technologies for clinical applications, appropriate evaluation tools (e.g., standards, well established...

Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

NARCIS (Netherlands)

Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S.

2015-01-01

Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in

Molecular subtyping of cancer: current status and moving toward clinical applications.

Science.gov (United States)

Zhao, Lan; Lee, Victor H F; Ng, Michael K; Yan, Hong; Bijlsma, Maarten F

2018-04-12

Cancer is a collection of genetic diseases, with large phenotypic differences and genetic heterogeneity between different types of cancers and even within the same cancer type. Recent advances in genome-wide profiling provide an opportunity to investigate global molecular changes during the development and progression of cancer. Meanwhile, numerous statistical and machine learning algorithms have been designed for the processing and interpretation of high-throughput molecular data. Molecular subtyping studies have allowed the allocation of cancer into homogeneous groups that are considered to harbor similar molecular and clinical characteristics. Furthermore, this has helped researchers to identify both actionable targets for drug design as well as biomarkers for response prediction. In this review, we introduce five frequently applied techniques for generating molecular data, which are microarray, RNA sequencing, quantitative polymerase chain reaction, NanoString and tissue microarray. Commonly used molecular data for cancer subtyping and clinical applications are discussed. Next, we summarize a workflow for molecular subtyping of cancer, including data preprocessing, cluster analysis, supervised classification and subtype characterizations. Finally, we identify and describe four major challenges in the molecular subtyping of cancer that may preclude clinical implementation. We suggest that standardized methods should be established to help identify intrinsic subgroup signatures and build robust classifiers that pave the way toward stratified treatment of cancer patients.

Ethics approval in applications for open-access clinical trial data: An analysis of researcher statements to clinicalstudydatarequest.com.

Directory of Open Access Journals (Sweden)

Derek So

Full Text Available Although there are a number of online platforms for patient-level clinical trial data sharing from industry sponsors, they are not very harmonized regarding the role of local ethics approval in the research proposal review process. The first and largest of these platforms is ClinicalStudyDataRequest.com (CSDR, which includes over three thousand trials from thirteen sponsors including GlaxoSmithKline, Novartis, Roche, Sanofi, and Bayer. CSDR asks applicants to state whether they have received ethics approval for their research proposal, but in most cases does not require that they submit evidence of approval. However, the website does require that applicants without ethical approval state the reason it was not required. In order to examine the perspectives of researchers on this topic, we coded every response to that question received by CSDR between June 2014 and February 2017. Of 111 applicants who stated they were exempt from ethics approval, 63% mentioned de-identification, 57% mentioned the use of existing data, 33% referred to local or jurisdictional regulations, and 20% referred to the approvals obtained by the original study. We conclude by examining the experience of CSDR within the broader context of the access mechanisms and policies currently being used by other data sharing platforms, and discuss how our findings might be used to help clinical trial data providers design clear and informative access documents.

Clinical application of the five-factor model.

Science.gov (United States)

Widiger, Thomas A; Presnall, Jennifer Ruth

2013-12-01

The Five-Factor Model (FFM) has become the predominant dimensional model of general personality structure. The purpose of this paper is to suggest a clinical application. A substantial body of research indicates that the personality disorders included within the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) can be understood as extreme and/or maladaptive variants of the FFM (the acronym "DSM" refers to any particular edition of the APA DSM). In addition, the current proposal for the forthcoming fifth edition of the DSM (i.e., DSM-5) is shifting closely toward an FFM dimensional trait model of personality disorder. Advantages of this shifting conceptualization are discussed, including treatment planning. © 2012 Wiley Periodicals, Inc.

A Review of Current Clinical Applications of Three-Dimensional Printing in Spine Surgery.

Science.gov (United States)

Cho, Woojin; Job, Alan Varkey; Chen, Jing; Baek, Jung Hwan

2018-02-01

Three-dimensional (3D) printing is a transformative technology with a potentially wide range of applications in the field of orthopaedic spine surgery. This article aims to review the current applications, limitations, and future developments of 3D printing technology in orthopaedic spine surgery. Current preoperative applications of 3D printing include construction of complex 3D anatomic models for improved visual understanding, preoperative surgical planning, and surgical simulations for resident education. Intraoperatively, 3D printers have been successfully used in surgical guidance systems and in the creation of patient specific implantable devices. Furthermore, 3D printing is revolutionizing the field of regenerative medicine and tissue engineering, allowing construction of biocompatible scaffolds suitable for cell growth and vasculature. Advances in printing technology and evidence of positive clinical outcomes are needed before there is an expansion of 3D printing applied to the clinical setting.

Clinical applications of cells labelling; Aplicaciones clinicas del marcado de celulas

Energy Technology Data Exchange (ETDEWEB)

Gonzalez, B M [Instituto Nacional de Pediatria (Mexico)

1994-12-31

Blood cells labelled with radionuclides are reviewed and main applications are described. Red blood cell labelling by both random and specific principle. A table with most important clinical uses, 99mTc labelling of RBC are described pre tinning and in vivo reduction of Tc, in vitro labelling and administration of labelled RBC and in vivo modified technique. Labelled leucocytes with several 99mTc-complex radiopharmaceuticals by in vitro technique and specific monoclonal s for white cells(neutrofiles). Labelled platelets for clinical use and research by in vitro technique and in vivo labelling.

Optical coherence tomography-current technology and applications in clinical and biomedical research.

Science.gov (United States)

Marschall, Sebastian; Sander, Birgit; Mogensen, Mette; Jørgensen, Thomas M; Andersen, Peter E

2011-07-01

Optical coherence tomography (OCT) is a noninvasive imaging technique that provides real-time two- and three-dimensional images of scattering samples with micrometer resolution. By mapping the local reflectivity, OCT visualizes the morphology of the sample. In addition, functional properties such as birefringence, motion, or the distributions of certain substances can be detected with high spatial resolution. Its main field of application is biomedical imaging and diagnostics. In ophthalmology, OCT is accepted as a clinical standard for diagnosing and monitoring the treatment of a number of retinal diseases, and OCT is becoming an important instrument for clinical cardiology. New applications are emerging in various medical fields, such as early-stage cancer detection, surgical guidance, and the early diagnosis of musculoskeletal diseases. OCT has also proven its value as a tool for developmental biology. The number of companies involved in manufacturing OCT systems has increased substantially during the last few years (especially due to its success in opthalmology), and this technology can be expected to continue to spread into various fields of application.

Co-Designing Mobile Apps to Assist in Clinical Nursing Education: A Study Protocol.

Science.gov (United States)

O'Connor, Siobhan; Andrews, Tom

2016-01-01

Mobile applications (apps) to train health professionals is gaining momentum as the benefits of mobile learning (mLearning) are becoming apparent in complex clinical environments. However, most educational apps are generic, off-the-shelf pieces of software that do not take into consideration the unique needs of nursing students. The proposed study will apply a user-centred design process to create a tailored mobile app for nursing students to learn and apply clinical skills in practice. The app will be piloted and evaluated to understand how nursing students use mobile technology in clinical settings to support their learning and educational needs.

Functional imaging in oncology. Clinical applications. Vol. 2

Energy Technology Data Exchange (ETDEWEB)

Luna, Antonio [Case Western Reserve Univ., Cleveland, OH (United States). Dept. of Radiology; MRI Health Time Group, Jaen (Spain); Vilanova, Joan C. [Girona Univ. (Spain). Clinica Girona - Hospital Sta. Caterina; Hygino da Cruz, L. Celso Jr. (ed.) [CDPI and IRM, Rio de Janeiro (Brazil). Dept. of Radiology; Rossi, Santiago E. [Centro de Diagnostico, Buenos Aires (Argentina)

2014-06-01

Easy-to-read manual on new functional imaging techniques in oncology. Explains current clinical applications and outlines future avenues. Includes numerous high-quality illustrations to highlight the major teaching points. In the new era of functional and molecular imaging, both currently available imaging biomarkers and biomarkers under development are expected to lead to major changes in the management of oncological patients. This two-volume book is a practical manual on the various imaging techniques capable of delivering functional information on cancer, including diffusion MRI, perfusion CT and MRI, dual-energy CT, spectroscopy, dynamic contrast-enhanced ultrasonography, PET, and hybrid modalities. This second volume considers the applications and benefits of these techniques in a wide range of tumor types, including their role in diagnosis, prediction of treatment outcome, and early evaluation of treatment response. Each chapter addresses a specific malignancy and is written by one or more acclaimed experts. The lucid text is complemented by numerous high-quality illustrations that highlight key features and major teaching points.

Functional imaging in oncology. Clinical applications. Vol. 2

International Nuclear Information System (INIS)

Luna, Antonio; Vilanova, Joan C.

2014-01-01

Easy-to-read manual on new functional imaging techniques in oncology. Explains current clinical applications and outlines future avenues. Includes numerous high-quality illustrations to highlight the major teaching points. In the new era of functional and molecular imaging, both currently available imaging biomarkers and biomarkers under development are expected to lead to major changes in the management of oncological patients. This two-volume book is a practical manual on the various imaging techniques capable of delivering functional information on cancer, including diffusion MRI, perfusion CT and MRI, dual-energy CT, spectroscopy, dynamic contrast-enhanced ultrasonography, PET, and hybrid modalities. This second volume considers the applications and benefits of these techniques in a wide range of tumor types, including their role in diagnosis, prediction of treatment outcome, and early evaluation of treatment response. Each chapter addresses a specific malignancy and is written by one or more acclaimed experts. The lucid text is complemented by numerous high-quality illustrations that highlight key features and major teaching points.

Clinical Hypnosis with Children and Adolescents—What? Why? How?: Origins, Applications, and Efficacy

Directory of Open Access Journals (Sweden)

Daniel P. Kohen

2014-08-01

Full Text Available This review article addresses the process, intention, and therapeutic value of clinical hypnosis with children and adolescents. A brief historical perspective is followed by a digest of the published laboratory and clinical research that has accelerated substantially over the past two decades. This review lends appropriate credence to the benefits and integration to clinical practice of this powerful tool for teaching young people self-regulation skills. The breadth of application is described, and several clinical vignettes are provided as examples of what is possible. In addition to the provision of the most relevant citations in the pediatric, psychological, and neuroscience literature, this synopsis concludes with information regarding availability of skill development training in pediatric clinical hypnosis.

Clinical Hypnosis with Children and Adolescents—What? Why? How?: Origins, Applications, and Efficacy

Science.gov (United States)

Kohen, Daniel P.; Kaiser, Pamela

2014-01-01

This review article addresses the process, intention, and therapeutic value of clinical hypnosis with children and adolescents. A brief historical perspective is followed by a digest of the published laboratory and clinical research that has accelerated substantially over the past two decades. This review lends appropriate credence to the benefits and integration to clinical practice of this powerful tool for teaching young people self-regulation skills. The breadth of application is described, and several clinical vignettes are provided as examples of what is possible. In addition to the provision of the most relevant citations in the pediatric, psychological, and neuroscience literature, this synopsis concludes with information regarding availability of skill development training in pediatric clinical hypnosis. PMID:27417468

Development of a personal digital assistant-based wireless application in clinical practice.

Science.gov (United States)

Chen, Yen-Cheng; Chiu, Hou-Chang; Tsai, Ming-Dar; Chang, Hang; Chong, Chee-Fah

2007-02-01

Our study aims to develop a personal digital assistant (PDA)-based wireless application in medical information processing by using Bluetooth and IEEE 802.11b wireless standards and SyncML codes. In this study, an "integrated database access module" is used to provide a unified integrated access interface while consistency of wireless data transmission is achieved by using the standardized SyncML protocol. A prototype of the system has been developed, implemented, and tested for its mobility, usability, stability, and performance with questionnaire survey. Response time for browsing/searching was usually less than 3s. The average time intervals needed for data transmissions were 68.6+/-8.5s for Bluetooth and 47.0+/-4.8s for 802.11b. The five-point Likert scale (from 1=least to 5=most) questionnaire survey of 30 medical professionals yielded a high degree of satisfaction with the system's mobility (4.18+/-0.89), usability (4.69+/-0.90), stability (3.81+/-0.94), and performance (3.97+/-0.88). The results of our study suggested that PDA applications which exploit wireless communication are convenient and feasible in clinical practice.

Construction of ethics in clinical research: clinical trials registration

OpenAIRE

C. A. Caramori

2007-01-01

Scientific development that has been achieved through decades finds in clinical research a great possibility of translating findings to human health application. Evidence given by clinical trials allows everyone to have access to the best health services. However, the millionaire world of pharmaceutical industries has stained clinical research with doubt and improbability. Study results (fruits of controlled clinical trials) and scientific publications (selective, manipulated and with wrong c...

[On the clinical applications of logotherapy: a review of Victor Emil Frankl inheritance].

Science.gov (United States)

Girmenia, E; Andrissi, L; Tambone, V

2014-01-01

The Viktor E. Frankl's thought has found wide application in many areas of the Clinic, not limited to the neuropsychiatric area. If the franklian work is known worldwide for being a theory and a practice within neurotic disorders, we must not forget how logotherapy has been put at the disposal of the sufferer in its broadest sense. Especially in the context of care and care of the chronically and evolutionary ill (cancer, heart disease, degenerative diseases, etc.), the thought and practice logotherapy have made and continue to make a valuable contribution. In this review we will cover in more detail the application of logotherapy in clinical-care, pausing to examine the international literature.

Platelet Rich Plasma- mechanism of action and clinical applications

OpenAIRE

Cristina N. Cozma; Laura Raducu; Cristian R. Jecan

2016-01-01

Platelet-rich plasma (PRP) is a blood-derived fraction containing high level of platelets, a high concentration of leukocytes and growth factors. PRP therapy has been growing as a viable treatment alternative for a number of clinical applications and has a potential benefit for use in wound healing. Nowadays platelet rich plasma is used in stimulating wound healing in skin and soft tissue ulcerations, accelerating wound healing in diabetic patients and facilitating bone proliferation in ortho...

Implementation of a scalable, web-based, automated clinical decision support risk-prediction tool for chronic kidney disease using C-CDA and application programming interfaces.

Science.gov (United States)

Samal, Lipika; D'Amore, John D; Bates, David W; Wright, Adam

2017-11-01

Clinical decision support tools for risk prediction are readily available, but typically require workflow interruptions and manual data entry so are rarely used. Due to new data interoperability standards for electronic health records (EHRs), other options are available. As a clinical case study, we sought to build a scalable, web-based system that would automate calculation of kidney failure risk and display clinical decision support to users in primary care practices. We developed a single-page application, web server, database, and application programming interface to calculate and display kidney failure risk. Data were extracted from the EHR using the Consolidated Clinical Document Architecture interoperability standard for Continuity of Care Documents (CCDs). EHR users were presented with a noninterruptive alert on the patient's summary screen and a hyperlink to details and recommendations provided through a web application. Clinic schedules and CCDs were retrieved using existing application programming interfaces to the EHR, and we provided a clinical decision support hyperlink to the EHR as a service. We debugged a series of terminology and technical issues. The application was validated with data from 255 patients and subsequently deployed to 10 primary care clinics where, over the course of 1 year, 569 533 CCD documents were processed. We validated the use of interoperable documents and open-source components to develop a low-cost tool for automated clinical decision support. Since Consolidated Clinical Document Architecture-based data extraction extends to any certified EHR, this demonstrates a successful modular approach to clinical decision support. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association.

MO-B-BRD-00: Clinical Applications of 3D Printing

International Nuclear Information System (INIS)

2015-01-01

This session is designed so that the learning objectives are practical. The intent is that the attendee may take home an understanding of not just the technology, but also the logistical steps necessary to execute these 3D printing techniques in the clinic. Four practical 3D printing topics will be discussed: (i) Creating bolus and compensators for photon machines; (ii) tools for proton therapy; (iii) clinical applications in imaging; (iv) custom phantom design for clinic and research use. The use of 3D printers within the radiation oncology setting is proving to be a useful tool for creating patient specific bolus and compensators with the added benefit of cost savings. Creating the proper protocol is essential to ensuring that the desired effect is achieved and modeled in the treatment planning system. The critical choice of printer material (since it determines the interaction with the radiation) will be discussed. Selection of 3D printer type, design methods, verification of dose calculation, and the printing process will be detailed to give the basis for establishing your own protocol for electron and photon fields. A practical discussion of likely obstacles that may be encountered will be included. The diversity of systems and techniques in proton facilities leads to different facilities having very different requirements for beam modifying hardware and quality assurance devices. Many departments find the need to design and fabricate facility-specific equipment, making 3D printing an attractive technology. 3D printer applications in proton therapy will be discussed, including beam filters and compensators, and the design of proton therapy specific quality assurance tools. Quality control specific to 3D printing in proton therapy will be addressed. Advantages and disadvantages of different printing technology for these applications will also be discussed. 3D printing applications using high-resolution radiology-based imaging data will be presented. This data

MO-B-BRD-00: Clinical Applications of 3D Printing

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

This session is designed so that the learning objectives are practical. The intent is that the attendee may take home an understanding of not just the technology, but also the logistical steps necessary to execute these 3D printing techniques in the clinic. Four practical 3D printing topics will be discussed: (i) Creating bolus and compensators for photon machines; (ii) tools for proton therapy; (iii) clinical applications in imaging; (iv) custom phantom design for clinic and research use. The use of 3D printers within the radiation oncology setting is proving to be a useful tool for creating patient specific bolus and compensators with the added benefit of cost savings. Creating the proper protocol is essential to ensuring that the desired effect is achieved and modeled in the treatment planning system. The critical choice of printer material (since it determines the interaction with the radiation) will be discussed. Selection of 3D printer type, design methods, verification of dose calculation, and the printing process will be detailed to give the basis for establishing your own protocol for electron and photon fields. A practical discussion of likely obstacles that may be encountered will be included. The diversity of systems and techniques in proton facilities leads to different facilities having very different requirements for beam modifying hardware and quality assurance devices. Many departments find the need to design and fabricate facility-specific equipment, making 3D printing an attractive technology. 3D printer applications in proton therapy will be discussed, including beam filters and compensators, and the design of proton therapy specific quality assurance tools. Quality control specific to 3D printing in proton therapy will be addressed. Advantages and disadvantages of different printing technology for these applications will also be discussed. 3D printing applications using high-resolution radiology-based imaging data will be presented. This data

Critical thinking in clinical nurse education: application of Paul's model of critical thinking.

Science.gov (United States)

Andrea Sullivan, E

2012-11-01

Nurse educators recognize that many nursing students have difficulty in making decisions in clinical practice. The ability to make effective, informed decisions in clinical practice requires that nursing students know and apply the processes of critical thinking. Critical thinking is a skill that develops over time and requires the conscious application of this process. There are a number of models in the nursing literature to assist students in the critical thinking process; however, these models tend to focus solely on decision making in hospital settings and are often complex to actualize. In this paper, Paul's Model of Critical Thinking is examined for its application to nursing education. I will demonstrate how the model can be used by clinical nurse educators to assist students to develop critical thinking skills in all health care settings in a way that makes critical thinking skills accessible to students. Copyright © 2012 Elsevier Ltd. All rights reserved.

Clinical application of functional MRI

International Nuclear Information System (INIS)

Taniwaki, Takayuki

2010-01-01

Described is the present state of clinical application of fMRI in the preoperative assessment of brain tumors, and plasticity in and pathophysiology of central diseases. For the tumor resection, fMRI is useful for risk assessment of postoperative nerve dysfunction, for selection of the patient rather suitable for brain mapping at the invasive surgery than at the pre-operation and for guidance of the operation itself. Preoperative fMRI alone can neither distinguish the regions of the primary and secondary functions nor exhibit the relation between the tumor and white matter fibers but there are compensatory means for these drawbacks. Benefit of preoperative fMRI has not yet been based on the evidence on double blind trials. Combination of fMRI imaging and electroencephalography (EEG) finding has shown that, in generalized epilepsy, extensive and stimulated activation occurs in both frontal/occipital regions and in thalamus area, respectively, and that the concomitant lowered activities are conceivably the reflection of burst discharge in normal brain functions. Plasticity in the human brain has been demonstrated by fMRI in cerebral vascular diseases, multiple sclerosis and amyotrophic lateral sclerosis. Pathogenesis of Parkinson disease and depression has been better understood by fMRI investigations revealing regions with elevated and reduced activities. Studies of attention deficit hyperactivity disorder have shown similar change of activities with functional reductions of the right dorsolateral frontal anterior area and of dorsal frontal cingulate gyrus, together with stimulated wider regions to given tasks. As above, fMRI has greatly contributed to our understanding of diseases of central nervous system and is to be expected to expand wider in this field. (T.T.)

Clinical application of cardiac SPECT

International Nuclear Information System (INIS)

Nishimura, Shigeyuki

1999-01-01

Single-photon emission computed tomography (SPECT) has replaced planar imaging techniques for myocardial scintigraphy. Thallium-201 was the dominant agent employed for myocardial perfusion imaging. Today new technetium-99m labelled radionuclides have been used as excellent alternatives to 201 Tl for detection of coronary artery disease, prognostification, and even assessment of myocardial viability. Pharmacologic stress imaging using either dipyridamole, adenosine or dobutamine is a substitute for exercise stress. Accurate determination of myocardial viability is vitally important for clinical decision making for patients with LV dysfunction who will most benefit from revascularization. Stunned and hibernated myocardium may result in profound regional LTV dysfunction in absence of necrosis. The various approach such as stress-redistribution-reinjection imaging, rest-redistribution imaging and stress-redistribution-24 hours delayed imaging has been utilized to assess myocardial viability with 201 Tl. Quantitative assessment of 99m Tc MIBI uptake reflect the degree of viability. 123 I-Metaiodobenzylguanidine (MIBG), an analog of norepinephrine, has been used for scintigraphic assessment of regional cardiac adrenergic innervation. Cardiac sympathetic denervation, assessed by 123 I-MIBG, due to ischemia in non-Q myocardial infarction and unstable angina has been shown. Quantitative cardiac MIBG scintigram was shown to have prognostic value in patients with severe congestive heart failure. 23 I-BMIPP (ρ-methyl-iodophenyl pentadecanoic acid) has been used to assess myocardial fatty acid utilization. BMIPP has the memory function of ischemia in unstable angina, since decreased BMIPP uptake persists several days after ischemic episode. Nuclear cardiology in Japan has experienced an expansion in the techniques including use of new radionuclides, 99m Tc perfusion agents, 123 I-MIBG and 23 I-BMIPP and in associated clinical application to the various cardiac diseases

Mismatch negativity: clinical and other applications.

Science.gov (United States)

Näätänen, R; Escera, C

2000-01-01

The perspectives of application of the mismatch negativity (MMN), generated by the brain's automatic response to change in auditory stimulation, are discussed. In light of the fact that the MMN (and its magnetic equivalent MMNm) currently provides the only objective measure of the accuracy of the central auditory function, these perspectives appear very promising. The MMN can be measured in the absence of attention and task requirements, which makes it particularly suitable for testing different clinical populations and infants. Furthermore, the MMN enables one to evaluate the accuracy of auditory discrimination separately for any acoustic feature, such as frequency, intensity and duration, and for learned categories, such as the phonemes of a particular language. In addition, by measuring the decay of the MMN amplitude as a function of the interstimulus interval, it is possible to estimate the duration of sensory (echoic) memory. Copyright 2000 S. Karger AG, Basel

Radiolabeled peptides: experimental and clinical applications

International Nuclear Information System (INIS)

Thakur, M.L.; Pallela, V.R.

1998-01-01

Radiolabeled receptor specific biomolecules hold unlimited potential in nuclear medicine. During the past few years much attention has been drawn to the development radiolabeled peptides for a variety of diagnostic applications, as well as for therapy of malignant tumors. Although only one peptide, In-111-DTPA-(D)-Phe 1 -octreotide, is available commercially for oncologic imaging, many more have been examined in humans with hematological disorders, and the early results appear to be promising. Impetus generated by these results have prompted investigators to label peptides with such radionuclides as Tc-99m, I-123, F-18, Cu-64, and Y-90. This review is intended to highlight the qualities of peptides, summarize the clinical results, and address some important issues associated with radiolabeling of highly potent peptides. While doing so, various methods of radiolabeling have been described, and their strengths and weaknesses have also been discussed. (author)

Prolactinomas : clinical studies

NARCIS (Netherlands)

Kars, Marleen

2008-01-01

Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An

Usability study of clinical exome analysis software: top lessons learned and recommendations.

Science.gov (United States)

Shyr, Casper; Kushniruk, Andre; Wasserman, Wyeth W

2014-10-01

dramatically accelerate clinician analysis and interpretation of patient genomic data. We present the first application of usability methods to evaluate software interfaces in the context of exome analysis. Our results highlight how the study of user responses can lead to identification of usability issues and challenges and reveal software reengineering opportunities for improving clinical next-generation sequencing analysis. While the evaluation focused on two distinctive software tools, the results are general and should inform active and future software development for genome analysis software. As large-scale genome analysis becomes increasingly common in healthcare, it is critical that efficient and effective software interfaces are provided to accelerate clinical adoption of the technology. Implications for improved design of such applications are discussed. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Advances in clinical application of optical coherence tomography in vitreomacular interface disease

Directory of Open Access Journals (Sweden)

Xiao-Li Xing

2013-08-01

Full Text Available Vitreous macular interface disease mainly includes vitreomacular traction syndrome, idiopathic macular epiretinal membrane and idiopathic macular hole. Optical coherence tomography(OCTas a new tool that provides high resolution biopsy cross section image non traumatic imaging inspection, has a unique high resolution, no damage characteristics, and hence clinical widely used, vitreous macular interface for clinical disease diagnosis, differential diagnosis and condition monitoring and quantitative evaluation, treatment options, etc provides important information and reference value. Vitreous macular interface disease in OCT image of anatomical morphology characteristics, improve the clinical on disease occurrence and development of knowledge. We reviewed the advances in the application of OCT in vitreomacular interface disease.

A simple versatile solution for collecting multidimensional clinical data based on the CakePHP web application framework.

Science.gov (United States)

Biermann, Martin

2014-04-01

Clinical trials aiming for regulatory approval of a therapeutic agent must be conducted according to Good Clinical Practice (GCP). Clinical Data Management Systems (CDMS) are specialized software solutions geared toward GCP-trials. They are however less suited for data management in small non-GCP research projects. For use in researcher-initiated non-GCP studies, we developed a client-server database application based on the public domain CakePHP framework. The underlying MySQL database uses a simple data model based on only five data tables. The graphical user interface can be run in any web browser inside the hospital network. Data are validated upon entry. Data contained in external database systems can be imported interactively. Data are automatically anonymized on import, and the key lists identifying the subjects being logged to a restricted part of the database. Data analysis is performed by separate statistics and analysis software connecting to the database via a generic Open Database Connectivity (ODBC) interface. Since its first pilot implementation in 2011, the solution has been applied to seven different clinical research projects covering different clinical problems in different organ systems such as cancer of the thyroid and the prostate glands. This paper shows how the adoption of a generic web application framework is a feasible, flexible, low-cost, and user-friendly way of managing multidimensional research data in researcher-initiated non-GCP clinical projects. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Clinical application and evaluation of the diagnostic significance of NMR-tomography

International Nuclear Information System (INIS)

Bielke, G.; Higer, P.

1987-01-01

Aim of the project was the clinical application and evaluation of the diagnostic significance of NMR-tomography. About 3 000 patients have been examined especially with diseases of the brain. In 75% of all cases pathological findings could be detected. A subgroup of these patients was used for comprehensive studies with regard to tissue characterization based on the calculation of relaxation time parameters. With methods of image processing and classification techniques we tried to get a clear correlation between combined NMR-parameters and human tissue types. The results show that this procedure is able to improve the detectibility and the association to finding groups and tumorgradings in certain cases. (orig./ECB) With 134 refs., 17 tabs., 86 figs [de

An Exploratory Study Investigating the Non-Clinical Benefits of Evidence-Based Veterinary Medicine

Directory of Open Access Journals (Sweden)

Elizabeth Jackson

2017-05-01

reputation and confidence of the veterinarian,  as well as employee engagement. In order to yield these benefits the two main barriers, time and resources, need to be overcome.Conclusion: The themes highlighted in this paper provide a solid, real world base for further, quantitative study of the non-clinical benefits of practising EBVM.  Application: The results of this research are applicable to practicing veterinarians, nurses and other practice staff. It is clear that practising EBVM not only leads to better clinical outcomes, but can also result in commercial benefits, such as better client retention and employee engagement

Parameters for measurement of oxidative stress in diabetes mellitus: applicability of enzyme-linked immunosorbent assay for clinical evaluation.

Science.gov (United States)

Noiri, Eisei; Tsukahara, Hirokazu

2005-05-01

Investigations of the mechanisms involved in the onset and progression of diabetes have recently confronted the role of reactive oxygen species (ROS) and oxidative stress. Prolonged exposure to hyperglycemic conditions induces nonenzymatic glycation of protein via the so-called Maillard reaction, resulting in Schiff-base products and Amadori products that engender ROS production. These processes initiate and exacerbate micro- and macrovascular complications in diabetes. Increased oxidative stress is induced by excessive ROS production and inadequate antioxidant defenses. Recently, oxidative stress status markers have been associated directly with the severity and prognosis of diabetes. To examine oxidative stress, reliable and high-throughput methods are needed to examine large numbers of clinical samples. The emerging availability of enzyme-linked immunosorbent assay (ELISA) for oxidative stress status markers allows its application to assessment of various pathophysiologic conditions, including diabetes. This review outlines the recent achievements of ELISA application for clinical studies elucidating oxidative stress. It introduces the potential applicability of ELISA for investigating oxidative stress in diabetes.

Applicability of supervised discriminant analysis models to analyze astigmatism clinical trial data.

Science.gov (United States)

Sedghipour, Mohammad Reza; Sadeghi-Bazargani, Homayoun

2012-01-01

In astigmatism clinical trials where more complex measurements are common, especially in nonrandomized small sized clinical trials, there is a demand for the development and application of newer statistical methods. The source data belonged to a project on astigmatism treatment. Data were used regarding a total of 296 eyes undergoing different astigmatism treatment modalities: wavefront-guided photorefractive keratectomy, cross-cylinder photorefractive keratectomy, and monotoric (single) photorefractive keratectomy. Astigmatism analysis was primarily done using the Alpins method. Prior to fitting partial least squares regression discriminant analysis, a preliminary principal component analysis was done for data overview. Through fitting the partial least squares regression discriminant analysis statistical method, various model validity and predictability measures were assessed. The model found the patients treated by the wavefront method to be different from the two other treatments both in baseline and outcome measures. Also, the model found that patients treated with the cross-cylinder method versus the single method didn't appear to be different from each other. This analysis provided an opportunity to compare the three methods while including a substantial number of baseline and outcome variables. Partial least squares regression discriminant analysis had applicability for the statistical analysis of astigmatism clinical trials and it may be used as an adjunct or alternative analysis method in small sized clinical trials.

Weightbath hydrotraction treatment: application, biomechanics, and clinical effects

Directory of Open Access Journals (Sweden)

Márta Kurutz

2010-04-01

Full Text Available Márta Kurutz1, Tamás Bender21Department of Structural Mechanics, Budapest University of Technology and Economics, Hungary; 2Department of Physical Medicine, Polyclinic and Hospital of the Hospitaller Brothers of St. John of God, Budapest, Medical University of Szeged, HungaryBackground and purpose: Weightbath hydrotraction treatment (WHT is a simple noninvasive effective method of hydro- or balneotherapy to stretch the spine or lower limbs, applied successfully in hospitals and health resort sanitaria in Hungary for more than fifty years. This study aims to introduce WHT with its biomechanical and clinical effects. History, development, equipment, modes of application, biomechanics, spinal traction forces and elongations, indications and contraindications of WHT are precented.Subjects and methods: The calculation of traction forces acting along the spinal column during the treatment is described together with the mode of suspension and the position of extra weight loads applied. The biomechanics of the treatment are completed by in vivo measured elongations of lumbar segments using a special underwater ultrasound measuring method. The clinical effects, indications, and contraindications of the treatment are also presented.Results: In the underwater cervical suspension of a human body, approximately 25 N stretching load occurs in the cervical spine, and about 11 N occurs in the lumbar spine. By applying extra weights, the above tensile forces along the spinal column can be increased. Thus, the traction effect can be controlled by applying such loads during the treatment. Elongations of segments L3–L4, L4–L5, and L5–S1 were measured during the usual WHT of patients suspended cervically in water for 20 minutes, loaded by 20–20 N lead weights on the ankles. The mean initial elastic elongations of spinal segments were about 0.8 mm for patients aged under 40 years, 0.5 mm between 40–60 years, and 0.2 mm for patients over 60 years. The mean

A comparative study: classification vs. user-based collaborative filtering for clinical prediction.

Science.gov (United States)

Hao, Fang; Blair, Rachael Hageman

2016-12-08

Recommender systems have shown tremendous value for the prediction of personalized item recommendations for individuals in a variety of settings (e.g., marketing, e-commerce, etc.). User-based collaborative filtering is a popular recommender system, which leverages an individuals' prior satisfaction with items, as well as the satisfaction of individuals that are "similar". Recently, there have been applications of collaborative filtering based recommender systems for clinical risk prediction. In these applications, individuals represent patients, and items represent clinical data, which includes an outcome. Application of recommender systems to a problem of this type requires the recasting a supervised learning problem as unsupervised. The rationale is that patients with similar clinical features carry a similar disease risk. As the "Big Data" era progresses, it is likely that approaches of this type will be reached for as biomedical data continues to grow in both size and complexity (e.g., electronic health records). In the present study, we set out to understand and assess the performance of recommender systems in a controlled yet realistic setting. User-based collaborative filtering recommender systems are compared to logistic regression and random forests with different types of imputation and varying amounts of missingness on four different publicly available medical data sets: National Health and Nutrition Examination Survey (NHANES, 2011-2012 on Obesity), Study to Understand Prognoses Preferences Outcomes and Risks of Treatment (SUPPORT), chronic kidney disease, and dermatology data. We also examined performance using simulated data with observations that are Missing At Random (MAR) or Missing Completely At Random (MCAR) under various degrees of missingness and levels of class imbalance in the response variable. Our results demonstrate that user-based collaborative filtering is consistently inferior to logistic regression and random forests with different

A comparative study: classification vs. user-based collaborative filtering for clinical prediction

Directory of Open Access Journals (Sweden)

Fang Hao

2016-12-01

Full Text Available Abstract Background Recommender systems have shown tremendous value for the prediction of personalized item recommendations for individuals in a variety of settings (e.g., marketing, e-commerce, etc.. User-based collaborative filtering is a popular recommender system, which leverages an individuals’ prior satisfaction with items, as well as the satisfaction of individuals that are “similar”. Recently, there have been applications of collaborative filtering based recommender systems for clinical risk prediction. In these applications, individuals represent patients, and items represent clinical data, which includes an outcome. Methods Application of recommender systems to a problem of this type requires the recasting a supervised learning problem as unsupervised. The rationale is that patients with similar clinical features carry a similar disease risk. As the “Big Data” era progresses, it is likely that approaches of this type will be reached for as biomedical data continues to grow in both size and complexity (e.g., electronic health records. In the present study, we set out to understand and assess the performance of recommender systems in a controlled yet realistic setting. User-based collaborative filtering recommender systems are compared to logistic regression and random forests with different types of imputation and varying amounts of missingness on four different publicly available medical data sets: National Health and Nutrition Examination Survey (NHANES, 2011-2012 on Obesity, Study to Understand Prognoses Preferences Outcomes and Risks of Treatment (SUPPORT, chronic kidney disease, and dermatology data. We also examined performance using simulated data with observations that are Missing At Random (MAR or Missing Completely At Random (MCAR under various degrees of missingness and levels of class imbalance in the response variable. Results Our results demonstrate that user-based collaborative filtering is consistently inferior

Magnetoencephalography: Fundamentals and Established and Emerging Clinical Applications in Radiology

International Nuclear Information System (INIS)

Braeutigam, Sven

2013-01-01

Magnetoencephalography is a noninvasive, fast, and patient friendly technique for recording brain activity. It is increasingly available and is regarded as one of the most modern imaging tools available to radiologists. The dominant clinical use of this technology currently centers on two, partly overlapping areas, namely, localizing the regions from which epileptic seizures originate, and identifying regions of normal brain function in patients preparing to undergo brain surgery. As a consequence, many radiologists may not yet be familiar with this technique. This review provides an introduction to magnetoencephalography, discusses relevant analytical techniques, and presents recent developments in established and emerging clinical applications such as pervasive developmental disorders. Although the role of magnetoencephalography in diagnosis, prognosis, and patient treatment is still limited, it is argued that this technology is exquisitely capable of contributing indispensable information about brain dynamics not easily obtained with other modalities. This, it is believed, will make this technology an important clinical tool for a wide range of disorders in the future

Diffusion weighted imaging demystified. The technique and potential clinical applications for soft tissue imaging

International Nuclear Information System (INIS)

Ahlawat, Shivani; Fayad, Laura M.

2018-01-01

Diffusion-weighted imaging (DWI) is a fast, non-contrast technique that is readily available and easy to integrate into an existing imaging protocol. DWI with apparent diffusion coefficient (ADC) mapping offers a quantitative metric for soft tissue evaluation and provides information regarding the cellularity of a region of interest. There are several available methods of performing DWI, and artifacts and pitfalls must be considered when interpreting DWI studies. This review article will review the various techniques of DWI acquisition and utility of qualitative as well as quantitative methods of image interpretation, with emphasis on optimal methods for ADC measurement. The current clinical applications for DWI are primarily related to oncologic evaluation: For the assessment of de novo soft tissue masses, ADC mapping can serve as a useful adjunct technique to routine anatomic sequences for lesion characterization as cyst or solid and, if solid, benign or malignant. For treated soft tissue masses, the role of DWI/ADC mapping in the assessment of treatment response as well as recurrent or residual neoplasm in the setting of operative management is discussed, especially when intravenous contrast medium cannot be given. Emerging DWI applications for non-neoplastic clinical indications are also reviewed. (orig.)

Diffusion weighted imaging demystified. The technique and potential clinical applications for soft tissue imaging

Energy Technology Data Exchange (ETDEWEB)

Ahlawat, Shivani [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Fayad, Laura M. [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Oncology, Baltimore, MD (United States); The Johns Hopkins Medical Institutions, Department of Orthopaedic Surgery, Baltimore, MD (United States)

2018-03-15

Diffusion-weighted imaging (DWI) is a fast, non-contrast technique that is readily available and easy to integrate into an existing imaging protocol. DWI with apparent diffusion coefficient (ADC) mapping offers a quantitative metric for soft tissue evaluation and provides information regarding the cellularity of a region of interest. There are several available methods of performing DWI, and artifacts and pitfalls must be considered when interpreting DWI studies. This review article will review the various techniques of DWI acquisition and utility of qualitative as well as quantitative methods of image interpretation, with emphasis on optimal methods for ADC measurement. The current clinical applications for DWI are primarily related to oncologic evaluation: For the assessment of de novo soft tissue masses, ADC mapping can serve as a useful adjunct technique to routine anatomic sequences for lesion characterization as cyst or solid and, if solid, benign or malignant. For treated soft tissue masses, the role of DWI/ADC mapping in the assessment of treatment response as well as recurrent or residual neoplasm in the setting of operative management is discussed, especially when intravenous contrast medium cannot be given. Emerging DWI applications for non-neoplastic clinical indications are also reviewed. (orig.)

Bioinformatics tools for the analysis of NMR metabolomics studies focused on the identification of clinically relevant biomarkers.

Science.gov (United States)

Puchades-Carrasco, Leonor; Palomino-Schätzlein, Martina; Pérez-Rambla, Clara; Pineda-Lucena, Antonio

2016-05-01

Metabolomics, a systems biology approach focused on the global study of the metabolome, offers a tremendous potential in the analysis of clinical samples. Among other applications, metabolomics enables mapping of biochemical alterations involved in the pathogenesis of diseases, and offers the opportunity to noninvasively identify diagnostic, prognostic and predictive biomarkers that could translate into early therapeutic interventions. Particularly, metabolomics by Nuclear Magnetic Resonance (NMR) has the ability to simultaneously detect and structurally characterize an abundance of metabolic components, even when their identities are unknown. Analysis of the data generated using this experimental approach requires the application of statistical and bioinformatics tools for the correct interpretation of the results. This review focuses on the different steps involved in the metabolomics characterization of biofluids for clinical applications, ranging from the design of the study to the biological interpretation of the results. Particular emphasis is devoted to the specific procedures required for the processing and interpretation of NMR data with a focus on the identification of clinically relevant biomarkers. © The Author 2015. Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Towards a traceable clinical guidelines application. A model-driven approach.

Science.gov (United States)

Domínguez, E; Pérez, B; Zapata, M

2010-01-01

The goal of this research is to provide an overall framework to enable model-based development of clinical guideline-based decision support systems (GBDSSs). The automatically generated GBDSSs are aimed at providing guided support to the physician during the application of guidelines and automatically storing guideline application data for traceability purposes. The development process of a GBDSS for a guideline is based on model-driven development (MDD) techniques which allow us to carry out such a process automatically, making development more agile and saving on human resource costs. We use UML Statecharts to represent the dynamics of guidelines and, based on this model, we use a MDD-based tool chain to generate the guideline-dependent components of each GBDSS in an automatic way. In particular, as for the traceability capabilities of each GBDSS, MDD techniques are combined with database schema mappings for metadata management in order to automatically generate the GBDSS-persistent component as one of the main contributions of this paper. The complete framework has been implemented as an Eclipse plug-in named GBDSSGenerator which, starting from the statechart representing a guideline, allows the development process to be carried out automatically by only selecting different menu options the plug-in provides. We have successfully validated our overall approach by generating the GBDSS for different types of clinical guidelines, even for laboratory guidelines. The proposed framework allows the development of clinical guideline-based decision support systems in an automatic way making this process more agile and saving on human resource costs.

Progress in clinical research and application of resting state functional brain imaging

International Nuclear Information System (INIS)

Long Miaomiao; Ni Hongyan

2013-01-01

Resting state functional brain imaging experimental design is free of stimulus task and offers various parametric maps through different data-driven post processing methods with endogenous BOLD signal changes as the source of imaging. Mechanism of resting state brain activities could be extensively studied with improved patient compliance and clinical application compared with task related functional brain imaging. Also resting state functional brain imaging can be used as a method of data acquisition, with implicit neuronal activity as a kind of experimental design, to reveal characteristic brain activities of epileptic patient. Even resting state functional brain imaging data processing method can be used to analyze task related functional MRI data, opening new horizons of task related functional MRI study. (authors)

Repetitive Transcranial Magnetic Stimulation for Clinical Applications in Neurological and Psychiatric Disorders: An Overview

Science.gov (United States)

Machado, Sergio; Arias-Carrión, Oscar; Paes, Flávia; Vieira, Renata Teles; Caixeta, Leonardo; Novaes, Felipe; Marinho, Tamires; Almada, Leonardo Ferreira; Silva, Adriana Cardoso; Nardi, Antonio Egidio

2013-01-01

Neurological and psychiatric disorders are characterized by several disabling symptoms for which effective, mechanism-based treatments remain elusive. Consequently, more advanced non-invasive therapeutic methods are required. A method that may modulate brain activity and be viable for use in clinical practice is repetitive transcranial magnetic stimulation (rTMS). It is a non-invasive procedure whereby a pulsed magnetic field stimulates electrical activity in the brain. Here, we focus on the basic foundation of rTMS, the main stimulation parametters, the factors that influence individual responses to rTMS and the experimental advances of rTMS that may become a viable clinical application to treat neurological and psychiatric disorders. The findings showed that rTMS can improve some symptoms associated with these conditions and might be useful for promoting cortical plasticity in patients with neurological and psychiatric disorders. However, these changes are transient and it is premature to propose these applications as realistic therapeutic options, even though the rTMS technique has been evidenced as a potential modulator of sensorimotor integration and neuroplasticity. Functional imaging of the region of interest could highlight the capacity of rTMS to bring about plastic changes of the cortical circuitry and hint at future novel clinical interventions. Thus, we recommend that further studies clearly determine the role of rTMS in the treatment of these conditions. Finally, we must remember that however exciting the neurobiological mechanisms might be, the clinical usefulness of rTMS will be determined by its ability to provide patients with neurological and psychiatric disorders with safe, long-lasting and substantial improvements in quality of life. PMID:25610279

A Bright Future for Precision Medicine: Advances in Fluorescent Chemical Probe Design and Their Clinical Application.

Science.gov (United States)

Garland, Megan; Yim, Joshua J; Bogyo, Matthew

2016-01-21

The Precision Medicine Initiative aims to use advances in basic and clinical research to develop therapeutics that selectively target and kill cancer cells. Under the same doctrine of precision medicine, there is an equally important need to visualize these diseased cells to enable diagnosis, facilitate surgical resection, and monitor therapeutic response. Therefore, there is a great opportunity for chemists to develop chemically tractable probes that can image cancer in vivo. This review focuses on recent advances in the development of optical probes, as well as their current and future applications in the clinical management of cancer. The progress in probe development described here suggests that optical imaging is an important and rapidly developing field of study that encourages continued collaboration among chemists, biologists, and clinicians to further refine these tools for interventional surgical imaging, as well as for diagnostic and therapeutic applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Recent Progress in Lab-on-a-Chip Technology and Its Potential Application to Clinical Diagnoses

Directory of Open Access Journals (Sweden)

Nae Yoon Lee

2013-03-01

Full Text Available We present the construction of the lab-on-a-chip (LOC system, a state-of-the-art technology that uses polymer materials (i.e., poly[dimethylsiloxane] for the miniaturization of conventional laboratory apparatuses, and show the potential use of these microfluidic devices in clinical applications. In particular, we introduce the independent unit components of the LOC system and demonstrate how each component can be functionally integrated into one monolithic system for the realization of a LOC system. In specific, we demonstrate microscale polymerase chain reaction with the use of a single heater, a microscale sample injection device with a disposable plastic syringe and a strategy for device assembly under environmentally mild conditions assisted by surface modification techniques. In this way, we endeavor to construct a totally integrated, disposable microfluidic system operated by a single mode, the pressure, which can be applied on-site with enhanced device portability and disposability and with simple and rapid operation for medical and clinical diagnoses, potentially extending its application to urodynamic studies in molecular level.

Clinical applications of proton magnetic resonance spectroscopy of the brain

International Nuclear Information System (INIS)

Laubenberger, J.; Bayer, S.; Thiel, T.; Hennig, J.; Langer, M.

1998-01-01

In spite of all the scientific advances of the past few years, proton magnetic resonance spectroscopy of the brain has not attained the status of a routine examination technique with clinically accepted indications. The method should be considered as an additional option to MR imaging for inherited and acquired encephalopathic changes as well as, in future, for localization diagnosis of epilepsies. A proton magnetic resonance spectroscopic investigation without a prior intensive clinical and imaging investigation is not useful. Above all, factors influencing metabolite distribution such as for example, serum osmolability must be known. Methodological prerequisites for the clinical application of proton resonance spectroscopy are, first of all, a high stability of the chosen technique as well as a sufficiently certain quantification of metabolites and the availability of a reference group. The use of short echo times is necessary for the quantification of glutamine and the osmolyte myo-inositol. Indications for individual cases in which clinical investigations and MR topography cannot provide sufficient certainty and spectroscopy can furnish additional information are, in addition to uses in neuropediatrics, the suspicion of Alzheimer's dementia, HIV encephalopathy in early manifestations, and unclarified depressions of consciousness accompanying liver cirrhosis. (orig.) [de

Driving clinical study efficiency by using a productivity breakdown model: comparative evaluation of a global clinical study and a similar Japanese study.

Science.gov (United States)

Takahashi, K; Sengoku, S; Kimura, H

2011-02-01

A fundamental management imperative of pharmaceutical companies is to contain surging costs of developing and launching drugs globally. Clinical studies are a research and development (R&D) cost driver. The objective of this study was to develop a productivity breakdown model, or a key performance indicator (KPI) tree, for an entire clinical study and to use it to compare a global clinical study with a similar Japanese study. We, thereby, hope to identify means of improving study productivity. We developed the new clinical study productivity breakdown model, covering operational aspects and cost factors. Elements for improving clinical study productivity were assessed from a management viewpoint by comparing empirical tracking data from a global clinical study with a Japanese study with similar protocols. The following unique and material differences, beyond simple international difference in cost of living, that could affect the efficiency of future clinical trials were identified: (i) more frequent site visits in the Japanese study, (ii) head counts at the Japanese study sites more than double those of the global study and (iii) a shorter enrollment time window of about a third that of the global study at the Japanese study sites. We identified major differences in the performance of the two studies. These findings demonstrate the potential of the KPI tree for improving clinical study productivity. Trade-offs, such as those between reduction in head count at study sites and expansion of the enrollment time window, must be considered carefully. © 2010 Blackwell Publishing Ltd.

77 FR 24985 - Importer of Controlled Substances; Notice of Application; Almac Clinical Services, Inc., (ACSI)

Science.gov (United States)

2012-04-26

... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances; Notice of Application; Almac Clinical Services, Inc., (ACSI) Pursuant to 21 U.S.C. 958(i), the Attorney General shall... on March 5, 2012, Almac Clinical Services, Inc., (ACSI), 25 Fretz Road, Souderton, Pennsylvania 18964...

Standards for the culture and quality control of umbilical cord mesenchymal stromal cells for neurorestorative clinical application (2017

Directory of Open Access Journals (Sweden)

Ao Q

2017-12-01

Full Text Available Qiang Ao,1,* Juan Xiao,2,3,* Yanqiu Yu,4 Gengsheng Mao,2 Qingyan Zou,5 Wenyong Gao,2,3 Hongyun Huang2,3 On behalf of Neurorestoratology Professional Committee of Chinese Medical Doctor Association (Chinese Association of Neurorestoratology 1Department of Tissue Engineering, China Medical University, Shen Yang, 2Institute of Neurorestoratology, General Hospital of Armed Police Forces, Beijing, 3Cell Therapy Center, Beijing Hongtianji Neuroscience Academy, Beijing, 4Department of Pathophysiology, China Medical University, Shen Yang, 5Guangdong 999 Brain Hospital, Guangzhou, People’s Republic of China *These authors contributed equally to this work Abstract: Formulating common standards for the culture and quality control of umbilical cord mesenchymal stromal cells (MSCs is crucial for the standardization of clinical neurorestorative therapy. But to date, there have been no standardized guidelines for the culture and quality control of MSCs in neurorestorative clinical application. Based on a relatively comprehensive review of published clinical studies as well as the existing methods of MSC culture and quality control, the Chinese Association of Neurorestoratology has developed standards for the culture and quality control of umbilical cord MSCs which possess the potential in neurorestorative clinical application. These guidelines include standardized training and management procedures for laboratory operators; standardized use and management of materials and equipment; standardized collection, culture and proliferation of umbilical cord MSCs; standardized management for cell preservation, transport and related safeguard measures; as well as standardization of a clean environment, routine maintenance and related tests and examinations and so on. These guidelines represent the minimum required standards for the culture and quality control of umbilical cord MSCs for potential use in current neurorestorative clinical therapy, and will be further

Statistical Validation of a Web-Based GIS Application and Its Applicability to Cardiovascular-Related Studies.

Science.gov (United States)

Lee, Jae Eun; Sung, Jung Hye; Malouhi, Mohamad

2015-12-22

There is abundant evidence that neighborhood characteristics are significantly linked to the health of the inhabitants of a given space within a given time frame. This study is to statistically validate a web-based GIS application designed to support cardiovascular-related research developed by the NIH funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) and discuss its applicability to cardiovascular studies. Geo-referencing, geocoding and geospatial analyses were conducted for 500 randomly selected home addresses in a U.S. southeastern Metropolitan area. The correlation coefficient, factor analysis and Cronbach's alpha (α) were estimated to quantify measures of the internal consistency, reliability and construct/criterion/discriminant validity of the cardiovascular-related geospatial variables (walk score, number of hospitals, fast food restaurants, parks and sidewalks). Cronbach's α for CVD GEOSPATIAL variables was 95.5%, implying successful internal consistency. Walk scores were significantly correlated with number of hospitals (r = 0.715; p restaurants (r = 0.729; p application were internally consistent and demonstrated satisfactory validity. Therefore, the GIS application may be useful to apply to cardiovascular-related studies aimed to investigate potential impact of geospatial factors on diseases and/or the long-term effect of clinical trials.

Application of single photon ECT for dynamic study

International Nuclear Information System (INIS)

Mukai, T.; Ishii, Y.; Tamaki, N.

1982-01-01

Feasibility of dynamic study in a form of ECT using a rotating gamma camera was evaluated. Since it takes longer one around time sampling, application for the dynamic study is limited under following conditions; 1) physiological gated process, 2) slow clearance process, 3) physiological steady state process. The gated study was applicated for heart pumping action synchronized with ECG. The ECG gated heart ECT either of blood pool or myocardium was useful to reveal a subtle wall motion abnormalities in a tomographic plane, even when a planar imaging failed to reveal it. As for slow dynamic process of tracer, an excretion process of hepatobiliary agent, was subjected to be analyzed in order to calculate clearance rate at each pixel. As for steady state process, an ECT of regional celebral blood flow (rCBF) was investigated during continuous infusion into intracarotid artery. All of these technique were proved to have a clinical feasibility and to potentiate usefulness of the single photon ECT (SPECT)

Clinical application of SPECT and PET in cerebrovascular disease

International Nuclear Information System (INIS)

Ra, Young Shin

2003-01-01

Single photon emission computed tomography(SPECT) and positron emission tomography(PET) are modern imaging techniques that allow for both qualitative are quantitative assessment of hemodynamic changes in cerebrovascular diseases. SPECT has been becoming an indispensable method to investigate regional cerebral blood flow because equipment and isotope are easily available in most general hospitals. Acetazolamide stress SPECT has also been proved to be useful to evaluate the cerebrovascular reserve of occlusive cerebrovascular diseases and to select surgical candidate. PET has gained wide spread clinical use in the evaluation of the hemodynamic and metabolic consequences of extracranial or intracranial arterial obstructive disease despite its complexity and limited availability. PET has been established as an invaluable tool in the pathophysilogy investigation of acute ischemic stroke. The potentials, limitations, and clinical applications of SPECT and PET in various cerebrovascular diseases will be discussed in this article with reviews of literatures

Clinical application of SPECT and PET in cerebrovascular disease

Energy Technology Data Exchange (ETDEWEB)

Ra, Young Shin [Ulsan University College of Medicine, Seoul (Korea, Republic of)

2003-02-01

Single photon emission computed tomography(SPECT) and positron emission tomography(PET) are modern imaging techniques that allow for both qualitative are quantitative assessment of hemodynamic changes in cerebrovascular diseases. SPECT has been becoming an indispensable method to investigate regional cerebral blood flow because equipment and isotope are easily available in most general hospitals. Acetazolamide stress SPECT has also been proved to be useful to evaluate the cerebrovascular reserve of occlusive cerebrovascular diseases and to select surgical candidate. PET has gained wide spread clinical use in the evaluation of the hemodynamic and metabolic consequences of extracranial or intracranial arterial obstructive disease despite its complexity and limited availability. PET has been established as an invaluable tool in the pathophysilogy investigation of acute ischemic stroke. The potentials, limitations, and clinical applications of SPECT and PET in various cerebrovascular diseases will be discussed in this article with reviews of literatures.

Experimental and clinical studies on CT lymphography

International Nuclear Information System (INIS)

Hirata, Yuzo; Kono, Michio

1982-01-01

Indirect lymphography using computed tomographic apparatus (CT Lymphography) was attempted in 15 dogs with newly devised contrast medium for the opacification of hilar and mediastinal lymphnodes. Clinical application was performed in 2 cases of lung cancer. Newly devised contrast material is an emulsion, which consists of oily contrast medium, non-ionic surfactant and glucose solution. The contrast medium was injected percutaneously into subdiaphragmatic space, or into bronchial walls by bronchofiberscopic technique. CT was able to demonstrate the opacified hilar and mediastinal nodes much more in number than demonstrated in conventional radiograms. It was true in 6 to 11 cases when injected into subdiaphragmatic spaces, and in 2 of 4 cases with an injection into bronchial walls. In clinical studies, CT revealed opacification of mediastinal nodes in one case of lung cancer. Although the procedure is still inferior to the demonstrability of routine indirect lymphography for the evaluation of the fine structure of each node, it showed no remarkable side effects. As the satisfactory method of opacifying hilar and mediastinal nodes has not yet been established, our method is thought to be of value in applying for detection of the metastatic lymphnodes. (author)

Temperature-controlled laser-soldering system and its clinical application for bonding skin incisions

Science.gov (United States)

Simhon, David; Gabay, Ilan; Shpolyansky, Gregory; Vasilyev, Tamar; Nur, Israel; Meidler, Roberto; Hatoum, Ossama Abu; Katzir, Abraham; Hashmonai, Moshe; Kopelman, Doron

2015-12-01

Laser tissue soldering is a method of repairing incisions. It involves the application of a biological solder to the approximated edges of the incision and heating it with a laser beam. A pilot clinical study was carried out on 10 patients who underwent laparoscopic cholecystectomy. Of the four abdominal incisions in each patient, two were sutured and two were laser soldered. Cicatrization, esthetical appearance, degree of pain, and pruritus in the incisions were examined on postoperative days 1, 7, and 30. The soldered wounds were watertight and healed well, with no discharge from these wounds or infection. The total closure time was equal in both methods, but the net soldering time was much shorter than suturing. There was no difference between the two types of wound closure with respect to the pain and pruritus on a follow-up of one month. Esthetically, the soldered incisions were estimated as good as the sutured ones. The present study confirmed that temperature-controlled laser soldering of human skin incisions is clinically feasible, and the results obtained were at least equivalent to those of standard suturing.

[Otomycosis and topical application of thimerosal: study of 152 cases].

Science.gov (United States)

Tisner, J; Millán, J; Rivas, P; Adiego, I; Castellote, A; Valles, H

1995-01-01

To evaluate the effectiveness of the topical application of Timerosal (merthilate tintura) in mycosis involving the external auditory canal. The study includes 152 patients with the clinical, otoscopic and microscopic diagnosis of otomycosis. Results were assessed 72 hours and 10 days after the application. Bacteriological study was performed in 83 patients, finding Aspergilly niger in 54.0% of the cases, Candida albicans in 25.4%, Aspergillus fumigatus in 15.8% and Penicillium in 4.8%. Improvement at 72 h. was found in 66.4% and at 10 days in 93.4% of the patients. Bacteriological contamination was found in 6.6% of the total. In most of the patients, the otomycosis healed after cleaning of the external auditory canal and topical application of timerosal. This method is easy to apply, fast, effective, of low cost and few side effects.

Studies on preparation of the database system for clinical records of atomic bomb survivors

International Nuclear Information System (INIS)

Nakamura, Tsuyoshi

1981-01-01

Construction of the database system aimed at multipurpose application of data on clinical medicine was studied through the preparation of database system for clinical records of atomic bomb survivors. The present database includes the data about 110,000 atomic bomb survivors in Nagasaki City. This study detailed: (1) Analysis of errors occurring in a period from generation of data in the clinical field to input into the database, and discovery of a highly precise, effective method of input. (2) Development of a multipurpose program for uniform processing of data on physical examinations from many organizations. (3) Development of a record linkage method for voluminous files which are essential in the construction of a large-scale medical information system. (4) A database model suitable for clinical research and a method for designing a segment suitable for physical examination data. (Chiba, N.)

78 FR 23594 - Importer of Controlled Substances, Notice of Application, Almac Clinical Services, Inc., (ACSI)

Science.gov (United States)

2013-04-19

... DEPARTMENT OF JUSTICE Drug Enforcement Administration Importer of Controlled Substances, Notice of Application, Almac Clinical Services, Inc., (ACSI) Pursuant to Title 21 Code of Federal Regulations 1301.34(a), this is notice that on March 5, 2013, Almac Clinical Services, Inc., (ACSI), 25 Fretz Road, Souderton...

[Universal ethical principles and their application in clinical drug trials].

Science.gov (United States)

Gonorazky, Sergio Eduardo

2015-03-01

Since 1931, and especially since the Nuremberg Code of 1947, an increasing number of declarations, regulations, norms, guidelines, laws, resolutions, and rules intended to create conditions for better protection of subjects participating in research studies have been published, although some have meant setbacks in the human rights of vulnerable populations. As such, violations of the dignity of experimental subjects in clinical trials continue. What researchers investigate and how the research is done, the quality and transparency of the data, and the analysis and the publication of results (of both raw and processed data) respond to the financial interests of the pharmaceutical companies, coming into permanent tension with bioethical principles and the needs of society. The active participation of civil society is necessary to make it so that pharmaceutical research, results and applications subordinate economic benefits to the protection of human rights.

The application of telemedicine in orthopedic surgery in singapore: a pilot study on a secure, mobile telehealth application and messaging platform.

Science.gov (United States)

Daruwalla, Zubin Jimmy; Wong, Keng Lin; Thambiah, Joseph

2014-06-05

The application of telemedicine has been described for its use in medical training and education, management of stroke patients, urologic surgeries, pediatric laparoscopic surgeries, clinical outreach, and the field of orthopedics. However, the usefulness of a secure, mobile telehealth application, and messaging platform has not been well described. A pilot study was conducted to implement a health insurance portability and accountability act (HIPAA) compliant form of communication between doctors in an orthopedic clinical setting and determine their reactions to MyDoc, a secure, mobile telehealth application, and messaging platform. By replacing current methods of communication through various mobile applications and text messaging services with MyDoc over a six week period, we gained feedback and determined user satisfaction with this innovative system from questionnaires handed to the program director, program coordinator, one trauma consultant, all orthopedic residents, and six non-orthopedic residents at the National University Hospital in Singapore. Almost everyone who completed the questionnaire strongly agreed that MyDoc should replace current systems of peer to peer communication in the hospital. The majority also felt that the quality of images, videos, and sound were excellent. Almost everyone agreed that they could communicate easily with each other and would feel comfortable doing so routinely. The majority felt that virtual consults through MyDoc should be made available to inpatients as well as outpatients to potentially lessen clinic loads and provide a secure manner in which patients can communicate with their primary teams any time convenient to both. It was also agreed by most that the potential of telerounding had advantages, especially on weekends as a supplement to normal rounds. Potential uses of MyDoc in an orthopedic clinical setting include HIPAA-compliant peer to peer communication, clinical outreach in the setting of trauma, supervision

Myocardial T1 and T2 mapping: Techniques and clinical applications

Energy Technology Data Exchange (ETDEWEB)

Kim, Pan Ki; Hong, Yoo Jin; Im, Dong Jin [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); and others

2017-01-15

Cardiac magnetic resonance (CMR) imaging is widely used in various medical fields related to cardiovascular diseases. Rapid technological innovations in magnetic resonance imaging in recent times have resulted in the development of new techniques for CMR imaging. T1 and T2 image mapping sequences enable the direct quantification of T1, T2, and extracellular volume fraction (ECV) values of the myocardium, leading to the progressive integration of these sequences into routine CMR settings. Currently, T1, T2, and ECV values are being recognized as not only robust biomarkers for diagnosis of cardiomyopathies, but also predictive factors for treatment monitoring and prognosis. In this study, we have reviewed various T1 and T2 mapping sequence techniques and their clinical applications.

Clinical application of fast neutrons

International Nuclear Information System (INIS)

Battermann, J.J.

1981-01-01

The results of treatments and clinical experiments with neutrons (from a medical d+T neutron generator with an output of 10 12 neutrons per second) are reported and discussed. Data on RBE values are presented after single doses and multiple fractions of neutrons and 60 Co-gamma rays on pulmonary metastases. The results of pilot studies on head and neck tumours, brain tumours and pelvic tumours are discussed. The accuracy of the calculated dose is tested with some in-vivo experiments during neutron irradiation of the pelvis. Estimations of RBE values for tumour control, skin damage and intestinal damage after fractionated neutron therapy are dealt with and the results obtained in treatment of sarcomas are discussed. The preliminary results are given of some clinical trials in Amsterdam. Also some data from other centres are reviewed. From these data some remarks about the future of neutron therapy are made. (Auth.)

Clinical Applications of Transcranial Magnetic Stimulation in Pediatric Neurology.

Science.gov (United States)

Narayana, Shalini; Papanicolaou, Andrew C; McGregor, Amy; Boop, Frederick A; Wheless, James W

2015-08-01

Noninvasive brain stimulation is now an accepted technique that is used as a diagnostic aid and in the treatment of neuropsychiatric disorders in adults, and is being increasingly used in children. In this review, we will discuss the basic principles and safety of one noninvasive brain stimulation method, transcranial magnetic stimulation. Improvements in the spatial accuracy of transcranial magnetic stimulation are described in the context of image-guided transcranial magnetic stimulation. The article describes and provides examples of the current clinical applications of transcranial magnetic stimulation in children as an aid in the diagnosis and treatment of neuropsychiatric disorders and discusses future potential applications. Transcranial magnetic stimulation is a noninvasive tool that is safe for use in children and adolescents for functional mapping and treatment, and for many children it aids in the preoperative evaluation and the risk-benefit decision making. © The Author(s) 2014.

A magneto-motive ultrasound platform designed for pre-clinical and clinical applications

Directory of Open Access Journals (Sweden)

Diego Ronaldo Thomaz Sampaio

Full Text Available Abstract Introduction Magneto-motive ultrasound (MMUS combines magnetism and ultrasound (US to detect magnetic nanoparticles in soft tissues. One type of MMUS called shear-wave dispersion magneto-motive ultrasound (SDMMUS analyzes magnetically induced shear waves (SW to quantify the elasticity and viscosity of the medium. The lack of an established presets or protocols for pre-clinical and clinical studies currently limits the use of MMUS techniques in the clinical setting. Methods This paper proposes a platform to acquire, process, and analyze MMUS and SDMMUS data integrated with a clinical ultrasound equipment. For this purpose, we developed an easy-to-use graphical user interface, written in C++/Qt4, to create an MMUS pulse sequence and collect the ultrasonic data. We designed a graphic interface written in MATLAB to process, display, and analyze the MMUS images. To exemplify how useful the platform is, we conducted two experiments, namely (i MMUS imaging to detect magnetic particles in the stomach of a rat, and (ii SDMMUS to estimate the viscoelasticity of a tissue-mimicking phantom containing a spherical target of ferrite. Results The developed software proved to be an easy-to-use platform to automate the acquisition of MMUS/SDMMUS data and image processing. In an in vivo experiment, the MMUS technique detected an area of 6.32 ± 1.32 mm2 where magnetic particles were heterogeneously distributed in the stomach of the rat. The SDMMUS method gave elasticity and viscosity values of 5.05 ± 0.18 kPa and 2.01 ± 0.09 Pa.s, respectively, for a tissue-mimicking phantom. Conclusion Implementation of an MMUS platform with addressed presets and protocols provides a step toward the clinical implementation of MMUS imaging equipment. This platform may help to localize magnetic particles and quantify the elasticity and viscosity of soft tissues, paving a way for its use in pre-clinical and clinical studies.

The applicability of Lean and Six Sigma techniques to clinical and translational research.

Science.gov (United States)

Schweikhart, Sharon A; Dembe, Allard E

2009-10-01

Lean and Six Sigma are business management strategies commonly used in production industries to improve process efficiency and quality. During the past decade, these process improvement techniques increasingly have been applied outside the manufacturing sector, for example, in health care and in software development. This article concerns the potential use of Lean and Six Sigma in improving the processes involved in clinical and translational research. Improving quality, avoiding delays and errors, and speeding up the time to implementation of biomedical discoveries are prime objectives of the National Institutes of Health (NIH) Roadmap for Medical Research and the NIH's Clinical and Translational Science Award program. This article presents a description of the main principles, practices, and methods used in Lean and Six Sigma. Available literature involving applications of Lean and Six Sigma to health care, laboratory science, and clinical and translational research is reviewed. Specific issues concerning the use of these techniques in different phases of translational research are identified. Examples of Lean and Six Sigma applications that are being planned at a current Clinical and Translational Science Award site are provided, which could potentially be replicated elsewhere. We describe how different process improvement approaches are best adapted for particular translational research phases. Lean and Six Sigma process improvement methods are well suited to help achieve NIH's goal of making clinical and translational research more efficient and cost-effective, enhancing the quality of the research, and facilitating the successful adoption of biomedical research findings into practice.

Quantification of human motion: gait analysis-benefits and limitations to its application to clinical problems.

Science.gov (United States)

Simon, Sheldon R

2004-12-01

The technology supporting the analysis of human motion has advanced dramatically. Past decades of locomotion research have provided us with significant knowledge about the accuracy of tests performed, the understanding of the process of human locomotion, and how clinical testing can be used to evaluate medical disorders and affect their treatment. Gait analysis is now recognized as clinically useful and financially reimbursable for some medical conditions. Yet, the routine clinical use of gait analysis has seen very limited growth. The issue of its clinical value is related to many factors, including the applicability of existing technology to addressing clinical problems; the limited use of such tests to address a wide variety of medical disorders; the manner in which gait laboratories are organized, tests are performed, and reports generated; and the clinical understanding and expectations of laboratory results. Clinical use is most hampered by the length of time and costs required for performing a study and interpreting it. A "gait" report is lengthy, its data are not well understood, and it includes a clinical interpretation, all of which do not occur with other clinical tests. Current biotechnology research is seeking to address these problems by creating techniques to capture data rapidly, accurately, and efficiently, and to interpret such data by an assortment of modeling, statistical, wave interpretation, and artificial intelligence methodologies. The success of such efforts rests on both our technical abilities and communication between engineers and clinicians.

New developments in clinical applications of CdTe and CdZnTe detectors

International Nuclear Information System (INIS)

Scheiber, C.

1996-01-01

This review about the medical applications of CdTe and CdZnTe is an update on the 1992 paper (1992). This new paper is legitimized by the recent progress which has been made in this field. First of all, the usefulness of a new material, i.e. CdZnTe, has been demonstrated. While the two materials are still being improved, it seems as yet too early to debate which of CdTe:Cl or CdZnTe will be the best choice. Historical applications span over the past 18 years, involving devices like miniature probes for per-operative scintigraphy or the monitoring of physiological functions and, closer to us, appliances dedicated to bone densitometry, and have been expanding as such devices have become commercially available, for many years now. Newly available microelectronic circuitry allows 2D-arrays to be built for digital quantitative X-ray (chest, dental..) and for high-resolution gamma cameras. The clinical demand is very high, especially in the field of nuclear medicine. Although there already exist clinical demonstrators, the future of such CdTe applications depends on further reduction in material and device mounting costs. New perspectives concern XCT applications, but the data resulting from research work are kept for restricted use within industrial R and D laboratories. (orig.)

Optical coherence tomography—current technology and applications in clinical and biomedical research

DEFF Research Database (Denmark)

Marschall, Sebastian; Sander, Birgit; Mogensen, Mette

2011-01-01

such as birefringence, motion, or the distributions of certain substances can be detected with high spatial resolution. Its main field of application is biomedical imaging and diagnostics. In ophthalmology, OCT is accepted as a clinical standard for diagnosing and monitoring the treatment of a number of retinal...

A study on job satisfaction among clinical and non-clinical hospital ...

African Journals Online (AJOL)

Methods: Two hundred clinical and non-clinical hospital staff were invited to take part in the study. They completed a sociodemographic questionnaire and the Job Descriptive Index (JDI). Results: The results indicated that majority clinical and non-clinical staff were satisfied with their jobs as regards the parameters of the ...

Clinical applications of gamma delta T cells with multivalent immunity

Directory of Open Access Journals (Sweden)

Drew C Deniger

2014-12-01

Full Text Available Gamma delta T cells hold promise for adoptive immunotherapy because of their reactivity to bacteria, viruses, and tumors. However, these cells represent a small fraction (1-5% of the peripheral T-cell pool and require activation and propagation to achieve clinical benefit. Aminobisphosphonates specifically expand the Vgamma9Vdelta2 subset of gamma delta T cells and have been used in clinical trials of cancer where objective responses were detected. The Vgamma9Vdelta2 TCR heterodimer binds multiple ligands and results in a multivalent attack by a monoclonal T cell population. Alternatively, populations of gamma delta T cells with oligoclonal or polyclonal TCR repertoire could be infused for broad-range specificity. However, this goal has been restricted by a lack of applicable expansion protocols for non-Vgamma9Vdelta2 cells. Recent advances using immobilized antigens, agonistic monoclonal antibodies (mAbs, tumor-derived artificial antigen presenting cells (aAPC, or combinations of activating mAbs and aAPC have been successful in expanding gamma delta T cells with oligoclonal or polyclonal TCR repertoires. Immobilized MHC Class-I chain-related A was a stimulus for gamma delta T cells expressing TCRdelta1 isotypes, and plate-bound activating antibodies have expanded Vdelta1 and Vdelta2 cells ex vivo. Clinically-sufficient quantities of TCRdelta1, TCRdelta2, and TCRdelta1negTCRdelta2neg have been produced following co-culture on aAPC, and these subsets displayed differences in memory phenotype and reactivity to tumors in vitro and in vivo. Gamma delta T cells are also amenable to genetic modification as evidenced by introduction of alpha beta TCRs, chimeric antigen receptors (CARs, and drug-resistance genes. This represents a promising future for the clinical application of oligoclonal or polyclonal gamma delta T cells in autologous and allogeneic settings that builds on current trials testing the safety and efficacy of Vgamma9Vdelta2 T cells.

Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications

Science.gov (United States)

Marzbani, Hengameh; Marateb, Hamid Reza; Mansourian, Marjan

2016-01-01

Neurofeedback is a kind of biofeedback, which teaches self-control of brain functions to subjects by measuring brain waves and providing a feedback signal. Neurofeedback usually provides the audio and or video feedback. Positive or negative feedback is produced for desirable or undesirable brain activities, respectively. In this review, we provided clinical and technical information about the following issues: (1) Various neurofeedback treatment protocols i.e. alpha, beta, alpha/theta, delta, gamma, and theta; (2) Different EEG electrode placements i.e. standard recording channels in the frontal, temporal, central, and occipital lobes; (3) Electrode montages (unipolar, bipolar); (4) Types of neurofeedback i.e. frequency, power, slow cortical potential, functional magnetic resonance imaging, and so on; (5) Clinical applications of neurofeedback i.e. treatment of attention deficit hyperactivity disorder, anxiety, depression, epilepsy, insomnia, drug addiction, schizophrenia, learning disabilities, dyslexia and dyscalculia, autistic spectrum disorders and so on as well as other applications such as pain management, and the improvement of musical and athletic performance; and (6) Neurofeedback softwares. To date, many studies have been conducted on the neurofeedback therapy and its effectiveness on the treatment of many diseases. Neurofeedback, like other treatments, has its own pros and cons. Although it is a non-invasive procedure, its validity has been questioned in terms of conclusive scientific evidence. For example, it is expensive, time-consuming and its benefits are not long-lasting. Also, it might take months to show the desired improvements. Nevertheless, neurofeedback is known as a complementary and alternative treatment of many brain dysfunctions. However, current research does not support conclusive results about its efficacy. PMID:27303609

Clinical features and applications of thallium-201. With reference to scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Fujii, Tadashige

1988-12-01

Thallium-201 is not only used widely in myocardial imaging but also has a great potential in other various nuclear medicine imaging studies. This paper presents clinical features and applications of thallium-201, focusing on clinical trials with thallium-201 at the Shinshu University School of Medicine. Thallium-201 myocardial scintigraphy offers information on (1) ventricular position and morphology, (2) hypertrophy or dilatation of the left ventricle, (3) hypertrophy or dilatation of the right ventricle, (4) site and extent of myocardial ischemia and infarct, (5) myocardial blood flow, (6) pulmonary congestion or interstitial pulmonary edema, and (7) pericardial effusion. It can be used in the following evaluation or diagnosis: (1) acute or old myocardial infarction, (2) angina pectoris, (3) treatment strategy or prognosis of ischemic heart disease, (4) treatment strategy or observation of bypass graft or drug therapy, (5) hypertrophic or dilated idiopathic cardiomyopathy, (6) myocardial lesions induced by sarcoidosis, collagen disease, and neuro-muscular disease, (7) ventricular hypertrophy and pulmonary edema, and (9) pericarditis, pericardial effusion, and systolic pericarditis associated with underlying disease. The significance of tumor, liver, bone marrow scintigraphies is also referred to. (Namekawa, K) 69 refs.

Uncertainty sources in radiopharmaceuticals clinical studies

International Nuclear Information System (INIS)

Degenhardt, Aemilie Louize; Oliveira, Silvia Maria Velasques de

2014-01-01

The radiopharmaceuticals should be approved for consumption by evaluating their quality, safety and efficacy. Clinical studies are designed to verify the pharmacodynamics, pharmacological and clinical effects in humans and are required for assuring safety and efficacy. The Bayesian analysis has been used for clinical studies effectiveness evaluation. This work aims to identify uncertainties associated with the process of production of the radionuclide and radiopharmaceutical labelling as well as the radiopharmaceutical administration and scintigraphy images acquisition and processing. For the development of clinical studies in the country, the metrological chain shall assure the traceability of the surveys performed in all phases. (author)

Translational Radiomics: Defining the Strategy Pipeline and Considerations for Application-Part 2: From Clinical Implementation to Enterprise.

Science.gov (United States)

Shaikh, Faiq; Franc, Benjamin; Allen, Erastus; Sala, Evis; Awan, Omer; Hendrata, Kenneth; Halabi, Safwan; Mohiuddin, Sohaib; Malik, Sana; Hadley, Dexter; Shrestha, Rasu

2018-03-01

Enterprise imaging has channeled various technological innovations to the field of clinical radiology, ranging from advanced imaging equipment and postacquisition iterative reconstruction tools to image analysis and computer-aided detection tools. More recently, the advancement in the field of quantitative image analysis coupled with machine learning-based data analytics, classification, and integration has ushered in the era of radiomics, a paradigm shift that holds tremendous potential in clinical decision support as well as drug discovery. However, there are important issues to consider to incorporate radiomics into a clinically applicable system and a commercially viable solution. In this two-part series, we offer insights into the development of the translational pipeline for radiomics from methodology to clinical implementation (Part 1) and from that point to enterprise development (Part 2). In Part 2 of this two-part series, we study the components of the strategy pipeline, from clinical implementation to building enterprise solutions. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Thymomodulin: biological properties and clinical applications.

Science.gov (United States)

Kouttab, N M; Prada, M; Cazzola, P

1989-01-01

Thymomodulin (Ellem Industria Farmaceutica s.p.a., Milan, Italy) is a calf thymus acid lysate derivative, composed of several peptides with a molecular weight range of 1-10 kD. Thymomodulin did not exhibit any mutagenic effect. Furthermore, thymomodulin used in animal studies showed no toxicity even when used at high concentrations. Of major significance are the observations in murine and human systems that thymomodulin remains active when administered orally. In vitro and in vivo administered thymomodulin was able to induce the maturation of T-lymphocytes. Additionally, studies in vitro showed that this thymic derivative can enhance the functions of mature T-lymphocytes with cascading effects on B-cell and macrophage functions. Extensive human clinical trials with thymomodulin showed that this agent can improve the clinical symptoms observed with various disease processes, including infections, allergies and malignancies, and can improve immunological functions during ageing.

Application of evidence-based dentistry: from research to clinical periodontal practice.

Science.gov (United States)

Kwok, Vivien; Caton, Jack G; Polson, Alan M; Hunter, Paul G

2012-06-01

Dentists need to make daily decisions regarding patient care, and these decisions should essentially be scientifically sound. Evidence-based dentistry is meant to empower clinicians to provide the most contemporary treatment. The benefits of applying the evidence-based method in clinical practice include application of the most updated treatment and stronger reasoning to justify the treatment. A vast amount of information is readily accessible with today's digital technology, and a standardized search protocol can be developed to ensure that a literature search is valid, specific and repeatable. It involves developing a preset question (population, intervention, comparison and outcome; PICO) and search protocol. It is usually used academically to perform commissioned reviews, but it can also be applied to answer simple clinical queries. The scientific evidence thus obtained can then be considered along with patient preferences and values, clinical patient circumstances and the practitioner's experience and judgment in order to make the treatment decision. This paper describes how clinicians can incorporate evidence-based methods into patient care and presents a clinical example to illustrate the process. © 2012 John Wiley & Sons A/S.

Clinical applications of PET-CT in nuclear medicine to medical specialists

International Nuclear Information System (INIS)

2012-08-01

This regional training course about Clinical Applications of PET-Tc in nuclear medicine include: imaging, pathology, scintigraphy, computed tomography, radiology, endoscopy, magnetic resonance, biopsy, and histology. It also describes pathologies and diseases of organs and bone structures such as: musculoskeletal and osseous damage, tumors, fibroids, metastasize, neoplasm, adenopathies and cancer of liver, brain, glands, kidney, neck, thorax, lungs, uterus, ovaries, craniums, hypophysis etc

Applicability Evaluation of Job Standards for Diabetes Nutritional Management by Clinical Dietitian.

Science.gov (United States)

Baek, Young Jin; Oh, Na Gyeong; Sohn, Cheong-Min; Woo, Mi-Hye; Lee, Seung Min; Ju, Dal Lae; Seo, Jung-Sook

2017-04-01

This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical dietitians of 40 tertiary hospitals, 47 general hospitals, and 9 hospitals. Based on each 5-point scale, the importance of overall duty was 4.4 ± 0.5, performance was 3.6 ± 0.8, and difficulty was 3.1 ± 0.7. 'Nutrition intervention' was 4.5 ± 0.5 for task importance, 'nutrition assessment' was 4.0 ± 0.7 for performance, and 'nutrition diagnosis' was 3.4 ± 0.9 for difficulty. These 3 items were high in each category. Based on the grid diagram, the tasks of both high importance and high performance were 'checking basic information,' 'checking medical history and therapy plan,' 'decision of nutritional needs,' 'supply of foods and nutrients,' and 'education of nutrition and self-management.' The tasks with high importance but low performance were 'derivation of nutrition diagnosis,' 'planning of nutrition intervention,' 'monitoring of nutrition intervention process.' The tasks of both high importance and high difficulty were 'derivation of nutrition diagnosis,' 'planning of nutrition intervention,' 'supply of foods and nutrients,' 'education of nutrition and self-management,' and 'monitoring of nutrition intervention process.' The tasks of both high performance and high difficulty were 'documentation of nutrition assessment,' 'supply of foods and nutrients,' and 'education of nutrition and self-management.'

How GPs implement clinical guidelines in everyday clinical practice--a qualitative interview study.

Science.gov (United States)

Le, Jette V; Hansen, Helle P; Riisgaard, Helle; Lykkegaard, Jesper; Nexøe, Jørgen; Bro, Flemming; Søndergaard, Jens

2015-12-01

Clinical guidelines are considered to be essential for improving quality and safety of health care. However, interventions to promote implementation of guidelines have demonstrated only partial effectiveness and the reasons for this apparent failure are not yet fully understood. To investigate how GPs implement clinical guidelines in everyday clinical practice and how implementation approaches differ between practices. Individual semi-structured open-ended interviews with seven GPs who were purposefully sampled with regard to gender, age and practice form. Interviews were recorded, transcribed verbatim and then analysed using systematic text condensation. Analysis of the interviews revealed three different approaches to the implementation of guidelines in clinical practice. In some practices the GPs prioritized time and resources on collective implementation activities and organized their everyday practice to support these activities. In other practices GPs discussed guidelines collectively but left the application up to the individual GP whilst others again saw no need for discussion or collective activities depending entirely on the individual GP's decision on whether and how to manage implementation. Approaches to implementation of clinical guidelines vary substantially between practices. Supporting activities should take this into account. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

RNA isolation from bloodstains collected on FTA cards – application in clinical and forensic genetics

OpenAIRE

Katarzyna Skonieczna; Jan Styczyński; Anna Krenska; Mariusz Wysocki; Aneta Jakubowska; Tomasz Grzybowski

2017-01-01

Aim of the study : In recent years, RNA analysis has been increasingly used in clinical and forensic genetics. Nevertheless, a major limitation of RNA-based applications is very low RNA stability in biological material, due to the RNAse activity. This highlights the need for improving the methods of RNA collection and storage. Technological approaches such as FTA Classic Cards (Whatman) could provide a solution for the problem of RNA degradation. However, different methods of RNA isolation fr...

TOPICAL REVIEW: Stem cell technology using bioceramics: hard tissue regeneration towards clinical application

Science.gov (United States)

Ohnishi, Hiroe; Oda, Yasuaki; Ohgushi, Hajime

2010-02-01

Mesenchymal stem cells (MSCs) are adult stem cells which show differentiation capabilities toward various cell lineages. We have already used MSCs for treatments of osteoarthritis, bone necrosis and bone tumor. For this purpose, culture expanded MSCs were combined with various ceramics and then implanted. Because of rejection response to allogeneic MSC implantation, we have utilized patients' own MSCs for the treatment. Bone marrow is a good cell source of MSCs, although the MSCs also exist in adipose tissue. When comparing osteogenic differentiation of these MSCs, bone marrow MSCs show more extensive bone forming capability than adipose MSCs. Thus, the bone marrow MSCs are useful for bone tissue regeneration. However, the MSCs show limited proliferation and differentiation capabilities that hindered clinical applications in some cases. Recent advances reveal that transduction of plural transcription factors into human adult cells results in generation of new type of stem cells called induced pluripotent stem cells (iPS cells). A drawback of the iPS cells for clinical applications is tumor formation after their in vivo implantation; therefore it is difficult to use iPS cells for the treatment. To circumvent the problem, we transduced a single factor of either SOX2 or NANOG into the MSCs and found high proliferation as well as osteogenic differentiation capabilities of the MSCs. The stem cells could be combined with bioceramics for clinical applications. Here, we summarize our recent technologies using adult stem cells in viewpoints of bone tissue regeneration.

A time-gated near-infrared spectroscopic imaging device for clinical applications.

Science.gov (United States)

Poulet, Patrick; Uhring, Wilfried; Hanselmann, Walter; Glazenborg, René; Nouizi, Farouk; Zint, Virginie; Hirschi, Werner

2013-03-01

A time-resolved, spectroscopic, diffuse optical tomography device was assembled for clinical applications like brain functional imaging. The entire instrument lies in a unique setup that includes a light source, an ultrafast time-gated intensified camera and all the electronic control units. The light source is composed of four near infrared laser diodes driven by a nanosecond electrical pulse generator working in a sequential mode at a repetition rate of 100 MHz. The light pulses are less than 80 ps FWHM. They are injected in a four-furcated optical fiber ended with a frontal light distributor to obtain a uniform illumination spot directed towards the head of the patient. Photons back-scattered by the subject are detected by the intensified CCD camera. There are resolved according to their time of flight inside the head. The photocathode is powered by an ultrafast generator producing 50 V pulses, at 100 MHz and a width corresponding to a 200 ps FWHM gate. The intensifier has been specially designed for this application. The whole instrument is controlled by an FPGA based module. All the acquisition parameters are configurable via software through an USB plug and the image data are transferred to a PC via an Ethernet link. The compactness of the device makes it a perfect device for bedside clinical applications. The instrument will be described and characterized. Preliminary data recorded on test samples will be presented.

Clinical application of magnetic resonance coronary angiography

International Nuclear Information System (INIS)

Murakami, Akihiko; Onoe, Teruyuki; Kodera, Akifumi; Ohtsuki, Tetsuya; Shiomi, Akio; Ida, Masaaki; Sawada, Takahisa

1999-01-01

We performed the magnetic resonance coronary angiography (MRCA) in the cases which underwent coronary angiography (CAG) and obtained images were compared. Lesion with significant constriction more than 75% on CAG were determined as abnormal findings on MRCA, however, lesions with about 50% constriction were as the normal findings. On the assessment of the re-constriction after PTCA, the changes in signal were found in about half of cases. This may come from the contribution of flexion lesions, the difficulty to assess moderate constriction after PTCA, etc. For the anomalous aortic origin of coronary artery, peripheral large vessels could be simultaneously imaged by MRCA and be also assessed among their clear spatial relationship. Although MRCA has some problems on the assessment for flexion or moderate constriction, these results suggested that MRCA is useful to clinical application as the non-invasive examination. (K.H.)

[Theory analysis and clinical application of spirit-regulating and pain-relieving acupuncture method].

Science.gov (United States)

Chen, Liang; Tang, Lewei; Du, Huaibin; Zheng, Hui; Liang, Fanrong

2015-04-01

The theoretical foundation and scientific connotation of spirit-regulating and pain-relieving acupuncture method as well as its clinical application for pain are discussed. During spirit regulation, attention should be paid on regulating heart and brain, while acupoints should be selected mainly from the Heart Meridian, Pericardium Meridian and Governor Vessel. It has significant efficacy for refractory pain in clinical treatment. Spirit-regulating and pain-relieving acupuncture method is development of acupuncture treating spirit, and it is an important method for pain in clinic. Improvement on sensitization of pain center and brain function is considered as one of the mechanisms in spirit-regulating and pain-relieving acupuncture method.

Multimodal imaging of bone metastases: From preclinical to clinical applications

Directory of Open Access Journals (Sweden)

Stephan Ellmann

2015-10-01

Full Text Available Metastases to the skeletal system are commonly observed in cancer patients, highly affecting the patients' quality of life. Imaging plays a major role in detection, follow-up, and molecular characterisation of metastatic disease. Thus, imaging techniques have been optimised and combined in a multimodal and multiparametric manner for assessment of complementary aspects in osseous metastases. This review summarises both application of the most relevant imaging techniques for bone metastasis in preclinical models and the clinical setting.

Aspects of matrix effects in applications of liquid chromatography-mass spectrometry to forensic and clinical toxicology--a review.

Science.gov (United States)

Peters, Frank T; Remane, Daniela

2012-06-01

In the last decade, liquid chromatography coupled to (tandem) mass spectrometry (LC-MS(-MS)) has become a versatile technique with many routine applications in clinical and forensic toxicology. However, it is well-known that ionization in LC-MS(-MS) is prone to so-called matrix effects, i.e., alteration in response due to the presence of co-eluting compounds that may increase (ion enhancement) or reduce (ion suppression) ionization of the analyte. Since the first reports on such matrix effects, numerous papers have been published on this matter and the subject has been reviewed several times. However, none of the existing reviews has specifically addressed aspects of matrix effects of particular interest and relevance to clinical and forensic toxicology, for example matrix effects in methods for multi-analyte or systematic toxicological analysis or matrix effects in (alternative) matrices almost exclusively analyzed in clinical and forensic toxicology, for example meconium, hair, oral fluid, or decomposed samples in postmortem toxicology. This review article will therefore focus on these issues, critically discussing experiments and results of matrix effects in LC-MS(-MS) applications in clinical and forensic toxicology. Moreover, it provides guidance on performance of studies on matrix effects in LC-MS(-MS) procedures in systematic toxicological analysis and postmortem toxicology.

Application of autogenic training for anxiety disorders: a clinical study in a psychiatric setting.

Science.gov (United States)

Sakai, M

1997-03-01

The effects of autogenic training for anxiety disorders were investigated in a psychiatric setting of a medical school hospital and the predictors of this treatment outcome were identified. Fifty-five patients who meet the DSM-III-R criteria for anxiety disorders were treated individually with autogenic training by the author from October 1981 to October 1995. The medical records of the patients were investigated retrospectively. The results showed that the autogenic training was successful. Twenty-eight patients (51%) were cured, fourteen (25%) much improved, eight (15%) improved and five (9%) unchanged at the end of the treatment. Forty-two patients (76%) were assessed as having had successful treatment. Pretreatment variables, such as patient's clinical characteristics, did not provide a useful guide to the outcome. Four treatment variables did have a bearing on outcome. First, practicing the second standard autogenic training exercise was a satisfactory predictor of a better outcome. Second, practicing generalization training also was a useful predictor. Third, the application of other behavioral treatment techniques was found to be positively associated with outcome. Fourth, longer treatment periods were associated with a better outcome. These findings suggested that autogenic training could be of significant benefit for the treatment of anxiety disorders.

Performance evaluation of the Cobas TaqMan MTB assay on respiratory specimens according to clinical application

Directory of Open Access Journals (Sweden)

Jong Eun Park

2017-11-01

Full Text Available Objective: To evaluate the performance of the Cobas TaqMan MTB assay (Cobas assay with respect to its clinical application. Methods: This was a retrospective analysis of 1154 results from 1034 patients for whom mycobacterial cultures and the Cobas assay were performed simultaneously. Based on the patient medical records, two categories of clinical application were defined: (1 the diagnosis of patients with a high probability of pulmonary tuberculosis according to clinical and radiological features (n = 128, and (2 the exclusion of tuberculosis in clinically indeterminate patients (n = 1026. Standard culture was used as the reference method. Results: The sensitivity of the Cobas assay for the detection of Mycobacterium tuberculosis was 70.4% (95% confidence interval (CI 49.7–85.5% for category 1, but only 25.0% (95% CI 4.5–64.4% for category 2. The specificity was ≥95.0% for both categories. The positive predictive value was 79.2% (95% CI 57.3–92.1% for category 1 and 33.3% (95% CI 6.0–75.9% for category 2, while the negative predictive value was 92.3% (95% CI 85.0–96.4% for category 1 and 99.4% (95% CI 98.7–99.8% for category 2. Conclusions: The results of this study indicate that Cobas assay results must be interpreted carefully according to the clinical purpose of the assay. Keywords: Mycobacterium tuberculosis, Pulmonary tuberculosis, Cobas TaqMan MTB assay, Korea

Application of MALDI-TOF MS for requalification of a Candida clinical isolates culture collection

Directory of Open Access Journals (Sweden)

Reginaldo Lima-Neto

2014-06-01

Full Text Available Microbial culture collections underpin biotechnology applications and are important resources for clinical microbiology by supplying reference strains and/or performing microbial identifications as a service. Proteomic profiles by MALDI-TOF MS have been used for Candida spp. identification in clinical laboratories and demonstrated to be a fast and reliable technique for the routine identification of pathogenic yeasts. The main aim of this study was to apply MALDI-TOF MS combined with classical phenotypic and molecular approaches to identify Candida clinical isolates preserved from 1 up to 52 years in a Brazilian culture collection and assess its value for the identification of yeasts preserved in this type of collections. Forty Candida spp. clinical isolates were identified by morphological and biochemical analyses. Identifications were also performed by the new proteomic approach based on MALDI-TOF MS. Results demonstrated 15% discordance when compared with morphological and biochemical analyses. Discordant isolates were analysed by ITS sequencing, which confirmed the MALDI-TOF MS identifications and these strains were renamed in the culture collection catalogue. In conclusion, proteomic profiles by MALDI-TOF MS represents a rapid and reliable method for identifying clinical Candida species preserved in culture collections and may present clear benefits when compared with the performance of existing daily routine methods applied at health centres and hospitals.

Economical and technical feasibility study of some radioisotopes production for medical application

International Nuclear Information System (INIS)

Souza, A.L.A.B. de.

1985-01-01

The economical and technical feasibility study of the production in reactors of some radioisotopes most used in medicine, are presented. The clinical applications of each radioisotope as well as its radioactive concentrations and specific activities are related. Irradiation procedures based in the foregoing data are given. Part of the study is dedicated to quality control. (M.A.C.) [pt

Applications of capillary electrophoresis with chemiluminescence detection in clinical, environmental and food analysis. A review

International Nuclear Information System (INIS)

Lara, Francisco J.; Airado-Rodríguez, Diego; Moreno-González, David; Huertas-Pérez, José F.; García-Campaña, Ana M.

2016-01-01

This paper reviews the latest developments and analytical applications of chemiluminescence detection coupled to capillary electrophoresis (CE-CL). Different sections considering the most common CL systems have been included, such as the tris(2,2′-bipyridine)ruthenium(II) system, the luminol and acridinium derivative reactions, the peroxyoxalate CL or direct oxidations. Improvements in instrumental designs, new strategies for improving both resolution and sensitivity, and applications in different fields such as clinical, pharmaceutical, environmental and food analysis have been included. This review covers the literature from 2010 to 2015. - Highlights: • An up-to-date critical review about the evolution of CE-CL is presented. • Tris(2,2′-bipyridine)ruthenium(II) and luminol as the most used CL systems. • Instrumental designs and strategies for improving resolution and sensitivity. • Applications in clinical, pharmaceutical, environmental and food analysis.

Clinical studies of 57Co-BLM for tumor detection

International Nuclear Information System (INIS)

Lee, Jhin Oh; Ryu, Yong Wun; Kim, Jang Hee

1986-12-01

Investigation with 57 Co-Bleomycin in patients with the various cancers and in tumor bearing animals are described. In the patients, 57 Co-Bleomycin appears to be one of the useful tumor-seeking radiopharmaceuticals, and worth applicable to clinical uses. Labelled yield of 57 Co-Bleo. was about 97% by thin layer chromatography. The pyrogen free tests were performed to meet U.S.P. critical ranges. In clinical studies with 57 Co-Bleo, 4 cases out of 5 patients with lung cancer, 2 cases among 3 thyroid cancer patients, and all 3 hepatoma patients showed positive tumor scans. The patients with stomach cancer, and the esophageal cancer showed false negative scintigraphy. A case with pulmonary tuberculosis showed a positive scan while liver abscess showed a negative picture. The merits of 57 Co-Bleomycin scintigraphy seems to be its relatively high affinity to tumors and low radiation hazard in spite of long physical half life. (Author)

Unique roles of SPET brain imaging in clinical and research studies

International Nuclear Information System (INIS)

Seibyl, J.; Jennings, D.; Tabamo, R.; Marek, K.

2005-01-01

The increasing availability of PET imaging in Nuclear medicine expands the armamentarium of clinical and research tools for improving diagnosis and treatment of neuropsychiatric disorders. Nonetheless, the role of SPEC imaging remains critical to both research and clinical practice. The development of rational strategies for guiding the selection of imaging modalities flows from primarily the nature of the clinical or research question and the availability of appropriate radiopharmaceuticals. There has been extensive SPECT and PET work in Parkinson's disease (PD) which highlights the value of both these scintigraphic modalities. Three main areas of interest in PD include imaging for improving diagnostic accuracy, for monitoring the progression of disease, and for assessing the therapeutic efficacy of drugs with neoroprotective potential. The demands of the clinical or research question posed to imaging dictates the selection of radiotracer and imaging modality. Diagnosis of PD represents the easiest challenge with many imaging bio markers showing high sensitivity for detecting abnormal reduction of dopaminergic function based on qualitative review of images. On the other hand, using imaging to evaluate treatments which purportedly slow the rate of disease progression, indicated by the reduction of the rate of loss in a quantitative imaging signal in patients studied over time, represents the most rigorous requirement of the imaging measure. In each of these applications presynaptic markers of dopaminergic function using SPECT and PET have been extremely valuable. Review of neuroimaging studies of PD provides a useful example of optimized approaches to clinical and research studies in neuropsychiatric disorders

Credibility, Replicability, and Reproducibility in Simulation for Biomedicine and Clinical Applications in Neuroscience

Science.gov (United States)

Mulugeta, Lealem; Drach, Andrew; Erdemir, Ahmet; Hunt, C. A.; Horner, Marc; Ku, Joy P.; Myers Jr., Jerry G.; Vadigepalli, Rajanikanth; Lytton, William W.

2018-01-01

Modeling and simulation in computational neuroscience is currently a research enterprise to better understand neural systems. It is not yet directly applicable to the problems of patients with brain disease. To be used for clinical applications, there must not only be considerable progress in the field but also a concerted effort to use best practices in order to demonstrate model credibility to regulatory bodies, to clinics and hospitals, to doctors, and to patients. In doing this for neuroscience, we can learn lessons from long-standing practices in other areas of simulation (aircraft, computer chips), from software engineering, and from other biomedical disciplines. In this manuscript, we introduce some basic concepts that will be important in the development of credible clinical neuroscience models: reproducibility and replicability; verification and validation; model configuration; and procedures and processes for credible mechanistic multiscale modeling. We also discuss how garnering strong community involvement can promote model credibility. Finally, in addition to direct usage with patients, we note the potential for simulation usage in the area of Simulation-Based Medical Education, an area which to date has been primarily reliant on physical models (mannequins) and scenario-based simulations rather than on numerical simulations. PMID:29713272

Credibility, Replicability, and Reproducibility in Simulation for Biomedicine and Clinical Applications in Neuroscience

Directory of Open Access Journals (Sweden)

Lealem Mulugeta

2018-04-01

Full Text Available Modeling and simulation in computational neuroscience is currently a research enterprise to better understand neural systems. It is not yet directly applicable to the problems of patients with brain disease. To be used for clinical applications, there must not only be considerable progress in the field but also a concerted effort to use best practices in order to demonstrate model credibility to regulatory bodies, to clinics and hospitals, to doctors, and to patients. In doing this for neuroscience, we can learn lessons from long-standing practices in other areas of simulation (aircraft, computer chips, from software engineering, and from other biomedical disciplines. In this manuscript, we introduce some basic concepts that will be important in the development of credible clinical neuroscience models: reproducibility and replicability; verification and validation; model configuration; and procedures and processes for credible mechanistic multiscale modeling. We also discuss how garnering strong community involvement can promote model credibility. Finally, in addition to direct usage with patients, we note the potential for simulation usage in the area of Simulation-Based Medical Education, an area which to date has been primarily reliant on physical models (mannequins and scenario-based simulations rather than on numerical simulations.

Personalized skincare: from molecular basis to clinical and commercial applications

Directory of Open Access Journals (Sweden)

Markiewicz E

2018-04-01

Full Text Available Ewa Markiewicz, Olusola Clement Idowu Research & Development, Hexis Lab, Science Central, The Core, Bath Lane, Newcastle upon Tyne, UK Abstract: Individual responses of human skin to the environmental stress are determined by differences in the anatomy and physiology that are closely linked to the genetic characteristics such as pigmentation. Ethnic skin phenotypes can be distinguished based on defined genotypic traits, structural organization and compartmentalized sensitivity to distinct extrinsic aging factors. These differences are not only responsible for the variation in skin performance after exposure to damaging conditions, but can also affect the mechanisms of drug absorption, sensitization and other longer term effects. The unique characteristics of the individual skin function and, particularly, of the ethnic skin type are currently considered to shape the future of clinical and pharmacologic interventions as a basis for personalized skincare. Individual approaches to skincare render a novel and actively growing area with a range of biomedical and commercial applications within cosmetics industry. In this review, we summarize the aspects of the molecular and clinical manifestations of the environmental stress on human skin and proposed protective mechanisms that are linked to ethnic differences and pathophysiology of extrinsic skin aging. We subsequently discuss the possible applications and translation of this knowledge into personalized skincare. Keywords: pigmentation, gene polymorphism, photodamage, environmental stress, cosmetics

Constructive interference in steady-state/FIESTA-C clinical applications in neuroimaging

International Nuclear Information System (INIS)

Kulkami, Makarand

2011-01-01

Full text: High spatial resolution is one of the major problems in neuroimaging, par ticularly in cranial and spinal nerve imaging. Constructive interference in steady-state/fast imaging employing steady-state acquisition with phase cycling is a robust sequence in imaging the cranial and spinal nerve patholo gies. This pictorial review is a concise article about the applications of this sequence in neuroimaging with clinical examples.

Animal models of osteogenesis imperfecta: applications in clinical research

Directory of Open Access Journals (Sweden)

Enderli TA

2016-09-01

Full Text Available Tanya A Enderli, Stephanie R Burtch, Jara N Templet, Alessandra Carriero Department of Biomedical Engineering, Florida Institute of Technology, Melbourne, FL, USA Abstract: Osteogenesis imperfecta (OI, commonly known as brittle bone disease, is a genetic disease characterized by extreme bone fragility and consequent skeletal deformities. This connective tissue disorder is caused by mutations in the quality and quantity of the collagen that in turn affect the overall mechanical integrity of the bone, increasing its vulnerability to fracture. Animal models of the disease have played a critical role in the understanding of the pathology and causes of OI and in the investigation of a broad range of clinical therapies for the disease. Currently, at least 20 animal models have been officially recognized to represent the phenotype and biochemistry of the 17 different types of OI in humans. These include mice, dogs, and fish. Here, we describe each of the animal models and the type of OI they represent, and present their application in clinical research for treatments of OI, such as drug therapies (ie, bisphosphonates and sclerostin and mechanical (ie, vibrational loading. In the future, different dosages and lengths of treatment need to be further investigated on different animal models of OI using potentially promising treatments, such as cellular and chaperone therapies. A combination of therapies may also offer a viable treatment regime to improve bone quality and reduce fragility in animals before being introduced into clinical trials for OI patients. Keywords: OI, brittle bone, clinical research, mouse, dog, zebrafish

Properties and clinical application of zirconia bioceramics in medicine

Directory of Open Access Journals (Sweden)

Čedomir Oblak

2014-01-01

Full Text Available Background: A group of inorganic non-metal biomaterials, that are commonly used in clinical medicine to replace or repair tissues, can be classified as a bioceramics. This group includes bioactive glasses, glass-ceramics, hydroxy-apatite and some other calcium phosphates. In addition, some bio-inert engineering ceramics materials have become increasingly utilised, aluminum oxide, zirconium oxide and their composites being the most popular. With the developement of yttria stabilized tetragonal zirconium oxide ceramics (Y-TZP medical community received a high strength biomaterial that is currently a material of choice for the manufacturing of medical devices. Y-TZP ceramics is becoming also increasingly used in dental medicine, where frameworks are manufactured by the use of computer-assisted technology.Conclusions: The article describes the basic properties of zirconia oxide ceramics important for the use in clinical medicine; high strength and fracture toughness, biocompatibility and negligible radiation. The ageing issue of this particular material, which is attributable to the thermo-dynamical instability of tetragonal zirconium oxide in hydrothermal conditions, is also discussed. When exposed to an aqueous environment over long periods of time, the surface of the Y-TZP ceramic will start transforming spontaneously into the monoclinic structure. The mechanism leading to the t-m transformation is temperature-dependent and is accompanied by extensive micro-cracking, which ultimately leads to strength degradation. The degradation might influence the clinical success rate of medical devices and therefore Y-TZP femoral heads are no longer made of pure zirconium oxide. Composites of zirconium and aluminium oxides are used instead, that are currently the strongest ceramic materials used in clinical medicine. In this work the clinical application of zirconia oxide ceramics in dental medicine is also presented. Conventional porcelain fused to metal

Feature Issue Introduction: Bio-Optics in Clinical Applications, Nanotechnology, and Drug Discovery

OpenAIRE

Nordstrom, Robert J.; Almutairi, Adah; Hillman, Elizabeth M.C.

2010-01-01

The editors introduce the Biomedical Optics Express feature issue, “Bio-Optics in Clinical Applications, Nanotechnology, and Drug Discovery,” which combines three technical areas from the 2010 Optical Society of America (OSA), Biomedical Optics (BIOMED) Topical Meeting held on 11–14 April in Miami, FL and includes contributions from conference attendees.

A CLINICAL STUDY ON BLUNT INJURY ABDOMEN

Directory of Open Access Journals (Sweden)

G. Kishore Babu

2016-10-01

Full Text Available BACKGROUND Abdominal trauma continues to account for a large number of trauma-related injuries and deaths. Motor vehicle accidents and urban violence, respectively, are the leading causes of blunt and penetrating trauma to this area of the body. Unnecessary deaths and complications can be minimized by improved resuscitation, evaluation and treatment. The new techniques and diagnostic tools available are important in the management of abdominal trauma. These improved methods, however, still depend on experience and clinical judgment for application and determination of the best care for the injured patient. The aim of the study is to 1. Analyse the incidence, clinical characteristics, diagnosis, indications for laparotomy, therapeutic methods and morbidity & mortality rates. 2. To study nature of blunt abdominal trauma. 3. To assess patient for surgical intervention and to avoid negative laparotomy. 4. To assess morbidity rate in different organs injury. 5. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS This study is a prospective study on 97 patients with Blunt injuries to the abdomen admitted in S.V.R.R.G.G. Hospital, Tirupati during October 2013-15. Inclusion Criteria Patients > 13 years, with Blunt injury to abdomen either by RTA, fall, object contact, assault giving written informed consent. Exclusion Criteria Patients <13 yrs. Blunt injuries due to blasts, patients with severe cardiothoracic and head injuries who are hemodynamically unstable. CONCLUSION Blunt Trauma to abdomen is on rise due to excessive use of motor vehicles. It poses a therapeutic and diagnostic dilemma for the attending surgeon due to wide range of clinical manifestations ranging from no early physical findings to progression to shock. So, the Trauma surgeon should rely on his physical findings in association with use of modalities like x-ray abdomen, USG abdomen and abdominal paracentesis. Hollow viscus perforations are

Recent advances in computational methods and clinical applications for spine imaging

CERN Document Server

Glocker, Ben; Klinder, Tobias; Li, Shuo

2015-01-01

This book contains the full papers presented at the MICCAI 2014 workshop on Computational Methods and Clinical Applications for Spine Imaging. The workshop brought together scientists and clinicians in the field of computational spine imaging. The chapters included in this book present and discuss the new advances and challenges in these fields, using several methods and techniques in order to address more efficiently different and timely applications involving signal and image acquisition, image processing and analysis, image segmentation, image registration and fusion, computer simulation, image based modeling, simulation and surgical planning, image guided robot assisted surgical and image based diagnosis. The book also includes papers and reports from the first challenge on vertebra segmentation held at the workshop.

Clinical Outcomes Used in Clinical Pharmacy Intervention Studies in Secondary Care

Directory of Open Access Journals (Sweden)

Lene Juel Kjeldsen

2017-05-01

Full Text Available The objective was to investigate type, frequency and result of clinical outcomes used in studies to assess the effect of clinical pharmacy interventions in inpatient care. The literature search using Pubmed.gov was performed for the period up to 2013 using the search phrases: “Intervention(s” and “pharmacist(s” and “controlled” and “outcome(s” or “effect(s”. Primary research studies in English of controlled, clinical pharmacy intervention studies, including outcome evaluation, were selected. Titles, abstracts and full-text papers were assessed individually by two reviewers, and inclusion was determined by consensus. In total, 37 publications were included in the review. The publications presented similar intervention elements but differed in study design. A large variety of outcome measures (135 had been used to evaluate the effect of the interventions; most frequently clinical measures/assessments by physician and health care service use. No apparent pattern was established among primary outcome measures with significant effect in favour of the intervention, but positive effect was most frequently related to studies that included power calculations and sufficient inclusion of patients (73% vs. 25%. This review emphasizes the importance of considering the relevance of outcomes selected to assess clinical pharmacy interventions and the importance of conducting a proper power calculation.

Clinical effectiveness of diode laser therapy as an adjunct to non-surgical periodontal treatment: a randomized clinical study.

Science.gov (United States)

Dukić, Walter; Bago, Ivona; Aurer, Andrej; Roguljić, Marija

2013-08-01

The aim of this randomized clinical study is to evaluate the effect of a 980-nm diode laser as an adjunct to scaling and root planing (SRP) treatment. Thirty-five patients with chronic periodontitis were selected for the split-mouth clinical study. SRP was performed using a sonic device and hand instruments. Quadrants were equally divided between the right and left sides. Teeth were treated with SRP in two control quadrants (control groups [CG]), and the diode laser was used adjunctively with SRP in contralateral quadrants (laser groups [LG]). Diode laser therapy was applied to periodontal pockets on days 1, 3, and 7 after SRP. Baseline data, including approximal plaque index (API), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), were recorded before the treatment and 6 and 18 weeks after treatment. Changes in PD and CAL were analyzed separately for initially moderate (4 to 6 mm) and deep (7 to 10 mm) pockets. The results were similar for both groups in terms of API, BOP, PD in deep pockets, and CAL. The laser group showed only significant PD gain in moderate pockets during the baseline to 18-week (P 0.05). The present study indicates that, compared to SRP alone, multiple adjunctive applications of a 980-nm diode laser with SRP showed PD improvements only in moderate periodontal pockets (4 to 6 mm).

Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors: A Randomized Controlled Trial.

Science.gov (United States)

Lyu, Ke-Xing; Zhao, Jing; Wang, Bin; Xiong, Guan-Xia; Yang, Wei-Qiang; Liu, Qi-Hong; Zhu, Xiao-Lin; Sun, Wei; Jiang, Ai-Yun; Wen, Wei-Ping; Lei, Wen-Bin

2016-12-05

Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up. A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up (WFU) group or telephone follow-up (TFU) group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method. Time consumption in WFU group for each patient (23.36 ± 6.16 min) was significantly shorter than that in TFU group (42.89 ± 7.15 min) (P smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions. Chinese Clinical Trial Registry, ChiCTR-IOR-15007498; http://www.chictr.org.cn/ showproj.aspx?proj=12613.

Approach to pharmacological and clinical applications of Anisi aetheroleum

Directory of Open Access Journals (Sweden)

Khaled Mohamed Mohamed Koriem

2015-01-01

Full Text Available Anisi aetheroleum is the oil obtained from Pimpinella anisum L. (P. anisum by steam distillation. P. anisum seeds were air-dried, and then the dry seeds were crushed, pulverized, and weighed in sequence for anise oil preparation. P. anisum is one of the oldest medicinal plants that belong to family Apiaceae. The fruit of P. anisum is harvested in August and September. P. anisum is widespread in Asia, Africa and Europe. Local names of P. anisum include anise, anisoon, roomy, saunf, sweet cumin and yansoon. The anise oil odour is aromatic while the oil tastes sweet. The average daily dose of Anisi aetheroleum is 0.3 g. trans-Anethole is the major ingredient of the anise oil. Anisi aetheroleum also displays a protective action against neurotoxicity. In addition, Anisi aetheroleum increases glucose absorption and reduces urine output in the rat. The plant oil have pharmacological (antimicrobial, hepatoprotective, anticonvulsant, anti-inflammatory, antispasmodic, bronchodilator, estrogenic, expectorant and insecticidal effects and clinical effects on nausea, constipation, menopausal period, virus, diabetes, obesity and sedative action. Owing to the wide application of Anisi aetheroleum in pharmacological and clinical fields, it is recommended for more clinical trails to discover a new medication from the active constituents of the plant oil in the future to treat human diseases especially chronic ones.

Real-time three dimensional transesophageal echocardiography: technical aspects and clinical applications

Directory of Open Access Journals (Sweden)

Sergio Mondillo

2010-02-01

Full Text Available Real-time three-dimensional transeso-phageal echocardiography (RT3DTEE is now commonly used in daily clinical practice. The transesophageal, compared to the transthoracic approach, allows the visualization of the whole spectrum of the mitral valve apparatus and the posterior cardiac structures. Moreover, images obtained by RT 3D TEE provide a unique and complete visualization of the mitral valve prosthetic elements. Indeed, the possibility to visualize guidewires and catheters in cardiac chambers and their relationship with cardiac structures during percutaneous transcatheter procedures reduces the time of radiation exposure and simplifies the approach becoming the reference method for monitoring. This review aims to underline the potential clinical applications and the advantages of RT3DTEE compared to other methods.

Clinical application of antenatal genetic diagnosis of osteogenesis imperfecta type IV.

Science.gov (United States)

Yuan, Jing; Li, Song; Xu, YeYe; Cong, Lin

2015-04-02

Clinical analysis and genetic testing of a family with osteogenesis imperfecta type IV were conducted, aiming to discuss antenatal genetic diagnosis of osteogenesis imperfecta type IV. Preliminary genotyping was performed based on clinical characteristics of the family members and then high-throughput sequencing was applied to rapidly and accurately detect the changes in candidate genes. Genetic testing of the III5 fetus and other family members revealed missense mutation in c.2746G>A, pGly916Arg in COL1A2 gene coding region and missense and synonymous mutation in COL1A1 gene coding region. Application of antenatal genetic diagnosis provides fast and accurate genetic counseling and eugenics suggestions for patients with osteogenesis imperfecta type IV and their families.

Intracoronary Optical Coherence Tomography: A Comprehensive Review: Clinical and Research Applications

OpenAIRE

Bezerra, Hiram G.; Costa, Marco A.; Guagliumi, Giulio; Rollins, Andrew M.; Simon, Daniel I.

2009-01-01

Cardiovascular optical coherence tomography (OCT) is a catheter-based invasive imaging system. Using light rather than ultrasound, OCT produces high-resolution in vivo images of coronary arteries and deployed stents. This comprehensive review will assist practicing interventional cardiologists in understanding the technical aspects of OCT based upon the physics of light and will also highlight the emerging research and clinical applications of OCT. Semi-automated imaging analyses of OCT syste...

[Recent development of metabonomics and its applications in clinical research].

Science.gov (United States)

Li, Hao; Jiang, Ying; He, Fu-Chu

2008-04-01

In the post-genomic era, systems biology is central to the biological sciences. Functional genomics such as transcriptomics and proteomics can simultaneous determine massive gene or protein expression changes following drug treatment or other intervention. However, these changes can't be coupled directly to changes in biological function. As a result, metabonomics and its many pseudonyms (metabolomics, metabolic profiling, etc.) have exploded onto the scientific scene in the past several years. Metabonomics is a rapidly growing research area and a system approach for comprehensive and quantitative analysis of the global metabolites in a biological matrix. Analytical chemistry approach is necessary for the development of comprehensive metabonomics investigations. Fundamentally, there are two types of metabonomics approaches: mass-spectrometry (MS) based and nuclear magnetic resonance (NMR) methodologies. Metabonomics measurements provide a wealth of data information and interpretation of these data relies mainly on chemometrics approaches to perform large-scale data analysis and data visualization, such as principal and independent component analysis, multidimensional scaling, a variety of clustering techniques, and discriminant function analysis, among many others. In this review, the recent development of analytical and statistical techniques used in metabonomics is summarized. Major applications of metabonomics relevant to clinical and preclinical study are then reviewed. The applications of metabonomics in study of liver diseases, cancers and other diseases have proved useful both as an experimental tool for pathogenesis mechanism re-search and ultimately a tool for diagnosis and monitoring treatment response of these diseases. Next, the applications of metabonomics in preclinical toxicology are discussed and the role that metabonomics might do in pharmaceutical research and development is explained with special reference to the aims and achievements of the

Clinical application of radioaerosol studies - pulmonary embolism, inhalation burns and glue-sniffers and COPD

International Nuclear Information System (INIS)

Sundram, Felix

1994-01-01

The alveolar epithelium and the capillary endothelium together form the alveolar capillary membrane. Fluid exchange occurs across this membrane, and is dependent on intravascular and interstitial hydrostatic and oncotic pressures, and on permeability of this membrane. Damage to either the alveolar or capillary component can result in a high permeability pulmonary oedema, even though the alveolar epithelium forms an extremely tight membrane which is ten times less permeable than the capillary endothelium. Nuclear medicine methods can be used to observe changes in integrity of pulmonary capillary endothelium (with first pass dual-indicator dilution technique using successive injections of radiotracer), and of alveolar epithelium, and it is important that the damage should be detected before patients develop clinical pulmonary oedema so that intensive therapy can be instituted early. We have used 99m Tc DTPA radioaerosol to measure alteration in pulmonary epithelial permeability and to image the distribution of ventilation in normal and some pathological states. In some clinical studies Tc-99m (tin) colloid radioaerosol has been used to obtain the ventilation images

Magnetic resonance spectroscopy in pediatric neuroradiology: clinical and research applications

International Nuclear Information System (INIS)

Panigrahy, Ashok; Nelson, Marvin D.; Blueml, Stefan

2010-01-01

Magnetic resonance spectroscopy (MRS) offers a unique, noninvasive approach to assess pediatric neurological abnormalities at microscopic levels by quantifying cellular metabolites. The most widely available MRS method, proton ( 1 H; hydrogen) spectroscopy, is FDA approved for general use and can be ordered by clinicians for pediatric neuroimaging studies if indicated. There are a multitude of both acquisition and post-processing methods that can be used in the implementation of MR spectroscopy. MRS in pediatric neuroimaging is challenging to interpret because of dramatic normal developmental changes that occur in metabolites, particularly in the first year of life. Still, MRS has been proven to provide additional clinically relevant information for several pediatric neurological disease processes such as brain tumors, infectious processes, white matter disorders, and neonatal injury. MRS can also be used as a powerful quantitative research tool. In this article, specific research applications using MRS will be demonstrated in relation to neonatal brain injury and pediatric brain tumor imaging. (orig.)

Applicability Of A Semi-Automated Clinical Chemistry Analyzer In Determining The Antioxidant Concentrations Of Selected Plants

Directory of Open Access Journals (Sweden)

Allan L. Hilario

2017-07-01

Full Text Available Plants are rich sources of antioxidants that are protective against diseases associated to oxidative stress. There is a need for high throughput screening method that should be useful in determining the antioxidant concentration in plants. Such screening method should significantly simplify and speed up most antioxidant assays. This paper aimed at comparing the applicability of a semi-automated clinical chemistry analyzer Pointe Scientific MI USA with the traditional standard curve method and using a Vis spectrophotometer in performing the DPPH assay for antioxidant screening. Samples of crude aqueous leaf extract of kulitis Amaranthus viridis Linn and chayote Sechium edule Linn were screened for the Total Antioxidant Concentration TAC using the two methods. Results presented in mean SD amp956gdl were compared using unpaired Students t-test P0.05. All runs were done in triplicates. The mean TAC of A. viridis was 646.0 45.5 amp956gdl using the clinical chemistry analyzer and 581.9 19.4 amp956gdl using the standard curve-spectrophotometer. On the other hand the mean TAC of S. edule was 660.2 35.9 amp956gdl using the semi-automated clinical chemistry analyzer and 672.3 20.9 amp956gdl using the spectrophotometer. No significant differences were observed between the readings of the two methods for A. viridis P0.05 and S. edible P0.05. This implies that the clinical chemistry analyzer can be an alternative method in conducting the DPPH assay to determine the TAC in plants. This study presented the applicability of a semi-automated clinical chemistry analyzer in performing the DPPH assay. Further validation can be conducted by performing other antioxidant assays using this equipment.

Applicability of supervised discriminant analysis models to analyze astigmatism clinical trial data

Directory of Open Access Journals (Sweden)

Sedghipour MR

2012-09-01

Full Text Available Mohammad Reza Sedghipour,1 Homayoun Sadeghi-Bazargani2,31Nikoukari Ophthalmology University Hospital, Tabriz, Iran; 2Department of Statistics and Epidemiology, Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Public Health Sciences, Karolinska Institute, Stockholm, SwedenBackground: In astigmatism clinical trials where more complex measurements are common, especially in nonrandomized small sized clinical trials, there is a demand for the development and application of newer statistical methods.Methods: The source data belonged to a project on astigmatism treatment. Data were used regarding a total of 296 eyes undergoing different astigmatism treatment modalities: wavefront-guided photorefractive keratectomy, cross-cylinder photorefractive keratectomy, and monotoric (single photorefractive keratectomy. Astigmatism analysis was primarily done using the Alpins method. Prior to fitting partial least squares regression discriminant analysis, a preliminary principal component analysis was done for data overview. Through fitting the partial least squares regression discriminant analysis statistical method, various model validity and predictability measures were assessed.Results: The model found the patients treated by the wavefront method to be different from the two other treatments both in baseline and outcome measures. Also, the model found that patients treated with the cross-cylinder method versus the single method didn't appear to be different from each other. This analysis provided an opportunity to compare the three methods while including a substantial number of baseline and outcome variables.Conclusion: Partial least squares regression discriminant analysis had applicability for the statistical analysis of astigmatism clinical trials and it may be used as an adjunct or alternative analysis method in small sized clinical trials.Keywords: astigmatism, regression, partial least squares regression

T-configured Dual Stent Placement in Malignant Biliary Hilar Obstruction: Technique and Clinical Application

International Nuclear Information System (INIS)

Jeon, Yong Sik; Kim, Ji Hyung

2010-01-01

To evaluate implanting techniques of T-configured dual stents in malignant hilar obstruction and investigate the clinical factors related to stent obstruction. The study included 28 patients undergoing T-configured dual stent implantation to palliate malignant biliary hilar obstruction. The unilobar approach was first attempted in the procedure, which progressed to bilobar approach when it was found that the unilobar approach was not feasible. If the stent was again obstructed, clinical palliation was attempted using stent re-insertion or PTBD. Clinical factors associated with T-configured dual stenting were examined in the patients with stent re-obstruction, which was followed by a correlation between these clinical factors and stent obstruction. Eleven of 13 patients were successfully treated by the unilobar approach. The two unsuccessful cases sustained angulation of the central large mesh stent. For the bilobar approach, 14 of 15 patients were successfully treated. For the one unsuccessful patient, the stent failed to pass through the central large mesh. Stent obstruction was revealed in 13 patients during the follow-up period. Balloon-assisted stent re-canalization was successfully performed in 5 patients. The analysis suggests that no definite correlation was found between stent obstruction and the clinical factors associated with dual stent placement. Conversely, bile containing sludge or debris was significantly correlated to early stent obstruction. Technical adoption considering the bile duct anatomy and obstruction pattern is important for T-configured dual stent implantation. The prudent evaluation of bile juice characters and cholangiographic findings is required for the appropriate clinical application of the T-configured dual stenting

The fate of prospective spine studies registered on www.ClinicalTrials.gov.

Science.gov (United States)

Ohnmeiss, Donna D

2015-03-01

There has been concern expressed about research ethics with respect to not fully reporting data collected during clinical studies. One site available for all clinical trials is ClinicalTrials.gov. The original purpose of this site was to facilitate patients seeking a trial for the treatment of their particular condition. The internationally available site offers general information about the study, sponsor name, principal investigator, patient selection criteria, enrollment goal, study design, outcome measures, participating centers, initiation date, date posted, date completed, and other pertinent data. The site can be used to identify studies conducted for a particular condition or intervention. The purpose of this study was to investigate the fate of spine-related studies registered on www.ClinicalTrials.gov, with particular focus on the publication rate of completed trials. Analysis and classification of clinical studies posted on an international research registry Web page and literature search for related publications. Not applicable. The primary outcome measure was publication of the study registered on ClinicalTrials.gov. Multiple searches were conducted on ClinicalTrials.gov Web site to identify studies related to commonly treated spinal conditions, including herniated disc, degenerative disc disease, stenosis, and spondylolisthesis. Studies related to tumors, fractures, or that included nonspine conditions were not included. For studies classified as completed more than 18 months before this review, literature searches were conducted to determine if the results of the study had been published and factors related to publication. The author has no financial conflict related to this work. There were 263 spine-related studies identified from searches on the ClinicalTrials.gov site. Data on the site had the studies classified as follows: 72 completed, 70 active, not recruiting (generally indicates collecting follow-up data), 74 recruiting, 11 recruiting by

The Clinical Impression of Severity Index for Parkinson's Disease: international validation study.

Science.gov (United States)

Martínez-Martín, Pablo; Rodríguez-Blázquez, Carmen; Forjaz, Maria João; de Pedro, Jesús

2009-01-30

This study sought to provide further information about the psychometric properties of the Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), in a large, international, cross-culturally diverse sample. Six hundred and fourteen patients with PD participated in the study. Apart from the CISI-PD, assessments were based on Hoehn & Yahr (HY) staging, the Scales for Outcomes in PD-Motor (SCOPA-M), -Cognition (SCOPA-COG) and -Psychosocial (SCOPA-PS), the Cumulative Illness Rating Scale-Geriatrics, and the Hospital Anxiety and Depression Scale. The total CISI-PD score displayed no floor or ceiling effects. Internal consistency was 0.81, the test-retest intraclass correlation coefficient was 0.84, and item homogeneity was 0.52. Exploratory and confirmatory factor analysis (CFI = 0.99, RMSEA = 0.07) confirmed CISI-PD's unifactorial structure. The CISI-PD showed adequate convergent validity with SCOPA-COG and SCOPA-M (r(S) = 0.46-0.85, respectively) and discriminative validity for HY stages and disease duration (P validation study, thus showing that the CISI-PD is a valid instrument to measure clinical impression of severity in PD. Its simplicity and easy application make it an attractive and useful tool for clinical practice and research.

Challenges in the Clinical Application of the American Society of Clinical Oncology Value Framework: A Medicare Cost-Benefit Analysis in Chronic Lymphocytic Leukemia.

Science.gov (United States)

Seymour, Erlene K; Schiffer, Charles A; de Souza, Jonas A

2017-12-01

The ASCO Value Framework calculates the value of cancer therapies. Given costly novel therapeutics for chronic lymphocytic leukemia, we used the framework to compare net health benefit (NHB) and cost within Medicare of all regimens listed in the National Comprehensive Cancer Network (NCCN) guidelines. The current NCCN guidelines for chronic lymphocytic leukemia were reviewed. All referenced studies were screened, and only randomized controlled prospective trials were included. The revised ASCO Value Framework was used to calculate NHB. Medicare drug pricing was used to calculate the cost of therapies. Forty-nine studies were screened. The following observations were made: only 10 studies (20%) could be evaluated; when comparing regimens studied against the same control arm, ranking NHB scores were comparable to their preference in guidelines; NHB scores varied depending on which variables were used, and there were no clinically validated thresholds for low or high values; treatment-related deaths were not weighted in the toxicity scores; and six of the 10 studies used less potent control arms, ranked as the least-preferred NCCN-recommended regimens. The ASCO Value Framework is an important initial step to quantify value of therapies. Essential limitations include the lack of clinically relevant validated thresholds for NHB scores and lack of incorporation of grade 5 toxicities/treatment-related mortality into its methodology. To optimize its application for clinical practice, we urge investigators/sponsors to incorporate and report the required variables to calculate the NHB of regimens and encourage trials with stronger comparator arms to properly quantify the relative value of therapies.

Clinical Research Informatics: Supporting the Research Study Lifecycle.

Science.gov (United States)

Johnson, S B

2017-08-01

Objectives: The primary goal of this review is to summarize significant developments in the field of Clinical Research Informatics (CRI) over the years 2015-2016. The secondary goal is to contribute to a deeper understanding of CRI as a field, through the development of a strategy for searching and classifying CRI publications. Methods: A search strategy was developed to query the PubMed database, using medical subject headings to both select and exclude articles, and filtering publications by date and other characteristics. A manual review classified publications using stages in the "research study lifecycle", with key stages that include study definition, participant enrollment, data management, data analysis, and results dissemination. Results: The search strategy generated 510 publications. The manual classification identified 125 publications as relevant to CRI, which were classified into seven different stages of the research lifecycle, and one additional class that pertained to multiple stages, referring to general infrastructure or standards. Important cross-cutting themes included new applications of electronic media (Internet, social media, mobile devices), standardization of data and procedures, and increased automation through the use of data mining and big data methods. Conclusions: The review revealed increased interest and support for CRI in large-scale projects across institutions, regionally, nationally, and internationally. A search strategy based on medical subject headings can find many relevant papers, but a large number of non-relevant papers need to be detected using text words which pertain to closely related fields such as computational statistics and clinical informatics. The research lifecycle was useful as a classification scheme by highlighting the relevance to the users of clinical research informatics solutions. Georg Thieme Verlag KG Stuttgart.

Evaluation of Three Approaches for Assessing Adherence to Vaginal Gel Application in Clinical Trials

Science.gov (United States)

van der Straten, Ariane; Cheng, Helen; Mensch, Barbara; Friedland, Barbara; Katzen, Lauren; Littlefield, Sarah; Buckley, Niall; Espinoza, Lilia; Keller, Marla J.; Herold, Betsy C.; Einstein, Mark H.

2014-01-01

Background: Accurate measurement of adherence to product use is an ongoing challenge in microbicide trials. Methods: We compared adherence estimates using two applicator tests (a dye stain assay [DSA] and an ultraviolet light assay [UVA]), the Wisebag (an applicator container that electronically tracks container openings), and self-reported adherence (ability, frequency, and percent missed doses). Healthy, HIV-negative, non-pregnant US women aged 23 to 45 received a Wisebag and 32 applicators filled with placebo gel, were instructed to insert one applicator daily for 30 days, returned the Wisebag and all applicators, and completed an exit interview. Emptied applicators were tested by UVA and then DSA, and scored by two blinded readers. Positive and negative controls were randomly included in applicator batches. Results: Among 42 women enrolled, 39 completed the study. DSA and UVA yielded similar sensitivity (97% and 95%) and specificity (79% and 79%). Two participants had fully inoperable Wisebags and nine had partially inoperable Wisebags. The proportion of participants considered to have high adherence (≥80%) varied: 43% (Wisebag), 46% (UVA), 49% (DSA), and 62% to 82% (self-reports). For estimating high adherence, Wisebag had a sensitivity of 76% (95% CI, 50% to 93%) and a specificity of 85% (95% CI, 62% to 97%) compared with DSA. Although 28% of participants reported forgetting to open the Wisebag daily, 59% said it helped them remember gel use. Conclusions: DSA and UVA performed similarly. Compared with these tests, self-reports overestimated and Wisebag underestimated adherence. Although Wisebag may encourage gel use, the applicator tests currently appear more useful for measuring use in clinical trials. PMID:24220357

Clinical application of digital radiography

Energy Technology Data Exchange (ETDEWEB)

Abe, Hiroyuki; Nagasaka, Hideo; Himi, Kazuhisa [Nihon Univ., Tokyo. School of Medicine

1983-04-01

Utility of digital subtraction angiography (DSA) by fluorography was advocated with demonstrable clinical cases. DSA is drawing attention for use at the outpatient clinic because it is relatively noninvasive, involves less risk than that by catheterization, and can be performed by intravenous injection. It also has a number of advantages such as instantaneous imaging and possible imaging of multiple sites by the same procedure. It still be extensively used in clinical practice not only as a screening method, but also as a functional imaging one.

Virtual reality for mobility devices: training applications and clinical results: a review.

Science.gov (United States)

Erren-Wolters, Catelijne Victorien; van Dijk, Henk; de Kort, Alexander C; Ijzerman, Maarten J; Jannink, Michiel J

2007-06-01

Virtual reality technology is an emerging technology that possibly can address the problems encountered in training (elderly) people to handle a mobility device. The objective of this review was to study different virtual reality training applications as well as their clinical implication for patients with mobility problems. Computerized literature searches were performed using the MEDLINE, Cochrane, CIRRIE and REHABDATA databases. This resulted in eight peer reviewed journal articles. The included studies could be divided into three categories, on the basis of their study objective. Five studies were related to training driving skills, two to physical exercise training and one to leisure activity. This review suggests that virtual reality is a potentially useful means to improve the use of a mobility device, in training one's driving skills, for keeping up the physical condition and also in a way of leisure time activity. Although this field of research appears to be in its early stages, the included studies pointed out a promising transfer of training in a virtual environment to the real-life use of mobility devices.

Black tea: Phytochemicals, cancer chemoprevention, and clinical studies.

Science.gov (United States)

Singh, Brahma N; Rawat, A K S; Bhagat, R M; Singh, B R

2017-05-03

Tea (Camellia sinensis L.) is the most popular, flavored, functional, and therapeutic non-alcoholic drink consumed by two-thirds of the world's population. Black tea leaves are reported to contain thousands of bioactive constituents such as polyphenols, amino acids, volatile compounds, and alkaloids that exhibit a range of promising pharmacological properties. Due to strong antioxidant property, black tea inhibits the development of various cancers by regulating oxidative damage of biomolecules, endogenous antioxidants, and pathways of mutagen and transcription of antioxidant gene pool. Regular drinking of phytochemicals-rich black tea is linked to regulate several molecular targets, including COX-2, 5-LOX, AP-1, JNK, STAT, EGFR, AKT, Bcl2, NF-κB, Bcl-xL, caspases, p53, FOXO1, TNFα, PARP, and MAPK, which may be the basis of how dose of black tea prevents and cures cancer. In vitro and preclinical studies support the anti-cancer activity of black tea; however, its effect in human trails is uncertain, although more clinical experiments are needed at molecular levels to understand its anti-cancer property. This review discusses the current knowledge on phytochemistry, chemopreventive activity, and clinical applications of black tea to reveal its anti-cancer effect.

Knowledge, perceptions and clinical application of the shortened dental arch concept among Malaysian government dentists.

Science.gov (United States)

Kasim, Siti Kamilah Mohd; Razak, Ishak Abdul; Yusof, Zamros Yuzadi Mohd

2018-02-01

To assess the knowledge and perceptions of Malaysian government dentists regarding the shortened dental arch (SDA) concept and its application in clinical practice. The SDA concept refers to a specific type of dentition with intact anterior teeth and a reduction in posterior occlusal pairs. Dentists' knowledge and perceptions of the SDA concept can influence its application in clinical practice. A self-administered questionnaire on the SDA concept was distributed to 326 government dentists in the states of Selangor and Kuala Lumpur, Malaysia. The data were analysed using SPSS version 22 software. The response rate was 84.0%. The majority of respondents had good knowledge on five of six knowledge items and good attitudes towards 10 of 17 perception items. However, only one-fifth (20.4%) reported having applied the SDA concept in the clinic. A larger number of participants who graduated locally than who graduated abroad perceived that patients 5 years of work experience perceived that the SDA concept enables simpler treatment planning (P concept, it is not widely applied in the clinic. Concerted efforts in SDA training of dentists are needed to help to shorten denture waiting lists and reduce costs. © 2017 FDI World Dental Federation.

Imaging-based quantification of hepatic fat: methods and clinical applications.

Science.gov (United States)

Ma, Xiaozhou; Holalkere, Nagaraj-Setty; Kambadakone R, Avinash; Mino-Kenudson, Mari; Hahn, Peter F; Sahani, Dushyant V

2009-01-01

Fatty liver disease comprises a spectrum of conditions (simple hepatic steatosis, steatohepatitis with inflammatory changes, and end-stage liver disease with fibrosis and cirrhosis). Hepatic steatosis is often associated with diabetes and obesity and may be secondary to alcohol and drug use, toxins, viral infections, and metabolic diseases. Detection and quantification of liver fat have many clinical applications, and early recognition is crucial to institute appropriate management and prevent progression. Histopathologic analysis is the reference standard to detect and quantify fat in the liver, but results are vulnerable to sampling error. Moreover, it can cause morbidity and complications and cannot be repeated often enough to monitor treatment response. Imaging can be repeated regularly and allows assessment of the entire liver, thus avoiding sampling error. Selection of appropriate imaging methods demands understanding of their advantages and limitations and the suitable clinical setting. Ultrasonography is effective for detecting moderate or severe fatty infiltration but is limited by lack of interobserver reliability and intraobserver reproducibility. Computed tomography allows quantitative and qualitative evaluation and is generally highly accurate and reliable; however, the results may be confounded by hepatic parenchymal changes due to cirrhosis or depositional diseases. Magnetic resonance (MR) imaging with appropriate sequences (eg, chemical shift techniques) has similarly high sensitivity, and MR spectroscopy provides unique advantages for some applications. However, both are expensive and too complex to be used to monitor steatosis. (c) RSNA, 2009.

Whole body detectors for clinical applications

International Nuclear Information System (INIS)

Silar, J.

The requirements are presented on the parameters of whole-body detectors suitable for clinical retention assays and the detector-patient configuration described. A whole-body detector was developed with an axial configuration of two pairs of large-volume scintillation detectors with NaI(Tl) crystals. One pair is placed under the bed, the other above the bed on which the patient is being examined. The axes of the crystals are located at a distance of 90 cm apart. The field of vision of the detector is described for the application of a 137 Cs source in the air and in a 24 cm layer of water. The positive characteristics of the detector are listed as being homogeneous sensitivity, energy resolution, long-term stability of signal pulse amplitude and average pulse rate in the integral mode. The results obtained show that the detector may be used to evaluate the level of contamination of persons by gamma emitters within the region of approximately 800 Bq to 74 MBq. The error in converting the number of signal pulses in the integral mode does not exceed 50% for gamma emitters with a photon energy above 30O keV. (J.B.)

Methodological characteristics of academic clinical drug trials--a retrospective cohort study of applications to the Danish Medicines Agency 1993-2005

DEFF Research Database (Denmark)

Berendt, Louise; Håkansson, Cecilia; Bach, Karin F

2010-01-01

The aim of this study was to investigate the temporal trends in characteristics of academic clinical drug trials. We here report characteristics on trial methodology.......The aim of this study was to investigate the temporal trends in characteristics of academic clinical drug trials. We here report characteristics on trial methodology....

Review of nanomaterials in dentistry: interactions with the oral microenvironment, clinical applications, hazards, and benefits.

Science.gov (United States)

Besinis, Alexandros; De Peralta, Tracy; Tredwin, Christopher J; Handy, Richard D