WorldWideScience

Sample records for clinical chemical values

  1. Short-term biological variation of clinical chemical values in dumeril's monitors (Varanus dumerili)

    DEFF Research Database (Denmark)

    Bertelsen, Mads Frost; Kjelgaard-Hansen, Mads Jens; Howell, Jennifer R.

    2007-01-01

    Plasma biochemical values are routinely used in the medical management of ill reptiles, and for monitoring the health of clinically normal animals. Laboratory tests, including clinical biochemical values, are subject to biological and analytical variation, the magnitude of which determines...... ( Varanus dumerili ). Albumin, cholesterol, phosphate, calcium, sodium, and total protein demonstrated levels of individuality suggesting that comparison of a single measurement to a conventional population-based reference range may be too insensitive to detect small but significant alterations in the value...... two consecutive analytical results that may be safely ascribed to natural variation. In the present study critical difference varied from 7 and 11%, respectively, for sodium and chloride to 75 and 125% for uric acid and AST....

  2. Beyond Values Clarification: Addressing Client Values in Clinical Behavior Analysis

    Science.gov (United States)

    Bonow, Jordan T.; Follette, William C.

    2009-01-01

    Ethical principles of psychology, as exemplified in the American Psychological Association (APA) Code of Ethics (2002), provide impractical advice for addressing client values during psychotherapy. These principles seem to argue that each client's values should be respected and protected at all times, except in cases in which this would result in…

  3. Trancranial Doppler: value in clinical practice.

    Science.gov (United States)

    Martinelli, O; Benedetti-Valentini, F

    2009-08-01

    The value of TCD in clinical practice is well established since it can be used to measure cerebral vasomotor reactivity and to detect and grade vasospasm (VSP) following subarachnoid haemorrhage and cerebral blood perfusion consequences of extracranial ICA stenosis or occlusion. Intracranial steno-occlusive disease can be detected more reliably by transcranial color-coded imaging (TCCI) that provides a two-dimensional imaging of parenchymal and vascular anatomy of brain too. In patients with suspected brain TCD diagnostic criteria for brain death have a sensitivity of 91 to 100% and specificity of 97 to 100% and they are particularly useful when clinical and EEG evaluations are difficult. TCD is a sensitive technique for real time detection of microembolic signals (MES) from prosthetic cardiac valves, myocardial infarction site, atrial fibrillation, aortic arch atheroma and this suggests the use of TCD for monitoring response to antithrombotic therapy. There is also a high correlation between contrast-enhanced TCD and trans-esophageal echocardiography for detecting paradoxical embolism through right-to-left cardiac or pulmonary shunts. Microembolization detected by TCD monitoring may confirm features of unstable carotid artery plaques as imaged by Duplex scanning and there is an increasing evidence that asymptomatic MES from unstable carotid plaques are an independent factor for ischemic stroke. TCD can be used as a monitoring tool during cardiac surgery and cerebrovascular operations to determine critical hemodynamic changes in cerebral arteries and to identify high-intensity transients referred to air or particulate emboli. Several research studies of the past 10 years have shown that MES may be detected by TCD during all phases of CEA and CAS and that sustained microembolism after carotid flow restoration is an indication of impending postoperative or post-procedural occlusion. Our series showed a clear difference between the number of patients with MES and the

  4. Value Source of Integrated Refining/Chemical Plant

    Institute of Scientific and Technical Information of China (English)

    Zhao Jianwei

    2009-01-01

    Based on an integrated refining/chemical plant processing 15 Mt/a of crude and manufacturing 1.0 Mt/a of ethylene under the guideline of"engaging in refining, olefins and aromatics by whatever appropriate means" to maximize the overall value of the integrated refining/chemical plant, it is necessary to concentrate on working on the flow diagram and the solution for mutual supply of materials between the refinery and ethylene plant. After analyzing the feedstock slate, the composition and properties of products, it is proposed to optimize the integrated refining/chemical plant in order to reduce investment and operating cost to realize maximization of the value of the integrated plant.

  5. Towards Data Value-Level Metadata for Clinical Studies.

    Science.gov (United States)

    Zozus, Meredith Nahm; Bonner, Joseph

    2017-01-01

    While several standards for metadata describing clinical studies exist, comprehensive metadata to support traceability of data from clinical studies has not been articulated. We examine uses of metadata in clinical studies. We examine and enumerate seven sources of data value-level metadata in clinical studies inclusive of research designs across the spectrum of the National Institutes of Health definition of clinical research. The sources of metadata inform categorization in terms of metadata describing the origin of a data value, the definition of a data value, and operations to which the data value was subjected. The latter is further categorized into information about changes to a data value, movement of a data value, retrieval of a data value, and data quality checks, constraints or assessments to which the data value was subjected. The implications of tracking and managing data value-level metadata are explored.

  6. Serum chemical values in hypothermic and rewarmed young calves.

    Science.gov (United States)

    Olson, D P; South, P J; Hendrix, K

    1983-04-01

    Serum chemical values were determined in cold-stressed Holstein bull calves ranging from 1 to 7 days of age. The animals were anesthetized and cold-stressed until their core body temperature (colonic) was lowered 10 C. Animals were then rewarmed in warm water, with heat pads or heat lamps, or were allowed to recover naturally (unassisted) at room temperature. Blood samples were collected at selected intervals during cooling and recovery. Increases (P less than 0.05) were observed in the concentrations of glucose, calcium, phosphorus, iron, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase, total protein, albumin, total globulin, serum urea nitrogen, uric acid, total bilirubin, indirect bilirubin, and cholesterol in the cold-stressed calves during cooling. Concentrations of chloride and insulin decreased (P less than 0.05) during the same period. Changes observed in many of the serum chemical values during rewarming were generally the reverse of the respective changes that occurred during cooling, although insulin values became exceedingly high in some cases midway or near the end of recovery. Serum enzyme values also remained high during most of recovery. Data did not indicate a clear advantage of one method of rewarming over the other methods used in terms of return of the serum chemical values to normal.

  7. Value-added Chemicals from Biomass by Heterogeneous Catalysis

    DEFF Research Database (Denmark)

    Voss, Bodil

    In the contemporary debate on resource utilisation, biomass has been discussed as an alternative carbon source to fossil reserves in order to reduce the emission of CO2 to the atmosphere. The replacement or supplement of oil based transportation fuels through biomass based conversions has already...... been implemented. The subject on chemical production has received less attention. This thesis describes and evaluates the quest for an alternative conversion route, based on a biomass feedstock and employing a heterogeneous catalyst capable of converting the feedstock, to a value-added chemical...... obtained for such a process and the hypothesis that process feasibility in comparison with the conventional synthesis gas based technologies may further be attainable, taking advantage of the conservation of chemical C-C bonds in biomass based feedstocks. With ethanol as one example of a biomass based...

  8. Chemical Conversion of Energetic Materials to Higher Value Products

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, A R; Hsu, P C; Coburn, M D; Schmidt, R D; Pagoria, P F; Lee, G S

    2005-04-19

    The objective of this program is to develop new processes for the disposal of surplus energetic materials. Disposal through open burning/open detonation (OB/OD) is considered less attractive today due to environmental, cost and safety concerns. The use of energetic materials as chemical feedstocks for higher value products can provide environmentally sound and cost-effective alternatives to OB/OD. Our recent studies on the conversion of surplus energetic materials (Explosive D, TNT) to higher value products will be described.

  9. Date fruit: chemical composition, nutritional and medicinal values, products.

    Science.gov (United States)

    Tang, Zhen-Xing; Shi, Lu-E; Aleid, Salah M

    2013-08-15

    Date fruit has served as a staple food in the Arab world for centuries. Worldwide production of date fruit has increased almost threefold over the last 40 years, reaching 7.68 million tons in 2010. Date fruit can provide many essential nutrients and potential health benefits to the consumer. Date fruit goes through four ripening stages named kimri, khalal, rutab and tamer. The main chemical components of date fruit include carbohydrates, dietary fibre, enzymes, protein, fat, minerals, vitamins, phenolic acids and carotenoids. The chemical composition of date fruit varies according to ripening stage, cultivar, growing environment, postharvest conditions, etc. The nutritional and medicinal activities of date fruit are related to its chemical composition. Many studies have shown that date fruit has antioxidant, antimutagenic, anti-inflammatory, gastroprotective, hepatoprotective, nephroprotective, anticancer and immunostimulant activities. Various date fruit-based products such as date syrup, date paste, date juice and their derived products are available. Date by-products can be used as raw materials for the production of value-added products such as organic acids, exopolysaccharides, antibiotics, date-flavoured probiotic-fermented dairy produce, bakery yeasts, etc. In this paper the chemical composition and nutritional and medicinal values of date fruit as well as date fruit-based products are reviewed.

  10. Economic and clinical value of levofloxacin

    Directory of Open Access Journals (Sweden)

    Mario Eandi

    2006-12-01

    Full Text Available Levofloxacin is a newer fluoroquinolone, with broad spectrum of antibacterial activity and good tolerability. This drug has a pharmacokinetic and pharmacodynamic profile that allows a once-a-day administration and offers the potential for intravenous-to-oral switch therapy. Due to these characteristics, the principal guidelines recommend it, as an option for the empirical therapy of patients with mild or more severe community acquired pneumonia (CAP, acute exacerbation of chronic bronchitis (AECB, complicated urinary tract infection (cUTI and skin and soft tissue infection (SSTI. These pathologies are common causes of morbidity and mortality and place a large burden on medical and economic resources, specially if hospitalization is required. The implementation of a critical pathway, based on levofloxacin use and on a risk prediction rule to establish the need for hospitalization, has the potential to decrease healthcare resource consumption without impairment of clinical outcomes, with respect to conventional management. The possibility of switch therapy allows to reduce length of hospital stay, with a saving in both direct and indirect costs, and an increase in patient satisfaction. In summary, when used according to appropriateness criteria and for approved indications, levofloxacin offers favorable economic features for the healthcare provider, whilst guaranteeing a positive impact on patient functioning and quality of life.

  11. Using cost accounting data to improve clinical value.

    Science.gov (United States)

    Andrianos, J; Dykan, M

    1996-05-01

    Value in health care can be defined as the provision of appropriate care at appropriate cost. While appropriate care is the province of clinical providers, cost data usually is maintained by financial managers. Collaboration between clinical providers and financial managers therefore is essential if optimum value is to be created. To this end, cost data are frequently given to providers for use in clinical care improvement projects. One such project has been implemented successfully at Virginia Mason Medical Center, Seattle, Washington.

  12. Microbial chemical factories: recent advances in pathway engineering for synthesis of value added chemicals.

    Science.gov (United States)

    Dhamankar, Himanshu; Prather, Kristala L J

    2011-08-01

    The dwindling nature of petroleum and other fossil reserves has provided impetus towards microbial synthesis of fuels and value added chemicals from biomass-derived sugars as a renewable resource. Microbes have naturally evolved enzymes and pathways that can convert biomass into hundreds of unique chemical structures, a property that can be effectively exploited for their engineering into Microbial Chemical Factories (MCFs). De novo pathway engineering facilitates expansion of the repertoire of microbially synthesized compounds beyond natural products. In this review, we visit some recent successes in such novel pathway engineering and optimization, with particular emphasis on the selection and engineering of pathway enzymes and balancing of their accessory cofactors.

  13. Clinical Considerations in the Assessment of Adolescent Chemical Dependency.

    Science.gov (United States)

    Winters, Ken

    1990-01-01

    Discusses relevant research findings of clinical assessment of adolescent chemical dependency so that service providers can better address these concerns. Three major issues are discussed: the definition of adolescent chemical dependency, clinical domains of assessment (chemical use problem severity, precipitating and perpetuating risk factors,…

  14. In Defense of a Social Value Requirement for Clinical Research.

    Science.gov (United States)

    Wendler, David; Rid, Annette

    2017-02-01

    Many guidelines and commentators endorse the view that clinical research is ethically acceptable only when it has social value, in the sense of collecting data which might be used to improve health. A version of this social value requirement is included in the Declaration of Helsinki and the Nuremberg Code, and is codified in many national research regulations. At the same time, there have been no systematic analyses of why social value is an ethical requirement for clinical research. Recognizing this gap in the literature, recent articles by Alan Wertheimer and David Resnik argue that the extant justifications for the social value requirement are unpersuasive. Both authors conclude, contrary to almost all current guidelines and regulations, that it can be acceptable across a broad range of cases to conduct clinical research which is known prospectively to have no social value. The present article assesses this conclusion by critically evaluating the ethical and policy considerations relevant to the claim that clinical research must have social value. This analysis supports the standard view that social value is an ethical requirement for the vast majority of clinical research studies and should be mandated by applicable guidelines and policies.

  15. How Cleveland Clinic used TDABC to improve value.

    Science.gov (United States)

    Donovan, Christopher J; Hopkins, Mike; Kimmel, Benjamin M; Koberna, Stephanie; Montie, Carrie A

    2014-06-01

    Cleveland Clinic partnered with Harvard Business School to conduct a pilot project to explore the differences between time-driven activity-based costing (TDABC) and relative value unit costing. The goal was to determine whether TDABC could improve the accuracy of cost information and identify value-improvement opportunities for two types of heart-value procedures. Using TDABC, leaders gained a detailed look into process steps that could be consolidated, reduced, or performed with a lower cost mix of personnel.

  16. Clinical value of acoustic voice measures: a retrospective study.

    Science.gov (United States)

    Werth, Katrin; Voigt, Daniel; Döllinger, Michael; Eysholdt, Ulrich; Lohscheller, Jörg

    2010-08-01

    Within this study a retrospective analysis of clinical voice perturbation measures, Dysphonia Severity Index and subjective perceived hoarseness was performed to determine their value under clinical aspects. The study included the data of 580 healthy and 1,700 pathologic voices, which were investigated under the following aspects. The relevant parameters were identified and their interrelation determined. Group differences between healthy and pathologic voices were figured out and investigated if voice quality measures allowed an automatic diagnosis of voice disorders. The analysis revealed significant changes between the clinical groups, which indicate the diagnostic relevance of voice quality measures. However, an individual diagnosis of the underlying voice disorder failed due to a vast spread of the parameter values within the respective groups. Classification accuracies of 75-90% were achieved. The high misclassification rate of up to 25% implied that in voice disorder diagnosis, the individual interpretation of the parameter values has to be done carefully.

  17. Perception of educational value in clinical rotations by medical students

    Directory of Open Access Journals (Sweden)

    Kandiah DA

    2017-02-01

    Full Text Available David A Kandiah School of Psychiatry and Clinical Neurosciences, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, WA, Australia Aim: Clinical teaching in Australian medical schools has changed to meet the needs of substantially increased medical student cohorts. As such, formal feedback from these student cohorts is needed about the value they place on the educational input from each clinical rotation. This study aims to determine which aspects of clinical placements are most educationally useful to medical students.Methods: In this study, final year medical students from the University of Western Australia (UWA were surveyed via an anonymous online questionnaire, identifying which clinical placements were found to be the most and the least useful to their learning and the positive aspects of these placements. Two focus groups were conducted prior to the design of the questionnaire to determine the key areas of focus important to medical students. Ethics approval for this study was obtained from the UWA Human Research Ethics Committee.Results: Our focus groups were consistent in finding that students enjoyed placements where they were included as a part of the medical team and played a role in patient care. This was consistent with the concept that inclusiveness and participation in the clinical setting are important in developing competence in tasks and skills. The ratio of students to doctors was crucial, with a low ratio given a higher rating as seen in the rural clinical school.Conclusion: The results of this project could benefit both the local and national medical curricula in identifying the most effective clinical attachments for learning and preparation for prevocational training. This is relevant especially due to the limited number of clinical placements and growing cohort of medical students. The results of this study can also be extrapolated to international medical education. Keywords

  18. Specificity, pathogenicity, and clinical value of antiendothelial cell antibodies

    NARCIS (Netherlands)

    Belizna, C; Tervaert, JWC

    1997-01-01

    Objective: To characterize the putative target antigens for antiendothelial cell antibodies (AECA), the possible pathophysiological role of AECA, and the clinical value of these antibodies as markers of disease activity, Methods: A structured literature search was done using Medline in combination w

  19. Perception of educational value in clinical rotations by medical students

    Science.gov (United States)

    Kandiah, David A

    2017-01-01

    Aim Clinical teaching in Australian medical schools has changed to meet the needs of substantially increased medical student cohorts. As such, formal feedback from these student cohorts is needed about the value they place on the educational input from each clinical rotation. This study aims to determine which aspects of clinical placements are most educationally useful to medical students. Methods In this study, final year medical students from the University of Western Australia (UWA) were surveyed via an anonymous online questionnaire, identifying which clinical placements were found to be the most and the least useful to their learning and the positive aspects of these placements. Two focus groups were conducted prior to the design of the questionnaire to determine the key areas of focus important to medical students. Ethics approval for this study was obtained from the UWA Human Research Ethics Committee. Results Our focus groups were consistent in finding that students enjoyed placements where they were included as a part of the medical team and played a role in patient care. This was consistent with the concept that inclusiveness and participation in the clinical setting are important in developing competence in tasks and skills. The ratio of students to doctors was crucial, with a low ratio given a higher rating as seen in the rural clinical school. Conclusion The results of this project could benefit both the local and national medical curricula in identifying the most effective clinical attachments for learning and preparation for prevocational training. This is relevant especially due to the limited number of clinical placements and growing cohort of medical students. The results of this study can also be extrapolated to international medical education. PMID:28223855

  20. Beyond clinical utility: The multiple values of DTC genetics.

    Science.gov (United States)

    Turrini, Mauro; Prainsack, Barbara

    2016-03-01

    One point of consensus in the otherwise very controversial discussion about the benefits and dangers of DTC genetics in the health domain is the lack of substantial clinical utility. At the same time, both the empirical and conceptual literature indicate that health-related DTC tests can have value and utility outside of the clinic. We argue that a broader and multi-faceted conceptualization of utility and value would enrich the ethical and social discussion of DTC testing in several ways: First, looking at ways in which DTC testing can have personal and social value for users - in the form of entertainment, learning, or a way to relate to others - can help to explain why people still take DTC tests, and will, further down the line, foster a more nuanced understanding of secondary and tertiary uses of DTC test results (which could very well unearth new ethical and regulatory challenges). Second, considering the economic value and broader utility of DTC testing foregrounds wider social and political aspects than have been dominant in the ethical and regulatory debates surrounding DTC genetics so far. These wider political aspects include the profound power asymmetries that characterize the collection and use of personal genetic data in many contexts.

  1. Beyond clinical utility: The multiple values of DTC genetics

    Directory of Open Access Journals (Sweden)

    Mauro Turrini

    2016-03-01

    Full Text Available One point of consensus in the otherwise very controversial discussion about the benefits and dangers of DTC genetics in the health domain is the lack of substantial clinical utility. At the same time, both the empirical and conceptual literature indicate that health-related DTC tests can have value and utility outside of the clinic. We argue that a broader and multi-faceted conceptualization of utility and value would enrich the ethical and social discussion of DTC testing in several ways: First, looking at ways in which DTC testing can have personal and social value for users – in the form of entertainment, learning, or a way to relate to others – can help to explain why people still take DTC tests, and will, further down the line, foster a more nuanced understanding of secondary and tertiary uses of DTC test results (which could very well unearth new ethical and regulatory challenges. Second, considering the economic value and broader utility of DTC testing foregrounds wider social and political aspects than have been dominant in the ethical and regulatory debates surrounding DTC genetics so far. These wider political aspects include the profound power asymmetries that characterize the collection and use of personal genetic data in many contexts.

  2. Clinical ethics and values: how do norms evolve from practice?

    Science.gov (United States)

    Spranzi, Marta

    2013-02-01

    Bioethics laws in France have just undergone a revision process. The bioethics debate is often cast in terms of ethical principles and norms resisting emerging social and technological practices. This leads to the expression of confrontational attitudes based on widely differing interpretations of the same principles and values, and ultimately results in a deadlock. In this paper I would like to argue that focusing on values, as opposed to norms and principles, provides an interesting perspective on the evolution of norms. As Joseph Raz has convincingly argued, "life-building" values and practices are closely intertwined. Precisely because values have a more indeterminate meaning than norms, they can be cited as reasons for action by concerned stakeholders, and thus can help us understand how controversial practices, e.g. surrogate motherhood, can be justified. Finally, norms evolve when the interpretations of the relevant values shift and cause a change in the presumptions implicit in the norms. Thus, norms are not a prerequisite of the ethical solution of practical dilemmas, but rather the outcome of the decision-making process itself. Struggling to reach the right decision in controversial clinical ethics situations indirectly causes social and moral values to change and principles to be understood differently.

  3. [Measurement of blood pressure variability and the clinical value].

    Science.gov (United States)

    Kékes, Ede; Kiss, István

    2014-10-19

    Authors have collected and analyzed literature data on blood pressure variability. They present the methods of blood pressure variability measurement, clinical value and relationships with target organ damages and risk of presence of cardiovascular events. They collect data about the prognostic value of blood pressure variability and the effects of different antihypertensive drugs on blood pressure variability. They underline that in addition to reduction of blood pressure to target value, it is essential to influence blood pressure fluctuation and decrease blood pressure variability, because blood pressure fluctuation presents a major threat for the hypertensive subjects. Data from national studies are also presented. They welcome that measurement of blood pressure variability has been included in international guidelines.

  4. Value-sensitive clinical accompaniment in community nursing science

    Directory of Open Access Journals (Sweden)

    Ebin Arries

    2010-03-01

    Full Text Available Clinical community health facilities where undergraduate students are placed for their practical work in community nursing science are dynamic and have undergone major transformation over the past few years. In the clinical field, community nurses and undergraduate students are representative of the different races and language and ethnic groups in the South African population, with each group espousing different value systems. Both parties – students and community nurses – report that, due to these differences, value conflicts are experienced during clinical accompaniment and that this has negative effects on clinical learning in community nursing science.

    The goal of this study was to explore and describe the experiences of students with regard to value-sensitive clinical accompaniment in the community nursing environment. An exploratory, descriptive and contextual design was used. Interactions between community nurses and students during clinical accompaniment were explored for value sensitivity by means of video recordings,participant observation and focus group interviews. Data were collected by means of video recordings, participant observation and focus group interviews. The data were analysed and coded by the researcher and the external coder, using an inductive descriptive method to identify important segments of the regularity of behaviour. The focus group interviews were transcribed, analysed and coded by the researcher and the external coder, using Tesch’s steps of analysis (Creswell 1994:155–156.Lincoln and Guba’s criteria (1985:290 for trustworthiness were applied to the study.

    The general findings indicate that clinical accompaniment in community nursing is not value sensitive and, as a result, guidelines for value-sensitive clinical accompaniment need to be developed for undergraduate students in the community nursing environment. The following values (values for which guidelines need to be developed were

  5. Correlation between the limit values of laboratory and clinical mycotoxicosis

    Directory of Open Access Journals (Sweden)

    Stojanov Igor M.

    2013-01-01

    Full Text Available Analysis of feed for the presence of fungi and mycotoxins is a request necessary to meet in order to ensure a healthy and economical production in livestock. These tests are related to legal regulation which prescribes the maximum legislated content (MLC, both for the presence of mycotoxins and the total number of fungi in certain feeds. Health problems that can occur during the production of animals are sometimes caused by the presence of mycotoxins in the feed. Laboratory testing is a good practice to confirm a suspicion, and allows timely treatment of contaminated feed. Potential problems arise under circumstances when there is a clinical outcome of mycotoxicosis and animal and laboratory findings suggest that the obtained values are below the level that is within the MLC. For these reasons, the subject of our research was to investigate the occurrence of mycotoxins and mold in feed, as well as the clinical presentation for animals that were fed with the feed with allowed values of these agents according to the recommended levels. The aim of this paper was to highlight the problems associated with clinical correlation of sick animals and laboratory findings, and suggest their overcoming. In the period of one year, a total of 176 samples of feed (complete mixture for broilers, corn and soy products were examined for the presence of fungi, 106 samples were examined for the presence of mycotoxins and 26 flocks of broilers and turkeys were clinically observed. Standard methods were used for isolation of molds and the ELISA test was used for the detection of mycotoxins. Clinical and pathomorphological observation of the flocks was done to determine the natural indicators of production. Studies indicated a problem because clinical and pathomorphological findings in some cases were not correlated with laboratory findings of molds and mycotoxins in the feed, and in some cases it did not necessarily mean that the animals were healthy. Synergism and

  6. The questioned p value: clinical, practical and statistical significance.

    Science.gov (United States)

    Jiménez-Paneque, Rosa

    2016-09-09

    The use of p-value and statistical significance have been questioned since the early 80s in the last century until today. Much has been discussed about it in the field of statistics and its applications, especially in Epidemiology and Public Health. As a matter of fact, the p-value and its equivalent, statistical significance, are difficult concepts to grasp for the many health professionals some way involved in research applied to their work areas. However, its meaning should be clear in intuitive terms although it is based on theoretical concepts of the field of Statistics. This paper attempts to present the p-value as a concept that applies to everyday life and therefore intuitively simple but whose proper use cannot be separated from theoretical and methodological elements of inherent complexity. The reasons behind the criticism received by the p-value and its isolated use are intuitively explained, mainly the need to demarcate statistical significance from clinical significance and some of the recommended remedies for these problems are approached as well. It finally refers to the current trend to vindicate the p-value appealing to the convenience of its use in certain situations and the recent statement of the American Statistical Association in this regard.

  7. Transcriptional Engineering of Microalgae: Prospects for High-Value Chemicals.

    Science.gov (United States)

    Bajhaiya, Amit K; Ziehe Moreira, Javiera; Pittman, Jon K

    2017-02-01

    Microalgae are diverse microorganisms that are of interest as novel sources of metabolites for various industrial, nutritional, and pharmaceutical applications. Recent studies have demonstrated transcriptional engineering of some metabolic pathways. We propose here that transcriptional engineering could be a viable means to manipulate the biosynthesis of specific high-value metabolic products.

  8. Seeking value in Medicare: performance measurement for clinical professionals.

    Science.gov (United States)

    Sprague, Lisa

    2013-10-30

    The Medicare program, despite its reputation of being a bill payer with little regard to the worth of the services it buys, has begun to put in place a range of programs aimed at assessing quality and value, with more to come. Attention to resource use and cost is nascent. The issues are complex, and it is no surprise that there is a level of contention between providers and regulators, even though both profess commitment to improved quality. This paper summarizes the quality and value programs that apply to physicians and other clinical professionals, as well as programs designed to encourage the adoption of technology to support quality improvement. Participation in all is voluntary. However, a decision not to participate increasingly carries a financial penalty, as Congress (and, by extension, the U.S. Department of Health and Human Services, or HHS) tries to encourage behavior it cannot force.

  9. Improving ruminal degradability and energetic values of bamboo shoot shell using chemical treatments.

    Science.gov (United States)

    Zhao, Liping; Ren, Liping; Zhou, Zhenming; Meng, Qingxiang; Huo, Yunlong; Wang, Fei

    2016-07-01

    This study evaluated effects of different treatments on nutritive value of bamboo shoot shell (BSS). Five treatments were sun-drying (control), ammoniation (5%/dry matter (DM) urea), Ca(OH)2 (4%/DM calcium hydroxide), NaOH (4%/DM sodium hydroxide), and AHP (4%/DM sodium hydroxide plus 1%/DM hydrogen peroxide). The results showed that chemical composition of BSS was greatly changed by chemicals (P chemical treatments significantly reduced neutral detergent fiber (NDF) content except AHP (P chemical treatments (P Chemical treatments greatly improved effective degradability (ED) of DM (P chemical treatments greatly improved nutritive value of BSS with highest value obtained from ammoniation, followed by strong alkalization, alkaline hydrogen peroxide and modest alkalization.

  10. The value of an aide memoire in the dermatology clinic.

    Science.gov (United States)

    Dutton, E S; Holder, J E; Graham-Brown, R A

    1999-03-01

    A randomized study was undertaken to investigate the effectiveness of a chart as an aid to memory illustrating the topical medication most frequently prescribed both in the dermatology clinic, and in general practice. One hundred subjects, half new referrals and half follow-ups, were recruited and asked to recall all of the topical preparations that had previously been prescribed for this condition. They were then asked to consult the chart, and any additional medication recognized at this time was noted, along with any clarification of formulation and strength where possible. Despite some limitations, our chart proved to be of considerable value. Thirty-eight patients could identify between three and eight additional preparations. Overall, the mean number of additional preparations recalled per patient was two. Clarification of strength and formulation was achieved by 21 patients. Eight charts were used, and provided additional information at consultation in 87% of subjects interviewed.

  11. Clinical value of core length in contemporary multicore prostate biopsy.

    Directory of Open Access Journals (Sweden)

    Sangchul Lee

    Full Text Available There is little data about the clinical value of core length for prostate biopsy (PBx. We investigated the clinical values of various clinicopathological biopsy-related parameters, including core length, in the contemporary multi-core PBx.Medical records of 5,243 consecutive patients who received PBx at our institution were reviewed. Among them, 3,479 patients with prostate-specific antigen (PSA ≤ 10 ng/ml level who received transrectal ultrasound (TRUS-guided multi (≥ 12-core PBx at our institution were analyzed for prostate cancer (PCa. Gleason score upgrading (GSU was analyzed in 339 patients who were diagnosed with low-risk PCa and received radical prostatectomy. Multivariate logistic regression analyses for PCa detection and prediction of GSU were performed.The mean age and PSA of the entire cohort were 63.5 years and 5.4 ng/ml, respectively. The overall cancer detection rate was 28.5%. There was no statistical difference in core length between patients diagnosed with PCa and those without PCa (16.1 ± 1.8 vs 16.1 ± 1.9 mm, P = 0.945. The core length was also not significantly different (16.4 ± 1.7 vs 16.4 ± 1.6mm, P = 0.889 between the GSU group and non-GSU group. Multivariate logistic regression analyses demonstrated that the core length of PBx did not affect PCa detection in TRUS-guided multi-core PBx (P = 0.923 and was not prognostic for GSU in patients with low-risk PCa (P = 0.356.In patients undergoing contemporary multi-core PBx, core length may not have significant impact on PCa detection and also GSU following radical prostatectomy among low-risk PCa group.

  12. Clinical value of isotope methods in adrenal morphology investigations

    Energy Technology Data Exchange (ETDEWEB)

    Jakubowski, W.; Feltynowski, T.; Graban, W. (Akademia Medyczna, Warsaw (Poland))

    1981-01-01

    In the years 1976-1980 in 105 patients 124 adrenal scintigrams were obtained, including 50 in patients with primary hyperaldosteronism syndrome, 27 with Cushings syndrome, 8 after bilateral total adrenalectomy, 4 with adrenal virilizing tumours, 6 with phaeochromocytoma, 10 with normal adrenal function. The results of scintigraphy were compared with those of arteriography, phlebography, computer tomography and postoperative findings. The clinical value of scintigraphy was found to be greatest in cases of adrenocortical disease. In cases of phaeochromocytoma isotope angioscintigraphy is a useful method for localizing the tumour since it makes possible demonstration of the vascular bed of the tumour. A close correlation was demonstrated between the results of scintigraphy and those of computer tomography. In the group of 27 patients treated surgically for adrenocortical disease in 87% of cases an agreement was found between the results of scintigraphy and the result of the operation. For different adrenocortical diseases this per cent was: 77% for Cushings syndrome, 91% for primary hyperaldosteronism, 100% for adrenal virilizing tumours. The study showed that adrenal scintigraphy is a very valuable diagnostic method of high clinical usefulness in adrenocortical diseases.

  13. Mo- and V-catalyzed transformation of biomass into high-value chemicals

    DEFF Research Database (Denmark)

    Nielsen, Lasse Bo; Dethlefsen, Johannes Rytter; Lupp, Daniel;

    2014-01-01

    The possibility of converting biomass into higher-value chemicals has received increased attention over the last few years. If biomass could be converted into biofules or platform chemicals, then it could constitute a large source of renewable energy and economy for society.......The possibility of converting biomass into higher-value chemicals has received increased attention over the last few years. If biomass could be converted into biofules or platform chemicals, then it could constitute a large source of renewable energy and economy for society....

  14. Combined Chemical Activation and Fenton Degradation to Convert Waste Polyethylene into High-Value Fine Chemicals.

    Science.gov (United States)

    Chow, Cheuk-Fai; Wong, Wing-Leung; Ho, Keith Yat-Fung; Chan, Chung-Sum; Gong, Cheng-Bin

    2016-07-04

    Plastic waste is a valuable organic resource. However, proper technologies to recover usable materials from plastic are still very rare. Although the conversion/cracking/degradation of certain plastics into chemicals has drawn much attention, effective and selective cracking of the major waste plastic polyethylene is extremely difficult, with degradation of C-C/C-H bonds identified as the bottleneck. Pyrolysis, for example, is a nonselective degradation method used to crack plastics, but it requires a very high energy input. To solve the current plastic pollution crisis, more effective technologies are needed for converting plastic waste into useful substances that can be fed into the energy cycle or used to produce fine chemicals for industry. In this study, we demonstrate a new and effective chemical approach by using the Fenton reaction to convert polyethylene plastic waste into carboxylic acids under ambient conditions. Understanding the fundamentals of this new chemical process provides a possible protocol to solve global plastic-waste problems.

  15. Contrast-enhanced postmortem computed tomography in clinical pathology: enhanced value of 20 clinical autopsies.

    Science.gov (United States)

    Westphal, Saskia E; Apitzsch, Jonas C; Penzkofer, Tobias; Kuhl, Christiane K; Mahnken, Andreas H; Knüchel, Ruth

    2014-09-01

    Postmortem computed tomography (PMCT) is a modern tool that complements autopsy diagnostics. In clinical autopsies, a major cause of death is cardiovascular disease. To improve the performance of PMCT in cardiovascular disease, full body angiography was developed (PMCT angiography [PMCTA]). Twenty PMCTA scans generated before autopsy were compared with native PMCT and clinical autopsy. The objective of the study was to quantify the additional diagnostic value of adding angiography to native imaging and to compare PMCT and PMCTA findings to autopsy findings. The diagnosis of the cause of death was identical or overlapped in 80% of the cases that used PMCTA and 70% that used PMCT. The additional diagnostic yield given by PMCT and PMCTA in combination with autopsy was 55%. PMCT yielded additional diagnoses in the musculoskeletal system. The greatest additional diagnostic value of PMCTA was in association with cardiovascular diagnoses. The accuracy of PMCTA for cardiac causes of death was 80%, and the positive predictive value was 90%. The findings indicate that native PMCT cannot display the cardiovascular system sufficiently clearly for high-quality diagnostic assessment. However, PMCTA is a powerful tool in autopsy cases with a history of cardiovascular disease and/or a suspected cardiovascular cause of death. The combination of PMCTA and clinical autopsy enhances diagnostic quality and completeness of the autopsy report. Furthermore, in cases without consent or with a restricted consent for clinical autopsy, PMCTA has the potential to provide information on cardiovascular causes of death.

  16. Value chain management for commodities: a case study from the chemical industry

    NARCIS (Netherlands)

    Kannegiesser, M.; Günther, H.O.; Beek, van P.; Grunow, M.; Habla, C.

    2009-01-01

    We present a planning model for chemical commodities related to an industry case. Commodities are standard chemicals characterized by sales and supply volatility in volume and value. Increasing and volatile prices of crude oil-dependent raw materials require coordination of sales and supply decision

  17. Relationship between chemical shift value and accessible surface area for all amino acid atoms

    Directory of Open Access Journals (Sweden)

    Rieping Wolfgang

    2009-04-01

    Full Text Available Abstract Background Chemical shifts obtained from NMR experiments are an important tool in determining secondary, even tertiary, protein structure. The main repository for chemical shift data is the BioMagResBank, which provides NMR-STAR files with this type of information. However, it is not trivial to link this information to available coordinate data from the PDB for non-backbone atoms due to atom and chain naming differences, as well as sequence numbering changes. Results We here describe the analysis of a consistent set of chemical shift and coordinate data, in which we focus on the relationship between the per-atom solvent accessible surface area (ASA in the reported coordinates and their reported chemical shift value. The data is available online on http://www.ebi.ac.uk/pdbe/docs/NMR/shiftAnalysis/index.html. Conclusion Atoms with zero per-atom ASA have a significantly larger chemical shift dispersion and often have a different chemical shift distribution compared to those that are solvent accessible. With higher per-atom ASA, the chemical shift values also tend towards random coil values. The per-atom ASA, although not the determinant of the chemical shift, thus provides a way to directly correlate chemical shift information to the atomic coordinates.

  18. Proposals for intervention values for soil clean-up: Second series of chemicals

    NARCIS (Netherlands)

    Berg R van den; Bockting GJM; Crommentuijn GH; Jansen PJCM; LBG

    1994-01-01

    The thoroughly revised intervention values for soil clean-up have recently come into force. In this report, proposals will be presented for intervention values for other chemicals on the basis of an ecotoxicological and a human-toxicological evaluation. The proposals made have followed the procedure

  19. In Search of Meaning: Values in Modern Clinical Behavior Analysis

    Science.gov (United States)

    Plumb, Jennifer C.; Stewart, Ian; Dahl, JoAnne; Lundgren, Tobias

    2009-01-01

    Skinner described behavior analysis as the field of values and purpose. However, he defined these concepts in terms of a history of reinforcement and failed to specify whether and how human and nonhuman values might differ. Human values have been seen as theoretically central within a number of nonbehavioral traditions in psychology, including…

  20. Methods for conversion of carbohydrates in ionic liquids to value-added chemicals

    Science.gov (United States)

    Zhao, Haibo; Holladay, Johnathan E.

    2011-05-10

    Methods are described for converting carbohydrates including, e.g., monosaccharides, disaccharides, and polysaccharides in ionic liquids to value-added chemicals including furans, useful as chemical intermediates and/or feedstocks. Fructose is converted to 5-hydroxylmethylfurfural (HMF) in the presence of metal halide and acid catalysts. Glucose is effectively converted to HMF in the presence of chromium chloride catalysts. Yields of up to about 70% are achieved with low levels of impurities such as levulinic acid.

  1. Clinical blood chemistry values and long acting phenothiazines.

    Science.gov (United States)

    Schneider, S J; Kirby, E J; Itil, T M

    1981-05-01

    Fifty-nine chronic schizophrenic patients received one year of treatment with either fluphenazine enanthate or pipothiazine palmitate IM. Both long acting neuroleptics significantly decreased serum albumin, total protein and creatinine values. Triglycerides were decreased only early in treatment. Pretreatment findings from therapy responders, as compared with those who failed to respond to treatment, included higher albumin values and to a lesser extent, lower lactic dehydrogenase values and greater height. These results were discussed with an eye toward the hepatocellular effects of long acting phenothiazines and the effect of liver function on the pharmacokinetics of these medications.

  2. Value chain management for commodities: a case study from the chemical industry

    DEFF Research Database (Denmark)

    Kannegiesser, M.; Gunther, H.O.; van Beek, P.

    2009-01-01

    quantity, price and supply decisions throughout the value chain. A two-phase optimization approach supports robust planning ensuring minimum profitability even in case of worst-case spot sales price scenarios. Model evaluations with industry case data demonstrate the impact of elasticities, variable raw......We present a planning model for chemical commodities related to an industry case. Commodities are standard chemicals characterized by sales and supply volatility in volume and value. Increasing and volatile prices of crude oil-dependent raw materials require coordination of sales and supply...... decisions by volume and value throughout the value chain to ensure profitability. Contract and spot demand differentiation with volatile and uncertain spot prices, spot sales quantity flexibility, spot sales price-quantity functions and variable raw material consumption rates in production are problem...

  3. Subjective experiences in psychotic disorders: diagnostic value and clinical correlates.

    Science.gov (United States)

    Peralta, V; Cuesta, M J

    1998-01-01

    This study evaluated the prevalence and clinical correlates of abnormal subjective experiences across functional psychotic disorders. Patients were recruited from consecutive admissions with the following diagnoses; schizophrenia (n = 40), schizophreniform disorder (n = 40), schizoaffective disorder (n = 21), mood disorder (n = 18), brief reactive psychosis (n = 15), and atypical psychosis (n = 16). Subjective experiences were assessed using the Frankfurt Complaint Questionnaire (FCQ), and the clinical status was assessed with the Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS) and the Manual for the Assessment and Documentation of Psychopathology (AMDP). Neither the FCQ total score nor individual subjective experiences displayed significant differences across diagnoses. When the clinical predictors of subjective experiences were studied by multiple regression analyses, a different pattern resulted for individual psychotic disorders. In schizophrenic patients, subjective experiences were predicted by female gender, euphoria, lack of insight, greater illness severity, and more positive symptoms. The only predictors of subjective experiences in the schizophreniform disorder group were the negative symptoms. Within the affective disorders group, subjective experiences had no clinical predictors.

  4. Educational Value of Horsemanship Clinics to Youth and Adult Riders

    Science.gov (United States)

    Cavinder, Clay A.; Antilley, Teri J.; Briers, Gary; Sigler, Dennis; Davidson, Deann; Gibbs, Pete G.

    2010-01-01

    Surveys evaluating the Texas AgriLife Extension Summer Horsemanship School Program were gathered from the summers of 2006 through 2009. Data indicate a high percentage of individuals expressed improved knowledge about horse awareness and training, and greater thinking skills were developed after participating in a clinic. Positive responses…

  5. Diagnostic value of urinary dysmorphic erythrocytes in clinical practice

    NARCIS (Netherlands)

    M.J. Crop (Meindert); Y.B. de Rijke (Yolanda); P.C.M.S. Verhagen (Paul); K. Cransberg (Karlien); R. Zietse (Bob)

    2010-01-01

    textabstractBackground: In clinical practice, discriminating between glomerular and nonglomerular causes of hematuria is often difficult. Dysmorphic red blood cells (dRBC) in the urinary sediment are claimed to be effective, but the cutoff points in the literature vary. This follow-up study aimed to

  6. Ecotoxicological assessments and the setting of limit values for chemicals in the environment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    The Committee on the Setting of Limit Values for Chemicals held its first open conference in Denmark in March 1992 at Mogenstrup Kro, Zealand. The conference proceedings were entitled `Risk Management and Risk Assessment in Different Sectors in Denmark`. The conference focused on risk assessment and the setting of limit values for chemicals in connection with human exposure to chemicals. The conference held in January 1996, which is covered by the present proceedings, dealt with the exposure of the environment to chemicals and the state-of-the-art as well as perspectives of ecotoxicological research. Special emphasis was placed on the illustration and discussion of the problems that have to be solved in order to secure satisfactory levels of protection of soil and aquatic environments in connection with exposure to chemicals. Also, problems connected with exposure through the atmosphere were discussed and exemplified by the work on the setting of limit values for tropospheric ozone. Furthermore, the global problems pertaining to what is believed to be the greenhouse effect and the degradation of the stratospheric ozone layer as well as the damage to crops caused by ozone were mentioned. (au)

  7. Legal value of clinical competence and its certification

    Directory of Open Access Journals (Sweden)

    Antonino Zagari

    2013-03-01

    Full Text Available What is the legal value of the assessment and certification of professional skills and competence? The certification of skills can be defined as a process by which a third party gives written assurance that a person satisfies all requirements needed to operate to the highest professional standards in a specific field. Today, the certification of skill scan have a legal value in the context of professional responsibility when a judge has to assess the degree of expertise of a doctor who is under investigation for malpractice. From a legal point of view, it has some value regarding credits for professional appointments or career development within the state system. It is desirable that more and more both national and regional legislation should use the system of certification of skills through accredited third-parties to improve and assess the performance of professionals and the institutions and structures in which they operate. The system of certification of skills has to become part of the requirements for the accreditation of public and private facilities that provide services to the national health service. We believe that the certification of skills not only helps to recognize human intellectual capital, which is the main value of a healthcare organization, but also facilitates decisions about career paths and the construction of an effective training and study curriculum and portfolio.

  8. HOSPITAL MANAGEMENT AND THE CREATION OF VALUE THROUGH CLINICAL RESEARCH

    Directory of Open Access Journals (Sweden)

    Arribas Fontaneda J

    2014-01-01

    Full Text Available Healthcare research should have a bearing on good clinical practice, but to measure the impact of knowledge generation on the quality of life of society has been shown to be a complex process to approach. This article attempts to analyse the effect that research activity has on patient satisfaction in a Spanish public hospital. It also opens the door for further studies that associate knowledge generation with the specific performance indicators of this type of organisation.

  9. Proximate analysis, backwards stepwise regression between gross calorific value, ultimate and chemical analysis of wood.

    Science.gov (United States)

    Telmo, C; Lousada, J; Moreira, N

    2010-06-01

    The gross calorific value (GCV), proximate, ultimate and chemical analysis of debark wood in Portugal were studied, for future utilization in wood pellets industry and the results compared with CEN/TS 14961. The relationship between GCV, ultimate and chemical analysis were determined by multiple regression stepwise backward. The treatment between hardwoods-softwoods did not result in significant statistical differences for proximate, ultimate and chemical analysis. Significant statistical differences were found in carbon for National (hardwoods-softwoods) and (National-tropical) hardwoods in volatile matter, fixed carbon, carbon and oxygen and also for chemical analysis in National (hardwoods-softwoods) for F and (National-tropical) hardwoods for Br. GCV was highly positively related to C (0.79 * * *) and negatively to O (-0.71 * * *). The final independent variables of the model were (C, O, S, Zn, Ni, Br) with R(2)=0.86; F=27.68 * * *. The hydrogen did not contribute statistically to the energy content.

  10. [Clinical value of scanning laser polarimetry in glaucoma diagnostics].

    Science.gov (United States)

    Kremmer, S; Anastassiou, G; Selbach, J M

    2012-02-01

    The term glaucoma is used as a melting pot of many different diseases which have in common that the retinal ganglion cells and their axons are damaged. Untreated, apoptosis can be induced causing ganglion cell death which subsequently leads to typical glaucomatous damage at the optic nerve head, scotomas of the visual fields, and in the worst case scenario to blindness. It is well known that patients with glaucoma can suffer a 20 to 50 % loss of retinal ganglion cells before a defect becomes evident in standard white on white perimetry. To prevent glaucomatous damage, it is important to detect changes of the retinal ganglion cells and their nerve fibre layer as early as possible and to monitor their follow-up as closely as possible in order to find an adequate treatment of glaucoma, and to control its efficiency. In the past few years, scanning laser polarimetry by means of GDx technology (Carl Zeiss Meditec, Dublin, USA) could be established as a new method to measure the retinal nerve fibre layer not only qualitatively but even quantitatively. Presently, the GDx plays an important role in actual glaucoma diagnostics on account of its high resolution, the comfort for both patient and user, and its highly reproducible measurements. Especially in difficult evaluable optic nerve heads (e. g., micro- and macrodiscs), tilted discs, and optic disc anomalies (e. g., optic nerve drusen) modern nerve fibre diagnostics by means of GDx technology is a helpful enrichment in clinical routine.

  11. Chemical technologies for exploiting and recycling carbon dioxide into the value chain.

    Science.gov (United States)

    Peters, Martina; Köhler, Burkhard; Kuckshinrichs, Wilhelm; Leitner, Walter; Markewitz, Peter; Müller, Thomas E

    2011-09-19

    While experts in various fields discuss the potential of carbon capture and storage (CCS) technologies, the utilization of carbon dioxide as chemical feedstock is also attracting renewed and rapidly growing interest. These approaches do not compete; rather, they are complementary: CCS aims to capture and store huge quantities of carbon dioxide, while the chemical exploitation of carbon dioxide aims to generate value and develop better and more-efficient processes from a limited part of the waste stream. Provided that the overall carbon footprint for the carbon dioxide-based process chain is competitive with conventional chemical production and that the reaction with the carbon dioxide molecule is enabled by the use of appropriate catalysts, carbon dioxide can be a promising carbon source with practically unlimited availability for a range of industrially relevant products. In addition, it can be used as a versatile processing fluid based on its remarkable physicochemical properties.

  12. Quantitative determinations of chemical compounds with nutritional value from Inca crops: Chenopodium quinoa ('quinoa').

    Science.gov (United States)

    González, J A; Roldán, A; Gallardo, M; Escudero, T; Prado, F E

    1989-12-01

    Quantitative determinations of total and soluble proteins, total and free sugars, starch, total lipids, tanins, ash (Ca, Na, K, Fe, and P), and caloric value were carried out on quinoa flour. Results show that the amount of soluble proteins was higher than the standard value for wheat and maize and was very close to that of barley's. The yield of free sugars like glucose (4.55%), fructose (2.41%) and sucrose (2.39%) were also of importance. Iron and calcium levels were higher than the reported values for maize and barley. The same occurred for the caloric value (435.5 Kcal/100 g). The content of saponins was also examined since its effect on red blood cells of group A and O has been related as a potential problem of the Andes population. From the chemical analysis a more complete view about quinoa as human food was presented.

  13. Predictive value of clinical history compared with urodynamic study in 1,179 women

    Directory of Open Access Journals (Sweden)

    Jorge Milhem Haddad

    2016-02-01

    Full Text Available SUMMARY Objective: to determine the positive predictive value of clinical history in comparison with urodynamic study for the diagnosis of urinary incontinence. Methods: retrospective analysis comparing clinical history and urodynamic evaluation of 1,179 women with urinary incontinence. The urodynamic study was considered the gold standard, whereas the clinical history was the new test to be assessed. This was established after analyzing each method as the gold standard through the difference between their positive predictive values. Results: the positive predictive values of clinical history compared with urodynamic study for diagnosis of stress urinary incontinence, overactive bladder and mixed urinary incontinence were, respectively, 37% (95% CI 31-44, 40% (95% CI 33-47 and 16% (95% CI 14-19. Conclusion: we concluded that the positive predictive value of clinical history was low compared with urodynamic study for urinary incontinence diagnosis. The positive predictive value was low even among women with pure stress urinary incontinence.

  14. Method for conversion of carbohydrate polymers to value-added chemical products

    Science.gov (United States)

    Zhang, Zongchao C [Norwood, NJ; Brown, Heather M [Kennewick, WA; Su, Yu [Richland, WA

    2012-02-07

    Methods are described for conversion of carbohydrate polymers in ionic liquids, including cellulose, that yield value-added chemicals including, e.g., glucose and 5-hydroxylmethylfurfural (HMF) at temperatures below 120.degree. C. Catalyst compositions that include various mixed metal halides are described that are selective for specified products with yields, e.g., of up to about 56% in a single step process.

  15. Chemical composition and metabolizable energy values of corn germ meal obtained by wet milling for layers

    Directory of Open Access Journals (Sweden)

    CS Albuquerque

    2014-03-01

    Full Text Available An experiment was carried out to determine the chemical composition, metabolizable energy values, and coefficients of nutrient digestibility of corn germ meal for layers. The chemical composition of corn germ meal was determined, and then a metabolism assay was performed to determine its apparent metabolizable energy (AME and apparent metabolizable energy corrected for nitrogen (AMEn values and its dry matter and gross energy apparent metabolizability coefficients (CAMDM and CAMGE, respectively. In the 8-day assay (four days of adaptation and four days of total excreta collection, 60 29-week-old white Lohman LSL layers were used. A completely randomized experimental design, with three treatments with five replicates of four birds each, was applied. Treatments consisted of a reference diet and two test diets, containing 20 or 30% corn germ meal. Results were submitted to analysis of variance and means were compared by the Tukey tests at 5% probability level. The chemical composition of corn germ meal was: 96.39% dry matter, 49.48% ether extract, 1.87% ashes, 7243 kcal gross energy/kg, 11.48% protein, 0.19% methionine, 0.21% cystine, 0.48% lysine, 0.40% threonine, 0.72% arginine, 0.35% isoleucine, 0.83% leucine, 0.57% valine, and 0.37% histidine, on as-fed basis. There were no statistical differences in AME, AMEn, CAMDM, and CAMGE values with the inclusion of 20 and 30% corn germ meal in the diets. On dry matter basis, AME, AMEn, CAMDM, and CAMGE values of corn germ meal were: 4,578 and 4,548 kcal/kg, 4,723 and 4,372 kcal/kg, 64.95 and 61.86%, respectively.

  16. Comparison of toxicity values across zebrafish early life stages and mammalian studies: Implications for chemical testing.

    Science.gov (United States)

    Ducharme, Nicole A; Reif, David M; Gustafsson, Jan-Ake; Bondesson, Maria

    2015-08-01

    With the high cost and slow pace of toxicity testing in mammals, the vertebrate zebrafish has become a tractable model organism for high throughput toxicity testing. We present here a meta-analysis of 600 chemicals tested for toxicity in zebrafish embryos and larvae. Nineteen aggregated and 57 individual toxicity endpoints were recorded from published studies yielding 2695 unique data points. These data points were compared to lethality and reproductive toxicology endpoints analyzed in rodents and rabbits and to exposure values for humans. We show that although many zebrafish endpoints did not correlate to rodent or rabbit acute toxicity data, zebrafish could be used to accurately predict relative acute toxicity through the rat inhalation, rabbit dermal, and rat oral exposure routes. Ranking of the chemicals based on toxicity and teratogenicity in zebrafish, as well as human exposure levels, revealed that 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), benzo(a)pyrene, and chlorpyrifos ranked in the top nine of all chemicals for these three categories, and as such should be considered high priority chemicals for testing in higher vertebrates.

  17. Opportunity for high value-added chemicals from food supply chain wastes.

    Science.gov (United States)

    Matharu, Avtar S; de Melo, Eduardo M; Houghton, Joseph A

    2016-09-01

    With approximately 1.3 billion tonnes of food wasted per annum, food supply chain wastes (FSCWs) may be viewed as the contemporary Periodic Table of biobased feedstock chemicals (platform molecules) and functional materials. Herein, the global drivers and case for food waste valorisation within the context of global sustainability, sustainable development goals and the bioeconomy are discussed. The emerging potential of high value added chemicals from certain tropical FSCW is considered as these are grown in three major geographical areas: Brazil, India and China, and likely to increase in volume. FSCW in the context of biorefineries is discussed and two case studies are reported, namely: waste potato, and; orange peel waste. Interestingly, both waste feedstocks, like many others, produce proteins and with the global demand for vegetable proteins on the rise then proteins from FSCW may become a dominant area.

  18. Glycerol conversion into value added chemicals over bimetallic catalysts in supercritical carbon dioxide

    Science.gov (United States)

    Hidayati, Luthfiana N.; Sudiyarmanto, Adilina, Indri B.

    2017-01-01

    Development of alternative energy from biomass encourage the experiments and production of biodiesel lately. Biodiesel industries widely expand because biodiesel as substitute of fossil fuel recognized as promising renewable energy. Glycerol is a byproduct of biodiesel production, which is resulted 10% wt average every production. Meanwhile, carbon dioxide is a gas that is very abundant amount in the atmosphere. Glycerol and carbon dioxide can be regarded as waste, possibly will produce value-added chemical compounds through chemically treated. In this preliminary study, conversion of glycerol and carbon dioxide using bimetallic catalyst Ni-Sn with various catalyst supports : MgO, γ-Al2O3, and hydrotalcite. Catalysts which have been prepared, then physically characterized by XRD, surface area and porosity analysis, and thermal gravity analysis. Catalytic test performance using supercritical carbon dioxide conditions. Furthermore, the products were analyzed by GC. The final product mostly contained of propylene glycol and glycerol carbonate.

  19. Chemical Composition, Physicochemical Characteristics, and Nutritional Value of Lannea kerstingii Seeds and Seed Oil

    Science.gov (United States)

    Ouilly, Judicaël Thomas; Bazongo, Patrice; Bougma, Adjima; Kaboré, Nèbpawindé; Lykke, Anne Mette; Ouédraogo, Amadé

    2017-01-01

    The chemical composition, main physicochemical properties, and nutritional value of seed flour and seed oil of Lannea kerstingii were studied. The results indicated that seeds contained 3.61% moisture, 57.85% fat, 26.39% protein, 10.07% carbohydrates, and 2.08% ash. Potassium was the predominant mineral, followed by magnesium and calcium. The essential amino acids were at higher levels than the estimated amino acid requirements of FAO/WHO/UNU except for lysine. Fatty acid composition showed that oleic acid was the major fatty acid, followed by palmitic, linoleic, and stearic acids. Physicochemical properties of the seed oil were melting point, 19.67°C; refractive index (25°C), 1.47; iodine value, 60.72/100 g of oil; peroxide value, 0.99 meq. O2/kg of oil; p-anisidine value, 0.08; total oxidation (TOTOX) value, 2.06; oxidative stability index (120°C), 52.53 h; free fatty acids, 0.39%; acid value, 0.64 mg of KOH/g of oil; saponification value, 189.73. Total amount of tocopherols, carotenoids, and sterols was 578.60, 4.60, and 929.50 mg/kg of oil, respectively. γ-Tocopherol (82%), lutein (80%), and β-sitosterol (93%) were the most abundant forms of tocopherols, carotenoids, and sterols, respectively. Seeds of L. kerstingii constitute an alternative source of stable vegetable oil and protein for nutritional and industrial applications. PMID:28255501

  20. Chemical Composition, Physicochemical Characteristics, and Nutritional Value of Lannea kerstingii Seeds and Seed Oil

    Directory of Open Access Journals (Sweden)

    Judicaël Thomas Ouilly

    2017-01-01

    Full Text Available The chemical composition, main physicochemical properties, and nutritional value of seed flour and seed oil of Lannea kerstingii were studied. The results indicated that seeds contained 3.61% moisture, 57.85% fat, 26.39% protein, 10.07% carbohydrates, and 2.08% ash. Potassium was the predominant mineral, followed by magnesium and calcium. The essential amino acids were at higher levels than the estimated amino acid requirements of FAO/WHO/UNU except for lysine. Fatty acid composition showed that oleic acid was the major fatty acid, followed by palmitic, linoleic, and stearic acids. Physicochemical properties of the seed oil were melting point, 19.67°C; refractive index (25°C, 1.47; iodine value, 60.72/100 g of oil; peroxide value, 0.99 meq. O2/kg of oil; p-anisidine value, 0.08; total oxidation (TOTOX value, 2.06; oxidative stability index (120°C, 52.53 h; free fatty acids, 0.39%; acid value, 0.64 mg of KOH/g of oil; saponification value, 189.73. Total amount of tocopherols, carotenoids, and sterols was 578.60, 4.60, and 929.50 mg/kg of oil, respectively. γ-Tocopherol (82%, lutein (80%, and β-sitosterol (93% were the most abundant forms of tocopherols, carotenoids, and sterols, respectively. Seeds of L. kerstingii constitute an alternative source of stable vegetable oil and protein for nutritional and industrial applications.

  1. Faithful but Different: Clinical Social Workers Speak Out about Career Motivation and Professional Values

    Science.gov (United States)

    Bradley, Carolyn; Maschi, Tina; O'Brien, Helen; Morgen, Keith; Ward, Kelly

    2012-01-01

    The purpose of this study was to describe licensed clinical social workers' (LCSWs) professional motivation to pursue a social work career and the decision to enter clinical practice. It used a probability sample of 245 New Jersey LCSWs and the Social Work Values Survey as part of an anonymous self-administered mail survey. Descriptive analyses…

  2. Screening values for Non-Carcinogenic Hanford Waste Tank Vapor Chemicals that Lack Established Occupational Exposure Limits

    Energy Technology Data Exchange (ETDEWEB)

    Poet, Torka S.; Mast, Terryl J.; Huckaby, James L.

    2006-02-06

    Over 1,500 different volatile chemicals have been reported in the headspaces of tanks used to store high-level radioactive waste at the U.S. Department of Energy's Hanford Site. Concern about potential exposure of tank farm workers to these chemicals has prompted efforts to evaluate their toxicity, identify chemicals that pose the greatest risk, and incorporate that information into the tank farms industrial hygiene worker protection program. Established occupation exposure limits for individual chemicals and petroleum hydrocarbon mixtures have been used elsewhere to evaluate about 900 of the chemicals. In this report headspace concentration screening values were established for the remaining 600 chemicals using available industrial hygiene and toxicological data. Screening values were intended to be more than an order of magnitude below concentrations that may cause adverse health effects in workers, assuming a 40-hour/week occupational exposure. Screening values were compared to the maximum reported headspace concentrations.

  3. Economic Evaluations for the Carbon Dioxide-involved Production of High-value Chemicals

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Lee, Dong Woog; Jang, Se Gyu; Kwak, No-Sang; Lee, In Young; Jang, Kyung Ryoung; Shim, Jae-Goo [KEPCO Research Institute, Daejon (Korea, Republic of); Choi, Jong Shin [Korea East-West Power Co. LTD, Seoul (Korea, Republic of)

    2014-06-15

    Economic evaluation of the manufacturing technology of high-value chemicals through the carbonation reaction of carbon dioxide contained in the flue gas was performed, and analysis of the IRR (Internal Rate of Return) and whole profit along the production plan of the final product was conducted. Through a carbonation reaction with sodium hydroxide that is generated from electrolysis and by using carbon dioxide in the combustion gas that is generated in the power plant, it is possible to get a high value products such as sodium bicarbonate compound and also to reduce the carbon dioxide emission simultaneously. The IRR (Internal Rate of Return) and NPV (Net Present Value) methods were used for the economic evaluation of the process which could handle carbon dioxide of 100 tons per day in the period of the 20 years of plant operation. The results of economic evaluation showed that the IRR of baseline case of technology was 67.2% and the profit that obtained during the whole operation period (20 years) was 346,922 million won based on NPV value. When considering ETS due to the emissions trading enforcement that will be activated in 2015, the NPV was improved to a 6,000 million won. Based on this results, it could be concluded that this CO2 carbonation technology is an cost-effective technology option for the reduction of greenhouse gas.

  4. Calorific Value and Chemical Composition of Five Semi-Arid Mexican Tree Species

    Directory of Open Access Journals (Sweden)

    Maginot Ngangyo-Heya

    2016-03-01

    Full Text Available The current global energy crisis has generated growing interest in looking for alternatives to traditional fossil fuels, presenting lignocellulosic materials as a promising resource for sustainable energy production. In this paper, the calorific values and chemical composition of the trunks, branches, twigs and leaves of five timber species of the semi-arid land of Mexico (Helietta parvifolia (Gray Benth., Ebenopsis ebano (Berl. Barneby, Acacia berlandieri (Benth., Havardia pallens (Benth. Britton & Rose and Acacia wrightii (Benth. were determined according to international standards. The results highlighted the calorific value ranges of 17.56 to 18.61 MJ kg−1 in trunks, 17.15 to 18.45 MJ kg−1 in branches, 17.29 to 17.92 MJ kg−1 in twigs, and 17.35to 19.36 MJ kg−1 in leaves. The pH presented an acidic trend (3.95–5.64. The content of mineral elements varied in trunks (1.09%–2.29%, branches (0.86%–2.75%, twigs (4.26%–6.76% and leaves (5.77%–11.79%, showing the higher proportion in Ca (57.03%–95.53%, followed by K (0.95%–19.21% and Mg (0.88%–13.47%. The highest amount of extractives was obtained in the methanolic solvent (3.96%–17.03%. The lignin recorded values of 28.78%–35.84% for trunks, 17.14%–31.39% for branches and 20.61%–29.92% for twigs. Lignin showed a moderately strong correlation (r = 0.66 with calorific value, but the best mathematical model was registered with the calorific value depending on the pH and lignin (R2 = 58.86%.

  5. A retrospective evaluation of haematological values in clinical cases of water buffaloes

    Directory of Open Access Journals (Sweden)

    Nittin D. Singh

    2013-04-01

    Full Text Available Aim: To evaluate the important haematological values of the retrospective clinical cases of buffaloes presented to the Teaching Veterinary Hospital of the College of Veterinary Science, Guru Angad Dev Veterinary and Animal Science University, Ludhiana over a period of 4 years from January 2007 to December 2010. Materials and methods: The blood was collected from jugular vein in EDTA containing vials. Statistical analysis of haematological values with different case history/clinical signs was performed using SPSS 16.0 version by applying one way ANOVA at P<0.05. Clinical pathology of these cases was monitored by comparing hemogram values with the reference range. Results: The most common disorders found in water buffaloes were digestive disorders followed by fever and respiratory disorders. Haematological values viz. TLC, DLC (neutrophil, lymphocyte and eosinophil counts showed significant differences depending upon the case history/clinical signs while haemoglobin count was found to be statistically nonsignificant. Conclusion: TLC and DLC are found to be the important indicators of health status of water buffaloes in general which are more related to clinical history/clinical signs of this species than other the haematological parameters viz. haemoglobin count. [Vet World 2013; 6(2.000: 103-105

  6. A review of catalytic microwave pyrolysis of lignocellulosic biomass for value-added fuel and chemicals.

    Science.gov (United States)

    Morgan, Hervan Marion; Bu, Quan; Liang, Jianghui; Liu, Yujing; Mao, Hanping; Shi, Aiping; Lei, Hanwu; Ruan, Roger

    2017-04-01

    Lignocellulosic biomass is an abundant renewable resource and can be efficiently converted into bio-energy by a bio-refinery. From the various techniques available for biomass thermo-chemical conversion; microwave assisted pyrolysis (MAP) seems to be the very promising. The principles of microwave technology were reviewed and the parameters for the efficient production of bio-oil using microwave technology were summarized. Microwave technology by itself cannot efficiently produce high quality bio-oil products, catalysts are used to improve the reaction conditions and selectivity for valued products during MAP. The catalysts used to optimize MAP are revised in the development of this article. The origins for bio-oils that are phenol rich or hydrocarbon rich are reviewed and their experimental results were summarized. The kinetics of MAP is discussed briefly in the development of the article. Future prospects and scientific development of MAP are also considered in the development of this article.

  7. Production of bioelectricity, bio-hydrogen, high value chemicals and bioinspired nanomaterials by electrochemically active biofilms.

    Science.gov (United States)

    Kalathil, Shafeer; Khan, Mohammad Mansoob; Lee, Jintae; Cho, Moo Hwan

    2013-11-01

    Microorganisms naturally form biofilms on solid surfaces for their mutual benefits including protection from environmental stresses caused by contaminants, nutritional depletion or imbalances. The biofilms are normally dangerous to human health due to their inherited robustness. On the other hand, a recent study suggested that electrochemically active biofilms (EABs) generated by electrically active microorganisms have properties that can be used to catalyze or control the electrochemical reactions in a range of fields, such as bioenergy production, bioremediation, chemical/biological synthesis, bio-corrosion mitigation and biosensor development. EABs have attracted considerable attraction in bioelectrochemical systems (BESs), such as microbial fuel cells and microbial electrolysis cells, where they act as living bioanode or biocathode catalysts. Recently, it was reported that EABs can be used to synthesize metal nanoparticles and metal nanocomposites. The EAB-mediated synthesis of metal and metal-semiconductor nanocomposites is expected to provide a new avenue for the greener synthesis of nanomaterials with high efficiency and speed than other synthetic methods. This review covers the general introduction of EABs, as well as the applications of EABs in BESs, and the production of bio-hydrogen, high value chemicals and bio-inspired nanomaterials.

  8. Combined single photon emission computerized tomography and conventional computerized tomography: Clinical value for the shoulder surgeons?

    Directory of Open Access Journals (Sweden)

    Michael T Hirschmann

    2011-01-01

    Full Text Available With the cases described, we strive to introduce single photon emission computerized tomography in combination with conventional computer tomography (SPECT/CT to shoulder surgeons, illustrate the possible clinical value it may offer as new diagnostic radiologic modality, and discuss its limitations. SPECT/CT may facilitate the establishment of diagnosis, process of decision making, and further treatment for complex shoulder pathologies. Some of these advantages were highlighted in cases that are frequently seen in most shoulder clinics.

  9. Impact of calibration fitting models on the clinical value of chromogranin A

    OpenAIRE

    Ferraro, Simona; Marano, Giuseppe; Ciardi, Laura; Vendramin, Chiara; Bongo, Angelo S.; Bellomo, Giorgio; Boracchi, Patrizia; Biganzoli, Elia M.

    2009-01-01

    Background: The clinical relevance of chromogranin A (CgA) concentrations depends on the analytical performance of the assay. The goal of the present study was to define the clinical involvements in CgA calibration models by evaluating the confidence intervals (CIs) for values from patients who were undergoing monitoring for disease. Methods: Thirty calibration curves for the CgA assay [immunoradiometric assay (IRMA), (CIS-BIO)] were built using linear regression (LR), and four-parameter log...

  10. Driving out waste: a framework to enhance value in clinical care.

    Science.gov (United States)

    Burton, David A

    2013-06-01

    Many healthcare providers today are seeking to improve the value of the care they deliver by implementing standardized clinical practice guidelines aimed at reducing variations in care, avoiding complications, and lowering costs. To succeed, such an initiative requires the full support and participation of the clinicians who will use the guidelines. Providers also should have a fully developed infrastructure consisting of a clinical content system, an analytics system, and a deployment system.

  11. Nutritive value and chemical composition of prickly pear seeds (Opuntia ficus indica L.) growing in Turkey.

    Science.gov (United States)

    Özcan, Mehmet Musa; Al Juhaimi, Fahad Y

    2011-08-01

    The proximate composition and physico-chemical properties (moisture, crude lipid, crude protein, ash, and crude fiber, peroxide value, saponification value, acidity, relative density and refractive index) of prickly pear seed and corresponding oil were determined. The mineral contents (Ca, Cu, Fe, K, Mg, Na, P, Mn and Zn) of samples were analyzed by inductively coupled plasma atomic emission spectrometry. Minerals determined were: calcium 471.2 mg/kg, potassium 532.7 mg/kg, magnesium 117.3 mg/kg, phosphorus 1,627.5 mg/kg and natrium 71.3 mg/kg. The fatty acid profiles of seed oil from the Opuntia ficus indica were analyzed by gas chromatography. Linoleic acid was established as the major fatty acid (61.01%), followed by oleic (25.52%) and palmitic (12.23%) acids. Both myristic, stearic and arachidonic acids were detected in O. ficus indica seed oil in low amounts. As a result, O. ficus indica seeds are an important source of natural fiber and, given its high linoleic acid content, its oil can be used as a nutraceutic agent.

  12. Baseline hematologic, endocrine, and clinical chemistry values in ducks and roosters.

    Science.gov (United States)

    Spano, J S; Pedersoli, W M; Kemppainen, R J; Krista, L M; Young, D W

    1987-01-01

    Venous blood samples were collected at 3-day intervals for a total of six samples from each of five adult male pekin ducks and five adult Ross roosters. Twenty biochemical, six hematologic, and three endocrine determinations were performed on each blood or serum sample collected. The data obtained provide reference values for future studies of avian species and illustrate the utility of an automated clinical chemistry analyzer in assessing multiple serum biochemistry values in small sample volumes obtained from birds.

  13. Clinical signif icance of C-reactive protein values in antibiotic treatment for pyogenic liver abscess

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To investigate the clinical signifi cance of C-reactive protein (CRP) values in determining the endpoint of antibiotic treatment for liver abscess after drainage. METHODS: The endpoints of antibiotic treatment in 46 patients with pyogenic liver abscess after complete percutaneous drainage were assessed by performing a retrospective study. After complete percutaneous drainage, normal CRP values were considered as the endpoint in 18 patients (experimental group), and normal body temperature for at least 2...

  14. Top Value Added Chemicals from Biomass - Volume I, Results of Screening for Potential Candidates from Sugars and Synthesis Gas

    Energy Technology Data Exchange (ETDEWEB)

    None

    2004-08-01

    This report identifies twelve building block chemicals that can be produced from sugars via biological or chemical conversions. The twelve building blocks can be subsequently converted to a number of high-value bio-based chemicals or materials. Building block chemicals, as considered for this analysis, are molecules with multiple functional groups that possess the potential to be transformed into new families of useful molecules. The twelve sugar-based building blocks are 1,4-diacids (succinic, fumaric and malic), 2,5-furan dicarboxylic acid, 3-hydroxy propionic acid, aspartic acid, glucaric acid, glutamic acid, itaconic acid, levulinic acid, 3-hydroxybutyrolactone, glycerol, sorbitol, and xylitol/arabinitol.

  15. DWI of Prostate Cancer: Optimal b-Value in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Guglielmo Manenti

    2014-01-01

    Full Text Available Aim. To compare the diagnostic performance of diffusion weighted imaging (DWI using b-values of 1000 s/mm2 and 2000 s/mm2 at 3 Tesla (T for the evaluation of clinically significant prostate cancer. Matherials and Methods. Seventy-eight prostate cancer patients underwent a 3T MRI scan followed by radical prostatectomy. DWI was performed using b-values of 0, 1000, and 2000 s/mm2 and qualitatively analysed by two radiologists. ADC maps were obtained at b-values of 1000 and 2000 s/mm2 and quantitatively analyzed in consensus. Results. For diagnosis of 78 prostate cancers the accuracy of DWI for the young reader was significantly greater at b = 2000 s/mm2 for the peripheral zone (PZ but not for the transitional zone (TZ. For the experienced reader, DWI did not show significant differences in accuracy between b-values of 1000 and 2000 s/mm2. The quantitative analysis in the PZ and TZ was substantially superimposable between the two b-values, albeit with a higher accuracy with a b-value of 2000 s/mm2. Conclusions. With a b-value of 2000 s/mm2 at 3T both readers differentiated clinical significant cancer from benign tissue; higher b-values can be helpful for the less experienced readers.

  16. The value of clinical and laboratory diagnostics for chest pain patients at the emergency department

    NARCIS (Netherlands)

    Jellema, Laurens-Jan C.; Backus, Barbra E.; Six, A. Jacob; Braam, Richard; Groenemeijer, Bjorn; van der Zaag-Loonen, Hester J.; Tio, Rene; van Suijlen, Jeroen D. E.

    2014-01-01

    Background: The focus during the diagnostic process for patients with acute chest pain is to discriminate patients who can be safely discharged from those who are at risk for an acute coronary syndrome (ACS). In this study the diagnostic value of the clinical examination is compared with laboratory

  17. Correlation of MIC value and disk inhibition zone diameters in clinical Legionella pneumophila serogroup 1 isolates

    NARCIS (Netherlands)

    Bruin, J.P. de; Diederen, B.M.; Ijzerman, E.P.; Boer, J.W. den; Mouton, J.W.

    2013-01-01

    OBJECTIVES: Routine use of disk diffusion tests for detecting antibiotic resistance in Legionella pneumophila has not been described. The goal of this study was to determine the correlation of MIC values and inhibition zone diameter (MDcorr) in clinical L. pneumophila isolates. METHODS: Inhibition z

  18. Sensitivity, specificity and predictive value of blood cultures from cattle clinically suspected of bacterial endocarditis

    DEFF Research Database (Denmark)

    Houe, Hans; Eriksen, L.; Jungersen, Gregers;

    1993-01-01

    This study investigated the number of blood culture-positive cattle among 215 animals clinically suspected of having bacterial endocarditis. For animals that were necropsied, the sensitivity, specificity and predictive value of the diagnosis of endocarditis were calculated on the basis...

  19. The value of clinical tests in acute full-thickness tears of the supraspinatus tendon

    DEFF Research Database (Denmark)

    Bak, Klaus; Sørensen, Anne Kathrine Belling; Jørgensen, Uffe Viegh;

    2010-01-01

    Early repair of rotator cuff tears leads to superior results. To detect symptomatic full-thickness tears of the supraspinatus tendon at an early stage, we conducted a prospective study to evaluate the value of clinical examination with and without subacromial lidocaine within the first weeks after...

  20. Personal values and self-esteem in general and clinical population

    Directory of Open Access Journals (Sweden)

    Vanesa C. Góngora

    2015-09-01

    Full Text Available The aim of this study is to investigate the association between personal values and self-esteem in general population and clinical population. The sample was composed of a group of patients with a diagnosis of anxiety disorders and/or depression (n = 60 and a comparison group, paired by sex and age, of general population (n = 60. The Portrait Values Questionnaire of Schwartz (PVQ and the Autoe Self-esteem Scale were used. T-tests were performed to compare the scores of both instruments between the two groups. The clinical sample scored significantly lower in Self-esteem, Self- direction, Hedonism, and Openness to Change. For this reason, Pearson correlations were calculated in differential groups (clinical and general between the PVQ and the Self-esteem Scale. In the general population group self-esteem was associated to one value: Self-direction. In the clinical group, self-esteem was associated mainly to Self- direction, but also to Hedonism, Power and Security; and to the axis Self-promotion and Openness to Change. Both in the clinical and general population samples it was found a significant association between the interest in having independent thought, freedom of action and exploring with higher levels of self-esteem. 

  1. Effect of white striping on chemical composition and nutritional value of chicken breast meat

    Directory of Open Access Journals (Sweden)

    Massimiliano Petracci

    2014-03-01

    Full Text Available White striping defect (appearance of white striations parallel to muscle fiber on surface of breast is considered an emerging issue in chicken breast meat which is related to increasing growth rate of modern hybrid birds. This study was aimed at evaluating the effect of white striping on chemical composition and nutritional value of chicken breast meat. During three replications, a total of 108 Pectoralis major muscles representing three degrees of white striping (absence=normal; presence classified in 2 levels as moderate or severe were selected to determine proximate composition (moisture, protein, lipid and collagen as well as sarcoplasmic and myofibrillar protein profile by sodium dodecyl sulphatepolyacrylamide gel electrophoresis analysis. The results showed that both severe and moderate white-striped fillets had higher fat content (2.53 vs 1.46 vs 0.78%; P<0.001, lower protein level (20.9 vs 22.2 vs 22.9%; P<0.001, decreased quality of protein as proven by higher collagen content (1.30 vs 1.37 vs 1.43%; P<0.001, and different pattern on myofibrillar and sarcoplasmic fractions when compared to normal fillets. Moreover, severe white-striped fillets exhibited higher energy content (450.7 vs 421.1 kJ/100g; P<0.01 with respect to normal meat. In conclusion, there was a large worsening of nutritional value of chicken breast meat following occurrence of white striping and this might impair consumer attitude towards poultry meat.

  2. Utility and necessity of repeat testing of critical values in the clinical chemistry laboratory.

    Directory of Open Access Journals (Sweden)

    Aijun Niu

    Full Text Available CONTEXT: Routine repeat testing of critical values is a long-standing practice in many clinical laboratories; however, its usefulness and necessity remain to be empirically established and no regulatory requirements yet exist for verification of the critical value results obtained by repeat analysis. OBJECTIVE: To determine whether repeat testing of critical values is useful and necessary in a clinical chemistry laboratory. METHODS: A total of 601 chemistry critical values (potassium, n = 255; sodium, n = 132; calcium, n = 108; glucose, n = 106 obtained from 72,259 routine clinical chemistry specimens were repeat tested. The absolute value and the percentage of difference between the two testing runs were calculated for each of the four critical values and then compared with the allowable error limit put forth in the College of American Pathologists (CAP. RESULTS: Among the repeat data for the 601 critical values, a total of 24 showed large differences between the initial result and the repeated result which exceeded the CAP limits for allowable error. The number and rates (% of large differences for within and outside the analytical measurement range (AMR were 12 (2.1% and 12 (41.4%, respectively. For the 572 critical values within the AMR for each test category, the mean absolute difference (mmol/L and difference(% between the two testing runs were: potassium, 0.1 mmol/L (2.7%; sodium, 2.1 mmol/L (1.7%; calcium, 0.05 mmol/L (3.0%; glucose, 0.18 mmol/L (2.6%. CONCLUSIONS: When the initial chemistry critical values are within the AMR, repeated testing does not improve accuracy and is therefore unnecessary. When the initial chemistry critical values are outside the AMR, however, the benefit of repeated testing justifies its performance and makes it necessary. Performing repeat clinical testing on a case-by-case, rather than routine, basis can improve patient care by delivering critical values more rapidly while providing savings

  3. Catalytic oxidation of biorefinery lignin to value-added chemicals to support sustainable biofuel production.

    Science.gov (United States)

    Ma, Ruoshui; Xu, Yan; Zhang, Xiao

    2015-01-01

    Transforming plant biomass to biofuel is one of the few solutions that can truly sustain mankind's long-term needs for liquid transportation fuel with minimized environmental impact. However, despite decades of effort, commercial development of biomass-to-biofuel conversion processes is still not an economically viable proposition. Identifying value-added co-products along with the production of biofuel provides a key solution to overcoming this economic barrier. Lignin is the second most abundant component next to cellulose in almost all plant biomass; the emerging biomass refinery industry will inevitably generate an enormous amount of lignin. Development of selective biorefinery lignin-to-bioproducts conversion processes will play a pivotal role in significantly improving the economic feasibility and sustainability of biofuel production from renewable biomass. The urgency and importance of this endeavor has been increasingly recognized in the last few years. This paper reviews state-of-the-art oxidative lignin depolymerization chemistries employed in the papermaking process and oxidative catalysts that can be applied to biorefinery lignin to produce platform chemicals including phenolic compounds, dicarboxylic acids, and quinones in high selectivity and yield. The potential synergies of integrating new catalysts with commercial delignification chemistries are discussed. We hope the information will build on the existing body of knowledge to provide new insights towards developing practical and commercially viable lignin conversion technologies, enabling sustainable biofuel production from lignocellulosic biomass to be competitive with fossil fuel.

  4. Salinity effect on nutritional value, chemical composition and bioactive compounds content of Cichorium spinosum L.

    Science.gov (United States)

    Petropoulos, Spyridon A; Levizou, Efi; Ntatsi, Georgia; Fernandes, Ângela; Petrotos, Konstantinos; Akoumianakis, Konstantinos; Barros, Lillian; Ferreira, Isabel C F R

    2017-01-01

    Soil salinization is an increasing problem for many areas throughout the world that renders prohibitive vegetables and crop production in general. In the present study, Cichorium spinosum L. plants were grown under saline conditions in order to evaluate chemical composition and bioactive compounds content of their leaves. Salinity increase resulted in significant changes of macro and micro-nutrients content (nutritional value, sugars, fatty acids, minerals, ascorbic acid and tocopherols), whereas the concentration of phenolic compounds was not significantly affected. Chicoric and 5-O-caffeoylquinic acid were the most abundant phenolic acids. In contrast, antioxidant activity and mineral composition were beneficially affected by mid-to-high and high salinity levels. In conclusion, C. spinosum can be cultivated under saline conditions without compromising the quality of the final product, especially in semi-arid areas where irrigation water is scarce and/or of low quality due to high content of NaCl (coastal areas or areas where underground water is saline).

  5. Recovery of metal values from spent lithium-ion batteries with chemical deposition and solvent extraction

    Science.gov (United States)

    Nan, Junmin; Han, Dongmei; Zuo, Xiaoxi

    This paper describes a new recycling process of metal values from spent lithium-ion batteries (LIBs). After the dismantling of the spent batteries steel crusts, the leaching of battery internal substances with alkaline solution and the dissolving of the residues with H 2SO 4 solution were carried out. Then mass cobalt was chemically deposited as oxalate, and Acorga M5640 and Cyanex272 extracted the small quantities of copper and cobalt, respectively. Lithium was recovered as deposition of lithium carbonate. It is shown that about 90% cobalt was deposited as oxalate with less than 0.5% impurities, and Acorga M5640 and Cyanex272 were efficient and selective for the extraction of copper and cobalt in sulfate solution. Over 98% of the copper and 97% of the cobalt was recovered in the given process. In addition, the waste solution was treated innocuously, and LiCoO 2 positive electrode material with good electrochemical performance was also synthesized by using the recovered compounds of cobalt and lithium as precursors. The process is feasible for the recycling of spent LIBs in scale-up.

  6. Chemical composition and metabolizable energy values of feedstuffs for broiler chickens

    Directory of Open Access Journals (Sweden)

    Eliane Aparecida da Silva

    2012-03-01

    Full Text Available The objective of this study was to estimate the values of apparent metabolizable energy and apparent metabolizable energy corrected for nitrogen balance and determine the chemical composition of the following feedstuffs: babassu meal, sunflower meal, corn gluten meal, babassu starch flour, meat and bones meal, beans, millet, cookies residue, pasta residue and bread-making residue. The traditional method of excreta collection was used with broilers in the period of 14 to 24 days of age, which were distributed in a completely randomized design with eleven treatments and six replicates of six birds each. Each feedstuff replaced the reference diet at levels of 30 or 40% depending on the type of feedstuff. Chicks were housed in cages fitted with trays to collect the excreta. The apparent metabolizable energy corrected for nitrogen balance (kcal/kg on the natural matter of feedstuffs were: babassu meal, 1,116; sunflower meal, 1,607; corn gluten meal, 3,826; babassu flour starch, 1,731; meat and bone flour, 2,524; common beans, 693; millet, 3,046; cookies residue, 3,351; pasta residue, 3,543 and bread-making residue, 3,494.

  7. Drawing inferences from clinical studies with missing values using genetic algorithm.

    Science.gov (United States)

    Priya, R Devi; Kuppuswami, S

    2014-01-01

    Missing data problem degrades the statistical power of any analysis made in clinical studies. To infer valid results from such studies, suitable method is required to replace the missing values. There is no method which can be universally applicable for handling missing values and the main objective of this paper is to introduce a common method applicable in all cases of missing data. In this paper, Bayesian Genetic Algorithm (BGA) is proposed to effectively impute both missing continuous and discrete values using heuristic search algorithm called genetic algorithm and Bayesian rule. BGA is applied to impute missing values in a real cancer dataset under Missing At Random (MAR) and Missing Completely At Random (MCAR) conditions. For both discrete and continuous attributes, the results show better classification accuracy and RMSE% than many existing methods.

  8. Top Value Added Chemicals From Biomass: I. Results of Screening for Potential Candidates from Sugars and Synthesis Gas

    Energy Technology Data Exchange (ETDEWEB)

    Werpy, Todd A.; Holladay, John E.; White, James F.

    2004-11-01

    This report identifies twelve building block chemicals that can be produced from sugars via biological or chemical conversions. The twelve building blocks can be subsequently converted to a number of high-value bio-based chemicals or materials. Building block chemicals, as considered for this analysis, are molecules with multiple functional groups that possess the potential to be transformed into new families of useful molecules. The twelve sugar-based building blocks are 1,4-diacids (succinic, fumaric and malic), 2,5-furan dicarboxylic acid, 3-hydroxy propionic acid, aspartic acid, glucaric acid, glutamic acid, itaconic acid, levulinic acid, 3-hydroxybutyrolactone, glycerol, sorbitol, and xylitol/arabinitol. In addition to building blocks, the report outlines the central technical barriers that are preventing the widespread use of biomass for products and chemicals.

  9. Personal values and self-esteem in general and clinical population

    OpenAIRE

    Vanesa C. Góngora

    2015-01-01

    The aim of this study is to investigate the association between personal values and self-esteem in general population and clinical population. The sample was composed of a group of patients with a diagnosis of anxiety disorders and/or depression (n = 60) and a comparison group, paired by sex and age, of general population (n = 60). The Portrait Values Questionnaire of Schwartz (PVQ) and the Autoe Self-esteem Scale were used. T-tests were performed to compare the scores of both instruments bet...

  10. Genetic counsellors in Sweden: their role and added value in the clinical setting.

    Science.gov (United States)

    Pestoff, Rebecka; Ingvoldstad, Charlotta; Skirton, Heather

    2016-03-01

    Genetic testing is becoming more commonplace in general and specialist health care and should always be accompanied by genetic counselling, according to Swedish law. Genetic counsellors are members of the multi-disciplinary team providing genetic counselling. This study examined the role and added value of genetic counsellors in Sweden, using a cross-sectional on-line survey. The findings showed that the genetic counsellors added value in the clinical setting by acting as the 'spider-in-the-web' regarding case management, having a more holistic, ethical and psychological perspective, being able to offer continuous support and build a relationship with the patient, and being more accessible than medical geneticists. The main difference between a genetic counsellor and medical geneticist was that the doctor had the main medical responsibility. Thus genetic counsellors in Sweden contribute substantially to the care of patients in the clinical genetic setting.

  11. ERP in chronic pancreatitis - ductal morphology, relation to exocrine function and pain - clinical value

    Energy Technology Data Exchange (ETDEWEB)

    Norup Lauridsen, K.; Raahede, J.; Kruse, A.; Thommesen, P.

    1985-08-01

    ERP was analyzed in 87 patients with chronic pancreatitis with special reference to its clinical value in management of pain, the dominating symptom in uncomplicated chronic pancreatitis. A significant correlation was found between ductal changes due to pancreatitis and decrease in pancreatic function. However, no association was found between severe pancreatic pain and pancreatic function or pancreatic morphology. The significance of ERP in management of patients with persistent severe pancreatic pain is discussed.

  12. Exploring the feasibility and synergistic value of the One Health approach in clinical research

    DEFF Research Database (Denmark)

    Cordoba Currea, Gloria Cristina; Sørensen, Tina Møller; Holm, Anne;

    2015-01-01

    diagnostic pathways (i.e., 16 possiblecombinations of diagnostic tools) to gold standard in human and veterinary primary care practice in Denmark.Fifty primary care practices and 100 veterinary clinics will each consecutively include 20 human patients or 8–10dogs, respectively. Data will be collected......Background: The One Health approach is emerging in response to the development of bacterial resistance. To thebest of our knowledge, the possibility to use this approach in a clinical context has not yet been explored. Thus, inthis paper, we report the procedures to implement a prospective...... observational study of diagnostic pathways in humanand canine patients with suspected urinary tract infection as a means to assess the feasibility and synergistic value ofsetting up One Health clinical research projects and interventions. Methods/design: A prospective observational study will compare different...

  13. Generating appropriate clinical data for value assessment of medical devices: what role does regulation play?

    Science.gov (United States)

    Tarricone, Rosanna; Torbica, Aleksandra; Ferré, Francesca; Drummond, Mike

    2014-10-01

    Assessing the value of health technologies, through health technology assessment is critically dependent on the existence of relevant and robust clinical data on the efficacy, safety and ideally, effectiveness of the technologies concerned. However, in the case of medical devices, such clinical data may not always be available, because of the different nature of the regulatory requirements in different jurisdictions. Therefore, we conducted a systematic review of the regulatory requirements in seven major jurisdictions in order to identify current challenges and to suggest possible improvements. There are differences in the requirements across jurisdictions and in the balance between pre-market and post-market controls. Several improvements are required in order to generate adequate clinical data for health technology assessment.

  14. Chemical Information Literacy: pK[subscript a] Values--Where Do Students Go Wrong?

    Science.gov (United States)

    Flynn, Alison B.; Amellal, Delphine G.

    2016-01-01

    Chemical information literacy is an essential skillset for navigating, evaluating, and using the wealth of print and online information. Accordingly, efforts are underway to improve students' acquisition and mastery of this skillset. However, less is known about students' abilities related to finding and using chemical information to solve…

  15. CT value analysis and clinical significance before and after percutaneous lumbar discectomy

    Institute of Scientific and Technical Information of China (English)

    刘雷; 裴福兴; 宋跃明; 沈彬; 周宗科; 宋文锴; 张聪

    2002-01-01

    To provide theoretical basis for effect and mechanism of percutaneous lumbar discectomy in clinic. Methods: A total of 180 patients with lumbar intervertebral disc herniation were evaluated by CT on the fifth day before and after operation. Meanwhile, CT value was measured in the determined level and region. Results: After operation, CT value of the central and posterior determined point of herniated intervertebral disc was lower significantly than that before operation (P<0.01), but CT value of the anterior determined point was different insignificantly. The excellent and good results of the patients together were 83% postoperatively. Conclusions: The curative effect of percutaneous lumbar discectomy is achieved through reduction of lumbar intradiscal pressure.

  16. Precision and negative predictive value of links between ClinicalTrials.gov and PubMed.

    Science.gov (United States)

    Huser, Vojtech; Cimino, James J

    2012-01-01

    One of the goals of translational science is to shorten the time from discovery to clinical use. Clinical trial registries were established to increase transparency in completed and ongoing clinical trials, and they support linking trials with resulting publications. We set out to investigate precision and negative predictive value (NPV) of links between ClinicalTrials.gov (CT.gov) and PubMed. CT.gov has been established to increase transparency in clinical trials and the link to PubMed is crucial for supporting a number of important functions, including ascertaining publication bias. We drew a random sample of trials downloaded from CT.gov and performed manual review of retrieved publications. We characterize two types of links between trials and publications (NCT-link originating from MEDLINE and PMID-link originating from CT.gov).The link precision is different based on type (NCT-link: 100%; PMID-link: 63% to 96%). In trials with no linked publication, we were able to find publications 44% of the time (NPV=56%) by searching PubMed. This low NPV shows that there are potentially numerous publications that should have been formally linked with the trials. Our results indicate that existing trial registry and publisher policies may not be fully enforced. We suggest some automated methods for improving link quality.

  17. Crime Scene Investigation: Clinical Application of Chemical Shift Imaging as a Problem Solving Tool

    Science.gov (United States)

    2016-02-26

    MDW/SGVU SUBJECT: Professional Presentation Approva l 26 FEB 2016 1. Your paper, entitled Crime Scene Investigation: Clinical Aoolication of...or technical information as a publication/presentation, a new 59 MDW Form 3039 must be submitted for review and approval.] Crime Scene Investiga...tion: Clinical Application of Chemical Shift Imaging as a Problem Solving Tool 1. TITLE OF MATERIAL TO BE PUBLISHED OR PRESENTED Crime Scene

  18. Understanding the Role of P Values and Hypothesis Tests in Clinical Research.

    Science.gov (United States)

    Mark, Daniel B; Lee, Kerry L; Harrell, Frank E

    2016-12-01

    P values and hypothesis testing methods are frequently misused in clinical research. Much of this misuse appears to be owing to the widespread, mistaken belief that they provide simple, reliable, and objective triage tools for separating the true and important from the untrue or unimportant. The primary focus in interpreting therapeutic clinical research data should be on the treatment ("oomph") effect, a metaphorical force that moves patients given an effective treatment to a different clinical state relative to their control counterparts. This effect is assessed using 2 complementary types of statistical measures calculated from the data, namely, effect magnitude or size and precision of the effect size. In a randomized trial, effect size is often summarized using constructs, such as odds ratios, hazard ratios, relative risks, or adverse event rate differences. How large a treatment effect has to be to be consequential is a matter for clinical judgment. The precision of the effect size (conceptually related to the amount of spread in the data) is usually addressed with confidence intervals. P values (significance tests) were first proposed as an informal heuristic to help assess how "unexpected" the observed effect size was if the true state of nature was no effect or no difference. Hypothesis testing was a modification of the significance test approach that envisioned controlling the false-positive rate of study results over many (hypothetical) repetitions of the experiment of interest. Both can be helpful but, by themselves, provide only a tunnel vision perspective on study results that ignores the clinical effects the study was conducted to measure.

  19. Clinical value of serum and bronchial aspiration fluid HE-4 levels in patients with lung cancer

    Institute of Scientific and Technical Information of China (English)

    Jin Jing; Lin Yuan; Yong-Biao Liu

    2016-01-01

    Objective: To evaluate the clinical value of serum and bronchial aspiration fluid HE-4 levels in patients with lung cancer.Methods:A total of 58 patients with lung cancer and 40 with benign lung disease were enrolled in our study. Compare the serum and bronchial aspiration fluid HE-4 levels between the two group. The specificity and sensitivity of serum and bronchial aspiration fluid HE-4 levels in determine whether lung cancer or not were analyzed by receiver operating characteristic (ROC) curve; Spearman was used to evaluate the association of clinical and pathologic features with levels of LYVE-1.Results: Serum HE-4 levels were significantly higher in patients with lung cancer group than in benign lung disease group. No significant difference was observed in terms of BAF HE-4 values in two patient groups. The areas under the receiver operating characteristic (ROC) curve of serum HE-4 was 0.798 and that of BAF HE-4 was 0.598. A high cancer staging, occurrence of lymph-node metastases, and occurrence of distant metastases patient were associated with high HE-4 levels. No significant difference was observed with sex, tumor location and tumor histology.Conclusion: The increase of level of serum HE-4 is more prominent than the increase of the level of BAF HE-4, and has certain clinical significance for diagnosis of lung cancer and occurrence of metastases.

  20. Haemophilia in a real-world setting: the value of clinical experience in data collection.

    Science.gov (United States)

    Dolan, Gerry; Iorio, Alfonso; Jokela, Vuokko; Juusola, Kristian; Lassila, Riitta

    2016-02-01

    At the 8th Annual Congress of the European Association for Haemophilia and Allied Disorders (EAHAD) held in Helsinki, Finland, in February 2015, Pfizer sponsored a satellite symposium entitled: 'Haemophilia in a real-world setting: The value of clinical experience in data collection' Co-chaired by Riitta Lassila (Helsinki University Central Hospital, Helsinki, Finland) and Gerry Dolan (Guy's and St Thomas' Hospital, London, UK); the symposium provided an opportunity to explore the practical value of real-world data in informing clinical decision-making. Gerry Dolan provided an introduction to the symposium by describing what is meant by real-world data (RWD), stressing the role RWD can play in optimising patient outcomes in haemophilia and highlighting the responsibility of all stakeholders to collaborate in continuous data collection. Kristian Juusola (Oulu University Hospital, Oulu, Finland) then provided personal experience as a haemophilia nurse around patient views on adherence to treatment regimes, and how collecting insights into real-world use of treatment can shape approaches to improving adherence. The importance of elucidating pharmacokinetic parameters in a real-world setting was then explored by Vuokko Jokela (Helsinki University, Helsinki, Finland). Finally, Alfonso Iorio (McMaster University, Hamilton, Ontario, Canada) highlighted the importance of quality data collection in translating clinical reality into scientific advances.

  1. [The added value of information summaries supporting clinical decisions at the point-of-care.

    Science.gov (United States)

    Banzi, Rita; González-Lorenzo, Marien; Kwag, Koren Hyogene; Bonovas, Stefanos; Moja, Lorenzo

    2016-11-01

    Evidence-based healthcare requires the integration of the best research evidence with clinical expertise and patients' values. International publishers are developing evidence-based information services and resources designed to overcome the difficulties in retrieving, assessing and updating medical information as well as to facilitate a rapid access to valid clinical knowledge. Point-of-care information summaries are defined as web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers. Their validity must be assessed against marketing claims that they are evidence-based. We periodically evaluate the content development processes of several international point-of-care information summaries. The number of these products has increased along with their quality. The last analysis done in 2014 identified 26 products and found that three of them (Best Practice, Dynamed e Uptodate) scored the highest across all evaluated dimensions (volume, quality of the editorial process and evidence-based methodology). Point-of-care information summaries as stand-alone products or integrated with other systems, are gaining ground to support clinical decisions. The choice of one product over another depends both on the properties of the service and the preference of users. However, even the most innovative information system must rely on transparent and valid contents. Individuals and institutions should regularly assess the value of point-of-care summaries as their quality changes rapidly over time.

  2. Dental Students' Perceived Value of Peer-Mentoring Clinical Leadership Experiences.

    Science.gov (United States)

    Sheridan, Rachel A; Hammaker, Daniel J; de Peralta, Tracy L; Fitzgerald, Mark

    2016-03-01

    This pilot study compared second- and fourth-year dental students' perceived values of newly implemented clinical leadership experiences (CLEs) at one U.S. dental school during the 2012-13 academic year. In the CLEs, fourth-year (D4) students mentored second-year (D2) dental students during faculty-supervised patient treatment. The two cohorts' perceived value of the experiences was measured with questionnaires consisting of five-point Likert scale questions and open text responses. Out of a total of 114 D2 and 109 D4 students, 46 D2 students and 35 D4 students participated (response rates of 40.4% and 32.1%, respectively). While responses from both cohorts showed they highly valued the CLEs, the D2s perceived greater value: 4.07 (0.53) v. 3.51 (0.95), pcommunication. Theme analysis of open text questions revealed that the respondents perceived the D4s were more accessible than faculty and provided guidance and individual attention; the CLEs increased student comfort; the CLEs reinforced D4 skills, knowledge, and confidence; and the CLEs provided management, leadership, and collaborative work experience. Theme analysis also highlighted student concerns about a lack of program structure. Overall, the majority of both groups valued CLEs in their dental education. Particular advantages they perceived were increased comfort, guidance, and attention. Further program development should address student concerns. These results suggest that similar programs should be considered and/or expanded in other dental schools' curricula.

  3. Clinical value of prognosis gene expression signatures in colorectal cancer: a systematic review.

    Directory of Open Access Journals (Sweden)

    Rebeca Sanz-Pamplona

    Full Text Available INTRODUCTION: The traditional staging system is inadequate to identify those patients with stage II colorectal cancer (CRC at high risk of recurrence or with stage III CRC at low risk. A number of gene expression signatures to predict CRC prognosis have been proposed, but none is routinely used in the clinic. The aim of this work was to assess the prediction ability and potential clinical usefulness of these signatures in a series of independent datasets. METHODS: A literature review identified 31 gene expression signatures that used gene expression data to predict prognosis in CRC tissue. The search was based on the PubMed database and was restricted to papers published from January 2004 to December 2011. Eleven CRC gene expression datasets with outcome information were identified and downloaded from public repositories. Random Forest classifier was used to build predictors from the gene lists. Matthews correlation coefficient was chosen as a measure of classification accuracy and its associated p-value was used to assess association with prognosis. For clinical usefulness evaluation, positive and negative post-tests probabilities were computed in stage II and III samples. RESULTS: Five gene signatures showed significant association with prognosis and provided reasonable prediction accuracy in their own training datasets. Nevertheless, all signatures showed low reproducibility in independent data. Stratified analyses by stage or microsatellite instability status showed significant association but limited discrimination ability, especially in stage II tumors. From a clinical perspective, the most predictive signatures showed a minor but significant improvement over the classical staging system. CONCLUSIONS: The published signatures show low prediction accuracy but moderate clinical usefulness. Although gene expression data may inform prognosis, better strategies for signature validation are needed to encourage their widespread use in the clinic.

  4. Economics evaluation for on-site pyrolysis of kraft lignin to value-added chemicals.

    Science.gov (United States)

    Farag, Sherif; Chaouki, Jamal

    2015-01-01

    This work is part of a series of investigations on pyrolysis of lignin. After obtaining the necessary information regarding the quantity and quality of the obtained products, a first step economics evaluation for converting lignin into chemicals was essential. To accomplish this aim, a pyrolysis plant with a 50t/d capacity was designed, and the total capital investment and operating costs were estimated. Next, the minimal selling price of the obtained dry oil was calculated and the effect of crucial variables on the estimated price was examined. The key result indicates the estimated selling price would not compete with the price of the chemicals that are fossil fuel based, which is primarily due to the high cost of the feedstock. To overcome this challenge, different scenarios for reducing the selling price of the obtained oil, which consequently is helping by taking a place among the fossil fuel based chemicals, were discussed.

  5. CLINICAL DIAGNOSTIC VALUE OF AUTOANTIBODIES IN THE DIAGNOSIS OF AUTOIMMUNE LIVER DISEASES

    Directory of Open Access Journals (Sweden)

    V. V. Bazarnyi

    2015-01-01

    Full Text Available We are studied the 15 patients with autoimmune liver diseases and 36 patients without autoimmune pathology found the diagnostic value of antinuclear and antimitochondrial autoantibodies (AMA-M2 tests, and antibodies to asialoglycoprotein receptor (anti-ASGPR. Based on the ROC analysis showed that the diagnostic sensitivity and diagnostic specificity of AMA-M2 was 73% and 100% and for anti-ASGPR – 60% and 77%, respectively. Therefore, the test for anti-ASGPR in autoimmune diseases of the liver showed no advantages over standart tests, and its using in clinical practice requires clarification. 

  6. Clinical value of serum Hcy and CysC in ischemic cerebrovascular disease patients

    Institute of Scientific and Technical Information of China (English)

    JiangBing; ChuKaiqiu

    2015-01-01

    To investigate the clinical value of plasma homocysteine (Hcy), cystatin C (CysC)in patients with VCI after ICVD.Hcy and CysC were detected in 99 ICVD patients , which were 42 patients with CN and 57 patients with VCI. In the VCI patients, the areas under the ROC curve (AUCROC) of Hcy and CysC were 0.966 and 0.768, diagnostic boundary values were 14.51 umol/l and 0.73 mg/l. It was concluded that Hcy and CysC can be used to diagnose and predict VCI in ICVD patients, and diagnosis efficiency of Hcy is higher than that of CysC.

  7. Threshold of toxicological concern values for non-genotoxic effects in industrial chemicals: re-evaluation of the Cramer classification.

    Science.gov (United States)

    Kalkhof, H; Herzler, M; Stahlmann, R; Gundert-Remy, U

    2012-01-01

    The TTC concept employs available data from animal testing to derive a distribution of NOAELs. Taking a probabilistic view, the 5th percentile of the distribution is taken as a threshold value for toxicity. In this paper, we use 824 NOAELs from repeated dose toxicity studies of industrial chemicals to re-evaluate the currently employed TTC values, which have been derived for substances grouped according to the Cramer scheme (Cramer et al. in Food Cosm Toxicol 16:255-276, 1978) by Munro et al. (Food Chem Toxicol 34:829-867, 1996) and refined by Kroes and Kozianowski (Toxicol Lett 127:43-46, 2002), Kroes et al. 2000. In our data set, consisting of 756 NOAELs from 28-day repeated dose testing and 57 NOAELs from 90-days repeated dose testing, the experimental NOAEL had to be extrapolated to chronic TTC using regulatory accepted extrapolation factors. The TTC values derived from our data set were higher than the currently used TTC values confirming the safety of the latter. We analysed the prediction of the Cramer classification by comparing the classification by this tool with the guidance values for classification according to the Globally Harmonised System of classification and labelling of the United Nations (GHS). Nearly 90% of the chemicals were in Cramer class 3 and assumed as highly toxic compared to 22% according to the GHS. The Cramer classification does underestimate the toxicity of chemicals only in 4.6% of the cases. Hence, from a regulatory perspective, the Cramer classification scheme might be applied as it overestimates hazard of a chemical.

  8. [Clinical tolerance, intestinal absorption, and energy value of four sugar alcohols taken on an empty stomach].

    Science.gov (United States)

    Beaugerie, L; Flourié, B; Pellier, P; Achour, L; Franchisseur, C; Rambaud, J C

    1991-01-01

    Sugar alcohols are incompletely digested in the human small intestine. The residual amounts reaching the colon are digested by colonic bacteria or excreted in stools. Clinical tolerance and energy value of sugar alcohols are related to their respective rates of digestion in the small intestine and the colon. Six healthy volunteers were tested in 5 periods during which they ingested 10 g lactulose, and then, in a random order, an iso-osmotic solution of 20 g isomalt, sorbitol, maltitol, and lactitol. The fraction of sugar alcohols absorbed in the small intestine was evaluated by comparing the amounts of hydrogen excreted in breath for 8 h after the ingestion of lactulose and of sugar alcohols. Energy value of sugar alcohols was determined knowing the amounts absorbed in the small intestine and digested in the colon. Tolerance to the sugar alcohols was good in all volunteers, and not different between sugar alcohols. The mean percentage of malabsorption in the small intestine was significantly higher for lactitol (84 +/- 14 percent, m +/- SEM) than for maltitol and isomalt (44 +/- 7 and 40 +/- 7 percent), its energy value (2.3 +/- 0.3 kcal/g) was significantly lower than the energy value of maltitol (3.1 +/- 0.1 kcal/g, P less than 0.05); whereas those of sorbitol and isomalt were close (2.7 +/- 0.2 and 2.8 +/- 0.1 kcal/g, respectively). In spite of these differences, our results suggest that in our experimental conditions, bacterial digestion of the sugar alcohols reaching the colon was complete, and did not affect their clinical tolerance.

  9. The Changing Landscape of Chemical Toxicity Values and Challenges Presented with Trichloroethylene

    Science.gov (United States)

    2012-12-11

    BUILDING STRONG® Emerging Contaminants (ECs)  Are chemicals or materials of interest that are characterized by: ►a perceived or real threat to...evolving or being re-evaluated. 2 Source: “Initiation of Emerging Contaminants Characterization and Response Actions for Protection of Human

  10. The Integrated Biorefinery: Conversion of Corn Fiber to Value-added Chemicals

    Energy Technology Data Exchange (ETDEWEB)

    Susanne Kleff

    2007-03-24

    This presentation provides a summary of Michigan Biotechnology Institute's efforts to employ the corn fiber fraction of a dry grind ethanol plant as a feedstock to produce succinic acid which has potential as a building block intermediate for a wide range of commodity chemicals.

  11. Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice.

    Directory of Open Access Journals (Sweden)

    Wilhelmina G Leen

    Full Text Available Cerebrospinal fluid (CSF analysis is an important tool in the diagnostic work-up of many neurological disorders, but reference ranges for CSF glucose, CSF/plasma glucose ratio and CSF lactate based on studies with large numbers of CSF samples are not available. Our aim was to define age-specific reference values. In 1993 The Nijmegen Observational CSF Study was started. Results of all CSF samples that were analyzed between 1993 and 2008 at our laboratory were systematically collected and stored in our computerized database. After exclusion of CSF samples with an unknown or elevated erythrocyte count, an elevated leucocyte count, elevated concentrations of bilirubin, free hemoglobin, or total protein 9,036 CSF samples were further studied for CSF glucose (n = 8,871, CSF/plasma glucose ratio (n = 4,516 and CSF lactate values (n = 7,614. CSF glucose, CSF/plasma glucose ratio and CSF lactate were age-, but not sex dependent. Age-specific reference ranges were defined as 5-95(th percentile ranges. CSF glucose 5(th percentile values ranged from 1.8 to 2.9 mmol/L and 95(th percentile values from 3.8 to 5.6 mmol/L. CSF/plasma glucose ratio 5(th percentile values ranged from 0.41 to 0.53 and 95(th percentile values from 0.82 to 1.19. CSF lactate 5(th percentile values ranged from 0.88 to 1.41 mmol/L and 95(th percentile values from 2.00 to 2.71 mmol/L. Reference ranges for all three parameters were widest in neonates and narrowest in toddlers, with lower and upper limits increasing with age. These reference values allow a reliable interpretation of CSF results in everyday clinical practice. Furthermore, hypoglycemia was associated with an increased CSF/plasma glucose ratio, whereas hyperglycemia did not affect the CSF/plasma glucose ratio.

  12. [Examination of the knee joint. The value of clinical findings in arthroscopic control].

    Science.gov (United States)

    Steinbrück, K; Wiehmann, J C

    1988-01-01

    Purely clinical examination of the knee joint can, at best, only be regarded as a "screening procedure". Diagnosis with the aid of apparatus (sonography, arthrography, CT, NMR) produces better results. However, arthroscopy performed by an experienced examiner confirms the diagnosis in cases of suspected meniscus injury or isolated lesions of the cruciate ligaments and leads to early and therefore optimal therapy. In a retrospective study 300 arthroscopies performed in 1985 were selected and evaluated. In 1986/87, a further 300 patients were clinically examined prospectively, according to the same criteria, and findings were compared with the arthroscopy performed the following day. Clinically, in 287 patients with multiple diagnoses, internal meniscus lesions were diagnosed in 162 cases (54%), external meniscus lesions in 38 (13%), chondropathia patellae in 54 (18%), and old ruptures of the cruciate ligaments in 46 (15%). In 13 patients no diagnosis could be established. Arthroscopically, pathology of the internal meniscus was found in 98 (33%) of the 300 patients, of the external meniscus in 40 (13%), cartilage damage in 103 (34%), old cruciate ligament ruptures in 51 (17%), and recent anterior cruciate ligament ruptures in 156 (52%); in 40 cases findings were normal. At 78%, the highest positive predictive value (proportion of tentative clinical diagnoses confirmed by arthroscopy) was found in cases of old ruptures of the anterior cruciate ligament, followed by external meniscus lesions (61%) and internal meniscus lesions (55%); i.e., only 55 out of 100 clinically suspected internal meniscus lesions are diagnosed by arthroscopy.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Value and Clinical Impact of an Infectious Disease-Supervised Outpatient Parenteral Antibiotic Therapy Program

    Science.gov (United States)

    Petrak, Russell M.; Skorodin, Nathan C.; Fliegelman, Robert M.; Hines, David W.; Chundi, Vishnu V.; Harting, Brian P.

    2016-01-01

    Background. Outpatient parenteral antibiotic therapy (OPAT) is a safe and effective modality for treating serious infections. This study was undertaken to define the value of OPAT in a multicentered infectious disease (ID) private practice setting. Methods. Over a period of 32 months, 6120 patients were treated using 19 outpatient ID offices in 6 states. Analysis included patient demographics, indications of OPAT, diagnoses, therapeutic agent, duration of therapy, and site of therapy initiation. Outcomes were stratified by therapeutic success, clinical relapse, therapeutic complications, and hospitalizations after initiating therapy. Statistical analysis included an ordinal logistic regression analysis. Results. Forty-three percent of patients initiated therapy in an outpatient office, and 57% began therapy in a hospital. Most common diagnoses treated were bone and joint (32.2%), abscesses (18.8%), cellulitis (18.5%), and urinary tract infection (10.8%). Ninety-four percent of patients were successfully treated, and only 3% were hospitalized after beginning therapy. Most common cause of treatment failure was a relapse of primary infection (60%), progression of primary infection (21%), and therapeutic complication (19%). Conclusions. An ID-supervised OPAT program is safe, efficient, and clinically effective. By maximizing the delivery of outpatient care, OPAT provides a tangible value to hospitals, payers, and patients. This program is a distinctive competency available to ID physicians who offer this service to patients.

  14. The clinical value of routine whole-body magnetic resonance imaging (MRI) in palliative care

    Energy Technology Data Exchange (ETDEWEB)

    Geitung, Jonn Terje (Department of Radiology, Haraldspass Deaconess (University) Hospital (Norway); Department of Surgical Sciences, University of Bergen (Norway)), Email: jtgeit@online.no; Eikeland, Joakim (Department of Public Health and Primary Health Care, University of Bergen (Norway)); Rosland, Jan Henrik (Department of Public Health and Primary Health Care, University of Bergen (Norway); Sunniva Clinic for Palliative Care, Haraldsplass Deaconess (University) Hospital (Norway))

    2012-03-15

    Background. Whole-body MRI (WBMRI) has become an accessible method for detecting different types of pathologies both in the skeleton and the viscera, which may explain painful conditions, for example tumors and inflammation. Purpose. To assess a possible value of using WBMRI in order to improve palliative care. Material and Methods. Twenty patients (all eligible patients) admitted to the Department for Palliative Care were consecutively included in this study. They underwent a modified WBMRI, with fewer and shorter pulse sequences than in a standard WBMRI, to reduce patient stress. However, the patients' physicians were to exclude patients where little might be obtained and discomfort, distress, and pain could be induced. The treating physicians registered clinical utility directly after receiving the MRI report in a questionnaire. The registration was repeated after ended treatment. Results. Eighty percent had new findings detected, and 40% of the patients had a change in treatment due to the MRI result, mainly changes in analgesics and/or radiation therapy. Conclusion. The WBMRI helped the clinicians to improve treatment and a majority of the patients benefited from this. In eight patients the treatment was changed due to the results. The clinical value (utility) was indicated to be high

  15. CHEMICAL COMPOSITION AND NUTRITIVE VALUE OF MAIZE STEMS DEPENDING ON THE CUTTING HEIGHT OF PLANTS AT HARVEST

    Directory of Open Access Journals (Sweden)

    Ireneus KOWALIK

    2013-12-01

    Full Text Available Studies were carried out in the two years in Trzcianka near Nowy Tomyśl, on brown soil, IIIa – IVa with pH 7.1 – 7.2. Plants of five maize cultivars were cut at the height of 15 cm and 55 cm. The lower parts of stems with leaves which remain on the field in case of high cutting, were characterized by a smaller content of protein and by a greater content of fibre, in comparison with the higher parts of plants. The energetic value of 1 kg of dry matter of the lower 40 cm part with leaves expressed in MJ NEL, in spite of significant differences in the chemical composition, was only insignificantly lower than the upper part. The content of dry matter, the chemical composition and the energetic value of both parts differed, depending on the cultivar.

  16. Effect of Microbial and Chemical Combo Additives on Nutritive Value and Fermentation Characteristic of Whole Crop Barley Silage

    Science.gov (United States)

    Kim, Dong Hyeon; Amanullah, Sardar M.; Lee, Hyuk Jun; Joo, Young Ho; Kim, Sam Churl

    2015-01-01

    This study was conducted to assess the effects of microbial and chemical combo additives on nutritive values, fermentation indices and aerobic stability of whole crop barley silage. Barley forage (Youngyang) was harvested at about 30% dry matter (DM) by treatments, chopped to 5 cm length and treated with distilled water only (CON), Lactobacillus plantarum (INO), propionic acid (PRO) or an equal mixture of INO and PRO (MIX). Barley forages were ensiled in 4 replications for 0, 2, 7, and 100 days. On 100 days of ensiling, MIX silage had higher (psilage, but lower (psilages was lower (psilage. The MIX silage had higher (psilages were higher (psilage. It is concluded that microbial and chemical combo additives using L. plantarum and propionic acid could efficiently improve nutritive values of barley silage in terms of increased in vitro DM digestibility compared to other treatments. In addition, all treatments except CON reduced yeast count which is the initiate microorganism of aerobic spoilage. PMID:26323517

  17. Computational chemical analysis of unconjugated bilirubin anions and insights into pKa values clarification

    Science.gov (United States)

    Vega-Hissi, Esteban G.; Estrada, Mario R.; Lavecchia, Martín J.; Pis Diez, Reinaldo

    2013-01-01

    The pKa, the negative logarithm of the acid dissociation equilibrium constant, of the carboxylic acid groups of unconjugated bilirubin in water is a discussed issue because there are quite different experimental values reported. Using quantum mechanical calculations we have studied the conformational behavior of unconjugated bilirubin species (in gas phase and in solution modeled implicitly and explicitly) to provide evidence that may clarify pKa values because of its pathophysiological relevance. Our results show that rotation of carboxylate group, which is not restricted, settles it in a suitable place to establish stronger interactions that stabilizes the monoanion and the dianion to be properly solvated, demonstrating that the rationalization used to justify the high pKa values of unconjugated bilirubin is inappropriate. Furthermore, low unconjugated bilirubin (UCB) pKa values were estimated from a linear regression analysis.

  18. Microwave assisted conversion of microcrystalline cellulose into value added chemicals using dilute acid catalyst.

    Science.gov (United States)

    Ching, Teck Wei; Haritos, Victoria; Tanksale, Akshat

    2017-02-10

    One of the grand challenges of this century is to transition fuels and chemicals production derived from fossil feedstocks to renewable feedstocks such as cellulosic biomass. Here we describe fast microwave conversion of microcrystalline cellulose (MCC) in water, with dilute acid catalyst to produce valuable platform chemicals. Single 10min microwave assisted treatment was able to convert >60% of MCC, with >50mol% yield of desirable products such as glucose, HMF, furfural and levulinic acid. Recycling of residual MCC with make-up fresh MCC resulted in an overall conversion of >93% after 5 cycles while maintaining >60% conversion in each cycle. Addition of isopropanol (70%v/v) as a co-solvent increased the yields of HMF and levulinic acid. This work shows for the first time proof of concept for complete conversion of recalcitrant microcrystalline cellulose in mild conditions of low temperature, dilute acid and short residence time using energy efficient microwave technology.

  19. Thermal conversion of glycerol to value-added chemicals: pyridine derivatives by one-pot microwave-assisted synthesis

    OpenAIRE

    BAYRAMOĞLU, Duygu; GÜREL, Gökay; SINAĞ, Ali; GÜLLÜ, Mustafa

    2014-01-01

    One-pot syntheses of the value-added heterocyclic compounds 3-methylpyridine and pyridine using a renewable chemical, glycerol, were achieved in acidic medium by thermal conversion reactions. Condensation/cyclization reactions of the thermal degradation products of glycerol were investigated in situ using different ammonia and acidic moiety producing inorganic ammonium salts under pyrolysis or microwave heating conditions. The reaction parameters were studied in detail and satisfying product ...

  20. Thermal conversion of glycerol to value-added chemicals: pyridine derivatives by one-pot microwave-assisted synthesis

    OpenAIRE

    BAYRAMOĞLU, Duygu; GÜREL, Gökay; SINAĞ, Ali; GÜLLÜ, Mustafa

    2015-01-01

    One-pot syntheses of the value-added heterocyclic compounds 3-methylpyridine and pyridine using a renewable chemical, glycerol, were achieved in acidic medium by thermal conversion reactions. Condensation/cyclization reactions of the thermal degradation products of glycerol were investigated in situ using different ammonia and acidic moiety producing inorganic ammonium salts under pyrolysis or microwave heating conditions. The reaction parameters were studied in detail and satisfying product ...

  1. Predictive value of combined clinically diagnosed bruxism and occlusal features for TMJ pain.

    Science.gov (United States)

    Manfredini, Daniele; Peretta, Redento; Guarda-Nardini, Luca; Ferronato, Giuseppe

    2010-04-01

    Several works showed a decreased role for occlusion in the etiology of temporomandibular disorders (TMD). Nonetheless, it may be hypothesized that occlusion acts as a modulator through which bruxism activities may cause damage to the stomatognathic structures. To test this hypothesis, a logistic regression model was created with the inclusion of clinically diagnosed bruxism and eight occlusal features as potential predictors for temporomandibular joint (TMJ) pain in a sample of 276 consecutive TMD patients. The final logit showed that the percentage of the total log likelihood for TMJ pain explained by the significant factors was small and amounted to 13.2%, with unacceptable levels of sensitivity (16.4%). The parameters overbite > or = 4 mm combined with clinically diagnosed bruxism [OR (odds ratio) 4.62], overjet > or = 5 mm (OR 2.83), and asymmetrical molar relationship combined with clinically diagnosed bruxism (OR 2.77) were those with the highest odds for disease, even though none of those values was significant with respect to confidence intervals. Thus, the hypothesis under evaluation has to be rejected. It is possible that future studies with a higher discriminatory power for the different bruxism activities might be indicated to get deeper into the analysis of the potential mechanisms through which occlusion may play a role, even if small, in the etiology of the different TMD.

  2. Comparison of diagnosis value for new onset myasthenia gravis by many clinical auxiliary examinations

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: The clinical values of neostigmine test, clinical electrophysiologic study and acetylcholine receptor antibody detection in diagnosing myasthenia gravis (MG) found newly are unclear in China.OBJECTIVE: To investigate the reference value of common clinical diagnosis parameters in correctly diagnosing untreated MG found newly.DESIGN: Retrospective case analysis.SETTING: Department of Neurology, Beijing Hospital, Ministry of Health.PARTICIPANTS: Totally 156 outpatients with MG admitted to Department of Neurology, Beijing Hospital,Ministry of Health between January 1999 and December 2002. The involved patients, 72 males and 84 females, were aged 2 - 79 years. They were classified according to Osserman's criteria: ⅡA 72, ⅡB 76, Ⅲ3 and Ⅳ 5. They were all subjected to being inquired of disease history, neostigmine test, and acetylcholine receptor antibody detection, met the diagnosis criteria of Neuroimmunology Committee of China, and confirmed by clinical electrophysiologic detections; Informed consents were obtained from all the involved subjects.METHODS: ①After admission, every patient was intramuscularly injected with 1.5 mg neostigmine; If the patient was a child, the injection dose was decreased according to his/her age. If his/her score of any observation index after injection was improved ≥ 50% as compared with before injection , his positive index was Set as positive. Positive neostigmine test was set if there was one positive index. ②Repetitive nerve stimulation and single fiber electromyography were performed with Dantec Keypoint electromyogram (EMG) apparatus. ③Acetylcholine receptor antibody was detected by ELISA method.MAIN OUTCOME MEASURES: Clinical absolute and relative scores of MG, acetylcholine receptor antibody level, and repetitive nerve stimulation and single fiber electromyography examination results.RESULTS: The positive rates of neostigmine test, repetitive nerve stimulation and single fiber electromyography examination

  3. Heterogeneously Catalyzed Valorization of Monoterpenes to High Value-Added Chemicals

    OpenAIRE

    Golets, Mikhail

    2014-01-01

    A potential industrial process is profitable only if it is successfully implemented by the continuously developing chemical industry. Throughout last decades heterogeneous catalysis has opened doors to the creation of various know-how products which previously were considered unfeasible. Moreover, the use of heterogeneous catalysts allows improving existing processes to shift towards more ecological and cost efficient practices. In particular, polymer or fuel compounds could be eco-friendly p...

  4. Clinical value of screening serum squamous cell carcinoma antigen (SCCA for HCC

    Directory of Open Access Journals (Sweden)

    Mohamed A.Ezzel Arab1 , Mohammad A.Hassanein2, Nashwa A. Abd El

    2010-06-01

    Full Text Available Background: Hepatocellular carcinoma (HCC is the fifth most common malignancy in the world. In Egypt, HCC was reported to account for about 4.7% of chronic liver disease (CLD patients. Squamous cell carcinoma antigen (SCCA has been reported to be strongly expressed in HCC tissue hampering its extensive use in clinical practice. Aim: Study the value of serum squamous cell carcinoma antigen (SCCA for screening of HCC. Materials & Method: The study comprised of two groups. Group A included 60 patients with HCC diagnostically confirmed by spiral CT, elevated alfa-fetoprotein (AFP, and/or liver biopsy .Group B CLD patients diagnosed on clinical, laboratory, and ultrasonographical investigations; group B suclassified into three categories according to CHILD-PUGH score included 30 patients, matched for sex and age. All groups were subjected to thorough history taking, full clinical examination, and laboratory investigations including liver functions, viral markers, and AFP and SCCA estimation using ELISA technique. Results: This study revealed a highly significant difference between patients with HCC and CLD regarding serum SCCA levels being higher in group A(10.35±20.677 than group B(1.64±2.462(p=0.02. SCCA level was elevated in patients with HCC with normal AFP levels representing its useful role in early detection and follow-up of patients treated for HCC. The cut-off value was established at 2 ng/ml with sensitivity of 80% and specificity of 70%. Conclusion: SCCA could represent a useful tool as a marker for detection of HCC.

  5. The phase boundary for the chiral transition in (2+1)-flavor QCD at small values of the chemical potential

    CERN Document Server

    Karsch, F; Miao, C; Mukherjee, S; Petreczky, P; Schmidt, C; Soeldner, W; Unger, W

    2010-01-01

    We determine the chiral phase transition line in (2+1)-flavor QCD for small values of the light quark chemical potential. We show that for small values of the chemical potential the curvature of the phase transition line can be deduced from an analysis of scaling properties of the chiral condensate and its susceptibilities. To do so we extend earlier studies of the magnetic equation of state in (2+1)-flavor QCD to finer lattice spacings, aT=1/8. We use these universal scaling properties of the chiral order parameter to extract the curvature of the transition line at two values of the cut-off, aT=1/4 and 1/8. We find that cut-off effects are small for the curvature parameter and determine the transition line in the chiral limit to leading order in the light quark chemical potential. We obtain Tc(\\mu_q)/Tc(0) = 1 - 0.059(2)(4) (\\mu_q/T)^2 +O(\\mu_q^4).

  6. Clinical and forensic signs related to chemical burns: a mechanistic approach.

    Science.gov (United States)

    Dinis-Oliveira, Ricardo Jorge; Carvalho, Félix; Moreira, Roxana; Proença, Jorge Brandão; Santos, Agostinho; Duarte, José Alberto; Bastos, Maria de Lourdes; Magalhães, Teresa

    2015-06-01

    This manuscript highlights and critically analyses clinical and forensic signs related to chemical burns. Signs that may lead to suspicion of a particular chemical are thoroughly discussed regarding its underlying mechanisms. Burns due to sulfuric, hydrofluoric, nitric, hydrochloric (muriatic) and acetic (including derivatives) acids, hydrogen sulphide, sodium (caustic soda) and calcium (cement) hydroxides, paraquat, burns after inflation and rupture of airbags, povidone-iodine, chlorhexidine/alcohol (in preterm infants), laxatives, and vesicants (warfare agents), will be reviewed since these are the most common agents found in daily practice, for which relevant and timed information may be helpful in formulating an emergency treatment protocols and toxicological analysis.

  7. Clinical application value of impulse oscillometry in geriatric patients with COPD

    Science.gov (United States)

    Liu, Zhonghui; Lin, Lianjun; Liu, Xinmin

    2017-01-01

    Background The diagnosis and assessment of COPD rely mainly on the use of spirometry, which is an effort-dependent test and requires good patient cooperation. Impulse oscillometry (IOS) is a non-volitional method that requires less effort and cooperation and presents advantages for geriatric patients. However, the clinical application value of IOS in geriatric patients with COPD remains unclear. Aim The aim of this study was to investigate the clinical application value of IOS in geriatric patients with COPD. Subjects and methods A total of 234 subjects were retrospectively enrolled in this study, including 133 patients with COPD and 101 healthy volunteers. All the participants underwent IOS and spirometry examination. The data were collected and analyzed in the overall group, the geriatric group (aged ≥65 years), and the advanced elderly group (aged ≥80 years). Results 1) In COPD patients, a significant increase in respiratory impedance (Z5), resonant frequency (Fres), and respiratory resistance (R5, R20, R5–R20) and a decrease in respiratory reactance (X5) were observed in the overall group, the geriatric group, and the advanced elderly group compared with the healthy control subjects. 2) The IOS parameters correlated well with spirometry in COPD. In particular, R5–R20 showed the best correlation with forced expiratory volume in 1 second (FEV1) in the different age groups. 3) Fres and R5–R20 had the best diagnostic efficiency for COPD. The area under the curve (AUC) values for Fres, expressed by the receiver operating characteristic (ROC) curve, were 0.905, 0.909, and 0.914, for the different age groups, respectively. 4) The optimal cutoff values for Fres to diagnose airflow obstruction from ROC curves was 17.715 in the COPD patients. Its sensitivity and specificity were 0.789 and 0.931, respectively, and the cutoff values were similar in geriatric and advanced elderly patients. Conclusion IOS demonstrated good relevance compared with spirometry for

  8. Free serum thyroxine. Analysis of its clinical value through ''ROC'' curves

    Energy Technology Data Exchange (ETDEWEB)

    Degrossi, O.J.; Altschuler, N.; de Cabrejas, M.L. (Comision Nacional de Energia Nuclear Atomica, Buenos Aires (Argentina). Dept. Aplicaciones Biologicas); Pinkas, M.; Garcia del Rio, H. (Hospital Aleman, Buenos Aires (Argentina). Servicio de Medicina Nuclear)

    1982-07-01

    The use of radiommunoassay (RIA) tehcniques has increased the diagnosis of thyroid functional alterations. A solid phase RIA method for free thyroxine (FT4) measurement was tested. Serum FT4, Total T4, T3 and TSH were determined by radioimmunoassay in 179 subjects. One hundred twenty two patients were normal (8 to 75 years old); FT4 was 1.42 +- 0.03 ng/100 ml (avg. value and std. error). In 27 cases of thyrotoxicosis the values were 4.66 +- 0.48 ng/100 ml and in 15 cases of hypothyroidism 0.50 +- 0.06 ng/100 ml (statistics probability <0,01). Four euthyroid patients under estrogen treatment, 9 hypothyroid patients under l-thyroxine treatment, one hyperthyroid patient under antithyroid drugs and one hyperthyroid patient under estrogen treatment, were studied. Total T4 and T3 values were in agreement with the variations of the serum protein transport capacity, and for that reason did not show the real thyroid function state. Clinical decision making analysis (with Receiver Operating Characteristic (ROC) curves) indicate that FT4 is the best choice for hyperthyroidism diagnosis and T4 for hypothyroidism. Cost/benefit analysis indicates also that FT4 has the best ratio.

  9. Value-based Clinical Quality Improvement (CQI) for Patients Undergoing Abdominal Wall Reconstruction.

    Science.gov (United States)

    Stephan, Bradley; Ramshaw, Bruce; Forman, Brandie

    2015-05-01

    Patients with complex ventral/incisional hernias often undergo an abdominal wall reconstruction (AWR). These operations have a high cost of care and often result in a long hospital stay and high complication rates. Using the principles of clinical quality improvement (CQI), several attempts at process improvement were implemented in one hernia program over a 3-year period. For consecutive cases of patients undergoing abdominal wall reconstruction, process improvement attempts included the use of a long-term resorbable synthetic mesh (TIGR® Resorbable Matrix, Novus Scientific, Uppsala, Sweden) in place of a biologic mesh, the use of the transversus abdominis release approach in place of an open or endoscopic component separation (external oblique release) technique, and the use of a preoperative transversus abdominis plane (TAP) block using a long-acting local anesthetic (Exparel®, Pacira Pharmaceutical, Parsippany, NJ) as a part of perioperative multi-modal pain management and an enhanced recovery program. After over 60 cases, improvement in materials costs and postoperative outcomes were documented. No mesh-related complications occurred and no mesh removal was required. In this real-world, value-based application of CQI, several attempts at process improvement led to decreased costs and improved outcomes for patients who underwent abdominal wall reconstruction for complex ventral/incisional hernias. Value-based CQI could be a tool for improved health care value globally.

  10. CLINICAL VALUE OF SERUM TUMOR SUPPLIED GROUP OF FACTOR IN DIAGNOSIS OF EPITHELIAL OVARIAN CANCER

    Institute of Scientific and Technical Information of China (English)

    程琪辉; 张喜平; 曾小澜

    2003-01-01

    Objective: To evaluate the clinical value of serum tumor supplied group of factor (TSGF) in diagnosis of epithelial ovarian cancer. Methods: The serum TSGF was tested in 69 patients with epithelial ovarian cancer, 28 patients with benign ovarian lesion and 61 healthy women. The serum levels of vascular endothelial growth factor (VEGF) and CA125 were determined in patients with epithelial ovarian cancer and in those with benign ovarian lesion. The correlations of TSGF with VEGF and CA125 were investigated. Results: The serum level of TSGF in patients with epithelial ovarian cancer was obviously higher than in patients with benign ovarian lesion and in healthy women (P0.05). The serum level of TSGF and VEGF and CA125 in patients with epithelial ovarian cancer showed positive correlation (P<0.01, P<0.05, respectively). Conclusion: There is no marked difference in diagnostic value among TSGF, VEGF and CA125. TSGF has a certain value in diagnosis of epithelial ovarian cancer, and is helpful to distinguish epithelial ovarian cancer from benign ovarian lesion.

  11. Upgrading of lignocellulosic biorefinery to value-added chemicals: Sustainability and economics of bioethanol-derivatives

    DEFF Research Database (Denmark)

    Cheali, Peam; Posada, John A.; Gernaey, Krist

    2015-01-01

    of operating profit for biorefineries producing bioethanol-derived chemicals (247 MM$/a and 241 MM$/a for diethyl ether and 1,3-butadiene, respectively). Second, the optimal designs for upgrading bioethanol (i.e. production of 1,3-butadiene and diethyl ether) performed also better with respect...... to sustainability compared with the petroleum-based processes. In both cases, the effects of the market price uncertainties were also analyzed by performing quantitative economic risk analysis and presented a significant risk of investment for a lignocellulosic biorefinery (12 MM$/a and 92 MM$/a for diethyl ether...

  12. Cyanobacteria as a Platform for the High-Value Chemicals Production

    DEFF Research Database (Denmark)

    Wlodarczyk, Artur Jacek

    consumer demands of an ever growing population. Considering the ability to convert solar energy and carbon dioxide into biomass, cyanobacteria and microalgae have potential for becoming such alternative in the future. Biosynthesis of a great number of plant high-value secondary metabolites requires...

  13. Clinical relevance and discriminatory value of elevated liver aminotransferase levels for dengue severity.

    Directory of Open Access Journals (Sweden)

    Linda K Lee

    Full Text Available BACKGROUND: Elevation of aspartate aminotransferase (AST and alanine aminotransferase (ALT is prominent in acute dengue illness. The World Health Organization (WHO 2009 dengue guidelines defined AST or ALT ≥ 1000 units/liter (U/L as a criterion for severe dengue. We aimed to assess the clinical relevance and discriminatory value of AST or ALT for dengue hemorrhagic fever (DHF and severe dengue. METHODOLOGY/PRINCIPAL FINDINGS: We retrospectively studied and classified polymerase chain reaction positive dengue patients from 2006 to 2008 treated at Tan Tock Seng Hospital, Singapore according to WHO 1997 and 2009 criteria for dengue severity. Of 690 dengue patients, 31% had DHF and 24% severe dengue. Elevated AST and ALT occurred in 86% and 46%, respectively. Seven had AST or ALT ≥ 1000 U/L. None had acute liver failure but one patient died. Median AST and ALT values were significantly higher with increasing dengue severity by both WHO 1997 and 2009 criteria. However, they were poorly discriminatory between non-severe and severe dengue (e.g., AST area under the receiver operating characteristic [ROC] curve=0.62; 95% confidence interval [CI]: 0.57-0.67 and between dengue fever (DF and DHF (AST area under the ROC curve=0.56; 95% CI: 0.52-0.61. There was significant overlap in AST and ALT values among patients with dengue with or without warning signs and severe dengue, and between those with DF and DHF. CONCLUSIONS: Although aminotransferase levels increased in conjunction with dengue severity, AST or ALT values did not discriminate between DF and DHF or non-severe and severe dengue.

  14. Novel catalysts for valorization of biomass to value-added chemicals and fuels

    Indian Academy of Sciences (India)

    Nishita Lucas; Narasimha Rao Kanna; Atul S Nagpure; Ganesh Kokate; Satyanarayana Chilukuri

    2014-03-01

    Key furan compounds such as 5-hydroxymethylfurfural (HMF), 2,5-furandicarboxylic acid (FDCA) and 2,5-dimethylfuran (DMF) were synthesized from renewable feedstocks. Dehydration of fructose was carried out in biphasic conditions employing several solid acid catalysts by targeting selective formation of HMF. Its selectivity is linearly dependent on total acidity clearly revealing that lower acidity favours selective formation of HMF. Oxidation and hydrogenolysis of HMF has been explored using 2 wt% Ru-K-OMS-2. The catalysts used for each transformation were subjected to detailed characterization using XRD, BET surface area, temperature-programmed desorption and transmission electron microscopy. The effect of various reaction parameters was also investigated for obtaining high yields of desired chemical intermediates. High FDCA yields of 93.4 mol% and 66 mol% were achieved in alkaline and base-free conditions, respectively. The 2 wt% Ru-K-OMS-2 is a versatile catalyst as it also catalyses HMF hydrogenolysis giving 33 mol% of DMF. Thus, utility of various novel materials as catalysts has been demonstrated in the multistep transformations of hexoses to furan-based fuels and chemicals.

  15. The clinical features and diagnostic value of CT in Fahr’s disease

    OpenAIRE

    Wei-dong Hu; Li Xiang; Xiu-rong Wang

    2013-01-01

    Objectives:  To study the clinical features and diagnostic value of CT in Fahr’s disease. Methods:  We retrospectively analyzed skull images of 8,000 cases and observed the incidence and imaging characteristics of Fahr’s disease. Results: Fahr’s disease were found in 6 patients (6/4000=0.075%)whose ages ranged from 16 to 62 years (average age:38.5±6.4years). We found that 6 Fahr’s disease had been incidentally detected in 4 men(4/6=66.7%) and 2 women(2/6=33.4%); serum calcium:2.13~2.42 mmol/L...

  16. DETECTION AND ITS CLINICAL VALUE OF MINIMAL RESIDUAL DISEASES IN ACUTE PROMYELOCYTIC LEUKEMIA

    Institute of Scientific and Technical Information of China (English)

    姜国胜; 唐天华; 毕可红; 张玉昆; 任海全; 赵良玉; 郭桂月; 刘秀兰; 任青华; 姜枫勤; 刘传芳; 彭军; 田志刚

    2002-01-01

    Objective: To detect the minimal residual diseases (MRD) in acute promyelocytic leukemia (APL) after complete remission (CR) and to analyze its clinical value in prognosis. Methods: Reverse transcription Polymerase chain reaction (RT/PCR) was used to detect MRD of patients with APL. Results: MRD positive rate in patients with APL was 92.8% (39/42) before treatment and 56.7 (21/37) immediately after the ATRA or chemotherapy- induced CR. Furthermore, MRD positive rate wasrelated to the relapse in APL patients and could be considered as a marker to predict the relapse of patients with APL after CR. The MRD detection could also be applied to direct the consolidation therapy to prevent relapses. Conclusion: RT-PCR is valuable to monitor MRD and can be used as a marker to predict relapses.

  17. Clinical value of high-sensitivity cardiac troponin assays after acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Yi-rui CAO

    2016-11-01

    Full Text Available In view of a variety of cardiovascular events complicated by acute ischemic stroke, the importance of monitoring myocardial ischemic symptoms and signs, electrocardiogram, echocardiogram and myocardial injury markers has been gradually recognized by clinicians. Cardiac troponin (cTn by conventional assay has been a unique marker of myocardial injury for its extremely high specificity. However, with the utilization of high-sensitivity cardiac troponin (hs-cTn, cTn is no longer exclusive of a disease, but was given more significance in the diagnosis and application value. Therefore, we described the clinical significance of alterations of serum hs-cTn concentration after ischemic stroke. DOI: 10.3969/j.issn.1672-6731.2016.11.015

  18. Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

    Directory of Open Access Journals (Sweden)

    Papamichael Georgios

    2011-02-01

    Full Text Available Abstract Background There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries. Methods A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010 were examined. Results Chemical restraint was applied in 33 cases (10.5% of total admissions. From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases, usually in combination with a benzodiazepine (61.7% of cases. In 36.4% of cases the patient was further subjected to restraint or seclusion. Conclusions In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.

  19. The clinical utility and prognostic value of multiparameter flow cytometry immunophenotyping in light-chain amyloidosis.

    Science.gov (United States)

    Paiva, Bruno; Vídriales, María-Belén; Pérez, José J; López-Berges, María-Consuelo; García-Sanz, Ramón; Ocio, Enrique M; de Las Heras, Natalia; Cuello, Rebeca; García de Coca, Alfonso; Pardal, Emilia; Alonso, José; Sierra, Magdalena; Bárez, Abelardo; Hernández, José; Suárez, Lissbett; Galende, Josefina; Mateos, María-Victoria; San Miguel, Jesús F

    2011-03-31

    The clinical value of multiparameter flow cytometry (MFC) immunophenotyping in primary or light chain amyloidosis (AL) remains unknown. We studied 44 consecutive bone marrow samples from newly diagnosed patients with amyloidosis; 35 patients with AL and 9 with other forms of amyloidosis. Monoclonal plasma cells (PCs) were identifiable by MFC immunophenotyping in 34 of 35 (97%) patients with AL, whereas it was absent from all but 1 of the 9 (11%) patients with other forms of amyloidosis. Quantification of bone marrow plasma cells (BMPCs) by MFC immunophenotyping was a significant prognostic factor for overall survival (OS) (≤ 1% vs > 1% BMPC cutoff; 2-year OS rates of 90% vs 44%, P = .02). Moreover, detecting persistent normal PCs at diagnosis identifies a subgroup of patients with AL with prolonged OS (> 5% vs ≤ 5% normal PC within all BMPC cutoff, 2-year rates of 88% vs 37%, P = .01). MFC immunophenotyping could be clinically useful for the demonstration of PC clonality in AL and for the prognostication of patients with AL.

  20. Neutropenic enterocolitis in children and young adults with cancer: prognostic value of clinical and image findings.

    Science.gov (United States)

    Rizzatti, Marcelo; Brandalise, Silvia Regina; de Azevedo, Amilcar Cardoso; Pinheiro, Vitória Régia Pereira; Aguiar, Simone dos Santos

    2010-09-01

    Intensive chemotherapy regimens can result in severe toxicities, particularly those that involve the digestive systems, leading to morbidity and mortality in this group of patients. Acute enterocolitis can be a frequent complication. The authors performed a retrospective review or patients treated at their institution to ascertain the prognostic value of the clinical symptoms and signs of acute enterocolitis, the corresponding abdominal ultrasonographic findings, and the impact of previous chemotherapy. Amongst 1159 patients with cancer treated at the Centro Infantil Boldrini from 2003 to 2007, 188 (16.2%) patients had 1 or more episode of enterocolitis. An intestinal wall thickness of >or=3 mm on ultrasound was considered diagnostic of enterocolitis. There were 231 episodes of enterocolitis with a death rate of 11.7%. Previous therapy with cytarabine and the presence of abdominal distention affected survival. An intestinal wall thickness of >or=10 mm in the ultrasonographic examination was associated with greater mortality. In multivariate analysis, age, gender, tumor type, degree of neutropenia, intestinal wall thickness, and number of intestinal segments were not statistically significant difference. In children and young adults with cancer and enterocolitis, the clinical findings of 4 or more symptoms and presence of abdominal distention were associated with higher risk of death. Use of cytarabine and an intestinal wall thickness of >or=10 mm were associated with a higher death rate.

  1. The clinical features and diagnostic value of CT in Fahr’s disease

    Directory of Open Access Journals (Sweden)

    Wei-dong Hu

    2013-11-01

    Full Text Available Objectives:  To study the clinical features and diagnostic value of CT in Fahr’s disease. Methods:  We retrospectively analyzed skull images of 8,000 cases and observed the incidence and imaging characteristics of Fahr’s disease. Results: Fahr’s disease were found in 6 patients (6/4000=0.075%whose ages ranged from 16 to 62 years (average age:38.5±6.4years. We found that 6 Fahr’s disease had been incidentally detected in 4 men(4/6=66.7% and 2 women(2/6=33.4%; serum calcium:2.13~2.42 mmol/L,serum phosphor:1.0~1.6 mmol/L.The most common CT feature of Fahr’s disease is the presence of small bilateral intracranial calcifications which are usually restricted to the bilateral globus pallidus, putamen, caudate nucleus, thalamus, dentate nucleus and white matter of the cerebral hemispheres. Conclusions: Combined with clinical manifestations and imaging features, we can make a clear diagnosis of the Fahr’s disease.

  2. Valuing structured professional judgment: predictive validity, decision-making, and the clinical-actuarial conflict.

    Science.gov (United States)

    Falzer, Paul R

    2013-01-01

    Structured professional judgment (SPJ) has received considerable attention as an alternative to unstructured clinical judgment and actuarial assessment, and as a means of resolving their ongoing conflict. However, predictive validity studies have typically relied on receiver operating characteristic (ROC) analysis, the same technique commonly used to validate actuarial assessment tools. This paper presents SPJ as distinct from both unstructured clinical judgment and actuarial assessment. A key distinguishing feature of SPJ is the contribution of modifiable factors, either dynamic or protective, to summary risk ratings. With modifiable factors, the summary rating scheme serves as a prognostic model rather than a classification procedure. However, prognostic models require more extensive and thorough predictive validity testing than can be provided by ROC analysis. It is proposed that validation should include calibration and reclassification techniques, as well as additional measures of discrimination. Several techniques and measures are described and illustrated. The paper concludes by tracing the limitations of ROC analysis to its philosophical foundation and its origin as a statistical theory of decision-making. This foundation inhibits the performance of crucial tasks, such as determining the sufficiency of a risk assessment and examining the evidentiary value of statistical findings. The paper closes by noting a current effort to establish a viable and complementary relationship between SPJ and decision-making theory.

  3. Time-course changes of hematology and clinical chemistry values in pregnant rats.

    Science.gov (United States)

    Honda, Tatsuya; Honda, Katsuya; Kokubun, Chisato; Nishimura, Tomonari; Hasegawa, Mina; Nishida, Atsuyuki; Inui, Toshihide; Kitamura, Kazuyuki

    2008-08-01

    The aim of this study is to report how pregnancy alters hematology and clinical chemistry values in rats. Female and male Sprague-Dawley rats were mated; the day of copulation was designated as Day 0. Hematology and clinical chemistry measurements were conducted on Days 7, 14, 17 and 21 in pregnant rats. Measurements were also conducted in non-pregnant rats. Red blood cells (RBC), hemoglobin (Hb), hematocrit (Ht), total protein and albumin decreased on Days 7, 14, 17 and 21; sodium, chloride and glucose decreased on Days 14, 17 and 21; iron decreased on Days 17 and 21; hemoglobin content of reticulocytes (CHr), calcium, inorganic phosphorus and the albumin/globulin ratio decreased on Day 21; and total cholesterol, phospholipid and high-density lipoprotein cholesterol decreased on Day 14 in pregnant rats compared with non-pregnant rats. Reticulocyte increased on Days 7, 14 and 17; mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, neutrophil count and rate increased on Days 14, 17 and 21; platelets, fibrinogen, triglyceride and free fatty acid increased on Days 17 and 21; and activated partial thromboplastin time was prolonged on Days 17 and 21 in pregnant rats compared with non-pregnant rats. The decreased RBC, Hb, Ht, CHr and iron in pregnant rats indicated that they suffered from iron deficiency anemia. These data can be used as background information for effective evaluation in reproductive toxicology studies.

  4. Clinical value of antibodies to lysobisphosphatidic acid in patients with primary antiphospholipid sindrome

    Directory of Open Access Journals (Sweden)

    S. Giunco

    2011-06-01

    Full Text Available To assess the clinical value of anti-lysobisphosphatidic acid (anti-LBPA antibodies in patients with primary antiphospholipid syndrome (APS, the sera of 140 primary APS patients were tested and compared with those of 70 control subjects affected with rheumatic systemic diseases (n. 24 or autoimmune thyroiditis (n. 46. Anti-LBPA anticardiolipin (aCL and anti-β2 Glycoprotein I (anti-β2GPI antibodies were determined using a “home made” ELISA method. Lupus anticoagulant (LA was assessed using a series of clotting tests in accordance with the literature. IgG anti-LBPA was significantly prevalent in primary APS (p=0.000 with a sensitivity of 58.6% and a specificity of 92.9%. IgM anti-LBPA showed a significant frequency in primary APS (p=0.000 with a sensitivity of 28.6% and a specificity of 97.1%. Anti-LBPA’s sensitivity and specificity for APS were lower or equal to those of aCL and anti-β2GPI. The prevalence of anti-LBPA in the different clinical and laboratory subsets of APS was lower than those of aCL and anti- β2GPI. It is interesting to observe that both IgG and IgM anti-LBPA were never found alone. The comparison between anti-LBPA and LA showed that the former had a higher sensitivity but a lower specificity. In conclusion, in view of our results anti-LBPA cannot at present be considered a further tool to be utilized to diagnose APS and to differentiate the different clinical and laboratory subsets of this disease.

  5. Aligning clinical compensation with clinical productivity: design and implementation of the financial value unit (FVU) system in an academic department of internal medicine.

    Science.gov (United States)

    Stites, Steven; Steffen, Patrick; Turner, Scott; Pingleton, Susan

    2013-07-01

    A new metric was developed and implemented at the University of Kansas School of Medicine Department of Internal Medicine, the financial value unit (FVU). This metric analyzes faculty clinical compensation compared with clinical work productivity as a transparent means to decrease the physician compensation variability and compensate faculty equitably for clinical work.The FVU is the ratio of individual faculty clinical compensation compared with their total work relative value units (wRVUs) generated divided by Medical Group Management Association (MGMA) salary to wRVUs of a similar MGMA physician.The closer the FVU ratio is to 1.0, the closer clinical compensation is to that of an MGMA physician with similar clinical productivity. Using FVU metrics to calculate a faculty salary gap compared with MGMA median salary and wRVU productivity, a divisional production payment was established annually.From FY 2006 to FY 2011, both total faculty numbers and overall clinical activity increased. With the implementation of the FVU, both clinical productivity and compensation increased while, at the same time, physician retention rates remained high. Variability in physician compensation decreased. Dramatic clinical growth was associated with the alignment of clinical work and clinical compensation in a transparent and equable process.

  6. Increasing fetal ovine number per gestation alters fetal plasma clinical chemistry values.

    Science.gov (United States)

    Zywicki, Micaela; Blohowiak, Sharon E; Magness, Ronald R; Segar, Jeffrey L; Kling, Pamela J

    2016-08-01

    Intrauterine growth restriction (IUGR) is interconnected with developmental programming of lifelong pathophysiology. IUGR is seen in human multifetal pregnancies, with stepwise rises in fetal numbers interfering with placental nutrient delivery. It remains unknown whether fetal blood analyses would reflect fetal nutrition, liver, and excretory function in the last trimester of human or ovine IUGR In an ovine model, we hypothesized that fetal plasma biochemical values would reflect progressive placental, fetal liver, and fetal kidney dysfunction as the number of fetuses per gestation rose. To determine fetal plasma biochemical values in singleton, twin, triplet, and quadruplet/quintuplet ovine gestation, we investigated morphometric measures and comprehensive metabolic panels with nutritional measures, liver enzymes, and placental and fetal kidney excretory measures at gestational day (GD) 130 (90% gestation). As anticipated, placental dysfunction was supported by a stepwise fall in fetal weight, fetal plasma glucose, and triglyceride levels as fetal number per ewe rose. Fetal glucose and triglycerides were directly related to fetal weight. Plasma creatinine, reflecting fetal renal excretory function, and plasma cholesterol, reflecting placental excretory function, were inversely correlated with fetal weight. Progressive biochemical disturbances and growth restriction accompanied the rise in fetal number. Understanding the compensatory and adaptive responses of growth-restricted fetuses at the biochemical level may help explain how metabolic pathways in growth restriction can be predetermined at birth. This physiological understanding is important for clinical care and generating interventional strategies to prevent altered developmental programming in multifetal gestation.

  7. Value of Prophylactic Postoperative Antibiotic Therapy after Bimaxillary Orthognathic Surgery: A Clinical Trial

    Directory of Open Access Journals (Sweden)

    Majid Eshghpour

    2014-10-01

    Full Text Available Introduction: Antibiotic therapy before or after orthognathic surgery is commonly recommended by surgeons to minimize the risk of wound infection. This article evaluates the value of Prophylactic antibiotic therapy in order to diminish the incidence of postoperative wound infection after orthognathic surgery.   Materials and Methods: Fifty candidates for bimaxillary orthognathic surgery were divided into cases and controls. Cefazolin (1g was administered intravenously to all participants 30 mins prior to surgery followed by a similar dose 4 hours later. Case-group patients ingested amoxicillin (500 mg orally for 7 days after surgery. Postoperative wound infection was assessed using clinical features, and the P-value significance was set at P  Results: Both groups were similar according to gender, age, and operating time. During the follow-up period no infection was observed in either the case or control group.   Conclusion:  The results of this study suggest that long-term postoperative antibiotic therapy is not essential for the prevention of postoperative infection, and that application of aseptic surgical technique and hygiene instruction after surgery are sufficient.

  8. "Dynamic range" of inferred phenotypic HIV drug resistance values in clinical practice.

    Directory of Open Access Journals (Sweden)

    Luke C Swenson

    Full Text Available BACKGROUND: 'Virtual' or inferred phenotypes (vPhenotypes are commonly used to assess resistance to antiretroviral agents in patients failing therapy. In this study, we provide a clinical context for understanding vPhenotype values. METHODS: All HIV-infected persons enrolled in the British Columbia Drug Treatment Program with a baseline plasma viral load (pVL and follow-up genotypic resistance and pVL results were included up to October 29, 2008 (N = 5,277. Change from baseline pVL was determined as a function of Virco vPhenotype, and the "dynamic range" (defined here by the 10th and 90th percentiles for fold-change in IC₅₀ amongst all patients was estimated from the distribution of vPhenotye fold-changes across the cohort. RESULTS: The distribution of vPhenotypes from a large cohort of HIV patients who have failed therapy are presented for all available antiretroviral agents. A maximum change in IC₅₀ of at least 13-fold was observed for all drugs. The dideoxy drugs, tenofovir and most PIs exhibited small "dynamic ranges" with values of 99% of samples. In contrast, zidovudine, lamivudine, emtricitabine and the non-nucleoside reverse transcriptase inihibitors (excluding etravirine had large dynamic ranges. CONCLUSION: We describe the populational distribution of vPhenotypes such that vPhenotype results can be interpreted relative to other patients in a drug-specific manner.

  9. System visualization of integrated biofuels and high value chemicals developed within the MacroAlgaeBiorefinery (MAB3) project

    DEFF Research Database (Denmark)

    Seghetta, Michele; Hasler, Berit; Bastianoni, Simone

    MacroAlgaeBiorefinery (MAB3) may functions as production platform and raw material supplier for future sustainable production chains of biofuels and high value chemicals. Biofuels are interesting energy source but challenges in terms of the composition of the biomass and resulting energy...... is integrated with a biogas biorefinery, a bioethanol biorefinery and a fish feed industry. The modeled system is able to adapt itself to different amount and quality of feedstock and to maximize valuable outputs (e.g. bio-fuels and chemical). Macroalgae are harvested and utilized as feedstock in bioethanol...... efficiencies has to be compensated for to make the biofuel prices competitive in replacing fossil fuel. Since it is difficult to increase the yield of the single biorefinery, the overall system productivity can be improved integrating different sub-systems. In this study, macroalgae cultivation in Denmark...

  10. Chemical composition and nutritional value of the most widely appreciated cultivated mushrooms: an inter-species comparative study.

    Science.gov (United States)

    Reis, Filipa S; Barros, Lillian; Martins, Anabela; Ferreira, Isabel C F R

    2012-02-01

    Herein, it was reported and compared the chemical composition and nutritional value of the most consumed species as fresh cultivated mushrooms: Agaricus bisporus (white and brown mushrooms), Pleurotus ostreatus (oyster mushroom), Pleurotus eryngii (King oyster mushroom), Lentinula edodes (Shiitake) and Flammulina velutipes (Golden needle mushroom). Shiitake revealed the highest levels of macronutrients, unless proteins, as also the highest sugars, tocopherols and PUFA levels, and the lowest SFA content. White and brown mushrooms showed similar macronutrients composition, as also similar values of total sugars, MUFA, PUFA and total tocopherols. Oyster and king oyster mushrooms gave the highest MUFA contents with similar contents in PUFA, MUFA and SFA in both samples. They also revealed similar moisture, ash, carbohydrates and energy values. This study contributes to the elaboration of nutritional databases of the most consumed fungi species worldwide, allowing comparison between them. Moreover it was reported that cultivated and the wild samples of the same species have different chemical composition, including sugars, fatty acids and tocopherols profiles.

  11. Process Design for the Biocatalysis of Value-Added Chemicals from Carbon Dioxide

    Energy Technology Data Exchange (ETDEWEB)

    Mark A. Eiteman

    2005-11-01

    This report describes results toward developing a process to sequester CO{sub 2} centered on the enzyme pyruvate carboxylase. The process involves the use of bacteria to convert CO{sub 2} and glucose as a co-substrate and generates succinic acid as a commodity chemical product. The first phase of this research has focused on strain development and on process development. Progress in strain development has been made in three areas. The gene encoding for alcohol dehydrogenase has been ''knocked out'' of the bacteria, and thereby eliminating the synthesis of the by-product ethanol. The gene for glucokinase has been overexpressed in the production strain with the goal of faster utilization of glucose (and hence CO{sub 2}). Efforts have continued toward integrating pyruvate carboxylase gene (pyc) onto the E. coli chromosome. Progress in process development has come in conducting several dozen fermentation experiments to find a defined medium that would be successful for the growth of the bacteria, while permitting a high rate of CO{sub 2} utilization in a subsequent prolonged production phase. Using this defined medium, the strains that continue to be constructed are being compared for CO{sub 2} utilization, so that we may understand the factors that govern the biological sequestration process.

  12. Process Design for the Biocatalysis of Value-Added Chemicals from Carbon Dioxide

    Energy Technology Data Exchange (ETDEWEB)

    Mark Eiteman

    2007-07-31

    This report describes results toward developing a process to sequester CO{sub 2} centered on the enzymes PEP carboxylase and pyruvate carboxylase. The process involves the use of bacteria to convert CO{sub 2} and glucose as a co-substrate and generates succinic acid as a commodity chemical product. The study reports on strain development and process development. In the area of strain development, knockouts in genes which divert carbon from the enzymatic steps involved in CO{sub 2} consumption were completed, and were shown not to affect significantly the rate of CO{sub 2} sequestration and succinic acid generation. Furthermore, the pyc gene encoding for pyruvate carboxylase proved to be unstable when integrated onto the chromosome. In the area of process development, an optimal medium, pH and base counterion were obtained, leading to a sequestration rate as great as 800 mg/Lh. Detailed studies of gas phase composition demonstrated that CO{sub 2} composition has a significant affect on CO{sub 2} sequestration, while the presence of 'toxic' compounds in the gas, including NO{sub 2}, CO and SO{sub 2} did not have a detrimental effect on sequestration. Some results on prolonging the rate of sequestration indicate that enzyme activities decrease with time, suggesting methods to prolong enzyme activity may benefit the overall process.

  13. Determination of decimal reduction time (D value of chemical agents used in hospitals for disinfection purposes

    Directory of Open Access Journals (Sweden)

    da S Martins Alzira M

    2003-10-01

    Full Text Available Abstract Background Prior to the selection of disinfectants for low, intermediate and high (sterilizing levels, the decimal reduction time, D-value, for the most common and persistent bacteria identified at a health care facility should be determined. Methods The D-value was determined by inoculating 100 mL of disinfecting solution with 1 mL of a bacterial suspension (104 – 105 CFU/mL for vegetative and spore forms. At regular intervals, 1 mL aliquots of this mixture were transferred to 8 mL of growth media containing a neutralizing agent, and incubated at optimal conditions for the microorganism. Results The highest D-values for various bacteria were determined for the following solutions: (i 0.1% sodium dichloroisocyanurate (pH 7.0 – E. coli and A. calcoaceticus (D = 5.9 min; (ii sodium hypochlorite (pH 7.0 at 0.025% for B. stearothermophilus (D = 24 min, E. coli and E. cloacae (D = 7.5 min; at 0.05% for B. stearothermophilus (D = 9.4 min and E. coli (D = 6.1 min and 0.1% for B. stearothermophilus (D = 3.5 min and B. subtilis (D = 3.2 min; (iii 2.0% glutaraldehyde (pH 7.4 – B. stearothermophilus, B. subtilis (D = 25 min and E. coli (D = 7.1 min; (iv 0.5% formaldehyde (pH 6.5 – B. subtilis (D = 11.8 min, B. stearothermophilus (D = 10.9 min and A. calcoaceticus (D = 5.2 min; (v 2.0% chlorhexidine (pH 6.2 – B. stearothermophilus (D = 9.1 min, and at 0.4% for E. cloacae (D = 8.3 min; (vi 1.0% Minncare® (peracetic acid and hydrogen peroxide, pH 2.3 – B. stearothermophilus (D = 9.1 min and E. coli (D = 6.7 min. Conclusions The suspension studies were an indication of the disinfectant efficacy on a surface. The data in this study reflect the formulations used and may vary from product to product. The expected effectiveness from the studied formulations showed that the tested agents can be recommended for surface disinfection as stated in present guidelines and emphasizes the importance and need to develop routine and novel programs to

  14. Evaluation of Physico-chemical Parameters of Manchar Lake Water and Their Comparison with Other Global Published Values

    Directory of Open Access Journals (Sweden)

    Muhammad Balal Arain

    2008-12-01

    Full Text Available The aim of current study was to evaluate the status of the Manchar lake water with respect to different physico-chemical parameters (electric conductivity, pH, chloride, phosphate, sulfate, total alkalinity, potassium, calcium, magnesium, manganese, iron, cadmium, copper, arsenic, nickel, zinc, chromium lead and selenium in 2005-2007. Among the elemental investigation of Manchar Lake water except Co, Cr, Cu and Mn, other elements (Al, As, Ca, Cd, Fe, Mg, Na, K, Ni, Pb and Se have higher values as compared to the permissible level of these elements in drinking water. The results were compared with WHO water quality guidelines as well as with literature values reported for global lake water.

  15. Clinical value of somatostatin receptor imaging in patients with suspected head and neck paragangliomas

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Matthias; Dietlein, Markus; Weber, Kerstin; Moka, Detlef; Schicha, Harald [Klinik und Poliklinik fuer Nuklearmedizin, Universitaet zu Koeln, Joseph-Stelzmann-Strasse 9, 50924 Koeln (Germany); Fischer, Eva; Michel, Olaf; Stennert, Eberhard [Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde, Universitaet zu Koeln, Koeln (Germany)

    2002-12-01

    Paragangliomas or glomus tumours of the head and neck region are rare somatostatin receptor-expressing neuroendocrine tumours. Precise preoperative diagnosis is of special importance in order to adequately weigh the potential benefit of the operation against the inherent risks of the procedure. In this study, the clinical value of somatostatin receptor imaging was assessed in 19 patients who underwent somatostatin receptor scintigraphy because of known or suspected paraganglioma of the head and neck region. The results were compared with the results of computed tomography and/or magnetic resonance imaging, histology and clinical follow-up. [{sup 111}In-DTPA-D-Phe{sup 1}]-octreotide scintigraphy was performed 4-6 and 24 h after i.v. injection of 140-220 MBq {sup 111}In-octreotide. Whole-body and planar images as well as single-photon emission tomography images were acquired and lesions were graded according to qualitative tracer uptake. Somatostatin receptor imaging was positive in nine patients, identifying paragangliomas for the first time in three patients and recurrent disease in six patients. In one patient, a second, previously unknown paraganglioma site was identified. Negative results were obtained in ten patients. These patients included one suffering from chronic hyperplastic otitis externa, one with granuloma tissue and an organised haematoma, one with an acoustic neuroma, one with an asymmetric internal carotid artery, two with ectasia of the bulbus venae jugularis and one with a jugular vein thrombosis. In two patients with a strong family history of paraganglioma, individual involvement could be excluded. In only one patient did somatostatin receptor imaging and magnetic resonance imaging yield false negative results in respect of recurrent paraganglioma tissue. It is concluded that somatostatin receptor scintigraphy provides important information in patients with suspected paragangliomas of the head and neck region and has a strong impact on further

  16. Process Design for the Biocatalysis of Value-Added Chemicals from Carbon Dioxide

    Energy Technology Data Exchange (ETDEWEB)

    Mark A. Eiteman

    2006-07-31

    This report describes results toward developing a process to sequester CO{sub 2} centered on the enzyme pyruvate carboxylase. The process involves the use of bacteria to convert CO{sub 2} and glucose as a co-substrate and generates succinic acid as a commodity chemical product. The phases of research have included strain development and process development. Though we continue to work on one important component of strain development, the research has principally focused on process development. In the previous year we constructed several strains which would serve as templates for the CO{sub 2} sequestration, including the knock-out of genes involved in the formation of undesirable byproducts. This project period the focus has been on the integration of the pyruvate carboxylase gene (pyc) onto the E. coli chromosome. This has proven to be a difficult task because of relatively low expression of the gene and resulting low enzyme activity when only one copy of the gene is present on the chromosome. Several molecular biology techniques have been applied, with some success, to improve the level of protein activity as described herein. Progress in process development has come as a result of conducting numerous fermentation experiments to select optimal conditions for CO{sub 2} sequestration. This process-related research has progressed in four areas. First, we have clarified the range of pH which results in the optimal rate of sequestration. Second, we have determined how the counterion used to control the pH affects the sequestration rate. Third, we have determined how CO{sub 2} gas phase composition impacts sequestration rate. Finally, we have made progress in determining the affect of several potential gaseous impurities on CO{sub 2} sequestration; in particular we have completed a study using NO{sub 2}. Although the results provide significant guidance as to process conditions for CO{sub 2} sequestration and succinate production, in some cases we do not yet understand

  17. A retrospective analysis of heterophoria values in a clinical population aged 18 to 30 years

    Directory of Open Access Journals (Sweden)

    N.T. Makgaba

    2006-01-01

    Full Text Available Information on heterophoria values in South Africans  is  scanty. The  purpose  of  this  paper therefore, is to present information on the distribution of heterophoria in a clinical popula-tion aged 18 to 30 years, which hitherto is not available. The data presented here was obtained from  the  record  cards  of  475  black  South African  patients  examined  at  the  Optometry clinic, University of Limpopo (Turfloop cam-pus between 2000 and 2005. The patients were examined by final year students under the supervision  of  qualified  optometrists.  Heterophoria was  measured  for  each  patient  using  the  von Graefe  method.  The  horizontal  heterophoria for distance vision (6 m ranged from 16 prism diopters (pd esophoria to 12 pd exophoria with a mean of 0.74 pd exophoria (SD = ± 2.84 pd. For  distance  vision,  esophoria  ranged  from 0.5 to 16 pd with a mean of 3.08 pd (SD = ± 3.09, while exophoria ranged from 0.5 pd to 12 pd with a mean of 2.21 pd (SD = 1.82 pd. For near vision (0.4 m, the horizontal phorias ranged from 17 pd esophoria to 15 pd exopho-ria with a mean of 3.84 pd exophoria (SD = ± 4.80 pd. The near esophorias ranged from 0.5 to 17 pd with a mean 4.88 pd (SD = ± 3.41, while the exophorias ranged from 1.0 to 15 pd with a mean of 6.30 pd (SD = ± 2.58. Vertical heterophoria for distance vision ranged from 5 to 3 pd right hyperphoria with a mean of 0.05 pd right hyperphoria (SD = ± 0.76 whereas at near it ranged from 4 to 6 pd right hyperphoria with a mean of 0.08 pd right hypophoria (SD =  ±  0.96.  The  distributions  of  heterophoria at distance and near were non-normal.  There was  no  significant  gender  variation  in  the horizontal  values  for  distance  vision  and  the vertical  (distance  and  near  ones.  However, there was a statistically significant gender varia-tion  in  the  near  horizontal  values  (p

  18. Environmental Chemical Assessment in Clinical Practice: Unveiling the Elephant in the Room.

    Science.gov (United States)

    Bijlsma, Nicole; Cohen, Marc M

    2016-02-02

    A growing body of evidence suggests chemicals present in air, water, soil, food, building materials and household products are toxicants that contribute to the many chronic diseases typically seen in routine medical practice. Yet, despite calls from numerous organisations to provide clinicians with more training and awareness in environmental health, there are multiple barriers to the clinical assessment of toxic environmental exposures. Recent developments in the fields of systems biology, innovative breakthroughs in biomedical research encompassing the "-omics" fields, and advances in mobile sensing, peer-to-peer networks and big data, provide tools that future clinicians can use to assess environmental chemical exposures in their patients. There is also a need for concerted action at all levels, including actions by individual patients, clinicians, medical educators, regulators, government and non-government organisations, corporations and the wider civil society, to understand the "exposome" and minimise the extent of toxic exposures on current and future generations. Clinical environmental chemical risk assessment may provide a bridge between multiple disciplines that uses new technologies to herald in a new era in personalised medicine that unites clinicians, patients and civil society in the quest to understand and master the links between the environment and human health.

  19. Environmental Chemical Assessment in Clinical Practice: Unveiling the Elephant in the Room

    Directory of Open Access Journals (Sweden)

    Nicole Bijlsma

    2016-02-01

    Full Text Available A growing body of evidence suggests chemicals present in air, water, soil, food, building materials and household products are toxicants that contribute to the many chronic diseases typically seen in routine medical practice. Yet, despite calls from numerous organisations to provide clinicians with more training and awareness in environmental health, there are multiple barriers to the clinical assessment of toxic environmental exposures. Recent developments in the fields of systems biology, innovative breakthroughs in biomedical research encompassing the “-omics” fields, and advances in mobile sensing, peer-to-peer networks and big data, provide tools that future clinicians can use to assess environmental chemical exposures in their patients. There is also a need for concerted action at all levels, including actions by individual patients, clinicians, medical educators, regulators, government and non-government organisations, corporations and the wider civil society, to understand the “exposome” and minimise the extent of toxic exposures on current and future generations. Clinical environmental chemical risk assessment may provide a bridge between multiple disciplines that uses new technologies to herald in a new era in personalised medicine that unites clinicians, patients and civil society in the quest to understand and master the links between the environment and human health.

  20. Recent progress in the development of solid catalysts for biomass conversion into high value-added chemicals

    Science.gov (United States)

    Hara, Michikazu; Nakajima, Kiyotaka; Kamata, Keigo

    2015-01-01

    In recent decades, the substitution of non-renewable fossil resources by renewable biomass as a sustainable feedstock has been extensively investigated for the manufacture of high value-added products such as biofuels, commodity chemicals, and new bio-based materials such as bioplastics. Numerous solid catalyst systems for the effective conversion of biomass feedstocks into value-added chemicals and fuels have been developed. Solid catalysts are classified into four main groups with respect to their structures and substrate activation properties: (a) micro- and mesoporous materials, (b) metal oxides, (c) supported metal catalysts, and (d) sulfonated polymers. This review article focuses on the activation of substrates and/or reagents on the basis of groups (a)–(d), and the corresponding reaction mechanisms. In addition, recent progress in chemocatalytic processes for the production of five industrially important products (5-hydroxymethylfurfural, lactic acid, glyceraldehyde, 1,3-dihydroxyacetone, and furan-2,5-dicarboxylic acid) as bio-based plastic monomers and their intermediates is comprehensively summarized. PMID:27877800

  1. The clinical value and the cost-effectiveness of follow-up in endometrial cancer patients.

    Science.gov (United States)

    Tjalma, W A A; van Dam, P A; Makar, A P; Cruickshank, D J

    2004-01-01

    The aim of the present article was to evaluate the cost-effectiveness of follow-up in endometrial cancer patients. A literature review was performed regarding the studies that addressed routine follow-up of endometrial cancer. For each published study, the costs of the follow-up program were calculated according to Belgium standards. A mean total of 13% relapsed. Symptomatology and clinical examination detected over 83% of the recurrences. The follow-up cost in euro after 5 and 10 years ranged between 127.68 and 2,028.78 and between 207.48 and 2,353.48, respectively. Based on the available data, there is little evidence of routine follow-up improving survival rates. Multiple protocols are used in practice without an evidence base. There is an urgent need for prospective randomized studies to evaluate the value of the current so-called 'standard medical practice of follow-up.' It is to be expected that the cost of follow-up could be reduced considerably, for instance, by tailoring to low- and high-risk groups, or by abandoning routine follow-up. Symptomatic patients, however, should be evaluated immediately. A reduction in the number of visits and examinations would mean an enormous reduction in costs. This economic benefit would be warmly welcomed in the times of increased health costs and decreased budgets.

  2. Clinical Value of Contrast-enhanced Ultrasound in Differentiating Benign and Malignant Focal Liver Lesions

    Institute of Scientific and Technical Information of China (English)

    XU Jinfeng; WU Ying; DONG Fajin; XIONG Yi; PENG Qihui; XIE Mingxing

    2007-01-01

    To explore the clinical value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant focal liver lesions (FLLs) with SonoVue, CEUS was used to examine 113 pa- tients with focal liver lesions (FLLs) in our hospital during July 2005 to December 2006. All the pa- tients underwent contrast-enhanced CT (CECT) or contrast-enhanced MRI(CEMRI). Except for pa- tients with focal fatty sparings (n=18) and with hemangiomas (n=8), all the patients were confirmed by operation or ultrasonic-guided liver puncture biopsy. A sulfur hexafluoride gas-based contrast agent was used with a MI of 0.15 to 0.17. Forty-eight cases of malignant FLLs, including 30 hepato- cellular carcinomas (HCCs), 2 cholangiocarcinomas and 16 metastatic tumors, were detected. Sev- enty-eight cases of benign FLLs, including 33 hemangiomas, 9 focal nodular hyperplasias (FNHs), 19 focal fatty sparings, 5 abscesses, 7 regenerative nodules and 2 inflammatory pseudo-tumor, were in- volved. The contrast pattern of benign and malignant FLLs was quite different. CEUS has higher specificity and sensitivity than conventional ultrasound in differentiating benign and malignant FLLs.

  3. THE EXPRESSION AND CLINICAL VALUE OF APOPTOSIS CONTROL GENE Bcl-2 AND Bax IN BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    ZHENG Jun; YAO Zhen-xiang; ZHANG Jing

    1999-01-01

    Objective: To study the expression and clinical value of apoptosis control gene bcl-2 and bax in breast cancer.Methods: Protein bax and bcl-2 in 41 breast cancers obtained from operations in our hospital in 1996 were detected using ABC immunohistochemical stain assay and compared with 10 cases with normal breast tissues.Results: The positive rate of bax in normal breast tissue was 90% and in breast cancer was 59%, with a significant statistical difference between them (P<0.05), but there was no statistical difference in bcl-2 protein expression. Among the 41 breast cancer, the group with lymph node metastasis (21 cases) had obviously low bax expression (43%) and high bcl-2 expression (76%), showing significant difference to the group without lymph node metastasis (P<0.05).Conclusion: The antiapoptosis function of bcl-2 was stronger than bax in breast cancer. Protein bax and bcl-2 assay may be useful in understanding the biological behaviors of breast cancer.

  4. The Clinical and Nonclinical Values of Nonexercise Estimation of Cardiovascular Endurance in Young Asymptomatic Individuals

    Directory of Open Access Journals (Sweden)

    Mahmoud A. Alomari

    2012-01-01

    Full Text Available Exercise testing is associated with barriers prevent using cardiovascular (CV endurance (CVE measure frequently. A recent nonexercise model (NM is alleged to estimate CVE without exercise. This study examined CVE relationships, using the NM model, with measures of obesity, physical fitness (PF, blood glucose and lipid, and circulation in 188 asymptomatic young (18–40 years adults. Estimated CVE correlated favorably with measures of PF (r=0.4-0.5 including handgrip strength, distance in 6 munities walking test, and shoulder press, and leg extension strengths, obesity (r=0.2-0.7 including % body fat, body water content, fat mass, muscle mass, BMI, waist and hip circumferences and waist/hip ratio, and circulation (r=0.2-0.3 including blood pressures, blood flow, vascular resistance, and blood (r=0.2-0.5 profile including glucose, total cholesterol, LDL-C, HDL-C, and triglycerides. Additionally, differences (P<0.05 in examined measures were found between the high, average, and low estimated CVE groups. Obviously the majority of these measures are CV disease risk factors and metabolic syndrome components. These results enhance the NM scientific value, and thus, can be further used in clinical and nonclinical settings.

  5. Clinical value of cancer cells joint detection in peripheral blood plasma of thyroid cancer patients

    Institute of Scientific and Technical Information of China (English)

    Yaqiong Ni; Qinjiang Liu ; Youxin Tian

    2014-01-01

    Objective:We aimed to detect cytokeratin 19 (CK19) and polymorphic epithelial mucin 1 (MUC1) expression in peripheral blood of thyroid cancer patients, and investigate the clinical value of it as a diagnostic marker for circulating blood micrometastases. Methods:The flow cytometry (FCM) was used to detect and analyze CK19 and MUC1-expressing cel s in peripheral blood of 491 thyroid cancer patients. Results:CK19 and MUC1 expression showed no statistical y significant dif-ference with gender and age in thyroid cancer patients (P>0.05), while had statistical y significant dif erence with tumor size, lymph node stage and distant metastasis (P<0.01). The expression of CK19 and MUC1 were positively correlated (r=0.628, P=0.00). Conclusion:CK19 is closely related to MUC1 expression, tumor size, extent of invasion and distant metastasis in peripheral blood of thyroid cancer patients. The circulating blood CK19 and MUC1 tests can help predict thyroid cancer micrometastases and prognosis.

  6. Diagnostic Value of the First and Second Generation of Thyrotropin Receptor Antibodies in Clinical Practice

    Directory of Open Access Journals (Sweden)

    V Fadeyev

    2006-06-01

    Full Text Available Introduction: The pathogenesis of Graves’ disease consists in production of stimulating antibodies against thyrotropin receptors (rTHS-AB. In the last decades two different assays for detection of rTHS-AB were introduced in clinical practice: I-st (with animal antigen and Il-nd generation (with human antigen assays. Design: 44 patient with hyperthyroidism (age 52.0 [34.0; 64.0] years; 42 women were enrolled in the study. 29 of them have hyperthyroidism due to Graves’ disease (GD, 15 due to multinodular toxic goiter (functional autonomy of the thyroid; FA. rTHS-AB in all the patients were detected by two methods: I-st (Medipan Diagnostica and II-nd generation (BRAHMS. Results: The sensitivity, specificity and likelihood ratio in the diagnostics of GD of the II-nd generation assay were higher than for the I-st generation assay for detection of rTHS-AB (93.1%, 94% and 15.5 vs. 75.9%, 80% and 3.8. Conclusion: II-nd generation assay (with human antigen has superior value for the diagnostics of Graves’ disease.

  7. Predictive Value of IL-8 for Sepsis and Severe Infections After Burn Injury: A Clinical Study.

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Cox, Robert A; Song, Juquan; Jeschke, Marc G

    2015-03-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring postburn inflammation is of paramount importance but, so far, there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As interleukin 8 (IL-8) is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict postburn sepsis, infections, and mortality. Plasma cytokines, acute-phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days after injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure [MOF], and mortality) were recorded. A cutoff level for IL-8 was determined using receiver operating characteristic analysis. Statistical significance is set at P Patients were grouped according to their average IL-8 levels relative to this cutoff and stratified into high (H) (n = 133) and low (L) (n = 335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area burned and incidence of MOF (P inflammatory and acute-phase responses compared with the L group (P burn patients.

  8. Clinical value of CT three-dimensional imaging in diagnosing gastrointestinal tract diseases

    Institute of Scientific and Technical Information of China (English)

    Shao-Yin Duan; Dan-Tong Zhang; Qing-Chi Lin; Yan-Huan Wu

    2006-01-01

    AIM: To discuss the clinical value of CT three-dimensional (3-D) imaging in diagnosing gastrointestinal tract diseases.METHODS: Three-D imaging findings of 52 patients were retrospectively analyzed. Three-D imaging methods included shaded surface display (SSD), volume rendering (VR), virtual endoscopy (VE) and multiplanar reformatting (MPR). The diagnosis results of CT 3-D were evaluated by comparison with those of endoscopy and/or surgical finding.RESULTS: Fifty-two patients with gastrointestinal tract diseases were diagnosed by CT 3-D imaging, of whom 50 cases were correctly diagnosed and 2 were misdiagnosed. There were 33 cases of gastric diseases (27 with carcinoma, 5 with peptic ulcer and 1 with leiomyoma) and 19 large intestinal diseases (10 with colon carcinoma, 2 with carcinoma of the rectum, 5 with colon polypus and 2 with tuberculosis of the ileocecal junction). Twenty-two cases with prominent lesions (9 with subsequent hollow lesions), 20 with stenosis of cavity (8 with concomitant prominent lesions) and 10 with hollow lesions (5 with concomitant prominent lesions) were shown in 3-D images. The minimal lesion shown was 1.0 cm × 0.8 cm × 0.5 cm.CONCLUSION: CT 3-D imaging, a non-invasive examination without pain, can display clearly and directly the lesions of gastrointestinal tract with accurate location and high diagnosis accuracy. It is an important complementary technique to endoscopy.

  9. Chemical Immobilization of Sloth Bears (Melursus ursinus) with Ketamine Hydrochloride and Xylazine Hydrochloride: Hematology and Serum Biochemical Values.

    Science.gov (United States)

    Veeraselvam, M; Sridhar, R; Perumal, P; Jayathangaraj, M G

    2014-01-01

    The present study was conducted to define the physiological responses of captive sloth bears immobilized with ketamine hydrochloride and xylazine hydrochloride and to determine and compare the values of hematology and serum biochemical parameters between sexes. A total of 15 sloth bears were immobilized using combination of ketamine hydrochloride and xylazine hydrochloride drugs at the dose rate of 5.0 milligram (mg) per kg body weight and 2.0 mg per kg body weight, respectively. The use of combination of these drugs was found satisfactory for the chemical immobilization of captive sloth bears. There were no significant differences observed in induction time and recovery time and physiological parameters such as heart rate, respiratory rate, and rectal temperature between sexes. Health related parameters comprising hematological values like packed cell volume (PCV), hemoglobin (Hb), red blood cell count (RBC), erythrocyte indices, and so forth and biochemical values like total protein, blood urea nitrogen (BUN), creatinine, alkaline amino-transferase (ALT), aspartate amino-transferase (AST), and so forth were estimated in 11 (5 males and 6 females) apparently healthy bears. Comparison between sexes revealed significant difference in PCV (P sloth bears for appropriate line treatment.

  10. Chemical Immobilization of Sloth Bears (Melursus ursinus with Ketamine Hydrochloride and Xylazine Hydrochloride: Hematology and Serum Biochemical Values

    Directory of Open Access Journals (Sweden)

    M. Veeraselvam

    2014-01-01

    Full Text Available The present study was conducted to define the physiological responses of captive sloth bears immobilized with ketamine hydrochloride and xylazine hydrochloride and to determine and compare the values of hematology and serum biochemical parameters between sexes. A total of 15 sloth bears were immobilized using combination of ketamine hydrochloride and xylazine hydrochloride drugs at the dose rate of 5.0 milligram (mg per kg body weight and 2.0 mg per kg body weight, respectively. The use of combination of these drugs was found satisfactory for the chemical immobilization of captive sloth bears. There were no significant differences observed in induction time and recovery time and physiological parameters such as heart rate, respiratory rate, and rectal temperature between sexes. Health related parameters comprising hematological values like packed cell volume (PCV, hemoglobin (Hb, red blood cell count (RBC, erythrocyte indices, and so forth and biochemical values like total protein, blood urea nitrogen (BUN, creatinine, alkaline amino-transferase (ALT, aspartate amino-transferase (AST, and so forth were estimated in 11 (5 males and 6 females apparently healthy bears. Comparison between sexes revealed significant difference in PCV (P<0.05 and mean corpuscular hemoglobin concentration (MCHC (P<0.05. The study might help to evaluate health profiles of sloth bears for appropriate line treatment.

  11. Impact of environmental chemicals, sociodemographic variables, depression, and clinical indicators of health and nutrition on self-reported health status

    Science.gov (United States)

    Public health researchers ideally integrate social, environmental, and clinical measures to identify predictors of poor health. Chemicals measured in human tissues are often evaluated in relation to intangible or rare health outcomes, or are studied one chemical at a time. Using ...

  12. A comparison of chemical and electrophoretic methods of serum protein determinations in clinically normal domestic animals of various ages.

    Science.gov (United States)

    Green, S A; Jenkins, S J; Clark, P A

    1982-10-01

    The biuret total protein method and a bromcresol green (BCG) albumin method were used on the Abbott ABA-100 chemistry analyzer to assay serum proteins in clinically normal cattle, sheep, ponies, pigs, and ducks. Total proteins were also read on a refractometer and mylar supported cellulose acetate electrophoresis was performed. Globulins and A/G ratios were calculated from the chemical method and the results compared with the electrophoretic method. Total protein, albumin and A/G ratios in the ponies, sheep and older cattle were in agreement between the two methods. The younger cattle and all the pigs had higher albumin levels and A/G ratios with the chemical BCG method. Ducks had slightly higher albumin values and A/G ratios with the electrophoretic method and the presence of pre-albumin was detected. Typical mylar supported cellulose acetate electrophoretic patterns are presented which show the excellent separation using these membranes. Means and range for normal animals are given and changes of proteins with age are discussed.

  13. Clinical Value of Hepatoma-Specific Alpha-Fetoprotein in the Diagnosis of Hepatocellular Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Runzhou Ni; Mingbing Xiao; Fei Jin; Cuihua Lu; Jiefei Huang; Xianyong Meng

    2006-01-01

    OBJECTIVE To study the clinical value of hepatoma-specific alpha-fetoprotein (HS-AFP) in the diagnosis and differential diagnosis of hepatocellular carcinoma (HCC).METHODS A method of vertical slab polyacrylamide gel electrophoresis with discontinuous buffer system was developed to separate AFP subtypes. After separation, the AFP subtypes were transferred to nitrocellulose and reacted first with rabbit anti-human AFP and then with goat anti-rabbit IgG-HRP. Finally, AFP subtypes were visualized by reacting with 3,3'-diaminobenzidine tetrahydrochloride. A HS-AFP band was determined in 82 cases with HCC and 95 cases with benign liver diseases.The correlations between the positive rates of HS-AFP and serum AFP concentration, tumor size as well as portal vein metastasis were analyzed.RESULTS Serum AFP in the cases with various liver diseases was separated into one to several bands. The fastest band on electrophoresis (FAFP) was found in all patients, while the band at the cathodal site (HSAFP) was detected predominantly in HCC but rarely in benign liver diseases. The positive rate of HS-AFP in HCC was 74.4%, which was significantly higher than that in benign liver diseases (9.1%, 7.3% and 10.0% in liver cirrhosis, chronic hepatitis and acute hepatitis respectively). HSAFP was detected in 3 out of 9 HCC cases with AFP<50 μg/L , but in none of 22 cases of benign liver diseases with the same AFP concentration. HS-AFP correlated with serum AFP concentration and tumor size to some extent, but not with portal vein metastasis.CONCLUSION HS-AFP increases the sensitivity of diagnosing HCC in patients with negative AFP, and is useful in distinguishing high AFP due to HCC from that caused by benign liver diseases.

  14. Clinical value analysis of routine ultrasound combined with endoscopic ultrasonography in judging ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Jing-Mei Tuo; Zhi-Hong Han

    2016-01-01

    Objective:To study the clinical value of routine ultrasound combined with endoscopic ultrasonography in judging ulcerative colitis.Methods: A total of 60 cases of patients with ulcerative colitis were collected as observation group of research and 60 cases of healthy volunteers were collected as control group of research. Intestinal wall thickness was detected by white light endoscopy, abdominal intestinal ultrasound and endoscopic ultrasonography; TNF-α, IL-1β, IL-4 and IL-10 contents were detected by Elisa kit; Th1, Th2, Th17 and Treg ratios were detected by flow cytometry.Results: (1) intestinal wall thickness: intestinal wall thickness of both active UC patients and quiescent UC patients was significantly higher than that of control group, intestinal wall thickness of active UC patients was significantly higher than that of quiescent UC patients and the higher the degree of activity, the higher the intestinal wall thickness; (2) inflammatory mediators: TNF-α and IL-1β contents in intestinal mucosa of active UC patients were higher than those of quiescent UC patients and positively correlated with intestinal wall thickness; IL-4 and IL-10 contents were lower than those of quiescent UC patients and negatively correlated with intestinal wall thickness; (3) T cell contents: Th1 and Th17 cell contents in intestinal mucosa of active UC patients were higher than those of quiescent UC patients and positively correlated with intestinal wall thickness; Th2 and Treg cell contents in intestinal mucosa of active UC patients were lower than those of quiescent UC patients and negatively correlated with intestinal wall thickness.Conclusion: Routine ultrasound combined with endoscopic ultrasonography can accurately determine the severity of ulcerative colitis; measured intestinal wall thickness is closely correlated with the degree of inflammation and abnormal immune response.

  15. Plasma globotriaosylsphingosine: diagnostic value and relation to clinical manifestations of Fabry disease.

    Science.gov (United States)

    Rombach, S M; Dekker, N; Bouwman, M G; Linthorst, G E; Zwinderman, A H; Wijburg, F A; Kuiper, S; Vd Bergh Weerman, M A; Groener, J E M; Poorthuis, B J; Hollak, C E M; Aerts, J M F G

    2010-09-01

    Fabry disease is an X-linked lysosomal storage disorder due to deficiency of alpha-Galactosidase A, causing accumulation of globotriaosylceramide and elevated plasma globotriaosylsphingosine (lysoGb3). The diagnostic value and clinical relevance of plasma lysoGb3 concentration was investigated. All male and adult female patients with classical Fabry disease could be discerned by an elevated plasma lysoGb3. In young pre-symptomatic Fabry heterozygotes, lysoGb3 levels can be normal. Individuals carrying the R112H and P60L mutations, without classical Fabry symptoms, showed no elevated plasma lysoGb3. Multiple regression analysis showed that there is no correlation of plasma lysoGb3 concentration with total disease severity score in Fabry males. However, plasma lysoGb3 concentration did correlate with white matter lesions (odds ratio: 6.1 per 100 nM lysoGb3 increase (95% CI: 1.4-25.9, p=0.015). In females, plasma lysoGb3 concentration correlated with overall disease severity. Furthermore, plasma lysoGb3 level was related to left ventricular mass (19.5+/-5.5 g increase per 10 nM lysoGb3 increase; p=0.001). In addition, it was assessed whether lifetime exposure to lysoGb3 correlates with disease manifestations. Male Fabry patients with a high lysoGb3 exposure (>10,000 U), were moderately or severely affected, only one mildly. Female patients with a low exposure (1000 U showed disease complications. Plasma lysoGb3 is useful for the diagnosis of Fabry disease. LysoGb3 is an independent risk factor for development of cerebrovascular white matter lesions in male patients and left ventricular hypertrophy in females. Disease severity correlates with exposure to plasma lysoGb3.

  16. CLINICAL VALUE OF ALARM SYMPTOMS IN DIAGNOSIS OF LOWER GASTROINTESTINAL DISEASES

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-bo; LIU Wen-zhong; GE Zhi-zheng; XIAO Shu-dong

    2006-01-01

    Objective To evaluate the clinical value of alarm symptoms in diagnosis of lower gastrointestinal diseases. Methods Data of consecutive autochthonous patients referred to the endoscopy center of Renji Hospital during the period of Oct. 2002 to Dec. 2003 were retrospectively analyzed. The prevalence of alarm symptoms in Shanghai patients with colorectal malignancies or other organic or functional lower gastrointestinal diseases was investigated. Results 83 (4. 9% ) cases of colorectal malignancies were found in 1681 patients referred to the center for colonoscopy because of lower gastrointestinal symptoms. All these malignancies were verified to be in the progressive stage. The prevalence of alarm symptoms was 81.9% (68/83). Hematochezia ( OR 4. 1, 95% CI 3.3-5.2, P<0.001) , melena (OR6.4, 95%CI3.7-11.0, P<0.001) and anemia (OR9.6, 95%CI3. 7-25. 0, P<0.001 ) were the most common and specific alarm symptoms. All the patients without alarm symptoms were above the age of 40 years. 264 (15.7%) cases of organic colorectal diseases other than malignancies and 1334 (79.4%) cases with no causal pathology identified were found in 1681 patients, and the prevalence of alarm symptoms in these two groups was 48. 5% (128/264) and 14. 8% (197/1334), respectively. Conclusion Alarm symptoms including hematochezia, melena, and anemia were useful in distinguishing organic from functional colorectal diseases in patients over 40 years old at the onset of symptoms. Furthermore, hematochezia, melena, anemia,severe weight loss, and abdominal mass were helpful in differentiating malignant from non-malignant colorectal diseases. Colonoscopy should be recommended for patients regardless of age with these alarm symptoms, and so do patients above the age of 40 years with no alarm symptoms before the diagnosis of functional diseases are made.

  17. Chemical composition and the nutritive value of pistachio epicarp (in situ degradation and in vitro gas production techniques

    Directory of Open Access Journals (Sweden)

    Somayeh Bakhshizadeh

    2014-04-01

    Full Text Available The nutritive value of pistachio epicarp (PE was evaluated by in situ and in vitro techniques. Chemical analysis indicated that PE was high in crude protein (11.30% and low in neutral detergent fiber (26.20%. Total phenols, total tannins, condensed tannins and hydrolysable tannins contents in PE were 8.29%, 4.48%, 0.49% and 3.79%, respectively. Ruminal dry matter and crude protein degradation after 48 hr incubation were 75.21% and 82.52%, respectively. The gas production volume at 48 hr for PE was 122.47 mL g-1DM. As a whole, adding polyethylene glycol (PEG to PE increased (p < 0.05 gas production volumes, organic matter digestibility and the metabolizable energy that illustrated inhibitory effect of phenolics on rumen microbial fermentation and the positive influence of PEG on digestion PE. The results showed that PE possessed potentials to being used as feed supplements.

  18. High-value chemicals obtained from selective photo-oxidation of glucose in the presence of nanostructured titanium photocatalysts.

    Science.gov (United States)

    Colmenares, Juan C; Magdziarz, Agnieszka; Bielejewska, Anna

    2011-12-01

    Glucose was oxidized in the presence of powdered TiO(2) photocatalysts synthesized by an ultrasound-promoted sol-gel method. The catalysts were more selective towards glucaric acid, gluconic acid and arabitol (total selectivity approx. 70%) than the most popular photocatalyst, Degussa P-25. The photocatalytic systems worked at mild reaction conditions: 30°C, atmospheric pressure and very short reaction time (e.g. 5 min). Such relatively good selectivity towards high-valued molecules are attributed to the physico-chemical properties (e.g. high specific surface area, nanostructured anatase phase, and visible light absorption) of novel TiO(2) materials and the reaction conditions. The TiO(2) photocatalysts have potential for water purification and energy production and for use in the pharmaceutical, food, perfume and fuel industries.

  19. Predicting Calcium Values for Gastrointestinal Bleeding Patients in Intensive Care Unit Using Clinical Variables and Fuzzy Modeling

    Directory of Open Access Journals (Sweden)

    G Khalili-Zadeh-Mahani

    2016-07-01

    Full Text Available Introduction: Reducing unnecessary laboratory tests is an essential issue in the Intensive Care Unit. One solution for this issue is to predict the value of a laboratory test to specify the necessity of ordering the tests. The aim of this paper was to propose a clinical decision support system for predicting laboratory tests values. Calcium laboratory tests of three categories of patients, including upper and lower gastrointestinal bleeding, and unspecified hemorrhage of gastrointestinal tract, have been selected as the case studies for this research. Method: In this research, the data have been collected from MIMIC-II database. For predicting calcium laboratory values, a Fuzzy Takagi-Sugeno model is used and the input variables of the model are heart rate and previous value of calcium laboratory test. Results: The results showed that the values of calcium laboratory test for the understudy patients were predictable with an acceptable accuracy. In average, the mean absolute errors of the system for the three categories of the patients are 0.27, 0.29, and 0.28, respectively. Conclusion: In this research, using fuzzy modeling and two variables of heart rate and previous calcium laboratory values, a clinical decision support system was proposed for predicting laboratory values of three categories of patients with gastrointestinal bleeding. Using these two clinical values as input variables, the obtained results were acceptable and showed the capability of the proposed system in predicting calcium laboratory values. For achieving better results, the impact of more input variables should be studied. Since, the proposed system predicts the laboratory values instead of just predicting the necessity of the laboratory tests; it was more generalized than previous studies. So, the proposed method let the specialists make the decision depending on the condition of each patient.

  20. The clinical value of enzyme-multiplied immunoassay technique monitoring the plasma concentrations of cyclosporine A a%The clinical value of enzyme-multiplied immunoassay technique monitoring the plasma concentrations of cyclosporine A aft

    Institute of Scientific and Technical Information of China (English)

    Xiao-Hui Luo; wu-Jun Xue; Pu-Xun Tian; Xiao-Ming Ding; Hang Yan; He-Li Xiang; Yang Li

    2011-01-01

    The feasibility and the clinical value of the enzyme-multiplied immunoassay technique (EMIT) monitoring of blood concentrations of cyclosporine A (CsA) in patients treated with CsA were investigated after kidney transplantation. The validation method was

  1. CHEMICALS

    CERN Multimedia

    Medical Service

    2002-01-01

    It is reminded that all persons who use chemicals must inform CERN's Chemistry Service (TIS-GS-GC) and the CERN Medical Service (TIS-ME). Information concerning their toxicity or other hazards as well as the necessary individual and collective protection measures will be provided by these two services. Users must be in possession of a material safety data sheet (MSDS) for each chemical used. These can be obtained by one of several means : the manufacturer of the chemical (legally obliged to supply an MSDS for each chemical delivered) ; CERN's Chemistry Service of the General Safety Group of TIS ; for chemicals and gases available in the CERN Stores the MSDS has been made available via EDH either in pdf format or else via a link to the supplier's web site. Training courses in chemical safety are available for registration via HR-TD. CERN Medical Service : TIS-ME :73186 or service.medical@cern.ch Chemistry Service : TIS-GS-GC : 78546

  2. Clinical value of measurement of pulmonary radioaerosol mucociliary clearance in the work up of primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Munkholm, Mathias; Nielsen, Kim Gjerum; Mortensen, Jann

    2015-01-01

    BACKGROUND: We aimed to evaluate and define the general clinical applicability and impact of pulmonary radioaerosol mucociliary clearance (PRMC) on the work up of patients suspected of having primary ciliary dyskinesia (PCD). In addition, we wanted to evaluate the accuracy of the reference values...... primarily to results from nasal ciliary function testing, to electron microscopic (EM) examination of the ultrastructure of the cilia, and to the final clinical diagnosis. RESULTS: Of the 239 patients, 27 ended up with a final clinical diagnosis of definitive PCD. No patients with a PRMC test...... that was normal or otherwise not consistent with PCD ended up with PCD as final clinical diagnosis (though a minority of patients in this group ended up unresolved in regard to PCD). Forty percent of patients with an abnormal PRMC test ended up with PCD as final clinical diagnosis. Furthermore, the PRMC test had...

  3. CLINICAL AND PROGNOSTIC VALUE OF INTERLEUKIN-12 IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    M. V. Zykov

    2011-01-01

    Full Text Available Abstract.  The  aim  of  present  study  was  to  evaluate  clinical  and  prognostic  value  of  various  inflammationmarkers  in  patients  after  Q-wave  myocardial  infarction  (MI.  Results:  Among  multiple  inflammation  factors  studied,  only  TNFα,  IL-12  and  CRP  levels  proved  to  be  significantly  increased  in  the  patients  with  multi-vesselcoronary  artery  disease,  as  compared  to  the  patients  with  single  coronary  lesions.  A  positive  correlation  was  revealed  between  the  levels  of  IL-12  and  IL-6  inflammation  markers,  and  severity  of  atherosclerotic  lesions  of  non-coronary  arteries  (brachiocephalic  vessels,  or  lower  limb  arteries.  Regression  analysis,  using  an  iterative  approach,    showed    that    patients’    age    of    ≥    53    years and  IL-12  levels  ≥  87.1  pg/ml  are  of  highest  predictive  value,    when    detecting    clinically    significant    coronary  lesions.    Meanwhile,    the    age    of    ≥    65    years    and    IL-  12  levels    exceeding    108.8    pg/ml    allow    of    detecting  haemodynamically    significant    non-coronary    lesions.  Acute    heart    failure    according    to    Killip    class    II    and  more,  and  IL-12  levels  over  90  pg/ml  have  been  verified  as    independent    variables    for    risk    stratification    of    any    cardiovascular  event  within  a  year  after  MI.  Hence,  among  all  studied  inflammatory  indexes,  IL-12  possesses  the  greatest  diagnostic  value  in  defining  patients  at  a  high  risk  for  severe  coronary  and  multifocal  atherosclerosis  and  subsequent  complications

  4. Natural background levels and threshold values of chemical species in three large-scale groundwater bodies in Northern Italy

    Energy Technology Data Exchange (ETDEWEB)

    Molinari, Antonio, E-mail: ant.molinari2002@libero.it [Politecnico di Milano, Dipartimento di Ingegneria Idraulica, Ambientale, Infrastrutture Viarie e Rilevamento, Piazza L. Da Vinci, 32-20133 Milano (Italy); Guadagnini, Laura [Politecnico di Milano, Dipartimento di Ingegneria Idraulica, Ambientale, Infrastrutture Viarie e Rilevamento, Piazza L. Da Vinci, 32-20133 Milano (Italy); Marcaccio, Marco [ARPA Emilia-Romagna, Direzione Tecnica, Largo Caduti del Lavoro, 6-40122 Bologna (Italy); Guadagnini, Alberto [Politecnico di Milano, Dipartimento di Ingegneria Idraulica, Ambientale, Infrastrutture Viarie e Rilevamento, Piazza L. Da Vinci, 32-20133 Milano (Italy)

    2012-05-15

    We analyze natural background levels (NBLs) and threshold values (TVs) of spatially distributed chemical species (NH{sub 4}, B and As) which may be a potential pressure and concern in three large scale alluvial and fluvio-deltaic aquifers at different depths of the Apennines and Po river plains in Emilia-Romagna, Northern Italy. Our results are based on statistical methodologies designed to separate the natural and anthropogenic contributions in monitored concentrations by modeling the empirical distribution of the detected concentration with a mixture of probability density functions. Available chemical observations are taken over a 20 years period and are associated with different depths and cover planar investigation scales of the order of hundreds of kilometers. High concentration values detected for NH{sub 4} and B appear to be related to high natural background levels. Due to interaction with the host rock in different geochemical environments we observed that concentration vary in time and space (including in depth) consistently with the hydrogeochemical features and the occurrence of natural attenuation mechanisms in the analyzed reservoirs. Conversely, estimated As NBLs are not consistent with the conceptual model of the hydrogeochemical behavior of the systems analyzed and experimental evidences of As content in aquifer cores. This is due to the inability of these techniques to incorporate the complex dynamics of the processes associated with the specific hydrogeochemical setting. Statistical analyses performed upon aggregating the concentration data according to different time observation windows allow identifying temporal dynamics of NBLs and TVs of target compounds within the observation time frame. Our results highlight the benefit of a dynamic monitoring process and analysis of well demarcated groundwater bodies to update the associated NBLs as a function of the temporal dependence of natural processes occurring in the subsurface. Monitoring

  5. Overall anatomical features and clinical value of the sacral nerve in high resolution computed tomography reconstruction

    Institute of Scientific and Technical Information of China (English)

    LIN Jing-fu; WANG Yan-hua; JIANG Bao-guo; ZHANG Pei-xun; LI Yan-ying; ZHANG Dian-ying

    2010-01-01

    Background Sacral nerve injury is a common complication of pelvic or sacral fractures. As the sacral nerve courser within the sacrum and has a complex relationship with the surrounding tissues, different parts of the sacral plexus injury have similar clinical symptoms and signs. Since lack of specific imaging technique in the diagnosis of sacral nerve injury,especially on multi-segment, multi-site, how to determine the preoperative location and extent of the sacral nerve injury accurately becomes a concem of the general orthopaedic and images practitioners. This study was conducted to gain an insight into the overall anatomical features of the sacral nerve (SN) on the same slice in high resolution computed tomography (HRCT) reconstruction and to determine the value of this information for the clinical diagnosis of related diseases.Methods Fifty healthy volunteers and 30 patients (40 sides) with SN lesions confirmed by surgery were scanned using a 16-slice helical CT scanner (Light Speed, GE, USA). Among the patients, 6 with intervertebral disk hernia (6 sides), 8with spinal stenosis (12 sides), 11 with pelvic trauma (14 sides), 4 with pelvic malignancies (6 sides), and 1 with sacral vertebral tuberculosis (2 sides). The SN multiplanar reconstruction was performed using a UNIX-based SCD4.1workstation where the image was set on the same slice. All images were stored in the Digital Imaging and Communications in Medicine format. The display of nerves in different sections was analyzed using a five-graded scale with coordinate curves of each individual score. The overall anatomic features visible on the slice were analyzed and the abnormalities of the lesions were studied.Results The image of the same slice clearly revealed the shape, running direction, thickness, tension and adjacent anatomy of the S1-S4 nerves. The rank of display rates in different sections was: outward-rotated oblique sagittal >outward-rotated oblique coronal > oblique coronal plane > coronal

  6. Clinical Value of Whole-body Magnetic Resonance Diffusion Weighted Imaging on Detection of Malignant Metastases

    Institute of Scientific and Technical Information of China (English)

    Cheng Li; Zhen-sheng Liu; Xian-mao Du; Ling He; Jian Chen; Wei Wang; Fei Sun; Fang Du; Zhi-gang Luo; Zhen-long Xue; Yi Zhao; Chang-wu Zhou

    2009-01-01

    To evaluate the value of whole-body diffusion weighted imaging (WB-DWI) on detection of malignant metastasis.Methods Forty-six patients with malignant tumors underwent WB-DWI examinations between April 2007 and August 2007 in our hospital. Before WB-DWI examination, the primary cancers of all the patients were confirmed by pathology, and the TNM-stage was assessed with conventional magnetic resonance imaging (MRI) or computed tomography (CT). WB-DWl was performed using short TI inversion recovery echo-planar imaging (STIR-EPI) sequence. Abnormal high signal intensities on WB-DWI were considered as metastases. The results of WB-DWI were compared with other imaging modalities. For the assessment of the diagnostic capability of WB-DWl, WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases, and with conventional MRI for demonstrating metastases in other locations.Results WB-DWI demonstrated 143 focuses, 14 of which were diagnosed to he benign lesions in routine imaging. The number of bone metastases depicted on WB-DWI and routine imaging was 85 and 86; lymph node metastases was 17 and 18; liver metastases was 14 and 14; lung metastases was 4 and 8; and brain metastases was 6 and 8, respectively. WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases, 4 lung metastases, 3 mediastinal lymph node metastases, and 2 brain metastases. Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone, all of which evolved greatly during clinical follow-up for more than 6 months. WB-DWI had higher detection rates for metastatic lesions in liver, bone, and lymph nodes than those in lung and brain (X2=30, P<0.001).Conclusions WB-DWI could detect most of metastatic lesions that were diagnosed with conventional MRI and CT. The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mediastinal lymph node, brain, and

  7. Recurrent renal cell carcinoma: clinical and prognostic value of FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Alongi, Pierpaolo; Picchio, Maria; Gianolli, Luigi [IRCCS San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); Zattoni, Fabio [University of Padua, Department of Oncological and Surgical Sciences, Urology Clinic, Padua (Italy); Spallino, Marianna [University of Milano-Bicocca, Milan (Italy); Saladini, Giorgio; Evangelista, Laura [Veneto Institute of Oncology IOV - IRCCS, Padua, Italy, Radiotherapy and Nuclear Medicine Unit, Padua (Italy)

    2016-03-15

    The purpose of our study was 1) to evaluate the diagnostic performance of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT), 2) to assess the impact of FDG PET/CT on treatment decision-making, and 3) to estimate the prognostic value of FDG PET/CT in the restaging process among patients with renal cell carcinoma (RCC). From the FDG PET/CT databases of San Raffaele Hospital in Milan, Italy, and the Veneto Institute of Oncology in Padua, Italy, we selected 104 patients with a certain diagnosis of RCC after surgery, and for whom at least 24 months of post-surgical FDG PET/CT, clinical, and instrumental follow-up data was available. The sensitivity and specificity of FDG PET/CT were assessed by histology and/or other imaging as standard of reference. Progression-free survival (PFS) and overall survival (OS) were computed using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used to identify predictors of outcome. FDG PET/CT resulted in a positive diagnosis in 58 patients and a negative diagnosis in 46 patients. Sensitivity and specificity were 74 % and 80 %, respectively. FDG PET/CT findings influenced therapeutic management in 45/104 cases (43 %). After a median follow-up period of 37 months (± standard deviation 12.9), 51 (49 %) patients had recurrence of disease, and 26 (25 %) had died. In analysis of OS, positive versus negative FDG PET/CT was associated with worse cumulative survival rates over a 5-year period (19 % vs. 69 %, respectively; p <0.05). Similarly, a positive FDG PET/CT correlated with a lower 3-year PFS rate. In addition, univariate and multivariate analysis revealed that a positive scan, alone or in combination with disease stage III-IV or nuclear grading 3-4, was associated with high risk of progression (multivariate analysis = hazard ratios [HRs] of 4.01, 3.7, and 2.8, respectively; all p < 0.05). FDG PET/CT is a valuable tool both in treatment decision-making and for

  8. Clinical uveitis evaluation and its value in the diagnosis of spondyloarthritis

    Directory of Open Access Journals (Sweden)

    Alla Aleksandrovna Godzenko

    2011-01-01

    Full Text Available Objective: to estimate the value of clinical parameters of uveitis for the diagnosis of spondyloarthritis (SA. Subjects and methods. One hundred and five uveitis patients referred by ophthalmologists to the Research Institute of Rheumatology, Russian Academy of Medical Sciences, in 2007–2009 were examined. X-ray study of the pelvis and lumbar spine, HLA-B27 test, and objective examination were performed in all the patients to detect inflammatory back pain, arthritis, and enthesitis. Results. The diagnosis of SA was verified in 60 patients: 24 had ankylosing spondylitis, 2 had reactive arthritis, and 38 had undifferentiat ed SA. The diagnosis of SA was discarded in 45 patients. Subsequent examination of these patients diagnosed BehНet's disease in 2 of them, sarcoidosis in 1, toxoplasmosis in 4, virus infection-associated uveitis in 8, Fuchs' syndrome in 1, and unspecified uveitis in 29. There was unilateral uveitis in 51 (85% of the 60 patients with SP and in 26 (58% of the 45 patients without SP (p = 0.0033; alternat ing eye lesion in 30 (50% of the 60 patients with SP and in 4 (8.9% of the 45 patients without SP (p = 0.00001; anterior uveitis in 57 (95% of the 60 patients with SP and in 32 of the 45 patients without SP (p = 0.0017; posterior uveitis in 6 (10% of the 60 patients with SP and in 20 (44% of the 45 patients without SP (p = 0.0001; panuveitis in 2 (3.3% of the 60 patients with SP and in 10 (22.2% of the 45 patients without SP (p = 0.0039, acute recurrent uveitis in 15 (33.3% of the 45 patients without SP and in 44 (73% of the 60 patients with SP (p = 0.0001. The age at onset was less than 30 years in 38 patients with SP and in 19 patients without SP (p = 0.04. Conclusion. The estimation of the location and course of uveitis is important in diagnosing SP that is probable in patients with acute anteri or unilateral uveitis with alternating eye lesion, which occurred before the age of 30 years.

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

    NARCIS (Netherlands)

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

    2002-01-01

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

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

    NARCIS (Netherlands)

    Hew, JM; Fock, JM; Kamps, WA

    2002-01-01

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

  11. The diagnostic value of xero-mammography in clinically occult breast carcinoma.

    Science.gov (United States)

    Kambouris, T; Kotoulas, K; Pontifex, G

    1984-05-01

    Seventy-four clinically occult breast carcinomas were detected in 7535 patients who were examined clinically and by xeromammography. The criteria by which a diagnosis of clinically occult breast carcinoma was established are described in detail. The most frequent finding of a clinically occult breast carcinoma in the xeromammogram was an irregular mass density 1 cm in diameter or less with microcalcifications. Axillary lymph node metastases were present in 29.7% of the total group of patients, which is much fewer than what might have been expected if the carcinomas had been discovered by palpation during the clinical examination or by the patient herself. This means a better prognosis and a lower death rate from breast carcinoma. Screening xeromammography is encouraged for all women after the age of 40, especially for those who belong to the high-risk group, even though they are quite asymptomatic, as there is hope of detecting cancers before they become palpable.

  12. Service quality and perceived value of technology-based service encounters: evaluation of clinical staff satisfaction in Taiwan.

    Science.gov (United States)

    Hung, Chung-Jye; Chang, Hsin Hsin; Eng, Cheng Joo; Wong, Kit Hong

    2013-01-01

    Previous research has evaluated technology-based service encounters (TBSEs) in the delivery of health care by assessing patient satisfaction. This study examined service quality and perceived value of TBSEs used in health organisations from the perspective of clinical staff, with staff technology readiness as a moderator. A quantitative survey was conducted in Taiwan, across private and public healthcare organisations. Results showed that TBSEs had a direct effect on service quality and perceived value, which in turn had a direct effect on staff satisfaction in using TBSEs. However, service quality had no effect on perceived value when moderated by technology readiness. Theoretical and managerial implications of these findings are discussed.

  13. Mathematical evaluation of the influence of multiple factors on implant stability quotient values in clinical practice : A retrospective study

    NARCIS (Netherlands)

    Huang, H.; Wismeijer, D.; Shao, X.; Wu, G.

    2016-01-01

    Objectives: The objective of this study is to mathematically evaluate the influence of multiple factors on implant stability quotient values in clinical practice. Patients and methods: Resonance frequency analysis was performed at T1 (measured immediately at the time of implant placement) and at T2

  14. The clinical application value of glycosylated hemoglobin(HbA1c) plus fasting plasma glucose in diagnosing diabetes

    Institute of Scientific and Technical Information of China (English)

    程多智

    2012-01-01

    Objective To evaluate clinical application value of HbA1c plus fasting plasma glucose(FPG) in diagnosing diabetes mellitus(DM).Methods 681 patients with DM were enrolled in this study. The level of HbA1c by Bio-RAD-10 glycated hemoglobin analyzer,FPG by OLYMPUS

  15. The Relationship between Clinical and Chemical Hyperandrogenism in 14-18-Years- Old Girls

    Directory of Open Access Journals (Sweden)

    Tahereh Naderi

    2012-04-01

    Full Text Available Background: One of the most common endocrine disorders in women's medicine is the increased androgen and the symptoms of increased androgens in women such as polycystic ovary syndrome. The two main components to diagnose this syndrome are menstrual disorder and clinical or laboratory hyperandrogenism, but other causes should be ruled out in order to confirm the diagnosis. This study aims to examine clinical Hyperandrogenism in female students of 14 to 18 years old in Shiraz in 2010.Materials and Methods: This cross-sectional study was conducted on 3200 female high school students of 14-18 years old in Shiraz. Data collection tools include questionnaires containing personal details, clinical Hyperandrogenism features (acne, alopecia and hirsutism based on Freeman-Galway scale and test results. The ultrasound was conducted based on Adams criteria. The data results are analyzed using SPSS-15 software and χ2 and t statistical tests.Results: : In this study, the frequency of hirsutism is 3.2%, prevalence of acne is 5% and alopecia is 4.2%. Mean of free testosterone (1.647±0.835 was higher in the group with hirsutism, acne and alopecia. Independent t-test showed no significant relationship between patients with hirsutism, acne and alopecia and non-affected people in terms of mean of total testosterone and free testosterone. However, there is a significant relationship between people with acne and hirsutism and polycystic ovary compared with those with acne and hirsutism and those without polycystic ovary (p >0.05..Conclusion: This study indicated that clinical and chemical hyperandrogenism can be a criterion to diagnose with polycystic ovary syndrome, but ultrasound was not helpful.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  17. Most oxidative stress response in water samples comes from unknown chemicals: the need for effect-based water quality trigger values.

    Science.gov (United States)

    Escher, Beate I; van Daele, Charlotte; Dutt, Mriga; Tang, Janet Y M; Altenburger, Rolf

    2013-07-02

    The induction of adaptive stress response pathways is an early and sensitive indicator of the presence of chemical and non-chemical stressors in cells. An important stress response is the Nrf-2 mediated oxidative stress response pathway where electrophilic chemicals or chemicals that cause the formation of reactive oxygen species initiate the production of antioxidants and metabolic detoxification enzymes. The AREc32 cell line is sensitive to chemicals inducing oxidative stress and has been previously applied for water quality monitoring of organic micropollutants and disinfection byproducts. Here we propose an algorithm for the derivation of effect-based water quality trigger values for this end point that is based on the combined effects of mixtures of regulated chemicals. Mixture experiments agreed with predictions by the mixture toxicity concept of concentration addition. The responses in the AREc32 and the concentrations of 269 individual chemicals were quantified in nine environmental samples, ranging from treated effluent, recycled water, stormwater to drinking water. The effects of the detected chemicals could explain less than 0.1% of the observed induction of the oxidative stress response in the sample, affirming the need to use effect-based trigger values that account for all chemicals present.

  18. Clinical value of FDG-PET/CT in suspected paraneoplastic syndromes

    DEFF Research Database (Denmark)

    Kristensen, Stine Bjørn; Hess, Søren; Petersen, Henrik

    2015-01-01

    examined the value of FDG-PET/CT for ruling in or out malignancy in a heterogeneous group of patients with suspected PNS. METHODS: We retrospectively extracted data from all patients referred 2009-2013 with suspected PNS. Data included age, sex, follow-up period, scan report, further diagnostic procedures...... true positives, 22 false positives, 103 true negatives, and three false negatives. Corresponding diagnostic values were: sensitivity 75 %, specificity 82 %, accuracy 82 %, and positive and negative predictive values of 29 % and 97 %, respectively. CONCLUSION: FDG-PET/CT has in patients with suspected...... PNS an impressively high negative predictive value and may be of value in ruling out PNS, the more so, the more the number of false positives can be minimized or used in differential diagnosis. We believe that FDG-PET/CT may become an important adjunct to the work-up and triage of patients...

  19. Costing nursing care: using the clinical care classification system to value nursing intervention in an acute-care setting.

    Science.gov (United States)

    Moss, Jacqueline; Saba, Virginia

    2011-08-01

    The purpose of this study was to combine an established methodology for coding nursing interventions and action types using the Clinical Care Classification System with a reliable formula (relative value units) to cost nursing services. Using a flat per-diem rate to cost nursing care greatly understates the actual costs and fails to address the high levels of variability within and across units. We observed nurses performing commonly executed nursing interventions and recorded these into an electronic database with corresponding Clinical Care Classification System codes. The duration of these observations was used to calculate intervention costs using relative value unit calculation formulas. The costs of the five most commonly executed interventions were nursing care coordination/manage-refer ($2.43), nursing status report/assess-monitor ($4.22), medication treatment/perform-direct ($6.33), physical examination/assess-monitor ($3.20), and universal precautions/perform-direct ($1.96). Future studies across a variety of nursing specialties and units are needed to validate the relative value unit for Clinical Care Classification System action types developed for use with the Clinical Care Classification System nursing interventions as a method to cost nursing care.

  20. Evaluation of the nutritional value of locally produced forage in Korea using chemical analysis and in vitro ruminal fermentation

    Science.gov (United States)

    Ki, Kwang Seok; Park, Su Bum; Lim, Dong Hyun; Seo, Seongwon

    2017-01-01

    Objective The use of locally produced forage (LPF) in cattle production has economic and environmental advantages over imported forage. The objective of this study was to characterize the nutritional value of LPF commonly used in Korea. Differences in ruminal fermentation characteristics were also examined for the LPF species commonly produced from two major production regions: Chungcheong and Jeolla. Methods Ten LPF (five from each of the two regions) and six of the most widely used imported forages originating from North America were obtained at least three times throughout a year. Each forage species was pooled and analyzed for nutrient content using detailed chemical analysis. Ruminal fermentation characteristics were also determined by in vitro anaerobic incubations using strained rumen fluid for 0, 3, 6, 12, 24, and 48 h. At each incubation time, total gas, pH, ammonia, volatile fatty acid (VFA) concentrations, and neutral detergent fiber digestibility were measured. By fitting an exponential model, gas production kinetics were obtained. Results Significant differences were found in the non-fiber carbohydrate (NFC) content among the forage species and the regions (pfermentation of LPF between the two regions and interactions between regions and forage species were also significant (pfermentation was lower in the forages from Chungcheong than from Jeolla (pfermentation was more active with the forages from Chungcheong than from Jeolla. Analysis of gas production profiles showed the rate of fermentation differed among forage species (pdigestion kinetics of LPF should be routinely employed to evaluate the correct nutritional value of LPF and to increase their use in the field. PMID:28002936

  1. Individualized Quality Control Plan (IQCP): Is It Value-Added for Clinical Microbiology?

    Science.gov (United States)

    Sharp, Susan E; Miller, Melissa B; Hindler, Janet

    2015-12-01

    The Center for Medicaid and Medicare Services (CMS) recently published their Individualized Quality Control Plan (IQCP [https://www.cms.gov/regulations-and-guidance/legislation/CLIA/Individualized_Quality_Control_Plan_IQCP.html]), which will be the only option for quality control (QC) starting in January 2016 if laboratories choose not to perform Clinical Laboratory Improvement Act (CLIA) [U.S. Statutes at Large 81(1967):533] default QC. Laboratories will no longer be able to use "equivalent QC" (EQC) or the Clinical and Laboratory Standards Institute (CLSI) standards alone for quality control of their microbiology systems. The implementation of IQCP in clinical microbiology laboratories will most certainly be an added burden, the benefits of which are currently unknown.

  2. Indispensable value of clinical trials in the modernization of traditional Chinese medicine: 12 years' experience at CUHK and future perspectives.

    Science.gov (United States)

    Liang, Willmann; Yew, David T; Hon, Kam Lun; Wong, Chun Kwok; Kwok, Timothy C Y; Leung, Ping Chung

    2014-01-01

    The last decade has seen a wealth of information reporting the beneficial effects of Chinese herbal medicines. While a lot more studies were done using in vitro and in vivo research platforms, much fewer investigations were conducted according to evidence-based requirements in clinical settings. The Institute of Chinese Medicine at the Chinese University of Hong Kong (CUHK) has had the opportunity to collaborate with clinicians over the years to initiate and conduct dozens of clinical trials investigating and verifying the therapeutic values of Chinese herbs in selected disease conditions. Of the many disorders, we chose to focus on those that are known for their difficulties achieving perfect results with conventional treatment methods. Examples include non-healing ulcers, allergic conditions, degenerative diseases and cancer. Protective effects of the herbs in such chronic diseases as coronary artery disease and osteoporosis were also part of our focus. Even in healthy individuals and those recovering from chemotherapy, Chinese herbs could help with the immune system and were studied in our clinical trials as well. This paper aims to highlight the important findings from these clinical studies while at the same time, stressing the indispensable value of clinical trials in modernizing the use of Chinese herbs in present-day medicine.

  3. The Predictive Value of Ultrasound Learning Curves Across Simulated and Clinical Settings

    DEFF Research Database (Denmark)

    Madsen, Mette E; Nørgaard, Lone N; Tabor, Ann

    2017-01-01

    OBJECTIVES: The aim of the study was to explore whether learning curves on a virtual-reality (VR) sonographic simulator can be used to predict subsequent learning curves on a physical mannequin and learning curves during clinical training. METHODS: Twenty midwives completed a simulation-based tra......OBJECTIVES: The aim of the study was to explore whether learning curves on a virtual-reality (VR) sonographic simulator can be used to predict subsequent learning curves on a physical mannequin and learning curves during clinical training. METHODS: Twenty midwives completed a simulation...

  4. Chemical compositions and nutritional value of Asian hard clam (Meretrix lusoria) from the coast of Andaman Sea.

    Science.gov (United States)

    Karnjanapratum, Supatra; Benjakul, Soottawat; Kishimura, Hideki; Tsai, Yung-Hsiang

    2013-12-15

    Chemical compositions and nutritive value of the edible portions including foot, mantle and viscera of Asian hard clam (Meretrix lusoria) harvested from the coast of Andaman Sea were determined. Proximate compositions varied with portions tested. Edible portions had moisture (76.23-84.22%) and protein (9.09-12.75%) as the major components. Carbohydrate (0.32-7.89%), fat (1.58-6.58%) and ash (1.23-2.58%) were also found at various levels, dependent upon portions. Myofibrillar proteins were observed as the major fraction in foot (40.54%) and mantle (31.65%), whilst non-protein nitrogen constituents were dominant in the viscera (36.85%). All portions contained a large amount of essential amino acids (167.66-187.63 mg/g sample), in which leucine (30.91-36.96 mg/g sample) and lysine (35.24-36.03 mg/g sample) were predominant. They were rich in polyunsaturated fatty acids (46.84-49.18% of total fatty acid) with high level of DHA (13.33-16.47 % of total fatty acids) and EPA (4.75-7.11% of total fatty acids). Cholesterol of 0.07-0.21% wet weight was detected. All portions were also rich in macro- (Na, K, Ca and Mg) and micro- (Fe, Zn, Cu and Cr) minerals. Therefore, Asian hard clam is an excellent source of several nutrients, which could be beneficial for the health of the consumers.

  5. Chemical composition and nutritive value of hot pepper seed (Capsicum annuum grown in Northeast Region of China

    Directory of Open Access Journals (Sweden)

    Yu ZOU

    2015-01-01

    Full Text Available Chemical composition and nutritive value of hot pepper seeds (Capsicum annuum grown in Northeast Region of China were investigated. The proximate analysis showed that moisture, ash, crude fat, crude protein and total dietary fiber contents were 4.48, 4.94, 23.65, 21.29 and 38.76 g/100 g, respectively. The main amino acids were glutamic acid and aspartic acid (above 2 g/100 g, followed by histidine, phenylalanine, lysine, arginine, cysteine, leucine, tryptophan, serine, glycine, methionine, threonine and tyrosine (0.8-2 g/100 g. The contents of proline, alanine, valine and isoleucine were less than 0.8 g/100 g. The fatty acid profile showed that linoleic acid, palmitic acid, oleic acid, stearic acid and linolenic acid (above 0.55 g/100 g as the most abundant fatty acids followed lauric acid, arachidic acid, gondoic acid and behenic acid (0.03-0.15 g/100 g. Analyses of mineral content indicated that the most abundant mineral was potassium, followed by magnesium, calcium, iron, zinc, sodium and manganese. The nutritional composition of hot pepper seeds suggested that they could be regarded as good sources of food ingredients and as new sources of edible oils.

  6. Chemical composition, in vitro gas production and energetic value of prickly pear fermented with and without Kluyveromyces marxianus

    Directory of Open Access Journals (Sweden)

    LESLIE BERUMEN

    2015-12-01

    Full Text Available The aim of this study was to characterize the chemical composition, in vitro gas production and energetic value of prickly pear during solid state fermentation (SSF with Kluyveromyces marxianus. Prickly pear was incubated in SSF at 28°C for 0, 24, 48, 72, 96 and 120 h without and inoculation with K. marxianus. The fermented cactus pear samples were dried at 55°C for 24 h, to determine the percent of dry matter (DM, crude protein (CP, neutral detergent fibre (NDF and acid detergent fibre (ADF. The volume of gas was recorded at 0, 3, 6, 9, 15, 24, 36, 48, 72 and 96 h and the parameters of in vitro gas production were obtained from the model: A= b*(1-e-c(t-L. In vitro gas production at 24 h was utilized for estimation of metabolizable energy (ME and short chain fatty acid (SCFA. Data were analyzed as a completely randomized design with a 2x6 factorial arrangement of treatments. The SSF in presence of K. marxianus increases the CP, maximum gas production (b, constant rate of gas production (c, ME and SCFA of prickly pear (P<0.05 but decreases NDF and ADF contents (P<0.05. We conclude that SSF with K. marxianus significantly improvement nutritional quality of prickly pear and may even promote animal performance.

  7. [The value of the triad: clinical examination, mammography and needle aspiration cytology in the diagnosis of breast carcinoma. Our experience].

    Science.gov (United States)

    Cipolla, C; Amato, C; Di Lisi, G; Graceffa, G; Cassano, T; Salanitro, L; Bajardi, G; De Simone, G F; Barberi, G; Tomasino, R M

    1990-11-01

    Based on the authors' personal experience of the use of the triad, clinical examination, mammography and needle-aspiration cytology, in the strategic diagnosis of breast cancer, the paper emphasizes the importance of early diagnosis as the sole means of obtaining an improved outcome. Using this integrated methodology the authors have obtained a specificity of 99%, sensitivity of 97.8%, and a diagnostic accuracy and prognostic value for positive tests of 98%. In conclusion, the authors affirm that the comparative interpretation of clinical examination, mammography and cytology appears to be an extremely efficacious and reliable method for the diagnosis of the nature of breast nodules.

  8. Clinical value of component-resolved diagnostics in peanut-allergic patients

    DEFF Research Database (Denmark)

    Eller, E; Bindslev-Jensen, C

    2013-01-01

    As replacement for the oral food challenge, decision-points for sensitization test have been established, but suboptimal sensitivity and/or specificity, as well as regional differences, have reduced the clinical usability. IgE toward specific peanut protein components has been reported to be of v...

  9. The clinical value of squamous cell carcinoma antigen in cancer of the uterine cervix

    NARCIS (Netherlands)

    de Bruijn, HWA; Duk, JM; van der Zee, AGJ; Pras, E; Willemse, PHB; Hollema, H; Mourits, MJE; de Vries, EGE; Aalders, JG; Boonstra, J.

    1998-01-01

    A review is given of the clinical use and interpretation of serum tumor marker levels during the treatment of patients with cancer of the uterine cervix, Pretreatment serum squamous cell carcinoma (SCC) antigen provides a new prognostic factor in early stage squamous cell carcinoma of the uterine ce

  10. The Value of Item Response Theory in Clinical Assessment: A Review

    Science.gov (United States)

    Thomas, Michael L.

    2011-01-01

    Item response theory (IRT) and related latent variable models represent modern psychometric theory, the successor to classical test theory in psychological assessment. Although IRT has become prevalent in the measurement of ability and achievement, its contributions to clinical domains have been less extensive. Applications of IRT to clinical…

  11. CLINICAL VALUE OF DETECTING T LYMPHOCYTE SUBSET AND NK CELL ACTIVITY IN PATIENTS WITH COLORECTAL CANCER

    Institute of Scientific and Technical Information of China (English)

    刘长安; 管增伟; 孙武; 邵玉霞; 李卓; 贾廷珍

    2001-01-01

    Objective To study on the expression and clinical significance of T lymphocyte subset and NK cell activity (NKA) in patients with colorectal cancer. Methods Fifty-seven cancer patients and 33 healthy controls were enrolled in this study. T lymphocyte subset was measured by SAP technique and NKA by LDH release assay based on K562 cells, which served as target cells.

  12. The value of the clinical impression in recognizing and treating sepsis patients in the emergency department

    NARCIS (Netherlands)

    van der Vegt, Anna Elizabeth; Holman, Mirjam; ter Maaten, Jan Cornelis

    2012-01-01

    Objectives Immediate bedside recognition of sepsis in the emergency department (ED) enables early treatment. This study aims to investigate whether the clinical impression score of different health care providers (a) is a good predictor of the severity of sepsis, (b) is mutually agreed, and (c) corr

  13. Radiographic aluminum equivalent value of bone : the development of a registration method and some clinical applications

    NARCIS (Netherlands)

    W.T. Trouerbach (Willem)

    1982-01-01

    textabstractThe aim of this thesis is to establish and develop a method suitable for obtaining an objective analysis of bone as registered on a radiographic image. This analysis concerns determination of the quantity of bone mineral present. The system has been tested in-vitro and in a clinical stud

  14. Oral squamous cell carcinoma and a clinically negative neck : the value of follow-up

    NARCIS (Netherlands)

    Wensing, Bart M; Merkx, Matthias A W; Krabbe, Paul F M; Marres, Henri A M; Van den Hoogen, Frank J A

    2011-01-01

    BACKGROUND: In squamous cell carcinoma of the oral cavity (SCCOC), regular follow-up comprises 5 years of prescheduled visits, irrespective of tumor stage/classification and/or treatment. We analyzed our standard treatment and follow-up protocol in patients with a preoperative clinically negative ne

  15. Oral squamous cell carcinoma and a clinically negative neck: the value of follow-up

    NARCIS (Netherlands)

    Wensing, B.M.; Merkx, M.A.W.; Krabbe, P.F.M.; Marres, H.A.M.; Hoogen, F.J.A. van den

    2011-01-01

    BACKGROUND: In squamous cell carcinoma of the oral cavity (SCCOC), regular follow-up comprises 5 years of prescheduled visits, irrespective of tumor stage/classification and/or treatment. We analyzed our standard treatment and follow-up protocol in patients with a preoperative clinically negative ne

  16. Extension of normal values on sensory function for facial areas using clinical tests on touch and two-point discrimination.

    Science.gov (United States)

    Vriens, J P M; van der Glas, H W

    2009-11-01

    The threshold value of a sensory test provides a numerical measure of the sensory function. In order to decide whether a threshold value from an affected site indicates 'abnormal' sensory function, it can be compared with normal values from a healthy control population. The aim of this study was to extend current information on normal values for static light touch and static two-point discrimination for facial sites. Using simple hand-held devices, 95% upper limits of confidence intervals of threshold values were determined for facial sites other than those studied previously and for a large sample of 100 healthy subjects. The MacKinnon-Dellon Disk-Criminator and the Aesthesiometer were used to measure novel normal values of two-point discrimination. As threshold values for two-point discrimination from the Aesthesiometer were similar to those obtained using the Disk-Criminator, the use of the Aesthesiometer might not be indicated. Apart from the Pressure Specified Sensory Device (a device with pressure control), Semmes-Weinstein nylon monofilaments and the Disk-Criminator are useful devices for studying sensory function, in particular under clinical test conditions in which easy and fast application are advantageous.

  17. Analyzing Patients’ Values by Applying Cluster Analysis and LRFM Model in a Pediatric Dental Clinic in Taiwan

    Directory of Open Access Journals (Sweden)

    Hsin-Hung Wu

    2014-01-01

    Full Text Available This study combines cluster analysis and LRFM (length, recency, frequency, and monetary model in a pediatric dental clinic in Taiwan to analyze patients’ values. A two-stage approach by self-organizing maps and K-means method is applied to segment 1,462 patients into twelve clusters. The average values of L, R, and F excluding monetary covered by national health insurance program are computed for each cluster. In addition, customer value matrix is used to analyze customer values of twelve clusters in terms of frequency and monetary. Customer relationship matrix considering length and recency is also applied to classify different types of customers from these twelve clusters. The results show that three clusters can be classified into loyal patients with L, R, and F values greater than the respective average L, R, and F values, while three clusters can be viewed as lost patients without any variable above the average values of L, R, and F. When different types of patients are identified, marketing strategies can be designed to meet different patients’ needs.

  18. Effects of Volunteering and Responsibility on the Perceived Value and Effectiveness of a Clinical Treatment

    Science.gov (United States)

    Gordon, Robert M.

    1976-01-01

    Both volunteer and nonvolunteer subjects were randomly assigned to one of two conditions. In the choice condition, subjects were led to believe that they had a choice, and in the second condition subjects were denied the choice of treatment. Volunteer subjects who were given a choice significantly valued the treatment more. (Author)

  19. Assessment of dual tasking has no clinical value for fall prediction in Parkinson's disease

    NARCIS (Netherlands)

    Smulders, K.; Esselink, R.A.J.; Weiss, A.; Kessels, R.P.C.; Geurts, A.C.H.; Bloem, B.R.

    2012-01-01

    The objective of this study is to investigate the value of dual-task performance for the prediction of falls inpatients with Parkinson's disease (PD). Two hundred sixty three patients with PD (H&Y 1-3, 65.2 +/- 7.9 years)walked two times along a 10-m trajectory, both under single-task and dual-task

  20. What is the clinical value of cancer stem cell markers in gliomas?

    DEFF Research Database (Denmark)

    Dahlrot, Rikke Hedegaard; Hermansen, Simon Kjær; Hansen, Steinbjørn

    2013-01-01

    . This review summarizes current reports on putative glioma CSC markers and reviews the prognostic value of the individual immunohistochemical markers reported in the literature. Using the Pubmed database, twenty-seven CSC studies looking at membrane markers (CD133, podoplanin, CD15, and A2B5), filament markers...

  1. Value of ovarian reserve testing before IVF: a clinical decision analysis

    NARCIS (Netherlands)

    B.W. Mol; T.E.M. Verhagen; D.J. Hendriks; J.A. Collins; A. Coomarasamy; B.C. Opmeer; F.J. Broekmans

    2006-01-01

    BACKGROUND: To assess the value of testing for ovarian reserve prior to a first cycle IVF incorporating patient and doctor valuation of mismatches between test results and treatment outcome. METHODS: A decision model was developed for couples who were considering participation in an IVF programme. T

  2. Clinical value of HIV-1 matched detection in patients’ blood and cerebrospinal fluid

    Directory of Open Access Journals (Sweden)

    E. V. Stepanova

    2013-01-01

    Full Text Available A comparative investigation has been applied to 100 HIV infected patients with CD4 lymphocytes rate <350 cells/microliter, demanding HAART prescription, divided into two groups: 1 – without clinical features of CNS damage (54 people and 2 – with features of CNS damage of various etiology (46 people. HIV viral load (VL indices in blood plasma and cerebrospinal fluid (CSF have been examined. 45,7% of damages are caused with mixed infections. CSF HIV VL level with the 2 group patients is 7,6 times as high as that of 1 group patients. HIV VL in plasma is considerably higher than in CSF. Eight patients showed increased CSF HIV VL. Brain damages of various etiology with clinical implications violate hematoencephalic barrier integrity, contribute to HIV accumulation in CSF and intensify virus replication in brain tissue. It has been concluded that CSF examination for HIV is expedient.

  3. Bile acid malabsorption in patients with chronic diarrhoea: clinical value of SeHCAT test

    DEFF Research Database (Denmark)

    Wildt, Signe; Nørby Rasmussen, S; Madsen, Jan Lysgård;

    2003-01-01

    BACKGROUND: Bile acid malabsorption (BAM), a cause of chronic diarrhoea, can be diagnosed by the SeHCAT test. The purpose of this study was to evaluate the usefulness of SeHCAT testing by assessing the extent of BAM and describing the clinical characteristics in a group of patients with chronic...... diarrhoea. Clinical outcome after treatment with cholestyramine was also evaluated. METHODS: During a 5-year period (1997-2001) the SeHCAT test was performed in 135 patients in whom a primary programme for diagnostic evaluation of chronic diarrhoea had not revealed a cause. File data from 133 patients could...... as a second-line investigation with a high diagnostic yield. The only a priori parameter to predict BAM was the existence of ileocaecal resections. The result of the SeHCAT test seems to predict the benefit of treatment with cholestyramine....

  4. Clinical value and influencing factors of intraoperative monitoring of jugular venous oxygen saturation

    Directory of Open Access Journals (Sweden)

    Jie SONG

    2016-10-01

    Full Text Available Intraoperative jugular venous oxygen saturation (SjvO2 monitoring has been widely used in clinic, which can monitor cerebral blood flow (CBF and oxygen metabolism. Reverse puncture and catheterization through jugular vein for monitoring SjvO2 is easy to operate and can collect blood samples repeatedly. It is an effective method for real-time dynamic evaluation of cerebral oxygen supply-demand and neurological function. This article reviews the clinical significance and influencing factors of SjvO2 monitoring during operation. It notes in particular that SjvO2 can not be used as the only way to monitor CBF and oxygen metabolism, and a comprehensive evaluation should be done combining with the change of other parameters. DOI: 10.3969/j.issn.1672-6731.2016.10.014

  5. [Cancer screening in clinical practice: the value of shared decision-making].

    Science.gov (United States)

    Cornuz, Jacques; Junod, Noëlle; Pasche, Olivier; Guessous, Idris

    2010-07-14

    Shared decision-making approach to uncertain clinical situations such as cancer screening seems more appropriate than ever. Shared decision making can be defined as an interactive process where physician and patient share all the stages of the decision making process. For patients who wish to be implicated in the management of their health conditions, physicians might express difficulty to do so. Use of patient decision aids appears to improve such process of shared decision making.

  6. Antibodies to autoantigen targets in myasthenia and their value in clinical practice

    Directory of Open Access Journals (Sweden)

    S. I. Dedaev

    2014-01-01

    Full Text Available Myasthenia gravis is a classic autoimmune disease, which clinical manifestations in the form of weakness and abnormal muscle fatigue, due to the damaging effect of polyclonal antibodies to different structures of the neuromuscular synapse and muscles. The study of autoimmune substrate with myasthenia is routine in many clinics dealing with the problems of neuromuscular pathology, and the identification of high concentration of serum antibodies to a number of antigenic structures is the gold standard in diagnosis.Determination of serum antibodies to various autoimmune targets is an important tool in clinical practice. The majority of patients shows the high concentration of antibodies to AchR that gives the opportunity to use it as an important diagnostic criterion. The specificity of changes in the concentration of AchR-antibodies due to pathogenetic treatment allows to objectify the suppression of autoimmune aggression and evaluate the reliability of remission. However, the absence of AchR-antibodies when there are clear clinical and electromyography signs of myasthenia gravis suggests an autoimmune attack against a number of other targets, the most studied of which is the MuSK. On the contrary, patients with myasthenia gravis associated with thymoma, almost always have a higher level of AchR-antibodies. The presence of thymoma is accompanied by the generation of antibodies to titin and RyR, which is also observed in persons with late-onset myasthenia without thymoma. High concentration of antibodies to these structures can be interpreted as a reliable sign of thymoma in patients younger than 60 years.

  7. Clinical values dataset processing through cluster analysis to find cardiovascular risk

    Science.gov (United States)

    Bucci, C. M.; Legnani, W. E.; Armentano, R. L.

    2016-04-01

    The scope of this work is to show another way to grouping population with clinical variables measured in health centres and to assign a cardiovascular risk indicator. To do this, two different datasets were used, one coming from France and another coming from Uruguay. The well proved Framingham index was used to validate the results. The preliminary results are very auspicious to encourage the research and get deeper knowledge of the cardiovascular risk indicators.

  8. The added value of ordinal analysis in clinical trials: An example in traumatic brain injury

    OpenAIRE

    Roozenbeek, Bob; Perel, Pablo; Edwards, Phil; Roberts, Ian; Murray, Gordon; Maas, Andrew; Steyerberg, Ewout

    2011-01-01

    textabstractIntroduction: In clinical trials, ordinal outcome measures are often dichotomized into two categories. In traumatic brain injury (TBI) the 5-point Glasgow outcome scale (GOS) is collapsed into unfavourable versus favourable outcome. Simulation studies have shown that exploiting the ordinal nature of the GOS increases chances of detecting treatment effects. The objective of this study is to quantify the benefits of ordinal analysis in the real-life situation of a large TBI trial.Me...

  9. The Value of Clinical Needs Assessments for Point-of-Care Diagnostics.

    Science.gov (United States)

    Weigl, Bernhard H; Gaydos, Charlotte A; Kost, Gerald; Beyette, Fred R; Sabourin, Stephanie; Rompalo, Anne; de Los Santos, Tala; McMullan, Jason T; Haller, John

    2012-06-01

    Most entrepreneurial ventures fail long before the core technology can be brought to the marketplace because of disconnects in performance and usability measures such as accuracy, cost, complexity, assay stability, and time requirements between technology developers' specifications and needs of the end-users. By going through a clinical needs assessment (CNA) process, developers will gain vital information and a clear focus that will help minimize the risks associated with the development of new technologies available for use within the health care system. This article summarizes best practices of the principal investigators of the National Institute of Biomedical Imaging and Bioengineering point-of-care (POC) centers within the National Institute of Biomedical Imaging and Bioengineering POC Technologies Research Network. Clinical needs assessments are particularly important for product development areas that do not sufficiently benefit from traditional market research, such as grant-funded research and development, new product lines using cutting-edge technologies developed in start-up companies, and products developed through product development partnerships for low-resource settings. The objectives of this article were to (1) highlight the importance of CNAs for development of POC devices, (2) discuss methods applied by POC Technologies Research Network for assessing clinical needs, and (3) provide a road map for future CNAs.

  10. Effects of Ramadan Fasting on Spirometric Values and Clinical Symptoms in Asthmatic Patients

    Directory of Open Access Journals (Sweden)

    Abdolreza Norouzy

    2013-07-01

    Full Text Available Introduction: Ramadan is the 9th Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset. The effect of Ramadan intermittent fasting on asthma control is controversial. The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study. The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting. Among spirometric variables, only peak expiratory flow improved after Ramadan (p <0.05. There was a reduction in the mean peak expiratory flow variability from 13% at the first week of fasting to 10% at the fourth week (p <0.05. Conclusion: In well-controlled asthmatic patients, Ramadan fasting resulted in improvement in peak expiratory flow and peak expiratory flow variability.

  11. Effects of Ramadan fasting on spirometric values and clinical symptoms in asthmatic patients

    Directory of Open Access Journals (Sweden)

    Abdolreza Norouzy

    2013-03-01

    Full Text Available Introduction: Ramadan is the 9th  Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset.  The effect of Ramadan intermittent fasting on asthma control is controversial.  The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study.  The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting.  Among spirometric variables, only peak expiratory flow improved after Ramadan (p

  12. [Biofunctional symmetry of individual values of clinic-laboratory indices in patients, suffering severe forms of an acute pancreatitis].

    Science.gov (United States)

    Sipliv'iĭ, V A; Kon', K V; Robak, B I; Evtushenko, A V

    2012-02-01

    Individual values of clinic-laboratory indices were analyzed in 125 patients, suffering severe forms of an acute pancreatitis (AP). In the early postoperative period there were analyzed 65 indices: clinical analysis of the blood, 24 hematological indices, biochemical analysis of the blood, coagulogram, estimates according to the ASSES, APACHE II, SAPS, SAPS II, SAPS III scales. There was established, that in 83.1% of patients in severe forms of an AP the ratio or the values difference of clinic-laboratory indices in dynamics of postoperative period are depicted according to the "Golden section" rule with deviation no more than 10-15%. In the patients, suffering sterile pancreonecrosis, in comparison with those, suffering infected pancreonecrosis and in the patients with infected pancreonecrosis without retroperitoneal space cellular tissue affection in comparison with patients, suffering infected pancreonecrosis and the retroperitoneal space cellular tissue affection there were more signs, the values ratio or difference of which have deviated from the "Golden section" rule no more than by 5%. While estimating the patients state severity in those, suffering severe forms of AP, using special scales, most precisely the coincidence with a "Golden section" rule was noted, according to scales ASSES and SAPS III. Prognostically unfavorable was a progressive increase of the points sum according to ASSES scale in dynamics of postoperative period.

  13. Chemical composition and nutritive value of four varieties of cassava leaves grown in South-Western Nigeria.

    Science.gov (United States)

    Oni, A O; Onwuka, C F I; Arigbede, O M; Anele, U Y; Oduguwa, O O; Onifade, O S; Tan, Z L

    2011-10-01

    The nutritive value of leaves of four varieties of cassava - MS 6, TMS 30555, Idileruwa and TMS 30572 was evaluated based on their chemical composition and in vitro fermentation. Crude protein (CP) contents of cassava leaves ranged from 177 to 240 g/kg dry matter (DM), with TMS 30555 showing the highest CP contents. Neutral detergent fibre (NDFom) and acid detergent fibre (ADFom) contents of cassava leaves ranged from 596 to 662 and 418 to 546 g/kg DM respectively. Condensed tannin (CT) and hydrocyanic acid contents ranged from 1.0 to 3.8 g/kg and 58.5 to 86.7 mg/kg DM respectively. The range of volatile fatty acids (VFA) in the supernatant after in vitro incubation of the cassava varieties was: acetate (14.7-31.5 mmol/l); propionate (4.5-6.3 mmol/l); butyrate (3.1-3.9 mmol/l); valerate (0.4-0.6 mmol/l); iso-butyrate (0.6-1.3 mmol/l); iso-valerate (1.1-1.9 mmol/l). The acetate:propionate ratio resulting from fermentation of TMS 30555 was higher(p leaves. The highest in vitro gas production of 50.5 ml/200 mg DM was recorded for MS6 being higher (p cassava leaves were positively correlated with gas production, while CT content was negatively correlated with gas production. The study showed that leaves of the varieties MS 6 and TMS 30555 are superior to the others in terms of CP and gas production indicating a higher digestibility and energy content and thus nutritive potential. They may therefore serve as supplements for ruminants fed on poor roughages.

  14. A prospective, clinical study on asymptomatic sensitisation and development of allergic rhinitis: high negative predictive value of allergological testing

    DEFF Research Database (Denmark)

    Bodtger, Uffe; Assing, Kristian; Poulsen, Lars K

    2011-01-01

    populations, conferring bias towards higher incidence rates. Objective: The aim was to determine the incidence of onset of symptoms among clinically well-characterised asymptomatic, sensitised subjects compared with controls, and to evaluate the predictive values of common allergological tests. Methods: We...... an annual incidence rate of 5% for the onset of symptoms in the AS group (healthy control group 0%). At baseline, the AS group displayed intermediate experimental allergen susceptibility. Subjects developing symptoms had higher levels of specific IgE and larger late-phase reaction than those persistently...... asymptomatic. However, the positive predictive values were low (14-27%) in contrast to the negative predictive values (95-100%). Conclusion: In a well-characterised young population, asymptomatic aeroallergen sensitisation conferred a low risk for onset of symptoms during the 2-year follow-up. Persistent...

  15. A clinical study of temporomandibular disorder. The value of bone scintigraphy as an aid to diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Sugiura, Masashi [Nippon Dental Univ. (Japan). School of Dentistry at Niigata

    2000-07-01

    Temporomandibular disorder (TMD) is still not defined with respect to the point of an entity, terminological problems, and clinical classification and gradings. Moreover, diagnostic problems of internal deranegement and osteodeformity at the temporomandibular joint such as type IV and mechanism of bone remodeling at condylar head are also still not clear. In this investigation, we tried to classify the severity and progressive grading according to the symptoms and objective laboratory data taken from soft tissues such as muscles related to mastication, discs and ligaments, and hard tissues such as condylar head and temporal bone changes around the temporomandibular joint. Preliminary diagnostic clinical tool of the assessment of temporomandibular joint by maens of bone scintigraphy was attributed to the additional diagnostic procedure and research for the bone remodeling for the temporomandibular disorder because this can be defined between subjective and objective symptoms in this disorder. Bone scintigraphy will solve many problems concerning undefined degenerative bone changes in TMD, enable more accurate diagnosis, and the selection of treatment and prognosis in future investigation. Also, it is believed single photon emission computed tomography (SPECT) nuclear bone imaging is a highly accurate diagnostic method for craniomandibular disorders. (author)

  16. Value of MRI in patients with a clinical suspicion of acute myocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Yelgec, N. Selcuk; Dymarkowski, Steven; Ganame, Javier; Bogaert, Jan [Gasthuisberg University Hospital, Department of Radiology, Leuven (Belgium)

    2007-09-15

    The diagnosis of myocarditis is difficult and is generally one of exclusion. Moreover, endomyocardial biopsy (EMB) is not a sensitive technique. Magnetic resonance imaging (MRI), however, has shown promising results in diagnosing myocarditis. We evaluated 20 patients with a clinical suspicion of acute myocarditis. Troponin I levels were elevated in 17/20 patients. Cardiac catheterization (n = 13) showed no evidence of coronary artery disease, while normal findings were reported in all five patients who underwent EMB. MRI performed 9.8 {+-} 7.5 days after the onset of symptoms showed an LV-EDV of 172 {+-} 50 ml and LV-EF of 57 {+-} 10%. Abnormalities on delayed contrast-enhanced MRI were found in 15/20 patients, involving 3.7 {+-} 2.1 segments using the 17-segment model. The lateral LV wall was most frequently involved (61% of enhanced segments). The enhancement was most frequently subepicardial, less often transmural, or midwall (respectively, 67%, 22%, and 11% of enhanced segments). Mild to moderate systolic wall motion abnormalities were invariably found in the abnormally enhancing myocardium on MRI. Associated pericardial effusion was found in six, pericardial enhancement in nine patients. In conclusion, the present study suggests an important role for MRI in evaluating patients with clinical suspicion of acute myocarditis. Not only can the myocardial damage be precisely depicted but also concomitant involvement of the pericardium and impact on regional and global ventricular function can be assessed. (orig.)

  17. Evaluating the Value of Augmenting In Vitro Hazard Assessment with Exposure and Pharmacokinetics Considerations for Chemical Prioritization

    Science.gov (United States)

    Over time, toxicity-testing paradigms have progressed from low-throughput in vivo animal studies for limited numbers of chemicals to high-throughput (HT) in vitro screening assays for thousands of chemicals. Such HT in vitro methods, along with HT in silico predictions of popula...

  18. Doctor and patient’s relationship at the present time and value of the clinical method

    Directory of Open Access Journals (Sweden)

    Orlando Cruz Martínez

    2010-12-01

    Full Text Available The history of mankind is not only made of the relationships and conflicts among men: the struggle to survive is also part of it and the hardest and most persistent of all has been men’s fight against diseases. The emergence of medical activity is inextricably linked to the development of human relationships. In fact, it is precisely the capacity of establishing relationships with others what identifies and distinguishes man from other biological beings. The recognition of the values of the doctor-patient relationship and its psychological moment is gnoseologically attached to the recognition of the values of the integral vision of man. That is why the Hippocratic school, constantly insisting that man is not only the physical aspect, but an inseparable whole with the psychic aspect and emphasizing on the importance of the environment and the doctor-patient relationship constitutes a milestone in the development of medicine. Over the centuries much has been learned and even more has been written about this unique kind of human relationship that causes everyday a renewed interest not only for medicine but also for many adjacent disciplines, as a sign of its decisive importance and the socio-historical conditions that determine it.

  19. Clinical value of prostate segmentation and volume determination on MRI in benign prostatic hyperplasia.

    Science.gov (United States)

    Garvey, Brian; Türkbey, Barış; Truong, Hong; Bernardo, Marcelino; Periaswamy, Senthil; Choyke, Peter L

    2014-01-01

    Benign prostatic hyperplasia (BPH) is a nonmalignant pathological enlargement of the prostate, which occurs primarily in the transitional zone. BPH is highly prevalent and is a major cause of lower urinary tract symptoms in aging males, although there is no direct relationship between prostate volume and symptom severity. The progression of BPH can be quantified by measuring the volumes of the whole prostate and its zones, based on image segmentation on magnetic resonance imaging. Prostate volume determination via segmentation is a useful measure for patients undergoing therapy for BPH. However, prostate segmentation is not widely used due to the excessive time required for even experts to manually map the margins of the prostate. Here, we review and compare new methods of prostate volume segmentation using both manual and automated methods, including the ellipsoid formula, manual planimetry, and semiautomated and fully automated segmentation approaches. We highlight the utility of prostate segmentation in the clinical context of assessing BPH.

  20. [THE COMPARATIVE ANALYSIS OF INFORMATION VALUE OF MAIN CLINICAL CRITERIA USED TO DIAGNOSE OF BACTERIAL VAGINOSIS].

    Science.gov (United States)

    Tsvetkova, A V; Murtazina, Z A; Markusheva, T V; Mavzutov, A R

    2015-05-01

    The bacterial vaginosis is one of the most frequent causes of women visiting gynecologist. The diagnostics of bacterial vaginosis is predominantly based on Amsel criteria (1983). Nowadays, the objectivity of these criteria is disputed more often. The analysis of excretion of mucous membranes of posterolateral fornix of vagina was applied to 640 women with clinical diagnosis bacterial vaginosis. The application of light microscopy to mounts of excretion confirmed in laboratory way the diagnosis of bacterial vaginosis in 100 (15.63%) women. The complaints of burning and unpleasant smell and the Amsel criterion of detection of "key cells" against the background of pH > 4.5 were established as statistically significant for bacterial vaginosis. According study data, the occurrence of excretions has no statistical reliable obligation for differentiation of bacterial vaginosis form other inflammatory pathological conditions of female reproductive sphere. At the same time, detection of "key cells" in mount reliably correlated with bacterial vaginosis.

  1. Clinical Value of Molecular Biological Methods in Respiratory Tuberculosis in Children

    Institute of Scientific and Technical Information of China (English)

    Ulia Ovchinnikova; Anna Starshinova; Irina Dovgalyuk; Natalia Kornev; Viacheslav Zhuravlev

    2014-01-01

    The pattern of clinical forms of respiratory tuberculosis in children shows a preponderance of intrathoracic lymph node tuberculosis (89.4%) that is characterized by a complicated process in every third child under present-day conditions. Positive result of PCR closely correlates with the severity and extent of the specific process in children. Real-time PCR (RT-PCR) was ascertain to exhibit the highest sensitivity in detecting Mycobacterium tuberculosis DNA in children with primary generalized tuberculosis (62.5%) and in those with a disseminated specific process (55.6%), which was much higher than conventional bacteriological study of diagnostic materials. By taking into account the findings, the RT-PCR detection of M. tuberculosis was considered as a substantial criterion for evaluating the magnitude of specific changes and the degree of tuberculosis infection activity in children.

  2. Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    Jun-Ying Xiang; Qin Ouyang; Guo-Dong Li; Nan-Ping Xiao

    2008-01-01

    AIM:To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis (UC).METHODS: The enzyme-linked immunosorbent assay(ELISA) was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), acid glycoprotein (AGP) were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria.RESULTS: The fecal calprotectin concentration in the patients with active UC was significantly higher than that in the inactive UC and in the controls (402.16±48.0 μg/g vs 35.93±3.39 μg/g, 11.5±3.42 μg/g, P < 0.01). The fecal calprotectin concentration in the inactive UC group was significantly higher than that in the control group (P < 0.05). A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics (AUCROC) was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP,respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC (r = 0.866, P < 0.001).CONCLUSION: Calprotectin in the patient's feces can reflect the disease activity of UC and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonly-used markers such as CRP, ESR and AGR.

  3. Biomass valorisation by staged degasification A new pyrolysis-based thermochemical conversion option to produce value-added chemicals from lignocellulosic biomass

    NARCIS (Netherlands)

    de Wild, P. J.; den Uil, H.; Reith, J. H.; Kiel, J. H. A.; Heeres, H. J.

    2009-01-01

    Pyrolysis of lignocellulosic biomass leads to an array Of useful solid, liquid and gaseous products. Staged degasification is a pyrolysis-based conversion route to generate value-added chemicals from biomass. Because of different thermal stabilities of the main biomass constituents hemicellulose. ce

  4. Clinical Value of 99Tcm-MDP SPECT Bone Scintigraphy in the Diagnosis of Unilateral Condylar Hyperplasia

    Directory of Open Access Journals (Sweden)

    Bing Wen

    2014-01-01

    Full Text Available Purpose. To investigate the clinical value of 99Tcm-MDP SPECT for the diagnosis of unilateral condylar hyperplasia (UCH. Methods. One hundred forty-nine patients who underwent mandibular 99Tcm-MDP SPECT between January 2009 and December 2012 were studied, including 105 cases that were clinically suspected of UCH and 44 comparable cases without UCH as a control group. Results. Increased bone activity was observed in the affected condyles for all UCH patients. In the UCH group, the relative percentage uptake on the affected side was 59% (SD±4.3%, significantly higher than the 41% (SD±4.1% uptake on the contralateral side (P<0.001. Similarly, the condyle/skull ratio was significantly higher for the affected side (1.66±0.63 than for the contralateral side (1.34±0.34, P<0.01. No significant difference was found in the control group between the left and right condyles. Values for the sensitivity (95%, specificity (61%, positive (84.4% and negative (84.6% predictive values, and accuracy (84.5% for 99Tcm-MDP SPECT in the diagnosis of UCH were calculated. However, for the hyperplastic condyle, no correlation was observed between the thickness of each cartilage layer and the relative uptake in the SPECT image. Conclusion. 99Tcm-MDP SPECT is accurate for diagnosing UCH and can provide a reference for treatment options.

  5. Exploring green catalysts for production of biofuels and value added chemicals for renewable and sustainable energy future

    Science.gov (United States)

    Budhi, Sridhar

    Porous silica have attracted significant attention in the past few decades due to their unique textural properties. They were extensively investigated for applications in catalysis, separation, environmental remediation and drug delivery. We have investigated the porous metal incorporated silica in the synthetic as well as catalytic perspectives. The synthesis of metal incorporated mesoporous silica via co-condensation such as SBA-15, KIT-5 are still challenging as it involves acidic synthetic route. Synthesis in high acidity conditions affects the incorporation of metal in silica due to high dissolution of metal precursors and breaking of metal oxygen and silica bond. The research presented here demonstrates an efficient way to incorporate metals by addition of diammonium hydrogen phosphate along with metal precursor during the synthesis. The incorporation efficiency has increased 2-3 times with this approach. Catalytic studies were performed to support our hypothesis. Such synthesized molybdenum incorporated mesoporous silica were investigated as catalyst for fast pyrolysis. When molydenum incorporated in silica was used as catalyst for fast pyrolysis of pine, it selectively produced furans (furan, methylfuran and dimethylfuran). Furans are considered value-added chemicals and can be used as a blendstock for diesel/jet grade fuel. The catalyst was very stable to harsh pyrolysis conditions and had a longer life before deactivation when compared with traditional zeolites. Further, this catalyst did not produce aromatic hydrocarbons in significant yields unlike zeolites. The origin of the furans was determined to be biopolymer cellulose and the selectivity for furans are attributed to low catalyst acidity. The effect of silica to alumina ratio (SAR) of beta-zeolite was investigated ranging to elucidate the relationship between the of number of acid sites on product speciation and catalyst deactivation on catalysts supplied by Johnson Matthey. The catalyst with low

  6. Top Value-Added Chemicals from Biomass - Volume II—Results of Screening for Potential Candidates from Biorefinery Lignin

    Energy Technology Data Exchange (ETDEWEB)

    Holladay, John E.; White, James F.; Bozell, Joseph J.; Johnson, David

    2007-10-01

    This report evaluates lignin’s role as a renewable raw material resource. Opportunities that arise from utilizing lignin fit into one of three categories: 1)power, fuel and syngas (generally near-term opportunities) 2) macromolecules (generally medium-term opportunities) 3) aromatics and miscellaneous monomers (long-term opportunities). Biorefineries will receive and process massive amounts of lignin. For this reason, how lignin can be best used to support the economic health of the biorefinery must be defined. An approach that only considers process heat would be shortsighted. Higher value products present economic opportunities and the potential to significantly increase the amount of liquid transportation fuel available from biomass. In this analysis a list of potential uses of lignin was compiled and sorted into “product types” which are broad classifications (listed above as power—fuel—syngas; macromolecules; and aromatics). In the first “product type” (power—fuel—gasification) lignin is used purely as a carbon source and aggressive means are employed to break down its polymeric structure. In the second “product type” (macromolecules) the opposite extreme is considered and advantage of the macromolecular structure imparted by nature is retained in high-molecular weight applications. The third “product type” (aromatics) lies somewhere between the two extremes and employs technologies that would break up lignin’s macromolecular structure but maintain the aromatic nature of the building block molecules. The individual opportunities were evaluated based on their technical difficulty, market, market risk, building block utility, and whether a pure material or a mixture would be produced. Unlike the “Sugars Top 10” report it was difficult to identify the ten best opportunities, however, the potential opportunities fell nicely into near-, medium- and long-term opportunities. Furthermore, the near-, medium- and long-term opportunities

  7. Assessing the Value of an Optional Radiation Oncology Clinical Rotation During the Core Clerkships in Medical School

    Energy Technology Data Exchange (ETDEWEB)

    Zaorsky, Nicholas G.; Malatesta, Theresa M.; Den, Robert B.; Wuthrick, Evan; Ahn, Peter H.; Werner-Wasik, Maria; Shi, Wenyin; Dicker, Adam P.; Anne, P. Rani; Bar-Ad, Voichita [Department of Radiation Oncology, Jefferson Medical College, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States); Showalter, Timothy N., E-mail: timothy.showalter@jeffersonhospital.org [Department of Radiation Oncology, Jefferson Medical College, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)

    2012-07-15

    Purpose: Few medical students are given proper clinical training in oncology, much less radiation oncology. We attempted to assess the value of adding a radiation oncology clinical rotation to the medical school curriculum. Methods and Materials: In July 2010, Jefferson Medical College began to offer a 3-week radiation oncology rotation as an elective course for third-year medical students during the core surgical clerkship. During 2010 to 2012, 52 medical students chose to enroll in this rotation. The rotation included outpatient clinics, inpatient consults, didactic sessions, and case-based presentations by the students. Tests of students' knowledge of radiation oncology were administered anonymously before and after the rotation to evaluate the educational effectiveness of the rotation. Students and radiation oncology faculty were given surveys to assess feedback about the rotation. Results: The students' prerotation test scores had an average of 64% (95% confidence interval [CI], 61-66%). The postrotation test scores improved to an average of 82% (95% CI, 80-83%; 18% absolute improvement). In examination question analysis, scores improved in clinical oncology from 63% to 79%, in radiobiology from 70% to 77%, and in medical physics from 62% to 88%. Improvements in all sections but radiobiology were statistically significant. Students rated the usefulness of the rotation as 8.1 (scale 1-9; 95% CI, 7.3-9.0), their understanding of radiation oncology as a result of the rotation as 8.8 (95% CI, 8.5-9.1), and their recommendation of the rotation to a classmate as 8.2 (95% CI, 7.6-9.0). Conclusions: Integrating a radiation oncology clinical rotation into the medical school curriculum improves student knowledge of radiation oncology, including aspects of clinical oncology, radiobiology, and medical physics. The rotation is appreciated by both students and faculty.

  8. Value of the free light chain analysis in the clinical evaluation of response in multiple myeloma patients receiving anti-myeloma therapy

    DEFF Research Database (Denmark)

    Toftmann Hansen, Charlotte; Pedersen, Per T.; Jensen, Bo Amdi;

    Value of the free light chain analysis in the clinical evaluation of response in multiple myeloma patients receiving anti-myeloma therapy.......Value of the free light chain analysis in the clinical evaluation of response in multiple myeloma patients receiving anti-myeloma therapy....

  9. Clinical value of MRI and acute madopar responsiveness test in diagnosing progressive supranuclear palsy

    Directory of Open Access Journals (Sweden)

    LI Xiao-hong

    2013-07-01

    Full Text Available Objective To investigate the MRI abnormalities and acute madopar responsiveness test in diagnosing progressive supranuclear palsy (PSP and Parkinson's disease (PD. Methods Seventeen patients with PSP and 17 gender and age matched patients with PD were studied with cranial MRI examinations and results of acute madopar responsiveness test, and the clinical manifestations of PSP were summarized. Results The atrophy of the midbrain tegmentum and hummingbird sign was demonstrated in all of the PSP patients in our study, but was not observed in the PD patients. The areas of the midbrain on mid-sagittal MRI in PSP patients [(77.35 ± 15.30 mm2] were significantly smaller than that in those with PD [(142.35 ± 31.49 mm2]. The average ratio of the area of the midbrain to the area of pons in the patients with PSP [(14.31 ± 2.47%] was significantly smaller than that in those with PD [(24.08 ± 4.73%; P = 0.000, for all]. According to the result of acute madopar responsiveness test, the maximum Unified Parkinson's Disease Rating Scale (UPDRS Ⅲ improvement rate of 2 patients with PSP and 16 patients with PD was more than 30% (χ2 = 23.142, P = 0.000. Conclusion The assessment of the mid-sagittal MRI and acute madopar responsiveness test may be a useful method to differentiate PSP from PD.

  10. Detection and clinical value of NMO-IgG in neuromyelitis optica

    Directory of Open Access Journals (Sweden)

    De-hui HUANG

    2014-09-01

    Full Text Available Neuromyelitis optica (NMO is an inflammatory demyelinating disease of the central nervous system (CNS of autoimmune etiology which predominantly affects the optic nerves and spinal cord. In 2004, a highly specific serum antibody, NMO-IgG, was found in the sera of NMO patients. Subsequently, the target antigen of NMO-IgG was identified as aquaporin 4 (AQP4, a water channel densely expressed in optic nerves, spinal cord and area around cerebral ventricles. NMO-IgG/AQP4 antibody has demonstrated extreme importance for the diagnosis and differential diagnosis, the evaluation of disease activity, therapeutic effect and prognosis of NMO. In recent years, different techniques have been used to examine NMO-IgG in serum and cerebrospinal fluid, including tissue-based, cell-based and protein-based assays. In this review, the authors give an overview of the tests currently available for the detection of NMO-IgG and their clinical significance. doi: 10.3969/j.issn.1672-6731.2014.09.003

  11. Retinal vein occlusion and macular edema – critical evaluation of the clinical value of ranibizumab

    Directory of Open Access Journals (Sweden)

    Keane PA

    2011-06-01

    Full Text Available Pearse A Keane1, Srinivas R Sadda21NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; 2Doheny Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USAAbstract: Retinal vein occlusions (RVOs constitute the second most common cause of retinal vascular disease after diabetic retinopathy, with a prevalence of between 1% and 2% in persons older than 40 years of age. Despite the existence of numerous potential therapeutic options, none is entirely satisfactory, and many patients with RVO suffer irreversible visual loss. Fortunately however, the recent introduction of antivascular endothelial growth factor (VEGF agents, such as ranibizumab (Lucentis®, Genentech, South San Francisco, CA and bevacizumab (Avastin®, Genentech, offers a potentially new treatment approach for clinicians managing this disorder. The results of the BRAVO and CRUISE trials have provided the first definitive evidence for the efficacy and safety of ranibizumab in the treatment of RVO. As a result, ranibizumab has recently been approved by the US Food and Drug Administration for the treatment of RVO-associated macular edema. In this review, we provide a critical evaluation of clinical trial data for the safety and efficacy of ranibizumab, and address unresolved issues in the management of this disorder. Keywords: ranibizumab, retinal vein occlusion, vascular endothelial growth factor, macular edema

  12. The study of clinical value of repetitive transcranial magnetic stimulation combined with dutoxetine for patients with generalized anxiety disorder

    Institute of Scientific and Technical Information of China (English)

    Ji-Dong Ren

    2016-01-01

    Objective:To analyze the clinical value of repetitive transcranial magnetic stimulation (RTMS) combined with dutoxetine for patients with generalized anxiety disorder (GAD).Methods:A total of 180 cases of patients with GAD were randomly divided into two groups (the control group and the observation group) with 90 cases each group. Patients in control group were treated with dutoxetine, while those in observation group were treated by dutoxetine combined with RTMS. The Hamilton anxiety scale and the clinical global impression scale were used to evaluate the efficacy of both groups before and after treatment, then the characteristics of mismatch negativity and P300 were detected by using brain evoked potential, and meanwhile, plasma cortisol, brain derived neurotrophic factor and homocysteine levels were detected and compared too.Results:Analysis of variance of repeated measure data showed that the main effect of time, main effect between groups and interaction effect of Hamilton anxiety scale and the clinical global impression scale scores, MMN incubation period, MMN amplitude, target N2 incubation period, target P3 incubation period, P2 non-target amplitude, levels of plasma cortisol, brain derived neurotrophic factor and homocysteine of both groups were statistically significant (P < 0.05).Conclusions:The treatment of RTMS combined with dutoxetine for patients with GAD has a faster and better curative effect, which is worthy of clinical promotion.

  13. Overview of Chronic Oral Toxicity Values for Chemicals Present in Hydraulic Fracturing Fluids, Flowback and Produced Waters

    Science.gov (United States)

    as part of EPA's Hydraulic Fracturing Drinking Water Assessment, EPA is summarizing existing toxicity data for chemicals reported to be used in hydraulic fracturing fluids and/or found in flowback or produced waters from hydraulically fractured wells

  14. Developing clinical practice guidelines: types of evidence and outcomes; values and economics, synthesis, grading, and presentation and deriving recommendations.

    Science.gov (United States)

    Woolf, Steven; Schünemann, Holger J; Eccles, Martin P; Grimshaw, Jeremy M; Shekelle, Paul

    2012-07-04

    Clinical practice guidelines are one of the foundations of efforts to improve healthcare. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearinghouses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this second paper, we discuss issues of identifying and synthesizing evidence: deciding what type of evidence and outcomes to include in guidelines; integrating values into a guideline; incorporating economic considerations; synthesis, grading, and presentation of evidence; and moving from evidence to recommendations.

  15. Clinical Values of Studying Kidney Elasticity with Virtual Touch Quantification in Gestational Hypertension Patients.

    Science.gov (United States)

    Wang, Yi; Feng, Yujin; Yang, Xiaoyun; Zhang, Liyan; Zhang, Tongdi; Wang, Wengang

    2016-02-07

    BACKGROUND The aim of this study was to investigate the differences in shear wave velocity (SWV) in renal cortex, renal medulla, and renal sinuses between gestational hypertension and normal pregnant women. MATERIAL AND METHODS Ninety patients with gestational hypertension and 30 women with normal pregnancy were enrolled in this study. Kidney biopsy was performed within 6 weeks to 3 months postpartum to determine the pathological nature of renal injury. According to the classification criteria for gestational hypertension, the patients were divided into 3 groups. Gestational hypertension only patients were classified as Group A; patients with mild preeclampsia as group B; patients with severe preeclampsia as group C; normal pregnant women as a control group. Virtual Touch Quantification technique was used to measure renal shear wave velocity; blood pressure, urine analysis, and renal function were also tested. RESULTS There was no difference in renal function between patients in group A and the control group (p>0.05), but there was a significant difference in renal function among patients in group A, B, and C, and there was a significant difference in renal function between patients in group B and C versus control (pkidney injury, the smaller the SWV value.

  16. Clinical value of renal injury biomarkers in diagnosis of chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Cheng-lu ZHANG

    2011-12-01

    Full Text Available Objective To investigate the levels of renal injury biomarkers in patients with chronic kidney disease(CKD and evaluate their clinical significances in diagnosis of CKD.Methods A total of 66 subjects(37 patients with CKD and 29 healthy individuals were involved in this study.Serum blood urea nitrogen(SBUN was determined by Glutamate dehydrogenase method;serum creatinine(SCr and urinary creatinine(UCr were detected by sarcosine oxidase method;serum uric acid(SUA was measured by uricase colorimetry;serum cystatin C(Cys C and urinary microalbumin(UmAlbwere analyzed by immunological transmission turbidimetry;urinary protein(U-PROwas measured by Coomassies Brilliant Blue(CBB assay.The UmAlb and U-PRO levels were expressed in units of mg/mmolUCr.Results The results of independent samples t test indicated that significant differences were found in SBUN,SCr,SUA,Cys C,UmAlb and U-PRO(P < 0.05 between patient group and healthy control group.The evaluation of diagnostic effects showed that the areas under the curve at ROC plot for SBUN,SCr,SUA,Cys C,UmAlb and U-PRO were 0.907,0.912,0.742,0.982,0.984 and 0.991,respectively.Conclusions U-PRO,UmAlb and Cys C are ideal biomarkers,SCr and SBUN come next,SUA is the weakest when the above biomarkers are applied to evaluate the renal injury and its severity of the patients with CKD.

  17. Clinical and operational value of the extensively drug-resistant tuberculosis definition.

    Science.gov (United States)

    Migliori, G B; Besozzi, G; Girardi, E; Kliiman, K; Lange, C; Toungoussova, O S; Ferrara, G; Cirillo, D M; Gori, A; Matteelli, A; Spanevello, A; Codecasa, L R; Raviglione, M C

    2007-10-01

    Currently, no information is available on the effect of resistance/susceptibility to first-line drugs different from isoniazid and rifampicin in determining the outcome of extensively drug-resistant tuberculosis (XDR-TB) patients, and whether being XDR-TB is a more accurate indicator of poor clinical outcome than being resistant to all first-line anti-tuberculosis (TB) drugs. To investigate this issue, a large series of multidrug-resistant TB (MDR-TB) and XDR-TB cases diagnosed in Estonia, Germany, Italy and the Russian Federation during the period 1999-2006 were analysed. Drug-susceptibility testing for first- and second-line anti-TB drugs, quality assurance and treatment delivery was performed according to World Health Organization recommendations in all study sites. Out of 4,583 culture-positive TB cases analysed, 361 (7.9%) were MDR and 64 (1.4%) were XDR. XDR-TB cases had a relative risk (RR) of 1.58 to have an unfavourable outcome compared with MDR-TB cases resistant to all first-line drugs (isoniazid, rifampicin ethambutol, streptomycin and, when tested, pyrazinamide), and an RR of 2.61 compared with "other" MDR-TB cases (those susceptible to at least one first-line anti-TB drug among ethambutol, pyrazinamide and streptomycin, regardless of resistance to the second-line drugs not defining XDR-TB). The emergence of extensively drug-resistant tuberculosis confirms that problems in tuberculosis management are still present in Europe. While waiting for new tools which will facilitate management of extensively drug-resistant tuberculosis, accessibility to quality diagnostic and treatment services should be urgently ensured and adequate public health policies should be rapidly implemented to prevent further development of drug resistance.

  18. Clinical Value of the Assessment of Changes in MEP Duration with Voluntary Contraction.

    Science.gov (United States)

    Brum, Marisa; Cabib, Christopher; Valls-Solé, Josep

    2015-01-01

    Transcranial magnetic stimulation (TMS) gives rise to muscle responses, known as motor evoked potentials (MEP), through activation of the motor pathways. Voluntary contraction causes facilitation of MEPs, which consists of shortening MEP latency, increasing MEP amplitude and widening MEP duration. While an increase in excitability of alpha motorneurons and the corticospinal tract can easily explain latency shortening and amplitude increase, other mechanisms have to be accounted for to explain the increase in duration. We measured the increase in duration of the MEP during contraction with respect to rest in a group of healthy volunteers and retrospectively assessed this parameter in patients who were examined in a standardized fashion during the past 5 years. We included 25 healthy subjects, 21 patients with multiple sclerosis, 33 patients with acute stroke, 5 patients with hereditary spastic paraparesis, and 5 patients with signs suggesting psychogenic paresis. We found already significant differences among groups in the MEP duration at rest, patients with MS had a significantly longer duration, and patients with stroke had significantly shorter duration, than the other two groups. The increase in MEP duration during voluntary contraction was different in patients and in healthy subjects. It was significantly shorter in MS and significantly longer in stroke patients. It was absent in the five patients with suspected psychogenic weakness. In patients with HSP, an abnormally increase in duration occurred only in leg muscles. Our results suggest that the increase in duration of the MEP during contraction may reveal the contribution of propriospinal interneurons to the activation of alpha motorneurons. This mechanism may be altered in some diseases and, therefore, the assessment proposed in this work may have clinical applicability for the differential diagnosis of weakness.

  19. Clinical value of the assessment of changes in MEP duration with voluntary contraction

    Directory of Open Access Journals (Sweden)

    Josep eValls-Sole

    2016-01-01

    Full Text Available Transcranial magnetic stimulation (TMS gives rise to muscle responses, known as motor evoked potentials (MEP, through activation of the motor pathways. Voluntary contraction causes facilitation of MEPs, which consists of shortening MEP latency, increasing MEP amplitude and widening MEP duration. While an increase in excitability of alpha motorneurons and the corticospinal tract can easily explain latency shortening and amplitude increase, other mechanisms have to be accounted for to explain the increase in duration. We measured the extent of the increase in duration that adds at the end of the MEP during contraction with respect to rest in a group of healthy volunteers and retrospectively assessed this parameter in patients who were examined in a standardized fashion during the past 5 years. We included 25 healthy subjects, 21 patients with multiple sclerosis, 33 patients with acute stroke, 5 patients with hereditary spastic paraparesis and 5 patients with signs suggesting psychogenic paresis. We found already significant differences among groups in the MEP duration at rest, patients with MS had a significantly longer duration, and patients with stroke had significantly shorter duration, than the other two groups. The increase in MEP duration during voluntary contraction was different in patients and in healthy subjects. It was significantly shorter in MS and significantly longer in stroke patients. It was absent in the 5 patients with suspected psychogenic weakness. In patients with HSP, an abnormally increase in duration occurred only in leg muscles. Our results suggest that the increase in duration of the MEP during contraction may reveal the contribution of propriospinal interneurons to the activation of alpha motorneurons. This mechanism may be altered in some diseases and, therefore, the assessment proposed in this work may have clinical applicability for the differential diagnosis of weakness.

  20. Whether western normative laboratory values used for clinical diagnosis are applicable to Indian population? An overview on reference interval.

    Science.gov (United States)

    Malati, T

    2009-04-01

    Reference Intervals denote normative values related to laboratory parameters/analytes used by diagnostic centers for clinical diagnosis. International guidelines recommend that every country must establish reference intervals for healthy individuals belonging to a group of homogeneous population. Considering enormous racial and ethnic diversity of Indian population, it is mandatory to establish reference intervals specific to Indian population. The overview on reference interval describes why the national organizations in India need to initiate nationwide efforts to establish its own laboratory standards for apparently healthy reference individuals belonging to our polygenetic, polyethnic, polyracial, multilinguistic and multicultural predominantly rural and appreciable urban Indian population with varied dietary habits.

  1. Six easy steps on how to create a lean sigma value stream map for a multidisciplinary clinical operation.

    Science.gov (United States)

    Lee, Emily; Grooms, Richard; Mamidala, Soumya; Nagy, Paul

    2014-12-01

    Value stream mapping (VSM) is a very useful technique to visualize and quantify the complex workflows often seen in clinical environments. VSM brings together multidisciplinary teams to identify parts of processes, collect data, and develop interventional ideas. An example involving pediatric MRI with general anesthesia VSM is outlined. As the process progresses, the map shows a large delay between the fax referral and the date of the scheduled and registered appointment. Ideas for improved efficiency and metrics were identified to measure improvement within a 6-month period, and an intervention package was developed for the department.

  2. Clinical value of determination HIV viral load in the cerebrospinal fluid of HIV-infected patients

    Directory of Open Access Journals (Sweden)

    V. B. Musatov

    2015-01-01

    Full Text Available Aim. To analyze the concentration of HIV RNA in the cerebrospinal fluid and to evaluate its significance in the pathology of the central nervous system among HIV infected persons.Materials: We examined 36 patients with HIV infection with signs of pathology of the central nervous system. All patients was done completed a standard investigation of cerebrospinal fluid, cytological examination and detection viral load of HIV in the cerebrospinal fluid and serum.Results. A different of opportunistic and HIV-related disease was diagnosed in 29 patients. The most frequent pathology of the nervous system (12 cases is a diffuse HIV-associated brain damage occurring in 7 patients in the form of aseptic non purulent meningitis and in 5 patients in the form of encephalitis. The average value of the absolute and relative count of CD4-lymphocytes in patients amounted 147,0 cells/μl (40,0; 408,75 and 10.0% (4,00; 18,50. Pathological changes in cellular composition and protein concentration of cerebrospinal fluid detected in 19 cases. Replication of HIV in the cerebrospinal fluid are detected in 31 of 32 patients not receiving antiretroviral therapy, including 17 patients with normal values of cerebrospinal fluid. The average HIV viral load in the cerebrospinal fluid was 15 133,0 copies/ml (2501,0; 30624,0 or 4,18 (3,35; 4,48 lg HIV RNA, average HIV viral load in serum – 62 784,0 copies/ml (6027,5; 173869,0 or 4,80 4,80 (3,7; 5,2 lg HIV RNA. The concentration of HIV in the cerebrospinal fluid was significantly lower than in serum (4,18 and 4,80 lg HIV RNA, p=0.027. 4 patients with severe, multietiology damage of the central nervous system viral, microbial and fungal etiology, there was an inverse relationship between the concentration of HIV in the cerebrospinal fluid and in serum, the concentrations of HIV was higher in the cerebrospinal fluid.Conclusion: Among the majority of HIV-infected patients with signs of the central

  3. Penicillin hypersensitivity: value of clinical history and skin testing in daily practice.

    Science.gov (United States)

    Kalogeromitros, Dimitrios; Rigopoulos, Dimitrios; Gregoriou, Stamatios; Papaioannou, Dimitrios; Mousatou, Vassiliki; Katsarou-Katsari, Alexandra

    2004-01-01

    Penicillin often is excluded as a treatment option based on patients' self-reported history of an adverse reaction to penicillin. The objective of this prospective study was to determine the likelihood of true penicillin allergy in patients with vague and convincing histories of penicillin allergy and to evaluate the diagnostic value added by appropriate skin testing. Six hundred thirty-eight patients with prior beta-lactam intake had a current indication for penicillin therapy and were referred for testing with the major (benzylpenicilloyl polylysine) and minor (minor determinant mixture) penicillin determinants from the inpatient and outpatient service of Athens University Dermatological hospital from January 2000 to December 2002. The prevalence of positive skin tests in the total group and in those patients with vague and convincing histories of penicillin allergy was determined. Positive skin tests were observed in 19/638 (3%) of the total group, 5 out of 542 (0.9%) patients without any history of penicillin allergy, 14 out of 96 (14.6%) patients with vague history (confidence interval [CI] 95% = 5.95-59.92), and 13 out of 18 (72.2%) patients with a convincing history of type I hypersensitivity reaction (chi2 = 286.3: odds ratio = 281.3: CI 95% = 62.19-1440.8). Patients with a vague history of penicillin allergy are 18 times more likely to have a positive penicillin skin test, and a convincing reaction history increases the likelihood by 281-fold compared with patients without a history of penicillin allergy. However, the fact that 5 of 18 (27.8%) patients with a convincing history were negative when skin tested points out that skin testing is helpful if the need for penicillin administration is compelling.

  4. The clinical and pathogenetic value of Foxp3+ T regulatory cells in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    A. S. Avdeeva

    2016-01-01

    Full Text Available T regulatory cells (Tregs play a key role in the immune system due to the suppression of a hyperimmune response to autoantigens and opportunistic enteric microorganisms. In recent years, there has been evidence that Tregs can suppress various immunoinflammatory responses to a wide range of physiological and pathological stimuli, including microorganisms, tumor cells, allogeneic grafts, and fetal cells.Tregs express a broad spectrum of membrane molecules that determine their functional activity and make it possible to identify these cells; however, none has discovered a universal surface marker that would distinguish this cell subpopulation from a pool of T lymphocytes. The most specific intracellular marker for Tregs is the nuclear transcription factor Foxp3 that is of fundamental importance in the development of Tregs and their inhibitory function.The results of the vast majority of studies indicate that there are increased numbers of Tregs in the synovial fluid of patients with rheumatoid arthritis (RA; however, the data on the level of this cell population in their peripheral blood are very contradictory. The majority of investigators have observed a decrease in the percentage of circulating Tregs while other studies have revealed its increase or no differences from the corresponding value of healthy donors or patients with osteoarthritis. It is believed that a quantitative defect in CD4+CD25+Foxp3+CD127 regulatory cells is especially characteristic of early RA and associated with the risk of the latter in asymptomatic patients positive for anti-cyclic citrullinated peptide antibodies. The use of disease-modifying antirheumatic drugs and biologic agents is accompanied by a certain change in the level and functional activity of Tregs, which is responsible for the therapeutic effect of the medicaments.Thus, an important part is assigned to Tregs in the pathogenesis of autoimmune rheumatic diseases, RA in particular. The decrease in the level

  5. Mathematical evaluation of the influence of multiple factors on implant stability quotient values in clinical practice: a retrospective study

    Science.gov (United States)

    Huang, Hairong; Wismeijer, Daniel; Shao, Xianhong; Wu, Gang

    2016-01-01

    Objectives The objective of this study is to mathematically evaluate the influence of multiple factors on implant stability quotient values in clinical practice. Patients and methods Resonance frequency analysis was performed at T1 (measured immediately at the time of implant placement) and at T2 (measured before dental restoration) in 177 patients (329 implants). Using a multivariate linear regression model, we analyzed the influence of the following eleven candidate factors: sex, age, maxillary/mandibular location, bone type, immediate/delayed implantation, bone grafting (presence or absence), insertion torque, I-/II-stage healing pattern, implant diameter, implant length, and T1–T2 time interval. Results The following factors were identified to significantly influence the implant stability quotient (ISQ) values at T1: insertion torque, bone grafting, I-/II-stage healing pattern, immediate/delayed implantation, maxillary/mandibular location, implant diameter, and sex. In contrast, the ISQ values at T2 were significantly influenced only by three factors: implant diameter, T1–T2 time interval, and insertion torque. Conclusion Among the eleven candidate factors, seven key factors were found to influence the T1-ISQ values, while only three key factors influenced the T2-ISQ values. Both T1 and T2-ISQ values were found to be influenced by implant diameter and insertion torque. T1 was influenced specifically by the sex of the patient, the location (maxillary or mandibular), the implantation mode (immediate/delayed implantation), the healing stage, and the absence or presence of bone graft materials. PMID:27785040

  6. Clinical Value of Tumor Markers for Determining Cause of Pleural Effusion

    Institute of Scientific and Technical Information of China (English)

    Yan Gu; Kan Zhai; Huan-Zhong Shi

    2016-01-01

    Background: It is often challenging to distinguish tuberculous pleural effusion (TPE) from malignant pleural effusion (MPE);thoracoscopy is among the techniques with the highest diagnostic ability in this regard.However, such invasive examinations cannot be performed on the elderly, or on those in poor physical condition.The aim of this study was to explore the differential diagnostic value of carbohydrate antigen 125 (CA 125), carbohydrate antigen 199 (CA 199), carcinoembryonic antigen (CEA), neuron-specific enolase (NS E), and squamous cell carcinoma (SCC) associated antigen in patients with TPE and MPE.Methods: Using electrochemiluminescence, we measured the concentration of tumor markers (TMs) in the pleural effusion and serum of patients with TPE (n =35) and MPE (n =95).We used receiver operating characteristic (ROC) curve analysis to evaluate the TMs and differentiate between TPE and MPE.Results: The cut-offvalues for each TM in serum were: CA125, 151.55 U/ml;CA199, 9.88 U/ml;CEA, 3.50 ng/ml;NSE, 13.27 ng/ml;and SCC, 0.85 ng/ml.Those in pleural fluid were: CA125, 644.30 U/ml;CA199, 12.08 U/ml;CEA, 3.35 ng/ml;NSE, 9.71 ng/ml;and SCC, 1.35 ng/ml.The cut-offvalues for the ratio ofpleural fluid concentration to serum concentration (P/S ratio) of each TM were: CA125, 5.93;CA199, 0.80;CEA, 1.47;NSE, 0.76;and SCC, 0.90.The P/S ratio showed the highest specificity in the case of CEA (97.14%).ROC curve analysis revealed that, for all TMs, the area under the curve in pleural fluid (0.95) was significantly different from that in serum (0.85;P < 0.001).Conclusions: TMs in TPE differ significantly from those in MPE, especially when detected in pleural fluid.The combined detection of TMs can improve diagnostic sensitivity.

  7. Clinical values of intraoperative indocyanine green fluorescence video angiography with Flow 800 software in cerebrovascular surgery

    Institute of Scientific and Technical Information of China (English)

    YE Xun; LIU Xing-ju; MA Li; LIU Ling-tong; WANG Wen-lei; WANG Shuo; CAO Yong

    2013-01-01

    Background Microscope-integrated near-infrared indocyanine green video angiography (ICG-VA) has been used in neurosurgery for a decade.This study aimed to assess the value of intraoperative indocyanine green (ICG) video angiography with Flow 800 software in cerebrovascular surgery and to discover its hemodynamic features and changes of cerebrovascular diseases during surgery.Methods A total of 87 patients who received ICG-VA during various surgical procedures were enrolled in this study.Among them,45 cases were cerebral aneurysms,25 were cerebral arteriovenous malformations (AVMs),and 17 were moyamoya disease (MMD).A surgical microscope integrating an infrared fluorescence module was used to confirm the residual aneurysms and blocking of perforating arteries in aneurysms.Feeder arteries,draining veins,and normal cortical vessels were identified by the time delay color mode of Flow 800 software.Hemodynamic parameters were recorded.All data were analyzed by SPSS version 18.0 (SPSS Inc.,USA).T-test was used to analyze the hemodynamic features of AVMs and MMDs,the influence on peripheral cortex after resection in AVMs,and superficial temporal artery to middle cerebral artery (STA-MCA) bypass in MMDs.Results The visual delay map obtained by Flow 800 software had more advantages than the traditional playback mode in identifying the feeder arteries,draining veins,and their relations to normal cortex vessels.The maximum fluorescence intensity (MFI) and the slope of ICG fluorescence curve of feeder arteries and draining veins were higher than normal peripheral vessels (MFI:584.24±85.86 vs.382.94±91.50,slope:144.95±38.08 vs.69.20±13.08,P <0.05).The artefiovenous transit time in AVM was significantly shorter than in normal cortical vessels ((0.60±0.27) vs.(2.08±1.42) seconds,P <0.05).After resection of AVM,the slope of artery in the cortex increased,which reflected the increased cerebral flow.In patients with MMD,after STA-MCA bypass,cortex perfusion of

  8. Clinical value of regression of electrocardiographic left ventricular hypertrophy after aortic valve replacement.

    Science.gov (United States)

    Yamabe, Sayuri; Dohi, Yoshihiro; Higashi, Akifumi; Kinoshita, Hiroki; Sada, Yoshiharu; Hidaka, Takayuki; Kurisu, Satoshi; Shiode, Nobuo; Kihara, Yasuki

    2016-09-01

    Electrocardiographic left ventricular hypertrophy (ECG-LVH) gradually regressed after aortic valve replacement (AVR) in patients with severe aortic stenosis. Sokolow-Lyon voltage (SV1 + RV5/6) is possibly the most widely used criterion for ECG-LVH. The aim of this study was to determine whether decrease in Sokolow-Lyon voltage reflects left ventricular reverse remodeling detected by echocardiography after AVR. Of 129 consecutive patients who underwent AVR for severe aortic stenosis, 38 patients with preoperative ECG-LVH, defined by SV1 + RV5/6 of ≥3.5 mV, were enrolled in this study. Electrocardiography and echocardiography were performed preoperatively and 1 year postoperatively. The patients were divided into ECG-LVH regression group (n = 19) and non-regression group (n = 19) according to the median value of the absolute regression in SV1 + RV5/6. Multivariate logistic regression analysis was performed to assess determinants of ECG-LVH regression among echocardiographic indices. ECG-LVH regression group showed significantly greater decrease in left ventricular mass index and left ventricular dimensions than Non-regression group. ECG-LVH regression was independently determined by decrease in the left ventricular mass index [odds ratio (OR) 1.28, 95 % confidence interval (CI) 1.03-1.69, p = 0.048], left ventricular end-diastolic dimension (OR 1.18, 95 % CI 1.03-1.41, p = 0.014), and left ventricular end-systolic dimension (OR 1.24, 95 % CI 1.06-1.52, p = 0.0047). ECG-LVH regression could be a marker of the effect of AVR on both reducing the left ventricular mass index and left ventricular dimensions. The effect of AVR on reverse remodeling can be estimated, at least in part, by regression of ECG-LVH.

  9. Clinical value of three-dimensional digital subtraction angiography in the endovascular treatment of intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    Tianxiao Li; Dengwei Zong

    2006-01-01

    BACKGROUND: The endovascular treatment of intracranial aneurysms requires clearly displayed anatomic structures of the aneurysm and the reference image of the aneurysm neck, the images of the form and struc ture of the aneurysm and the three-dimensional (3D) intracranial vascular structure are very important for the diagnosis and treatment of cerebral aneurysms. OBJECTIVE: To investigate the value of 3D digital subtraction angiography (3D DSA) in diagnosing intracra nial aneurysm, and compare the reliability with two-dimensional (2D) DSA in evaluating the intracranial aneurysm suitable for the endovascular occlusion: DESIGN: A double-blind case observation. SETTING: Department of Interventional Radiology, Henan People's Hospital. PARTICIPANTS: The patients, who were suspected to have intracranial aneurysms, were examined with 2D DSA and 3D DSA in Henan People's Hospital from October 2004 to October 2005. Fifty intracranial aneurysms were detected in 44 patients (19 males and 25 females) of 30-75 years, with an average of 51 years, including 5 cases were multiple aneurysms, including 2 aneurysms in 4 cases and 3 aneurysms in 1 case. The aneurysms located respectively at internal carotid artery (n =19), anterior cerebral artery (n =16), middle cerebral artery (n =8), basilar artery (n =6), and posterior inferior cerebellar artery (n =1 ). METHODS: The 50 ruptured intracranial aneurysms were examined with 2D DSA and 3D DSA. The method of volume reconstruction was applied to reconstruct the 3D DSA images, and the automatically generated images could be shifted, rotated and magnified, besides, the corresponding processing could also be performed, including resecting the unnecessary structure and sharpening margin of the images. Observations: ① Display of aneurysm neck: The site and range of the aneurysm neck, and the involvement of branches originated from the aneurysm arteries; ② Display of aneurysm form: The displays of aneurysm form and with or without arteries

  10. Mathematical evaluation of the influence of multiple factors on implant stability quotient values in clinical practice: a retrospective study

    Directory of Open Access Journals (Sweden)

    Huang H

    2016-10-01

    Full Text Available Hairong Huang,1 Daniel Wismeijer,1 Xianhong Shao,2 Gang Wu1 1Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA, MOVE Research Institute, VU University Amsterdam and University of Amsterdam, Amsterdam, Nord-Holland, the Netherlands; 2Best & Easy Dental Clinic, Hangzhou, Zhejiang Province, People’s Republic of China Objectives: The objective of this study is to mathematically evaluate the influence of multiple factors on implant stability quotient values in clinical practice.Patients and methods: Resonance frequency analysis was performed at T1 (measured immediately at the time of implant placement and at T2 (measured before dental restoration in 177 patients (329 implants. Using a multivariate linear regression model, we analyzed the influence of the following eleven candidate factors: sex, age, maxillary/mandibular location, bone type, immediate/delayed implantation, bone grafting (presence or absence, insertion torque, I-/II-stage healing pattern, implant diameter, implant length, and T1–T2 time interval.Results: The following factors were identified to significantly influence the implant stability quotient (ISQ values at T1: insertion torque, bone grafting, I-/II-stage healing pattern, immediate/delayed implantation, maxillary/mandibular location, implant diameter, and sex. In contrast, the ISQ values at T2 were significantly influenced only by three factors: implant diameter, T1–T2 time interval, and insertion torque.Conclusion: Among the eleven candidate factors, seven key factors were found to influence the T1-ISQ values, while only three key factors influenced the T2-ISQ values. Both T1 and T2-ISQ values were found to be influenced by implant diameter and insertion torque. T1 was influenced specifically by the sex of the patient, the location (maxillary or mandibular, the implantation mode (immediate/delayed implantation, the healing stage, and the absence or presence of bone

  11. Uncertainty of measurement and clinical value of semen analysis: has standardisation through professional guidelines helped or hindered progress?

    Science.gov (United States)

    Tomlinson, M J

    2016-09-01

    This article suggests that diagnostic semen analysis has no more clinical value today than it had 25-30 years ago, and both the confusion surrounding its evidence base (in terms of relationship with conception) and the low level of confidence in the clinical setting is attributable to an associated high level of 'uncertainty'. Consideration of the concept of measurement uncertainty is mandatory for medical laboratories applying for the ISO15189 standard. It is evident that the entire semen analysis process is prone to error every step from specimen collection to the reporting of results and serves to compound uncertainty associated with diagnosis or prognosis. Perceived adherence to published guidelines for the assessment of sperm concentration, motility and morphology does not guarantee a reliable and reproducible test result. Moreover, the high level of uncertainty associated with manual sperm motility and morphology can be attributed to subjectivity and lack a traceable standard. This article describes where and why uncertainty exists and suggests that semen analysis will continue to be of limited value until it is more adequately considered and addressed. Although professional guidelines for good practice have provided the foundations for testing procedures for many years, the risk in following rather prescriptive guidance to the letter is that unless they are based on an overwhelmingly firm evidence base, the quality of semen analysis will remain poor and the progress towards the development of more innovative methods for investigating male infertility will be slow.

  12. Clinical value of digital image analysis in the diagnosis of urinary bladder cancer, particularly in aggressive tumors: a preliminary report.

    Science.gov (United States)

    Borkowski, T; Monika Dulewicz, A; Borkowski, A; Piętka, D; Radziszewski, P

    2016-06-01

    The aim of the project was to evaluate the clinical value of a computer analysis of cytological specimen images obtained from urine and bladder washing samples. Three sample types (voided urine, catheterized urine and bladder washing) from 59 patients with primary or recurrent tumor were analyzed. All patients underwent cystoscopy and biopsy or resection. The histological results were compared with the results of the image analyzing computer system of collected urine samples. The consistency between the computer diagnosis and the clinical or histological diagnosis both in the presence and absence of cancer was as follows: 77% for voided urine samples, 72.5% for catheterized urine samples and 78% for bladder washing samples. The specificity of the method at the standard pathology level was 71%, and the sensitivity was 83%. The positive and negative predictive values (PPV and NPV) were 87.5% and 63% respectively. The sensitivity for G3 or CIS or T2 or T3 tumors reached nearly 100%. Computer analysis of urine provided correct diagnoses in cancer and control patients with the sensitivity of 83% and specificity of 71% and gave excellent results in aggressive tumors such as T2, T3, G3 and in CIS.

  13. CLINICAL VALUE OF BAFF AND APRIL CONCENTRATIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS

    Directory of Open Access Journals (Sweden)

    T. A. Panafidina

    2016-01-01

    Full Text Available Systemic lupus erythematosus (SLE is characterized by the pathological activation and differentiation of B lymphocytes. The B-lymphocyte stimulator (BLyS, also known as B cell-activating factor of the tumor necrosis factor family (BAFF, and its homologue, a proliferation-inducing ligand (APRIL, belong to the ligands of the tumor necrosis factor (TNF family and play a key role in B-lymphocyte selection and survival.Objective: to determine serum BAFF and APRIL concentrations in patients with SLE and a relationship of the clinical and laboratory parameters of the disease to the level of these cytokines.Subjects and methods. The investigation enrolled 73 patients (62 women and 11 men; median age, 30.0 [28.0; 46.0] years with SLE (disease duration, 5.0 [1.5; 11.0] years and its high activity (the median SLEDAI-2K scores of 8 [2; 13].Involvement of the kidneys and joints were found in 40 and 36% of cases, respectively; there were hematologic disorders in 38%, antinuclear factor (ANF in 94.5%, and anti-double stranded DNA antibodies in 77%. The concurrent antiphospholipid syndrome was detected in 15% of the patients. 66% of the patients took glucocorticoids (GCs (the median dose was 10 [0; 15] mg/day, calculated with reference to prednisolone, 42% received cytotoxic drugs (cyclophosphamide, mycophenolate mofetil, azathioprine; 12% used biological agents (BAs; 31.5% received no therapy at enrolment in the investigation. Serum BAFF and APRIL concentrations were estimated using an enzyme immunoassay.Results and discussion. The concentrations of BAFF and APRIL did not differ essentially in the patients with SLE and in the controls: the median level of BAFF was 0.02 [0.01; 0.64] and 0.02 [0.01; 0.03] ng/ml; that of APRIL was 2.09 [0.01; 3.80] and 0.01 [0.01; 4.16] ng/ml, respectively. The elevated concentration of BAFF (>0.82 ng/ml was revealed in 5.5% of the patients with SLE and that of APRIL (>5.96 ng/ml in 4.1%. There was a positive correlation between

  14. The value of pre operative S-100B and SUV in clinically stage III melanoma patients undergoing therapeutic lymph node dissection

    NARCIS (Netherlands)

    Kruijff, S.; Bastiaannet, E.; Speijers, M. J.; Kobold, A. C. M.; Brouwers, A. H.; Hoekstra, H. J.

    2011-01-01

    Introduction: High preoperative serum S-100B values and Standardized Uptake Values (SUV) of Fluorodeoxyglucose (FDG) in PET for clinically stage III melanoma patients could be indicators of recurrence after surgical treatment. Aim was to assess the correlation and the prognostic value of these marke

  15. [Clinical application value of prognostic nutritional index for predicting survival in patients with advanced non-small cell lung cancer].

    Science.gov (United States)

    Xu, W J; Kang, Y M; Zhou, L; Chen, F F; Song, Y H; Zhang, C Q

    2017-02-23

    Objective: To explore the clinical application value of prognostic nutritional index(PNI) for predicting overall survival(OS) in patients with advanced non-small cell lung cancer (NSCLC). Methods: 123 patients with histologically confirmed non-small cell lung cancer were enrolled in this study, and their clinical and laboratory data were reviewed. The PNI was calculated as 10×serum albumin value+ 5×total lymphocyte countin peripheral blood.Univariate and multivariate analyses were used to identify the potential prognostic factors for advanced NSCLC. Results: PNI of the 123 NSCLC patients was 46.24±6.56. PNI was significantly associated with age, weight loss and pleural effusion (P0.05). The median OS of the 123 patients was 19.5 months. The median OS in the higher PNI group (PNI≥46.24) and lower PNI group(PNI<46.24) were 25.2 months and 16.4 months, respectively.The 1-year survival rates were 80.6% and 63.9%, and 2-year survival rates were 54.8% and 19.6%, respectively (P<0.01). Univariate analysis showed that PNI, age, dyspnea, and weight loss were related to the OS of the advanced NSCLC patients (P<0.05). Multivariate analysis identified PNI as an independent prognostic factor for OS of advanced NSCLC (P<0.001). Conclusion: PNI can be easily calculated, and may be used as a relatively new prognostic indicator for advanced NSCLC in clinical practice.

  16. Clinical value of FDG-PET/CT in suspected paraneoplastic syndromes: a retrospective analysis of 137 patients

    Energy Technology Data Exchange (ETDEWEB)

    Bjoern Kristensen, Stine; Hess, Soeren; Petersen, Henrik; Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

    2015-12-15

    Paraneoplastic syndromes (PNS) are relatively infrequent manifestations appearing before or after a cancer declares itself. Autoimmune mechanisms may be involved, but their cause and pathogenesis are often unknown. Due to disparity of symptoms, PNS remain a major diagnostic challenge. We examined the value of FDG-PET/CT for ruling in or out malignancy in a heterogeneous group of patients with suspected PNS. We retrospectively extracted data from all patients referred 2009-2013 with suspected PNS. Data included age, sex, follow-up period, scan report, further diagnostic procedures, and final clinical diagnosis. Conclusions of the scan reports were compared to the final follow-up outcome as determined during an average follow-up of 31 months (range 6-51.5) in patients who were not diagnosed with cancer in immediate continuation of a positive PET/CT scan. A total of 137 patients were included. Main causes for referral were neurological (n = 67), rheumatological (n = 25), dermatological (n = 18), nephrological (n = 6), haematological (n = 2), abnormal biochemistry (n = 11), and others (n = 8). The cancer prevalence was 8.8 %. The FDG-PET/CT results were as follows: nine true positives, 22 false positives, 103 true negatives, and three false negatives. Corresponding diagnostic values were: sensitivity 75 %, specificity 82 %, accuracy 82 %, and positive and negative predictive values of 29 % and 97 %, respectively. FDG-PET/CT has in patients with suspected PNS an impressively high negative predictive value and may be of value in ruling out PNS, the more so, the more the number of false positives can be minimized or used in differential diagnosis. We believe that FDG-PET/CT may become an important adjunct to the work-up and triage of patients with suspected PNS. (orig.)

  17. Interactive cervical motion kinematics: sensitivity, specificity and clinically significant values for identifying kinematic impairments in patients with chronic neck pain.

    Science.gov (United States)

    Sarig Bahat, Hilla; Chen, Xiaoqi; Reznik, David; Kodesh, Einat; Treleaven, Julia

    2015-04-01

    Chronic neck pain has been consistently shown to be associated with impaired kinematic control including reduced range, velocity and smoothness of cervical motion, that seem relevant to daily function as in quick neck motion in response to surrounding stimuli. The objectives of this study were: to compare interactive cervical kinematics in patients with neck pain and controls; to explore the new measures of cervical motion accuracy; and to find the sensitivity, specificity, and optimal cutoff values for defining impaired kinematics in those with neck pain. In this cross-section study, 33 patients with chronic neck pain and 22 asymptomatic controls were assessed for their cervical kinematic control using interactive virtual reality hardware and customized software utilizing a head mounted display with built-in head tracking. Outcome measures included peak and mean velocity, smoothness (represented by number of velocity peaks (NVP)), symmetry (represented by time to peak velocity percentage (TTPP)), and accuracy of cervical motion. Results demonstrated significant and strong effect-size differences in peak and mean velocities, NVP and TTPP in all directions excluding TTPP in left rotation, and good effect-size group differences in 5/8 accuracy measures. Regression results emphasized the high clinical value of neck motion velocity, with very high sensitivity and specificity (85%-100%), followed by motion smoothness, symmetry and accuracy. These finding suggest cervical kinematics should be evaluated clinically, and screened by the provided cut off values for identification of relevant impairments in those with neck pain. Such identification of presence or absence of kinematic impairments may direct treatment strategies and additional evaluation when needed.

  18. New Dimensions in Patient–Physician Interaction: Values, Autonomy, and Medical Information in the Patient-Centered Clinical Encounter

    Science.gov (United States)

    Agarwal, Aakash Kumar; Murinson, Beth Brianna

    2012-01-01

    Patient–physician interactions are increasingly influenced by the extraordinary diversification of populations and rapid expansion of medical knowledge that characterize our modern era. By contrast, the patient–physician interaction models currently used to teach medical trainees have little capacity to address these twin challenges. We developed a new model of patient–physician interaction to explicitly address these problems. Historically, models of patient–physician interaction viewed patient autonomy and the manifestation of clearly defined health care-related values as tightly linked, and it was assumed that patients’ medical knowledge was low. Unfortunately, this does not adequately represent patients such as 1) the highly educated non-medical specialist who possesses little familiarity with health-related values but is highly autonomous, and 2) the patient from a non-Western background who may have well-established health care-related values but a low sense of personal independence. In addition, it is evident to us that the assumption that all patients possess little medical knowledge can create alienation between patient and physician, e.g. the well-informed patient with a rare disease. We propose a paradigm that models autonomy, health care-related values formation, and medical knowledge as varying from patient to patient. Four examples of patient types are described within the context of the model based on clinical experience. We believe that adopting this model will have implications for optimizing patient–physician interactions and teaching about patient-centered care. Further research is needed to identify relevant patient types within this framework and to assess the impact on health care outcomes. PMID:23908841

  19. Arthroscopy vs. MRI for a detailed assessment of cartilage disease in osteoarthritis: diagnostic value of MRI in clinical practice

    Directory of Open Access Journals (Sweden)

    Haage Patrick

    2010-04-01

    Full Text Available Abstract Background In patients with osteoarthritis, a detailed assessment of degenerative cartilage disease is important to recommend adequate treatment. Using a representative sample of patients, this study investigated whether MRI is reliable for a detailed cartilage assessment in patients with osteoarthritis of the knee. Methods In a cross sectional-study as a part of a retrospective case-control study, 36 patients (mean age 53.1 years with clinically relevant osteoarthritis received standardized MRI (sag. T1-TSE, cor. STIR-TSE, trans. fat-suppressed PD-TSE, sag. fat-suppressed PD-TSE, Siemens Magnetom Avanto syngo MR B 15 on a 1.5 Tesla unit. Within a maximum of three months later, arthroscopic grading of the articular surfaces was performed. MRI grading by two blinded observers was compared to arthroscopic findings. Diagnostic values as well as intra- and inter-observer values were assessed. Results Inter-observer agreement between readers 1 and 2 was good (kappa = 0.65 within all compartments. Intra-observer agreement comparing MRI grading to arthroscopic grading showed moderate to good values for readers 1 and 2 (kappa = 0.50 and 0.62, respectively, the poorest being within the patellofemoral joint (kappa = 0.32 and 0.52. Sensitivities were relatively low at all grades, particularly for grade 3 cartilage lesions. A tendency to underestimate cartilage disorders on MR images was not noticed. Conclusions According to our results, the use of MRI for precise grading of the cartilage in osteoarthritis is limited. Even if the practical benefit of MRI in pretreatment diagnostics is unequivocal, a diagnostic arthroscopy is of outstanding value when a grading of the cartilage is crucial for a definitive decision regarding therapeutic options in patients with osteoarthritis.

  20. The Changing Landscape of Chemical Toxicity Values and Possible Impacts to DoD Legacy Site Cleanup

    Science.gov (United States)

    2011-12-05

    SUPPLEMENTARY NOTES Presented at the Emerging Contaminants Program , 2011 Society for Risk Analysis Annual meeting, Charleston, SC, December 4-7...by ANSI Std Z39-18 Emerging Contaminants (ECs)  Are chemicals or materials of interest that are characterized by: ►a perceived or real...but the standard is evolving or being re-evaluated. Source: “Initiation of Emerging Contaminants Characterization and Response Actions for

  1. Asscessment of the clinical value of CK-M2 and oligosaccharide protein inserum from patients with gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    Gui Lan Zhao; Jie Lin; Shu You Peng; Qi Yun Li; Fan Zhou; Xian Sheng Chen; Xin You Xie; Yi Xiong Zheng

    2000-01-01

    AIM To evaluate the clinical value of creatine kinase macroisoenzyme type 2 (CK-M2) and oligosaccharideprotein (OP) in serum from patients with gastric carcinoma (GC).METHODS Serum level of CK-M2 was detected by agar gel electrophoresis. OP concentration was measuredby an enzyme immunoassay.RESULTS Serum levels of CK-M2 and OP in 57 cases of GC were significantly higher than those in 51 caseswith gastric precancerous lesion and 28 controls. The diagnostic sensitivity and specificity for GC with CK-M2 was 56.10% and 98.63% respectively. CK-M2 and OP were not associated with histologic type and degreeof differentiation.CONCLUSION These results suggest that CK-M2 may serve as a marker to diagnose GC, and the specificityis higher, whereas OP is not more significant for GC diagnosis, but it could be a useful indicator forevaluation the status of body immune.

  2. Case of asymmetrical arthrogryposis. A clinical study and a preliminary report on the value of CT-scanning

    Energy Technology Data Exchange (ETDEWEB)

    Hageman, G.; Vette, J.K.; Willemse, J. (University Hospital, Utrecht (Netherlands))

    1983-01-01

    Following the introduction of the conception that arthrogryposis is a symptom and not a clinical entity, a case of the very rare asymmetric form of neurogenic arthrogryposis is presented. The asymmetry of congenital contractures and weakness is associated with hemihypotrophy. The value of muscular CT-scanning prior to muscle biopsy is demonstrated. Muscular CT-scanning shows the extension of adipose tissue, which has replaced damaged muscles and therby indicates the exact site for muscle biopsy. Since orthopaedic treatment in arthrogryposis can be unrewarding due to severe muscular degeneration, preoperative scanning may provide additional important information on muscular function and thus be of benefit for surgery. The advantage of muscular CT-scanning in other forms of arthrogryposis requires further determination. The differential diagnosis with Werdnig-Hoffmann disease is discussed.

  3. The Clinical Value of Axillary Ultrasonogra- phy for Detection of Axillary Lymph Node Metastasis in Cases with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sedigheh Tahmasebi

    2014-10-01

    Full Text Available Background: The axillary lymph node stage is one of the single most important determinants in the prognosis of breast cancer patients. The disadvantages of the two previous methods used for evaluating axillary node metastasis, i.e., axillary lymph node dissection and sentinel lymph node biopsy, have directed researchers to investigate new techniques for this purpose. The aim of the current study was to evaluate the clinical usefulness of axillary ultrasonography in detecting axillary metastasis. Methods: This study was conducted during a 12-month period. The breast cancer cases included in this study were all clinically diagnosed as stages I and II, with no prior treatment to the axillary region by surgery and/or chemo-radiotherapy. Excluded from the study group were patients with palpable axillary lymph nodes, those who had major organ failure or concomitant malignancy. All included patients with non-palpable axillary lymph nodes underwent axillary ultrasound examination. An ultrasound- guided core needle biopsy was performed on patients with suspected metastasis. Results: There were 125 female patients with a mean age of 49.6 years included in this study. From these, 16 (12.8% cases had positive axillary sonographic findings. Pathologic evaluation of tissue specimens (taken by ultrasound-guided core needle biopsy in 10 (62.5% out of 16 patients were positive, and in the patient group of 6 (37.5% cases, studies were negative. Axillary ultrasonography had a sensitivity of 35.7%, specificity of 93.8%, positive predictive value of 62.5%, and negative predictive value of 83.5%. Conclusion: The axillary ultrasonogram is a reliable technique in the determination of axillary nodal metastatic involvement in breast cancer patients. By use of this method a significant amount of complications and costs related to the previous techniques can be avoided.

  4. Chemical Composition, In vivo Digestibility and Metabolizable Energy Values of Caramba (Lolium multiflorum cv. caramba) Fresh, Silage and Hay

    Science.gov (United States)

    Özelçam, H.; Kırkpınar, F.; Tan, K.

    2015-01-01

    The experiment was conducted to determine nutritive values of caramba (Lolium multiflorum cv. caramba) fresh, silage and hay by in vivo and in vitro methods. There was a statistically significant difference (psilage (8.91%) and hay (6.35%). According to results of experiment, the crude fiber, neutral detergent fiber, acid detergent fiber (ADF), acid detergent lignin contents of the three forms of caramba varied between 30.22% to 35.06%, 57.41% to 63.70%, 35.32% to 43.29%, and 5.55% to 8.86% respectively. There were no significant differences between the three forms of caramba in digestibility of nutrients and in vivo metabolizable energy (ME) values (p>0.05). However, the highest MECN (ME was estimated using crude nutrients) and MEADF values were found in fresh caramba (psilage or hay is a good alternative source of forage for ruminants. PMID:26323399

  5. Clinical value of diascopy and other non-invasive techniques on differential diagnosis algorithms of oral pigmentations: A systematic review

    Science.gov (United States)

    Pena-Cristóbal, Maite; Otero-Rey, Eva-María; Tomás, Inmaculada; Blanco-Carrión, Andrés

    2016-01-01

    Objectives To determine the diagnostic value of diascopy and other non-invasive clinical aids on recent differential diagnosis algorithms of oral mucosal pigmentations affecting subjects of any age. Material and Methods Data Sources: this systematic review was conducted by searching PubMed, Scopus, Dentistry & Oral Sciences Source and the Cochrane Library (2000-2015); Study Selection: two reviewers independently selected all types of English articles describing differential diagnosis algorithms of oral pigmentations and checked the references of finally included papers; Data Extraction: one reviewer performed the data extraction and quality assessment based on previously defined fields while the other reviewer checked their validity. Results Data Synthesis: eight narrative reviews and one single case report met the inclusion criteria. Diascopy was used on six algorithms (66.67%) and X-ray was included once (11.11%; 44.44% with text mentions); these were considered helpful tools in the diagnosis of intravascular and exogenous pigmentations, respectively. Surface rubbing was described once in the text (11.11%). Conclusions Diascopy was the most applied method followed by X-ray and surface rubbing. The limited scope of these procedures only makes them useful when a positive result is obtained, turning biopsy into the most recommended technique when diagnosis cannot be established on clinical grounds alone. Key words:Algorithm, differential diagnosis, flow chart, oral mucosa, oral pigmentation, systematic review. PMID:27703615

  6. Diagnosis and Clinical Value of CT on Brain Abscess%脑脓肿CT诊断的临床分析

    Institute of Scientific and Technical Information of China (English)

    高廷军; 李涛

    2015-01-01

    Objective To probe manifest actions of brain abscess on CT and clinical value of CT in brain abscess. Methods CT feature in 29 patients pathologically o r clinically proved were retro spectively analyzed. Results 25 cases of CT examination for the ifrst time to make a deifnite diagnosis, the other 4 cases after 7-15 d, review of the diagnosis of brain abscess. Conclusion CT has characteristic manifestations on brain abscess. It should be the ifrst choice for t he diagnosis.%目的: CT对脑脓肿的诊断价值和临床意义。方法分析29例经手术病理和临床证实的脑脓肿的CT表现及临床,得出CT对于临床诊断疗效。结果25例首次CT检查就做出明确诊断,另4例经7~15 d后复查,诊断为脑脓肿。结论脑脓肿CT表现有一定特征性,是诊断脑脓肿首选方法。

  7. Eucalyptus dundasii Maiden essential oil, chemical composition and insecticidal values against Rhyzopertha dominica (F.) and Oryzaephilus surinamensis (L.)

    OpenAIRE

    Aref Shiva Parsia; Valizadegan Oruj; Farashiani Mohammad Ebrahim

    2015-01-01

    The insecticidal effects of Eucalyptus dundasii Maiden essential oil was studied on the adults of the lesser grain borer, Rhyzopertha dominica (F.), and the saw-toothed grain beetle, Oryzaephilus surinamensis (L.). Essential oil was obtained by the hydro-distillation method and essential oil composition was analysed by GC-MS. Chemical analysis indicated that 1,8-cineole (54.15%), p-cymene (12.41%), α-thujene (11.37%), and E-caryophyllene (6.7%) were major constituents. For R. dominica and O. ...

  8. Hyperbolic discounting: value and time processes of substance abusers and non-clinical individuals in intertemporal choice.

    Directory of Open Access Journals (Sweden)

    Jiuqing Cheng

    Full Text Available The single parameter hyperbolic model has been frequently used to describe value discounting as a function of time and to differentiate substance abusers and non-clinical participants with the model's parameter k. However, k says little about the mechanisms underlying the observed differences. The present study evaluates several alternative models with the purpose of identifying whether group differences stem from differences in subjective valuation, and/or time perceptions. Using three two-parameter models, plus secondary data analyses of 14 studies with 471 indifference point curves, results demonstrated that adding a valuation, or a time perception function led to better model fits. However, the gain in fit due to the flexibility granted by a second parameter did not always lead to a better understanding of the data patterns and corresponding psychological processes. The k parameter consistently indexed group and context (magnitude differences; it is thus a mixed measure of person and task level effects. This was similar for a parameter meant to index payoff devaluation. A time perception parameter, on the other hand, fluctuated with contexts in a non-predicted fashion and the interpretation of its values was inconsistent with prior findings that supported enlarged perceived delays for substance abusers compared to controls. Overall, the results provide mixed support for hyperbolic models of intertemporal choice in terms of the psychological meaning afforded by their parameters.

  9. Clinical diagnostic value of Molybdenum Target X-ray combined with four Serum tumor markers in the detection of Mastocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Ding-Hua Xu; Chun-Xian Cai; Guang-Xue Huang

    2015-01-01

    Objective: To explore the clinical diagnostic value of Molybdenum Target X-ray combined with serum CA15-3, CA125, CEA and CYFRA21-1 tumor markers in the detection of Mastocarcinoma. Method:90 cases confirmed by surgery pathology diagnosis according to the diagnosis of breast nodules disease patients were divided into benign tumor group (n=32) and breast cancer group (n=58), all patients were with preoperative line of molybdenum target X-ray radiography examination; Another group chose healthy women of our hospital for check-up in 56 cases as the control group, electrochemiluminescence immunoassay detection of three groups of participants were four kinds of serum tumor markers level, evaluation of single and combined testing the sensitivity of the diagnosis of breast cancer, specific degree, positive predictive value and negative predictive value. Results: CA15-3, CA125, CEA and CYFRA21-1 in breast cancer group were significantly higher than that of the control group and benign tumor group, the difference was statistically significant (all P0.05); Molybdenum target X-ray slice of the sensitivity of the diagnosis of breast cancer was higher, but the specific degree was low, and lower the sensitivity of the serum tumor markers in the diagnosis of breast cancer, the specific degree was higher, the molybdenum target X-ray slice joint the sensitivity of the four tumor markers in the diagnosis of breast cancer was 89.66%, 78.13%. Conclusions: The combined Mastocarcinoma detection of Molybdenum Target X-ray with serum CA15-3, CA125, CEA and CYFRA21-1 tumor markers can improve the detective rate and plays an important role in Mastocarcinoma early detection.

  10. The effect of terebinth (Pistacia terebinthus L.) coffee addition on the chemical and physical characteristics, colour values, organic acid profiles, mineral compositions and sensory properties of ice creams.

    Science.gov (United States)

    Yüksel, Arzu Kavaz; Şat, Ihsan Güngör; Yüksel, Mehmet

    2015-12-01

    The aim of this research was to evaluate the effect of terebinth (Pistacia terebinthus L.) coffee addition (0.5, 1 and 2 %) on the chemical and physical properties, colour values, organic acid profiles, mineral contents and sensory characteristics of ice creams. The total solids, fat, titratable acidity, viscosity, first dripping time and complete melting time values, a (*) and b (*) colour properties, citric, lactic, acetic and butyric acid levels and Ca, Cu, Mg, Fe, K, Zn and Na concentrations of ice creams showed an increase with the increment of terebinth coffee amount, while protein, pH, L (*), propionic acid and orotic acid values decreased. However, Al and malic acid were not detected in any of the samples. The overall acceptability scores of the sensory properties showed that the addition of 1 % terebinth coffee to the ice cream was more appreciated by the panellists.

  11. Diagnostic value of magnetic resonance lymphography in preoperative staging of clinically negative necks in squamous cell carcinoma of the oral cavity: A pilot study

    NARCIS (Netherlands)

    Wensing, B.M.; Deserno, W.M.L.L.G.; Bondt, R.B. de; Marres, H.A.M.; Merkx, M.A.W.; Barentsz, J.O.; Hoogen, F.J. van den

    2011-01-01

    Pilot study evaluating the diagnostic value of magnetic resonance lymphography (MRL) compared with conventional imaging techniques in the preoperative staging of the clinically (palpable) negative neck (cN0) in squamous cell carcinoma of the oral cavity (SCCOC). Patients with SCCOC without clinical

  12. Insulin glargine in the management of diabetes mellitus: an evidence-based assessment of its clinical efficacy and economic value

    Directory of Open Access Journals (Sweden)

    Rhian Clissold

    2007-11-01

    Full Text Available Rhian Clissold1, Steve Clissold21Endocrinology Department, Frenchay Hospital, Bristol, UK; 2Content Ed Net Communications S.L., Madrid, SpainIntroduction: Diabetes is a chronic disease associated with high morbidity and mortality, which represents a major public health concern. Interventions that can enhance patient care and reduce clinic visits will not only relieve some of this burden, they will also improve patient QOL and wellbeing.Aims: This review assesses the evidence for the use of insulin glargine in type 1 and type 2 diabetes mellitus.Evidence review: Once-daily insulin glargine has a prolonged, peakless activity profile, making it a candidate as a long-acting (basal insulin. In combination with bolus insulin to cover prandial glucose surges, it facilitates a more physiologic approach to patient management. Evidence from large, randomized, controlled clinical trials in patients with type 1 diabetes has confirmed its effectiveness and tolerability relative to neutral protamine hagedorn (NPH insulin, with a tendency toward causing less hypoglycemia. In patients with type 2 diabetes requiring insulin therapy, once-daily insulin glargine has proven to be clinically superior to NPH insulin in terms of providing at least as effective glycemic control, but with significantly fewer episodes of nocturnal hypoglycemia. A variety of economic analyses have confirmed the cost effectiveness of insulin glargine in type 1 and type 2 diabetes and in particular it was shown to be significantly superior to NPH insulin.Clinical value: Insulin glargine has established itself as a first-line choice in patients with type 1 diabetes, including children (>6 years and adolescents, and is a recommended treatment option. In patients with type 2 diabetes it is clearly associated with less hypoglycemia than NPH insulin, and this may help overcome one of the major barriers to starting insulin therapy in this class of patient. Thus, insulin glargine is a valuable

  13. Helical CT evaluation of the chemical composition of urinary tract calculi with a discriminant analysis of CT-attenuation values and density

    Energy Technology Data Exchange (ETDEWEB)

    Bellin, Marie-France; Meric, Jean-Baptiste [AP-HP, Department of Radiology, Hopital Paul-Brousse, Villejuif Cedex (France); Renard-Penna, Raphaelle; Grenier, Philippe [AP-HP, Department of Radiology, Hopital Pitie-Salpetriere, Paris Cedex 13 (France); Conort, Pierre; Richard, Francois [AP-HP, Department of Urology, Hopital Pitie-Salpetriere, Paris Cedex 13 (France); Bissery, Anne; Mallet, Alain [AP-HP, Department of Biostatistics, Hopital Pitie-Salpetriere, Paris Cedex 13 (France); Daudon, Michel [AP-HP, Department of Biochemistry, Hopital Necker, Paris Cedex 15 (France)

    2004-11-01

    The aim of this study was to evaluate the efficacy of helical CT using a combination of CT-attenuation values and visual assessment of stone density as well as discriminant linear analysis to predict the chemical composition of urinary calculi. One hundred human urinary calculi were obtained from a stone-analysis laboratory and placed in 20 excised pig kidneys. They were scanned at 80, 120 and 140 kV with 3-mm collimation. Average, highest and lowest CT-attenuation values and CT variability were recorded. The internal calculus structure was assessed using a wide window setting, and visual assessment of stone density was recorded. A stepwise discriminant linear analysis was performed. The following three variables were discriminant: highest CT-attenuation value, visual density, and highest CT-attenuation value/area ratio, all at 80 kV. The probability of correctly classifying stone composition with these three variables was 0.64, ranging from 0.54 for mixed calculi to 0.69 for pure calculi. The probabilities of correctly classifying calculus composition were: 0.91 for calcium oxalate monohydrate and brushite, 0.89 for cystine, 0.85 for uric acid, 0.11 for calcium oxalate dihydrate, 0.10 for hydroxyapatite, and 0.07 for struvite calculi. When the first two ranks of highest probability for the accurate classification of each calculus type were taken into account, 81% of the calculi were correctly classified. Assessment at 80 kV of the highest CT-attenuation value, visual density and the highest CT-attenuation value/area ratio accurately predicts the chemical composition of 64-81% of urinary calculi. When the first two ranks of highest probability for the accurate classification of each calculus type were taken into account, all cystine, calcium oxalate monohydrate and brushite calculi were correctly classified. (orig.)

  14. Nutritional value, performance, carcass quality, visceral organ size, and blood clinical chemistry of broiler chicks fed 30% tannin-free fava bean diets.

    Science.gov (United States)

    Usayran, N N; Sha'ar, H; Barbour, G W; Yau, S K; Maalouf, F; Farran, M T

    2014-08-01

    Two experiments were conducted to evaluate the chemical and nutritional values of 5 tannin-free fava bean (FB) cultivars (FB9, FB10, FB13, FB17, and FB24) on growth, visceral organ size, and blood clinical chemistry of broiler chicks fed a corn-soybean meal 48 (SBM48) diet containing 30% tannin-free FB. In the first experiment, 49 Hy-line roosters, 55 wk of age, were individually precision-fed 30 g of each FB cultivar and soybean meal 44 (SBM44). Protein, methionine, and lysine contents of the FB seeds (0.005% tannin) were 27.7, 0.23, and 1.98% of DM, respectively. The AMEn of all FB cultivars was 2,839 kcal/kg and higher (P control) or 30% of FB9, FB10, FB13, FB17, or FB24 seeds were each fed to Ross 308 1-wk-old male broiler chicks for 14 d. The determined FB nutrient values were used in formulating FB-containing diets. Birds fed FB-containing diets had better (P control. When compared with the control birds, relative weights of abdominal fat pad and liver were reduced (P < 0.05) by 30% inclusion of all dietary FB varieties, except for FB17 and FB13, respectively. Broiler chicks fed the FB13 diet had plasma thrombocyte and white blood cell (WBC) differential counts higher (P < 0.05) than those fed the FB10 diet and WBC count higher (P < 0.05) than the birds fed the FB17 diet. In conclusion, tannin-free FB was lower in protein, methionine, and lysine, but higher in AMEn, compared with SBM44. Moreover, FB seeds, especially FB10, can be included in a broiler chick diet with no adverse effects on performance, but FB13 increased WBC count.

  15. The Relationship between Clinical and Chemical Hyperandrogenism in 14-18-Years- Old Girls

    OpenAIRE

    Tahereh Naderi; Marzieh Akbarzadeh; Mohammad Hossain Dabbaghmanesh; Hamidreza Tabatabaee; Zahra Zareh

    2012-01-01

    Background: One of the most common endocrine disorders in women's medicine is the increased androgen and the symptoms of increased androgens in women such as polycystic ovary syndrome. The two main components to diagnose this syndrome are menstrual disorder and clinical or laboratory hyperandrogenism, but other causes should be ruled out in order to confirm the diagnosis. This study aims to examine clinical Hyperandrogenism in female students of 14 to 18 years old in Shiraz in 2010.Materials ...

  16. The clinical efficacy of Diphoterine® in the management of cutaneous chemical burns: a 2-year evaluation study.

    Science.gov (United States)

    Zack-Williams, S D L; Ahmad, Z; Moiemen, N S

    2015-03-31

    Diphoterine(®) is an amphoteric irrigating agent for the treatment of chemical burns and rapidly neutralises both acids and alkalis faster than water alone. Diphoterine(®) is widely used as a first aid agent in a wide range of industries globally. This is a retrospective review of the clinical use of Diphoterine(®) on chemical burns in an adult tertiary referral burn centre, often with a delay of several hours after the injury. patients admitted with chemical burns within 24 hours of the incident with an abnormal wound pH or in pain, were treated with Diphoterine(®) spray. Over a 32-month period, 1,875 burn referrals were admitted of which 131 (7%) were chemical burns. Diphoterine(®) was used in 47 patients (36%). The male to female ratio for the 131 patients was 4:1. Alkaline burns were the commonest (55%). patients who received Diphoterine(®) were significantly younger (38 vs 43 years; p=0.05) and presented earlier (0.5 vs 2.55 days; p=0.004). There was a significant change in the wound pH pre- and post-application of Diphoterine(®), compared to patients who were treated with water irrigation only, with a pH change of 1.076 vs 0.4 (p burns.

  17. Analysis of determination modalities concerning the exposure and emission limits values of chemical and radioactive substances; Analyse des modalites de fixation des valeurs limites d'exposition et d'emission pour les substances chimiques et radioactives

    Energy Technology Data Exchange (ETDEWEB)

    Schieber, C.; Schneider, T

    2002-08-01

    This document presents the generic approach adopted by various organizations for the determination of the public exposure limits values to chemical and radioactive substances and for the determination of limits values of chemical products emissions by some installations. (A.L.B.)

  18. Detection of serum carbaminohemoglobin and glycated hemoglobin contents in diabetic nephropathy patients with hemodialysis and assessment of their clinical value

    Institute of Scientific and Technical Information of China (English)

    Ming-Ai Song; Lu Wang

    2016-01-01

    Objective:To analyze the serum carbaminohemoglobin and glycated hemoglobin contents in diabetic nephropathy patients with hemodialysis as well as their clinical value.Methods:A total of 84 cases of diabetic nephropathy patients who received hemodialysis treatment in our hospital from August 2012 to November 2015 were selected as dialysis group, 76 cases of diabetic nephropathy patients without hemodialysis who received treatment in our hospital during the same period were selected as non-dialysis group, and 88 cases of people without diabetes or renal dysfunction who received physical examination in our hospital during the same period were selected as healthy control group. Serum carbaminohemoglobin and glycated hemoglobin contents as well as serum nutrition, dialysis adequacy and disease severity-related indicators of three groups were detected.Results:Serum CarHb and HbA1c contents of dialysis group were lower than those of non-dialysis group; BSF, TSF, MAMC and AMA values of dialysis group were higher than those of non-dialysis group; serum iPTH,β2-MG, PTX3 and OPN levels of dialysis group were lower than those of non-dialysis group while Kt/V level was higher than that of non-dialysis group; sTfR, IGF-1 and NF-κBp65 values of dialysis group were lower than those of non-dialysis group while APN, Hepcidin and GH values were higher than those of non-dialysis group; serum CarHb and HbA1c levels of dialysis group were positively correlated with iPTH,β2-MG, PTX3, OPN, sTfR, IGF-1 and NF-κBp65, and negatively correlated with BSF, TSF, MAMC, AMA, Kt/V, APN, Hepcidin and GH.Conclusion:Serum carbaminohemoglobin and glycated hemoglobin contents in diabetic nephropathy patients with hemodialysis can be the direct indexes to judge disease severity, dialysis effectiveness, etc, and have positive significance in guiding the treatment of disease.

  19. Value of FNAC in diagnosis of different types of thyroiditis and its comparison with clinical and biochemical findings.

    Science.gov (United States)

    Parveen, K; Barua, A R; Hossain, A; Zaman, J; Momen, A

    2009-07-01

    FNAC has developed tremendous improvement in the diagnosis of thyroiditis. The present study was designed to asses the usefulness of FNAC to diagnose various types of thyroiditis and to study their smear patterns. Over a period of one-year, 70 cases of thyroiditis have been evaluated on the basis of cytomorphological criteria and clinical findings of patients. The age ranged from 12-60 years. Majority of the cases were between 21 to 30 years of age with female preponderance in each group of thyroiditis. Among 70 cases, 26(37.14%) cases were Hashimoto's thyroiditis, 21(30%) cases were lymphocytic thyroiditis, seven (10%) cases as granulomatous thyroiditis and 16(22.8%) were non-specific thyroiditis. Further study was carried out in these 70 cases regarding biochemical thyroid status, ultrasonography and radionucleotide scan. Blood was drawn from all patients for estimation of antibody titer to compare with cytological diagnosis. It was found that, clinical examination and history of patients had limited value in the diagnosis of thyroiditis. Ultrasonography and thyroid scan could not reliably differentiate between patients with autoimmune thyroiditis and those with simple and nodular goiter. Biochemically hypothyroidism is more frequently evaluated with Hashimoto's diseases. On the other hand, hyperthyroidism was observed in most other types of thyroiditis. Cytologically diagnosed 78.72% cases of autoimmune thyroiditis had positive antibody titer. From the present study it is concluded that FNAC is a safe, reliable, cost effective and time saving method in the diagnosis of thyroiditis. Being a benign condition also reduce the rate of unnecessary operation, which can be treated conservatively.

  20. Chemical characterisation and in vitro assessment of the nutritive value of co-products yield from the corn wet-milling process.

    Science.gov (United States)

    Malumba, Paul; Boudry, Christelle; Roiseux, Olivier; Bindelle, Jérôme; Beckers, Yves; Béra, François

    2015-01-01

    The chemical characteristics of co-products recovered during a laboratory-scale wet milling procedure as well as that of whole corn flour were characterised and their digestibility and fermentability value determined using a 2 steps in vitro digestibility and fermentation model of the pig digestive tract. Five co-products differing in their chemical composition were collected and analysed. These co-products differed in their in vitro dry matter Digestibility and in their kinetic of fermentation. High coefficients of digestibility were observed for starchy samples, while low coefficients of digestibility were observed for samples rich in lignocellulosic components. Fermentation patterns of samples analysed were different as well as the profile of volatile fatty acids produced during the fermentation. The production of straight-chain fatty acids produced was significantly correlated with the proportion of starch in the sample, while branched-chain fatty acids were correlated to proteins concentration of samples.

  1. The value of quantitative gallium-67 single-photon emission tomography in the clinical management of malignant external otitis

    Energy Technology Data Exchange (ETDEWEB)

    Stokkel, M.P.M.; Eck-Smit, B.L.F. van [Department of Nuclear Medicine and Diagnostic Radiology, Leiden University Hospital (Netherlands); Takes, R.P.; Baatenburg de Jong, R.J. [Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Hospital (Netherlands)

    1997-11-01

    The objective of this study was to establish whether quantitative gallium-67 single-photon emission tomography (SPET) represents an accurate method for the assessment of infection and, moreover, for the monitoring of therapeutic effect. Eight patients (five males, three females) with the clinical diagnosis of MEO were studied. In three patients antibiotic treatment was prolonged for several weeks because visual analysis of gallium scintigraphy still showed slightly increased uptake in the affected area on the first follow-up scan. In one patient, it was decided to stop antibiotic treatment despite a slight increase in uptake on the second follow-up scan. Lesion to non-lesion (L/NL) ratios obtained from {sup 67}Ga SPET images at initial diagnosis and during follow-up were assessed in correlation with clinical and biochemical data and with the results of CT scans. In addition to a raised erythrocyte sedimentation rate (ESR), all patients showed increased uptake on the affected side, with L/NL ratios ranging from 1.4 to 3.6 at the time of diagnosis. CT scans failed to demonstrate abnormalities in four patients. Including four scans demonstrating slightly increased uptake in the affected area, L/NL ratios after 6-8 weeks of antibiotic treatment were 1.0{+-}0.1. Despite a persistently elevated ESR in the majority of patients, none of them demonstrated local recurrence or complications during follow-up. In all patients, leucocyte count was within the normal range throughout the course. No relation was found between the slightly increased uptake on the follow-up scans and surgical treatment. It is concluded that in addition to the visual analysis of {sup 67}Ga SPET imaging, L/NL ratios should be calculated for a more accurate assessment of disease activity in MEO. Despite visually slightly increased uptake, L/NL ratios of 1.0{+-}0.1 during follow-up are highly indicative of complete recovery, regardless of ESR values or leucocytosis. CT scans are of little value for

  2. Value of STOP-Bang questionnaire in screening patients with obstructive sleep apnea hypopnea syndrome in sleep disordered breathing clinic

    Institute of Scientific and Technical Information of China (English)

    Luo Jinmei; Huang Rong; Zhong Xu; Xiao Yi; Zhou Jiong

    2014-01-01

    Background Obstructive sleep apnea hypopnea syndrome (OSAHS) is the most common sleep-disordered breathing and is still underdiagnosed.This study was designed to evaluate the value of the STOP-Bang questionnaire (SBQ) in screening OSAHS in sleep-disordered breathing clinics in order to extend it into the general Chinese population.Methods Two hundred and twelve patients undergoing overnight polysomnography (PSG) in the sleep-disordered breathing clinic of Pecking Union Medical College Hospital between May 2011 and January 2012 were prospectively included and were asked to fill in the SBQ.A score of 3 or more of the SBQ indicated a high risk of OSAHS.We analyzed the sensitivities and specificities of SBQ in screening OSAHS.Logistic regression analysis was used to evaluate the probabilities of the severity of OSAHS based upon the apnea hypopnea index (AHI).Results The patients at high risk of OSAHS had higher AHI,higher oxygen desaturation index (ODI),lower pulse oxygen saturation (LSpO2) during sleep time and less sleep time in stage N3.SBQ scores were positively correlated with AHI,ODI and the ratio of SpO2 lower than 90%,and negatively correlated with LSpO2 during sleep.The sensitivities of the SBQ with AHI ≥5/h,AHI ≥15/h,AHI ≥30/h as cut-offs were 94.9%,96.5%,and 97.7%,respectively,and the specificities were 50.0%,28.6%,and 17.9%,respectively.The Logistic regression analysis showed the probability of severe OSAHS increased and the probability of normal subjects decreased with increasing SBQ score.Conclusions The STOP-Bang questionnaire has excellent sensitivity in screening OSAHS patients and can predict the severity of OSAHS.More studies will be required to determine the value of SBQ in the general Chinese population.

  3. Salvinorin A: A Mini Review of Physical and Chemical Properties Affecting Its Translation from Research to Clinical Applications in Humans.

    Science.gov (United States)

    Orton, Edward; Liu, Renyu

    2014-01-01

    Salvinorin A is a potent and selective agonist of kappa opioid receptors in the brain. Recent studies in several animal models have revealed that Salvinorin A has anti-addiction, anti-depression properties and exhibits pronounced neuroprotective effects against hypoxia/ischemia induced brain damage, and have raised interest in potential clinical applications in several acute pathologies involving oxygen deficiency in the brain. This review focuses on the chemical and physical properties of Salvinorin A and their impact on development of a rational formulation to enable its translation from a research compound to a novel therapeutic agent.

  4. Prediction of pKa values for druglike molecules using semiempirical quantum chemical methods

    DEFF Research Database (Denmark)

    Jensen, Jan Halborg; Swain, Christopher J; Olsen, Lars

    2017-01-01

    Rapid yet accurate pKa prediction for druglike molecules is a key challenge in computational chemistry. This study uses PM6-DH+/COSMO, PM6/COSMO, PM7/COSMO, PM3/COSMO, AM1/COSMO, PM3/SMD, AM1/SMD, and DFTB3/SMD to predict the pKa values of 53 amine groups in 48 druglike compounds. The approach uses...... uncertainties of ±0.2-0.3 pH units, which make them statistically equivalent. However, for all but PM3/SMD and AM1/SMD the RMSEs are dominated by a single outlier, cefadroxil, caused by proton transfer in the zwitterionic protonation state. If this outlier is removed, the RMSE values for PM3/COSMO and AM1/COSMO...... drop to 1.0 ± 0.2 and 1.1 ± 0.3, whereas PM3/SMD and AM1/SMD remain at 1.5 ± 0.3 and 1.6 ± 0.3/0.4 pH units, making the COSMO-based predictions statistically better than the SMD-based predictions. For pKa calculations where a zwitterionic state is not involved or proton transfer in a zwitterionic state...

  5. Prospective ECG-triggered coronary CT angiography: clinical value of noise-based tube current reduction method with iterative reconstruction.

    Directory of Open Access Journals (Sweden)

    Junlin Shen

    Full Text Available OBJECTIVES: To evaluate the clinical value of noise-based tube current reduction method with iterative reconstruction for obtaining consistent image quality with dose optimization in prospective electrocardiogram (ECG-triggered coronary CT angiography (CCTA. MATERIALS AND METHODS: We performed a prospective randomized study evaluating 338 patients undergoing CCTA with prospective ECG-triggering. Patients were randomly assigned to fixed tube current with filtered back projection (Group 1, n = 113, noise-based tube current with filtered back projection (Group 2, n = 109 or with iterative reconstruction (Group 3, n = 116. Tube voltage was fixed at 120 kV. Qualitative image quality was rated on a 5-point scale (1 = impaired, to 5 = excellent, with 3-5 defined as diagnostic. Image noise and signal intensity were measured; signal-to-noise ratio was calculated; radiation dose parameters were recorded. Statistical analyses included one-way analysis of variance, chi-square test, Kruskal-Wallis test and multivariable linear regression. RESULTS: Image noise was maintained at the target value of 35HU with small interquartile range for Group 2 (35.00-35.03HU and Group 3 (34.99-35.02HU, while from 28.73 to 37.87HU for Group 1. All images in the three groups were acceptable for diagnosis. A relative 20% and 51% reduction in effective dose for Group 2 (2.9 mSv and Group 3 (1.8 mSv were achieved compared with Group 1 (3.7 mSv. After adjustment for scan characteristics, iterative reconstruction was associated with 26% reduction in effective dose. CONCLUSION: Noise-based tube current reduction method with iterative reconstruction maintains image noise precisely at the desired level and achieves consistent image quality. Meanwhile, effective dose can be reduced by more than 50%.

  6. Radiogenic p-isotopes from SNIa, nuclear physics uncertainties and Galactic chemical evolution compared with values in primitive meteorites

    CERN Document Server

    Travaglio, C; Rauscher, T; Dauphas, N; Roepke, F K R; Hillebrandt, W

    2014-01-01

    The nucleosynthesis of proton-rich isotopes is calculated for multi-dimensional Chandrasekhar-mass models of Type Ia supernovae with different metallicities. The predicted abundances of the short-lived radioactive isotopes 92Nb, 97Tc, 98Tc and 146Sm are given in this framework. The abundance seeds are obtained by calculating s-process nucleosynthesis in the material accreted onto a carbon-oxygen white dwarf from a binary companion. A fine grid of s-seeds at different metallicities and 13C-pocket efficiencies is considered. A galactic chemical evolution model is used to predict the contribution of SNIa to the solar system p-nuclei composition measured in meteorites. Nuclear physics uncertainties are critical to determine the role of SNeIa in the production of 92Nb and 146Sm. We find that, if standard Chandrasekhar-mass SNeIa are at least 50% of all SNIa, they are strong candidates for reproducing the radiogenic p-process signature observed in meteorites.

  7. Influence of bath PH value on microstructure and corrosion resistance of phosphate chemical conversion coating on sintered Nd-Fe-B permanent magnets

    Science.gov (United States)

    Ding, Xia; Xue, Long-fei; Wang, Xiu-chun; Ding, Kai-hong; Cui, Sheng-li; Sun, Yong-cong; Li, Mu-sen

    2016-10-01

    The effect of bath PH value on formation, microstructure and corrosion resistance of the phosphate chemical conversion (PCC) coatings as well as the effect on the magnetic property of the magnets is investigated in this paper. The results show that the coating mass and thickness increase with the decrease of the bath PH value. Scanning electron microscopy observation demonstrates that the PCC coatings are in a blocky structure with different grain size. Transmission electron microscope and X-ray diffractometer tests reveal the coatings are polycomponent and are mainly composed of neodymium phosphate hydrate and praseodymium phosphate hydrate. The electrochemical analysis and static immersion corrosion test show the corrosion resistance of the PCC coatings prepared at bath PH value of 0.52 is worst. Afterwards the corrosion resistance increases first and then decreases with the increasing of the bath PH values. The magnetic properties of all the samples with PCC treatment are decreased. The biggest loss is occurred when the bath PH value is 0.52. Taken together, the optimum PH range of 1.00-1.50 for the phosphate solution has been determined.

  8. Long-term storage effect on chemical composition, nutritional value and quality of Greek onion landrace "Vatikiotiko".

    Science.gov (United States)

    Petropoulos, S A; Ntatsi, G; Fernandes, Â; Barros, L; Barreira, J C M; Ferreira, I C F R; Antoniadis, V

    2016-06-15

    The effect of storage at two temperatures (5±1 and 25±1 °C and 60-70±5% RH for both temperatures) on marketability and quality features of dry bulbs of local landrace "Vatikiotiko", "Sivan F1", "Red Cross F1" and "Creamgold" was examined. During storage measurements for fresh and dry weight of bulbs, tunic and flesh color, bulb firmness, nutritional value and mineral composition were taken at regular intervals. Storage concluded when either bulbs lost marketable quality or sprouting occurred. "Vatikiotiko" onion can be stored for at least 7months at 25±1 °C, whereas at 5±1 °C storage could be prolonged without significant marketability and quality loss. The fact that "Vatikiotiko" landrace can be considered a "storage" onion has to be capitalized in order to increase total production and yield, since storage could cover the market needs that arise throughout the year.

  9. Eucalyptus dundasii Maiden essential oil, chemical composition and insecticidal values against Rhyzopertha dominica (F. and Oryzaephilus surinamensis (L.

    Directory of Open Access Journals (Sweden)

    Aref Shiva Parsia

    2015-01-01

    Full Text Available The insecticidal effects of Eucalyptus dundasii Maiden essential oil was studied on the adults of the lesser grain borer, Rhyzopertha dominica (F., and the saw-toothed grain beetle, Oryzaephilus surinamensis (L.. Essential oil was obtained by the hydro-distillation method and essential oil composition was analysed by GC-MS. Chemical analysis indicated that 1,8-cineole (54.15%, p-cymene (12.41%, α-thujene (11.37%, and E-caryophyllene (6.7% were major constituents. For R. dominica and O. surinamensis, the LC50 of E. dundasii essential oil was 41.69 and 57.92 μl · l-1 of air, respectively. Increasing the concentration of the essential oil and the exposure time, increased mortality. The durability of fumigant toxicity on O. surinamensis adults was higher than on R. dominica adults and was statistically different. Based on the mean of the repellent indexes and the standard deviation, E. dundasii essence was repellent for both insects at 70, 140, and 280 μl · l-1 of air concentrations. Statistical analysis showed that Relative Growth Rate (RGR in O. surinamensis was higher than in R. dominica, and the Relative Consumption Rate (RCR, the Efficiency of Conversion of Ingested food (ECI, and the Feeding Deterrence Index (FDI in O. surinamensis was lower than in R. dominica. The many diverse bio-effects of E. dundasii essential oil confirmed that it is a good candidate for management of R. dominica and O. surinamensis

  10. Open and Closed Endotracheal Suctioning and Arterial Blood Gas Values: A Single-Blind Crossover Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Azam Faraji

    2015-01-01

    Full Text Available Aim. This study was aimed at comparing the effects of the open and closed suctioning techniques on the arterial blood gas values in patients undergoing open-heart surgery. Methods. In a clinical trial, we recruited 42 patients after open-heart surgery in an educational hospital. Each patient randomly underwent both open and closed suctioning. ABGs, PaO2, SaO2, PaCO2, were analyzed before and one, five, and fifteen minutes after each suctioning episode. Results. At first the pressure of oxygen in arterial blood increased; however, this increase in the open technique was greater than that of the closed system (P<0.001. The pressure of oxygen decreased five and fifteen minutes after both suctioning techniques (P<0.05. The trends of carbon dioxide variations after the open and closed techniques were upward and downward, respectively. Moreover, the decrease in the level of oxygen saturation five and fifteen minutes after the open suctioning was greater than that of the closed suctioning technique (P<0.05.  Conclusion. Arterial blood gas disturbances in the closed suctioning technique were less than those of the open technique. Therefore, to eliminate the unwanted effects of endotracheal suctioning on the arterial blood gases, the closed suctioning technique is recommended.

  11. Clinical and microbiologic effects of chemical versus mechanical cleansing in professional supportive implant therapy

    NARCIS (Netherlands)

    Strooker, H; Rohn, S; Van Winkelhoff, AJ

    1998-01-01

    The aim of the present study was to compare the cleansing properties of mechanical supportive care for dental implants with the use of an etching gel. Sixteen patients underwent a 5-month clinical trial with monthly recalls. These patients, wearing maxillary complete dentures and mandibular overdent

  12. Determination of Chemical Composition, Physical Characteristics and Nutritive Value of Treated Walnut Hull by Neurospora Sitophila through Nylon Bag and Gas Production Methods

    Directory of Open Access Journals (Sweden)

    Maasoomeh Takalloozadeh

    2015-01-01

    Full Text Available In this research, chemical composition, gas production characteristics, effective degradability and nutritive value index (NVI of DM and CP by in situ method of treated walnut hull by Nurospora Sitophila were studied. Three fistulated Kermani ram were used for determination of Walnut hull degradability. Data were analysed using completely randomize design. By processing walnut hull with Neurospora Sitophila, water holding capacity and total content of tannin and phenol decreased significantly, while the insoluble ash increased significantly. Processing had no significant effect on degradability parameters and NVI of dry matter and crude protein. Gas production volume in untreated Walnut hull in times 6, 12 and 24 hours increased significantly with comparison to the treated Walnut hull. Generally, processing of walnut hull with Nurospora Sitophila had no significant effect on nutritive value of this feedstuff.

  13. Chemical composition and biological value of spray dried porcine blood by-products and bone protein hydrolysate for young chickens.

    Science.gov (United States)

    Jamroz, D; Wiliczkiewicz, A; Orda, J; Skorupińska, J; Słupczyńska, M; Kuryszko, J

    2011-10-01

    The chemical composition of spray dried porcine blood by-products is characterised by wide variation in crude protein contents. In spray dried porcine blood plasma (SDBP) it varied between 670-780 g/kg, in spray dried blood cells (SDBC) between 830-930 g/kg, and in bone protein hydrolysate (BPH) in a range of 740-780 g/kg. Compared with fish meal, these feeds are poor in Met and Lys. Moreover, in BPH deep deficits of Met, Cys, Thr and other amino acids were found. The experiment comprised 7 dietary treatments: SDBP, SDBC, and BPH, each at an inclusion rate of 20 or 40 g/kg diet, plus a control. The addition of 20 or 40 g/kg of the analysed meals into feeds for very young chickens (1-28 d post hatch) significantly decreased the body weight (BW) of birds. Only the treatments with 40 g/kg of SDBP and SDBC showed no significant difference in BW as compared with the control. There were no significant differences between treatments and type of meal for feed intake, haematocrit and haemoglobin concentrations in blood. Addition of bone protein and blood cell meals to feed decreased the IgG concentration in blood and caused shortening of the femur and tibia bones. However, changes in the mineral composition of bones were not significantly affected by the type of meal used. The blood by-products, which are rich in microelements, improved retention of Ca and Cu only. In comparison to control chickens, significantly better accretion of these minerals was found in treatments containing 20 g/kg of SDBP or 40 g/kg of SDBC. Great variability in apparent ileal amino acid digestibility in chickens was determined. In this respect, some significant differences related to the type of meal fed were confirmed for Asp, Pro, Val, Tyr and His. In general, the apparent ileal digestibility of amino acids was about 2-3 percentage units better in chickens fed on diets containing the animal by products than in control birds.

  14. [Value of (99)Tc(m)-MDP SPECT/CT in clinical decision-making for nasopharyngeal carcinoma and a comparison of the values of different imaging techniques for diagnosing skull-base bone invasion].

    Science.gov (United States)

    Li, W; Zhang, R S; Zhang, L Q; Lu, B G; Fu, W H

    2017-02-23

    Objective: To analyze the clinical value of SPECT/CT in diagnosis of skull base bone invasion and clinical decision-making for nasopharyngeal carcinoma (NPC), and to compare their diagnostic value with SPECT/CT, CT, MRI, and MRI combined with SPECT (MRI-SPECT) for skull base bone invasion. Methods: Before treatment, among 348 newly diagnosed NPC patients, CT scan was performed in 186 patients (group A) and the remaining 162 patients received MRI scan (group B). Clinical doctors then made clinical management decisions according to the CT or MRI results. After that, all patients underwent (99)Tc(m)-MDP SPECT/CT examination for nasopharyngeal local tomography, and the results were provided to the clinical doctors to make clinical management decisions again. The changes between the two clinical management decisions were scored according to diagnosis, range of lesion, staging, treatment regimens, and auxiliary examination. The diagnostic value of CT scan, MRI scan, SPECT/CT and MRI-SPECT for skull base bone invasion was then evaluated and compared. Results: In terms of changes in scores of clinical management decisions, the score of group A was 1.387 and group B was 0.951, showing a significant difference between the two groups by Wilcoxon test (Z=6.570, P<0.001). By χ(2) test, there were correlations between CT and SPECT/CT (χ(2) =98.495, P<0.001), and between MRI and SPECT/CT (χ(2) =32.662, P<0.001). The consistency of CT and SPECT/CT (Kappa=0.713) was greater than MRI and SPECT (Kappa=0.449). The sensitivity of CT, MRI, SPECT/CT and MRI-SPECT was 67.1%, 84.5%, 90.8% and 100%, the specificity was 73.3%, 92.3%, 85.6% and 84.6%, and the area under the ROC curve was 0.702, 0.884, 0.882 and 0.923, respectively. Conclusions: SPECT/CT has important impact on clinical management decision for NPC. In the judgement of skull base invasion, the diagnostic value of SPECT/CT is significantly higher than CT and approximately equal to MRI. SPECT/CT should be one of the routine

  15. Chemical Composition of Date-Pits and Its Potential for Developing Value-Added Product - a Review

    Directory of Open Access Journals (Sweden)

    Hossain Mohammad Zakir

    2014-12-01

    Full Text Available Moisture, protein, oil and carbohydrate contents of date-pits varied from 3.1-12.5, 2.3-6.9, 5.0-12.5 and 70.9-86.9 g/100 g date-pits, respectively. BET-monolayer (i.e. strongly bound moisture content, solids-melting peak (at moisture: 6.7 g/100 g date-pits, and melting point of oil were 4.3 g/100 g dry-solids, 106oC, and 1.8oC, respectively. The major fatty acids were lauric, myristic, palmitic, stearic, oleic, and linoleic acids and polyphenol content varied from 21.0-62.0 mg/g date-pits depending on the varieties, types of solvent and temperature used for extraction. Date-pits showed effectives in animal and poultry feeds and it could be used as value added products, such as: dietary fibres, functional polysaccharides, caffeine-free drinks (similar to coffee, oil (biofuel or cooking oil, and other functional or medicinal products. Date-pits powder and activated carbon from date–pits showed effective in purifying water by removing different types of pollutants, such as heavy metals, boron, dyes, phenolic compounds, and pesticides. Date-pits also showed effective to be used as ingredient for composed, biomass, and fermentation processes.

  16. Clinical and pathological characteristics of mitochondrial myopathy and the screening value of simplified serum lactic acid exercise test

    Directory of Open Access Journals (Sweden)

    Xiao-fen ZHU

    2016-12-01

    Full Text Available Objective To analyze clinical and pathological characteristics of mitochondrial myopathy (MM in 15 patients, and to study the value of simplified serum lactic acid exercise test in the screening of mitochondrial myopathy.  Methods A total of 15 patients with mitochondrial myopathy diagnosed clinically and pathologically, 11  patients with other muscular diseases (OM, and 21 normal controls were collected. All subjects went up and down stairs for 5 min with medium effort. Blood samples for serum lactic acid detection were collected from all subjects before exercise, immediately after exercise and 10 min after exercise. Serum lactic acid levels were compared among 3 groups and among 3 time points. Results Patients with mitochondrial myopathy mainly presented as paroxysmally progressive muscular   soreness and weakness. Histopathological examination showed there were 8 cases with the proportion of ragged red fibers (RRF more than 5%. Serum lactic acid level before exercise, immediately after exercise and 10 min after exercise were (3.57 ± 1.88, (10.98 ± 4.84 and (7.87 ± 4.38 mmol/L in MM group, (1.89 ± 0.98, (6.05 ± 4.07 and (4.13 ± 3.14 mmol/L in OM group, (1.91 ± 0.53, (3.37 ± 1.22 and (2.52 ± 0.89 mmol/L in control group. Serum lactic acid level in MM group was significantly higher than that in control and OM groups before exercise (P = 0.000, 0.001, immediately after exercise (P = 0.000, 0.001, and 10 min after exercise (P = 0.000, 0.003. Serum lactic acid level in OM group was significantly higher than that in control group immediately after exercise (P = 0.042. Serum lactic acid level in 3 groups immediately after exercise (P = 0.000, 0.000, 0.003 and 10 min after exercise (P = 0.000, 0.000, 0.013 was significantly higher than that before exercise. Serum lactic acid level immediately after exercise was significantly higher than that 10 min after exercise in 3 groups (P = 0.000, 0.000, 0.003. Serum lactic acid level had most

  17. The Quest for Value-Added Products from Carbon Dioxide and Water in a Dielectric Barrier Discharge: A Chemical Kinetics Study.

    Science.gov (United States)

    Snoeckx, Ramses; Ozkan, Alp; Reniers, Francois; Bogaerts, Annemie

    2017-01-20

    Recycling of carbon dioxide by its conversion into value-added products has gained significant interest owing to the role it can play for use in an anthropogenic carbon cycle. The combined conversion with H2 O could even mimic the natural photosynthesis process. An interesting gas conversion technique currently being considered in the field of CO2 conversion is plasma technology. To investigate whether it is also promising for this combined conversion, we performed a series of experiments and developed a chemical kinetics plasma chemistry model for a deeper understanding of the process. The main products formed were the syngas components CO and H2 , as well as O2 and H2 O2 , whereas methanol formation was only observed in the parts-per-billion to parts-per-million range. The syngas ratio, on the other hand, could easily be controlled by varying both the water content and/or energy input. On the basis of the model, which was validated with experimental results, a chemical kinetics analysis was performed, which allowed the construction and investigation of the different pathways leading to the observed experimental results and which helped to clarify these results. This approach allowed us to evaluate this technology on the basis of its underlying chemistry and to propose solutions on how to further improve the formation of value-added products by using plasma technology.

  18. Predicting Ebola Infection and Survival Using qRT-PCR and Basic Clinical Labs: Comparing Ebola Virus Survival, Clinical Features, and Laboratory Values in 3 Non Human Primate Models

    Science.gov (United States)

    2016-12-22

    sample collection and yielded a panel of 46 routine clinical lab values [21]. Viral RNA Viral burden was measured on sera collected at pre...tested predictor. The measurement of the area under the ROC curve, known as ROC AUC, transfers the performance curve into a value range between 0.5 and... present our findings in a systematic format concentrating on laboratory values that we think reflect EBOV disease pathogenesis and that are easily

  19. Rhizomes of Eremostachys laciniata: Isolation and Structure Elucidation of Chemical Constituents and a Clinical Trial on Inflammatory Diseases

    Directory of Open Access Journals (Sweden)

    Abbas Delazar

    2013-08-01

    Full Text Available Purpose: The purpose of this study was the isolation and structure elucidation of chemical compounds from the rhizomes of Eremostachys laciniata (L Bunge (EL, an Iranian traditional medicinal herb with a thick root and pale purple or white flowers as well as the clinical studies on the therapeutic efficacy and safety of topical application of the EL extract in the management of some inflammatory conditions, e.g., arthritis, rheumatoid arthritis and septic arthritis (Riter’s syndrome. Methods: The structures of the isolated compounds were elucidated unequivocally on the basis of one and two dimensional NMR, UV and HR-FABMS spectroscopic data analyses. A single-blinded randomized clinical trial was carried out with the extract of the rhizomes of E. laciniata (EL to determine the efficacy and safety of the traditional uses of EL compared to that of piroxicam in treatment of inflammatory diseases, e.g., osteoarthritis, rheumatoid arthritis and Reiter’s syndrome. Results: Eleven iridoid glycosides, two phenylethanoids and two phytosterols were isolated and identified for the first time from the rhizomes of EL. After 14 days of treatment with the EL and piroxicam ointments, all groups showed significant improvements compared to the control groups. EL (5% ointment induced better initial therapeutic response than piroxicam (5% onitment. Conclusion: This clinical trial established that EL was suitable for topical applications as a safe and effective complementary therapy for inflammatory diseases.

  20. Roles of Chemical Complexity and Evolutionary Theory in Some Hepatic and Intestinal Enzymatic Systems in Chemical Reproducibility and Clinical Efficiency of Herbal Derivatives

    Directory of Open Access Journals (Sweden)

    Francesco Di Pierro

    2014-01-01

    Full Text Available Despite the great marketing success, most physicians attribute poor efficacy to herbals. This perception is due to two situations that are an integral part of the herbal topic. The first is the poor phytochemical reproducibility obtained during the production process of herbal extracts, as herbal extracts are not always standardized in the whole manufacturing process, but only in their titer. The second problem is linked to the evolution of important enzymatic systems: cytochromes and ABC proteins. They are both enzyme classes with detoxifying properties and seem to have evolved from the molecular mould provided by active plant substances. During the evolution, as still happens today, polyphenols, saponins, terpenes, and alkaloids were ingested together with food. They do not possess any nutritional value but seem to be provided with a potential pharmacological activity. Cytochromes and ABC proteins, which evolved over time to detoxify food from vegetable chemical “actives,” now seem to limit the action of herbal derivatives. The comprehension of these 2 events may explain the origin of the widespread scepticism of physicians about herbal medicine and suggests that, after correct herbal standardization, use of antagonists of cytochromes and ABC systems will make it possible to recover their pharmacological potential.

  1. Surface phenomena on gel-derived bioceramics - chemical and clinical aspects

    Energy Technology Data Exchange (ETDEWEB)

    Cholewa-Kowalska, K.; Laczka, M. [Univ. of Mining and Metallurgy, Cracow (Poland). Dept. of Glass and Enamels; Osyczka, A. [Jagiellonian Univ., Cracow (Poland). Dept. of Animal Biochemistry

    2002-07-01

    Two gel-derived glass-ceramic biomaterials S2, and A2 were obtained in the form of dense sinters. Chemical compositions of these materials were as follows (mole%): S2: 16CaO, 4P{sub 2}O{sub 5}, 80SiO{sub 2}; A2: 54CaO, 6P{sub 2}O{sub 5}, 40SiO{sub 2}. Biomaterials were produced from gel-derived powders by the hot-pressing process. The A2 material sintered at the temperature 800 C, while the S2 material required higher temperature of sintering (above 1000 C). The obtained biomaterials were tested with respect to the ability of apatite-like layer forming on the surface of these materials. The ability of formation of an apatite-like layer was examined in cell-free ''in vitro'' conditions (contact of materials with simulated body fluid SBF) as well as by the examination of mineral deposits formed on the surface of these materials as a result of bone marrow cell culture. FTIR and EDAX methods were used for the identification of layers forming on the surface of biomaterials. It has been found that only A2 material is able to form an apatite-like layer during immersion in SBF. On the other hand, the mineralised nodules identified as calcium phosphates, formed as a result of bone marrow cell culture, were found on no-bioactive S2 material as well as on A2 sinters. Hence, it may be postulated that the bone-forming behaviour of osteoblastic cells on the biomaterials is not strictly related to their bioactivity. (orig.)

  2. Prognostic value of clinical, laboratory and molecular predictors in the formation of personalized approaches to breast cancer treatment

    Directory of Open Access Journals (Sweden)

    Phokhach A.V.

    2016-06-01

    group without Herceptin (27,4±3,4 months and higher than the HER-2 / neu-negative patients (38,1±3,0 months. The value of coefficient Spearman rank correlation to tumor response and the factor of menopause, age, general condition of the patient were - 0.174; -0.222; -0.250 (P 0.05, in accordance. In the presence of neutropenia at 1 week after treatment it has been revealed significantly better tumor response to treatment - the correlation coefficient: 0.204 (p <0.05. Conclusion. Molecular subtypes detection had shown that HER-2/neu-positive and tripple negative breast cancer demonstrated the most aggresive course of disease. It was found that a more pronounced tumor response to combination chemotherapy can be expected in young patients, pre-menopausal, high ECOG status. The presence of neutropenia has a significantly positive impact on the results of treatment of patients with metastatic breast cancer. Citation: Phokhach AV, Elhajj MH, Bondarenko IN, Zavizion VF, Hurtovyi VA. [Prognostic value of clinical, laboratory and molecular predictors in the formation of personalized approaches to breast cancer treatment]. Morphologia. 2016;10(2:53-60. Russian.

  3. Prognostic value of site SYNTAX score and rationale for combining anatomic and clinical factors in decision making: Insights from the SYNTAX trial

    NARCIS (Netherlands)

    Y.-J. Zhang (Yao-Jun); A. Iqbal (Anwarul); C.A.M. Campos (Carlos); D. van Klaveren (David); C.V. Bourantas (Christos); K.D. Dawkins (Keith); A. Banning (Adrian); J. Escaned (Javier); T. de Vries (Ton); M-A.M. Morel (Marie-Angèle); V. Farooq (Vasim); Y. Onuma (Yoshinobu); H.M. Garcia-Garcia (Hector); G.W. Stone (Gregg); E.W. Steyerberg (Ewout); F.W. Mohr (Friedrich); P.W.J.C. Serruys (Patrick)

    2014-01-01

    textabstractBackground The results of SYNTAX trial have been reported based on "corelab" calculated SS (cSS). It has been shown that reproducibility of SS is better among the core laboratory technicians than interventional cardiologists. Thus, the prognostic value and clinical implication of the "si

  4. Clinical values of detecting excision repair cross complementing 1 and top-oisomerase I in individualized therapies of metastatic colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    邱继刚

    2014-01-01

    Objective To explore the clinical values of detecting drug related molecules excision repair cross complementing 1(ERCC1)and top-oisomeraseⅠ(TOPOⅠ)in individualized therapies of metastatic colorectal cancer.Methods From June 2009 to December 2011,90 patients at Huadong Hospital with metastatic colorectal cancer were randomly

  5. Predicting long-term independency in activities of daily living after middle cerebral artery stroke: does information from MRI have added predictive value compared with clinical information?

    NARCIS (Netherlands)

    Schiemanck, S.K.; Kwakkel, G.; Post, M.W.; Kappelle, L.J.; Prevo, A.J.

    2006-01-01

    BACKGROUND AND PURPOSE: To investigate whether neuroimaging information has added predictive value compared with clinical information for independency in activities of daily living (ADL) 1 year after stroke. METHODS: Seventy-five first-ever middle cerebral artery stroke survivors were evaluated in l

  6. The value of clinical electrophysiology in the assessment of the eye and visual system in the era of advanced imaging.

    Science.gov (United States)

    Whatham, Andrew R; Nguyen, Vincent; Zhu, Yuan; Hennessy, Michael; Kalloniatis, Michael

    2014-03-01

    Electrophysiological techniques allow clinical investigations to include a 'dissection' of the visual system. Using suitable electrophysiological techniques, the 'dissection' allows function to be ascribed to the different photoreceptors (rod and cone photoreceptors), retinal layers, retinal location or the visual pathway up to the visual cortex. Combined with advances in genetics, retinal biochemistry, visual fields and ocular imaging, it is now possible to obtain a better understanding of diseases affecting the retina and visual pathways. This paper reviews core electrophysiological principles that can complement other examination techniques, including advanced ocular imaging, and help the interpretation of other clinical data and thus, refine and guide clinical diagnosis.

  7. Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes.

    Science.gov (United States)

    Marzorati, Chiara; Pravettoni, Gabriella

    2017-01-01

    In the last 10 years, value has played a key role in the health care system. In this concept, innovations in medical practice and the increasing importance of patient centeredness have contributed to draw the attention of the medical community. Nonetheless, a large consensus on the meaning of "value" is still lacking: patients, physicians, policy makers, and other health care professionals have different ideas on which component of value may play a prominent role. Yet, shared clinical decision-making and patient empowerment have been recognized as fundamental features of the concept of value. Different paradigms of health care system embrace different meanings of value, and the absence of common and widely accepted definition does not help to identify a unique model of care in health care system. Our aim is to provide an overview of those paradigms that have considered value as a key theoretical concept and to investigate how the presence of value can influence the medical practice. This article may contribute to draw attention toward patients and propose a possible link between health care system based on "value" and new paradigms such as patient-centered system (PCS), patient empowerment, and P5 medicine, in order to create a predictive, personalized, preventive, participatory, and psycho-cognitive model to treat patients. Indeed, patient empowerment, value-based system, and P5 medicine seem to shed light on different aspects of a PCS, and this allows a better understanding of people under care.

  8. The effect of free air carbon dioxide enrichment and nitrogen fertilisation on the chemical composition and nutritional value of wheat and barley grain.

    Science.gov (United States)

    Wroblewitz, Stefanie; Hüther, Liane; Manderscheid, Remy; Weigel, Hans-Joachim; Wätzig, Hermann; Dänicke, Sven

    2013-08-01

    A rising atmospheric CO2 concentration might influence the nutrient composition of feedstuffs and consequently the nutritional value for livestock. The present study investigates the effects of atmospheric CO2 enrichment on the chemical composition and nutritional value of winter wheat cv. "Batis" and winter barley cv. "Theresa". Both cereals were grown at two different atmospheric CO2 concentrations (ambient CO2 [AMBI]: 380 ppm and enriched CO2 [free air carbon dioxide enrichment, FACE]: 550 ppm) for two growing seasons. The influence of two different nitrogen (N) fertilisation levels (adequate N supply [N100] and nearly 50% of adequate N supply [N50]) were studied as well. A significant effect was observed for the crude protein content, which declined at FACE condition in a range of 8-16 g kg(-1) in wheat and of 10-20 g kg(-1) in barley. A reduced N fertilisation level resulted in a strong reduction of crude protein concentration in both cereal species. In wheat, a decrease in N supply significantly enhanced the concentration of starch and crude fibre. In barley, only the concentration of fructose increased under FACE condition and reduced N fertilisation. The FACE did not have major effects on the concentrations of minerals, while the influence of N fertilisation was different for both cereals. Whereas no effects could be observed for barley, a reduced N supply caused a significant reduction in concentrations of zinc, manganese and iron in wheat. Furthermore, an undirected effect of atmospheric CO2 and N fertilisation levels were found for the amino acid concentrations. Based on these results, future scenarios of climate change would have an impact on the nutritional value of cereal grains.

  9. Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes

    Directory of Open Access Journals (Sweden)

    Marzorati C

    2017-03-01

    Full Text Available Chiara Marzorati,1,2 Gabriella Pravettoni2,3 1Foundations of the Life Sciences, Bioethics and Cognitive Science, European School of Molecular Medicine (SEMM, 2Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 3Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy Abstract: In the last 10 years, value has played a key role in the health care system. In this concept, innovations in medical practice and the increasing importance of patient centeredness have contributed to draw the attention of the medical community. Nonetheless, a large consensus on the meaning of “value” is still lacking: patients, physicians, policy makers, and other health care professionals have different ideas on which component of value may play a prominent role. Yet, shared clinical decision-making and patient empowerment have been recognized as fundamental features of the concept of value. Different paradigms of health care system embrace different meanings of value, and the absence of common and widely accepted definition does not help to identify a unique model of care in health care system. Our aim is to provide an overview of those paradigms that have considered value as a key theoretical concept and to investigate how the presence of value can influence the medical practice. This article may contribute to draw attention toward patients and propose a possible link between health care system based on “value” and new paradigms such as patient-centered system (PCS, patient empowerment, and P5 medicine, in order to create a predictive, personalized, preventive, participatory, and psycho-cognitive model to treat patients. Indeed, patient empowerment, value-based system, and P5 medicine seem to shed light on different aspects of a PCS, and this allows a better understanding of people under care. Keywords: health care system, value, value-based medicine, patient empowerment, clinical decision

  10. Clinical Value of High Mobility Group Box 1 and the Receptor for Advanced Glycation End-products in Head and Neck Cancer: A Systematic Review.

    Science.gov (United States)

    Nguyen, Austin; Bhavsar, Sheila; Riley, Erinn; Caponetti, Gabriel; Agrawal, Devendra

    2016-10-01

    Introduction High mobility group box 1 is a versatile protein involved in gene transcription, extracellular signaling, and response to inflammation. Extracellularly, high mobility group box 1 binds to several receptors, notably the receptor for advanced glycation end-products. Expression of high mobility group box 1 and the receptor for advanced glycation end-products has been described in many cancers. Objectives To systematically review the available literature using PubMed and Web of Science to evaluate the clinical value of high mobility group box 1 and the receptor for advanced glycation end-products in head and neck squamous cell carcinomas. Data synthesis A total of eleven studies were included in this review. High mobility group box 1 overexpression is associated with poor prognosis and many clinical and pathological characteristics of head and neck squamous cell carcinomas patients. Additionally, the receptor for advanced glycation end-products demonstrates potential value as a clinical indicator of tumor angiogenesis and advanced staging. In diagnosis, high mobility group box 1 demonstrates low sensitivity. Conclusion High mobility group box 1 and the receptor for advanced glycation end-products are associated with clinical and pathological characteristics of head and neck squamous cell carcinomas. Further investigation of the prognostic and diagnostic value of these molecules is warranted.

  11. Clinical Value of High Mobility Group Box 1 and the Receptor for Advanced Glycation End-products in Head and Neck Cancer: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Nguyen, Austin

    2016-04-01

    Full Text Available Introduction High mobility group box 1 is a versatile protein involved in gene transcription, extracellular signaling, and response to inflammation. Extracellularly, high mobility group box 1 binds to several receptors, notably the receptor for advanced glycation end-products. Expression of high mobility group box 1 and the receptor for advanced glycation end-products has been described in many cancers. Objectives To systematically review the available literature using PubMed and Web of Science to evaluate the clinical value of high mobility group box 1 and the receptor for advanced glycation end-products in head and neck squamous cell carcinomas. Data synthesis A total of eleven studies were included in this review. High mobility group box 1 overexpression is associated with poor prognosis and many clinical and pathological characteristics of head and neck squamous cell carcinomas patients. Additionally, the receptor for advanced glycation end-products demonstrates potential value as a clinical indicator of tumor angiogenesis and advanced staging. In diagnosis, high mobility group box 1 demonstrates low sensitivity. Conclusion High mobility group box 1 and the receptor for advanced glycation end-products are associated with clinical and pathological characteristics of head and neck squamous cell carcinomas. Further investigation of the prognostic and diagnostic value of these molecules is warranted.

  12. Added value of CT perfusion compared to CT angiography in predicting clinical outcomes of stroke patients treated with mechanical thrombectomy

    Energy Technology Data Exchange (ETDEWEB)

    Tsogkas, Ioannis; Knauth, Michael; Schregel, Katharina; Behme, Daniel; Psychogios, Marios Nikos [University Medicine Goettingen, Department of Neuroradiology, Goettingen (Germany); Wasser, Katrin; Maier, Ilko; Liman, Jan [University Medicine Goettingen, Department of Neurology, Goettingen (Germany)

    2016-11-15

    CTP images analyzed with the Alberta stroke program early CT scale (ASPECTS) have been shown to be optimal predictors of clinical outcome. In this study we compared two biomarkers, the cerebral blood volume (CBV)-ASPECTS and the CTA-ASPECTS as predictors of clinical outcome after thrombectomy. Stroke patients with thrombosis of the M1 segment of the middle cerebral artery were included in our study. All patients underwent initial multimodal CT with CTP and CTA on a modern CT scanner. Treatment consisted of full dose intravenous tissue plasminogen activator, when applicable, and mechanical thrombectomy. Three neuroradiologists separately scored CTP and CTA images with the ASPECTS score. Sixty-five patients were included. Median baseline CBV-ASPECTS and CTA-ASPECTS for patients with favourable clinical outcome at follow-up were 8 [interquartile range (IQR) 8-9 and 7-9 respectively]. Patients with poor clinical outcome showed a median baseline CBV-ASPECTS of 6 (IQR 5-8, P < 0.0001) and a median baseline CTA-ASPECTS of 7 (IQR 7-8, P = 0.18). Using CBV-ASPECTS and CTA-ASPECTS raters predicted futile reperfusions in 96 % and 56 % of the cases, respectively. CBV-ASPECTS is a significant predictor of clinical outcome in patients with acute ischemic stroke treated with mechanical thrombectomy. (orig.)

  13. Assessment of cerebral visual impairment with the L94 visual perceptual battery: clinical value and correlation with MRI findings.

    Science.gov (United States)

    Ortibus, E; Lagae, L; Casteels, I; Demaerel, P; Stiers, P

    2009-03-01

    In this article we describe visual perceptual abilities of a clinical population, referred for visual problems to our multidisciplinary team and assessed with the five computer tasks from the L94 visual perceptual battery. Clinical and neuroimaging findings were correlated with the findings on this task battery. Seventy children (35 males, 35 females) constituted our cohort. Age ranged from 4 to 20 years (mean 7y [SD 3y]). Forty children were born before 37 weeks gestational age. Thirty-six children had cerebral palsy (CP), of whom 24 had spastic diplegia, five had spastic hemiplegia, and four had spastic quadriplegia. Three children had ataxic CP. Perceptual visual impairment (PVI) was established in comparison to the performance age obtained on non-verbal intelligence subtests, instead of chronological age. Our results suggest that children with a history of preterm birth and a clinical CP picture are most at risk for a specific PVI. Correlations among other clinical variables did not define a clinical subgroup more at risk. Children with periventricular leucomalacia were almost equally represented in both PVI and non-PVI groups. Normal magnetic resonance imaging did not exclude the presence of PVI. In these children, however, we found another impairment profile, more in favour of dorsal stream impairment.

  14. Objective malignancy grading of squamous cell carcinoma of the lung. Stereologic estimates of mean nuclear size are of prognostic value, independent of clinical stage of disease

    DEFF Research Database (Denmark)

    Ladekarl, M; Bæk-Hansen, T; Henrik-Nielsen, R

    1995-01-01

    BACKGROUND: The prognostic value of quantitative histopathologic parameters was evaluated in 55 consecutively treated patients with operable lung carcinoma of squamous (N = 39) and mixed, adenosquamous (N = 16) cell type. Patients alive were followed for at least 12 years. METHODS: Using a projec......BACKGROUND: The prognostic value of quantitative histopathologic parameters was evaluated in 55 consecutively treated patients with operable lung carcinoma of squamous (N = 39) and mixed, adenosquamous (N = 16) cell type. Patients alive were followed for at least 12 years. METHODS: Using...... of nuclei to tissue, and the number of mitotic profiles per 10(3) nuclear profiles. For each patient, information was recorded regarding sex, age at diagnosis, and clinical stage of disease. RESULTS: Single-factor analyses showed that a favorable prognosis was associated with early clinical stages (Stages I...... volume were found to be parameters of significant, independent prognostic value. CONCLUSIONS: The present feasibility study indicates that estimates of the mean nuclear volume are of prognostic value, independent of the clinical stage of disease. This quantitative histopathologic variable is highly...

  15. A review of the empirical evidence of the value of structuring and coding of clinical information within electronic health records for direct patient care

    Directory of Open Access Journals (Sweden)

    Dipak Kalra

    2013-05-01

    Full Text Available Background The case has historically been presented that structured and/or coded electronic health records (EHRs benefit direct patient care, but the evidence base for this is not well documented.Methods We searched for evidence of direct patient care value from the use of structured and/or coded information within EHRs. We interrogated nine international databases from 1990 to 2011. Value was defined using the Institute of Medicine’s six areas for improvement for healthcare systems: effectiveness, safety, patient-centredness, timeliness, efficiency and equitability. We included studies satisfying the Cochrane Effective Practice and Organisation of Care (EPOC group criteria.Results Of 5016 potentially eligible papers, 13 studies satisfied our criteria: 10 focused on effectiveness, with eight demonstrating potential for improved proxy and actual clinical outcomes if a structured and/or coded EHR was combined with alerting or advisory systems in a focused clinical domain. Three studies demonstrated improvement in safety outcomes. No studies were found reporting value in relation to patient-centredness, timeliness, efficiency or equitability.Conclusions We conclude that, to date, there has been patchy effort to investigate empirically the value from structuring and coding EHRs for direct patient care. Future investments in structuring and coding of EHRs should be informed by robust evidence as to the clinical scenarios in which patient care benefits may be realised.

  16. Clinical value of nutritional status in neurodegenerative diseases: What is its impact and how it affects disease progression and management?

    Science.gov (United States)

    Tsagalioti, Eftyhia; Trifonos, Christina; Morari, Aggeliki; Vadikolias, Konstantinos; Giaginis, Constantinos

    2016-11-30

    Neurodegenerative diseases constitute a major problem of public health that is associated with an increased risk of mortality and poor quality of life. Malnutrition is considered as a major problem that worsens the prognosis of patients suffering from neurodegenerative diseases. In this aspect, the present review is aimed to critically collect and summarize all the available existing clinical data regarding the clinical impact of nutritional assessment in neurodegenerative diseases, highlighting on the crucial role of nutritional status in disease progression and management. According to the currently available clinical data, the nutritional status of patients seems to play a very important role in the development and progression of neurodegenerative diseases. A correct nutritional evaluation of neurodegenerative disease patients and a right nutrition intervention is essential in monitoring their disease.

  17. The risk factors for abnormal ankle-brachial index in type 2 diabetic patients and clinical predictive value for diabetic foot

    Institute of Scientific and Technical Information of China (English)

    张净

    2013-01-01

    Objective To investigate the prevalence of diabetic foot (DF) and the normal,high and low ankle brachial index (ABI) in type 2 diabetic patients and explore the risk factor for abnormal ABI and the clinical predictive value for DF.Methods A total of 2 681 type 2 diabetic patients who visited our hospital between January,2007and December,2009 were enrolled in the study.The clinical data were analyzed and the risk factors for abnormal ABI were determined by logistic regression analysis.Results ABI was normal (0.9-<1.3) in 2 362 cases

  18. Value of internal limiting membrane peeling in surgery for idiopathic macular hole stage 2 and 3: a randomised clinical trial

    DEFF Research Database (Denmark)

    Christensen, U C; Krøyer, K; Sander, B

    2009-01-01

    AIM: To determine the effect of internal limiting membrane (ILM) peeling on anatomical and functional success rates in stage 2 and 3 idiopathic macular hole surgery (MHS). METHODS: Randomised clinical trial of stage 2 and 3 idiopathic macular hole without visible epiretinal fibrosis and with less...

  19. The effects of clinical and statistical heterogeneity on the predictive values of results from meta-analyses

    NARCIS (Netherlands)

    Melsen, W G; Rovers, M M; Bonten, M J M; Bootsma, M C J

    2014-01-01

    Variance between studies in a meta-analysis will exist. This heterogeneity may be of clinical, methodological or statistical origin. The last of these is quantified by the I(2) -statistic. We investigated, using simulated studies, the accuracy of I(2) in the assessment of heterogeneity and the effec

  20. Functional roles and clinical values of insulin-like growth factor-binding protein-5 in different types of cancers

    Institute of Scientific and Technical Information of China (English)

    G(o)k(c)e Güllü; Sevgi Karabulut; Mustafa Akkiprik

    2012-01-01

    Insulin-like growth factor-binding proteins (IGFBPs) are critical regulators of the mitogenic activity of insulin-like growth factors (IGFs).IGFBP5,one of these IGFBPs,has special structural features,including a nuclear transport domain,heparin-binding motif,and IGF/extracellular matrix/acid-labile subunit-binding sites.Furthermore,IGFBP5 has several functional effects on carcinogenesis and even normal cell processes,such as cell growth,death,motility,and tissue remodeling.These biological effects are sometimes related with IGF (IGF-dependent effects) and sometimes not (IGF-independent effects).The functional role of IGFBP5 is most likely determined in a cell-type and tissue-type specific manner but also depends on cell context,especially in terms of the diversity of interacting proteins and the potential for nuclear localization.Clinical findings show that IGFBP5 has the potential to be a useful clinical biomarker for predicting response to therapy and clinical outcome of cancer patients.In this review,we summarize the functional diversity and clinical importance of IGFBP5 in different types of cancers.

  1. Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes

    Science.gov (United States)

    Marzorati, Chiara; Pravettoni, Gabriella

    2017-01-01

    In the last 10 years, value has played a key role in the health care system. In this concept, innovations in medical practice and the increasing importance of patient centeredness have contributed to draw the attention of the medical community. Nonetheless, a large consensus on the meaning of “value” is still lacking: patients, physicians, policy makers, and other health care professionals have different ideas on which component of value may play a prominent role. Yet, shared clinical decision-making and patient empowerment have been recognized as fundamental features of the concept of value. Different paradigms of health care system embrace different meanings of value, and the absence of common and widely accepted definition does not help to identify a unique model of care in health care system. Our aim is to provide an overview of those paradigms that have considered value as a key theoretical concept and to investigate how the presence of value can influence the medical practice. This article may contribute to draw attention toward patients and propose a possible link between health care system based on “value” and new paradigms such as patient-centered system (PCS), patient empowerment, and P5 medicine, in order to create a predictive, personalized, preventive, participatory, and psycho-cognitive model to treat patients. Indeed, patient empowerment, value-based system, and P5 medicine seem to shed light on different aspects of a PCS, and this allows a better understanding of people under care. PMID:28356752

  2. Predictive value of antinuclear antibodies in autoimmune diseases classified by clinical criteria: Analytical study in a specialized health institute, one year follow-up

    Science.gov (United States)

    Soto, María Elena; Hernández-Becerril, Nidia; Perez-Chiney, Ada Claudia; Hernández-Rizo, Alfredo; Telich-Tarriba, José Eduardo; Juárez-Orozco, Luis Eduardo; Melendez, Gabriela; Bojalil, Rafael

    2013-01-01

    Introduction: Determination of antinuclear antibodies (ANA) by indirect immunofluorescence (IIF) is usually the initial test for the diagnosis of systemic rheumatic diseases (SRD). Assigning predictive values to positive and negative results of the test is vital because lack of knowledge about ANAs and their usefulness in classification criteria of SRD leads to inappropriate use. Methods: Retrospective study, ANA tests requested by different specialties, correlation to patients' final diagnosis. Results: The prevalence of autoimmune disease was relatively low in our population yielding a low PPV and a high NPV for the ANA test. 40% of the patients had no clinical criteria applied prior to test. Coexistence of two or more autoimmune disorders affects prevalence and predictive values. Conclusion: Application of the test after careful evaluation for clinical criteria remarkably improves the positive likelihood ratio for the diagnosis. PMID:26623249

  3. Pathophysiology of dilatation of pupils due to scorpion and snake envenomation and its therapeutic value: Clinical observations

    Science.gov (United States)

    Bawaskar, Himmatrao S; Bawaskar, Parag H; Bawaskar, Pramodini H

    2017-01-01

    Dilated nonreacting pupils are routinely taken as a sign of irreversible brain damage. Alpha-receptor stimulation (scorpion sting) and presynaptic acetylcholine receptor blocker (krait bite) may result in dilation of pupils without involvement of the brain. This study was aimed to clinically evaluate the response of pupils in scorpion sting and krait bite. Victims of scorpion sting and krait bite were chosen from Raigad district. Scorpion sting and krait bite cases were admitted to hospital and were clinically evaluated in detail regarding neurological manifestations. Both cases had nonreacting dilation of pupils, complete neurological recovery accompanied with reverse of pupillary size and its response to light. In scorpion sting and krait bite poisoning, dilated nonreacting pupils are not the signs of irreversible brain damage. PMID:28300747

  4. Predictive value of clinical risk indicators in child development: final results of a study based on psychoanalytic theory

    OpenAIRE

    Maria Cristina Machado Kupfer; Alfredo Nestor Jerusalinsky; Leda Mariza Fischer Bernardino; Daniele Wanderley; Paulina Schmidtbauer Barbosa Rocha; Silvia Eugenia Molina; Léa Martins Sales; Regina Stellin; M. Eugênia Pesaro; Rogerio Lerner

    2010-01-01

    We present the final results of a study using the IRDI (Clinical Risk Indicators in Child Development). Based on a psychoanalytic approach, 31 risk signs for child development were constructed and applied to 726 children between the ages of 0 and 18 months. One sub-sample was evaluated at the age of three. The results showed a predictive capacity of IRDIs to indicate developmental problems; 15 indicators for the IRDI were also highlighted that predict psychic risk for the constitution of the ...

  5. Immunophenotyping of peripheral blood, ranges of serum chemistries and clinical hematology values of healthy chimpanzees (Pan troglodytes).

    Science.gov (United States)

    Stone, G A; Johnson, B K; Druilhet, R; Garza, P B; Gibbs, C J

    2000-10-01

    This paper presents clinical chemistry, hematology and immunophenotyping data from 102 chimpanzees over a 2-year period. The groupings were: 3 years or less, 4-7 years, and 8 + years. These data are intended to augment formerly published information on these parameters and to serve as a concise reference guide for primate veterinarians and researchers for whom these data may be useful. This study has larger samplings than previously published data and more panel constituents by immunophenotyping.

  6. Evaluating the value of a web-based natural medicine clinical decision tool at an academic medical center

    Directory of Open Access Journals (Sweden)

    Karpa Kelly

    2011-10-01

    Full Text Available Abstract Background Consumer use of herbal and natural products (H/NP is increasing, yet physicians are often unprepared to provide guidance due to lack of educational training. This knowledge deficit may place consumers at risk of clinical complications. We wished to evaluate the impact that a natural medicine clinical decision tool has on faculty attitudes, practice experiences, and needs with respect to H/NP. Methods All physicians and clinical staff (nurse practitioners, physicians assistants (n = 532 in departments of Pediatrics, Family and Community Medicine, and Internal Medicine at our medical center were invited to complete 2 electronic surveys. The first survey was completed immediately before access to a H/NP clinical-decision tool was obtained; the second survey was completed the following year. Results Responses were obtained from 89 of 532 practitioners (16.7% on the first survey and 87 of 535 (16.3% clinicians on the second survey. Attitudes towards H/NP varied with gender, age, time in practice, and training. At baseline, before having an evidence-based resource available, nearly half the respondents indicated that they rarely or never ask about H/NP when taking a patient medication history. The majority of these respondents (81% indicated that they would like to learn more about H/NP, but 72% admitted difficulty finding evidence-based information. After implementing the H/NP tool, 63% of database-user respondents indicated that they now ask patients about H/NP when taking a drug history. Compared to results from the baseline survey, respondents who used the database indicated that the tool significantly increased their ability to find reliable H/NP information (P Conclusions Our results demonstrate healthcare provider knowledge and confidence with H/NP can be improved without costly and time-consuming formal H/NP curricula. Yet, it will be challenging to make providers aware of such resources.

  7. Diagnostic Value of Panoramic Radiography, Cone Beam Computed Tomography (CBCT and Clinical Measurement in Determining Bone Dimensions

    Directory of Open Access Journals (Sweden)

    Amirreza Babaloo

    2015-07-01

    Full Text Available Introduction: Calculation of the bone dimensions is of great importance for implant treatment. Several radiographic modalities have been used for this purpose. This study compared the accuracy of mesiodistal measurements of bone using panoramic radiography, cone beam computed tomography (CBCT, and the clinical methods. Methods: In this descriptive cross-sectional study, panoramic and CBCT images were obtained from 100 implant patients. Mesiodistal bone dimensions (distance between tooth CEJ in the mesial of edentulous region and CEJ of the tooth in distal of edentulous region were calculated using a scaled ruler on the orthopantomograms and the system software in the CBCT images. During the implant insertions, a mucoperiosteal flap was raised and clinical dimensions of the bone were measured by a periodontal probe and bone gauge. The differences of bone height and thickness measurements between gold standard and CBCT or panoramic modalities were analyzed using Student’s t- test. Results: The mean bone height was 10.64±1.55, 11.44±1.51, and 10.68±1.6 mm in the clinical, panoramic and CBCT modalities, respectively. Statistically significant difference was noted between the clinical and panoramic techniques (P0.05. During the bone height calculations, 79%, 62% and 78% of the images were ranked in the normal range using CBCT, panoramic and gold standard measurements, respectively. The mean areas under the ROC curve were 0.92 and 0.83 in CBCT and panoramic techniques, respectively. Conclusion: Accuracy of the CBCT images was higher than panoramic technique in measuring the bone dimensions and this technique can be confidently used to calculate the bone dimensions for the implant surgeries.   Keywords: Partially edentulous jaw; panoramic radiography; cone-beam computed tomography; bone dimensions

  8. Current perspectives of mi-RNA in oesophageal adenocarcinoma: Roles in predicting carcinogenesis, progression and values in clinical management.

    Science.gov (United States)

    Amin, Moein; Lam, Alfred King-yin

    2015-06-01

    Aberrant expressions of micro-ribonucleic acids (miRs) are closely associated with the pathogenesis in many human cancers. In oesophageal adenocarcinomas, altered expressions of different sets of miRs are noted to be associated with the development of adenocarcinoma from Barrett's oesophagus. In different studies, miRs such as miR-192, miR-196 and miR-21 were frequently noted to up-regulated whereas miR-203, miR-205 and miR-let-7 were commonly down-regulated during the development of Barrett's oesophagus to oesophageal adenocarcinoma. In addition, changes in the expression of miRs are associated with the predication of metastasis, prognosis and response to chemo-radiation in the patients with oesophageal adenocarcinoma. Experimental studies in manipulating the miRs in cancer cell lines could provide hints for therapeutics for the cancer. However, the number of studies reported on these aspects of oesophageal adenocarcinoma was limited and the miRs noted needed to be confirmed by additional studies. Overall, the mechanisms of involvements of miRs in pathogenesis and progression of oesophageal adenocarcinoma are complex. Although miRs have the potential to act as prognostic and clinical biomarkers for cancer therapy in oesophageal adenocarcinoma, more works in larger populations and clinical trials are needed to validate these clinical implications.

  9. Four-hour quantitative real-time polymerase chain reaction-based comprehensive chromosome screening and accumulating evidence of accuracy, safety, predictive value, and clinical efficacy.

    Science.gov (United States)

    Treff, Nathan R; Scott, Richard T

    2013-03-15

    Embryonic comprehensive chromosomal euploidy may represent a powerful biomarker to improve the success of IVF. However, there are a number of aneuploidy screening strategies to consider, including different technologic platforms with which to interrogate the embryonic DNA, and different embryonic developmental stages from which DNA can be analyzed. Although there are advantages and disadvantages associated with each strategy, a series of experiments producing evidence of accuracy, safety, clinical predictive value, and clinical efficacy indicate that trophectoderm biopsy and quantitative real-time polymerase chain reaction (qPCR)-based comprehensive chromosome screening (CCS) may represent a useful strategy to improve the success of IVF. This Biomarkers in Reproductive Medicine special issue review summarizes the accumulated experience with the development and clinical application of a 4-hour blastocyst qPCR-based CCS technology.

  10. Predictive value of PSA velocity over early clinical and pathological parameters in patients with localized prostate cancer who undergo radical retropubic prostatectomy

    Directory of Open Access Journals (Sweden)

    Martinez Carlos A.L.

    2004-01-01

    Full Text Available OBJECTIVES: To analyze the behavior of the prostate specific antigen velocity (PSAV in localized prostate adenocarcinoma. MATERIALS AND METHODS: We conducted a retrospective study of 500 men who had localized prostate adenocarcinoma, who underwent radical retropubic prostatectomy between January 1986 and December 1999. The PSAV was calculated for each patient and subsequently, the values were correlated with 5 groups: age, initial PSA value, clinical stage, tumor volume and Gleason score. RESULTS: The behavior of PSAV presented statistic significance with an increment between 1.3 ng/mL and 9.6 ng/mL, ranging from 38.6% and 59.8% when compared with the initial PSA value (p < 0.0001, clinical stage (p = 0.0002, tumor volume (p < 0.0001 and Gleason score (p = 0.0009. CONCLUSION: PSAV up to 2.5 ng/mL/year is associated with factors of good prognosis, such as initial PSA below 10 mg/mL, clinical stage T1, tumor volume below 20% and Gleason score lower than 7.

  11. Flash co-pyrolysis of biomass with polyhydroxybutyrate: Part 1. Influence on bio-oil yield, water content, heating value and the production of chemicals

    Energy Technology Data Exchange (ETDEWEB)

    T. Cornelissen; M. Jans; J. Yperman; G. Reggers; S. Schreurs; R. Carleer [Hasselt University, Diepenbeek (Belgium). Laboratory of Applied Chemistry

    2008-09-15

    Bio-oil obtained via flash pyrolysis shows potential to be applied as a renewable fuel. However, bio-oil often contains high amounts of water, which is a major drawback for its application. The influence of a biopolymer - polyhydroxybutyrate (PHB) on the pyrolysis of willow is investigated using a semi-continuous home-built pyrolysis reactor. The flash co-pyrolysis of willow/PHB blends (w/w ratio 7:1, 3:1, 2:1 and 1:1) clearly shows particular merits: a synergetic increase in pyrolysis yield, a synergetic reduction of the water content in bio-oil, an increase in heating value, and a production of easily separable chemicals. The occurrence of synergetic interactions is observed based on a comparison between the actual pyrolysis results of the willow/PHB blends, the theoretical pyrolysis results calculated from the reference pyrolysis experiments (pure willow and pure PHB) and their respective w/w ratio. The co-pyrolysis of 1:1 willow/PHB shows the best overall results. 24 refs., 9 figs., 5 tabs.

  12. The history of derogations from chemical parametric values set by the European Drinking Water Directive (Council Directive 98/83/EC), in Italy and the Piedmont region.

    Science.gov (United States)

    Zicari, Giuseppe; Marro, Silvia; Soardo, Vincenzo; Berruti, Renza; Maggi, Claudio; Cerrato, Elena; Ferrari, Romina; Gulino, Margherita

    2014-01-01

    Italian legislation (Article 13 of Legislative Decree 31/2001) provides for the possibility of establishing derogations from chemical parametric values for drinking water set by EU legislation (Council Directive 98/83/EC), if the supply of drinking water cannot be maintained by any other reasonable means. A derogation is possible only after obtaining a specific authorization and must be limited to the shortest time possible. This paper presents the history of derogations granted in Italy and the case of arsenic and nickel in Piedmont. From 2003 to 2009, 13 regions requested a derogation (Campania, Emilia Romagna, Latium, Lombardy, Marche, Piedmont, Apulia, Sardinia, Sicily, Tuscany, Trentino Alto Adige, Umbria, Venetia) at different times and for a total of 13 parameters. In 2012, tap water provided to almost one million Italians in 112 municipalities of three regions (Latium, Tuscany and Campania), did not comply with the legal limits for the following parameters: arsenic, boron and fluorides. Currently, in the Piedmont region there are no derogations from the maximum permitted concentrations of contaminants in drinking water. In the past derogations have been applied for the nickel parameter (years 2006-2007) and from the arsenic parameter (years 2006-2008).

  13. Clinical Value of Natriuretic Peptides in Predicting Time to Dialysis in Stage 4 and 5 Chronic Kidney Disease Patients

    Science.gov (United States)

    Sundqvist, Sofia; Larson, Thomas; Cauliez, Bruno; Bauer, Fabrice; Dumont, Audrey; Le Roy, Frank; Hanoy, Mélanie; Fréguin-Bouilland, Caroline; Godin, Michel

    2016-01-01

    Background Anticipating the time to renal replacement therapy (RRT) in chronic kidney disease (CKD) patients is an important but challenging issue. Natriuretic peptides are biomarkers of ventricular dysfunction related to poor outcome in CKD. We comparatively investigated the value of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) as prognostic markers for the risk of RRT in stage 4 and 5 CKD patients, and in foretelling all-cause mortality and major cardiovascular events within a 5-year follow-up period. Methods Baseline plasma BNP (Triage, Biosite) and NT-proBNP (Elecsys, Roche) were measured at inclusion. Forty-three patients were followed-up during 5 years. Kaplan-Meier analysis, with log-rank testing and hazard ratios (HR), were calculated to evaluate survival without RRT, cardiovascular events or mortality. The independent prognostic value of the biomarkers was estimated in separate Cox multivariate analysis, including estimated glomerular filtration rate (eGFR), creatininemia and comorbidities. Results During the first 12-month follow-up period, 16 patients started RRT. NT-proBNP concentration was higher in patients who reached endpoint (3221 ng/L vs 777 ng/L, p = 0.02). NT-proBNP concentration > 1345 ng/L proved significant predictive value on survival analysis for cardiovascular events (p = 0.04) and dialysis within 60 months follow-up (p = 0.008). BNP concentration > 140 ng/L was an independent predictor of RRT after 12 months follow-up (p<0.005), and of significant predictive value for initiation of dialysis within 60 months follow-up. Conclusions Our results indicate a prognostic value for BNP and NT-proBNP in predicting RRT in stage 4 and 5 CKD patients, regarding both short- and long-term periods. NT-proBNP also proved a value in predicting cardiovascular events. Natriuretic peptides could be useful predictive biomarkers for therapeutic guidance in CKD. PMID:27548064

  14. Clinical utility and prognostic value of appropriateness criteria in stress echocardiography for the evaluation of valvular heart disease.

    Science.gov (United States)

    Bhattacharyya, Sanjeev; Kamperidis, Vasilis; Shah, Benoy Nalin; Roussin, Isabelle; Chahal, Navtej; Li, Wei; Khattar, Rajdeep; Senior, Roxy

    2013-09-01

    We examined the prognostic value of stress echocardiography appropriateness criteria for evaluation of valvular heart disease in 100 consecutive patients. Of the studies, 49%, 36%, and 15% were classified as appropriate, uncertain, and inappropriate, respectively. Over a median of 12.6 months, 24 events (12 deaths and 12 heart failure admissions) occurred. The 12-month event-free survival was significantly reduced in patients with appropriate or uncertain studies compared with patients with inappropriate studies (p = 0.04 and p = 0.005, respectively). There was no survival difference between patients with an appropriate or uncertain indication (p = 0.1). The only independent predictors of events were a positive stress echocardiogram (hazard ratio: 15.5, p valvular heart disease provide the ability to differentiate between patients at high- (appropriate group) and low- (inappropriate group) risk of cardiac events. Reclassification of the uncertain group may improve the differential value of these criteria.

  15. Reliability and reference values of two clinical measurements of dynamic and static knee position in healthy children

    DEFF Research Database (Denmark)

    Ortqvist, Maria; Moström, Eva B; Roos, Ewa M.

    2011-01-01

    PURPOSE: The purposes of this study were to evaluate reliability of the Single-limb mini squat test (a dynamic measure of medio-lateral knee position) and the Quadriceps-angle (Q-angle) (a static measure of medio-lateral knee position), present paediatric reference values of the Q......-angle measurements was found. Reference values for the Q-angle (mean 13.5° (1.9)-15.3° (2.8)) varies with age and gender. No associations were found between dynamic and static measures. CONCLUSIONS: The Single-limb mini squat test showed a moderate reliability and the Q-angle showed a fair to moderate reliability...

  16. Identification of Chemicals of Interest to the Department of Defense and U.S. Air Force Among the U.S. Environmental Protection Agency’s Integrated Risk Information System Chemicals that are Due for Reassessment of their Toxicity Values

    Science.gov (United States)

    2010-03-16

    10-087, 16 March 2010 LIST OF ACRONYMS ATSDR Agency for Toxic Substances and Disease Registry CASRN Chemical Abstract Services Registry Number...included 473 chemicals with Chemical Abstract Services Registry Numbers (CASRNs) that are evaluated in this report (additional detail in Appendix A). The... Chemical Abstract Services Registry Numbers (CASRNs): 2,4-/2,6- dinitrotoluene mixture; refractory ceramic fibers; uranium, soluble salts; nickel, soluble

  17. Kreapelin's Scientific Value of his Clinical Observations in the Research of Thought and Language Disorders in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Maria Luísa Figueira

    2014-10-01

    Full Text Available During the transition of the XIX to the XXth century, several changes took place in the dominant moral psychiatric paradigm. In the movement, that opposes the former romantic and normative vision of behaviour and intentions, the primacy of observation and description emerges as a superior clinical method, organizing knowledge and investigation. Kraepelin in one of the main figures that emerges, with a remarkable masterpiece, his "Treatise of Psychiatry", including several editions, each one resulting in reformulations according to the new data he obtained. Comparing Kraepelin's work - or other contemporary authors - with posterior essays on thought and language in shizophrenia would be incongruous, because the irreducibility of a clinical to an experimental method. The aim of this paper is merely to show the relation between clinical descriptions and the resulting hypothesis or constructs. Description is viewed as a systematic exploration of the psychopathological reality and an important source of scientific intuitions. This is what has happened with the work of Kraepelin, Bleuler and many others, from which we can extrapolate the ideas for knowledge produced in laboratorial context. In particular, we shall review investigation data about thought and language, produced between the sixties and the eighties, a very fertile scientific period in this area of knowledge and, which has, almost disappeared. In fact, today's literaure about thought diosorder in schizophrenia is based predominantly on the neuropsychological paradigm with the use of test batteries that evaluate cognitive deficits. The importance of this perspective is that it enables the development of response indicators with the psychopharmacological therapies and the implementation of rehabilitation programs. However, it doesn't contain the richness of the period mentioned earlier. We chose some of the particular aspects of cognitive functioning to illustrate the influence of Kraepelin

  18. Long-term tolerability of PRRT in 807 patients with neuroendocrine tumours: the value and limitations of clinical factors

    Energy Technology Data Exchange (ETDEWEB)

    Bodei, Lisa; Grana, Chiara M. [European Institute of Oncology, Division of Nuclear Medicine, Milan (Italy); Kidd, Mark; Drozdov, Ignat; Lepensky, Christopher; Modlin, Irvin M. [Yale School of Medicine, Department of Surgery, New Haven, CT (United States); Paganelli, Giovanni [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Nuclear Medicine and Radiometabolic Units, Meldola (Italy); Cremonesi, Marta [European Institute of Oncology, Division of Medical Physics, Milan (Italy); Kwekkeboom, Dik J.; Krenning, Eric P. [Erasmus Medical Center, Department of Nuclear Medicine, Rotterdam (Netherlands); Baum, Richard P. [Zentralklinik Bad Berka, Theranostics Center for Molecular Radiotheraphy and Molecular Imaging, Bad Berka (Germany)

    2015-01-15

    Peptide receptor radionuclide therapy (PRRT) with {sup 90}Y and {sup 177}Lu provides objective responses in neuroendocrine tumours, and is well tolerated with moderate toxicity. We aimed to identify clinical parameters predictive of long-term renal and haematological toxicity (myelodysplastic syndrome and acute leukaemia). Of 807 patients studied at IEO-Milan (1997-2013), 793 (98 %) received {sup 177}Lu (278, 34.4 %), {sup 90}Y (358, 44.4 %) or {sup 177}Lu and {sup 90}Y combined (157. 19.5 %), and 14 (2 %) received combinations of PRRT and other agents. Follow-up was 30 months (1-180 months). The parameters evaluated included renal risk factors, bone marrow toxicity and PRRT features. Data analysis included multiple regression, random forest feature selection, and recursive partitioning and regression trees. Treatment with {sup 90}Y and {sup 90}Y + {sup 177}Lu was more likely to result in nephrotoxicity than treatment with {sup 177}Lu alone (33.6 %, 25.5 % and 13.4 % of patients, respectively; p < 0.0001). Nephrotoxicity (any grade), transient and persistent, occurred in 279 patients (34.6 %) and was severe (grade 3 + 4) in 12 (1.5 %). In only 20-27 % of any nephrotoxicity was the disease modelled by risk factors and codependent associations (p < 0.0001). Hypertension and haemoglobin toxicity were the most relevant factors. Persistent toxicity occurred in 197 patients (24.3 %). In only 22-34 % of affected patients was the disease modelled by the clinical data (p < 0.0001). Hypertension (regression coefficient 0.14, p < 0.0001) and haemoglobin toxicity (regression coefficient 0.21, p < 0.0001) were pertinent factors. Persistent toxicity was associated with shorter PRRT duration from the first to the last cycle (mean 387 vs. 658 days, p < 0.004). Myelodysplastic syndrome occurred in 2.35 % of patients (modelled by the clinical data in 30 %, p < 0.0001). Platelet toxicity grade (2.05 ± 1.2 vs. 0.58 ± 0.8, p < 0.0001) and longer PRRT duration (22.6 ± 24 vs. 15.5

  19. A multicentre study of 513 Danish patients with systemic lupus erythematosus. II. Disease mortality and clinical factors of prognostic value

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Petersen, J; Ullman, S;

    1998-01-01

    In this Danish multicentre study, predictive clinical factors of mortality and survival were calculated for 513 patients with systemic lupus erythematosus (SLE), 122 of whom died within a mean observation period of 8.2 years equalling a mortality rate of 2.9% per year. Survival rates were 97%, 91...... influence on survival related to mortality caused by infections. Diffuse central nervous system disease and myocarditis were related to increased SLE-related mortality, whereas photosensitivity predicted a decreased mortality. Non-fatal infections and thrombotic events predicted a decreased overall survival...

  20. Changing Nephrology Nurses' Beliefs about the Value of Evidence-Based Practice and Their Ability to Implement in Clinical Practice.

    Science.gov (United States)

    Hain, Debra; Haras, Mary S

    2015-01-01

    A rapidly evolving healthcare environment demands sound research evidence to inform clinical practice and improve patient outcomes. Over the past several decades, nurses have generated new knowledge by conducting research studies, but it takes time for this evidence to be implemented in practice. As nurses strive to be leaders and active participants in healthcare redesign, it is essential that they possess the requisite knowledge and skills to engage in evidence-based practice (EBP). Professional nursing organizations can make substantial contributions to the move healthcare quality forward by providing EBP workshops similar to those conducted by the American Nephrology Nurses'Association.

  1. [From classificational medicine to clinical medicine (the end of the XVIII century to 1870s). Communication 3. The second stage of clinical medicine development: introduction of methods of laboratory experiment and chemical analysis].

    Science.gov (United States)

    Stochik, A M; Zatravkin, S N

    2011-01-01

    The article concerns the end stage of clinical medicine establishment covering the period from early 1840s to the middle 1870s of the XIX century. Basic scientific achievements related to introduction into practical medicine of the methods of laboratory experiment and chemical analysis are reviewed.

  2. Positive Predictive Value of the WHO Clinical and Immunologic Criteria to Predict Viral Load Failure among Adults on First, or Second-Line Antiretroviral Therapy in Kenya.

    Directory of Open Access Journals (Sweden)

    Anthony Waruru

    Full Text Available Routine HIV viral load (VL monitoring is the standard of care for persons receiving antiretroviral therapy (ART in developed countries. Although the World Health Organization recommends annual VL monitoring of patients on ART, recognizing difficulties in conducting routine VL testing, the WHO continues to recommend targeted VL testing to confirm treatment failure for persons who meet selected immunologic and clinical criteria. Studies have measured positive predictive value (PPV, negative predictive value, sensitivity and specificity of these criteria among patients receiving first-line ART but not specifically among those on second-line or subsequent regimens. Between 2008 and 2011, adult ART patients in Nyanza, Kenya who met national clinical or immunologic criteria for treatment failure received targeted VL testing. We calculated PPV and 95% confidence intervals (CI of these criteria to detect virologic treatment failure among patients receiving a first-line ART, b second/subsequent ART, and c any regimen. Of 12,134 patient specimens tested, 2,874 (23.7% were virologically confirmed as treatment failures. The PPV for 2,834 first-line ART patients who met either the clinical or immunologic criteria for treatment failure was 34.4% (95% CI 33.2-35.7, 33.1% (95% CI 24.7-42.3 for the 40 patients on second-line/subsequent regimens, and 33.4% (95% CI 33.1-35.6 for any ART. PPV, regardless of criteria, for first-line ART patients was lowest among patients over 44 years old and highest for patients aged 15 to 34 years. PPV of immunological and clinical criteria for correctly identifying treatment failure was similarly low for adult patients receiving either first-line or second-line/subsequent ART regimens. Our data confirm the inadequacy of clinical and immunologic criteria to correctly identify treatment failure and support the implementation of routine VL testing.

  3. Positive Predictive Value of the WHO Clinical and Immunologic Criteria to Predict Viral Load Failure among Adults on First, or Second-Line Antiretroviral Therapy in Kenya.

    Science.gov (United States)

    Waruru, Anthony; Muttai, Hellen; Ng'ang'a, Lucy; Ackers, Marta; Kim, Andrea; Miruka, Fredrick; Erick, Opiyo; Okonji, Julie; Ayuaya, Tolbert; Schwarcz, Sandra

    2016-01-01

    Routine HIV viral load (VL) monitoring is the standard of care for persons receiving antiretroviral therapy (ART) in developed countries. Although the World Health Organization recommends annual VL monitoring of patients on ART, recognizing difficulties in conducting routine VL testing, the WHO continues to recommend targeted VL testing to confirm treatment failure for persons who meet selected immunologic and clinical criteria. Studies have measured positive predictive value (PPV), negative predictive value, sensitivity and specificity of these criteria among patients receiving first-line ART but not specifically among those on second-line or subsequent regimens. Between 2008 and 2011, adult ART patients in Nyanza, Kenya who met national clinical or immunologic criteria for treatment failure received targeted VL testing. We calculated PPV and 95% confidence intervals (CI) of these criteria to detect virologic treatment failure among patients receiving a) first-line ART, b) second/subsequent ART, and c) any regimen. Of 12,134 patient specimens tested, 2,874 (23.7%) were virologically confirmed as treatment failures. The PPV for 2,834 first-line ART patients who met either the clinical or immunologic criteria for treatment failure was 34.4% (95% CI 33.2-35.7), 33.1% (95% CI 24.7-42.3) for the 40 patients on second-line/subsequent regimens, and 33.4% (95% CI 33.1-35.6) for any ART. PPV, regardless of criteria, for first-line ART patients was lowest among patients over 44 years old and highest for patients aged 15 to 34 years. PPV of immunological and clinical criteria for correctly identifying treatment failure was similarly low for adult patients receiving either first-line or second-line/subsequent ART regimens. Our data confirm the inadequacy of clinical and immunologic criteria to correctly identify treatment failure and support the implementation of routine VL testing.

  4. A survey on concomitant common bile duct stone and symptomatic gallstone and clinical values in Shiraz, Southern Iran

    Science.gov (United States)

    Hosseini, Seyed Vahid; Ayoub, Abbass; Rezaianzadeh, Abbas; Bananzadeh, Ali Mohammad; Ghahramani, Leila; Rahimikazerooni, Salar; Khazraei, Hajar

    2016-01-01

    Background: Common bile duct stone (CBDS) as a result of gallstone is one of the gastrointestinal disorders. In this study, the incidence of CBDS and symptomatic gallstone in Shiraz were investigated, and their management suggested. Materials and Methods: This is a retrospective study that enrolled among 560 patients. The incidence of gallstone together with CBDS was evaluated using an ultrasonography studyand clinical data in the period between March 2014 and 2014 in Shiraz. Comparison between data was done using Student’s t-test or Chi-square test. Results: Of these patients, 18.6% were male, and 81.4% were female with a mean age of 47.67 ± 0.74 years. The concomitant rate of gallstone and CBDS was 8.6%. 6.8% of patients with concomitant of gallstone and CBDS showed symptoms while 1.8% had not been diagnosed before the operation. The mean of serum alkaline phosphatase level in patients with the only gallstone was 255.80 IU/L and patients with concomitant gallstone, and CBDS was 580.88 IU/L with a significant difference between two groups (P < 0.001). Furthermore, liver function tests (aspartate aminotransferase, alanine transaminase) showed a significant difference between two groups of patients (P < 0.01, P < 0.001). Conclusions: Clinical variables such as tenderness, fever, and Morphy sign were more severein patients with concomitant gallstone and CBDS. The concomitant rate of gallstone and CBDS in our society is less that Western countries and asymptomatic patients showed fewer ratios than other countries. We think the approach for asymptomatic CBDS patients with gallstone can be affected by our results. PMID:27656616

  5. The value of ADC values for prostate cancer diagnosis and clinical assessment%ADC 值在前列腺癌诊断及临床评估中的价值

    Institute of Scientific and Technical Information of China (English)

    宋志强; 杜向东; 马静; 方佳; 陈丽佳; 宋法亮

    2015-01-01

    目的:探讨磁共振扩散加权成像(DWI)表观扩散系数(ADC)在前列腺癌临床评估中的价值。方法对照组10例(健康志愿者),实验组216例,疑似前列腺增生或前列腺癌的患者,均行前列腺 T1 WI、T2 WI 及 DWI。实验组中124例经前列腺穿刺或手术后获取病理资料,并收集相关临床及生化学资料。根据病理结果分为前列腺增生组、前列腺癌组。87例前列腺癌病例按照TNM 分期、Gleason 分级、危险因素分级进行分组。对各组 ADC 值进行统计学分析。结果前列腺癌的 ADC 值较前列腺增生、正常前列腺组低,组间 ADC 值有统计学差异性(F=11.72,P<0.0001)。ADC 值与临床 TNM 分期无相关性(r=-0.235,P =0.143)。ADC 值与 Gleason 分级、危险因素分级呈负相关(r=-0.542,P <0.05;r=-0.529,P <0.05)。不同病理级别、危险因素分级的前列腺癌的 ADC 值有统计学差异性(F =4.84,P =0.0102;F =3.423,P =0.0371)。结论磁共振 DWI 的 ADC 值对前列腺癌的诊断、鉴别诊断及临床病情评估提供有价值的参考。%Objective To explore the value of apparent diffusion coefficient (ADC)for prostate cancer diagnosis and clinical as-sessment.Methods 10 healthy volunteers were in the control group,21 6 cases suspected of prostate hyperplasia or prostate cancer were in the experimental group.All were performed T1 WI,T2 WI and diffusion-weighted imaging (DWI).Of 21 6 cases in the ex-perimental group,124 were undergone operation or needle biopsy and were classified into benign prostatic hyperplasia (BPH)group and prostate cancer (PCa)group according pathological results.Then the 87 PCa cases were grouped by the clinical TNM stage,Gleason grading and risk factors classification,respectively.The ADC values obtained by DWI were measured and statistically analysed.Results ADC values of PCa group were lower than BPH group and control group,respectively(F=11.72,P<0.000 1).There were no significant correlation between

  6. Chemical composition and bio-pesticidal values of essential oil isolated from the seed of Heracleum persicum Desf. ex Fischer (Apiaceae

    Directory of Open Access Journals (Sweden)

    Asgar Ebadollahi

    2014-11-01

    Full Text Available The present investigation was aimed to analyse the chemical composition of essential oil isolated from Heracleum persicum Desf. ex Fischer and assess its lethal and sub-lethal effects against Tribolium castaneum (Herbst. Essential oil from hydro-distilled seeds of H. persicum was analyzed by gas chromatography-mass spectrometry (GC-MS, and hexyl butyrate (50.58%, octyl acetate (9.80% and hexyl hexanoate (8.75% were found as principal constituents. Repellent activity, contact and fumigant toxicity and antifeedant effects of this oil were assessed against the adults of T. castaneum. The essential oil strongly repelled T. castaneum adults even at the lowest concentration (0.035 μL cm-2. Complete repellency (100% occurred when the highest concentration (0.212 μL cm-2 was applied for 8 h. T. castaneum was very susceptible to H. persicum oil at both contact and fumigant bioassays. In the fumigant toxicity, essential oil killed the larvae, pupae and adults and significantly decreased larvae emerged from treated eggs. LC10 to LC40 values of fumigation adult’s bioassay as sub-lethal concentrations were used to evaluate the antifeedant effects. H. persicum essential oil has significant antifeedant effects on T. castaneum adults and decrease of feeding happened when oil concentrations increased. The results of the present study indicate that essential oil of H. persicum, with wide bio-effects on T. castaneum, is a source of biologically active agents which may potentially prove to be efficient insecticides.

  7. Quantitative evaluation of correlation of dose and FDG-PET uptake value with clinical chest wall complications in patients with lung cancer treated with stereotactic body radiation therapy.

    Science.gov (United States)

    Algan, O; Confer, M; Algan, S; Matthiesen, C; Herman, T; Ahmad, S; Ali, I

    2015-01-01

    The aim of this study was to investigate quantitatively the dosimetric factors that increase the risk of clinical complications of rib fractures or chest wall pain after stereotactic body radiation therapy (SBRT) to the lung. The correlations of clinical complications with standard-uptake values (SUV) and FDG-PET activity distributions from post-treatment PET-imaging were studied. Mean and maximum doses from treatment plans, FDG-PET activity values on post-SBRT PET scans and the presence of clinical complications were determined in fifteen patients undergoing 16 SBRT treatments for lung cancer. SBRT treatments were delivered in 3 to 5 fractions using 5 to 7 fields to prescription doses in the range from 39.0 to 60.0 Gy. The dose and FDG-PET activity values were extracted from regions of interest in the chest wall that matched anatomically. Quantitative evaluation of the correlation between dose deposition and FDG-PET activity was performed by calculating the Pearson correlation coefficient using pixel-by-pixel analysis of dose and FDG-PET activity maps in selected regions of interest associated with clinical complications. Overall, three of fifteen patients developed rib fractures with chest wall pain, and two patients developed pain symptoms without fracture. The mean dose to the rib cage in patients with fractures was 37.53 Gy compared to 33.35 Gy in patients without fractures. Increased chest wall activity as determined by FDG-uptake was noted in patients who developed rib fractures. Enhanced activity from PET-images correlated strongly with high doses deposited to the chest wall which could be predicted by a linear relationship. The local enhanced activity was associated with the development of clinical complications such as chest wall inflammation and rib fracture. This study demonstrates that rib fractures and chest wall pain can occur after SBRT treatments to the lung and is associated with increased activity on subsequent PET scans. The FDG-PET activity

  8. Clinical value of serum anti-mullerian hormone and inhibin B in prediction of ovarian response in patients with polycystic ovary syndrome.

    Science.gov (United States)

    Zhang, Fan; Liu, Xiao-Ling; Rong, Nan; Huang, Xiao-Wen

    2017-02-01

    The present study aimed to investigate the clinical value of serum anti-mullerian hormone (AMH) and inhibin B (INHB) in predicting the ovarian response of patients with polycystic ovary syndrome (PCOS). A total of 120 PCOS patients were enrolled and divided into three groups in terms of the ovarian response: a low-response group (n=36), a normal-response group (n=44), and a high-response group (n=40). The serum AMH and INHB levels were measured by enzyme-linked immunosorbent assay (ELISA). The follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels were determined by chemiluminescence microparticle immunoassay. The correlation of the serum AMH and INHB levels with other indicators was analyzed. A receiver operating characteristic (ROC) curve was established to analyze the prediction of ovarian response by AMH and INHB. The results showed that there were significant differences in age, body mass index (BMI), FSH, total gonadotropin-releasing hormone (GnRH), LH, E2, and antral follicle counts (AFCs) between the groups (Pvalue of the serum AMH level was 0.817, with a cut-off value of 1.29 ng/mL. The sensitivity and specificity were 71.2% and 79.6%, respectively. The AUC value of serum INHB was 0.674, with a cut-off value of 38.65 ng/mL, and the sensitivity and specificity were 50.7% and 74.5%, respectively. ROC curve analysis showed when the serum AMH and INHB levels were used to predict a high ovarian response, the AUC value of the serum AMH level was 0.742, with a cut-off value of 2.84 ng/mL, and the sensitivity and specificity were 72.7% and 65.9%, respectively; the AUC value of the serum INHB level was 0.551 with a cut-off of 45.76 ng/mL, and the sensitivity and specificity were 76.3% and 40.2%, respectively. It was suggested the serum AMH and INHB levels have high clinical value in predicting the ovarian response of PCOS patients.

  9. IgD multiple myeloma: Clinical, biological features and prognostic value of the serum free light chain assay.

    Science.gov (United States)

    Djidjik, R; Lounici, Y; Chergeulaïne, K; Berkouk, Y; Mouhoub, S; Chaib, S; Belhani, M; Ghaffor, M

    2015-09-01

    IgD multiple myeloma (MM) is a rare subtype of myeloma, it affects less than 2% of patients with MM. To evaluate the clinical and prognostic attributes of serum free light chains (sFLCs) analysis, we examined 17 cases of IgD MM. From 1998 to 2012, we obtained 1250 monoclonal gammapathies including 590 multiple myeloma and 17 patients had IgD MM. With preponderance of men patients with a mean age at diagnosis of: 59±12years. Patients with IgD MM have a short survival (Median survival=9months). The presenting features included: bone pain (75%), lymphadenopathy (16%), hepatomegaly (25%), splenomegaly (8%), associated AL amyloidosis (6%), renal impairment function (82%), infections (47%), hypercalcemia (37%) and anemia (93%). Serum electrophoresis showed a subtle M-spike (Mean=13.22±10g/L) in all patients associated to a hypogammaglobulinemia. There was an over-representation of Lambda light chain (65%); high serum β2-microglobulin in 91% and Bence Jones proteinuria was identified in 71%. The median rate of sFLCs κ was 19.05mg/L and 296.75mg/L for sFLCs λ. sFLCR was abnormal in 93% of patients and it showed concordance between baseline sFLCR and the survival (P=0.034). The contribution of FLC assay is crucial for the prognosis of patients with IgD MM.

  10. Value of 18F-FDG PET in Clinical Staging of Non-Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    Suwen Liu; Jinming Yu; Ligang Xing

    2005-01-01

    OBJECTIVE To evaluate the feasibility of 18F-deoxyglucose positron emission tomography (18F-FDG PET) in the staging of non-small cell lung cancer(NSCLC).METHODS 105 patients with NSCLC had been examined by 18F-FDG PET before radiotherapy. The results of the 18F-FDG PET examination were compared with those of CT:RESULTS The staging was changed in 38 patients because of 18F-FDG PET findings, with PET resulting in upstaging in 31 patients and downstaging in seven patients. Because of distant metastasis detected by PET, 21 patients received palliative treatment. Six of the seven downstaged patients underwent radical surgery, among which the PET findings were concordant with the pathological findings in five patients. Distant metastasis detected by PET elevated the pre-PET stage: at stage 110.0% (2/20), stage Ⅱ 14.3% (3/21 ) and stage Ⅲ 25.0% (16/64), respectively.CONCLUSION 18F-FDG PET, by changing clinical staging in 36.2% (38/105)of NSCLC patients, has an impact on treatment strategy in NSCLC patients.

  11. Clinical value of contrast-enhanced ultrasonography in the characterization of focal liver lesions:a prospective multicenter trial

    Institute of Scientific and Technical Information of China (English)

    Wen-Ping Wang; Yan Wang; Jian-Jun Yuan; Ying Wu; Yan Luo; Rui Li; Xiao-Dong Zhou; Jun Zhang; Chao-Wen Qian; Xu-Yan Tan; Qing-Hua Xu

    2009-01-01

    BACKGROUND: Contrast-enhanced ultrasonography (CEUS) is increasingly accepted in clinical settings for diagnostic imaging of focal liver lesions (FLLs). This study aimed to assess the efifcacy of CEUS in the characterization of FLLs in comparison with ifnal diagnosis based on gold standard assessment. METHODS: The study was approved by the local ethics committee and participating patients provided written informed consent. A total of 148 patients with 164 FLLs were studied. Unenhanced ultrasonography (US) and CEUS were performed using fundamental and harmonic imaging, respectively. Contrast enhancement was assessed during the arterial, portal and late vascular phases after intravenous administration of contrast (SonoVue®, Bracco, Italy). Sensitivity, speciifcity and diagnostic accuracy of US and CEUS were compared in identifying the lesion as benign, malignant or indeterminate and its actual tumor type. Final diagnosis was established by biopsy (129/164), MR imaging (11/164) or medical history (24/164). RESULTS: When compared to the gold standard, the number of indeterminate diagnoses was reduced from 56.7% (93/164) as assessed by fundamental imaging to 6.1% (10/164) after SonoVue® enhanced US examination. Sensitivity and speciifcity improved from 49% and 25%at baseline US to 93% and 75% with CEUS, respectively (P<0.01). Diagnostic accuracy of CEUS was 88% in contrast to 41% of baseline US. CONCLUSION: SonoVue® enhanced US improves the characterization of FLLs and may limit the need for further investigations.

  12. Do Simulation-Based Skill Exercises and Post-Encounter Notes Add Additional Value to a Standardized Patient-Based Clinical Skills Examination?

    Directory of Open Access Journals (Sweden)

    Michael D. Prislin

    2011-01-01

    Full Text Available Background. Standardized patient (SP clinical assessments have limited utility in assessing higher-level clinical competencies. This study explores the value of including simulation exercises and postencounter notes in an SP clinical skills examination. Methods. Two exercises involving cardiac auscultation and ophthalmic funduscopy simulations along with written post encounter notes were added to an SP-based performance examination. Descriptive analyses of students' performance and correlations with SP-based performance measures were obtained. Results. Students' abilities to detect abnormalities on physical exam were highly variable. There were no correlations between SP-based and simulation-derived measures of physical examination competency. Limited correlations were found between students' abilities to perform and document physical examinations and their formulation of appropriate differential diagnoses. Conclusions. Clinical simulation exercises add depth to SP-based assessments of performance. Evaluating the content of post encounter notes offers some insight into students' integrative abilities, and this appears to be improved by the addition of simulation-based post encounter skill exercises. However, further refinement of this methodology is needed.

  13. Is anti-doping analysis so far from clinical, legal or forensic targets?: The added value of close relationships between related disciplines.

    Science.gov (United States)

    Segura, Jordi

    2009-11-01

    There are many areas of common interest between anti-doping laboratories and those working in the clinical, legal and forensic fields. In addition to methodological similarities, there are aspects of the findings in sport drug testing that overlap with other fields in such a way that sport drug testing and clinical, legal or forensic work may benefit from mutual interaction. Three recent examples are presented from the author's experience. Case report 1 concerns the clinical relevance of hCG findings in sport drug testing as potential indicators of the presence of a (testicular) tumour in athletes. Case report 2 refers to difficulties that accredited laboratories can encounter due to differences between national legal systems and the administrative regulation systems of sport authorities. The example involves a network of blood collection for further autologous transfusion. Case report 3 relates to additional forensic-type investigations needed to interpret a situation where intoxication of a whole delegation was responsible for apparent doping cases. Clinical, legal and forensic fields must recognize the added value that some results and developments coming from anti-doping laboratories may have. At the same time anti-doping analysts should be aware of new issues, methodologies and problems appearing in related fields.

  14. Default values for assessment of potential dermal exposure of the hands to industrial chemicals in the scope of regulatory risk assessments

    NARCIS (Netherlands)

    Marquart, H.; Warren, N.D.; Laitinen, J.; Hemmen, J.J. van

    2006-01-01

    Dermal exposure needs to be addressed in regulatory risk assessment of chemicals. The models used so far are based on very limited data. The EU project RISKOFDERM has gathered a large number of new measurements on dermal exposure to industrial chemicals in various work situations, together with info

  15. CT脑灌注成像临床诊断急性脑梗死价值评价与平扫CT值差值的测量价值%Value Evaluation on Clinical Diagnosis of CT Cerebral Perfusion Imaging on Acute Cerebral infarction and Measurement Value of Difference Value of Plain Scan CT Value

    Institute of Scientific and Technical Information of China (English)

    余东

    2015-01-01

    Objective This Paper is to explore the application value of CT perfusion imaging and differential value of measured CT value in the diagnosis of acute cerebral infarction. Methods Thirty six patients with acute cerebral infarction admitted the Radiology Department of the Hospital were selected as research subjects, retrospective analysis and summary were conducted according to clinical data. CT plaint scan and brain CT perfusion imaging were made respectively, The time to peak (TIP), cerebral blood flow (CBF) and cerebral blood volume (CBV) of CT perfusion imaging were evaluated, the difference of CT value on both sides of symmetric positions was measured. In addition, 36 patients with no brain disease and normal nervous function were divided into the control group, and diagnostic value of the difference between CT perfusion imaging and CT measurement value in acute cerebral infarction was analyzed. Results It is visually found that there were 17 patients with suspicious lesions with the sensitivity at 47.2%, and it was found that there were 28 patients with suspicious lesions by measuring CT value difference. It was found that the CTP of 3 patients was normal CT perfusion imaging examination, and such 2 patients were finally diagnosed to suffer from transient ischemic attack, and others were abnomal, rCBF, rCBV and rTTP changed obviously, the comparison in lesion center and perimeter and controlled side satisfied p<0.05, and the differences were statistically significant. Conclusion CT perfusion imaging and the difference value in CT value measurement delivers high application value in the diagnosis of acute cerebral infarction, and it is capable of diagnosing cerebral infarction in early differential diagnosis, the infarct area and ischemic penumbra area may be differentiated via through quantitative analysis, providing important basis for clinical determination on the existence of infarct and development of therapeutic schedule.%目的:探讨CT灌注成像

  16. Comparison of clinical semi-quantitative assessment of muscle fat infiltration with quantitative assessment using chemical shift-based water/fat separation in MR studies of the calf of post-menopausal women

    Energy Technology Data Exchange (ETDEWEB)

    Alizai, Hamza; Nardo, Lorenzo; Karampinos, Dimitrios C.; Joseph, Gabby B.; Yap, Samuel P.; Baum, Thomas; Krug, Roland; Majumdar, Sharmila; Link, Thomas M. [University of California, San Francisco, Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States)

    2012-07-15

    The goal of this study was to compare the semi-quantitative Goutallier classification for fat infiltration with quantitative fat-fraction derived from a magnetic resonance imaging (MRI) chemical shift-based water/fat separation technique. Sixty-two women (age 61 {+-} 6 years), 27 of whom had diabetes, underwent MRI of the calf using a T1-weighted fast spin-echo sequence and a six-echo spoiled gradient-echo sequence at 3 T. Water/fat images and fat fraction maps were reconstructed using the IDEAL algorithm with T2* correction and a multi-peak model for the fat spectrum. Two radiologists scored fat infiltration on the T1-weighted images using the Goutallier classification in six muscle compartments. Spearman correlations between the Goutallier grades and the fat fraction were calculated; in addition, intra-observer and inter-observer agreement were calculated. A significant correlation between the clinical grading and the fat fraction values was found for all muscle compartments (P < 0.0001, R values ranging from 0.79 to 0.88). Goutallier grades 0-4 had a fat fraction ranging from 3.5 to 19%. Intra-observer and inter-observer agreement values of 0.83 and 0.81 were calculated for the semi-quantitative grading. Semi-quantitative grading of intramuscular fat and quantitative fat fraction were significantly correlated and both techniques had excellent reproducibility. However, the clinical grading was found to overestimate muscle fat. (orig.)

  17. Pathological Hallmarks, Clinical Parallels, and Value for Drug Testing in Alzheimer's Disease of the APP[V717I] London Transgenic Mouse Model

    Directory of Open Access Journals (Sweden)

    An Tanghe

    2010-01-01

    Full Text Available The APP[V717I] London (APP-Ld mouse model recapitulates important pathological and clinical hallmarks of Alzheimer's disease (AD and is therefore a valuable paradigm for evaluating therapeutic candidates. Historically, both the parenchymal and vascular amyloid deposits, and more recently, truncated and pyroglutamate-modified Abeta3(pE-42 species, are perceived as important hallmarks of AD-pathology. Late stage symptoms are preceded by robust deficits in orientation and memory that correlate in time with Abeta oligomerization and GSK3-mediated phosphorylation of endogenous murine Tau, all markers that have gained considerable interest during the last decade. Clinical parallels with AD patients and the value of the APP-Ld transgenic mouse model for preclinical in vivo testing of candidate drugs are discussed.

  18. CLINICAL VALUE OF THE MARKERS OF PROLIFERATION AND APOPTOSIS IN PATIENTS WITH CLEAR CELL RENAL CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    N. A. Gorban

    2014-07-01

    Full Text Available Renal cell carcinoma (RCC is a heterogeneous disease in which the patients survive for months to years. At the present time the prognostic models have no sufficient information or exact prognostic value. Cell proliferation and apoptosis play a key role in cell cycle regulation; and impairment in these processes is commonly detected in different human tumors. The investigation enrolled 76 patients (49 men, 27 women aged 32 to 73 years (mean age 56 ± 7.6 years diagnosed with RCC. The follow-up was 8 to 116 months (mean 36.5 months. All the patients underwent nephrectomy; antibodies against р53, Bcl-2, and Ki-67 were investigated by immunohistochemistry. The expression of p53 and none or reduced expression of Bcl-2 are poor prognostic factors and associated with the metastatic potential of a tumor and with low relapse-free survival. High Ki-67 levels are a risk factor for metastases. A combination of p53 expression and high proliferative activity reflects the aggressive potential of a tumor and suggests the high risk of metastases just at the disease diagnosis and early tumor dissemination. 

  19. Clinical value of Helicobacter pylori stool antigen test, ImmunoCard STAT HpSA, for detecting H pylori infection

    Institute of Scientific and Technical Information of China (English)

    Yi-Hui Li; Hong Guo; Peng-Bin Zhang; Xiao-Yan Zhao; Si-Ping Da

    2004-01-01

    AIM: To evaluate the reliability of the Helicobacter pylori stool antigen test, ImmunoCard STAT HpSA, for detecting H pylori infection.METHODS: Stool specimens were collected from 53 patients who received upper endoscopy examination due to gastrointestinal symptoms. ImmunoCard STAT HpSA wasused to detect H pylori stool antigens. H pyloriinfection wasdetected based on three different tests: the urease test, Warthin-Starry staining and culture. H pylori status wasdefined as positive when both the urease test and histology or culture alone was positive.RESULTS: Sensitivity, specificity, positive predictive and negative predictive values and the total accuracy of ImmunoCard STAT HpSA for the diagnosis of H pylorinfection were 92.6% (25/27), 88.5% (23/26), 89.3% (25/28), 92%(23/25) and 90.6% (48/53), respectively.CONCLUSION: The stool antigen test, ImmunoCard STAT HpSA, is a simple noninvasive and accurate test for the diagnosis of H pyloriinfection.

  20. The clinical value of human leukocyte antigen HLA-DRB1 subtypes associated to Graves' disease in Romanian population.

    Science.gov (United States)

    Martin, Sorina; Dutescu, Monica Irina; Sirbu, Anca; Barbu, Carmen; Albu, Alice; Florea, Suzana; Fica, Simona

    2014-01-01

    The aim of this study was to identify the primary susceptibility HLA-DRB1 alleles associated with GD in Romanian population and to seek whether specific HLA-DRB1 haplotypes are associated with differences in the clinical presentation of GD at diagnosis. Molecular typing of HLA-DRB1 alleles was performed in 77 Romanian Caucasian GD patients and 445 racially matched controls. In GD patients, age, presence of eye disease, goiter grade, autoantibody status and titer, TSH, FT4, FT3, TT3 levels were recorded at diagnosis. The allelic frequencies of HLA-DRB1*03 (41.55% vs. 17.75%, p < 0.0001, χ(2) = 20.81) and DRB1*11 (42.85% vs. 30.56%, p = 0.045, χ(2) = 3.98)were higher, whereas those of HLA-DRB1*01(3.89% vs. 16.40%, p = 0.007, χ(2) = 7.281) and DRB1*15 (10.38% vs. 21.34%, p = 0.038, χ(2) = 4.309)were lower in GD patients than in controls. FT4/TT3 ratio (p = 0.015) and anti-thyroglobulin antibodies (p = 0.024) were higher in *03/11 patients compared to *X/X, *11/Z, *03/Y patients (where X is any other allele than *03 and *11, Y is any other allele than *11, Z is any other allele than *03). In conclusion, HLA-DRB1*03 and DRB1*11 may be the primary susceptibility HLA-DRB1 alleles associated with GD in Romanian population, whereas HLA-DRB1*01 and DRB1*15 seem to be protective. At diagnosis, HLA-DRB1*03/11 GD patients had higher FT4/TT3 ratio and anti-thyroglobulin antibody levels.

  1. Prognostic value of magnetic resonance imaging in patients with clinically isolated syndrome conversion to multiple sclerosis: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Wei-Yan Zhang

    2013-01-01

    Full Text Available Background: Numerous studies have investigated the associations of brain or spinal cord MRI with the risk of developing Multiple Sclerosis (MS in people with Clinically Isolated Syndrome (CIS, however, the findings are uncertain. Therefore, we performed a meta-analysis based on 24 publications to comprehensively evaluate such associations. Materials and Methods: The databases of EMBASE and MEDLINE (January 1980-August 2011 were searched electronically for all relevant studies. Data were extracted from each study independently by both reviewers using a predefined structured spreadsheet. The quality of each study was assessed independently by two reviewers according to Newcastle-Ottawa Scale for reading cohort study proposed by Deeks et al. The meta-analysis including 24 qualified studies was performed by using the Cochrane Collaborations RevMan5.0 software. Results: Twenty-four identified studies met the inclusion criteria and minimum quality threshold. A meta-analysis of cohort studies indicated that the CISs having MRI lesions did have significantly increased risk for MS (risk ratio [RR] = 3.71, 95% confidence interval [CI], 3.27-4.21, P 9 lesions (RR = 0.97, 95% CI, 0.82-1.15, P = 0.72. Meanwhile, the CIS patients with abnormal baseline MRI, especially with infratentorial lesions, had a high risk of conversion to MS compared to patients without the such infratentorial lesions (RR = 1.37, % CI, 1.09-1.73, P = 0.0008. Conclusions: Despite some limitations, this meta-analysis established solid statistical evidence for an association between the presence or absence of MRI lesions within the brain or spinal cord MRI and the risk of developing MS, particularly for studies with large sample size. The CIS patients with abnormal baseline MRI, especially with infratentorial lesions, had a high risk of conversion to MS. However, this association warrants additional validation in larger and well designed studies.

  2. Value of past clinical history in differentiating bronchial asthma from COPD in male smokers presenting with SOB and fixed airway obstruction

    Directory of Open Access Journals (Sweden)

    Prahlad Rai Gupta

    2015-01-01

    Full Text Available Objective: Differentiating asthma from chronic obstructive pulmonary disease (COPD is difficult. Steroid trial may be of help but has several pitfalls. The present study aims to assess the value of past clinical profile of asthma and its differential diagnosis from COPD in male smokers and thereby to formulate clinical parameters to diagnose bronchial asthma in such patients. Patients and Methods: Male smokers who reported at the Respiratory Medicine Department of the National Institute of Medical Sciences (NIMS Hospital, Jaipur, (India, with shortness of breath (SOB and showing less than 12% postbronchodilator bronchial reversibility (BR on spirometry were recruited. These patients were given oral prednisolone 1 mg/kg for two weeks. Post steroid (PS spirometry was performed to ascertain BR. The past clinical history was recorded and analyzed to determine if it is of any use in differentiating asthma from COPD. Result: Out of 104 patients, four were lost to follow up, 52 were diagnosed as bronchial asthma, and the remaining 48 as COPD. It was revealed that past history of (H/O seasonal variation, wheezing, eye allergy, nasal allergy, dust allergy, skin allergy, and family H/O asthma/allergy were positive in 50, 40, 34, 30, 18, 14, and 12 asthma patients as compared to 10, 8, 2, 4, 6, 0, and 0 in 48 COPD patients (P < 0.001. The odds ratio (OR for diagnosing asthma was highest for the presence of any other two symptoms/variables, besides SOB, in the past (OR = 275, P < 0.0001. Conclusion: Past clinical history is of immense value in differentiating asthma from COPD in male smokers presenting with SOB and fixed airway obstruction.

  3. Comparative assessment of diagnostic value of electrodiagnostic methods and radiologic evaluations in patients with clinical signs of cervical radiculopathy

    Directory of Open Access Journals (Sweden)

    S.A. Moosavi

    2006-01-01

    Full Text Available Background and purpose: Cervical radiculopathy is one of the most common diseases that must be diagnosed early and properly to prevent its serious side effects. For this purpose different paraclinical methods such as MRI, X-ray, EMG, NCV and SSEP are used. Each of these methods has its limitations and some of them are expensive or invassive. The aim of this study was to compare the electrodiagnostic and radiologic methods in diagnosis of cervical radiculopathy.Materials and Methods: In this study 36 patients (22 Female, l4 Male with complaint of cervical pain radiated to upper limbs were evaluated. The evaluation included EMG, NCV, MRI, X-ray and SSEP. Exclusion criteria were fracture dislocation and infection of bone joints or soft tissues .MRI and X-ray were performed in MRI centers of Isfahan, Sepahan and Alzahra hospital in Isfahan city. MRI was graded on severity of 1 to 3. EMG, NCV and SSEP were performed in electrodiagnostic center of Alzahra hospital by one professional technician. Results were compared with text books and analyzed by SPSS software.Results: Sensitivity of SSEP was 28.6% and specifity was 100%. Partial agreement between SSEP and MRI existed in moderate and severe cervical involvements (P = 0.005. Frequencies of abnormalities were: EMG 50%, NCV 5.6%, X-ray 33.3% and MRI 77.8%.Conclusion: This study shows that SSEP has lower value than EMG in diagnosis of cervical radiculopathy. Also in a patient with cervical radiculopathy, cervical MRI and EMG of upper limbs are necessary. SSEP abnormalities in the presence of moderate and severe MRI changes such as myelopathy, are more valuable. Therefore, SSEP in cervical radiculopathy is recommended before surgery.

  4. Measurement of the principal values of the chemical-shift tensors of overlapping protonated and unprotonated carbons with the 2D-SUPER technique and dipolar dephasing (DD-SUPER)

    Science.gov (United States)

    Liu, Wei; Wang, Wei D.; Wang, Wei; Bai, Shi; Dybowski, Cecil

    2010-09-01

    A modified 2D-SUPER technique is demonstrated to allow independent measurement of the principal values of the chemical-shift tensors of overlapping protonated and unprotonated carbons. The insertion of a dipolar-dephasing period into the sequence causes loss of signal from protonated carbons. The spectrum obtained with this modification allows one to determine the principal values of the unprotonated carbons with high precision. Subsequent fitting of the usual 2D-SUPER spectrum, with the chemical-shift parameters of the unprotonated carbons fixed, gives the parameters of the overlapped resonances of the protonated carbons. As an example, we report the determination of the 13C chemical-shift parameters of the carbons of form II of piroxicam. The experimental results are compared with those obtained from calculations using the DFT/GIAO method. Potential applications of this method are discussed.

  5. Evaluation of epidemiological cut-off values indicates that biocide resistant subpopulations are uncommon in natural isolates of clinically-relevant microorganisms.

    Directory of Open Access Journals (Sweden)

    Ian Morrissey

    Full Text Available To date there are no clear criteria to determine whether a microbe is susceptible to biocides or not. As a starting point for distinguishing between wild-type and resistant organisms, we set out to determine the minimal inhibitory concentration (MIC and minimal bactericidal concentration (MBC distributions for four common biocides; triclosan, benzalkonium chloride, chlorhexidine and sodium hypochlorite for 3319 clinical isolates, with a particular focus on Staphylococcus aureus (N = 1635 and Salmonella spp. (N = 901 but also including Escherichia coli (N = 368, Candida albicans (N = 200, Klebsiella pneumoniae (N = 60, Enterobacter spp. (N = 54, Enterococcus faecium (N = 53, and Enterococcus faecalis (N = 56. From these data epidemiological cut-off values (ECOFFs are proposed. As would be expected, MBCs were higher than MICs for all biocides. In most cases both values followed a normal distribution. Bimodal distributions, indicating the existence of biocide resistant subpopulations were observed for Enterobacter chlorhexidine susceptibility (both MICs and MBCs and the susceptibility to triclosan of Enterobacter (MBC, E. coli (MBC and MIC and S. aureus (MBC and MIC. There is a concern on the potential selection of antibiotic resistance by biocides. Our results indicate however that resistance to biocides and, hence any potential association with antibiotic resistance, is uncommon in natural populations of clinically relevant microorganisms.

  6. Determination of pKa values of tenoxicam from 1H NMR chemical shifts and of oxicams from electrophoretic mobilities (CZE) with the aid of programs SQUAD and HYPNMR.

    Science.gov (United States)

    Rodríguez-Barrientos, Damaris; Rojas-Hernández, Alberto; Gutiérrez, Atilano; Moya-Hernández, Rosario; Gómez-Balderas, Rodolfo; Ramírez-Silva, María Teresa

    2009-12-15

    In this work it is explained, by the first time, the application of programs SQUAD and HYPNMR to refine equilibrium constant values through the fit of electrophoretic mobilities determined by capillary zone electrophoresis experiments, due to the mathematical isomorphism of UV-vis absorptivity coefficients, NMR chemical shifts and electrophoretic mobilities as a function of pH. Then, the pK(a) values of tenoxicam in H(2)O/DMSO 1:4 (v/v) have been obtained from (1)H NMR chemical shifts, as well as of oxicams in aqueous solution from electrophoretic mobilities determined by CZE, at 25 degrees C. These values are in very good agreement with those reported by spectrophotometric and potentiometric measurements.

  7. Clinical value of electrocardiography in diagnosis of hyperkalemia%心电图诊断高钾血症的临床价值

    Institute of Scientific and Technical Information of China (English)

    江波

    2016-01-01

    Objective To investigate the clinical value of electrocardiography in the diagnosis of hyperkalemia, and to provide scientific guidance for clinical treatment. Methods The clinical data of 19 patients with hyperkalemia who were admitted to our hospital from March 2015 to March 2016 were collected, and their electrocardiographic findings were analyzed. The targeted therapy was given to the patients with hyperkalemia with reference to the electrocardiographic findings.Results The changes in electrocardiographic findings reflected the concentration of serum potassium in the patients with hyperkalemia and were used for the diagnosis of hyperkalemia. All the 19 patients were diagnosed with hyperkalemia, and after the treatment to reduce serum potassium, cardiovascular and neuromuscular symptoms were effectively controlled. Conclusion Electrocardiography has a high clinical value in the diagnosis of hyperkalemia and holds promise for wide clinical application due to an easy and convenient procedure.%目的:研究心电图诊断高血压的应用价值,为临床治疗提供科学指导。方法共收录2015年3月-2016年3月期间,我院收治的19例高钾血症患者资料,对其心电图资料进行分析;结合心电图诊断结果,对高钾血症患者采取针对性治疗方案。结果心电图变化可翻译高钾血症的血清钾浓度高低,对高钾血诊断具有借鉴意义;本次19例均确诊为高钾血症,通过降低血清钾治疗后,心血管症状、神经肌肉症状等均得到有效控制。结论心电图诊断高钾血症有较高的临床价值,操作简单、便捷,值得推广。

  8. Adding value(s)

    DEFF Research Database (Denmark)

    Carré, David

    2015-01-01

    , 1992). In response, behavioral economics (Camerer, 1999) has shown that agents have values other than optimization underpinning their decisions. Therefore, concerns arose regarding which values are guiding the agent but not about how such values became relevant for the agent. In this presentation, I......Most economic inquires revolve around agents making decisions. Getting the ‘best value’, it is assumed, drives such decisions: gaining most while risking least. This assumption has been debunked by showing that people does not always choose neither maximum benefit nor less risk (Kahneman & Tversky...... will explore the consequences of shifting to the latter perspective, i.e. looking for the generative framework of values. Here I argue that economic behavior should also be seen as a sense-making process, guided by values that are chosen/rejected along with fellow human beings, in specific socio...

  9. The clinical impact of breast scintigraphy acquired with a breast specific γ-camera (BSGC) in the diagnosis of breast cancer: incremental value versus mammography.

    Science.gov (United States)

    Spanu, Angela; Sanna, Daniela; Chessa, Francesca; Manca, Alessandra; Cottu, Pierina; Fancellu, Alessandro; Nuvoli, Susanna; Madeddu, Giuseppe

    2012-08-01

    We investigated the clinical impact of breast scintigraphy acquired with a breast specific γ-camera (BSGC) in the diagnosis of breast cancer (BC) and assessed its incremental value over mammography (Mx). A consecutive series of 467 patients underwent BSGC scintigraphy for different indications: suspicious lesions on physical examination and/or on US/MRI negative at Mx (BI-RADS 1 or 3), characterization of lesions suspicious at Mx (BI-RADS 4), preoperative staging in lesions highly suggestive of malignancy at Mx (BI-RADS 5). Definitive histopathological findings were obtained in all cases after scintigraphy: 420/467 patients had BC, while 47/467 patients had benign lesions. The scintigraphic data were correlated to Mx BI-RADS category findings and to histology. The incremental value of scintigraphy over Mx was calculated. Scintigraphy was true-positive in 97.1% BC patients, detecting 96.2% of overall tumor foci, including 91.5% of carcinomas ≤10 mm, and it was true-negative in 85.1% of patients with benign lesions. Scintigraphy gave an additional value over Mx in 141/467 cases (30.2%). In particular, scintigraphy ascertained BC missed at Mx in 31 patients with BI-RADS 1 or 3, including 26 patients with heterogeneously/high dense breast (19/26 with tumors ≤10 mm) and detected additional clinically occult ipsilateral or controlateral tumor foci (all breast and in multifocal/multicentric disease, and the specificity as well as it better defined local tumor extension, thus guiding the surgeon to a more appropriate surgical treatment.

  10. Prognostic value of stromal and epithelial periostin expression in human prostate cancer: correlation with clinical pathological features and the risk of biochemical relapse or death

    Directory of Open Access Journals (Sweden)

    Nuzzo Pier Vitale

    2012-12-01

    Full Text Available Abstract Background The purpose of the present study was to evaluate the prognostic value of POSTN expression following prostatectomy. Methods Periostin (POSTN expression in prostate cancer (PCa and in normal specimens was evaluated in 90 patients by an immuno-reactive score(IRS based on the intensity of immunostaining and on the quantity of stained cells. The t-test was applied to compare IRS values in cancer specimens to values in normal specimens. Pearson’s test was used to correlate POSTN expression to clinical pathologic features. PSA progression-free and survival curves were constructed by the Kaplan–Meier method and compared using the log-rank test. Multi-parametric models were constructed according to the Cox technique adding all the covariates predicting for either PSA progression or death into the models after univariate analysis. Results Both stromal and epithelial POSTN expression were significantly increased in tumor tissues. In particular, we found stromal expression to be significantly higher than epithelial expression as compared to normal tissues (p Conclusions Although requiring further validation through larger studies, our findings show that POSTN might represent a novel prognostic marker for PCa.

  11. The clinical value of MRA at 3.0 T for the diagnosis and therapeutic planning of patients with subarachnoid haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yuan-Chang; Sun, Zhen-Kui; Li, Ming-Hua; Li, Yong-Dong; Wang, Wu; Tan, Hua-Qiao; Gu, Bin-Xian [Shanghai Jiao Tong University, Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People' s Hospital, Shanghai (China); Chen, Shi-Wen [Shanghai Jiao Tong University, Department of Neurosurgery, Sixth Affiliated People' s Hospital, Shanghai (China)

    2012-07-15

    To evaluate the clinical value of unenhanced magnetic resonance angiography (MRA) at 3.0 T for the diagnosis and therapeutic planning of patients with subarachnoid haemorrhage (SAH). A total of 165 patients with SAH were referred for three-dimensional time-of-flight MRA (3D-TOF-MRA) before digital subtraction angiography (DSA). For each aneurysm, 3D-TOF-MRA was used to determine whether the aneurysm was suitable for coil placement with or without balloon/stent-assisted coiling, surgical clipping or conservative treatment. Treatment planning with 3D-TOF-MRA was compared with actual treatment decisions or treatment that had been carried out in each aneurysm decided using DSA. The aneurysm-based evaluation yielded accuracy of 96.9%, sensitivity of 97.6%, specificity of 93.1%, positive predictive value (PPV) of 98.8% and negative predictive value (NPV) of 87.1%, in the detection of intracranial aneurysms. Treatment planning could be correctly made on the basis of aneurysm anatomy and working view by volume rendering (VR) 3D-TOF-MRA with accuracy, sensitivity, specificity, PPV and NPV of 94.9%, 94.0%, 100%, 100% and 74.4%, respectively, on a per aneurysm-based evaluation. VR 3D-TOF-MRA offers high diagnostic accuracy in the detection of ruptured intracranial aneurysms, and appears to be an effective treatment planning tool for most patients with SAH. (orig.)

  12. A progress report on the LDRD project entitled {open_quotes}Microelectronic silicon-based chemical sensors: Ultradetection of high value molecules{close_quotes}

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, R.C.

    1996-09-01

    This work addresses a new kind of silicon based chemical sensor that combines the reliability and stability of silicon microelectronic field effect devices with the highly selective and sensitive immunoassay. The sensor works on the principle that thin SiN layers on lightly doped Si can detect pH changes rapidly and reversibly. The pH changes affect the surface potential, and that can be quickly determined by pulsed photovoltage measurements. To detect other species, chemically sensitive films were deposited on the SiN where the presence of the chosen analyte results in pH changes through chemical reactions. A invention of a cell sorting device based on these principles is also described. A new method of immobilizing enzymes using Sandia`s sol-gel glasses is documented and biosensors based on the silicon wafer and an amperometric technique are detailed.

  13. The Value of Value

    DEFF Research Database (Denmark)

    Sørensen, Asger

    and the regularity of such a phenomenon is both hard to verify and, if true, difficult to explain, it seems fair to say that since the Enlightenment, an approaching fin-de-siecle has brought an increased interest in matters concerning morality and ethics.1 The present peak has in public-political discourse and some...... parts of business ethics given prominence to especially one term, namely `value'. The question that interests me is the following: What does the articulation of ethics and morality in terms of values mean for ethics and morality as such. Or, to put the question in a more fashionably way: What...... is the value of value for morality and ethics?To make things a bit more precise, we can make use of the common distinction between ethics and morality, i.e. that morality is the immediate, collective and unconscious employment of morals, whereas ethics is the systematic, individual and conscious reflections...

  14. Clinical Significance and Prognostic Value of CA72-4 Compared with CEA and CA19-9 in Patients with Gastric Cancer

    Directory of Open Access Journals (Sweden)

    M. Ychou

    2000-01-01

    Full Text Available Carcinoembryonic antigen (CEA and CA 19-9 are both widely used in the follow up of patients with gastrointestinal cancer. More recently another tumor marker, named CA 72-4 has been identified and characterized using two different monoclonal antibodies B72.3 and CC49. Several reports evaluated CA 72-4 as a serum tumor marker for gastric cancer and compared its clinical utility with that of CEA or CA 19-9; few reports concerned its prognostic value. In the present study, CA 72-4 is evaluated and compared with CEA and CA 19-9 in various populations of patients with gastric cancer and benign disease; for 52 patients with gastric adenocarcinoma and 57 patients without neoplastic disease CEA, CA 19-9 and CA 72-4 were evaluated before treatment. Sensitivity of the tumor markers CA 72-4, CA 19-9 and CEA at the recommended cut-off level in all 52 patients were 58%, 50% the sensitivity increased to 75%. of these markers, for non metastatic patients, multivariate analyses indicated that none of the markers were significant, when adjusted for gender and age (which were indicators of poor prognosis; patients with abnormal values of CA72-4 tended to have shorter survival than patients with normal values (p < 0.07. In the metastatic population, only high values of CA19-9 (p < 0.02 and gender (women (p < 0.03 were indicators of poor prognosis in univariate analysis; multivariate analysis revealed that both CA72-4 (p = 0.034 and CA19-9 p = 0.009, adjusted for gender were independent prognostic factors. However, CA72-4 lost significance (p = 0.41 when adjusted for CA19-9 and gender, indicating that CA19-9 provides more prognostic information than CA72-4.

  15. Cyclic voltammetry using silver as cathode material: a simple method for determining electro and chemical features and solubility values of CO2 in ionic liquids.

    Science.gov (United States)

    Reche, Irene; Gallardo, Iluminada; Guirado, Gonzalo

    2015-01-28

    A report is presented on the use of cyclic voltammetry using silver as a working electrode. The combined electrocatalytic properties of silver and ionic liquids allow cyclic voltammetry to be turned into an ideal tool for the rapid and accurate access to diffusion coefficient values and solubility values of carbon dioxide in ionic liquids under standard conditions.

  16. Clinical value of serum amylase, serum trypsinogen-2, IL-10 and platelet activating factor detection in diagnosis of post-ERCP pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Di Wang; Xue-Song Li; Peng-Peng Cai

    2016-01-01

    Objective:To explore the clinical value of serum amylase, serum trypsinogen-2, IL-10 and platelet activating factor detection in the diagnosis of post-ERCP pancreatitis.Methods:A total of 256 patients with ERCP were selected in our hospital of the digestive department of internal medicine from January 2015 to December 2015. According to different symptoms, signs, serum amylase and pancreatic CT examination results after ERCP, the subjects were divided into three groups: control group, hyperlipidemia group and PEP group. Serum trypsinogen-2, IL-10, platelet activating factor were detected.Results:There were statistically significant differences in serum trypsinogen-2, IL-10, platelet activating factor among control group, hyperlipidemia group and PEP group patients with serum amylase (Fgroup = 269.578, 139.492, 145.637, 126.891, allP = 0.000), and the value of PEP group was the highest. There were statistically significant differences in serum trypsinogen-2, IL-10, platelet activating factor at different time point (Ftime = 602.506, 494.375, 462.512, 239.564, allP = 0.000), the serum amylase level in the patients with hyperlipidemia group reached the highest value after 4 h, but the 24 h was lower than the normal level after operation, the serum amylase in PEP group increased rapidly after 4 h, and the 24 h was still increased after operation; The serum trypsinogen-2, IL-10, platelet activating factor were all highest 4 h after the operation in the hyperlipidemia group and PEP group, and the 24 h after the operation were all decreased. In PEP group, serum amylase, serum trypsinogen-2, IL-10, platelet activating factor 4 h after the operation and 24 h after the operation were significantly higher than those before operation (Finteractive = 28.492, 22.614, 16.573, 7.819, allP = 0.000). In PEP group, the serum amylase had positive correlations with serum trypsinogen-2, IL-10, platelet activating factor (r=0.591, 0.662, 0.681, allP<0.05).Conclusions: Serum amylase

  17. Clinical value of exercise-induced asthma diagnosis%运动性哮喘诊断方法的临床评价

    Institute of Scientific and Technical Information of China (English)

    荀秋芬; 胡成平

    2012-01-01

    运动性哮喘(exercise-induced asthma,EIA)表现为运动后出现咳嗽、喘息、呼吸困难等症状.诊断EIA除详细的病史及体格检查外,尚需进行运动激发试验.目前诊断EIA的客观实验较多,各种诊断方法的临床价值将在文中详细探讨.%Exercise induced asthma (EIA) show symptoms of coughing,wheezing and shortness of breath after exercise.In addition to a detailed history and physical examination,exercise challenge test is also essential.There are various kinds of objective experiments for the diagnosis of EIA.This article is going to discuss Clinical value of various diagnostic methods of it briefly.

  18. Incorporating longitudinal pediatric patient-centered outcome measurement into the clinical workflow using a commercial electronic health record: a step toward increasing value for the patient.

    Science.gov (United States)

    Carberry, Kathleen; Landman, Zachary; Xie, Michelle; Feeley, Thomas; Henderson, John; Fraser, Charles

    2016-01-01

    Patient-centered outcomes measurement provides healthcare organizations with crucial information for increasing value for patients; however, organizations have struggled to obtain outcomes data from electronic health record (EHR) systems. This study describes how Texas Children's Hospital customized a commercial EHR system and assembled a cross-functional team to capture outcomes data using existing functionality. Prior to its installation and customization, no surgical subspecialties besides the congenital heart and transplant surgery groups conducted prospective, patient outcomes measurement, but by 2015, the outcomes of over 1300 unique patients with supracondylar fractures, cleft lip and/or palate, or voiding dysfunction had been tracked. Key factors for integrating outcomes measurement into the clinical workflow include ongoing communication between cross-functional teams composed of clinicians and technical professionals, an iterative design process, organizational commitment, and prioritizing measurement as early as possible during EHR optimization.

  19. Value Set Authority Center

    Data.gov (United States)

    U.S. Department of Health & Human Services — The VSAC provides downloadable access to all official versions of vocabulary value sets contained in the 2014 Clinical Quality Measures (CQMs). Each value set...

  20. 结节性硬化的CT、MRI影像诊断及临床价值%CT, MRI Imaging Diagnosis and Clinical Value of Nodular Sclerosis

    Institute of Scientific and Technical Information of China (English)

    钟先金

    2016-01-01

    Objective To analyze and discuss clinical value of CT and MRI in the diagnosis of nodular sclerosis.Methods CT and MRI imaging data of 43 patients during the period from February 2013 to December 2015 in our hospital for treatment of patients with tuberous sclerosis were analyzed retrospectively.Results CT and MRI imaging data showed that the main pathological changes the characteristics of tuberous sclerosis patients with subependymal nodules and cortical and subcortical tubercle, subependymal giant cell astrocytoma, cerebral white matter abnormalities.Conclusion CT showed nodular calciifcation than MRI obviously, but MRI can check through many layers and MRI have important clinical value in the treatment of nodular sclerosis, which has obvious advantages in detecting smaller nodules.%目的:对结节性硬化的CT、MRI影像诊断及临床价值予以分析和探讨。方法选取2013年2月~2015年12月于我院进行治疗的结节性硬化的患者43例的CT与MRI影像资料进行回顾性分析。结果 CT和MRI影像资料都表明结节性硬化患者的主要病变特征有室管膜下结节、皮层以及皮层下结节、室管膜下巨细胞星形细胞瘤、脑白质异常。结论 CT在显示结节钙化方面较MRI较为明显,但是MRI能够通过多方面多层次进行检查,在检测较小结节方面有明显的优势,因此CT与MRI在结节性硬化当中均具有重要的临床价值。

  1. 超声引导下经皮肾穿刺活检的临床价值%The Clinical Value of Ultrasound Guided Percutaneous Renal biopsy

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To investigate the clinical value of Ultrasound guided percutaneous renal biopsy. Methods Retrospective analysis of 115 cases of ultrasound guided percutaneous renal biopsy ultrasound positioning points, the puncture success rate, pathological findings and postoperative complications. Results In 115 cases, 1 case without success, the success rate was 99.1%,pathological results of IgA ephropathy and mesangial proliferative glomerulonephritis accounted for 72% of the total, postoperative complications accounted for 1.3% of gross hematuria, perirenal hematoma accounted for 1.7%, accounted for 43% of low back pain. Conclusions Ultrasound guided percutaneous renal puncture biopsy with high success rate, less complications, and is of high clinical value.%  目的探讨超声引导定位经皮肾穿刺活检的临床价值。方法回顾分析115例经超声引导定位经皮肾穿刺活检声像图定位要点,穿刺取材成功率,病理结果及术后并发症。结果115例中,1例未取材成功,取材成功率99.1%,病理结果IgA肾病及系膜增生性肾小球肾炎占总数的72%,术后并发症肉眼血尿占1.3%,肾周血肿占1.7%,腰痛占43%。结论超声引导定位经皮肾穿刺活检取材成功率高,并发症少,具有很高的临床价值。

  2. Clinical value of 12 occlusal features for the prediction of disc displacement with reduction (RDC/TMD Axis I group IIa).

    Science.gov (United States)

    Chiappe, G; Fantoni, F; Landi, N; Biondi, K; Bosco, M

    2009-05-01

    The purpose of this study is to quantify the clinical value of 12 occlusal variables for the prediction of disc displacement with reduction diagnosed according to research diagnostic criteria (RDC)/temporomandibular disorder (TMD). Twelve occlusal features were clinically assessed by the same three operators. The sample consisted of 165 TMD patients (65 males, 100 females; mean age: 32.55 +/-11.685 years) with only disc displacement with reduction (RDC/TMD Axis I group IIa) and a control sample of 145 healthy subjects (65 males, 80 females; mean age:31.24+/-12.436 years) diagnosed with RDC/TMD Axis I group 0. A stepwise multiple logistic regression model was used to identify the significant correlation between occlusal features and disease. The odds ratio for disc displacement was 2.84 for absence of canine guidance, 2.14 for mediotrusive interference and 1.75 for retruded contact position (RCP)/maximum intercuspation (MI) slide >or=2 mm. Other occlusal variables did not reveal to be statistically significant. The percentage of the total log likelihood for disc displacement explained by the significant occlusal factors was acceptable with a Nagelkerke's R(2) = 0.124. The final model including the significant occlusal features revealed an optimal discriminant capacity to predict patients with disc displacement with a sensitivity of 63.6% or with a specificity of 64.8% for healthy subjects and an accuracy of 64.2%. Occlusal features showed a low predictive value for detecting disc displacement. Multifactorial complex pathologies such as TMD should be investigated using a multivariate statistical analysis; moreover,the future of aetiopathogenic research in this matter requires a multifactorial approach.

  3. SU-E-T-02: 90Y Microspheres Dosimetry Calculation with Voxel-S-Value Method: A Simple Use in the Clinic

    Energy Technology Data Exchange (ETDEWEB)

    Maneru, F; Gracia, M; Gallardo, N; Olasolo, J; Fuentemilla, N; Bragado, L; Martin-Albina, M; Lozares, S; Pellejero, S; Miquelez, S; Rubio, A [Complejo Hospitalario de Navarra, Pamplona, Navarra (Spain); Otal, A [Hospital Clinica Benidorm, Benidorm, Alicante (Spain)

    2015-06-15

    Purpose: To present a simple and feasible method of voxel-S-value (VSV) dosimetry calculation for daily clinical use in radioembolization (RE) with {sup 90}Y microspheres. Dose distributions are obtained and visualized over CT images. Methods: Spatial dose distributions and dose in liver and tumor are calculated for RE patients treated with Sirtex Medical miscrospheres at our center. Data obtained from the previous simulation of treatment were the basis for calculations: Tc-99m maggregated albumin SPECT-CT study in a gammacamera (Infinia, General Electric Healthcare.). Attenuation correction and ordered-subsets expectation maximization (OSEM) algorithm were applied.For VSV calculations, both SPECT and CT were exported from the gammacamera workstation and registered with the radiotherapy treatment planning system (Eclipse, Varian Medical systems). Convolution of activity matrix and local dose deposition kernel (S values) was implemented with an in-house developed software based on Python code. The kernel was downloaded from www.medphys.it. Final dose distribution was evaluated with the free software Dicompyler. Results: Liver mean dose is consistent with Partition method calculations (accepted as a good standard). Tumor dose has not been evaluated due to the high dependence on its contouring. Small lesion size, hot spots in health tissue and blurred limits can affect a lot the dose distribution in tumors. Extra work includes: export and import of images and other dicom files, create and calculate a dummy plan of external radiotherapy, convolution calculation and evaluation of the dose distribution with dicompyler. Total time spent is less than 2 hours. Conclusion: VSV calculations do not require any extra appointment or any uncomfortable process for patient. The total process is short enough to carry it out the same day of simulation and to contribute to prescription decisions prior to treatment. Three-dimensional dose knowledge provides much more information than

  4. MRI 对子宫颈癌影像分析的临床价值%MRI image analysis of cervical cancer clinical value

    Institute of Scientific and Technical Information of China (English)

    朱志嫦; 庄伟雄; 郝敬军; 黄文飞; 李思霞

    2013-01-01

    Objective:To investigate the MRI image analysis of cervical cancer clinical value. Methods:diagnosed with cervical cancer, but not for surgical resection of 90 patients, its MRI, then the results of MRI imaging using double blind method of observation and analysis, the analysis results with pathological findings and clinical phases were compared to assess the MRI staging of cervical cancer diagnostic accuracy. Results:MRI of cervical cancer diagnostic accuracy was 100 percent, staging accuracy was 91.11%. Conclusion:MRI image analysis of cervical cancer has a high value.%目的:探讨MRI对子宫颈癌影像分析的临床价值。方法:选取确诊为子宫颈癌但并未进行手术切除的患者90例,对其进行MRI检查,然后将MRI影像学检查的结果采用双盲法进行观察与分析,将分析结果与手术病理结果及临床分期进行对照,评估MRI对子宫颈癌分期的诊断准确度。结果:MRI对子宫颈癌的诊断准确率为100%,分期准确率为91.11%。结论:MRI对子宫颈癌影像分析具有很高的价值。

  5. Prognostic Value of Volume-Based {sup 18}F-Fluorodeoxyglucose PET/CT Parameters in Patients with Clinically Node-Negative Oral Tongue Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Su Jin [Dept. of Nuclear Medicine, Ajou University School of Medicine, Suwon (Korea, Republic of); Choi, Joon Young; Lee, Hwan Joo; Hyun, Seung Hyup; Moon, Seung Hwan; Kim, Byung Tae [Dept. of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Baek, Chung Hwan; Son, Young Ik [Dept. of Otorhinolaryngology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-11-15

    To evaluate the prognostic value of volume-based metabolic parameters measured with {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET) in patients with clinically node-negative (cN0) oral tongue squamous cell carcinoma (OTSCC) as compared with other prognostic factors. In this study, we included a total of 57 patients who had been diagnosed with cN0 tongue cancer by radiologic, ({sup 18}F-FDG PET/CT, and physical examinations. The maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors were measured with ({sup 18}F-FDG PET. The prognostic significances of these parameters and other clinical variables were assessed by Cox proportional hazards regression analysis. In the univariate analysis, pathological node (pN) stage, American Joint Committee on Cancer (AJCC) stage, SUVmax, SUVavg, MTV, and TLG were significant predictors for survival. On a multivariate analysis, pN stage (hazard ratio = 10.555, p = 0.049), AJCC stage (hazard ratio = 13.220, p = 0.045), and MTV (hazard ratio = 2.698, p 0.033) were significant prognostic factors in cN0 OTSCC patients. The patients with MTV {>=} 7.78 cm{sup 3} showed a worse prognosis than those with MTV < 7.78 cm{sup 3} (p = 0.037). The MTV of primary tumor as a volumetric parameter of ({sup 18}F-FDG PET, in addition to pN stage and AJCC stage, is an independent prognostic factor for survival in cN0 OTSCC.

  6. 宫外孕的彩超诊断价值及临床意义%Diagnostic value and clinical significance of color Doppler ultrasound for ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    高鸣

    2014-01-01

    目的:探讨彩超对宫外孕的诊断价值以及临床意义。方法回顾性分析88例宫外孕患者的临床及影像学资料。结果超声检查的88例宫外孕患者,诊断符合82例,误诊6例,确诊率为93.18%。结论彩超对宫外孕的诊断分辨力高、简便、快捷、诊断符合率较高,能为临床提供及时和切实可靠的诊断依据。%Objective To explore the diagnostic value and clinical significance of color Doppler ultrasound for ectopic pregnancy. Methods A retrospective analysis was made on the clinical and imaging data of 88 ectopic pregnancy patients. Results Among the 88 cases, who underwent color Doppler ultrasound examination, there were 82 cases with qualified diagnosis and 6 misdiagnosed cases. The accurate diagnosis rate was 93.18%. Conclusion Color Doppler ultrasound for ectopic pregnancy has the advantages of high diagnostic definition, convenience, high speed, and high diagnose accordance rate, thus it can provide timely and reliable information for clinicosis.

  7. Comparing oncology clinical programs by use of innovative designs and expected net present value optimization: Which adaptive approach leads to the best result?

    Science.gov (United States)

    Parke, Tom; Marchenko, Olga; Anisimov, Vladimir; Ivanova, Anastasia; Jennison, Christopher; Perevozskaya, Inna; Song, Guochen

    2017-01-01

    Designing an oncology clinical program is more challenging than designing a single study. The standard approaches have been proven to be not very successful during the last decade; the failure rate of Phase 2 and Phase 3 trials in oncology remains high. Improving a development strategy by applying innovative statistical methods is one of the major objectives of a drug development process. The oncology sub-team on Adaptive Program under the Drug Information Association Adaptive Design Scientific Working Group (DIA ADSWG) evaluated hypothetical oncology programs with two competing treatments and published the work in the Therapeutic Innovation and Regulatory Science journal in January 2014. Five oncology development programs based on different Phase 2 designs, including adaptive designs and a standard two parallel arm Phase 3 design were simulated and compared in terms of the probability of clinical program success and expected net present value (eNPV). In this article, we consider eight Phase2/Phase3 development programs based on selected combinations of five Phase 2 study designs and three Phase 3 study designs. We again used the probability of program success and eNPV to compare simulated programs. For the development strategies, we considered that the eNPV showed robust improvement for each successive strategy, with the highest being for a three-arm response adaptive randomization design in Phase 2 and a group sequential design with 5 analyses in Phase 3.

  8. QT interval variability in body surface ECG : measurement, physiological basis, and clinical value: position statement and consensus guidance endorsed by the European Heart Rhythm Association jointly with the ESC Working Group on Cardiac Cellular Electrophysiology

    NARCIS (Netherlands)

    Baumert, Mathias; Porta, Alberto; Vos, Marc A; Malik, Marek; Couderc, Jean-Philippe; Laguna, Pablo; Piccirillo, Gianfranco; Smith, Godfrey L; Tereshchenko, Larisa G; Volders, Paul G A

    2016-01-01

    This consensus guideline discusses the electrocardiographic phenomenon of beat-to-beat QT interval variability (QTV) on surface electrocardiograms. The text covers measurement principles, physiological basis, and clinical value of QTV. Technical considerations include QT interval measurement and the

  9. The clinical and economic value of the dipeptide alanyl-glutamine in total parenteral nutrition of critically ill patients treated in intensive care units in Italy

    Directory of Open Access Journals (Sweden)

    Maurizio Muscaritoli

    2009-06-01

    Full Text Available Introduction: the supplementation of alanyl-glutamine dipeptide in critically ill patients necessitating total parenteral nutrition (TPN improves clinical outcomes, reducing mortality, infection rate, and shortening ICU hospital lengths of stay (LOS, as compared to standard TPN regimens. Here we present a pharmacoeconomic evaluation of alanyl-glutamine dipeptide in critically ill patients admitted to Italian Intensive Care Units (ICUs. Methods: a Discrete Event Simulation model that incorporates outcomes rates from 200 Italian ICUs for over 60,000 patients, alanyl-glutamine dipeptide efficacy data synthesized by means of a Bayesian Random-Effects meta-analysis, and national cost data has been developed to evaluated the alternatives from the point of view of the hospital. Simulated clinical outcomes are death and infection rates in ICU, death rate in general ward, and hospital LOSs. One-way and probabilistic sensitivity analyses are performed by varying all uncertain parameter values in a plausible range. Results: alanyl-glutamine dipeptide results more effective and less costly than standard TPN: reduced mortality rate (23.55% ± 15.2% vs 34.50% ± 2.06%, infection rate (15.91% ± 3.95% vs 18.97% ± 3.94%, and hospital LOS (25.47 ± 0.26 vs 26.00 ± 0.27 days come at a lower total cost per patient (23,922 ± 3,249 vs 24,145 ± 3,361 Euro. Treatment cost is completely offset by savings on ICU and antibiotic costs. The cost/effectiveness acceptability curve indicates an estimated 78% probability of alanyl-glutamine dipeptide resulting dominant and a 90% probability of resulting cost/effective for a willingness to pay up to 1,500 Euro for one patient death avoided. Conclusions: alanyl-glutamine dipeptide is expected to improve clinical outcomes and to do so with a concurrent saving for the hospital.

  10. Positive predictive value of additional synchronous breast lesions in whole-breast ultrasonography at the diagnosis of breast cancer: clinical and imaging factors

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ah Hyun; Kim, Min Jung; Kim, Eun Kyung; Moon, Hee Jung [Dept. of Radiology, Research Institute of Radiological Science, Seoul (Korea, Republic of); Park, Hee Jung [Dept. of Surgery, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    To evaluate the positive predictive value (PPV) of bilateral whole-breast ultrasonography (BWBU) for detection of synchronous breast lesions on initial diagnosis of breast cancer and evaluate factors affecting the PPV of BWBU according to varying clinicoimaging factors. A total of 75 patients who had synchronous lesions with pathologic confirmation at the initial diagnosis of breast cancer during January 2007 and December 2007 were included. The clinical factors of the patients were evaluated. One observer retrospectively reviewed the imaging studies of the index breast cancer lesion and the synchronous lesion. The PPV for additional biopsy was calculated for BWBU and various clinical and imaging factors affecting the PPV for BWBU were evaluated. The overall PPV for additional biopsy was 25.7% (18 of 70). The PPV for synchronous lesions detected both on mammography and BWBU, and detected only on BWBU, was 76.9% (10 of 13) and 14.3% (7 of 49), respectively. There was no clinical factor affecting the PPV for BWBU. Among the imaging factors, ipsilateral location of the synchronous lesion to the index lesion (P=0.06) showed a marginal statistically significant correlation with malignancy in the synchronous breast lesion. A mass with calcification on mammography presentation (P<0.01), presence of calcification among the ultrasonography findings (P<0.01), and high Breast Imaging Reporting and Data System final assessment (P<0.01) were imaging factors that were associated with malignancy in the additional synchronous lesion. BWBU can detect additional synchronous malignancy at the diagnosis of breast cancer with a relatively high PPV, especially when mammography findings are correlated with ultrasonographic findings.

  11. Clinical outcomes after utilizing surviving sepsis campaign in children with septic shock and prognostic value of initial plasma NT-proBNP

    Directory of Open Access Journals (Sweden)

    Rujipat Samransamruajkit

    2014-01-01

    Full Text Available Background and Objective: The surviving sepsis campaign treatment guideline (SSC implementation is associated with improved outcome in adults with severe sepsis. The effect on outcome of pediatric sepsis is less clear. Purpose : To determine the clinical outcomes of SSC implementation and to investigate the prognostic value of initial plasma NT-proBNP and procalcitonin in children. Materials and Methods: Infants and children (aged 1month/0-15 years with severe sepsis or septic shock were prospectively enrolled and treated according to the guidelines. Initial blood drawn was saved for NT-pro-BNP, procalcitonin measurements and clinical data were also recorded. Results: A total of 47 subjects were recruited. Since the application of the SSC, our mortality rate had significantly decreased from 42-19% (P = 0.003 as compared to the data in the previous 3 years. Clinical factors that significantly increased the mortality rate were: Initial central venous oxygen saturation < 7 0% after fluid resuscitation [odds ratio (OR = 23.3; 95% confidence interval (CI 3.7-143; P = 0.001], and initial albumin level (≤ 3 g/dl, OR = 6.7; 95% CI 1.2-37.5, P = 0.03. There was asignificant difference between the initial NT-proBNP levels between survivors and non survivors, (6280.3 ± 9597 ng/L, P < 0.001, but not for procalcitonin (12.7 ± 24.8, 29.3 ± 46 μg/L, P = 0.1, respectively. An initial NT-proBNP level of more than 11,200 pg/ml predicted Pediatric Intensive Care Unit (PICU mortality with a sensitivity of 85.7% and a specificity of 90%. Conclusions: A modified SSC for severe sepsis and septic shock significantly reduced the mortality rate in our PICU. High initial NT-ProBNP level was associated with mortality.

  12. The value of repeat scintigraphy in patients with a high clinical suspicion for Meckel diverticulum after a negative or equivocal first Meckel scan

    Energy Technology Data Exchange (ETDEWEB)

    Vali, Reza; Daneman, Alan; McQuattie, Susan; Shammas, Amer [Hospital for Sick Children, Diagnostic Imaging, Toronto (Canada)

    2015-09-15

    Technetium {sup 99m}Tc-pertechnetate is the most common and accurate noninvasive method of preoperative investigation for Meckel diverticulum. Despite introducing various methods to increase the sensitivity of the study, there are many case reports of false-negative Meckel scans. A repeat scan is sometimes requested in patients with a high suspicion for Meckel diverticulum and negative or equivocal first Meckel scan. The purpose of this retrospective study is to evaluate the value of repeat scintigraphy for these patients. Seven hundred fifty-three Meckel scans were recorded retrospectively. In 33 cases (22 male and 11 female; mean age: 6.8 years), the Meckel scintigraphy was repeated either due to a high clinical suspicion of Meckel diverticulum and a negative study (n = 21) or due to equivocal findings in the first scan (n = 12). The study was interpreted as positive if an abnormal focal activity was identified in the abdomen and pelvis during the procedure. The results were correlated with pathology and clinical symptoms. Seven out of 12 (58%) equivocal studies were positive on the second study. Six of them were proven to be positive at operation (confirmed by pathology) while one of them was negative on laparoscopy. From 21 negative first scans with a high suspicion for Meckel diverticulum, three (14%) were positive on the second study. All three were proven to be Meckel diverticulum on pathology. Repeat Meckel scans in patients with equivocal findings on the first study or a negative result with a high clinical suspicion for a Meckel diverticulum are useful especially in cases in which the first study had been done without appropriate preparation. (orig.)

  13. Clinical value of rapid urine trypsinogen-2 test strip, urinary trypsinogen activation peptide, and serum and urinary activation peptide of carboxypeptidase B in acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Jesús Sáez; Juan Martínez; Celia Trigo; José Sánchez-Payá; Luis Compa(n)y; Raquel Laveda; Pilar Gri(n)ó; Cristina García; Miguel Pérez-Mateo

    2005-01-01

    AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP),and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosisof acute pancreatitis.METHODS: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.RESULTS: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.CONCLUSION: In patients with acute abdominal pain,hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase.Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis.

  14. 百草枯致眼化学伤15例分析%Clinical analysis of 15 cases of paraquat-induced ocular chemical injury

    Institute of Scientific and Technical Information of China (English)

    严新华; 徐欣悦

    2015-01-01

    目的 探讨百草枯(Paraquat)致眼化学伤的临床表现和治疗方法.方法 对2012年7月至2014年6月百草枯致眼化学伤15例(21眼)进行回顾性分析.结果 百草枯所致眼损伤均出现特征性的结膜伪膜,立即给以结膜囊冲洗,抗生素滴眼液和自体血清滴眼,全身糖皮质激素应用联合伪膜撕除.除1例穹隆部发生睑球粘连外,其余均恢复良好.结论 百草枯致眼化学伤典型临床特征为结膜伪膜,患者应及时救治.采用上述治疗方案,效果良好.%Objective To investigate the clinical manifestation and therapeutic method of paraquat-induced ocular chemical injury.Methods A retrospective analysis was conducted on the clinical data of 21 eyes from 15 patients with paraquat-induced ocular chemical injury from July 2012 to June 2014.Results Specific pseudomembranous conjunctivitis was manifested on all patients.The treatment with rinsing conjunctival sac, antibiotic eye drops and autologous serum eye drops, as well as systematically injection with glucocorticoid were used combined with pseudomembrane removal.All patients were recovered well except symblepharon occurred on the zone of the fomix in one patient.Conclusion The specific clinical manifestation of paraquat-induced ocular chemical injury is conjunctival pseudomembrane.Those patients should to be rescued timely with the methods given above and they will recover well.

  15. 氨溴索佐治哮喘性支气管炎的临床价值%Clinical value of ambroxol in the treatment of asthmatic bronchitis

    Institute of Scientific and Technical Information of China (English)

    乔卓妮

    2012-01-01

    Objective To investigate the clinical value of ambroxol in the treatment of asthmatic bronchitis. Methods Ninety patients of asthmatic bronchitis admitted into our hospital from September 2010 to September 2011 were randomly divided into two groups, the study group (n=45) and the control group (n=45). The control group was given conventional treatment, but the study group was treated by ambroxol on the basis of conventional treatment The clinical efficacy, the disappearance time of symptoms and signs and the pulmonary function in the two groups was observed and compared after treatment Results The clinical efficacy in the study group was significantly better than that in the control group (P<0.05). The disappearance time of symptoms and signs in the study group was significantly less than those in the control group (P<0.05). The recovery of pulmonary function in the study group was significantly better than that in the control group (P<0.05). Conclusion Ambroxol had significant clinical effects in the treatment of asthmatic bronchitis.%目的 探讨氨溴索在哮喘性支气管炎治疗中的临床价值.方法 选择2010年9月至2011年9月在本院诊治的哮喘性支气管炎患者90例,将患者随机分成两组:实验组45例,对照组45例.对照组给予常规治疗,实验组则在常规治疗基础上再给予氨溴索治疗.观察两组患者的临床疗效、症状体征消失时间及其肺功能恢复情况.结果 实验组的临床疗效明显优于对照组(P<0.05);实验组症状体征消失时间明显快于对照组(P<0.05);实验组的肺功能恢复状态明显优于对照组(P<0.05).结论 临床应用氨溴索佐治哮喘性支气管炎的效果良好.

  16. Lack of contralateral suppression in transient-evoked otoacoustic emissions in multiple chemical sensitivity: a clinical correlation study

    Directory of Open Access Journals (Sweden)

    Alessandro Micarelli

    2016-01-01

    Full Text Available Multiple chemical sensitivity (MCS is a chronic disorder characterized by a variety of symptoms associated with the exposure to chemicals at a concentration below the toxic level. Previous studies have demonstrated peculiar responses in brain activity in these patients with respect to sensory stimuli while the association between chemical sensitivity and other environmental intolerances such as noise sensitivity has been questioned by researchers. In this study, a cohort of 18 MCS patients underwent transient-evoked otoacoustic emission (TEOAE testing with and without contralateral suppression to evaluate the functionality of the medial olivocochlear (MOC reflex involved in speech-in-noise sensitivity. Results were compared with an age- and gender-matched control group (n = 20 and correlation analysis with disease onset and quick environmental exposure sensitivity inventory (qEESI symptom severity scale was performed. Subjects affected by MCS showed statistically significant impairment of MOC reflex, and the onset of the disease and several symptom subscales showed to be correlated to such reduction in some of the frequencies tested. These data suggest that alterations of MOC reflex could be part of the complex features of this disease although more studies are needed to further explore auditory perception disorders in environmental intolerances.

  17. DNA Methylation Pyrosequencing Assay Is Applicable for the Assessment of Epigenetic Active Environmental or Clinical Relevant Chemicals

    Directory of Open Access Journals (Sweden)

    Ana-Maria Florea

    2013-01-01

    Full Text Available Exposure of cells and organisms to stressors might result in epigenetic changes. Here it is shown that investigation of DNA methylation using pyrosequencing is an alternative for in vitro and in vivo toxicological testing of epigenetic effects induced by chemicals and drugs. An in vitro evaluation of global and CpG site specific DNA methylation upon treatment of cells with chemicals/drugs is shown. Bisulfite genomic sequencing of methylation controls showed high methylation of LINE1 in methylation positive control and low methylation in the negative controls. The CpG sites within the LINE1 element are methylated at different levels. In vitro cell cultures show a methylation level ranging from 56% to 49%. Cultures of drug resistant tumor cells show significant hypomethylation as compared with the originating nonresistant tumor cells. The in vitro testing of epigenetically active chemicals (5-methyl-2’-deoxycytidine and trichostatin A revealed a significant change of LINE1 methylation status upon treatment, while specific CpG sites were more prone to demethylation than others (focal methylation. In conclusion, DNA methylation using pyrosequencing might be used not only for testing epigenetic toxins/drugs but also in risk assessment of drugs, food, and environmental relevant pollutants.

  18. THE CHARACTERIZATION OF EPOXY VALUE BY INFRARED SPECTROSCOPY METHOD COMBINED WITH CHEMICAL ANALYSIS%红外与化学法联用表征环氧树脂环氧值

    Institute of Scientific and Technical Information of China (English)

    马楠楠; 赵娟; 陈福花

    2013-01-01

    Two separation methods for bisphenol-A epoxy resin' s epoxy value were investigated:infrared spectroscopy method combined with chemical analysis.Through this paper,epoxy value was determined through chemical analysis,and epoxy index was analyzed by infrared spectroscopy.The relation of epoxy index and epoxy value was given by a standard curve.The standard curve can be used to determine the unknown epoxy resin's epoxy value,and supporting data for performance testing and curing mechanism research could also be provided.%研究了双酚A型环氧树脂环氧值的两种表征方法.通过化学分析法测定环氧值,采用红外光谱法分析环氧指数,得到环氧指数-环氧值的标准曲线.此标准曲线可以用于测定未知牌号环氧树脂的环氧值,继而为环氧树脂性能检测和固化机理研究提供数据支持.

  19. CT、MRI对宫颈癌的临床诊断价值对比%Clinical Diagnosis Value of the Cervical Cancer by CT and MRI

    Institute of Scientific and Technical Information of China (English)

    姚福会; 曹艳文; 孔德莉

    2015-01-01

    目的:对比分析CT、MRI对宫颈癌的临床诊断价值。方法2014年4月~2015年4月选择我院及协作院收治的62例宫颈癌患者,所有患者术前均接受MRI及CT检查,以术后病理检查为金标准,比较两种方法的诊断准确率。结果 MRI的诊断准确率为96.77%,高于CT的80.65%(P<0.05)。结论与CT相比,MRI对宫颈癌的诊断准确率更高,可为宫颈癌的临床诊断提供可靠依据。%Objective To analyze the clinical diagnosis value of the cervical cancer by CT and MRI.MethodsFrom April 2014 to April 2015,62 cases of patients with cervical cancer in our hospital and the colaboration hospital as research object. Before operation,al patients were examined by MRI and CT, with postoperative pathologic examination as the gold standard,compared the diagnosis accurate rate of two methods. ResultsThe diagnosis accurate rate of MRI was 96.77%,which was significantly higher than the control group(80.65%)(P<0.05).Conclusion The diagnosis accurate rate of MRI is higher than CT,it can provide a reliable basis for the clinical diagnosis of cervical cancer.

  20. Clinical value of MRI in the diagnosis of nasal vestibular cyst%MRI在诊断鼻前庭囊肿中的临床价值

    Institute of Scientific and Technical Information of China (English)

    何志刚

    2015-01-01

    目的:探讨MRI在诊断鼻前庭囊肿中的临床价值.方法:收治鼻前庭囊肿患者35例,所有患者均经手术病理证实.所有患者均平躺,头部稍向后仰,采用MRI进行扫描检查.结果:35例患者中单侧29例(其中左侧5例,右侧24例),双侧6例,囊肿呈梨状孔底部外侧均匀的圆形阴影,囊内可显示囊肿圆形、椭圆形等形状,表面光滑,边缘清晰,囊肿直径0.8~3.1 cm,平均2.2 cm.结论:MRI是诊断鼻前庭囊肿的重要手段,值得临床推广.%Objective:To explore the clinical value of MRI in the diagnosis of nasal vestibular cyst.Methods:35 patients with nasal vestibular cyst were selected.All patients were confirmed by surgical pathologic.All patients were supine,head slightly tilted,and given scan checked by usign MRI.Results:In 35 patients,29 cases were unilateral,including 5 cases of left side,24 cases of right side,6 cases of bilateral side.The cyst was a circular shadow with piriform aperture bottom uniform lateral.The cyst could be displayed round,oval shape and other shape,the surface was smooth,the edge was clear,the cyst diameter was 0.8 to 3.1 cm,the average was 2.2 cm.Conclusion:MRI is an important method for the diagnosis of nasal vestibular cyst,and it is worthy of clinical promotion.

  1. 关于腹部创伤的CT诊断及临床价值分析%Analysis CT Diagnosis and Clinical Value of Abdominal Trauma

    Institute of Scientific and Technical Information of China (English)

    任悠悠

    2016-01-01

    Objective To investigate the value of CT abdominal trauma diagnosis.Methods Selected 47 patients with abdominal trauma underwentCT diagnosis from August 2014 to August 2015 in our hospital as research subjects, comparative analyzed CT diagnosis and surgical treatment results. ResultsDiagnosis by CT, 47 patients showed kidney damage, liver damage, spleen injury, intestinal injury, retroperitoneal hemorrhage, and the number of cases accounted 7, 13, 16, 6, 5. Comparison with surgical ifndings, CT diagnosis in 45 patients with consistent, diagnostic accuracy was 95.74% (45/47), 2 cases of misdiagnosis, misdiagnosis rate was 4.26%, mainly due to vascular injury or multiple injuries and lead to misdiagnosis.Conclusion Abdominal trauma CT diagnosis with high clinical value, which can effectively improve diagnostic accuracy, providing more forcefully reference for clinical treatment.%目的:观察腹部创伤中CT诊断的应用价值。方法选择我院2014年8月~2015年8月行腹部创伤治疗47例患者作为研究对象,均行CT诊断,对比分析CT诊断结果与手术治疗结果。结果通过CT诊断后,47例患者表现出肾脏损伤、肝损伤、脾损伤、肠道损伤及腹膜后出血,例数分别为7、13、16、6、5。与手术结果对比,45例患者CT诊断结果与之一致,诊断准确率为95.74%(45/47),2例误诊,误诊率为4.26%,主要因为血管损伤或多发性损伤而导致误诊。结论在腹部创伤中采取CT诊断具有较高的临床价值,可有效提高诊断准确率,为临床治疗提供更有力地参考依据。

  2. 腹部超声检查子宫内膜病变的临床诊断价值%Clinical diagnostic value of abdominal ultrasonography endometrial lesions

    Institute of Scientific and Technical Information of China (English)

    潘俊腾; 马晓静

    2014-01-01

    Objective:To explore the clinical value of abdominal ultrasonography in the diagnosis of endometrial lesions.Methods:80 cases with endometrial lesions were selected from March 2003 to April 2014.They were examined by color doppler ultrasound. Results:The ultrasound diagnosis of endometrial lesions was in 69 cases,and the diagnostic accordance rate was 86.25%.In 69 cases,35 cases were endometrial carcinoma,and the diagnosis coincidence rate was 92.1%;12 cases were endometrial polyp,and the diagnosis coincidence rate was 85.7%;13 cases were endometrial hyperplasia,and the diagnosis coincidence rate was 81.25%;9 cases were submucosal myoma of uterus,and the diagnosis coincidence rate was 75%.The pathological diagnosis:38 cases were endometrial carcinoma;14 cases were endometrial polyps;16 cases were endometrial hyperplasia;12 cases were submucosal myoma of uterus.Conclusion:The abdominal ultrasonography endometrial lesions has clear image.Check is painless and other advantages.The clinical diagnostic value in the diagnosis of abdominal diseases is high.%目的:探讨腹部超声检查对子宫内膜病变的临床诊断价值。方法:2003年3月-2014年4月收治子宫内膜病变患者80例,均采用彩色超声诊断仪进行检查。结果:本组超声诊断为子宫内膜病变69例,诊断符合率86.25%。其中子宫内膜癌35例,诊断符合率92.1%;子宫内膜息肉12例,诊断符合率85.7%;子宫内膜增生13例,诊断符合率81.25%;子宫黏膜下肌瘤9例,诊断符合率75.0%。病理诊断为子宫内膜癌38例,子宫内膜息肉14例,子宫内膜增生16例,子宫黏膜下肌瘤12例。结论:腹部超声检查子宫内膜病变具有图像清晰、检查无痛苦等优点,对诊断腹部疾病有较高的临床诊断价值。

  3. Clinical value of SPECT/CT in the painful total knee arthroplasty (TKA): a prospective study in a consecutive series of 100 TKA

    Energy Technology Data Exchange (ETDEWEB)

    Hirschmann, Michael T. [Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Department of Orthopaedic Surgery and Traumatology, Bruderholz (Switzerland); Amsler, Felix [Amsler Consulting, Basel (Switzerland); Rasch, Helmut [Kantonsspital Baselland, Institute of Radiology and Nuclear Medicine, Bruderholz (Switzerland)

    2015-11-15

    Bone single photon emission computed tomography (SPECT)/CT is considered as beneficial in unhappy patients with pain, stiffness or swelling after total knee arthroplasty (TKA). The purpose of this study was to identify typical patterns of bone tracer uptake (BTU), distribution and intensity values in patients after TKA. The above findings were correlated with the type and fixation of TKA, the time from TKA and intraoperative findings at revision surgery. A total of 100 knees of 84 consecutive patients (mean age ± SD 70 ± 11 years) after TKA with persistent knee pain were prospectively included. All patients underwent clinical examination, standardized radiographs and {sup 99m}Tc-hydroxymethane diphosphonate (HDP) SPECT/CT as part of a routine diagnostic algorithm. The diagnosis before and after SPECT/CT and final treatment were recorded. TKA component position was determined on 3-D reconstructed images. Intensity and anatomical distribution of BTU was determined. Maximum intensity values were recorded as well as ratios in relation to the proximal midshaft of the femur. Univariate analyses (chi-square test, Pearson's correlation and t test for independent samples) were performed (p < 0.05). SPECT/CT changed the clinical diagnosis and final treatment in 85/100 (85 %) knees. Intraoperative findings confirmed the preoperative SPECT/CT diagnosis in 32/33 knees (97 %). TKA loosening as well as progression of patellofemoral osteoarthritis (OA) was correctly diagnosed in 100 % of knees. Typical patterns of BTU for specific pathologies were identified. Loose femoral TKA components significantly correlated with increased BTU at the lateral femoral regions (p < 0.05). Loose tibial TKA components significantly correlated with increased BTU at all tibial regions (p < 0.05) and around the tibial peg (p > 0.01). The diagnostic benefits of SPECT/CT in patients after TKA have been proven. Typical pathology-related BTU patterns were identified, which will improve reporting

  4. A new chemical formulation for control of dental unit water line contamination: An 'in vitro' and clinical 'study'

    Directory of Open Access Journals (Sweden)

    Dolci Giovanni

    2002-02-01

    Full Text Available Abstract Background Water delivered by dental units during routine dental practice is highly contaminated. The aim of this study is to evaluate the efficacy of a new chemical solution flushed through Dental Unit Water Lines (DUWL for the control of contamination inside dental units. Materials and methods Six old dental units equipped with a device designed to automatically flush disinfecting solutions through the water system (Castellini Autosteril were selected. Water samples from DUWL effluents were collected in each dental unit for 10 randomly selected days, before and after a 5 minute DUWL disinfecting cycle with TetraAcetylEthileneDiamine (TAED and persalt (Ster4spray produced by Farmec spa, and distributed by Castellini spa. Water samples were plated in R2A Agar and cultured at room temperature for 7 days, and the total number of heterotrophic microorganisms counted and expressed in Log10 CFU/mL A general linear model was fitted and multiple regression ANOVA for repeated measures was used for the statistical analysis. Results The mean contamination in DUWL effluent at baseline was 5.45 ± 0.35 CFU/mL (range 4.79 to 5.93 CFU/mL. When water samples were tested "in vitro" against the chemical, no growth of heterotrophic bacteria was detected after a 5 minute contact in any of the water samples tested. After undergoing a 5 minute disinfecting cycle with the chemical, DUWL mean contamination in water effluents was 2.01 ± 0.32 CFU/mL (range 1.30 to 2.74 CFU/mL (significant difference with respect to baseline. Conclusions An inbetween patient disinfecting procedure consisting of flushing DUWL with TAED and persalt equivalent to 0.26% peracetic acid could be useful in routine dental practice for cross-contamination control.

  5. Clinical value of PICCO in weaning of mechanical ventilation patients%PICCO 在机械通气患者撤机中的应用

    Institute of Scientific and Technical Information of China (English)

    王超; 王勇强; 孙静静

    2014-01-01

    Objective To explore the clinical value of pulse index continuous cardiac output ( PICCO) in weaning of mechanical ventilation patients.Methods We prospectively analyzed the data of 58 cases from Jan, 2013 to Jun, 2013 in our hospital, which were divided into two groups including weaning successful group (n=38) and weaning failure group (n=20).Extravascular lung water index ( EVLWI) , global end diastolic volume index ( GEDVI) , intra-thoracic blood volume index ( ITBVI) , pulmonary vascular permeability index ( PVPI) were monitored by PICCO at the time points including 15 min before weaning, 15 min after weaning, 30 min after weaning, and 48 hours after weaning or reintubation.Results The APACHEⅡscore, the duration of ventilator and Cr value of weaning failure group were higher than weaning successful group (P 0.05).After weaning 30 min the GEDVI and ITBVI of weaning failure group were higher than which of weaning successful group ( t values were -3.261, -3.828, P<0.01).Also after weaning 48 hours or reintubation the EVLWI, GEDVI, ITBVI and PVPI of weaning failure group were higher than which weaning successful group ( t values were -8.788,-4.668, -4.270, -6.884, P<0.01).Conclusion The PICCO monitoring benefits early diagnosis of pulmonary edema induced by weaning, which provides reliable instructions for clinical use.%目的探讨脉搏指示连续心排量监测( PICCO)在机械通气患者撤机中的应用价值。方法前瞻性收集我院2013-01~2013-1058例机械通气患者的资料,根据撤机是否成功分为撤机成功组38例和撤机失败组20例,PICCO监测撤机前15 min及撤机后15 min、30 min、48 h或再插管时的血流动力学参数:血管外肺水指数( EVLWI )、全心舒张末期容积( GEDVI )、胸腔内血容积指数( ITBVI)和肺血管通透性指数( PVPI)。结果撤机失败组患者的APACHEⅡ评分、机械通气时间、血肌酐(Cr)显著高于撤机成功组(P<0.05),血白

  6. 脑钠肽检测预测心绞痛复发的临床价值%Clinical value of BNP testing to predict recurrence of angina

    Institute of Scientific and Technical Information of China (English)

    刘建修; 杨粟毅; 邹园枚

    2015-01-01

    目的:探讨脑钠肽(BNP)检测预测心绞痛复发的临床价值。方法选取我科2011年1月至2013年1月收治的82例稳定性心绞痛患者,所有患者均随访至2014年8月,以心绞痛再发为随访终点,按照是否再发分为未再发组72例和再发组10例。比较两组患者治疗前后的BNP水平、成功治疗后的基本特点,采用受试者工作特征(ROC)曲线计算BNP成功治疗后预测心绞痛的截断值,同时预测心绞痛再发的敏感性和特异性。结果未再发组成功治疗后的BNP水平显著低于治疗前与再发组治疗后,再发组成功治疗后的BNP水平显著高于治疗前(P<0.01)。未再发组的收缩压(SBP)、舒张压(DBP)、总甘油三酯(TG)和总胆固醇(TC)水平水平明显低于再发组(P<0.05)。BNP在成功治疗后缓解期的截断值为58.20 pg/ml,其ROC曲线的敏感性为71.09%,特异性为96.97%。结论稳定性心绞痛患者在其治疗前后测定其BNP水平,对于预测心绞痛再发有一定临床价值。%Objective To analyze the clinical value of brain natriuretic peptide (BNP) detection in predicting recurrence of angina. Methods Eighty-two patients of unstable angina in our department from January 2011 to Janu-ary 2013 were enrolled in the study. The patients were followed up to August 2014, with angina recurrence as the end of follow-up. According to the recurrence status, the patients were divided into non-recurrence group (n=72) and recur-rence group (n=10). BNP levels before and after treatment and the basic characteristics of successful treatment were compared in two groups of patients. Receiver operating characteristic (ROC) curve was used to calculate BNP cutoff value to predict angina pectoris after successful treatment and predict the sensitivity and specificity. Results BNP levels in non-recurrence group after treatment were significantly lower than those before treatment, and the levels was also significantly lower than those in

  7. Diagnostic values of chest pain history, ECG, troponin and clinical gestalt in patients with chest pain and potential acute coronary syndrome assessed in the emergency department.

    Science.gov (United States)

    Mokhtari, Arash; Dryver, Eric; Söderholm, Martin; Ekelund, Ulf

    2015-01-01

    In the assessment of chest pain patients with suspected acute coronary syndrome (ACS) in the emergency department (ED), physicians rely on global diagnostic impressions ('gestalt'). The aim of this study was to determine the diagnostic value of the ED physician's overall assessment of ACS likelihood, and the values of the main diagnostic modalities underlying this assessment, namely the chest pain history, the ECG and the initial troponin result. 1,151 consecutive ED chest pain patients were prospectively included. The ED physician's interpretation of the chest pain history, the ECG, and the global likelihood of ACS were recorded on special forms. The discharge diagnoses were retrieved from the medical records. A chart review was carried out to determine whether patients with a non-ACS diagnosis at the index visit had ACS or suffered cardiac death within 30 days. The gestalt was better than its components both at ruling in ("Obvious ACS", LR 29) and at ruling out ("No Suspicion of ACS", LR 0.01) ACS. In the "Strong suspicion of ACS" group, 60% of the patients did not have ACS. A positive TnT (LR 24.9) and an ischemic ECG (LR 8.3) were strong predictors of ACS and seemed superior to pain history for ruling in ACS. In patients with a normal TnT and non-ischemic ECG, chest pain history typical of AMI was not a significant predictor of AMI (LR 1.9) while pain history typical of unstable angina (UA) was a moderate predictor of UA (LR 4.7). Clinical gestalt was better than its components both at ruling in and at ruling out ACS, but overestimated the likelihood of ACS when cases were assessed as strong suspicion of ACS. Among the components of the gestalt, TnT and ECG were superior to the chest pain history for ruling in ACS, while pain history was superior for ruling out ACS.

  8. Clinical value of {sup 18}F-fluorodihydroxyphenylalanine positron emission tomography/computed tomography ({sup 18}F-DOPA PET/CT) for detecting pheochromocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Luster, Markus; Zeich, Katrin; Glatting, Gerhard; Buck, Andreas K.; Solbach, Christoph; Reske, Sven N. [University of Ulm, Department of Nuclear Medicine, Ulm (Germany); Karges, Wolfram [RWTH Aachen, Division of Endocrinology and Diabetes, Aachen (Germany); Pauls, Sandra [University of Ulm, Department of Radiology, Ulm (Germany); Verburg, Frederik A. [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Dralle, Henning [University Halle-Wittenberg, Department of General, Visceral and Vascular Surgery, Halle (Germany); Neumaier, Bernd [University of Ulm, Department of Nuclear Medicine, Ulm (Germany); Max-Planck-Institut fuer Neurologische Forschung, Section for Radiochemistry, Cologne (Germany); Mottaghy, Felix M. [University of Ulm, Department of Nuclear Medicine, Ulm (Germany); RWTH Aachen, Department of Nuclear Medicine, Aachen (Germany)

    2010-03-15

    In detecting pheochromocytoma (PHEO), positron emission tomography (PET) with the radiolabelled amine precursor {sup 18}F-fluorodihydroxyphenylalanine ({sup 18}F-DOPA) offers excellent specificity, while computed tomography (CT) provides high sensitivity and ability to localize lesions; therefore, the combination of these modalities could be advantageous in this setting. The aim of this study was to investigate whether combined {sup 18}F-DOPA PET/CT more accurately detects and localizes PHEO lesions than does each modality alone. {sup 18}F-DOPA PET, CT and {sup 18}F-DOPA PET/CT images of 25 consecutive patients undergoing diagnostic scanning of suspected sporadic or multiple endocrine neoplasia type 2 syndrome-associated PHEO were reviewed retrospectively in randomized sequence. Two blinded observers scored the images regarding the likelihood of PHEO being present and localizable. Results were correlated with subsequent clinical history and, when available, histology. Of the 19 lesions detected by all three modalities, PET identified each as positive for PHEO, but was unable to definitively localize 15 of 19 (79%). CT could definitively localize all 19 lesions, but could not definitively diagnose or exclude PHEO in 18 of 19 (95%) lesions. Furthermore, CT falsely identified as negative for PHEO one lesion which was judged to be positive for this tumor by both PET and PET/CT. Only in PET/CT scans were all 19 lesions accurately characterized and localized. On a per-patient basis, the sensitivity of {sup 18}F-DOPA PET/CT for PHEO was 100% and the specificity 88%, with a 100% positive predictive value and an 88% negative predictive value. {sup 18}F-DOPA PET/CT more accurately diagnoses and localizes adrenal and extra-adrenal masses suspicious for PHEO than do {sup 18}F-DOPA PET or CT alone. (orig.)

  9. 急性肺挫伤的螺旋CT诊断及临床价值%Acute pulmonary contusion of spiral CT diagnosis and its clinical value

    Institute of Scientific and Technical Information of China (English)

    范晓萌; 陈琪宝; 刘海俊; 邹玉红; 张东升

    2012-01-01

    目的 探讨急性肺挫伤的螺旋CT诊断及其临床应用价值.方法 回顾性分析38例急性肺挫伤的CT表现及临床资料.结果 实质型28例,表现为单侧或双侧肺实质内沿支气管走行分布的斑片状边缘模糊密度增高影.间质型5例,表现为肺纹理不均匀性增粗、边缘模糊.磨玻璃型5例,表现为一侧或双侧局部肺野透亮度减低、其内见正常走行肺纹理的磨玻璃样影.本组中合并肺撕裂伤伴肺内血肿3例.伴其他部位不同程度损伤16例.结论 胸部螺旋CT平扫对肺挫伤诊断准确率高,能实时明确创伤的部位、性质、程度和范围,并能对临床治疗、转归和预后判断起到很好的指导作用,应作为急诊危重及复合伤患者首选的影像检查方法.%Objective To investigate acute pulmonary contusion of spiral CT diagnosis and clinical application value. Methods a retrospective analysis of 38 cases of acute pulmonary contusion CT findings and clinical data. Results 28 cases with solid type, showed unilateral or bilateral lung parenchyma along the bronchial walking distribution of patch)' fuzzy edge density increased. Interstitial type in 5 cases , for the performance of lung texture inhomogeneity thickening, edge blur. Ground glass type in 5 cases, showed unilateral or bilateral partial lung field penetrating brightness, which reduce the normal running of lung texture of ground glass opacity. The group combined with pulmonary laceration with intrapulmonary hematoma in 3 cases. With other parts of the different degree of injury in 16 cases. Conclusion thoracic spiral CT scan in pulmonary contusion with high diagnostic accuracy, real -time definitive trauma site, nature, extent and range, and to the clinical treatment, outcome and prognostic play a very good role in guiding, should serve as a critical and complex trauma patients preferred imaging method.

  10. Clinical Value of CT for Neonatal Hypoxic Ischemic Encephalopathy%CT对新生儿缺氧缺血性脑病的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    刘义康; 余红胜; 吉六舟

    2013-01-01

    Objective To study the clinical value of CT diagnosis and prognosis of hypoxic ischemic encephalopathy (HIE)in neonate.Methods Retrospective analysis of CT images of 40 cases diagnosed with HIE clinically or by CT was performed,and CT examinations were carried out before and after the systematic treatment.Results In the 40 cases,CT examination proved that there were 14 ones of mild brain injuries,17 ones of moderate injuries and 9 ones of severe injuries.The CT follow-up proved that for the patients with mild injuries,the low-density region shrinked or disappeared and SAH was absorbed,and that 15 patients with moderate injuries recovered,and that the remained 2 patients with moderated injuries and 9 ones with severe injuries progressed into encephalomalacia,brain atrophy,hydrocephalus,cerebral tissue calcification and etc.Conclusion CT examination can reflect the degree and dynamic changes of brain injuries of HIE,and thus can lay a foundation for clinical diagnosis as well as the evaluation of the curative effect and prognosis.%目的:研究CT对新生儿缺氧缺血性脑病(HIE)的诊断及预后表现,探讨CT对该病的临床应用价值.方法:回顾分析40例临床及CT诊断为HIE病例的CT影像资料,所有病例均经系统治疗前、后CT检查.结果:40例患儿治疗前CT初诊脑轻度损害14例、中度损害17例、重度损害9例;系统治疗后随访复查CT显示脑轻度损害病例脑实质低密度范围逐渐缩小或消失,SAH吸收,直至完全恢复正常.中度损害恢复正常15例,余下2例及9例重度损害演变为脑软化、脑萎缩、脑积水、脑组织钙化等.结论:CT检查能真实反映HIE脑组织损害程度及动态变化,可为临床诊断、疗效观察及预后评价提供影像学依据.

  11. Clinical values for abnormal {sup 18}F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hwan Seo [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Jae Seung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Roh, Jong-Lyel, E-mail: rohjl@amc.seoul.kr [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Seung-Ho; Nam, Soon Yuhl [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Sang Yoon [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Biomedical Research Institute, Korea Institute of Science and Technology, Seoul (Korea, Republic of)

    2014-08-15

    Highlights: • Abnormal {sup 18}F-FDG uptakes in the head and neck (HN) region can be carefully interpreted as being index primary, second primary cancer (SP) or benign. • {sup 18}F-FDG PET/CT identified 91.9% primary HN squamous cell carcinomas (HNSCC). • The specificity and negative predictive value of {sup 18}F-FDG PET/CT for identification of SP were as high as 98.7% and 99.3%, respectively. • Proper detection of primary tumors and SP in the HN region may promote appropriate therapeutic planning of HNSCC patients. - Abstract: Purpose: Fluorine 18-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) is used to identify index or second primary cancer (SP) of the head and neck (HN) through changes in {sup 18}F-FDG uptake. However, both physiologic and abnormal lesions increase {sup 18}F-FDG uptake. Therefore, we evaluated {sup 18}F-FDG uptake in the HN region to determine clinical values of abnormal tracer uptake. Methods: A prospective study approved by the institutional review board was conducted in 314 patients with newly diagnosed HN squamous cell carcinoma (HNSCC) and informed consent was obtained from all enrolled patients. The patients received initial staging workups including {sup 18}F-FDG PET/CT and biopsies. All lesions with abnormal HN {sup 18}F-FDG uptake were recorded and most of those were confirmed by biopsies. Diagnostic values for abnormal {sup 18}F-FDG uptake were calculated. Results: Abnormal {sup 18}F-FDG uptake was identified in primary tumors from 285 (91.9%) patients. False-negative results were obtained for 22.3% (23/103) T1 tumors and 2.2% (2/93) T2 tumors (P < 0.001). Thirty-eight regions of abnormal {sup 18}F-FDG uptake were identified in 36 (11.5%) patients: the thyroid (n = 13), maxillary sinus (n = 7), palatine tonsil (n = 6), nasopharynx (n = 5), parotid gland (n = 2) and others (n = 5). Synchronous SP of the HN was identified in eight (2.5%) patients: the thyroid (n = 5), palatine

  12. Population Genomics and the Statistical Values of Race: An Interdisciplinary Perspective on the Biological Classification of Human Populations and Implications for Clinical Genetic Epidemiological Research

    Science.gov (United States)

    Maglo, Koffi N.; Mersha, Tesfaye B.; Martin, Lisa J.

    2016-01-01

    The biological status and biomedical significance of the concept of race as applied to humans continue to be contentious issues despite the use of advanced statistical and clustering methods to determine continental ancestry. It is thus imperative for researchers to understand the limitations as well as potential uses of the concept of race in biology and biomedicine. This paper deals with the theoretical assumptions behind cluster analysis in human population genomics. Adopting an interdisciplinary approach, it demonstrates that the hypothesis that attributes the clustering of human populations to “frictional” effects of landform barriers at continental boundaries is empirically incoherent. It then contrasts the scientific status of the “cluster” and “cline” constructs in human population genomics, and shows how cluster may be instrumentally produced. It also shows how statistical values of race vindicate Darwin's argument that race is evolutionarily meaningless. Finally, the paper explains why, due to spatiotemporal parameters, evolutionary forces, and socio-cultural factors influencing population structure, continental ancestry may be pragmatically relevant to global and public health genomics. Overall, this work demonstrates that, from a biological systematic and evolutionary taxonomical perspective, human races/continental groups or clusters have no natural meaning or objective biological reality. In fact, the utility of racial categorizations in research and in clinics can be explained by spatiotemporal parameters, socio-cultural factors, and evolutionary forces affecting disease causation and treatment response. PMID:26925096

  13. Population Genomics and the Statistical Values of Race:An Interdisciplinary Perspective on the Biological Classification of Human Populations and Implications for Clinical Genetic Epidemiological Research

    Directory of Open Access Journals (Sweden)

    Koffi N. Maglo

    2016-02-01

    Full Text Available The biological status and biomedical significance of the concept of race as applied to humans continue to be contentious issues despite the use of advanced statistical and clustering methods to determine continental ancestry. It is thus imperative for researchers to understand the limitations as well as potential uses of the concept of race in biology and biomedicine. This paper deals with the theoretical assumptions behind cluster analysis in human population genomics. Adopting an interdisciplinary approach, it demonstrates that the hypothesis that attributes the clustering of human populations to frictional effects of landform barriers at continental boundaries is empirically incoherent. It then contrasts the scientific status of the cluster and cline constructs in human population genomics, and shows how cluster may be instrumentally produced. It also shows how statistical values of race vindicate Darwin’s argument that race is evolutionarily meaningless. Finally, the paper explains why, due to spatiotemporal parameters, evolutionary forces and socio-cultural factors influencing population structure, continental ancestry may be pragmatically relevant to global and public health genomics. Overall, this work demonstrates that, from a biological systematic and evolutionary taxonomical perspective, human races/continental groups or clusters have no natural meaning or objective biological reality. In fact, the utility of racial categorizations in research and in clinics can be explained by spatiotemporal parameters, socio-cultural factors and evolutionary forces affecting disease causation and treatment response.

  14. 胃食管反流病诊断方法的临床价值%Clinical Value of Diagnostic Methods for Gastroesophageal Reflux Disease

    Institute of Scientific and Technical Information of China (English)

    宋菁婧

    2011-01-01

    Although gastroesophageal reflux disease (GERD) can be diagnosed based on reflux symptoms, upper gastrointestinal endoscopy, 24-hour esophageal pH-monitoring and proton pump inhibitor (PPI) therapeutic test etc, there is no standardized diagnosis flowchart and criteria at the moment, and debate on the diagnosis of GERD is still going on.This article reviewed the clinical value of relevant diagnostic methods for GERD.%胃食管反流病(GERD)虽可根据反流症状群、上消化道内镜检查、24 h食管pH监测、质子泵抑制剂(PPI)诊断性治疗等综合分析而作出诊断,但目前尚缺乏统一、明确的诊断流程和标准,因此GERD的诊断仍存在诸多争议.本文就GERD相关诊断方法的临床价值作一综述.

  15. Expression and clinical value of the soluble major histocompatibility complex class I-related chain A molecule in the serum of patients with renal tumors.

    Science.gov (United States)

    Zhao, Y-K; Jia, C-M; Yuan, G-J; Liu, W; Qiu, Y; Zhu, Q-G

    2015-06-29

    We investigated the expression and clinical value of the soluble major histocompatibility complex class I-related chain A (sMICA) molecule in the serum of patients with renal tumors. Sixty patients diagnosed with renal tumors were enrolled in the experimental group, whereas 20 healthy volunteers served as the control group. The sMICA levels were measured via enzyme-linked immunosorbent assay, and the results were analyzed in combination with data from pathol-ogy examination. The experimental group had a statistically significant higher sMICA level (P < 0.05) than the control group. The sMICA level was higher in patients with malignant tumors than in those with be-nign tumors. We also observed a positive relationship among different tumor-node-metastasis (TNM) pathological stages with more advanced diseases exhibiting higher sMICA levels. As a tumor-associated antigen, MICA has a close relationship with renal tumorigenesis and immune es-cape. Our results indicated that sMICA levels were related to tumor pathol-ogy, TNM stage, and metastasis. Therefore, sMICA might be a potential marker for tumor characteristics, prognosis, and recurrence prediction.

  16. Clinical value ofSerumTSH combined with 3 kinds ofVEGF determination in the early diagnosis of papillary thyroid carcinoma

    Institute of Scientific and Technical Information of China (English)

    Ming Zeng

    2015-01-01

    Objective:To discuss the clinical value of Serum TSH combined with 3 kinds of VEGF (VEGF-C, VEGF-D and VEGFR-3) determination in the early diagnosis of papillary thyroid carcinoma (PTC). Method:Selected 37 cases of patients with thyroid benign tumor (Benign group) and 37 cases of patients with PTC (PTC group), then collected the serum of these both groups, to determine the TSH, VEGF-C, VEGF-D and VEGFR-3 levels of all cases by chemiluminescence immunoassay and enzyme linked immunosorbent assay respectively. Through Logistic model, to calculate the curve area of TSH combined with 3 kinds of VEGF.Results:PTC group: VEGF-C, VEGFR-3 and TSH levels were obviously higher than that in Benign group (P<0.05); and VEGF-C, VEGFR-3 and TSH levels inⅢ-Ⅳ period patients were obviously higher than that in I-Ⅱ period patients (P<0.05); AUC area of VEGF-C, VEGFR-3 and TSH were respectively 0.805, 0.736 and 0.710, reached to significance level (P<0.05); AUC area of combined diagnosis was 0.859.Conclusion:VEGF-C, VEGFR-3 and TSH between papillary thyroid carcinoma and thyroid benign tumor had significant difference. Combined determination could improve the early diagnose rate of PTC, and could be regarded as one of the important auxiliary index of PTC early diagnosis.

  17. Objective evaluation by reflectance spectrophotometry can be of clinical value for the verification of blanching/non blanching erythema in the sacral area.

    Science.gov (United States)

    Sterner, Eila; Fossum, Bjöörn; Berg, Elisabeth; Lindholm, Christina; Stark, André

    2014-08-01

    Early detection of non blanching erythema (pressure ulcer category I) is necessary to prevent any further skin damage. An objective method to discriminate between blanching/non blanching erythema is presently not available. The purpose of this investigation was to explore if a non invasive objective method could differentiate between blanching/non blanching erythema in the sacral area of patients undergoing hip fracture surgery. Seventy-eight patients were included. The sacral area of all patients was assessed using (i) conventional finger-press test and (ii) digital reading of the erythema index assessed with reflectance spectrophotometry. The patients were examined at admission and during 5 days postsurgery. Reflectance spectrophotometry measurements proved able to discriminate between blanching/non blanching erythema. The reliability, quantified by the intra-class correlation coefficient, was excellent between repeated measurements over the measurement period, varying between 0·82 and 0·96, and a significant change was recorded in the areas from day 1 to day 5 (P < 0·0001). The value from the reference point did not show any significant changes over the same period (P = 0·32). An objective method proven to identify early pressure damage to tissue can be a valuable tool in clinical practice.

  18. Serum antibodies to 25 myelin oligodendrocyte glycoprotein epitopes in multiple sclerosis and neuromyelitis optica: clinical value for diagnosis and disease activity

    Institute of Scientific and Technical Information of China (English)

    XU Yan; ZHANG Yao; LIU Cai-yan; PENG Bin; WANG Jian-ming; ZHANG Xiao-jun; LI Hai-feng; CUI Li-ying

    2012-01-01

    Background Whether antibody to myelin oligodendrocyte glycoprotein (MOG) can be a diagnostic marker for multiple sclerosis (MS) is still controversial.Recent studies suggested that serum specific anti-MOG epitope antibody might be an MS specific marker.However,these studies did not include neuromyelitis optica (NMO) which might be proven to also have anti-MOG antibody.Hence,the present study was undertaken to investigate the clinical value of serum antibodies to 25 MOG epitopes in conventional MS (CMS) and NMO.Methods Serum anti-MOG epitope IgG was detected in 61 CMS patients,54 NMO patients,and 77 healthy controls,using enzyme-linked immunosorbent assay (ELISA).Results Anti-MOG27-38 IgG levels in both CMS and NMO patients were significantly higher than that in healthy controls (optical density (OD):0.64±0.38,0.48±0.23 vs.0.19±0.09; P=0.000).CMS and NMO patients in relapse stage had significantly higher anti-MOG27-38 IgG level than patients in remission stage (OD:0.55±0.14 vs.0.24±0.09,P=0.027).Conclusion Although serum anti-MOG epitope IgG could not differentiate MS from NMO,it may be a useful marker for monitoring disease activity.

  19. Clinical value of whole-blood interferon-gamma assay in patients with suspected pulmonary tuberculosis and AFB smear- and polymerase chain reaction-negative bronchial aspirates.

    Science.gov (United States)

    Lee, Jaehee; Lee, Shin Yup; Yoo, Seung Soo; Cha, Seung Ick; Won, Dong Il; Park, Jae Yong; Lee, Won-Kil; Kim, Chang Ho

    2012-07-01

    Combining a polymerase chain reaction (PCR) test with bronchoscopy is frequently performed to allow a rapid diagnosis of smear-negative pulmonary tuberculosis (PTB). However, limited data are available concerning clinical judgment in patients with suspected PTB and AFB smear- and PCR-negative bronchial aspirates (BA). The present study evaluated the usefulness of whole-blood QuantiFERON-TB Gold In-Tube (QFT) testing in these patients. Of 166 patients with suspected PTB who had undergone bronchoscopy because of smear-negative sputum or inadequate sputum production, 93 (56%) were diagnosed with culture-positive PTB. Seventy-four patients were either AFB smear- or PCR-positive. In the 75 patients whose BA AFB smear and PCR results were both negative, 19 were finally diagnosed with PTB by culture. The QFT test had a negative predictive value of 91% for PTB. The QFT test may be useful for excluding PTB in patients with suspected PTB whose BA AFB smear and PCR results are both negative.

  20. Clinical value of SPECT/CT for evaluation of patients with painful knees after total knee arthroplasty- a new dimension of diagnostics?

    Directory of Open Access Journals (Sweden)

    Rasch Helmut

    2011-02-01

    Full Text Available Abstract Background The purpose of our study was to evaluate the clinical value of hybrid SPECT/CT for the assessment of patients with painful total knee arthroplasty (TKA. Methods Twenty-three painful knees in patients following primary TKA were assessed using Tc-99m-HDP-SPECT/CT. Rotational, sagittal and coronal position of the TKA was assessed on 3D-CT reconstructions. The level of the SPECT-tracer uptake (0-10 and its anatomical distribution was mapped using a validated localization scheme. Univariate analysis (Wilcoxon-Mann-Whitney, Spearmean`s-rho test, p Results SPECT/CT imaging changed the suspected diagnosis and the proposed treatment in 19/23 (83% knees. Progression of patellofemoral OA (n = 11, loosening of the tibial (n = 3 and loosening of the femoral component (n = 2 were identified as the leading causes of pain after TKA. Patients with externally rotated tibial trays showed higher tracer uptake in the medial patellar facet (p = 0.049 and in the femur (p = 0.051. Patients with knee pain due to patellofemoral OA showed significantly higher tracer uptake in the patella than others (p Conclusions SPECT/CT was very helpful in establishing the diagnosis and guiding subsequent management in patients with painful knees after TKA, particularly in patients with patellofemoral problems and malpositioned or loose TKA.

  1. Valuing hope.

    Science.gov (United States)

    McMillan, John; Walker, Simon; Hope, Tony

    2014-01-01

    This article argues that hope is of value in clinical ethics and that it can be important for clinicians to be sensitive to both the risks of false hope and the importance of retaining hope. However, this sensitivity requires an understanding of the complexity of hope and how it bears on different aspects of a well-functioning doctor-patient relationship. We discuss hopefulness and distinguish it, from three different kinds of hope, or 'hopes for', and then relate these distinctions back to differing accounts of autonomy. This analysis matters because it shows how an overly narrow view of the ethical obligations of a clinician to their patient, and autonomy, might lead to scenarios where patients regret the choices they make.

  2. Clinical value of micrografting treating burns%微粒植皮术治疗烧伤的临床价值

    Institute of Scientific and Technical Information of China (English)

    陆颖

    2015-01-01

    目的:研究分析微粒植皮术治疗烧伤的临床价值。方法选取我院2010年5月至2012年5月收治的大面积烧伤患者80例为研究对象,随机分为2组:对照组和观察组。对照组采取自体皮与异种皮混合植皮修复术,观察组采取微粒植皮修复术,对两组患者植皮修复术功能恢复、创面愈合及瘢痕效果进行对比。结果观察组的总有效率为97.50%,对照组的总有效率为77.50%,观察组明显高于对照组,P<0.05,差异有统计学意义。观察组第一年及第三年的瘢痕指数明显低于对照组,P<0.05,差异有统计学意义。结论应用微粒植皮术治疗大面积烧伤,手术操作简单方便,能够缩短治疗时间,且有效减少患者术后瘢痕增生,临床效果显著,有利于提高治疗满意度,具有临床推广价值。%Objective To study clinical value of micrografting treating burns.Methods choose 80 cases of large area burn patients in our hospital from May 2010 to May 2012 as study objects, and randomly divide them into 2 groups: control and observation group. The control group was treated with mixed graft repair of autologous and xenogeneic skin, and observation group with micrografting. Compare two groups with skin graft repair function, wound healing and scar effect.Results total effective rate of observation group was 97.50%, which was significantly higher than 77.50% of control group, P< 0.05, the difference showed statistical significance. Scar index of observation group in the first year and third year was significantly lower than control group,P < 0.05, and difference showed statistical significance.Conclusion applying micrografting operation for large area burns, which is simple and convenient, can shorten treatment time and effectively reduce postoperative scar hyperplasia with significant clinical effect, It is beneficial to improve treatment satisfaction, which has clinical value of being spreaded.

  3. Radiogenic p-isotopes from type Ia supernova, nuclear physics uncertainties, and galactic chemical evolution compared with values in primitive meteorites

    Energy Technology Data Exchange (ETDEWEB)

    Travaglio, C. [INAF—Astrophysical Observatory Turin, Strada Osservatorio 20, I-10025 Pino Torinese (Turin) (Italy); Gallino, R. [B2FH Association, I-10025 Pino Torinese (Turin) (Italy); Rauscher, T. [Centre for Astrophysics Research, School of Physics, Astronomy and Mathematics, University of Hertfordshire, Hatfield AL10 9AB (United Kingdom); Dauphas, N. [Origins Laboratory, Department of the Geophysical Sciences and Enrico Fermi Institute, The University of Chicago, Chicago, IL 60637 (United States); Röpke, F. K. [Universität Würzburg, Am Hubland, D-97074 Würzburg (Germany); Hillebrandt, W., E-mail: travaglio@oato.inaf.it, E-mail: claudia.travaglio@b2fh.org [Max-Planck-Institut für Astrophysik, Karl-Schwarzschild-Str. 1, D-85748 Garching bei München (Germany)

    2014-11-10

    The nucleosynthesis of proton-rich isotopes is calculated for multi-dimensional Chandrasekhar-mass models of Type Ia supernovae (SNe Ia) with different metallicities. The predicted abundances of the short-lived radioactive isotopes {sup 92}Nb, {sup 97,} {sup 98}Tc, and {sup 146}Sm are given in this framework. The abundance seeds are obtained by calculating s-process nucleosynthesis in the material accreted onto a carbon-oxygen white dwarf from a binary companion. A fine grid of s-seeds at different metallicities and {sup 13}C-pocket efficiencies is considered. A galactic chemical evolution model is used to predict the contribution of SN Ia to the solar system p-nuclei composition measured in meteorites. Nuclear physics uncertainties are critical to determine the role of SNe Ia in the production of {sup 92}Nb and {sup 146}Sm. We find that, if standard Chandrasekhar-mass SNe Ia are at least 50% of all SN Ia, they are strong candidates for reproducing the radiogenic p-process signature observed in meteorites.

  4. Clinical Risk Factors of Diabetic Nephropathy and Clinical Analysis of Blood Pressure Control Critical Values%探讨糖尿病肾病的临床风险因素及血压控制临界值分析

    Institute of Scientific and Technical Information of China (English)

    钟文渊

    2015-01-01

    that the critical value of diabetic nephropathy in patients with diastolic blood pressure control critical value 79mmHg,systolic blood pressure control critical value 140mmHg.Conclusion Systolic blood pressure,cholesterol,high density lipoprotein cholesterol and low-density lipoprotein cholesterol and other factors associated with diabetic nephropathy is closely control ed in 79mmHg diastolic blood pressure below 140mmHg systolic blood pressure levels can significantly improve the clinical safety of patients with diabetic nephropathy.

  5. Diagnostic and Prognostic Value of the Cerebrospinal Fluid Concentration of Immunoglobulin Free Light Chains in Clinically Isolated Syndrome with Conversion to Multiple Sclerosis.

    Directory of Open Access Journals (Sweden)

    Gleb Makshakov

    Full Text Available In this study, we evaluated the diagnostic and prognostic significance of cerebrospinal fluid free light chains (CSF FLC at the time of clinically isolated syndrome (CIS.We compared FLC-parameters at the moment of CIS in patients with conversion to multiple sclerosis (MS after 2 years (CIS-MS, patients who remained stable both clinically and radiologically after 2 years (CIS-nonMS, patients with non-inflammatory neurologic diseases (NIND as a comparison group and patients with other inflammatory neurologic diseases (IND with intrathecal oligoclonal bands (OCB synthesis. ROC-analysis was conducted to define FLC-assay characteristics and cut-off values. We also compared FLC-concentrations in CIS patients to determine their OCB-status. A correlation analysis was performed between FLC-concentrations and the expanded disability scale score (EDSS, annualized relapse rate (ARR and MRI-activity (i.e., number of new and gadolinium-enhancing (Gd+ lesions in patients.The levels of kappa-FLC (k-FLCCSF and lambda-FLC (λ-FLCCSF as well as kappa- and lambda-quotients (Q-k and Q-λ were elevated in CIS-MS compared to the CIS-nonMS and NIND groups. These levels did not differ significantly when compared with the IND group. We identified several patients with high k-FLCCSF and λ-FLCCSF in OCB-negative CIS and IND groups. The level of k-FLCCSF production was significantly higher in OCB-positive patients in the CIS-MS group compared to the CIS-nonMS group. The concentrations of k-FLCCSF and Q-k in the CIS-MS group showed significant correlation with the level of EDSS after 2 years (k-FLC: r = 0.4477,p = 0.0016; Q-k: r = 0.4621, p = 0.0016. λ-FLCCSF and Q-λ inversely correlated with the number of Gd+ lesions (CSF λ-FLC: r = -0.3698, p = 0.0223; Q-λ: r = -0.4527, p = 0.0056.The concentration of CSF FLC predicts conversion to MS within 2 years following CIS. OCB-positive patients with an early conversion have a higher concentration of CSF-FLC. We have also shown

  6. Clinical value of transvaginal color Doppler ultrasound in diagnosis of ectopic pregnancy%阴道彩超诊断异位妊娠的临床价值

    Institute of Scientific and Technical Information of China (English)

    刘华; 张卉

    2012-01-01

    目的 探讨经阴道彩超检查对早期异位妊娠的诊断价值.方法 对226例经阴道超声检查诊断为早期异位妊娠的超声声像图和临床资料进行回顾性分析.结果 226例经阴道超声检查诊断为异位妊娠的病例,218例与临床及病理诊断符合,诊断符合率为96.4%,漏诊率为1.77% (4/226),误诊率为1.77%(4/226).结论 经阴道彩超诊断异位妊娠技术操作简单,图像显示清晰,对异位妊娠的检出率非常高.同时对异位妊娠发生的部位定位较准确,对病变的进展程度也可作出相应的评价.%[Objective]To explore the diagnostic value of transvaginal color Doppler ultrasound examination for early ectopic pregnancy. [Methods] The ultrasound images and clinical data of 226 early ectopic pregnancy cases diagnosed by transvaginal color Doppler ultrasound were analyzed retrospectively. [ Results ] Among 226 early ectopic pregnancy cases diagnosed by transvaginal color Doppler ultrasound, 218 cases accorded with the clinical and pathological diagnosis, the diagnostic accordance rate was 96.4% , the rate of missed diagnosis was 1.77% (4/226), and the rate of misdiagnosis was 1.77% (4/226). [Conclusion] The transvaginal color Doppler ultrasound in diagnosis of ectopic pregnancy has the advantages of simple operation, clear image display and high detection rate. Meanwhile, it can accurately determine the position of ectopic pregnancy, and make an appropriate evaluation on degree of disease.

  7. 研究MRI在诊断小乳腺癌的临床价值%Research on Clinical Value of MRI in Diagnosis of Small Breast Tumor

    Institute of Scientific and Technical Information of China (English)

    黄继康

    2015-01-01

    Objective To investigate clinical diagnosis value of MRI on small breast cancer. Methods Sixty nine patients with small breast canceradmitted by in the Radiology Department of the Hospital who were confirmed via surgical pathology were selected as research subjects, and retrospective analysis and summary were made according to clinical data.The mammography and MRI examinations were respectively conducted, pathological examination results were treated as gold standard, and two types of diagnosis ways were compared and analyzed. Results The accuracy of MRI detection on small breast cancer was 86.9%, being significantly higher than that of molybdenum target at 73.9%(p<0.05). The sensitivity of MRI to detect morphological features of lesions was 91.3%, being significantly higher than the molybdenum target at 78.3% (p<0.05). Conclusion MRI poses high accuracy in the diagnosis of small breast cancer, and its sensitivity in detecting lesions is better than mammography examination, delivering vital significance in improve the positive rate of small breast cancer .%目的:探讨MRI对小乳腺癌的临床诊断价值。方法以我院放射科收治的经手术病理证实的69例小乳腺癌患者为研究对象,根据其临床资料进行回顾性分析和总结。分别对其进行钼靶检查和MRI检查,以病理检查结果为金标准,对比分析两种诊断方式的诊断结果。结果 MRI检测小乳腺癌的准确性为86.9%,明显高于钼靶73.9%(p<0.05);MRI检测病灶形态学特征的敏感性为91.3%,明显高于钼靶78.3%(p<0.05)。结论 MRI在小乳腺癌诊断中具有较高准确性,在探测病灶形态方面敏感性更高,明显优于钼靶检查,对提升小乳腺癌的确诊率具有重要的意义。

  8. The Clinical Value of Early Diagnostic Methods of Bladder Cancer%膀胱癌早期诊断方法的临床价值

    Institute of Scientific and Technical Information of China (English)

    平秦榕; 颜汝平; 王剑松

    2015-01-01

    膀胱癌是泌尿生殖系统中最为常见的恶性肿瘤。目前,尿脱落细胞学检查和膀胱镜检查是临床上诊断膀胱癌最可靠的方法。但膀胱镜检查为有创检查,且对于肉眼见不到的微小肿瘤容易造成漏诊,而传统的尿脱落细胞学检查虽为无创检查,但敏感性低,易出现假阳性结果。近年文献报道了许多新的膀胱癌早期诊断方法,本文从尿液肿瘤标记物检测、DNA 检测分析、尿液脱落细胞染色体异常的检测、荧光膀胱镜检查等四个方面对各种膀胱癌早期诊断方法的临床价值作一综述。%Bladder cancer is the most common malignant tumor in urogenital system .At present ,the urinary cytology and cystoscopy are the most reliable methods for clinical diagnosis of bladder cancer . However ,cystoscopy belongs to an invasive procedure and could easily misdiagnose the tiny tumor which is invisible to the naked eye ,while urinary cytology has lower sensibility and easily produces false positive results even though it is a non‐invasive method .In recent years , many new methods of early diagnosis of bladder cancer have been reported in the literature .In this paper ,we reviewed the recent progress about the clinical value of early diagnostic methods of bladder cancer from the following aspects such as urine tumor markers detection ,DNA analysis ,detection of chromosome aberration of urine exfoliated cells ,fluorescence cystoscopy and so on .

  9. 脊柱侧弯影像检查的临床评价%Clinical value of the imaging study for spine scoliosis

    Institute of Scientific and Technical Information of China (English)

    彭雪华; 何玲; 朱铭; 蔡金华

    2009-01-01

    Objective: To discuss the values of different imagings in the morbidity of the structural scoliosis and guidance for the clinical course. Methods: A total of 155 cases of spine scoliosis underwent X radiography. Of them, 69 cases also underwent with computed tomography (CT) and Magnetic resonance imaging (MRI), 40 cases with CT, and 20 cases with heart ultrasound. Cases underwent CT further underwent the cured multiplanar reconstruction (CMPR) and volume reconstruction (VR). Results: A total of 81 cases are idiopathic scoliosis (IS) (52.3%, 15 cases with congenital heart diseases), 60 cases are congenital spine scoliosis (38.7%, 5 cases with congenital heart diseases),and others are 14 cases (9.0%). Conclusion: At present, X-radiography XT and MRI imaging are the most frequently used examining methods for spine scoliosis. Each of them has its own advantages and disadvantages. The selection of them should be according to the clinical conditions, which plays an important in the search for the causes of the spine scoliosis and comprehensive assessment in pre-operation or post-operation.%目的:讨论不同影像方法对结构性脊柱侧弯发病情况及其指导临床诊治价值.方法:对155例脊柱侧弯者,均行X线片检查,其中69例行计算机体层成像(Computed tomography,CT)和磁共振成像(Magneticl resonance imaging,MRI)检查,40例行CT检查,20例行心脏超声,CT检查者均行多层面曲面重建(Cured multiplanar reconstruction,CMPR)及容积重组技术(Volume reconstruction,VR).结果:特发性脊柱侧弯(Idiopathic scoliosis,IS)81例(52.3%,15例合并先天性心脏病).先天性脊柱侧弯60例(38.7%,5例合并先天性心脏病).其它类14例(9.0%).结论:X线、CT及MRI是目前脊柱侧弯最常用的影像检查方法,各有其优缺点,应根据临床实际情况合理选择,对脊柱侧弯病因查找及术前术后的综合评估起重要作用.

  10. The Clinical Value of Dual Time Point F-18 FDG PET/CT Imaging for the Differentiation of Colonic Focal Uptake Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Suk; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2009-08-15

    F-18 FDG can be accumulated in the liver, bowel, kidney, urinary tract, and muscles physiologically. The aim of this study was to evaluate the clinical value of dual time point 18F-FDG PET/CT imaging for the differentiation of the colonic focal uptake lesions. One hundred thirty two patients (M:F=77:55, Age 62.8{+-}11.6 years) underwent {sup 18}F-FDG PET/CT at two time points, prospectively: early image at 50-60 min and delayed image at 4-4.5 hours after the intravenous injection of {sup 18}F-FDG. Focally increased uptake lesions on early images but disappeared or shifted on delayed images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on delayed images, colonoscopy and histopathologic examination were performed. SUVmax changes between early and delayed images were also compared. Among the 132 patients, 153 lesions of focal colonic uptake were detected on early images of {sup 18}F-FDG PET/CT. Of these, 72 (47.1%) lesions were able to judge with physiological uptake because the focal increased uptake disappeared from delayed image. Among 81 lesions which was showed persistent increased uptake in delayed image, 61 (75.3%) lesions were confirmed as the malignant tumor and 14 (17.3%) lesions were confirmed as the benign lesions including adenoma and inflammatory disease. Remaining 6 (7.4%) lesions were confirmed as the physiological uptake because there was no particular lesion in the colonoscopy. In the malignant lesions, the calculated dual time point change for SUVmax ({delta}%SUVmax) was 20.8%{+-}18.7%, indicating a significant increase in SUVmax between the two point (p<0.01). In contrast, the change in SUVmax for the non-malignant lesions including benign lesions and physiological uptake was -13.7%{+-}24.2%. For the differentiation of the malignant and non-malignant focal colonic uptake lesions, {delta}%SUVmax was the most effective parameter, and the cut-off value using -5% provided the best sensitivity

  11. Clinical value of four indicators of combined detection%糖尿病肾病4项指标联合检测的临床价值

    Institute of Scientific and Technical Information of China (English)

    赖馨; 陈丽芳; 万彦彬

    2015-01-01

    Objective To explore the clinical application value of the changes in the levels of urine N‐acetyl‐β‐D‐glucosaminidase (NAG) ,retinol binding protein (RBP) ,transferring (TRF) ,and α1‐microglobulin (α1‐MG) for early diagnosis ,forecast and illness monitoring of type 2 diabetes mellitus (T2DM ) .Methods According to test result of urinary albumin excretion rate(UAER) ,83 patients suffering from T2DM were divided into normal UAER group ,early diabetic nephropathy group and clinical diabetic ne‐phropathy group ,meanwhile ,28 healthy persons were selected into the healthy control group ,the levels of NAG ,RBP ,TRF ,and α1‐MG were compared in the four groups .Results The levels of NAG ,RBP ,TRF ,and α1‐MG in the normal UAER group ,early dia‐betic nephropathy group and clinical diabetic nephropathy group were significant higher than the control group ,the differences were significant (P< 0 .05) .The four indicators in the early diabetic nephropathy group and clinical diabetic nephropathy group were sig‐nificant higher than those of the normal UAER group ,their differences were statistical significant (P< 0 .05) .In the clinical diabetic nephropathy group ,the positive rates of the indicators were highest ,with NAG 64 .0% ,RBP 52 .0% ,TRF 72 .0% and α1‐MG 76 .0% .For both the early diabetic nephropathy group and clinical diabetic nephropathy group ,the positive rates in the combined detection of four items were relatively high ,reaching 80 .0% and 96 .0% .Conclusion The combined detection of NAG ,RBP ,TRF , and α1‐MG showed relatively high positive rates ,could be taken as the basis for the early diagnosis of diabetic nephropathy .%目的:探讨尿 N‐乙酰β‐D‐氨基葡萄糖酐酶(NAG)、视黄醇结合蛋白(RBP)、转铁蛋白(TRF)、α1‐微球蛋白(α1‐MG)水平变化对2型糖尿病肾病早期诊断、预测及病情监测的临床应用价值。方法83例2型糖尿病(T2DM )患者根据尿清蛋

  12. Clinical diagnosis value of CT manifestations for pulmonary fungal infections%CT表现对肺部真菌感染的临床诊断价值

    Institute of Scientific and Technical Information of China (English)

    贾策; 杨文鹃

    2012-01-01

    OBJECTIVE To probe into the clinical diagnosis value of CT manifestations for pulmonary fungal infections. METHODS From Jan. 2006 to Sep. 2011, 48 cases with pulmonary fungal infections in our hospital were selected for our study. All the patients underwent routine supine chest CT scan. The shapes and types of pulmonary lesions were statistically analyzed, and the relationship between CT classification and underlying diseases was analyzed. RESULTS CT imaging findings in 48 patients included diffuse, aspergilloma, consolidation and nodular. Diffuse were found in 19 cases, accounting for 39. 6%; aspergilloma in 13 cases, accounting for 27. 1% ; consolidation in 12 cases, accounting for 25. 0% t nodules in 4 cases, accounting for 8. 3%. In addition, for tuberculosis patients, CT images were mainly diffuse (63. 6%). For chronic bronchiectasis patients, CT images were mainly aspergilloma (72. 73%). For diabetic patients, CT images were mainly solidvariant (66. 7%) and nodules (33. 3%). For lung cancer patients, CT images were mainly diffuse (75. 0%). For HIV-infected patients, CT images were mainly diffuse (50. 0%) and consolidation(50. 0%). For patients without underlying diseases, CT images were dispersed. CONCLUSION CT images are of clinical diagnosis values for pulmonary fungal infections in patients and have certain characteristics.%目的 探讨CT影像学表现对肺部真菌感染患者临床诊断的价值.方法 选择2006年1月-2011年9月医院肺部真菌感染病例48例,所有患者均行胸部常规仰卧位CT平扫,对所有患者肺内病灶的形态及分型情况进行统计分析,并分析不同基础疾病与CT分型的关系.结果 48例患者CT影像表现主要分为弥散型、曲菌球型、实变型和结节型,其中弥散型19例,占39.6%;曲菌球型13例,占27.1%;实变型12例,占25.0%;结节型4例,占8.3%;另外,对于肺结核患者,CT影像主要为弥散型占63.6%;对于慢性支气管扩张患

  13. 胎盘植入产前超声诊断的临床应用价值%Clinical Value of Prenatal Ultrasound Diagnosis of Placenta Implantation

    Institute of Scientific and Technical Information of China (English)

    欧阳一兵; 郭晓燕; 温穗文; 余桂云

    2014-01-01

    目的:探讨产前超声诊断在胎盘植入的临床应用价值。方法回顾性分析34例经由临床及病理学证实为胎盘植入的孕妇相关资料,分析其多普勒超声检查的声像学特征,及胎盘植入与产后出血及胎盘的关系。结果经由产前超声诊断提示共11例确诊,占比32.4%,出现漏诊23例,占比67.6%;经产前超声诊断提示胎盘植入的11例患者的影像学特征主要有:胎盘后间隙部分或者全部消失,胎盘有内漩涡流形成,胎盘附着处的子宫肌层菲薄及胎盘异常性增厚等,产后大出血与非产后大出血的胎盘植入发生率为(56.3%vs11.1%),胎盘前置与非胎盘前置的胎盘植入发生率为(71.4%vs 5.0%),前壁胎盘与非前壁胎盘的发生率为(53.3%vs15.8%),P<0.05。结论经超声检查对胎盘植入进行产前的诊断,对预防产后出血、保障母婴平安有着重要的价值。%Objective To explore the clinical value of prenatal ultrasound diagnosis of placenta implantation .Methods Doing retrospective analysis of 34 cases with placenta implantation confirmed by clinical and pathological pregnant relevant information, analyzing features of Doppler ultrasonographic and relationship of postpartum hemorrhage with placenta implantation placenta .Results Among 34 cases, 11 cases were diagnosed as placenta implantation by prenatal ultrasound , accounting for 32.4%.23 cases were missed , accounting for 66.7%.The main imaging characteristics were as follows:some or all of clearance of behind placenta disappeared , there was vortex flow in the placenta formation ,and there was myometrium meager attachment of the placenta and placental abnormalities thickening in the 11 pla-centa implantation of 34 cases patients diagnosed by prenatal ultrasound.Incidence of placenta accreta in postpartum hemorrhage patients and non-postpartum hemorrhage patients was 56.3%vs11.1%,incidence of placenta accreta

  14. Results of investigating the characteristics of bone marrow in patients with squamous cell carcinoma of the head and neck, their clinical value

    Directory of Open Access Journals (Sweden)

    E. G. Timonina

    2016-01-01

    Full Text Available To reveal the specific features of hematopoiesis in patients with head and neck squamous cell carcinoma (HNSCC, the authors analyzed the indicators of 41 bone marrow aspirates in relation to the clinical and morphological characteristics of the tumor and micrometastases detected in bone marrow. Puncture samples were morphologically and molecularly examined at the Laboratory of Hematopoiesis Immunology, N.N. Blokhin Russian Cancer Research Center. The found changes in the bone marrow cell composition in HNSCC patients showed themselves as an increase in the relative count of segmented neutrophils and a decrease in the level of immature granulocytes with no alternations in the neutrophil maturation index and in the percentage of granulocyte lineage cells. Bone marrow hypocellularity is a characteristic feature of high-grade HNSCC. The significantly enhanced leuko-erythroblastic ratio was due to a reduction in red blood cells: the erythroid cell maturation index rose, by increasing the percentage of bone marrow oxyphilic normoblasts in patients with locally advanced HNSCC. A highly sensitive method for detecting mRNA of the specific squamous cell carcinoma protein E48 was perfected using reverse-transcription polymerase chain reaction and Southern blotting, followed by an enzyme immunoassay that could recognize bone marrow micrometastases in 35 % of the patients with HNSCC. The patients with found bone marrow micrometastases showed a significant decrease in the proportion of polychromatophilic normoblasts and a significant increase in granulocytes in the presence of normal values of lymphocytes and other cellular elements of myelograms. It was established that in the presence of regional lymph node involvement, bone marrow micrometastases were significantly more frequently in the patients with HNSCC and tumor progression over a period of up to 9 months. 

  15. Clinical application value of magnetic resonance imaging inner ear hydrography%磁共振内耳水成像的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    张文武; 李维; 傅伟琪; 周旭洋; 陈国栋

    2015-01-01

    目的:探讨磁共振(MRI)内耳水成像在内耳病变患者中的临床价值。方法对45例怀疑内耳病变患者,行磁共振内耳水成像扫描,并进行最大密度投影(MIP)、多平面重建(MPR)、容积重建(VR)后处理。结果45例患者均能清晰显示内耳结构,其中内耳畸形8例,结构正常37例。结论内耳水成像能清晰、立体的显示内耳膜迷路及内听道精细解剖结构,并显示其发育状况及通畅程度,能够为内耳病变患者的诊断和术前评估提供重要的影像学依据。%Objective To explore the clinical value of magnetic resonance imaging (MRI) inner ear hydrography in inner ear disease patients.Methods MRI inner ear hydrography was applied in 45 patients with suspected inner ear disease, with process of maximum intensity projection (MIP), multiplanar reconstruction (MRP), and volume reconstruction (VR).Results The inner ear anatomical structures were displayed clearly in all the 45 cases, and there were 8 cases with inner ear malformations and 37 cases with normal structure.Conclusion The magnetic resonance inner ear hydrography can not only clearly and stereoscopically show anatomical structure of inner ear membranous labyrinth and inner auditory canal, but also show their developmental situation and unobstructed degree. It can provide important imaging parameters for the diagnosis and preoperative assessment of patients with inner ear disease.

  16. Isavuconazole and nine comparator antifungal susceptibility profiles for common and uncommon Candida species collected in 2012: application of new CLSI clinical breakpoints and epidemiological cutoff values.

    Science.gov (United States)

    Castanheira, Mariana; Messer, Shawn A; Rhomberg, Paul R; Dietrich, Rachel R; Jones, Ronald N; Pfaller, Michael A

    2014-08-01

    The in vitro activity of isavuconazole and nine antifungal comparator agents was assessed using reference broth microdilution methods against 1,421 common and uncommon species of Candida from a 2012 global survey. Isolates were identified using CHROMagar, biochemical methods and sequencing of ITS and/or 28S regions. Candida spp. were classified as either susceptible or resistant and as wild type (WT) or non-WT using CLSI clinical breakpoints or epidemiological cutoff values, respectively, for the antifungal agents. Isolates included 1,421 organisms from 21 different species of Candida. Among Candida spp., resistance to all 10 tested antifungal agents was low (0.0-7.9 %). The vast majority of each species of Candida, with the exception of Candida glabrata, Candida krusei, and Candida guilliermondii (modal MICs of 0.5 µg/ml), were inhibited by ≤0.12 µg/ml of isavuconazole (99.0 %; range 94.3 % [Candida tropicalis] to 100.0 % [Candida lusitaniae and Candida dubliniensis]). C. glabrata, C. krusei, and C. guilliermondii were largely inhibited by ≤1 µg/ml of isavuconazole (89.7, 96.9 and 92.8 %, respectively). Decreased susceptibility to isavuconazole was most prominent with C. glabrata where the modal MIC for isavuconazole was 0.5 µg/ml for those strains that were SDD to fluconazole or WT to voriconazole, and was 4 µg/ml for those that were either resistant or non-WT to fluconazole or voriconazole, respectively. In conclusion, these data document the activity of isavuconazole and generally the low resistance levels to the available antifungal agents in a large, contemporary (2012), global collection of molecularly characterized species of Candida.

  17. Clinical Value of Color Doppler Ultrasound in Diagnosis of Accessory Breast%彩超诊断副乳腺的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    田涛

    2015-01-01

    目的:探讨彩色多普勒超声对副乳腺的诊断价值,以便为临床诊治和随访提供可靠的影像学依据。方法选取2008年4月~2012年8月在我院经高频超声及临床诊治的21例副乳患者,回顾性分析超声声像图特征,并鉴别诊断。结果副乳就是多余的乳房,一般发生在腋前区或腋下,也可见于胸壁、腹部等。副乳大多成对出现,对称分布,一般都比正常乳房要小,平常期的副乳实质回声一般略低于正常乳腺组织或强弱相间,高于脂肪组织,边界不整齐,无包膜,乳腺小叶结构不完整,实质内大多无明显的血流分布,与正常乳腺有明显分界,可发生小叶增生、导管扩张、纤维腺瘤、副乳癌等。结论高频超声是诊断副乳腺病变最为实用和有效的检查手段,且适用于哺乳期妇女,便于临床诊治和随访。%Objective To investigate the diagnostic value of color Doppler ultrasound in the diagnosis and treatment of accessory breast in order to provide reliable imaging evidence for clinical diagnosis and follow-up. Methods 21 cases of high frequency ultrasound and clinical diagnosis and treatment of the two patients were selected in our hospital in April 2008~August 2012, retrospective analysis of the ultrasonographic features and differential diagnosis. Results Accessory breast generally occurs in the anterior axillary region or axillary, are also found in the chest, abdomen etc. accessory breast mostly appear in pairs, symmetrical distribution, generally than normal breast to small, usual accessory breast parenchyma echo generally slightly lower than normal breast tissue or strength of the interphase, higher than the adipose tissue, irregular borders, no capsule, breast lobular structure is not complete, parenchyma mostly without obvious blood flow distribution, a clear demarcation with normal breast, can occur as a result of lobular hyperplasia, duct dilatation

  18. the Clinical Value of Spiral CT Diagnosis of Abdominal Hernia Applied%螺旋CT诊断应用于腹部疝中的临床价值

    Institute of Scientific and Technical Information of China (English)

    蒋宏华

    2013-01-01

    Objective Study and analysis of spiral CT diagnosis applied in abdominal hernia in the important clinical value. Methods The study object of study mainly for our 34 cases were treated abdominal hernia patients, and to all the research object of the clinical data were retrospectively analyzed. Results All patients with spiral CT diagnosis are more accurate. 34 cases of abdominal hernia patients, according to its hernia of the specific position, spiral CT diagnosed inguinal region hernia patients for 15 cases, umbilical hernia (3 cases), intraperitoneal hernia 4 cases, 2 cases of obturator hernia and traumatic abdominal wall hernia patients, 4 cases of abdominal incisional hernia patients 6 patients. Patients with abdominal hernia content of small intestine, Spiral CT performance under for intestinal obstruction of the patients in 34 cases, spiral CT diagnosis and surgical results of the coincidence rate is 100%. Conclusion For abdominal hernia patients is concerned, using spiral CT to carry on the diagnosis is very effective, it has the safe, convenient wait for a characteristic, can for clinical diagnosis and treatment to provide more substantial and reality basis.%  目的研究并分析螺旋CT诊断应用于腹部疝中的重要临床价值。方法本组研究的研究对象主要为我院收治的34例腹部疝患者,并对所有研究对象的临床资料进行回顾性分析。结果所有患者的螺旋CT诊断均较为准确。34例腹部疝患者中,根据其疝的具体位置,螺旋CT诊断出腹股沟区疝患者为15例、脐疝3例、腹腔内疝4例、闭孔疝2例和外伤性腹壁疝患者4例、腹壁切口疝患者6例。患者的腹部疝内容物为小肠;螺旋CT下表现为肠梗阻的患者为34例,螺旋CT的诊断与手术结果的符合率为100%。结论对于腹部疝的患者而言,运用螺旋CT来对其进行诊断是十分有效的,其具有安全、方便等特点,可以为临床的诊断与治疗提供较为可观与真实的依据。

  19. [Antifungal susceptibility profiles of Candida species to triazole: application of new CLSI species-specific clinical breakpoints and epidemiological cutoff values for characterization of antifungal resistance].

    Science.gov (United States)

    Karabıçak, Nilgün; Alem, Nihal

    2016-01-01

    The Clinical and Laboratory Standards Institute (CLSI) Subcommittee on Antifungal Susceptibility Testing has newly introduced species-specific clinical breakpoints (CBPs) for fluconazole and voriconazole. When CBPs can not be determined, wild-type minimal inhibitory concentration (MIC) distributions are detected and epidemiological cutoff values (ECVs) provide valuable means for the detection of emerging resistance. The aim of this study is to determine triazole resistance patterns in Candida species by the recently revised CLSI CBPs. A total of 140 Candida strains isolated from blood cultures of patients with invasive candidiasis hospitalized in various intensive care units in Turkey and sent to our reference laboratory between 2011-2012, were included in the study. The isolates were identified by conventional methods, and susceptibility testing was performed against fluconazole, itraconazole and voriconazole, by the 24-h CLSI broth microdilution (BMD) method. Azole resistance rates for all Candida species were determined using the new species-specific CLSI CBPs and ECVs criteria, when appropriate. The species distribution of the isolates were as follows; C.parapsilosis (n= 31 ), C.tropicalis (n= 26 ), C.glabrata (n= 21), C.albicans (n= 18), C.lusitaniae (n= 16), C.krusei (n= 16), C.kefyr (n= 9), C.guilliermondii (n= 2), and C.dubliniensis (n= 1). According to the newly determined CLSI CBPs for fluconazole and C.albicans, C.parapsilosis, C.tropicalis [susceptible (S), ≤ 2 µg/ml; dose-dependent susceptible (SDD), 4 µg/ml; resistant (R), ≥ 8 µg/ml], and C.glabrata (SDD, ≤ 32 µg/ml; R≥ 64 µg/ml) and for voriconazole and C.albicans, C.parapsilosis, C.tropicalis (S, ≤ 0.12 µg/ml; SDD, 0.25-0.5 µg/ml; R, ≥ 1 µg/ml), and C.krusei (S, ≤ 0.5 µg/ml; SDD, 1 µg/ml; R, ≥ 2 µg/ml), it was found that three of C.albicans, one of C.parapsilosis and one of C.glabrata isolates were resistant to fluconazole, while two of C.albicans and two of C

  20. Clinical value of ultrasonography in hepatobiliary disease census in%超声在肝胆疾病普查中的临床价值

    Institute of Scientific and Technical Information of China (English)

    彭毅

    2014-01-01

    Objective to explore the clinical value of abdominal ultrasonography in hepatobiliary disease census in. Methods retrospective analysis of the clinical data of 1688 person times in 2013 June to 2013 december in our hospital medical center for health examination by abdominal ultrasonography in hepatobiliary organs. Results of 1688 lines of liver and gallbladder ultrasound census, 438 patients with positive, accounting for 25.95%. the pathology, spiral ct diagnosed 402 cases, diagnostic accuracy was 91.78%. Positive diagnosis in patients with primary liver cancer in 16 cases, 24 cases of liver hemangioma, 32 cases of liver cyst, fatty liver, 110 cases, 23 cases of cirrhosis of the liver, gallbladder in 5 cases, 10 cases of gallbladder polyp and gallbladder stones in 82 cases, 100 cases of cholecystitis. Conclusion application of ultrasound technology in the liver and gallbladder disease census, not only can detect no significant clinical symptoms of malignant lesions, can detect the fatty liver, cirrhosis of the liver, cholecystitis and gall bladder calculi many benign lesions, such as the liver and gallbladder disease in the diagnosis accuracy is high, and is an important non-invasive means in the early detection of disease.%目的:探讨腹部超声检查在肝胆疾病普查中的临床价值。方法回顾性分析了2013年6月~2013年12月在我院体检中心行健康体检中采用腹部超声检查肝胆脏器的1688人次的临床资料。结果本组1688人次行肝胆超声普查中,阳性患者438例,占25.95%。经病理、螺旋 ct 确诊402例,诊断准确率为91.78%。阳性确诊患者中原发性肝癌16例,肝血管瘤24例,肝囊肿32例,脂肪肝110例,肝硬化23例,胆囊癌5例,胆囊息肉10例,胆囊结石82例,胆囊炎100例。结论应用 B 超技术在肝胆疾病普查中,不仅能够检测出无明显临床症状的恶性病变,能够检测出脂肪肝、肝硬化、胆囊炎、胆囊结石等很多良

  1. 急诊静脉血气分析的临床价值%Clinical value of venous blood gas analysis in emergency medical care

    Institute of Scientific and Technical Information of China (English)

    徐安忆; 单仁飞; 秦杰; 沈建飞

    2016-01-01

    Objective To analyze the correlation between arterial and peripheral venous blood gas analysis variables. Methods The datas including PubMed,Medline,Embase were systematically searched for the variables in adult emergency peripheral venous and arterial blood gas analysis,including pH,PCO2,HCO3- and BE from January 1966 to March,2015. The quality of studies was critically evaluated and the data were extracted by two reviewers independently. Meta-analysis was conducted by using the RevMan 5.2. Results Totally 17 studies were finally identified. The pH value of arterial blood gas analysis in patients with non shock is similar to venous blood gas analysis (WMD=0.00,95%CI:-0.01~0.02,P>0.05). The PCO2 value of arterial blood gas analysis and venous blood gas analysis is obviously different (WMD=-3.87,95%CI:-4.35~-3.38,P0.05)as well as BE value(MD=0.09,95%CI:-0.97~0.55). Conclusion It had sufficient evidence to support that the pH and HCO3- of the arterial blood gas analysis in patients with non shock patients is similar with peripheral venous blood gas analysis. But there is no enough data to show the correlation between arterial and venous blood gas analysis in patients with shock or disturbance of acid-base balance. The difference between peripheral venous blood gas analysis and arterial blood gas analysis PCO2 value is obvious,it is difficult to predict the PCO2 value of arterial blood gas analysis by using PCO2 value of peripheral venous gas analysis in clinical,but the partial pressure of CO2 could apply in the arterial hypercarbia selection or partial carbon dioxide pressure monitoring.%目的:分析动脉和外周静脉血气分析变量之间的相关性。方法计算机检索PubMed、Medline、Embase数据库,收集1966年1月至2015年3月成人急诊比较外周动脉和静脉血气分析值,包括氢离子浓度指数(pH)值、二氧化碳分压(PCO2)、碳酸氢盐(HCO3-)和剩余碱(BE)的研究。由2名研究者独立对文献进

  2. Clinical Study of Drug-resistant Pulmonary Tuberculosis Treated by Combination of Anti-Tuberculosis Chemicals and Compound Astragalus Capsule(复方黄芪胶囊)

    Institute of Scientific and Technical Information of China (English)

    姜艳; 李新; 于志勇; 尹红义; 韩玉庆

    2004-01-01

    Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB). Methods: Ninety-two patients with DR-TB were equally randomized into the treated group (treated with combination therapy) and the control group (treated with anti-TB chemicals alone). The therapeutic course for both groups was 18 months. Therapeutic effects between the two groups were compared at the end of the therapeutic course. Sputum bacterial negative rate, focal absorption effective rate, cavity closing rate, 10-day symptom improving rate, the incidence of adverse reaction and 2-year bacteriological recurrence rate between the two groups were compared. Results: In the treated group, the sputum bacterial negative conversion rate was 84. 8%, focal absorption effective rate 91.3 %, cavity closing rate 58. 7 % and 10-day symptom improving rate 54.4%, while in the control group, the corresponding rates were 65.2%,73.9 %, 37. 0% and 26.1%, respectively. Comparison between the groups showed significant difference in all the parameters ( P<0.05, P<0.05, P<0.05 and P<0.01 ). The incidence of adverse reaction and 2year bacteriological recurrence rate in the treated group were 23.9 % and 2.6 % respectively, while those in the control group 50.0% and 16.7%, which were higher than the former group with significant difference ( P<0.01 and P<0.05, respectively). Conclusion: The therapeutic effect of combined treatment with antiTB and CAC is superior to that of treatment with anti-TB chemicals alone, and the Chinese herbal medicine showed an adverse reaction alleviating effect, which provides a new therapy for DR-TB, and therefore, it is worth spreading in clinical practice.

  3. 心电图诊断高钾血症的临床应用价值探讨%The Clinical Value of Ecg Diagnosis of Hyperkalemia

    Institute of Scientific and Technical Information of China (English)

    张桂艳

    2016-01-01

    Objective To investigate the clinical value of ecg diagnosis of hyperkalemia. Methods Select our hospital 117 cases of patients with hyperkalemia in research from January 2014 to February 2016, on the basis of different serum K+ concentration was divided into group I 39 cases (5.5~6.9mmol/L), II group of 40 cases (7.0~10.0mmol/L), III group of 38 patients (>10.0mmol/L). For three groups of patients with abnormal ecg diagnosis rate and characteristic performance records and analysis.Results Group I, II, III group patients successive increase the incidence of abnormal ecg, III group had a signiifcantly higher rate of abnormal electrocardiogram (ecg) in patients with group I and II group of patients,P<0.05). 117 cases of patients with hyperkalemia electrocardiogram (ecg) were characterized by tall upright T wave, hyperkalemia patients with different concentration electrocardiogram T wave amplitude and the relationship between serum K+ concentration is not parallel. Group I occasionally occur in patients with high T wave, presents the tent; II group of patients with ST segment showed a downward trend, T wave height, pointed, P wave decreased or disappeared; A wide QRS complex III group patients, and gradually merged in T wave, sine wave shape.Conclusion Using electrocardiogram diagnosis hyperkalaemia, the serum K+ concentration and different abnormal ecg showed that there was a positive correlation between the serum K+ concentration increased, the incidence of abnormal ecg patients also increased, it can be used as a reference in clinical diagnosis and treatment of hyperkalemia, has the very high clinical value.%目的:探讨心电图诊断高钾血症的临床应用价值。方法选取我院2014年1月~2016年2月期间收治的117例高钾血症患者纳入研究,依据不同的血清钾浓度划分为I组39例(5.5~6.9mmol/L)、II组40例(7.0~10.0mmol/L)、III组38例(>10.0mmol/L)。对3组患者的心电图诊断异常率及特征表现

  4. [Laboratory chemical analysis in ascites].

    Science.gov (United States)

    Satz, N

    1991-04-13

    Chemical analysis of ascitic fluid may be helpful in determining the underlying disease. We discuss the diagnostic accuracy of the common and newer chemical parameters (protein, LDH, lactate, glucose, cholesterol, triglycerides, phospholipids, fibronectin, albumin gradient [value of serum minus value of ascites], ferritin, tumor markers, immunomodulators, leukocytes, bacterial and cytologic examinations). We also review the pathogenesis and clinical findings of the most frequent ascites forms (benign hepatic, infective, malignant ascites, ascites associated with liver metastases or hepatocellular carcinoma, cardiac and pancreatic ascites) and the most important diagnosis criteria. In the malignant ascites a high cholesterol, a narrow albumin gradient or a high ferritin value have high diagnostic accuracy, but diagnosis is by the finding of malignant cells. For the diagnosis of infective ascites, bacteriology is mandatory even though the results are negative in most cases, particularly in spontaneous bacterial peritonitis where diagnosis has to be established clinically, by a low pH or by a high leukocyte count. Benign hepatic ascites is diagnosed by demonstrating an underlying chronic liver disease and laboratory examinations of the peritoneal fluid to exclude other causes. The laboratory tests in ascites associated with liver metastases or with hepatocellular carcinoma were similar to those in benign hepatic ascites and the two ascites forms must be separated by other clinical and technical findings. Pancreatic ascites can easily be distinguished from the other forms by the high amylase and lipase content.

  5. 血液检验在临床贫血诊断中的价值%Application Value Analysis of Blood Test in the Diagnosis of Clinical Anemia

    Institute of Scientific and Technical Information of China (English)

    陈群; 张志城; 邓宝佳; 邝紫华

    2016-01-01

    目的:探讨临床贫血诊断中血液检验的应用价值。方法:以47例地中海贫血患者、53例缺铁性贫血患者及40例健康体检者为研究对象。对比分析三组患者血液中RBC、MCH、Hb、MCV和RDW五项观察指标差异,计算血液检验方法应用于不同类型贫血诊断中检验灵敏度、特异性和约登指数,对各项数据结果予进行对比分析。结果:三组各项血液检测观察指标差异明显(P<0.05);地中海贫血组MCH和Hb水平明显高于缺铁性贫血组(P<0.05),明显低于对照组(P<0.05),而RDW指标水平明显低于缺铁性贫血组(P<0.05);缺铁性贫血组RDW水平明显高于其它两组(P<0.05)。结论:临床诊断贫血时血液检验可取得良好的诊断效果,但其误诊率也较高,辅以其它诊断方式可取得更为确切的鉴别诊断结果。%Objective To explore the application value of blood test in the diagnosis of clinical anemia.Methods 47 cases of pa-tients with the Mediterranean anemia,53 patients with iron deficiency anemia and 40 cases of healthy subjects were studied.Compared and analyzed the difference in three groups of patients with blood RBC,MCH,Hb,MCV and RDW five observation indexs,calculated the blood test method application in different types of Anemia Diagnosis mid-term test sensitivity,specificity and Youden′s finger. Results The difference of all the blood test observation indexs in the three groups was significant (P<0.05 );MCH and Hb level in mediterranean anemia group was significantly higher than that of iron deficiency anemia group (P<0.05 ),was significantly lower than that in the contrast group (P<0.05 ),and RDW levels was significantly lower than that of ischemic anemia group (P<0.05 );ischemic anemia group of RDW levels were significantly higher than those in the other two groups (P<0.05 ).Conclusion The clini-cal diagnosis of anemia in the blood test can achieve good results,but the

  6. Clinical observation of diagnostic value and safety of insulin tolerance test%ITT试验的诊断价值及安全性观察

    Institute of Scientific and Technical Information of China (English)

    李林蔓; 任伟; 李金超; 刘静婧; 刘秀蓉; 刘德珍; 王玲莉

    2012-01-01

    Objective To evaluate the practical value and safety of the insulin tolerance test (ITT). Methods A total of 67 patients with suspected growth hormone deficiency (GHD) admitted from July 2009 to March 2011 were involved in this study. There were 27 male patients and 40 female patients, aged 7 to 64. All patients underwent the ITT test. The reaction to hypoglycemia, changes in blood pressure and heart rate, and other vital signs were observed in the process of clinical investigation. Results All the 67 subjects completed the trial, among them no one suffered from severe hypoglycemia, as manifested as coma, convulsions, and so on. Based on the provocation test, the result of 53 cases (79.1%) was negative. Among them, 31 patients, including those who had undergone surgery of pituitary adenoma and those with Sheehan's syndrome, were diagnosed to suffer from GHD. This test was helpful in diagnosing 22 of patients with short stature as GHD. Although some subjects showed fluctuation of vital signs during the test, all of them were relieved within 3 min to 5 min with oral glucose solution. Conclusion When ITT is carried out in carefully selected patients under enhanced preventive measures and intensively monitored blood glucose level and vital signs, it is a safe and reliable clinical diagnostic test.%目的 探讨胰岛素低血糖-生长激素刺激试验(ITT)的应用价值和安全性.方法 选择2009年7月-2011年3月连续收治的疑似生长激素缺乏症(GHD)患者67例,男27例,女40例,年龄7~ 64岁.所有患者均进行ITT试验,检测过程中观察受试者低血糖反应情况及血压、心率等生命体征的变化.结果 67例受试者均完成试验,无一例脱落或出现昏迷、惊厥等严重低血糖反应.激发试验结果53例(79.1%)为阴性,其中31例垂体瘤术后患者和席汉综合征患者通过该试验可确诊为GHD,22例身材矮小患者通过该试验有助于其诊断GHD.试验过程中部分受试者虽有生命体征

  7. 肛周感染疾病超声诊断的临床评价%Clinical value of ultrasound in diagnosis of perianal infectious diseases

    Institute of Scientific and Technical Information of China (English)

    韩如冰; 李冰; 韩继红

    2014-01-01

    OBJECTIVE To explore the imaging findings of ultrasound in diagnosis of perianal infections diseases so as to provide basis for clinical intervention .METHODS A total of 60 patients with perianal infectious diseases were recruited as the study objects ,then the sonographic genotyping was performed according to the lesion sites ,char-acteristics ,and ultrasonographic features ,the actual results of surgeries were observed and compared ,and the val-ue of ultrasound in diagnosis of the perianal infectious diseases was evaluated .RESULTS The ultrasound diagnosis was performed for 30 cases of simple perianal abscess ,17 cases of complex perianal abscess ,and 13 cases of anal fistula;the surgical diagnosis was carried out for 32 cases of simple perianal abscess ,15 cases of complex perianal abscess ,and 13 cases of anal fistula .The accordance rate of diagnosis of the simple perianal abscess was 93 .75% , the complex perianal abscess 88 .23% ,the anal fistula 100 .00% ,and the total accordance rate was 93 .99% . CONCLUSION The ultrasound examination can make up for the deficiencies of clinical examinations and define the nature of perianal infectious diseases ,sites ,internal structure ,peripheral tissues ,and sinus fistula so as to pro-vide scientific bases for the severity of lesions ,treatment programs ,and optimization of surgical approach .%目的:探讨超声诊断肛周感染性疾病的影像学情况,为临床干预提供依据。方法选取2009年1月-2012年1月60例肛周感染性疾病患者为研究对象,根据病变部位、特征、超声声像图等进行分型分析和实际手术结果进行对比,评价超声在肛周感染性疾病的诊断价值。结果超声诊断单纯肛周脓肿30例、复杂肛周脓肿17例、肛瘘13例,手术诊断单纯肛周脓肿32例、复杂肛周脓肿15例、肛瘘13例,诊断符合率单纯肛周脓肿为93.75%、复杂肛周脓肿为88.23%、肛瘘为100.00%,总符合率为93.99%。

  8. 真菌性鼻窦炎的CT影像特征及临床价值%Fungal Sinusitis CT Imaging Features and Clinical Value

    Institute of Scientific and Technical Information of China (English)

    李晓波; 赵桐; 陈孝柏

    2013-01-01

    Objective To investigate the computed tomographic characteristics of fungal sinusitis,and the value in clinical diagnosis. Methods Computed tomographic date of 56 cases of fungal sinusitis confirmed by operation and pathology were analyzed. Results There are 55 cases of unilateral single sinusitis and 1 case of bilateral single sinusitis.The most commonly infected sinus was maxil ary sinus,fol owed by sphenoid sinus and ethmoid sinus.Soft tissue images were presented in al the infected sinuses of al cases,including bubbles、blob-shaped article or tape or gravel sample calicification. Part of the sinus cavity expansion ,sinus wal bone hyperplasia sclerosis,lesions of maxil ary sinus mouth jam or wal inside sinus bone hyperplasia sclerosis or damage. Conclusion CT scan is very important to fungal sinusitis diagnosis,also can give direction to functional endoscopic sinus surgery.%目的探讨真菌性鼻窦炎的CT影像特征及其临床价值。方法回顾性分析56例经手术和病理证实的真菌性鼻窦炎的 CT征象。结果55例单侧单窦发病,1例双侧单窦发病;以上颌窦最多见,其次是蝶窦、筛窦;病变鼻窦内充满软组织密度影,其内可见气泡、点状、条带状、沙砾样钙化;部分窦腔扩大,窦壁骨质增生硬化,病变上颌窦口阻塞或内侧壁骨质吸收破坏。结论 CT对真菌性鼻窦炎诊断有重要价值,对功能性内窥镜手术有一定指导意义。

  9. 3项丙型肝炎检测项目的价值比较%Comparison the clinical value of three methods for diagnosis for hepatitis C

    Institute of Scientific and Technical Information of China (English)

    陈茹; 王丽; 滕晓梅; 王庆国

    2015-01-01

    Objective To compare the clinical value of hepatitis C virus (HCV)antibody(HCV-Ab),hepatitis C virus core anti-gen (HCV-cAg),hepatitis C virus ribonucleic acid (HCV-RNA)in diagnosis for hepatitis C.Methods A total of 258 patients with hepatitis C were recruited in this study,HCV-RNA was detected by fluorescence quantitative PCR detection,HCV-Ab and HCV-cAg were detected by the double antigen sandwich ELISA statutory,and the test data was analyze.Results The result of HCV-Ab detection was significant difference with those of HCV-cAg and HCV-RNA detection respectively(P 0.05).Conclusion The coincidence rate of HCV-cAg detection and HCV-RNA detection was high,and complement with HCV-Ab,the early detection could be done to prevent the omission of HCV infection and to improve the detection rate.%目的:探讨检测丙型肝炎病毒(HCV)抗体(HCV-Ab)、HCV核心抗原(HCV-cAg)、HCV核糖核酸(HCV-RNA)对丙型肝炎诊断的价值。方法258例该院 HCV 患者为研究对象,采用荧光定量 PCR 检测 HCV-RNA,同时采用双抗原夹心酶联免疫法定性检测 HCV-Ab,双抗体夹心酶联免疫法定性检测 HCV-cAg,并进行比较。结果 HCV-Ab 分别与 HCV-cAg、HCV-RNA 检测结果差异有统计学意义(P 0.05)。结论 HCV-cAg 与 HCV-RNA 检测符合率高,与 HCV-Ab 互为补充,可对 HCV 感染做到早期检测,防止漏检,提高检出率。

  10. MRI findings of cervical vertebral Modic changes and their clinical value%颈椎Modic改变的MRI表现与临床意义

    Institute of Scientific and Technical Information of China (English)

    潘卫星; 马玲飞; 杨德顺; 米玉成; 王安武

    2014-01-01

    目的:探讨颈椎Modic改变的MRI表现与临床意义。方法回顾性分析116例颈椎Modic改变的MRI图像资料,记录Modic改变的类型、节段分布情况。结果116例患者中共计150个节段存在Modic改变,按照Modic分型,其中Ⅰ型23个节段,Ⅱ型110个节段,Ⅰ~Ⅱ混合型13个节段,Ⅲ型4个节段,发生率分别为15.3%、73.3%、8.7%、2.7%。按发生节段其中C5-6占57个节段,C6-7占41个节段,C4-5占29个节段,其余23个节段,分布情况与椎间盘突出好发部位相符。结论Modic改变是颈椎退行性病变中的一种常见表现,是引起颈痛的原因之一,并与椎间盘退变密切相关,MRI是首要检查方法。%Objective To discuss MRI findings of cervical vertebral Modic changes and their clinical value .Methods We retrospectively analysed MR imagings of cervical vertebral Modic changes in 116 cases and recorded types and distribtion of Modic changes .Results There were 150 segments with Modic changes including 23 segments in type Ⅰ ,110 segments in type Ⅱ ,13 segments in mixed type Ⅰ ~ Ⅱ and 4 segments in type Ⅲ according to Modic typing .The prevalence of typeⅠ ,type Ⅱ ,mixed type Ⅰ ~ Ⅱ and type Ⅲ were 15 .3% ,73 .3% ,8 .7% and 2 .7% ,respevtively .The distribution of Modic changes were 57 segments in C5-6 ,41 segments in C6-7 ,29 segments in C4-5 and 23 segments in the rest cervical seg-ments ,matching up with the common place to cervical vertebral disc protrution .Conclusion Modic changes ,which are cosely associated with disc degenertion ,are common presentation in cervical vertebral digenertive disease and one of causes to neck pain .M RI is the first choice to M odic changes .

  11. Electrical impedance scanning as a new imaging modality in breast cancer detection - a short review of clinical value on breast application, limitations and perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Malich, A. E-mail:ansgar.malich@med.uni-jena.de; Boehm, T.; Facius, M.; Kleinteich, I.; Fleck, M.; Sauner, D.; Anderson, R.; Kaiser, W.A

    2003-01-21

    Objective. Cancer cells exhibit altered local dielectric properties compared to normal cells, measurable as different electrical conductance and capacitance using electrical impedance scanning (EIS). Therefore, active biocompatible current is applied to the patient for calculation of both parameters taking into account frequency, voltage and current flow. Subjects and methods. 240 women with 280 sonographically and/or mammographically suspicious findings were examined using EIS. All lesions were histologically proven. A lesion was scored as positive, when a focal increased conductance and/or capacitance was measurable using EIS. The lesion was visible as a bright area in a 256 grey-scale computer output. Due to system limitations patients having a pacemaker or pregnant had to be excluded from the study. Results. 91/113 malignant and 108/167 benign lesions were correctly identified using EIS (80.5% sensitivity, 64.7% specificity). NPV and PPV of 83.1% and 60.7% were observed, respectively. Accuracy was 0.73. A wide range of factors can induce false positive results, although by an experienced observer a number of these findings can be detected such as scars, skin alterations, contact artefacts, air bubbles and naevi, hairs and interfering bone. Based upon visibility on ultrasound (194 lesions visible, 86 not visible) significant differences in the detection rate occurred. Histology-dependent detectability rate varied significantly with lowest rate in CIS-cases (50%). Specificity values varied histology-depending, too; probably depending on the rate of proliferation between 75% (inflammatory lesions) and papillomata (50%). Best detectability was observed in malignant lesions with a size between 20 and 30 mm. Further possible applications will be discussed regarding the currently available literature (lymph nodes, salivary glands, mathematical and animal based models). Conclusion. EIS appears to be a promising new additional technology providing a rather high

  12. 经阴道超声诊断子宫内膜病变的临床价值%Clinical value of transvaginal ultrasound diagnosis of endometrial lesions

    Institute of Scientific and Technical Information of China (English)

    王佳; 王堃

    2015-01-01

    Objective:To discuss the clinical value of transvaginal ultrasound diagnosis of endometrial lesions.Methods:112 patients with endometrial lesions were selected,transvaginal color Doppler ultrasound examination,analysis of ultrasonic diagnosis and pathological diagnosis rate.Results:The coincidence rate of transvaginal color Doppler ultrasound in diagnosis of endometrial hyperplasia was 80%,endometrial polyps was 97.3%,uterine submucosal myoma was 92.3%,endometrial carcinoma was 90%, endometrial hyperplasia,endometrial polyps,uterine mucous fibroids,endometrial cancer,the blood flow signals rates were 13.3%, 13.5%,38.5% and 60%.Conclusion:Transvaginal color Doppler ultrasound has a high diagnostic rate of endometrial lesions,which has the advantages of small damage,repeatability and so on.%目的:探讨经阴道彩色多普勒超声诊断子宫内膜病变的临床价值。方法:收治子宫内膜病变患者112例,经阴道彩色多普勒超声检查,分析超声诊断与病理诊断的符合率。结果:经阴道彩色多普勒超声诊断的符合率分别为子宫内膜增生80%,子宫内膜息肉97.3%,子宫黏膜下肌瘤92.3%,子宫内膜癌90%;子宫内膜增生、子宫内膜息肉、子宫黏膜下肌瘤、子宫内膜癌的血流信号显示率分别为13.3%、13.5%、38.5%、60%。结论:经阴道彩色多普勒超声对子宫内膜病变有较高的诊断率,具有损伤小,可重复性等优点。

  13. 抗链球菌DNA酶B抗体检测的临床应用价值%The clinical value of detecting anti-streptococcal DNase B

    Institute of Scientific and Technical Information of China (English)

    胡惠静; 吴晓岩

    2014-01-01

    目的:通过同时检测患者血清中抗链球菌DNA酶B抗体(ADNase B)和抗链球菌溶血素O抗体(ASO)的含量,探讨ADNase B检测的临床应用价值。方法采用速率散射比浊法同时检测患者血清中ADNase B和ASO的含量。结果在2375名疑似风湿性疾病的患者中,405名ADNase B超出参考范围上限,占17.1%;220名ASO超出参考范围上限,占9.2%;513名ADNase B和(或)ASO超出参考范围上限,占21.6%;112名ADNase B和ASO均超出参考范围上限,占4.7%。结论ADNase B的阳性检出率高于ASO;二者联合检测能够进一步提高链球菌感染的检出率。%Objective To investigate the clinical value of anti-streptococcal DNase B (ADNase B) through quantitatively detecting ADNase B and anti-streptolysin O (ASO) in patient serum. Methods The content of ADNase B and ASO in patient serum was detected by means of particle-enhanced immunonephelometry using the BN ProSpec System. Results In 2375 patients who were suspected of rheumatic fever, there were 405, 220, 513 and 112 patients whose ADNase B,ASO,"ADNase B and/ or ASO"and "ADNase B and ASO"exceeded the reference range, accounting for 17.1%,9.2%,21.6% and 4.7%,respectively. Conclusion The positive rate of ADNase B was higher than that of ASO;the detection of ADNase B and ASO could improve the positive detectable rate of streptococcal infection.

  14. Detection of plasmacytoid dendritic cell (pDC) content in peripheral blood and renal tissue of children with henoch-schonlein purpura and its clinical value

    Institute of Scientific and Technical Information of China (English)

    Rong-Mei Xiang

    2016-01-01

    Objective:To study the plasmacytoid dendritic cell (pDC) content in peripheral blood and renal tissue of children with henoch-schonlein purpura and its clinical value.Methods:30 cases of henoch-schonlein purpura children with renal damage were enrolled in HSPN group, 30 cases of henoch-schonlein purpura children without renal damage were enrolled in NHSPN group, and 30 cases of healthy volunteers were enrolled in the control group. Then contents of pDC, Th2 cell, IL-4, IL-5, IL-10 and IL-13 in peripheral blood as well as contents of pDC, Th17 cell, IL-17, IL-21 and IL-23 in renal tissue of three groups were detected.Results: (1) pDC contents in peripheral blood of HSPN group and NHSPN group were lower than those of control group and the decrease of pDC contents in peripheral blood of HSPN group was more obvious; CD304 contents in renal tissue of HSPN group and NHSPN group were higher than those of control group and the increase of CD304 contents in renal tissue of HSPN group was more obvious; (2) Th2 cell as well as IL-4, IL-5, IL-10 and IL-13 contents in peripheral blood of HSPN group and NHSPN group were higher than those of control group and the increase of related indexes in peripheral blood of HSPN group was more obvious; Th17 cell as well as IL-17, IL-21 and IL-23 contents in kidney tissue of HSPN group were higher than those of NHSPN group; (3) in peripheral blood, pDC content was negatively correlated with Th2 cell level as well as IL-4, IL-5, IL-10 and IL-13 contents, and in renal tissue, pDC content was positively correlated with Th17 cell level as well as IL-17, IL-21 and IL-23 contents. Conclusions:Abnormal pDC content correlates with the pathogenesis of henoch-schonlein purpura, pDC content decreases in peripheral blood and will result in enhancement of Th2 cell function, and pDC content increases in kidney and will result in enhancement of Th17 cell function.

  15. Prognostic value of metabolic parameters and clinical impact of {sup 18}F-fluorocholine PET/CT in biochemical recurrent prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Colombie, M.; Bailly, C.; Rusu, D.; Rousseau, N. [Institut de Cancerologie de l' Ouest Rene Gauducheau, Nuclear Medicine, 44805 Nantes-St Herblain Cedex (France); Campion, L. [ICO Cancer Center, Statistics, Saint-Herblain (France); Nantes University, Nantes-Angers Cancer Research Center, INSERM U892-CNRS UMR 6299, Nantes (France); Rousseau, T. [Urologic Clinic Nantes-Atlantis, Saint Herblain (France); Mathieu, C. [University Hospital, Nuclear Medicine, Nantes (France); Ferrer, L. [ICO Cancer Center, Physics, Saint-Herblain (France); Kraeber-Bodere, F. [Institut de Cancerologie de l' Ouest Rene Gauducheau, Nuclear Medicine, 44805 Nantes-St Herblain Cedex (France); University Hospital, Nuclear Medicine, Nantes (France); Nantes University, Nantes-Angers Cancer Research Center, INSERM U892-CNRS UMR 6299, Nantes (France); Rousseau, C. [Institut de Cancerologie de l' Ouest Rene Gauducheau, Nuclear Medicine, 44805 Nantes-St Herblain Cedex (France); Nantes University, Nantes-Angers Cancer Research Center, INSERM U892-CNRS UMR 6299, Nantes (France)

    2015-11-15

    To evaluate the therapeutic impact of {sup 18}F-fluorocholine (FCH) PET/CT in biochemical recurrent prostate cancer (PC) and to investigate the value of quantitative FCH PET/CT parameters in predicting progression-free survival (PFS). This retrospective study included 172 consecutive patients with PC who underwent FCH PET/CT for biochemical recurrence. Mean rising PSA was 10.7 ± 35.0 ng/ml. Patients with positive FCH PET were classified into three groups: those with uptake only in the prostatic bed, those with locoregional disease, and those with distant metastases. Referring physicians were asked to indicate the hypothetical therapeutic strategy with and without the FCH PET/CT results. Clinical variables and PET parameters including SUVmax, SUVpeak, SUVmean, total lesion choline kinase activity (TLCKA) and standardized added metabolic activity (SAM) were recorded and a multivariate analysis was performed to determine the factors independently predicting PFS. In 137 of the 172 patients, the FCH PET/CT scan was positive, and of these, 29.9 % (41/137) had prostatic recurrence, 42.3 % (58/137) had pelvic lymph node recurrence with or without prostatic recurrence, and 27.7 % (38/137) had distant metastases. The FCH PET/CT result led to a change in treatment plan in 43.6 % (75/172) of the 172 patients. Treatment was changed in 49.6 % (68/137) of those with a positive FCH PET/CT scan and in 20 % (7/35) of those with a negative FCH PET/CT scan. After a median follow-up of 29.3 months (95 % CI 18.9 - 45.9 months), according to multivariate analysis age <70 years, SAM ≥23 and SUVmean ≥3 were parameters independently predicting PFS. A nomogram constructed using the three parameters showed 49 months of PFS in patients with the best scores (0 or 1) and only 11 months in patients with a poor score (score 3). This study indicates that a positive FCH PET result in PC patients with biochemical recurrence predicts a shorter PFS and confirms the major impact of the FCH PET

  16. Clinical Psychology Ph.D. Program Admissions: Differential Values as a Function of Program Characteristics and the Implications of the Mentor-Model Approach

    Science.gov (United States)

    Metzger, Jesse A.

    2010-01-01

    The aims of this research were to 1) examine the qualities for which applicants are selected for entrance into clinical psychology Ph.D. programs, and 2) investigate the prevalence and impact of the mentor-model approach to admissions on multiple domains of programs and the field at large. Fifty Directors of Clinical Training (DCTs) provided data…

  17. Echinocandin and triazole antifungal susceptibility profiles for clinical opportunistic yeast and mold isolates collected from 2010 to 2011: application of new CLSI clinical breakpoints and epidemiological cutoff values for characterization of geographic and temporal trends of antifungal resistance.

    Science.gov (United States)

    Pfaller, Michael A; Messer, Shawn A; Woosley, Leah N; Jones, Ronald N; Castanheira, Mariana

    2013-08-01

    The SENTRY Antimicrobial Surveillance Program monitors global susceptibility and resistance rates of newer and established antifungal agents. We report the echinocandin and triazole antifungal susceptibility patterns for 3,418 contemporary clinical isolates of yeasts and molds. The isolates were obtained from 98 laboratories in 34 countries during 2010 and 2011. Yeasts not presumptively identified by CHROMagar, the trehalose test, or growth at 42°C and all molds were sequence identified using internal transcribed spacer (ITS) and 28S (yeasts) or ITS, translation elongation factor (TEF), and 28S (molds) genes. Susceptibility testing was performed against 7 antifungals (anidulafungin, caspofungin, micafungin, fluconazole, itraconazole, posaconazole, and voriconazole) using CLSI methods. Rates of resistance to all agents were determined using the new CLSI clinical breakpoints and epidemiological cutoff value criteria, as appropriate. Sequencing of fks hot spots was performed for echinocandin non-wild-type (WT) strains. Isolates included 3,107 from 21 Candida spp., 146 from 9 Aspergillus spp., 84 from Cryptococcus neoformans, 40 from 23 other mold species, and 41 from 9 other yeast species. Among Candida spp., resistance to the echinocandins was low (0.0 to 1.7%). Candida albicans and Candida glabrata that were resistant to anidulafungin, caspofungin, or micafungin were shown to have fks mutations. Resistance to fluconazole was low among the isolates of C. albicans (0.4%), Candida tropicalis (1.3%), and Candida parapsilosis (2.1%); however, 8.8% of C. glabrata isolates were resistant to fluconazole. Among echinocandin-resistant C. glabrata isolates from 2011, 38% were fluconazole resistant. Voriconazole was active against all Candida spp. except C. glabrata (10.5% non-WT), whereas posaconazole showed decreased activity against C. albicans (4.4%) and Candida krusei (15.2% non-WT). All agents except for the echinocandins were active against C. neoformans, and the

  18. Public Values

    DEFF Research Database (Denmark)

    Beck Jørgensen, Torben; Rutgers, Mark R.

    2015-01-01

    administration is approached in terms of processes guided or restricted by public values and as public value creating: public management and public policy-making are both concerned with establishing, following and realizing public values. To study public values a broad perspective is needed. The article suggest......This article provides the introduction to a symposium on contemporary public values research. It is argued that the contribution to this symposium represent a Public Values Perspective, distinct from other specific lines of research that also use public value as a core concept. Public...... a research agenda for this encompasing kind of public values research. Finally the contributions to the symposium are introduced....

  19. The value of integrating pre-clinical data to predict nausea and vomiting risk in humans as illustrated by AZD3514, a novel androgen receptor modulator.

    Science.gov (United States)

    Grant, Claire; Ewart, Lorna; Muthas, Daniel; Deavall, Damian; Smith, Simon A; Clack, Glen; Newham, Pete

    2016-04-01

    Nausea and vomiting are components of a complex mechanism that signals food avoidance and protection of the body against the absorption of ingested toxins. This response can also be triggered by pharmaceuticals. Predicting clinical nausea and vomiting liability for pharmaceutical agents based on pre-clinical data can be problematic as no single animal model is a universal predictor. Moreover, efforts to improve models are hampered by the lack of translational animal and human data in the public domain. AZD3514 is a novel, orally-administered compound that inhibits androgen receptor signaling and down-regulates androgen receptor expression. Here we have explored the utility of integrating data from several pre-clinical models to predict nausea and vomiting in the clinic. Single and repeat doses of AZD3514 resulted in emesis, salivation and gastrointestinal disturbances in the dog, and inhibited gastric emptying in rats after a single dose. AZD3514, at clinically relevant exposures, induced dose-responsive "pica" behaviour in rats after single and multiple daily doses, and induced retching and vomiting behaviour in ferrets after a single dose. We compare these data with the clinical manifestation of nausea and vomiting encountered in patients with castration-resistant prostate cancer receiving AZD3514. Our data reveal a striking relationship between the pre-clinical observations described and the experience of nausea and vomiting in the clinic. In conclusion, the emetic nature of AZD3514 was predicted across a range of pre-clinical models, and the approach presented provides a valuable framework for predicition of clinical nausea and vomiting.

  20. Valor preditivo do "Clinical Risk Index for Babies" para o risco de mortalidade neonatal Predictive value of the "Clinical Risk Index for Babies" for the risk of neonatal death

    Directory of Open Access Journals (Sweden)

    Oscar T. Matsuoka

    1998-12-01

    Full Text Available OBJETIVO: Comparar o valor preditivo do CRIB (Clinical Risk Index for Babies para o risco de mortalidade neonatal ao peso de nascimento (PN e idade gestacional (IG. MÉTODO: Numa coorte prospectiva foram estudados, durante o ano de 1996, 71 recém-nascidos admitidos na unidade de terapia intensiva, com PN 10 foi de 100%. CONCLUSÕES: O escore de CRIB > 10 correspondeu a maiores especificidade e valor preditivo positivo em relação aos demais parâmetros. A área determinada pela "receiver operating characteristic" relativa ao CRIB também foi superior. O CRIB mostrou-se um marcador mais acurado na previsão de risco de mortalidade quando comparado ao PN ou IG isoladamente.OBJECTIVE: Several indicators, mainly birthweight and gestational age, have been used to predict the mortality risk in neonatal intensive care units. In order to assess the potential value of CRIB in predicting neonatal mortality, the score was used over the first 12 hours of life of the newborns admitted to this unit, during the year of 1996. METHOD: The inclusion criteria consisted of all infants without inevitably lethal congenital malformations, birthweight below 1,500g and/or gestational age less than 31 weeks. Newborn children who died within 12 hours after delivery were excluded. The CRIB score covers birth weight, gestational age, the presence of congenital malformations (not inevitably lethal and three indexes of physiological status during first 12 hours after birth - maximum and minimum appropriate fraction of inspired oxygen and maximum (most acidotic base excess. RESULTS: In a prospective cohort, seventy one newborn children were studied. The birthweight (average was 1,119 ± 275.6 g, gestational age 30 weeks 4/7 ±2 weeks 3/7; male (57%; Apgar 1° min. score <=3 ( 36.2% and Apgar 5° min. score < 5 (5.8%. The mortality rate was 29.6% (gold standard. But mortality rate by birthweight less than 1,000 gr. or gestational age lower than 29 weeks was 60.0% and for the

  1. Study on Values Taking of Ignition Probabilities in Hazardous Chemical Leakage Accidents%危险化学品泄漏事故点火概率取值研究

    Institute of Scientific and Technical Information of China (English)

    袁雄军; 朱常龙; 葛秀坤; 任常兴; 王凯全

    2011-01-01

    为计算危险化学品泄漏后发生火灾、爆炸等事故的概率,提高风险评估的量化水平,对点火概率的取值进行研究.从模型计算和直接取参考值2个方面探讨点火概率的取值问题,提出不同情形下的取值建议,并结合案例应用对点火概率2种取值方法进行对比分析研究.研究结果表明:点火概率模型计算不确定性较大且适用性有限,而直接取值的参考值均由一系列事件统计而得出,具有一