WorldWideScience

Sample records for clinical endocrynological center

  1. NIH Clinical Centers

    Data.gov (United States)

    Federal Laboratory Consortium — The NIH Clinical Center consists of two main facilities: The Mark O. Hatfield Clinical Research Center, which opened in 2005, houses inpatient units, day hospitals,...

  2. Cassel Psych Center Computerized Biofeedback Clinic.

    Science.gov (United States)

    Cassel, Russell N.

    1982-01-01

    Describes Cassel Psych Center, a computerized biofeedback clinic, where the "well" patient is a major concern, and where biofeedback instruments are used with computers to form a Computerized-Biofeedback Clinical Support System. The Center's activities are designed to parallel the services of the pathologist in a medical setting. (PAS)

  3. The National Institutes of Health Clinical Center

    Science.gov (United States)

    ... here are three patients whose lives have been changed for the better at the Clinical Center. Annie ... caused retinal tumors, which had resulted in Clenton's blindness. "I was dreadfully ill and had no idea ...

  4. An Instructional Resource Center in a Senior Dental Clinic.

    Science.gov (United States)

    Berrong, Joseph M.; And Others

    1982-01-01

    Development of an instructional materials center and self-instructional materials on clinical dental procedures is described. The center is located near students' operatories and the student-tested programs were developed cost-effectively and relatively quickly. (MSE)

  5. The practice-unit centered clinical database--the implementation.

    OpenAIRE

    Bryner, U. M.

    1991-01-01

    A clinical database system under the name ClinTrac has been developed for the purpose of acquiring, processing, storing, analyzing, and communicating clinical information. The core of this system consists of a practice-unit centered database.

  6. The National Institutes of Health Clinical Center

    Science.gov (United States)

    ... and slow growth in height. The first tell-tale sign for the family was Jane's unusual weight ... 50 years ago. Clinical research is how physician-scientists translate promising discoveries in the laboratory into better ...

  7. 78 FR 13880 - Clinical Center; Notice of Meeting

    Science.gov (United States)

    2013-03-01

    ...:15 p.m. Agenda: To review the FY14 Clinical Center Budget. Place: National Institutes of Health... vehicles, including taxicabs, hotel, and airport shuttles will be inspected before being allowed on...

  8. 77 FR 12602 - Clinical Center Notice of Meeting

    Science.gov (United States)

    2012-03-01

    ....m. Agenda: To review the FY13 Clinical Center Budget. Place: National Institutes of Health, Building... entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport shuttles will...

  9. Brucellosis in Kosovo and Clinical Features of Brucellosis at University clinical center of Kosovo

    OpenAIRE

    Emine Qehaja Buçaj; Edmond Puca; Sadie Namani; Muharem Bajrami; Valbon Krasniqi; Lindita Ajazaj Berisha; Xhevat Jakupi; Bahrie Halili; Dhimiter Kraja

    2015-01-01

    Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about epidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo. Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the diseas...

  10. Extending Medical Center Computer Application to Rural Health Clinics

    OpenAIRE

    Gottfredson, Douglas K.

    1983-01-01

    A paper entitled “A COMPUTER DATA BASE FOR CLINICIANS, MANAGERS AND RESEARCHERS,” presented during the 1981 SCAMC, described the Salt Lake VA Medical Center computer system. Since that time, two Rural Health Clinics each about 150 miles from Salt Lake City were established by the SL VAMC to reduce traveling distances and improve services for Veterans. Although many existing computer applications were available with no modifications, additional software was needed to support unique needs of th...

  11. An eMERGE Clinical Center at Partners Personalized Medicine

    Directory of Open Access Journals (Sweden)

    Jordan W. Smoller

    2016-01-01

    Full Text Available The integration of electronic medical records (EMRs and genomic research has become a major component of efforts to advance personalized and precision medicine. The Electronic Medical Records and Genomics (eMERGE network, initiated in 2007, is an NIH-funded consortium devoted to genomic discovery and implementation research by leveraging biorepositories linked to EMRs. In its most recent phase, eMERGE III, the network is focused on facilitating implementation of genomic medicine by detecting and disclosing rare pathogenic variants in clinically relevant genes. Partners Personalized Medicine (PPM is a center dedicated to translating personalized medicine into clinical practice within Partners HealthCare. One component of the PPM is the Partners Healthcare Biobank, a biorepository comprising broadly consented DNA samples linked to the Partners longitudinal EMR. In 2015, PPM joined the eMERGE Phase III network. Here we describe the elements of the eMERGE clinical center at PPM, including plans for genomic discovery using EMR phenotypes, evaluation of rare variant penetrance and pleiotropy, and a novel randomized trial of the impact of returning genetic results to patients and clinicians.

  12. Clinical spectrum of hypopituitarism in India: A single center experience

    Directory of Open Access Journals (Sweden)

    Abhay Gundgurthi

    2012-01-01

    Full Text Available Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 - 76 years. There were 78 (69% males and 35 females (31%. There were 22 subjects aged ≤18 years (childhood and adolescence and 91 adults (>18 years. Visual disturbances were the most common presenting complaint (33%, though headache was the most common symptom (81%. Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97% was the most common abnormality seen followed by hypothyroidism (83.2%, hypoadrenalism (79.6%, growth hormone deficiency (88.1% of the 42 patients tested, and diabetes insipidus (13.3%. Panhypopituitarism was seen in 104 (92% patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases.

  13. U.S. Ebola Treatment Center Clinical Laboratory Support.

    Science.gov (United States)

    Jelden, Katelyn C; Iwen, Peter C; Herstein, Jocelyn J; Biddinger, Paul D; Kraft, Colleen S; Saiman, Lisa; Smith, Philip W; Hewlett, Angela L; Gibbs, Shawn G; Lowe, John J

    2016-04-01

    Fifty-five hospitals in the United States have been designated Ebola treatment centers (ETCs) by their state and local health authorities. Designated ETCs must have appropriate plans to manage a patient with confirmed Ebola virus disease (EVD) for the full duration of illness and must have these plans assessed through a CDC site visit conducted by an interdisciplinary team of subject matter experts. This study determined the clinical laboratory capabilities of these ETCs. ETCs were electronically surveyed on clinical laboratory characteristics. Survey responses were returned from 47 ETCs (85%). Forty-one (87%) of the ETCs planned to provide some laboratory support (e.g., point-of-care [POC] testing) within the room of the isolated patient. Forty-four (94%) ETCs indicated that their hospital would also provide clinical laboratory support for patient care. Twenty-two (50%) of these ETC clinical laboratories had biosafety level 3 (BSL-3) containment. Of all respondents, 34 (72%) were supported by their jurisdictional public health laboratory (PHL), all of which had available BSL-3 laboratories. Overall, 40 of 44 (91%) ETCs reported BSL-3 laboratory support via their clinical laboratory and/or PHL. This survey provided a snapshot of the laboratory support for designated U.S. ETCs. ETCs have approached high-level isolation critical care with laboratory support in close proximity to the patient room and by distributing laboratory support among laboratory resources. Experts might review safety considerations for these laboratory testing/diagnostic activities that are novel in the context of biocontainment care. PMID:26842705

  14. Nutrient menu planning for clinical research centers. Control by computer.

    Science.gov (United States)

    Wheeler, M L; Wheeler, L A

    1975-10-01

    A computer program has been developed for the dietetic service of the Clinical Research Center at the University of Florida. Presently, it is used in menu planning and nutrient analysis for selective, controlled-nutrient diets and for constant diets. The program is able to compute food weights for a patient-selected daily menu which would satisfy up to twenty-three nutrient constraints and which may be optimized with respect to one or more of these. The principal benefit of the program is a saving in the dietetian's time in calculating the nutrient content of the diet and in planning diets with several constrained nutrients. It is also being used as a teaching resource for dietetic interns and dietetic trainees. PMID:1159257

  15. Clinical characteristics of patients with gastroesophageal reflux disease in several centers of Northwest China

    Institute of Scientific and Technical Information of China (English)

    高麦仓

    2013-01-01

    Objective To investigate the clinical characteristics of gastroesophageal reflux disease (GERD) in several endoscopy centers of Northwest China.Methods From September 2008 to September 2009,a questionnaire survey was carried out in the endoscopy centers of four hospitals

  16. Clinical Marine Toxicology: A European Perspective for Clinical Toxicologists and Poison Centers

    Directory of Open Access Journals (Sweden)

    Luc De Haro

    2013-08-01

    Full Text Available Clinical marine toxicology is a rapidly changing area. Many of the new discoveries reported every year in Europe involve ecological disturbances—including global warming—that have induced modifications in the chorology, behavior, and toxicity of many species of venomous or poisonous aquatic life including algae, ascidians, fish and shellfish. These changes have raised a number of public issues associated, e.g., poisoning after ingestion of contaminated seafood, envenomation by fish stings, and exposure to harmful microorganism blooms. The purpose of this review of medical and scientific literature in marine toxicology is to highlight the growing challenges induced by ecological disturbances that confront clinical toxicologists during the everyday job in the European Poison Centers.

  17. Brucellosis in Kosovo and Clinical Features of Brucellosis at University clinical center of Kosovo

    Directory of Open Access Journals (Sweden)

    Emine Qehaja Buçaj

    2015-12-01

    Full Text Available Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about epidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo. Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the disease, clinical presentations, serological test, serum biochemistry and reatment were collected from hospital medical records. The diagnosis of brucellosis based on clinical and laboratory findings. Results: This descriptive study included 47 patients, who 33 of them (70.2% were males. The mean age was 37.9 ± 19.3 years. The route of transmission of the disease was known in 28 59.5% of them. Direct contact with livestock in 22 (46.8% and ingestion of dairy products in six cases (12.7% were reported as the transmission route. The majority of patients (27 patients, 57.4% were from rural area. The main presenting symptoms were atigue, fever and arthralgia. Osteoarticular manifestations were the common forms of localized disease. Regarding to the therapy, 45 (95.7% of patients were treated with streptomycin and doxycycline for the first three weeks. Conclusion: Human brucellosis is not a common in Kosovo but there is a potential risk. Osteoarticular symptoms were the most common presentation reasons. The most effective and preferred treatment regimen was Streptomycin plus Doxycycline for the first three weeks, and Doxycycline plus Rifampicin thereafter. J Microbiol Infect Dis 2015;5(4: 147-150

  18. 75 FR 57470 - Clinical Center; Proposed Collection; Comment Request; Customer and Other Partners Satisfaction...

    Science.gov (United States)

    2010-09-21

    ...; Customer and Other Partners Satisfaction Surveys SUMMARY: In compliance with the requirement of Section... review and approval. Proposed Collection: Title: Customer and Other Partners Satisfaction Surveys. Type... satisfaction of various Clinical Center customers and other partners with Clinical Center services; (2)...

  19. 77 FR 14805 - Clinical Laboratory Improvement Advisory Committee, Centers for Disease Control and Prevention...

    Science.gov (United States)

    2012-03-13

    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory Committee, Centers for Disease Control and Prevention: Notice of Charter Renewal This gives notice under the... Improvement Advisory Committee, Centers for Disease Control and Prevention (CDC), Department of Health...

  20. Introducing a Method for Achieving Standardization and Harmonization in Clinical and Research Laboratory Centers

    Directory of Open Access Journals (Sweden)

    Dastmardi, M. (MSc

    2014-05-01

    Full Text Available Background and Objective: Proficiency testing schemes as a part of quality system in clinical and research laboratory centers provides the opportunity to evaluate the quality of test results. In this paper, we try to introduce the proficiency testing schemes as a useful method for achieving standardization and homogenization of test results in clinical and research laboratory centers. Keywords: Proficiency Testing Schemes; Quality Improvement; Laboratory Centers

  1. Clinical Validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62): Further Evaluation and Clinical Applications

    Science.gov (United States)

    McAleavey, Andrew A.; Nordberg, Samuel S.; Hayes, Jeffrey A.; Castonguay, Louis G.; Locke, Benjamin D.; Lockard, Allison J.

    2012-01-01

    Self-report instruments of psychological symptoms are increasingly used in counseling centers but rely on rigorous evaluation of their clinical validity. Three studies reported here (total N = 26,886) investigated the validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62; Locke et al., 2011) as an assessment and…

  2. The Use of Clinical Hypnosis in a College Counseling Center.

    Science.gov (United States)

    Cohen, Herbert A.

    This report describes the use of hypnosis at the Hiram College Counseling Center, a counseling technique that has been especially helpful in academic, athletic, and personal improvement areas. The induction techniques of hypnosis are described as well as the use of hyperempiria. The use of hypnosis in improving study habits and alleviating test…

  3. [The Clinical Investigation Centers in France: Whatzat? What for? How does it work?

    OpenAIRE

    Montagne, Olivier; Le Corvoisier, Philippe

    2008-01-01

    International audience For the last 15 years, French university-affiliated hospitals have dramatically modified how biomedical research is conducted in France. Multidisciplinary and technically complex research projects are increasingly difficult to conduct in clinical units. To ensure quality, good clinical practice, and security, platforms dedicated to clinical research with specific staff have been implanted. These units, called Clinical Investigation Centers (CICs), are open to academi...

  4. Problems of clinical dosimetry in Russian radiotherapy centers

    International Nuclear Information System (INIS)

    Due to the general catastrophic situation of radiation oncology in Russia, its outdated equipment and shortage of medical physicists, the clinical dosimetry is also in a very poor state and doesn't meet the modern requirements of the quality assurance in radiotherapy. In Russia there are 140 radiotherapy departments, 100 medical accelerators and 250 gamma apparatus but only 150 clinical dosimeters and 75 dose field analyzers, 90% of which are morally and physically obsolete and do not meet the requirements of the quality assurance. Ten percent of the radiotherapy departments are not equipped with clinical dosimeters at all. There is no national program of quality assurance in radiotherapy. Service for dosimetry equipment calibration is lacking. The national standards and protocols of clinical dosimetry haven't been elaborated. Two-hundred-and-sixty medical physicists work in radiotherapy, 90% of whom have insufficient experience and qualification. Ten percent of radiotherapy departments do not have medical physicists in its staff at all and the rest of the departments face a shortage of medical physicists. The number of medical physicists is not enough to provide the full medical physics service. Qualified medical physicists do not stay long in clinics because of the small salary. As a result of these drawbacks the accuracy of the therapeutic dose delivery to the tumour often achieves 30% instead of the 5% admissible error. This situation leads to high radiation risks, particularly for radiation overdosage or underdosage during the patient's treatment. However, there are no radiation accident statistics in Russia; therefore it's impossible to evaluate them in terms of quantity. Unfortunately, this is the outcome of the lack of the state policy in this field. Neither the Health Ministry nor the Rosatom is concerned about this problem. The only thing that the Health Ministry is undertaking now is the purchase of the new equipment, dosimetry equipment included, for

  5. Cochlear implantation at the ear, nose and throat clinic of the Clinical center of Vojvodina

    Directory of Open Access Journals (Sweden)

    Komazec Zoran

    2007-01-01

    sophisticated audiological evaluation is essential to shorten the time for diagnosing hearing impairment. The results of the investigation performed at the Cochlear Implantation Center of the ENT Clinic in Novi Sad show that cochlear implantation is an effective procedure which should be continued.

  6. Clinical course of ectopic pregnancy: A single-center experience

    OpenAIRE

    Aqueela Ayaz; Sameh Emam; Mian Usman Farooq

    2013-01-01

    OBJECTIVES: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP) in a general hospital. MATERIALS AND METHODS: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome...

  7. A breast cancer clinical registry in an Italian comprehensive cancer center: an instrument for descriptive, clinical, and experimental research.

    Science.gov (United States)

    Baili, Paolo; Torresani, Michele; Agresti, Roberto; Rosito, Giuseppe; Daidone, Maria Grazia; Veneroni, Silvia; Cavallo, Ilaria; Funaro, Francesco; Giunco, Marco; Turco, Alberto; Amash, Hade; Scavo, Antonio; Minicozzi, Pamela; Bella, Francesca; Meneghini, Elisabetta; Sant, Milena

    2015-01-01

    In clinical research, many potentially useful variables are available via the routine activity of cancer center-based clinical registries (CCCR). We present the experience of the breast cancer clinical registry at Fondazione IRCCS "Istituto Nazionale dei Tumori" to give an example of how a CCCR can be planned, implemented, and used. Five criteria were taken into consideration while planning our CCCR: (a) available clinical and administrative databases ought to be exploited to the maximum extent; (b) open source software should be used; (c) a Web-based interface must be designed; (d) CCCR data must be compatible with population-based cancer registry data; (e) CCCR must be an open system, able to be connected with other data repositories. The amount of work needed for the implementation of a CCCR is inversely linked with the amount of available coded data: the fewer data are available in the input databases as coded variables, the more work will be necessary, for information technology staff, text mining analysis, and registrars (for collecting data from clinical records). A cancer registry in a comprehensive cancer center can be used for several research aspects, such as estimate of the number of cases needed for clinical studies, assessment of biobank specimens with specific characteristics, evaluation of clinical practice and adhesion to clinical guidelines, comparative studies between clinical and population sets of patients, studies on cancer prognosis, and studies on cancer survivorship. PMID:25953447

  8. Clinical Perspectives on Colorectal Cancer Screening at Latino-Serving Federally Qualified Health Centers

    Science.gov (United States)

    Coronado, Gloria D.; Petrik, Amanda F.; Spofford, Mark; Talbot, Jocelyn; Do, Huyen Hoai; Taylor, Victoria M.

    2015-01-01

    Purpose: Colorectal cancer is the second most common cause of cancer death in the United States, and rates of screening for colorectal cancer are low. We sought to gather the perceptions of clinic personnel at Latino-serving Federally Qualified Health Centers (operating 17 clinics) about barriers to utilization of screening services for colorectal…

  9. Effectively implementing FDA medication alerts utilizing patient centered medical home clinical pharmacists.

    Science.gov (United States)

    Arenz, Barbara J; Diez, Heidi L; Bostwick, Jolene R; Kales, Helen C; Zivin, Kara; Dalack, Gregory W; Fluent, Tom E; Standiford, Connie J; Stano, Claire; Mi Choe, Hae

    2016-03-01

    FDA medication alerts can be successfully implemented within patient centered medical home (PCMH) clinics utilizing clinical pharmacists. Targeted selection of high-risk patients from an electronic database allows PCMH pharmacists to prioritize assessments. Trusting relationships between PCMH clinical pharmacists and primary care providers facilitates high response rates to pharmacist recommendations. This health system approach led by PCMH pharmacists provides a framework for proactive responses to FDA safety alerts and medication related quality measure improvement. PMID:27001101

  10. Clinical imaging centers: The role of state radiation control programs

    International Nuclear Information System (INIS)

    Radiation Protection is mandated in all 50 states. Regulatory control over naturally occurring and accelerator produced radioactive materials use is exclusively by state government. Although states are independent bodies there are many similarities in their regulatory approaches. Differences in the degree of regulatory control are minimized through use of the Suggested State Regulations for the Control of Radiation and other guidance documents provided by the Conference of Radiation Control Program Directors, Inc. This paper discusses the general requirements to obtain a license and/or registration to produce radioactive material in an accelerator, prepare an imaging agent and/or operate an imaging clinic. These requirements include minimum standards for training and experience of all principal users, equipment specifications, facilities design and construction, specific operating and emergency procedures, radiation protection surveys and monitoring of personnel exposures, ongoing training of staff, and a commitment to ALARA (the philosophy of keeping radiation exposures as low as reasonably achievable). The nature and frequency of routine inspections to ensure adequate protection of workers and the public is also covered

  11. Clinical course of ectopic pregnancy: A single-center experience

    Directory of Open Access Journals (Sweden)

    Aqueela Ayaz

    2013-01-01

    Full Text Available Objectives: The objective was to highlight the frequency, clinical profile, and predisposing factors of ectopic pregnancy (EP in a general hospital. Materials and Methods: This descriptive study was conducted at the Obstetrics and Gynaecology department of Hera General hospital, Makkah, Saudi Arabia, from July 1, 2009 to December 29, 2010. Data were collected on chief medical complaints, sociodemographic characteristics, past obstetrics and gynecological history, management done, and outcome of management. Data were analyzed using Microsoft Office Excel (version 2007. Results: Out of total 7564 pregnancies, 44 (0.58% patients were diagnosed as EP. Out of 44, 22 (50% patients presented within 24 h of onset of symptoms. Mean age was 28 ± 7 years. Multigravida were predominant in 25 (57%, and 21 (48% had gestational age of 6-8 weeks at the time of presentation; the common presenting features were amenorrhea (41, 93.2%, abdominal pain (39, 88.6%, and tenderness (38, 86%. Previous pelvic surgery (13, 29.5%, infertility treatment (11, 25%, and pelvic inflammatory disease (10, 22.7% were the common predisposing factors. Twenty-five (57% presented with ruptured EP and were operated within 24 h, and the remaining were kept under observation till further diagnosis. After confirming the diagnosis, 12/19 underwent laparoscopy, whereas 7/19 received medical treatment. Surgery confirmed fallopian tube pregnancies in 35 (94.5%. No mortality was observed. Conclusion: Previous pelvic surgeries were the major etiological factor for EP. Other factors were infertility treatment and pelvic inflammatory disease. The most common site of EP was fallopian tubes.

  12. Clinical Outcomes of Heart-Lung Transplantation: Review of 10 Single-Center Consecutive Patients

    OpenAIRE

    Yun, Jae Kwang; Choi, Se Hoon; Park, Seung-Il; [...

    2016-01-01

    Background Heart-lung transplantation (HLT) has provided hope to patients with end-stage lung disease and irreversible heart dysfunction. We reviewed the clinical outcomes of 10 patients who underwent heart-lung transplantation at Asan Medical Center. Methods Between July 2010 and August 2014, a total of 11 patients underwent HLT at Asan Medical Center. After excluding one patient who underwent concomitant liver transplantation, 10 patients were enrolled in our study. We reviewed the demograp...

  13. Selecting a commercial clinical information system: an academic medical center's experience.

    OpenAIRE

    Wong, E.T.; Abendroth, T. W.

    1994-01-01

    Choosing a commercial clinical information system to meet the information needs of patient care, research, education, administration, finance, and ongoing changes of the healthcare system of an academic medical center is a challenging task. For the past six months, The Milton S. Hershey Medical Center undertook this task through (i) establishing a task force, (ii) assessing end-user information needs, (iii) understanding future institutional development and strategies, (iv) conceptualizing th...

  14. Significant alterations in reported clinical practice associated with increased oversight of organ transplant center performance.

    Science.gov (United States)

    Schold, Jesse D; Arrington, Charlotte J; Levine, Greg

    2010-09-01

    In the past several years, emphasis on quality metrics in the field of organ transplantation has increased significantly, largely because of the new conditions of participation issued by the Centers for Medicare and Medicaid Services. These regulations directly associate patients' outcomes and measured performance of centers with the distribution of public funding to institutions. Moreover, insurers and marketing ventures have used publicly available outcomes data from transplant centers for business decision making and advertisement purposes. We gave a 10-question survey to attendees of the Transplant Management Forum at the 2009 meeting of the United Network for Organ Sharing to ascertain how centers have responded to the increased oversight of performance. Of 63 responses, 55% indicated a low or near low performance rating at their center in the past 3 years. Respondents from low-performing centers were significantly more likely to indicate increased selection criteria for candidates (81% vs 38%, P = .001) and donors (77% vs 31%, P < .001) as well as alterations in clinical protocols (84% vs 52%, P = .007). Among respondents indicating lost insurance contracts (31%), these differences were also highly significant. Based on respondents' perceptions, outcomes of performance evaluations are associated with significant changes in clinical practice at transplant centers. The transplant community and policy makers should practice vigilance that performance evaluations and regulatory oversight do not inadvertently lead to diminished access to care among viable candidates or decreased transplant volume. PMID:20929114

  15. Clinical Characteristics of Bowel Obstruction in Southern Iran; Results of a Single Center Experience

    OpenAIRE

    Majid Akrami; Ali Ghaeini Hesarooeih; Maryam Barfei; Vahid Zangouri; Zahra Alborzi

    2015-01-01

    Objective: To determine the epidemiological, clinical, laboratory characteristics as well as outcome of 411 patients with bowel obstruction in Southern Iran. Methods: This was a cross-sectional study being performed in Shahid Faghihi hospital of Shiraz between 2006 and 2012. We reviewed the medical charts of the 411 patients with initial diagnosis of bowel obstruction who were admitted to our center during the study period. The patients’ demographic, clinical and laboratory findings as wel...

  16. An Effective Model for a Comprehensive Performance Measurement of Clinical and Research Laboratory Centers

    OpenAIRE

    Ghazinoory S; Assadifard R; Ebrahimi A.; Dastmardi M

    2011-01-01

    Bachground and objectives: Improvement of the effectiveness of services isone of the most important strategies in many clinical and research laboratorycenters. The increased client satisfaction (researchers or patients), resourcedevelopment innovation, efficacy, continuity of services and income are alsothe important strategies of these centers. For achieving these strategies, wecombined the qualitative and the quantitative approaches to evaluate theeffective model based on frameworks of the ...

  17. Clinical patterns and characteristics of uveitis in a tertiary center for uveitis in China

    NARCIS (Netherlands)

    Yang, P.; Zhang, Z.; Zhou, H.; Li, B.; Huang, X.; Gao, Y.; Zhu, L.; Ren, Y.; Klooster, J.; Kijlstra, A.

    2005-01-01

    Purpose: To address the clinical pattern and characteristics of uveitis in a tertiary center for uveitis in China and compare the similarity and difference in the distribution of uveitis entities between China and other countries. Methods: A retrospective study was performed on the patients with uve

  18. Two-center clinical trial of implant-retained mandibular overdentures versus complete dentures - Chewing ability

    NARCIS (Netherlands)

    Geertman, ME; Boerrigter, EM; VantHof, MA; VanWaas, MAJ; vanOort, RP; Boering, G; Kalk, W

    1996-01-01

    This study is a two-center clinical trial with the aim to assess the treatment effects of implant-retained mandibular overdentures versus conventional complete dentures. Treatment had been assigned according to a balanced allocation method. The following criteria were used to enhance the comparabili

  19. Clinical Assessment at College Counseling Centers: The Consultant-on-Duty Model

    Science.gov (United States)

    Schoen, Eva; McKelley, Ryan

    2012-01-01

    The consultant-on-duty (COD) clinical consultation model maximizes efficient use of services, is distinct from other university counseling center (UCC) services, and precedes therapy. This model enables clinicians to ensure optimal fit between client need and type of UCC services provided, including brief therapy. The 4 objectives of the COD model…

  20. Clinical skills training in undergraduate medical education using a student-centered approach

    DEFF Research Database (Denmark)

    Tolsgaard, Martin Grønnebæk

    2013-01-01

    professors. This study showed that student teachers performed as good as or even better than associate professors when teaching simple clinical skills. The second study of this thesis examined how complex clinical skills--such as patient management skills--develop with increasing levels of competence. The...... practicing in pairs significantly out-performed those training alone using RIME-based assessments and that dyad training significantly improved students' confidence in managing future patient encounters. The final study examined students' use of self-directed clinical encounter cards (CECs) based on the RIME...... development initiatives are required before implementation in large and dispersed settings. In conclusion, this thesis demonstrated different aspects of student-centered approaches to clinical skills learning. Whereas self-directed learning is difficult in clinical clerkship, the experimental studies...

  1. An Effective Model for a Comprehensive Performance Measurement of Clinical and Research Laboratory Centers

    Directory of Open Access Journals (Sweden)

    Ghazinoory S

    2011-01-01

    Full Text Available Bachground and objectives: Improvement of the effectiveness of services isone of the most important strategies in many clinical and research laboratorycenters. The increased client satisfaction (researchers or patients, resourcedevelopment innovation, efficacy, continuity of services and income are alsothe important strategies of these centers. For achieving these strategies, wecombined the qualitative and the quantitative approaches to evaluate theeffective model based on frameworks of the Balance Scorecard (BSC and theLaboratory Quality Management Systems (LQMS.Material and Methods: This paper describes the basic steps required fordesigning and developing of a model for performance measurement inlaboratory centers. For model validation, the relationship between the criteria,the strategies and the strategic objectives was evaluated using both the AHPmethod and the evaluation by the experts.Results: Implementation of the above mentioned model, conducted in one ofthe largest Laboratory centers, has resulted in a remarkable enhancement inthe efficiency (22%, profit (33%, level of quality of service (27% and inthe clients’ satisfaction (4%.Conclusion: This research model is a valuable tool for effective evaluationand continuous improvement of the clinical and research laboratory centers.Applying this model leads to increased resource productivity as well as theclients and community satisfaction from the laboratories services.Key words: Laboratory Centers, Performance Management, BalanceScorecard (BSC, Laboratory Quality Management Systems (LQMS

  2. Animal-Assisted Therapy for Patients Undergoing Treatment at NIH Clinical Center | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Therapy Dogs Animal-Assisted Therapy for Patients Undergoing Treatment at NIH Clinical Center ... She and her friendly beagle, Juno, are trusted animal-assisted therapy volunteers. Accompanied by Parker or other Clinical Center ...

  3. Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

    Directory of Open Access Journals (Sweden)

    Shah M

    2013-09-01

    Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

  4. The Counseling Center Assessment of Psychological Symptoms (CCAPS): Merging clinical practice, training, and research.

    Science.gov (United States)

    Youn, Soo Jeong; Castonguay, Louis G; Xiao, Henry; Janis, Rebecca; McAleavey, Andrew A; Lockard, Allison J; Locke, Benjamin D; Hayes, Jeffrey A

    2015-12-01

    The goal of this article is to present information about a standardized multidimensional measure of psychological symptoms, the Counseling Center Assessment of Psychological Symptoms (CCAPS; Locke et al., 2011; Locke, McAleavey, et al., 2012; McAleavey, Nordberg, Hayes, et al., 2012), developed to assess difficulties specific to college students' mental health. We provide (a) a brief review and summary of the psychometric and research support for the CCAPS; (b) examples of the use of the CCAPS for various purposes, including clinical, training, policy, and counseling center advocacy; and (c) implications of the integration of routine outcome monitoring and feedback for the future of training, research, and clinical practice. In particular, the article emphasizes how the assimilation of and symbiotic relationship between research and practice can address the scientist-practitioner gap. PMID:26641373

  5. Setting up a health care quality management system in a multidisciplinary clinical research center

    Directory of Open Access Journals (Sweden)

    L. V. Laktionova

    2014-07-01

    Full Text Available The paper discusses the issues of setting up a quality management system in a multidisciplinary specialized clinical research center. It describes the experience with information technologies used in a prophylactic facility to set up effective out- and inpatient health care control. Measures to optimize work under present-day conditions to upgrade the quality of health care are given using the federal health facility as an example.

  6. Clinical and functional outcomes of the PCCP study : a multi-center prospective study in Italy

    OpenAIRE

    Antonini, G.; Giancola, R.; D. Berruti; E. Blanchietti; Pecchia, P.; Francione, V.; Greco, P.; T.C. Russo; L. Pietrogrande

    2013-01-01

    The standard surgical management of hip fractures is associated with tissue trauma and bleeding which are added to the fracture injury. The percutaneous compression plate (PCCP) is a minimally invasive device that has been demonstrated in previous studies to reduce postoperative complications and blood loss. This prospective, multi-center, observational study assessed clinical and functional outcomes with PCCP as treatment for trochanteric fractures. Patients with a stable or unstable proxima...

  7. Radiation protection in the department of nuclear medicine in the clinical center of Montenegro

    International Nuclear Information System (INIS)

    Radiation protection in the Department of nuclear medicine in the Clinical center of Montenegro - Podgorica, is presented. Particularly, environment irradiation is discussed and dose rate is calculated in dependence on source distance. A last monthly doses measurement for six employees in this Department showed doses of 50 μSv, 53 μSv, 49 μSv, 62 μSv, 111 μSv and 118 μSv

  8. Implementation of Epic Beaker Clinical Pathology at an academic medical center

    OpenAIRE

    Krasowski, Matthew D.; Joseph D Wilford; Wanita Howard; Susan K Dane; Scott R Davis; Karandikar, Nitin J.; Blau, John L; Bradley A Ford

    2016-01-01

    Background: Epic Beaker Clinical Pathology (CP) is a relatively new laboratory information system (LIS) operating within the Epic suite of software applications. To date, there have not been any publications describing implementation of Beaker CP. In this report, we describe our experience in implementing Beaker CP version 2012 at a state academic medical center with a go-live of August 2014 and a subsequent upgrade to Beaker version 2014 in May 2015. The implementation of Beaker CP was concu...

  9. The Epidemiology of Upper Respiratory Infections at a Tertiary Care Center: Prevalence, Seasonality, and Clinical Symptoms

    OpenAIRE

    2014-01-01

    Improved multiplex PCR detection methods are facilitating the correlation of the etiology of respiratory tract infections with specific symptoms or clinical manifestations. We conducted a retrospective analysis of the incidence of respiratory pathogens and initial symptoms in 1,286 patients at a tertiary care center tested by multiplex respiratory pathogen PCR from July 1, 2012, to June 30, 2013. Rhinovirus/enterovirus (Rhino/Entero) infections were the most prevalent (25.4%) followed by resp...

  10. MENTOR TRAINING WITHIN ACADEMIC HEALTH CENTERS WITH CLINICAL AND TRANSLATIONAL SCIENCE AWARDS

    OpenAIRE

    Abedin, Zainab; Rebello, Tahilia J.; Richards, Boyd F.; Pincus, Harold Alan

    2013-01-01

    Multiple studies highlight the benefits of effective mentoring in academic medicine. Thus, we sought to quantify and characterize the mentoring practices at academic health centers (AHCs) with Clinical and Translational Science Awards (CTSA). Here we report findings pertaining specifically to mentor training at the level of the KL2 mentored award program, and at the broader institutional level. We found only 4 AHCs did not provide any form of training. One-time orientation was most prevalent ...

  11. Person-centered approaches in medicine: clinical tasks, psychological paradigms, and postnonclassic perspective

    Directory of Open Access Journals (Sweden)

    Mezzich J.E.

    2013-01-01

    Full Text Available The article aims to demonstrate advances in methodological means suggested by Vygotsky’s cultural-historical concept in association with a theoretical model of a Person-centered diagnosis and practical use of the construct for clinical psychology and medicine. This, to a greater extent, arises from the fact that the cultural-historical concept (due to its humanistic nature and epistemological content is closely related to the person-centered integrative approach. But for all that the concept corresponds to the ideals of postnonclassical model of scientific rationality with a number of ‘key’ features. Above all it manifests its “methodological maturity” to cope with open self-developing systems, which is most essential at the modern stage of scientific knowledge.The work gives consideration to ‘defining pillars’ of Person-centered approach in modern medicine, to humanistic traditions of the Russian clinical school, and high prospects in diagnostics of such mental constructs as “subjective pattern of disease” and “social situation of personal development in disease” - within the context of person-centered integrative diagnosis.This article discusses the need for implementation a cross-cultural study of subjective pattern of disease and its correlation with a particular “social situation of personality development under disease conditions”. It aims at development and substantiation of the model of person-centered integrative approach, enhancement of its diagnostic scope and, consequently, improvement of the model of person-centered care in modern psychiatry and medicine.

  12. The Radiological Physics Center: 40 years of vigilance and quality assurance for NCI sponsored clinical trials

    International Nuclear Information System (INIS)

    The RPC was established in 1968 to contribute to the development, conduct, and QA of multi-institutional cooperative group clinical trials. One key aspect to the RPC's function is that it operates as an independent quality assurance office for multi-institutional cooperative group clinical trials. The RPC grant was originally awarded through a competition sponsored by the AAPM. In 1967, a memorandum of agreement was reached between the AAPM and the Committee for Radiation Therapy Studies (CRTS) for clinical radiation dosimetry related to inter-institutional studies. The agreement called for the establishment of a center of operations for the implementation of this scientific program, in other words, the creation of a Radiological Physics Center. The RPC has been funded continuously since 1968 under Dr. Shalek's guidance (1968-1985), followed by Dr. William Hanson (1985-2001) and currently by Dr. Geoffrey Ibbott (2001-present). The RPC currently monitors 1768 institutions that participate in cooperative group clinical trials sponsored by the National Cancer Institute (NCI). These institutions are located primarily in the USA and Canada, but also include participants from 30 other countries. Within the 1768 institutions, there are over 3300 megavoltage therapy machines that are monitored by the RPC QA program. In 1999, the RPC joined with several other QA offices to form the Advanced Technology Consortium (ATC). The role of the ATC is to support the development and conduct of advanced technology clinical trials, to facilitate communications among the four QA offices and to reduce duplication of effort among the quality assurance offices. The four major components of the RPC's QA program are: 1) the remote TLD audit of machine calibration, 2) on-site dosimetry review visits, 3) credentialing for advanced technology clinical trials, and 4) review of patient treatment records

  13. Improved quality monitoring of multi-center acupuncture clinical trials in China

    Directory of Open Access Journals (Sweden)

    Zheng Hui

    2009-12-01

    Full Text Available Abstract Background In 2007, the Chinese Science Division of the State Administration of Traditional Chinese Medicine(TCM convened a special conference to discuss quality control for TCM clinical research. Control and assurance standards were established to guarantee the quality of clinical research. This paper provides practical guidelines for implementing strict and reproducible quality control for acupuncture randomized controlled trials (RCTs. Methods A standard quality control program (QCP was established to monitor the quality of acupuncture trials. Case report forms were designed; qualified investigators, study personnel and data management personnel were trained. Monitors, who were directly appointed by the project leader, completed the quality control programs. They guaranteed data accuracy and prevented or detected protocol violations. Clinical centers and clinicians were audited, the randomization system of the centers was inspected, and the treatment processes were audited as well. In addition, the case report forms were reviewed for completeness and internal consistency, the eligibility and validity of the patients in the study was verified, and data was monitored for compliance and accuracy. Results and discussion The monitors complete their reports and submit it to quality assurance and the sponsors. Recommendations and suggestions are made for improving performance. By holding regular meetings to discuss improvements in monitoring standards, the monitors can improve quality and efficiency. Conclusions Supplementing and improving the existed guidelines for quality monitoring will ensure that large multi-centre acupuncture clinical trials will be considered as valid and scientifically stringent as pharmaceutical clinical trials. It will also develop academic excellence and further promote the international recognition of acupuncture.

  14. Anticipated Ethics and Regulatory Challenges in PCORnet: The National Patient-Centered Clinical Research Network.

    Science.gov (United States)

    Ali, Joseph; Califf, Robert; Sugarman, Jeremy

    2016-01-01

    PCORnet, the National Patient-Centered Clinical Research Network, seeks to establish a robust national health data network for patient-centered comparative effectiveness research. This article reports the results of a PCORnet survey designed to identify the ethics and regulatory challenges anticipated in network implementation. A 12-item online survey was developed by leadership of the PCORnet Ethics and Regulatory Task Force; responses were collected from the 29 PCORnet networks. The most pressing ethics issues identified related to informed consent, patient engagement, privacy and confidentiality, and data sharing. High priority regulatory issues included IRB coordination, privacy and confidentiality, informed consent, and data sharing. Over 150 IRBs and five different approaches to managing multisite IRB review were identified within PCORnet. Further empirical and scholarly work, as well as practical and policy guidance, is essential if important initiatives that rely on comparative effectiveness research are to move forward. PMID:26192996

  15. Standardized ultrasound evaluation of carotid stenosis for clinical trials: University of Washington Ultrasound Reading Center

    Directory of Open Access Journals (Sweden)

    Beach Kirk W

    2010-09-01

    Full Text Available Abstract Introduction Serial monitoring of patients participating in clinical trials of carotid artery therapy requires noninvasive precision methods that are inexpensive, safe and widely available. Noninvasive ultrasonic duplex Doppler velocimetry provides a precision method that can be used for recruitment qualification, pre-treatment classification and post treatment surveillance for remodeling and restenosis. The University of Washington Ultrasound Reading Center (UWURC provides a uniform examination protocol and interpretation of duplex Doppler velocity measurements. Methods Doppler waveforms from 6 locations along the common carotid and internal carotid artery path to the brain plus the external carotid and vertebral arteries on each side using a Doppler examination angle of 60 degrees are evaluated. The UWURC verifies all measurements against the images and waveforms for the database, which includes pre-procedure, post-procedure and annual follow-up examinations. Doppler angle alignment errors greater than 3 degrees and Doppler velocity measurement errors greater than 0.05 m/s are corrected. Results Angle adjusted Doppler velocity measurements produce higher values when higher Doppler examination angles are used. The definition of peak systolic velocity varies between examiners when spectral broadening due to turbulence is present. Examples of measurements are shown. Discussion Although ultrasonic duplex Doppler methods are widely used in carotid artery diagnosis, there is disagreement about how the examinations should be performed and how the results should be validated. In clinical trails, a centralized reading center can unify the methods. Because the goals of research examinations are different from those of clinical examinations, screening and diagnostic clinical examinations may require fewer velocity measurements.

  16. Psychological Center as a Foundation for the Practical Training of Clinical psychologists at the Saint-Petersburg State University

    Directory of Open Access Journals (Sweden)

    Ekaterina A Burina

    2016-05-01

    In overall, the Psychological Center with its long-term experience of preparation and practical skills training for the students of the Clinical Psychology specialty, has proven its necessity, relevance, and effectiveness.

  17. Epidemiological, Clinical and Paraclinical Study of Hydatid Cysts in Three Educational Medical Centers in 10 Years

    Directory of Open Access Journals (Sweden)

    Simindokht Shoaee

    2016-01-01

    Full Text Available Background: Echinococcosis or hydatidosis, caused by the larval stage of Echinococcus granulosus (E. granulosus, is an important public health problem in many areas of the world  and  Iran is a country of endemic situation for hydatidosis In the present study, we evaluated epidemiological, complications and clinical characteristics of hydatidosis at three University Medical Centers in Tehran over a 10-year period.Materials and Methods: This is a descriptive cross-sectional study performed in patients with hydatid cysts. Information about age, gender, number of cysts, organ involvement, morbidity and mortality and relapse were collected from medical records of hydatid patients. Paraclinic information such as CT Scan, MRI, ultrasound, complete blood count, pathological diagnosis and complication of disease were collected.Results: Overall, 81 patients, 35 (43.2% male and 46 (56.8% female, who were diagnosed as having hydatid cyst by clinical and radiological findings, with pathologic documentation were studied in three university medical center registries over a 10-year period (2003- 2012 in Tehran. Fourteen patients (17% of cases had complications resulting from this disease. Patients' age ranged from 5 to 86 years, and the peak prevalence of the disease was between 20 and 40 (34% of cases.Conclusion: Iran  is a country of endemic situation for hydatidosis. Prevalence rate of hydatidosis in Iran was reported to be 0.61-2 in 100000 populations. The highest  rate of infection and complications were in patients of 20-40 years age. Clinical examination revealed that abdominal pain was the most common complaint and was present in 51.7% of the cases. Other most common complain were cough, abdominal mass, dyspnea, icterus, chest pain, dyspepsia, back pain and seizure; and it was result of occupying effect of cysts in organs. This is similar with previous studies in Iran

  18. Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

    International Nuclear Information System (INIS)

    The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

  19. Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

    2010-10-15

    The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

  20. Supporting Clinical Cognition: A Human-Centered Approach to a Novel ICU Information Visualization Dashboard.

    Science.gov (United States)

    Faiola, Anthony; Srinivas, Preethi; Duke, Jon

    2015-01-01

    Advances in intensive care unit bedside displays/interfaces and electronic medical record (EMR) technology have not adequately addressed the topic of visual clarity of patient data/information to further reduce cognitive load during clinical decision-making. We responded to these challenges with a human-centered approach to designing and testing a decision-support tool: MIVA 2.0 (Medical Information Visualization Assistant, v.2). Envisioned as an EMR visualization dashboard to support rapid analysis of real-time clinical data-trends, our primary goal originated from a clinical requirement to reduce cognitive overload. In the study, a convenience sample of 12 participants were recruited, in which quantitative and qualitative measures were used to compare MIVA 2.0 with ICU paper medical-charts, using time-on-task, post-test questionnaires, and interviews. Findings demonstrated a significant difference in speed and accuracy with the use of MIVA 2.0. Qualitative outcomes concurred, with participants acknowledging the potential impact of MIVA 2.0 for reducing cognitive load and enabling more accurate and quicker decision-making. PMID:26958190

  1. Catheter-associated urinary tract infections in Clinical Center of Banja Luka

    Directory of Open Access Journals (Sweden)

    Verhaz Antonija

    2003-01-01

    Full Text Available Introduction Catheter-associated urinary tract infections are the most common nosocomial infections of the urinary tract, and among the most common nosocomial infections in general. The major problems of these infections include antibiotic resistance and enormous direct and indirect cost of treatment. Material and methods A retrospective study on major causes of infections and antibiotic resistance was conducted at four clinics of the Clinical Center of Banja Luka. An anonymous questionnaire was distributed to nursing staff dealing with urinary catheters in order to get an overview of their clinical performance. Results The results showed that in 89% of cases (out of 198 patients with developed catheter-associated urinary tract infection infections were caused by gram-negative bacteria, in 7% by gram-positive bacteria and in 4% by Candida. The most common bacteria were: Escherichia coli (33.6%, Pseudomonas aeruginosa (14.1%, Proteus mirabilis (13.3%, and Enterobacter (10.5%. Majority of bacteria presented with extremely high resistance (72-100% to ampicillin, gentamycin and cotrimoxazole, and in some cases a significant resistance to ciprofloxacine, nalidixic acid, ceftriaxone and ceftazidime. The questionnaire showed that nursing staff did not follow guidelines for medical care of patients with urinary catheters. Conclusion It can be concluded that poor hygienic and epidemiological conditions, as well as irrational use of antibiotics contribute to uncontrolled development of urinary tract infections in catheterized patients.

  2. NIH Clinical Center: There’s No Other Hospital Like It | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... help advance medical knowledge that leads to new cures, therapies, and treatments.” Currently, there are about 1,500 clinical research studies in progress at the NIH Clinical Center. About half are studies of the natural history of disease, especially rare diseases, which often ...

  3. Readability of informed consent forms in clinical trials conducted in a skin research center.

    Science.gov (United States)

    Samadi, Aniseh; Asghari, Fariba

    2016-01-01

    Obtaining informed consents is one of the most fundamental principles in conducting a clinical trial. In order for the consent to be informed, the patient must receive and comprehend the information appropriately. Complexity of the consent form is a common problem that has been shown to be a major barrier to comprehension for many patients. The objective of this study was to assess the readability of different templates of informed consent forms (ICFs) used in clinical trials in the Center for Research and Training in Skin Diseases and Leprosy (CRTSDL), Tehran, Iran. This study was conducted on ICFs of 45 clinical trials of the CRTSDL affiliated with Tehran University of Medical Sciences. ICFs were tested for reading difficulty, using the readability assessments formula adjusted for the Persian language including the Flesch-Kincaid reading ease score, Flesch-Kincaid grade level, and Gunning fog index. Mean readability score of the whole text of ICFs as well as their 7 main information parts were calculated. The mean ± SD Flesch Reading Ease score for all ICFs was 31.96 ± 5.62 that is in the difficult range. The mean ± SD grade level was calculated as 10.71 ± 1.8 (8.23-14.09) using the Flesch-Kincaid formula and 14.64 ± 1.22 (12.67-18.27) using the Gunning fog index. These results indicate that the text is expected to be understandable for an average student in the 11(th) grade, while the ethics committee recommend grade level 8 as the standard readability level for ICFs. The results showed that the readability scores of ICFs assessed in our study were not in the acceptable range. This means they were too complex to be understood by the general population. Ethics committees must examine the simplicity and readability of ICFs used in clinical trials. PMID:27471590

  4. Incorporating the principles of the patient- centered medical home into a student-run free clinic

    Directory of Open Access Journals (Sweden)

    Riddle MC

    2014-09-01

    Full Text Available Megan C Riddle,1,* Jiahui Lin,3,* Jonathan B Steinman,2 Joshua D Salvi,2 Margaret M Reynolds,3 Anne S Kastor,3,† Christina Harris,4 Carla Boutin-Foster3 1Department of Psychiatry and Behavioral Sciences, University of Washington, 2Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD–PhD Program, 3Department of Internal Medicine, Weill Cornell Medical College, New York, NY, 4Department of Medicine, Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, LA, USA *These authors contributed equally to this work †Anne S Kastor passed away on July 5, 2013. Abstract: As the health care delivery landscape changes, medical schools must develop creative strategies for preparing future physicians to provide quality care in this new environment. Despite the growing prominence of the patient-centered medical home (PCMH as an effective model for health care delivery, few medical schools have integrated formal education on the PCMH into their curricula. Incorporating the PCMH model into medical school curricula is important to ensure that students have a comprehensive understanding of the different models of health care delivery and can operate effectively as physicians. The authors provide a detailed description of the process by which the Weill Cornell Community Clinic (WCCC, a student-run free clinic, has integrated PCMH principles into a service-learning initiative. The authors assessed patient demographics, diagnoses, and satisfaction along with student satisfaction. During the year after a PCMH model was adopted, 112 students and 19 licensed physicians volunteered their time. A review of the 174 patients seen from July 2011 to June 2012 found that the most common medical reasons for visits included management of hypertension, hyperlipidemia, diabetes, gastrointestinal conditions, arthritis, anxiety, and depression. During the year after the adoption of the PCMH model, 87

  5. Clinical analysis of pediatric patients who visited Masan Samsung Emergency Center

    Directory of Open Access Journals (Sweden)

    Jae Wook Yoo

    2010-03-01

    Full Text Available Purpose : Through a clinical and retrospective analysis of pediatric patients who visited the Regional Emergency Medical Center of Masan Samsung Hospital from January 2007 to December 2008, we characterized pediatric and adolescent emergency patients to improve emergency care in future. Methods : We reviewed the medical records of 14,065 pediatric patients below 19 years of age. Results : The male to female ratio was 1.5:1, and the most common age group was less than 3 years (49.6%. The peak month was May (10.0%, the peak day of the week was Sunday (24.7%, and the peak time of day was 20:00&#8211;20:59 (8.5%. There was no difference in the number of visits per day based on weather (sunny, rain [below 10 mm per day], snow, and fog or daily temperature difference; however, visits increased on sandy, dusty days and decreased on rainy days with more than 10 mm of rain per day. Based on the international classification of disease (ICD-10 system, the most common disease code was code R (symptoms, sign, and abnormal clinical laboratory finding (31.5%, and the most common symptom was fever (13.1%. Final outcomes were discharged (73.8%, admitted (25.7%, transferred (0.4%, and expired (0.1%. In adolescent patients aged 15&#8211;19 years, the most common disease code was Injury & Poisoning (code S&T, 36.9%; the most common symptom was abdominal pain (9.6%. Conclusion : Pediatric patients visiting the emergency center were most likely to be male and under 3 years of age and to visit between 20:00 and 21:00 on Sundays and in May, and the most common symptom was fever. Differences between adolescents and pediatric patients showed that adolescents had a higher visiting rate with abdominal pain and a larger temperature difference.

  6. Implementation of Epic Beaker Clinical Pathology at an academic medical center

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski

    2016-01-01

    Full Text Available Background: Epic Beaker Clinical Pathology (CP is a relatively new laboratory information system (LIS operating within the Epic suite of software applications. To date, there have not been any publications describing implementation of Beaker CP. In this report, we describe our experience in implementing Beaker CP version 2012 at a state academic medical center with a go-live of August 2014 and a subsequent upgrade to Beaker version 2014 in May 2015. The implementation of Beaker CP was concurrent with implementations of Epic modules for revenue cycle, patient scheduling, and patient registration. Methods: Our analysis covers approximately 3 years of time (2 years preimplementation of Beaker CP and roughly 1 year after using data summarized from pre- and post-implementation meetings, debriefings, and the closure document for the project. Results: We summarize positive aspects of, and key factors leading to, a successful implementation of Beaker CP. The early inclusion of subject matter experts in the design and validation of Beaker workflows was very helpful. Since Beaker CP does not directly interface with laboratory instrumentation, the clinical laboratories spent extensive preimplementation effort establishing middleware interfaces. Immediate challenges postimplementation included bar code scanning and nursing adaptation to Beaker CP specimen collection. The most substantial changes in laboratory workflow occurred with microbiology orders. This posed a considerable challenge with microbiology orders from the operating rooms and required intensive interventions in the weeks following go-live. In postimplementation surveys, pathology staff, informatics staff, and end-users expressed satisfaction with the new LIS. Conclusions: Beaker CP can serve as an effective LIS for an academic medical center. Careful planning and preparation aid the transition to this LIS.

  7. An audit of consent refusals in clinical research at a tertiary care center in India

    Directory of Open Access Journals (Sweden)

    S J Thaker

    2015-01-01

    Full Text Available Background and Rationale: Ensuring research participants′ autonomy is one of the core ethical obligations of researchers. This fundamental principle confers on every participant the right to refuse to take part in clinical research, and the measure of the number of consent refusals could be an important metric to evaluate the quality of the informed consent process. This audit examined consent refusals among Indian participants in clinical studies done at our center. Materials and Methods: The number of consent refusals and their reasons in 10 studies done at our center over a 5-year period were assessed. The studies were classified by the authors according to the type of participant (healthy vs patients, type of sponsor (investigator-initiated vs pharmaceutical industry, type of study (observational vs interventional, level of risk [based on the Indian Council of Medical Research (ICMR "Ethical Guidelines for Biomedical Research on Human Participants"], available knowledge of the intervention being studied, and each patient′s disease condition. Results: The overall consent refusal rate was 21%. This rate was higher among patient participants [23.8% vs. healthy people (14.9%; P = 0.002], in interventional studies [33.6% vs observational studies (7.5%; P < 0.0001], in pharmaceutical industry-sponsored studies [34.7% vs investigator-initiated studies (7.2%; P < 0.0001], and in studies with greater risk (P < 0.0001. The most common reasons for consent refusals were multiple blood collections (28%, inability to comply with the study protocol (20%, and the risks involved (20%. Conclusion: Our audit suggests the adequacy and reasonable quality of the informed consent process using consent refusals as a metric.

  8. Autoverification in a core clinical chemistry laboratory at an academic medical center

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski

    2014-01-01

    Full Text Available Background: Autoverification is a process of using computer-based rules to verify clinical laboratory test results without manual intervention. To date, there is little published data on the use of autoverification over the course of years in a clinical laboratory. We describe the evolution and application of autoverification in an academic medical center clinical chemistry core laboratory. Subjects and Methods: At the institution of the study, autoverification developed from rudimentary rules in the laboratory information system (LIS to extensive and sophisticated rules mostly in middleware software. Rules incorporated decisions based on instrument error flags, interference indices, analytical measurement ranges (AMRs, delta checks, dilution protocols, results suggestive of compromised or contaminated specimens, and ′absurd′ (physiologically improbable values. Results: The autoverification rate for tests performed in the core clinical chemistry laboratory has increased over the course of 13 years from 40% to the current overall rate of 99.5%. A high percentage of critical values now autoverify. The highest rates of autoverification occurred with the most frequently ordered tests such as the basic metabolic panel (sodium, potassium, chloride, carbon dioxide, creatinine, blood urea nitrogen, calcium, glucose; 99.6%, albumin (99.8%, and alanine aminotransferase (99.7%. The lowest rates of autoverification occurred with some therapeutic drug levels (gentamicin, lithium, and methotrexate and with serum free light chains (kappa/lambda, mostly due to need for offline dilution and manual filing of results. Rules also caught very rare occurrences such as plasma albumin exceeding total protein (usually indicative of an error such as short sample or bubble that evaded detection and marked discrepancy between total bilirubin and the spectrophotometric icteric index (usually due to interference of the bilirubin assay by immunoglobulin (Ig M monoclonal

  9. Clinical and epidemiological characteristics of patients with uveitis in an emergency eye care center in Brazil

    Directory of Open Access Journals (Sweden)

    Eduardo Nery Rossi Camilo

    2014-01-01

    Full Text Available Purpose: To analyze the clinical and epidemiological characteristics of patients with uveitis in an emergency eye care center. Methods: We conducted a prospective, observational study of patients with active uveitis admitted between May 2012 and July 2012 to an emergency eye care center. Results: The majority of patients were male (63.2%, with a mean age of 43.2 years; 66.2% patients were of mixed ethnicity, 22.5% were Caucasian, and 11.3% were black. Anterior uveitis was observed in 70.1% patients, posterior uveitis in 26.5%, and panuveitis in 3.4%; no patient was diagnosed with intermediate uveitis. All patients had a sudden and acute presentation. The most frequent symptoms were ocular pain (76.9%, redness (59.8%, and visual blurring (46.2%. The majority of patients had unilateral disease (94.9% with a mean symptom duration of 6.2 days. Diffuse and anterior uveitis were associated with ocular pain (p<0.001. Scotomata and floaters were more frequent in patients with posterior uveitis (p=0.003 and p=0.016, respectively. Patients with anterior uveitis presented with better visual acuity (p=0.025. Granulomatous keratotic precipitates were more frequent in patients with posterior uveitis (p=0.038. An etiological diagnosis based on the evaluation at the emergency center was made in 45 patients (38.5%. Conclusions: Acute anterior uveitis was the most frequent form of uveitis. Initial patient evaluation provided sufficient information for deciding primary therapy and aided in arriving at an etiological diagnosis in a considerable number of patients.

  10. DICOM for Clinical Research: PACS-Integrated Electronic Data Capture in Multi-Center Trials.

    Science.gov (United States)

    Haak, Daniel; Page, Charles-E; Reinartz, Sebastian; Krüger, Thilo; Deserno, Thomas M

    2015-10-01

    Providing surrogate endpoints in clinical trials, medical imaging has become increasingly important in human-centered research. Nowadays, electronic data capture systems (EDCS) are used but binary image data is integrated insufficiently. There exists no structured way, neither to manage digital imaging and communications in medicine (DICOM) data in EDCS nor to interconnect EDCS with picture archiving and communication systems (PACS). Manual detours in the trial workflow yield errors, delays, and costs. In this paper, requirements for a DICOM-based system interconnection of EDCS and research PACS are analysed. Several workflow architectures are compared. Optimized for multi-center trials, we propose an entirely web-based solution integrating EDCS, PACS, and DICOM viewer, which has been implemented using the open source projects OpenClinica, DCM4CHEE, and Weasis, respectively. The EDCS forms the primary access point. EDCS to PACS interchange is integrated seamlessly on the data and the context levels. DICOM data is viewed directly from the electronic case report form (eCRF), while PACS-based management is hidden from the user. Data privacy is ensured by automatic de-identification and re-labelling with study identifiers. Our concept is evaluated on a variety of 13 DICOM modalities and transfer syntaxes. We have implemented the system in an ongoing investigator-initiated trial (IIT), where five centers have recruited 24 patients so far, performing decentralized computed tomography (CT) screening. Using our system, the chief radiologist is reading DICOM data directly from the eCRF. Errors and workflow processing time are reduced. Furthermore, an imaging database is built that may support future research. PMID:26001521

  11. Clinical and experimental studies of multiple sclerosis in Russia: experience of the leading national research centers

    Directory of Open Access Journals (Sweden)

    Zavalishin IA

    2015-08-01

    Full Text Available Igor A Zavalishin,1 Alexey A Belogurov Jr,2–4 Yakov A Lomakin,2 Natalia A Ponomarenko,2 Sofia N Morozova,1 Zinaida A Suslina,1,† Michael A Piradov,1 Sergey N Illarioshkin,1 Alexander G Gabibov2–5 1Research Center of Neurology, 2Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, 3Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, 4Institute of Gene Biology, RAS, 5Chemistry Department, Moscow State University, Moscow, Russia †Dr Zinaida A Suslina passed away on June 22, 2014 Abstract: Mechanisms of axonal damage and adaptive capacity in multiple sclerosis (MS, including cortical reorganization, have been actively studied in recent years. The lack of regenerative capabilities and the irreversibility of neurodegeneration in MS are critical factors for the optimization of MS treatment. In this study, we present the results of clinical and basic studies in the field of MS by two leading Russian centers. Clinical and neuroimaging correlations show that spinal damage in MS is accompanied by functional reorganization of the cerebral cortex, which is determined not only by the efferent component but also by the afferent component. Comparative analysis of MS treatment with both interferon β1b (IFN-β1b and IFN-β1a at a dosage of 22 µg for 3 years through subcutaneous administration and glatiramer acetate showed equally high efficiency in reducing the number of exacerbations in relapsing-remitting MS and secondary-progressive MS. We demonstrate a reduced risk of disability in relapsing-remitting MS and secondary-progressive MS patients in all groups treated with IFN-β1 and glatiramer acetate. MS appears to be a disease that would greatly benefit from the development of personalized therapy; thus, adequate molecular predictors of myelin degradation are greatly needed. Therefore, novel ideas related to the viral hypothesis of the etiology of MS and new targets for

  12. New insights into the clinical evaluation of hereditary transthyretin amyloidosis patients: a single center's experience

    Directory of Open Access Journals (Sweden)

    Suhr OB

    2012-08-01

    Full Text Available Ole B Suhr,1 Sandra Gustavsson,1 Victoria Heldestad,2 Rolf Hörnsten,3 Per Lindqvist,1 Erik Nordh,2 Urban Wiklund41Department of Public Health and Clinical Medicine, 2Department of Pharmacology and Clinical Neuroscience, 3Department of Surgical and Perioperative Sciences, Clinical Physiology, Heart Centre, 4Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, SwedenAbstract: Over the last decade, new medical treatment modalities have emerged based on increased insights into amyloid formation. With the increased possibilities for treatment of amyloidosis caused by transthyretin (TTR amyloid deposits comes the need for diagnostic procedures for early diagnosis and better tools to follow disease progression. This is of particular importance in clinical trials evaluating the efficacy of new treatments. Until recently, the treatment of TTR amyloidosis (ATTR was based solely on liver transplantation, a procedure that has halted disease progression in many patients. Liver transplantation has been especially effective in patients under the age of 50 years carrying the TTR V30M mutation, whereas the outcome of the procedure has been variable for others, particularly elderly male patients and those carrying a non-V30M mutation. This review concentrates on new insights derived from our center's experience with liver transplantation, how to implement this experience in evaluation of new treatment modalities for ATTR, and how to facilitate early diagnosis of neuropathy with easily available diagnostic tools. Attention has focused on manifestations of the disease that involve the heart and the peripheral nervous system; change in peripheral nerve function has been the primary endpoint in two controlled clinical trials, one finished and one ongoing. New insights into the amyloid formation process and the lessons learned from liver transplantation give the opportunity to design potentially effective treatment modalities for ATTR

  13. Demographic and clinical profile of substance abusing women seeking treatment at a de-addiction center in north India

    OpenAIRE

    Naresh Nebhinani; Siddharth Sarkar; Sunil Gupta; Surendra Kumar Mattoo; Debasish Basu

    2013-01-01

    Background: In the recent decades increasing number of women have been seeking deaddiction services. Despite that the report data is very limited from India. Objectives: The present research aimed to study the demographic and clinical profile of women seeking deaddiction treatment at a tertiary care center in North India. Materials and Methods: Retrospective structured chart review of 100 women substance abusers seeking treatment at a deaddiction center between September 1978 and December 201...

  14. The development of a telemedical cancer center within the Veterans Affairs Health Care System: a report of preliminary clinical results.

    Science.gov (United States)

    Billingsley, Kevin G; Schwartz, David L; Lentz, Susan; Vallières, Eric; Montgomery, R Bruce; Schubach, William; Penson, David; Yueh, Bevan; Chansky, Howard; Zink, Claudia; Parayno, Darla; Starkebaum, Gordon

    2002-01-01

    In order to optimize the delivery of multidisciplinary cancer care to veterans, our institution has developed a regional cancer center with a telemedical outreach program. The objectives of this report are to describe the organization and function of the telemedical cancer center and to report our early clinical results. The Veterans Affairs Health Care System is organized into a series of integrated service networks that serve veterans within different areas throughout the United States. Within Veterans Integrated Service Network 20 (Washington, Alaska, Idaho, Oregon) we have developed a regional cancer center with telemedicine links to four outlying facilities within the service area. The telemedical outreach effort functions through the use of a multidisciplinary telemedicine tumor board. The tumor board serves patients in outlying facilities by providing comprehensive, multidisciplinary consultation for the complete range of malignancies. For individuals who do require referral to the cancer center, the tumor board serves to coordinate the logistical and clinical details of the referral process. This program has been in existence for 1 year. During that time 85 patients have been evaluated in the telemedicine tumor board. Sixty-two percent of the patients were treated at their closest facility; 38% were referred to the cancer center for treatment and/or additional diagnostic studies. The patients' diagnoses included the entire clinical spectrum of malignant disease. Preliminary clinical results demonstrate the program is feasible and it improves access to multidisciplinary cancer care. Potential benefits include improved referral coordination and minimization of patient travel and treatment delays. PMID:12020412

  15. Clinical Characteristics of Bowel Obstruction in Southern Iran; Results of a Single Center Experience

    Directory of Open Access Journals (Sweden)

    Majid Akrami

    2015-01-01

    Full Text Available Objective: To determine the epidemiological, clinical, laboratory characteristics as well as outcome of 411 patients with bowel obstruction in Southern Iran. Methods: This was a cross-sectional study being performed in Shahid Faghihi hospital of Shiraz between 2006 and 2012. We reviewed the medical charts of the 411 patients with initial diagnosis of bowel obstruction who were admitted to our center during the study period. The patients’ demographic, clinical and laboratory findings as well as their management and outcome was recorded in data gathering forms. The data were then analyzed according to the outcome and clinical characteristics. Results: Among the 411 patients with initial diagnosis of bowel obstruction, 253 (61.5% were men and 158 (38.5% were women. The mean age of the patients was 48.2±19.7 years. Besides, 73.6% were observed and 26.4% were operated. Those who were operated had those who underwent operation had significantly lower frequency of obstipation (28.1% vs. 71.9%; p=0.045 and abdominal distention (32.3% vs. 67.7%; p=0.007. Intraoperative findings included adhesion band formation in 50 (48.1%, mass 18 (17.3%, and hernia 7 (6.7%. We found that the frequency of malignancy was significantly higher in those who were managed conservatively compared to those undergoing operation (64.3% vs. 35.7%; p=0.042. The mean hospital stay was significantly higher in those who underwent operation (8.1±7.5 vs. 2.6±2.2 days; p=0.035. Conclusion: The results of this study demonstrates although some signs and symptoms, such as abdominal pain, vomiting, abdominal tenderness, abdominal distention, and obstipation, were more common among the patients with bowel obstruction, they were not sensitive and specific enough for definite diagnosis. Due to the lack of positive predictive value of clinical signs and symptoms in diagnosis of bowel obstruction, a reasonable and logical modality is needed for bowel obstruction diagnosis with better

  16. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo

    OpenAIRE

    Haliti NR; Haliti FR; Koçani FK; Gashi AA; Mrasori SI; Hyseni VI; Bytyqi SI; Krasniqi LL; Murtezani AF; Krasniqi SL

    2015-01-01

    Naim R Haliti,1 Fehim R Haliti,2 Ferit K Koçani,3 Ali A Gashi,4 Shefqet I Mrasori,3 Valon I Hyseni,5 Samir I Bytyqi,5 Lumnije L Krasniqi,2 Ardiana F Murtezani,5 Shaip L Krasniqi5 1Department of Forensic Medicine, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, 2Department of Children Dentistry, University Dentistry Clinical Center of Kosovo, 3Department of Oral Disease, University Dentistry Clinical Center of Kosovo, 4Department of Oral Surgery,...

  17. Clinical trials of boron neutron capture therapy [in humans] [at Beth Israel Deaconess Medical Center][at Brookhaven National Laboratory

    International Nuclear Information System (INIS)

    Assessment of research records of Boron Neutron Capture Therapy was conducted at Brookhaven National Laboratory and Beth Israel Deaconess Medical Center using the Code of Federal Regulations, FDA Regulations and Good Clinical Practice Guidelines. Clinical data were collected FR-om subjects' research charts, and differences in conduct of studies at both centers were examined. Records maintained at Brookhaven National Laboratory were not in compliance with regulatory standards. Beth Israel's records followed federal regulations. Deficiencies discovered at both sites are discussed in the reports

  18. Demographic and Clinical Features of Pediatric Uveitis at a Tertiary Referral Center in Iran

    Science.gov (United States)

    Rahimi, Mansour; Oustad, Marjan; Ashrafi, Afsaneh

    2016-01-01

    Purpose: To determine the clinical features and distribution of uveitis in the pediatric age group at a referral eye care center in Shiraz, South Iran. Materials and Methods: All new cases of uveitis in patients 18-year-old or younger referred from January 2007 to December 2013 were enrolled in this study. The patient underwent a complete history of systemic and ocular diseases, comprehensive ophthalmic examination. Patients were classified according to the International Uveitis Study Group definitions. The definitive diagnosis was based on clinical manifestations and laboratory investigations. Results: Seventy-seven eyes (54 patients) comprised the study sample. The mean age at the onset of uveitis was 12.5 years. The female-to-male ratio was 1.25. Anterior uveitis was the most frequent anatomical location (40.7%), followed by intermediate uveitis (33.3%), posterior uveitis (18.5%), and panuveitis (7.5%). Seventy-four percent of patients presented with chronic uveitis. Noninfectious uveitis (81.5%) was the most frequent etiology. Thirty-seven percent of patients had a specific diagnosis for uveitis, and 63% were classified as idiopathic cases. Toxocariasis was the most common infectious cause. Associated systemic diseases were present in 14.8% of patients. The most frequent systemic disease was juvenile idiopathic arthritis in 9.2% of patients. Complications occurred in 66 (85.5%) of affected eyes. The most common complications were posterior synechia (20.7%), cataract (18.8%), and cystoid macular edema (12.9%). Conclusions: Uveitis in the majority of children had an insidious onset and was chronic. Over half the patients had a specific diagnosis. Idiopathic cases were more common in the intermediate uveitis group.

  19. A Reliable Billing Method for Internal Medicine Resident Clinics: Financial Implications for an Academic Medical Center

    Science.gov (United States)

    Kapa, Suraj; Beckman, Thomas J.; Cha, Stephen S.; Meyer, Joyce A.; Robinet, Charlotte A.; Bucher, Diane K.; Hardy, Jeanne M.; McDonald, Furman S.

    2010-01-01

    Background The financial success of academic medical centers depends largely on appropriate billing for resident-patient encounters. Objectives of this study were to develop an instrument for billing in internal medicine resident clinics, to compare billing practices among junior versus senior residents, and to estimate financial losses from inappropriate resident billing. Methods For this analysis, we randomly selected 100 patient visit notes from a resident outpatient practice. Three coding specialists used an instrument structured on Medicare billing standards to determine appropriate codes, and interrater reliability was assessed. Billing codes were converted to US dollars based on the national Medicare reimbursement list. Inappropriate billing, based on comparisons with coding specialists, was then determined for residents across years of training. Results Interrater reliability of Current Procedural Terminology components was excellent, with κ ranging from 0.76 for examination to 0.94 for diagnosis. Of the encounters in the study, 55% were underbilled by an average of $45.26 per encounter, and 18% were overbilled by an average of $51.29 per encounter. The percentages of appropriately coded notes were 16.1% for postgraduate year (PGY) 1, 26.8% for PGY-2, and 39.3% for PGY-3 residents (P < .05). Underbilling was 74.2% for PGY-1, 48.8% for PGY-2, and 42.9% for PGY-3 residents (P < .01). There was significantly less overbilling among PGY-1 residents compared with PGY-2 and PGY-3 residents (9.7% versus 24.4% and 17.9%, respectively; P < .05). Conclusions Our study reports a reliable method for assessing billing in internal medicine resident clinics. It exposed large financial losses, which were attributable to junior residents more than senior residents. The findings highlight the need for educational interventions to improve resident coding and billing. PMID:21975617

  20. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    International Nuclear Information System (INIS)

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center

  1. First six months of clinical usage of an ATM network link between two Veterans Affairs Medical Centers

    Science.gov (United States)

    Duerinckx, Andre J.; Gentili, Amilcare; El-Saden, Suzie; Harmon, Craig; Kenagy, John J.; Grant, Edward G.

    1998-07-01

    Purpose/Background: Asynchronous transfer mode (ATM) network technology has recently been used for high speed transmission of radiological images between hospitals and inside hospitals. However, the number of clinical sites which routinely use this technology is limited. The purpose of this study was to analyze the very early impact of an ATM link between a large tertiary referral center and small peripheral clinic on cost and clinical practice. Methodology: An ATM link using 155 bps (OC3) technology was installed between the West Los Angeles VA Medical Center and the Sepulveda VA, a large outpatient facility which provides full service radiological services. The West Los Angeles VA Medical Center is a large tertiary referral center with sub-specialist radiologist. The clinical impact of this ATM link between a large full-scale DICOM-3 compliant PACS system at the West LA VA on a smaller PACS system at the Sepulveda VA was evaluated. Results: The ability to freely exchange complicated MRI and CT studies between a tertiary referral center and a clinic could have a direct impact on patient care. Over the last six months, all and CT studies from Sepulveda VA were readily available via the ATM connection to all radiologists at the West LA VA. On average the workload at the Sepulveda VA in CT and MRI was about one tenth of the same workload at West LA VA, thus creating interesting possibilities for sharing or radiologist resources. Conclusions: Although our preliminary data and work loads have been too limited to draw any final conclusions yet, we feel that future results will show that the ability to provide immediate and fast interactive consultation between general radiologists in a large outpatient facility and sub- specialists at a tertiary referral center can have an impact upon the quality of patient care.

  2. A descriptive analysis of patients presenting to psychosexual clinic at a tertiary care center

    Directory of Open Access Journals (Sweden)

    Rohit Verma

    2013-01-01

    Full Text Available Background: Psychosexual problems are very common presentation, be it with psychiatric or physical illness but there are very few studies available on psychosexual disorders especially in the Indian context. Indian society is deeply ingrained in customs and several misconceptions, myths, prejudices, and social taboos are attached to sex which makes it further very difficult to tackle. Objectives: The aim of this current study was to descriptively analyze the nature of sexual disorders in a tertiary care center. Materials and Methods: The current retrospective chart review included 698 consecutive subjects seeking treatment for their psychosexual problems at the Sexual Clinic, Department of Psychiatry, Dr. Ram Manohar Hospital, New Delhi (between 2006 and 2010. Results: This study observed erectile dysfunction (ED (29.5%, Premature ejaculation (PME (24.6%, Dhat syndrome (DS (18.1%, and ED with PME (17.5% as the common sexual dysfunctions leading to treatment seeking. DS was the major complaint among younger and unmarried individuals. We observed more married individuals seeking treatment for sexual disorders. Conclusions: These findings provide important information on a relatively under-researched area.

  3. Frequency of kidney diseases and clinical indications of pediatric renal biopsy: A single center experience.

    Science.gov (United States)

    Imtiaz, S; Nasir, K; Drohlia, M F; Salman, B; Ahmad, A

    2016-01-01

    Kidney biopsy occupies a fundamental position in the management of kidney diseases. There are very few renal pathology studies available in the literature from developing world. This study scrutinized the frequency and clinicopathological relationship of kidney biopsies done at the kidney center from 1997 to 2013 amongst pediatric patients. Kidney allograft biopsy were excluded. The specimen was examined under light microscopy and immunofluorescence while electron microscopy was not done. The study includes 423 patients, mean age was 10.48 ± 4.58 years, males 245 (57.9%) were more than females 178 (42.1%). Nephrotic syndrome 314 (74.2%) was the most common clinical presentation followed by acute nephritic syndrome 35 (8.3%) and acute renal failure 24 (5.7%). Primary glomerulonephritis (PGN) was the most common group of diseases, seen in 360 (85.1%) followed by secondary glomerulonephritis (SGN) in 27 (6.4%) and tubulointerstitial nephritis in 21 (5.0%). Among PGN, minimal change disease (MCD) was the most dominant disease, with 128 (30.3%) cases followed by focal segmental glomerulosclerosis FSGS in 109 (25.8%) and membranous glomerulonephropathy in 27 (6.4%). Lupus nephritis (LN) was the leading cause of glomerular disease in SGN followed by hemolytic uremic syndrome. In conclusion, MCD is the most common histological finding, especially in younger children and FSGS is second to it. SGN is rare, and the most common disease in this category is LN while tubulointerstitial and vascular diseases are infrequent. PMID:27194835

  4. Bariatric Surgery in University Clinic Center Tuzla - Results After 30 Operations

    Science.gov (United States)

    Ahmetasevic, Emir; Pasic, Fuad; Beslin, Miroslav Bekavac; Ilic, Miroslav; Ahmetasevic, Dzenita; Mesic, Mirza

    2016-01-01

    Introduction: Project of Bariatric surgery in University clinic center (UCC) Tuzla has been initiated in 2009 as an idea of professor Dešo Mešić and soon after that Bariatric surgical team led by doctor Fuad Pasic has been created. Material and methods: Practical team education was realized in Croatia in hospital „Sisters of Mercy” under supervision of professor Miroslav-Bekavac Beslin. First bariatric operations in UCC Tuzla has been done in 2011 and it was biliopancreatic diversion (BPD) Scopinaro. Results and discussion: So far there has been done 30 operations and among them there have been used almost all operative modalities - restrictive, malabsorptive and combined (laparoscopic gastric banding-LAPGB, Roux-y mini gastric bypass, open and laparoscopic gastric sleeve resection, and over mentioned Scopinaro’s BPD). Beginning results are very promising according to the fact that almost all operated patients after one year stopped using antihypertensive, antidiabetic and antidepressant therapy, that average year’s weight loss is 35-100 kilograms and total satisfactions of patients after surgeries is obvious. PMID:27147808

  5. Mentor training within academic health centers with Clinical and Translational Science Awards.

    Science.gov (United States)

    Abedin, Zainab; Rebello, Tahilia J; Richards, Boyd F; Pincus, Harold Alan

    2013-10-01

    Multiple studies highlight the benefits of effective mentoring in academic medicine. Thus, we sought to quantify and characterize the mentoring practices at academic health centers (AHCs) with Clinical and Translational Science Awards (CTSA). Here we report findings pertaining specifically to mentor training at the level of the KL2 mentored award program, and at the broader institutional level. We found only four AHCs did not provide any form of training. One-time orientation was most prevalent at the KL2 level, whereas formal face-to-face training was most prevalent at the institutional level. Despite differences in format usage, there was general consensus at both the KL2 and institutional level about the topics of focus of face-to-face training sessions. Lower-resource training formats utilized at the KL2 level may reveal a preference for preselection of qualified mentors, while institutional selection of resource-heavy formats may be an attempt to raise the mentoring qualifications of the academic community as a whole. The present work fits into the expanding landscape of academic mentoring literature and sets the framework for future longitudinal, outcome studies focused on identifying the most efficient strategies to develop effective mentors. PMID:24127925

  6. University Counseling Center Use of Prolonged Exposure Therapy: In-Clinic Treatment for Students with PTSD

    Science.gov (United States)

    Bonar, Ted C.

    2015-01-01

    Students utilize university counseling center services to address distress related to post-traumatic stress disorder (PTSD). Since counseling centers services such as group work or general psychotherapy may not address specific PTSD-symptom reduction, centers often give community referrals in such cases. Evidence-based therapies (EBTs), including…

  7. Cochlear implant surgery at the Clinical Center of Vojvodina - ten-year experience

    Directory of Open Access Journals (Sweden)

    Dankuc Dragan

    2014-01-01

    Full Text Available Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implantation of the Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina in 2002 after long preparations and that was the first successful cochlear implantation in Serbia. Material and Methods. Over the period from November 2002 to November 2013, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Results. The analysis encompassed 99 patients, the youngest and the oldest one being 1 year and 61 years old, respectively. Prelingual and postlingual deafness developed in 84 (84.9% and in 15 (15.1%, respectively. Postlingual deafness was observed in all 11 adult patients. The prelingual deafness was diagnosed in 84 (95.4% children, whereas in four (4.6% children it occurred after the development of speech between 6 and 8 years of age. Progressive hearing loss was observed in 11 patients - seven adults and four children. The majority of our patients, i.e. 74 (74.75% manifested idiopathic deafness of unknown cause. A range of usually reported hearing loss etiologies included ototoxic medications in seven (7.07%, hereditary factor in six (6.06%, and bacterial meningitis in four (4.04% patients. Somewhat less common causes were perinatal hypoxia in three (3.03%, premature birth in three (3.03%, Down syndrome in one (1.01%, and chronic otitis media in one (1.01% patient. Conclusion. Both intraoperative and postoperative complications were analyzed in the investigated patient population. The complications developed in 11 patients, i.e. in 10.5% of 105 surgical procedures. The majority of procedures (89.5% were not accompanied by any post-surgical complications. Unsuccessful implantation in a single-step procedure and transient facial nerve paralysis can be considered most frequent among our patients, whereas cochlear ossification and transient ataxia occurred more rarely. Stimulation of facial nerve, intraoperative

  8. Intensity modulated radiation therapy (IMRT) for sinonasal tumors: a single center long-term clinical analysis

    International Nuclear Information System (INIS)

    Radiotherapy has a central role in the treatment of sinonasal malignancies, either as postoperative or as primary therapy. To study the efficacy and safety of intensity modulated radiotherapy (IMRT) for sinonasal tumors a single center retrospective evaluation focusing on survival and therapy related toxicity was performed. One hundred twenty two patients with primary (n = 82) or recurrent (n = 40) malignant sinonasal tumors were treated with intensity modulated radiotherapy between 1999 and 2009 at the University Clinic of Heidelberg and the German Cancer Research Center and retrospectively analyzed. Most patients had adenoid cystic carcinomas (n = 47) or squamous cell carcinoma (n = 26). 99 patients received postoperative radiotherapy. The median total dose was 64 Gy in conventional fractionation (1.8–2 Gy). Overall survival (OS), progression free survival (PFS) and local recurrence free survival (LRFS) rates were calculated using the Kaplan-Meier method. The log-rank test and Fishers Exact test were applied for univariate analysis, Cox-regression was used for multivariate analysis. Median follow up was 36 months. 1-, 3- and 5-year estimated overall survival rates were 90, 70 and 54 % respectively. Median progression free survival and local recurrence free survival was 45 and 63 months respectively. Progression free survival and local recurrence free survival at 1, 3 and 5 years were 76, 57 and 47, and 79, 60 and 51 % respectively. 19 patients (15.5 %) were diagnosed with distant metastases. Univariate analysis revealed significantly improved OS and LRFS for treatment of tumors after primary diagnosis, first series of irradiation and radiation dose ≥60 Gy. Multivariate analysis revealed only treatment in primary situation as an independent prognostic factor for OS and LRFS. Acute CTC grade III mucositis was seen in 5 patients (4.1 %) and CTC grade II dysgeusia in 19 patients (15.6 %). Dysgeusia, dysosmia and ocular toxicity were the most common late adverse

  9. Observations from Ground Zero at the World Trade Center in New York City, Part II: Theoretical and clinical considerations.

    Science.gov (United States)

    Acosta, Judith K; Levenson, Richard L

    2002-01-01

    Part I of this series discussed our observations of Ground Zero of the World Trade Center (WTC) immediately after the attack on September 11, 2001, as well as the stress-response of police officers on site. This paper offers a variety of clinical techniques for emergency mental health practitioners and first responders for use with victims of critical incidents. The suggested interventions are based on the theory and clinical practice of Emergency Medical Hypnosis, Neuro-Linguistic Programming, and Ericksonian Psychotherapy. Specific examples of how they were applied with police personnel following the World Trade Center attack are provided along with specific clinical guidelines. These interventions are designed to augment and enhance standard CISM, mental health, and medical practice in the field. PMID:12166017

  10. Distribution of guidance models for cardiac resynchronization therapy in the setting of multi-center clinical trials

    Science.gov (United States)

    Rajchl, Martin; Abhari, Kamyar; Stirrat, John; Ukwatta, Eranga; Cantor, Diego; Li, Feng P.; Peters, Terry M.; White, James A.

    2014-03-01

    Multi-center trials provide the unique ability to investigate novel techniques across a range of geographical sites with sufficient statistical power, the inclusion of multiple operators determining feasibility under a wider array of clinical environments and work-flows. For this purpose, we introduce a new means of distributing pre-procedural cardiac models for image-guided interventions across a large scale multi-center trial. In this method, a single core facility is responsible for image processing, employing a novel web-based interface for model visualization and distribution. The requirements for such an interface, being WebGL-based, are minimal and well within the realms of accessibility for participating centers. We then demonstrate the accuracy of our approach using a single-center pacemaker lead implantation trial with generic planning models.

  11. Initial clinical experience with scanned proton beams at the Italian National Center for Hadrontherapy (CNAO)

    International Nuclear Information System (INIS)

    We report the initial toxicity data with scanned proton beams at the Italian National Center for Hadrontherapy (CNAO). In September 2011, CNAO commenced patient treatment with scanned proton beams within two prospective Phase II protocols approved by the Italian Health Ministry. Patients with chondrosarcoma or chordoma of the skull base or spine were eligible. By October 2012, 21 patients had completed treatment. Immobilization was performed using rigid non-perforated thermoplastic-masks and customized headrests or body-pillows as indicated. Non-contrast CT scans with immobilization devices in place and MRI scans in supine position were performed for treatment-planning. For chordoma, the prescribed doses were 74 cobalt grey equivalent (CGE) and 54 CGE to planning target volume 1 (PTV1) and PTV2, respectively. For chondrosarcoma, the prescribed doses were 70 CGE and 54 CGE to PTV1 and PTV2, respectively. Treatment was delivered five days a week in 35-37 fractions. Prior to treatment, the patients' positions were verified using an optical tracking system and orthogonal X-ray images. Proton beams were delivered using fixed-horizontal portals on a robotic couch. Weekly MRI incorporating diffusion-weighted-imaging was performed during the course of proton therapy. Patients were reviewed once weekly and acute toxicities were graded with the Common Terminology Criteria for Adverse Events (CTCAE). Median age of patients =50 years (range, 21-74). All 21 patients completed the proton therapy without major toxicities and without treatment interruption. Median dose delivered was 74 CGE (range, 70-74). The maximum toxicity recorded was CTCAE Grade 2 in four patients. Our preliminary data demonstrates the clinical feasibility of scanned proton beams in Italy. (author)

  12. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo

    Directory of Open Access Journals (Sweden)

    Haliti NR

    2015-10-01

    Full Text Available Naim R Haliti,1 Fehim R Haliti,2 Ferit K Koçani,3 Ali A Gashi,4 Shefqet I Mrasori,3 Valon I Hyseni,5 Samir I Bytyqi,5 Lumnije L Krasniqi,2 Ardiana F Murtezani,5 Shaip L Krasniqi5 1Department of Forensic Medicine, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, 2Department of Children Dentistry, University Dentistry Clinical Center of Kosovo, 3Department of Oral Disease, University Dentistry Clinical Center of Kosovo, 4Department of Oral Surgery, University Dentistry Clinical Center of Kosovo, 5Institute of Pharmacology and Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, Prishtina, Kosovo Background: Because Kosovo has no reliable information on antimicrobial and analgesic use in dental practice, the survey reported here evaluated the antibiotic and analgesic prescriptions in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo (UDCCK.Methods: The data of 2,442 registered patients for a 1-year period were screened and analyzed concerning antibiotic and analgesic use as per standards of rational prescription.Results: Dentistry doctors prescribed antibiotics significantly more often than analgesics. Antibiotics were prescribed in 8.11% of all cases, while only 1.35% of total prescriptions were for analgesics. The total consumption of antibiotic drugs in the UDCCK was 4.53 Defined Daily Doses [DDD]/1,000 inhabitants/day, compared with only 0.216 DDD/1,000 inhabitants/day for analgesics. From a total number of 117 patients, 32 patients received combinations of two antibiotics.Conclusion: Pharmacotherapy analysis showed that the prescription rates of antibiotics and analgesics in the UDCCK are not rational in terms of the qualitative aspects of treatment. For the qualitative improvement of prescription of these drug groups, we recommend the implementation of treatment guidelines following rational standards. Keywords: antibiotic, analgesics

  13. Issues in Designing/Developing Clinical Program Content for a Cancer Center Web Site

    OpenAIRE

    Lundy, Alalia; Salmons, Theodora Xenia

    2001-01-01

    Content Management for healthcare websites entails the creation, modification, and removal of clinical information on a website by web development technical teams. This poster addresses issues in successful clinical website Content Management. The main obstacle to successful Content Management is the challenge of interaction between healthcare (clinical content) provider and technocrat (web developer). When developing the presentation of clinical information, the foremost issue (after informa...

  14. The Problem-Oriented Medical Synopsis: a patient-centered clinical information system.

    OpenAIRE

    Stitt, F W

    1993-01-01

    A clinical information system consists of four major components: the clinical database, decision support, data analysis (including outcomes), and the development system. We have created such a system using generally available database methodology. The clinical database, for record-keeping, is called the Problem-Oriented Medical Synopsis, and is quite an old system, originating in 1966. We describe the suitability of a problem-oriented model of clinical records management to the relational mod...

  15. Clinical and functional outcomes of the PCCP study: a multi-center prospective study in Italy.

    Science.gov (United States)

    Antonini, G; Giancola, R; Berruti, D; Blanchietti, E; Pecchia, P; Francione, V; Greco, P; Russo, T C; Pietrogrande, L

    2013-04-01

    The standard surgical management of hip fractures is associated with tissue trauma and bleeding which are added to the fracture injury. The percutaneous compression plate (PCCP) is a minimally invasive device that has been demonstrated in previous studies to reduce postoperative complications and blood loss. This prospective, multi-center, observational study assessed clinical and functional outcomes with PCCP as treatment for trochanteric fractures. Patients with a stable or unstable proximal femoral fracture of type AO 31.A1 or 31.A2 were enrolled in eight hospitals in Italy. The primary outcome of interest was the recovery of the pre-fracture functional status at 1-year follow-up; secondary outcomes of interest included blood transfusions, surgical time, complications, and mortality. A total of 273 patients were enrolled. The ASA score was 3 or 4 in 72.5 % of patients. The mean surgical time was 44.1 min; the mean post-surgery blood transfusions was 0.9 units. At 1 year, 48 patients (17.6 %) died, 28 (10.2 %) were lost to follow-up, 4 patients (1.5 %) were excluded, hence 193 patients (70.3 %) were available for final evaluation. At the 1-year follow-up visit, 51.9 % of patients recovered or improved their pre-fracture modified Harris Hip Score, 49.1 % of patients improved or maintained their walking abilities, and 66.6 % of patients residing at home pre-surgery maintained their domicile. The overall mortality rate was 17.6 %. Major complications included two fracture collapses, one excessive sliding of the cephalic screw leading to a partial fracture collapse and one back-out of the diaphyseal screw. This study demonstrates that treatment of trochanteric fractures with PCCP gives good outcomes and significant advantages such as low blood loss, short surgical time, low risk of complications, and good functional recovery in the majority of the patients. PMID:23543403

  16. Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical center: a clinical audit

    OpenAIRE

    Chen M; LaMattina KC; Patrianakos T; Dwarakanathan S

    2014-01-01

    Ming Chen,1 Kara C LaMattina,2 Thomas Patrianakos,2 Surendar Dwarakanathan2 1Department of Surgery, Division of Ophthalmology, University of Hawaii, Honolulu, HI, USA; 2Division of Ophthalmology, John H Stroger, Jr Hospital of Cook County, Chicago, IL, USA Purpose: To compare the complication rate of posterior capsule rupture (PCR) with vitreous loss during phacoemulsification at an ambulatory surgical center with published results as a clinical audit for quality control. Methods: A retrospe...

  17. Clinical and Laboratory Characteristics of Dengue-Orientia tsutsugamushi co-Infection from a Tertiary Care Center in South India

    OpenAIRE

    Basheer, Aneesh; Iqbal, Nayyar; Mookkappan, Sudhagar; Anitha, Patricia; Nair, Shashikala; Kanungo, Reba; Kandasamy, Ravichandran

    2016-01-01

    Background Concurrent infection with multiple pathogens is common in tropics, posing diagnostic and treatment challenges. Although co-infections of dengue, malaria, leptospirosis and typhoid in various combinations have been described, data on dengue and scrub typhus co-infection is distinctly limited. Methodology This study was a retrospective analysis of dengue and scrub typhus co-infection diagnosed between January 2010 and July 2014 at a tertiary care center. Clinical and laboratory featu...

  18. CLINICAL AND LABORATORY CHARACTERISTICS OF DENGUE-ORIENTI TSUTSUGAMUSHI CO-INFECTION FROM A TERTIARY CARE CENTER IN SOUTH INDIA

    OpenAIRE

    Aneesh Basheer; Nayyar Iqbal; Sudhagar Mookkappan; Patricia Anitha; Shashikala Nair; Reba Kanungo; Ravichandran Kandasamy

    2016-01-01

    Background Concurrent infection with multiple pathogens is common in tropics, posing diagnostic and treatment challenges. Although co-infections of dengue, malaria, leptospirosis and typhoid in various combinations have been described, data on dengue and scrub typhus co-infection is distinctly limited. Methodology This was a retrospective analysis of dengue and scrub typhus co-infection diagnosed between January 2010 and July 2014 at a tertiary care center. Clinical and laboratory...

  19. Characteristics of ambulatory care clinics and pharmacists in Veterans Affairs medical centers. IMPROVE investigators. Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers.

    Science.gov (United States)

    Alsuwaidan, S; Malone, D C; Billups, S J; Carter, B L

    1998-01-01

    The type and extent of ambulatory care clinical pharmaceutical services in selected Veterans Affairs medical centers (VAMCs) were studied as part of a larger project. Questionnaires were sent to the 174 VAMCs to determine the extent of clinical pharmacy activity in ambulatory care clinics, characteristics of outpatient pharmacies and clinics, and characteristics of ambulatory care pharmacists in VAMCs and to identify sites for the IMPROVE (Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers) project. Fifty VAMCs responded to the survey. There were 512 ambulatory care clinics within these VAMCs. There was some pharmacist coverage in 75% of the clinics. The highest pharmacist coverage was in walk-in refill, therapeutic drug monitoring, and anticoagulation clinics. Clinical pharmacists at 68% of the VAMCs had prescribing privileges in ambulatory care clinics. Clinical pharmacists managed 29.9% of the clinics. The types of clinics most commonly managed by pharmacists were therapeutic drug monitoring, anticoagulation, walk-in refill, and lipid clinics. Nurse practitioners or physician assistants also were providing primary care in 41% of the clinics. There were 242 ambulatory care clinical pharmacy specialists practicing in the 50 VAMCs. Of these, 41.3% had three years or less of ambulatory care experience. Most pharmacists were in the clinic five days per week. A Pharm.D. degree was the highest degree obtained for 76.9%. Ambulatory care pharmaceutical services are common in VAMCs and are being provided by numerous clinical pharmacists. PMID:9437478

  20. A clinical decision support system for integrating tuberculosis and HIV care in Kenya: a human-centered design approach.

    Directory of Open Access Journals (Sweden)

    Caricia Catalani

    Full Text Available With the aim of integrating HIV and tuberculosis care in rural Kenya, a team of researchers, clinicians, and technologists used the human-centered design approach to facilitate design, development, and deployment processes of new patient-specific TB clinical decision support system for medical providers. In Kenya, approximately 1.6 million people are living with HIV and have a 20-times higher risk of dying of tuberculosis. Although tuberculosis prevention and treatment medication is widely available, proven to save lives, and prioritized by the World Health Organization, ensuring that it reaches the most vulnerable communities remains challenging. Human-centered design, used in the fields of industrial design and information technology for decades, is an approach to improving the effectiveness and impact of innovations that has been scarcely used in the health field. Using this approach, our team followed a 3-step process, involving mixed methods assessment to (1 understand the situation through the collection and analysis of site observation sessions and key informant interviews; (2 develop a new clinical decision support system through iterative prototyping, end-user engagement, and usability testing; and, (3 implement and evaluate the system across 24 clinics in rural West Kenya. Through the application of this approach, we found that human-centered design facilitated the process of digital innovation in a complex and resource-constrained context.

  1. A clinical decision support system for integrating tuberculosis and HIV care in Kenya: a human-centered design approach.

    Science.gov (United States)

    Catalani, Caricia; Green, Eric; Owiti, Philip; Keny, Aggrey; Diero, Lameck; Yeung, Ada; Israelski, Dennis; Biondich, Paul

    2014-01-01

    With the aim of integrating HIV and tuberculosis care in rural Kenya, a team of researchers, clinicians, and technologists used the human-centered design approach to facilitate design, development, and deployment processes of new patient-specific TB clinical decision support system for medical providers. In Kenya, approximately 1.6 million people are living with HIV and have a 20-times higher risk of dying of tuberculosis. Although tuberculosis prevention and treatment medication is widely available, proven to save lives, and prioritized by the World Health Organization, ensuring that it reaches the most vulnerable communities remains challenging. Human-centered design, used in the fields of industrial design and information technology for decades, is an approach to improving the effectiveness and impact of innovations that has been scarcely used in the health field. Using this approach, our team followed a 3-step process, involving mixed methods assessment to (1) understand the situation through the collection and analysis of site observation sessions and key informant interviews; (2) develop a new clinical decision support system through iterative prototyping, end-user engagement, and usability testing; and, (3) implement and evaluate the system across 24 clinics in rural West Kenya. Through the application of this approach, we found that human-centered design facilitated the process of digital innovation in a complex and resource-constrained context. PMID:25170939

  2. Online Information about Cancer Clinical Trials: Evaluating the Web Sites of Comprehensive Cancer Centers

    OpenAIRE

    Monaco, Valerie; Krills, Sandra K.

    2003-01-01

    The objective of this study was to examine the information provided on comprehensive cancer centers’ Web sites regarding clinical trials. Thirty-nine Web sites were visually inspected for four categories of variables: navigation to the clinical trial information, search functionality provided to the visitor, information content provided about trials, and the reading level of the information provided. Results indicated that for those Web sites that provided information about clinical trials, t...

  3. Clinical profile, outcomes, and progression to type 2 diabetes among Indian women with gestational diabetes mellitus seen at a diabetes center in south India

    OpenAIRE

    Manni Mohanraj Mahalakshmi; Balaji Bhavadharini; Maheswari Kumar; Ranjit Mohan Anjana; Shah, Sapna S.; Akila Bridgette; Mridusmita Choudhury; Margaret Henderson; Lane Desborough; Mohan Viswanathan; Harish Ranjani

    2014-01-01

    Aim: To describe the clinical profile, maternal and fetal outcomes, and the conversion rates to diabetes in women with gestational diabetes mellitus (GDM) seen at a tertiary care diabetes center in urban south India. Materials and Methods: Clinical case records of 898 women with GDM seen between 1991 and 2011 were extracted from the Diabetes Electronic Medical Records (DEMR) of a tertiary care diabetes center in Chennai, south India and their clinical profile was analyzed. Follow-up data of 1...

  4. Patient-centered clinical impact of incidentally detected abnormalities on chest CT scans

    Directory of Open Access Journals (Sweden)

    Sherine G. Moftah

    2014-09-01

    Conclusion: The clinically significant different incidental abnormalities on chest CT scans represented 10.4% of all incidental findings, 3.3% were due to malignancies. The clinical impact of incidental abnormalities on chest CT may be of utmost importance on patient care.

  5. Clinical skills training in undergraduate medical education using a student-centered approach

    DEFF Research Database (Denmark)

    Tolsgaard, Martin Grønnebæk

    2013-01-01

    professors. This study showed that student teachers performed as good as or even better than associate professors when teaching simple clinical skills. The second study of this thesis examined how complex clinical skills--such as patient management skills--develop with increasing levels of competence. The...... practicing in pairs significantly out-performed those training alone using RIME-based assessments and that dyad training significantly improved students' confidence in managing future patient encounters. The final study examined students' use of self-directed clinical encounter cards (CECs) based on the RIME......This thesis focuses on how to engage students in self-directed learning and in peer-learning activities to improve clinical skills training in undergraduate medical education. The first study examined the clinical skills teaching provided by student teachers compared to that provided by associate...

  6. Preparing Academic Medical Centers for the Clinical Learning Environment Review: Alliance of Independent Academic Medical Centers National Initiative IV Outcomes and Evaluation

    Science.gov (United States)

    Wehbe-Janek, Hania; Markova, Tsveti; Polis, Rachael L.; Peters, Marguerite; Liu, Yang

    2016-01-01

    Background: Driven by changes to improve quality in patient care and population health while reducing costs, evolvement of the health system calls for restructuring health professionals' education and aligning it with the healthcare delivery system. In response to these changes, the Accreditation Council for Graduate Medical Education's Clinical Learning Environment Review (CLER) encourages the integration of health system leadership, faculty, and residents in restructuring graduate medical education (GME). Innovative approaches to achieving this restructuring and the CLER objectives are essential. Methods: The Alliance of Independent Academic Medical Centers National Initiative (NI) IV provided a multiinstitutional learning collaborative focused on supporting GME redesign. From October 2013 through March 2015, participants conducted relevant projects, attended onsite meetings, and participated in teleconferences and webinars addressing the CLER areas. Participants shared best practices, resources, and experiences. We designed a pre/post descriptive study to examine outcomes. Results: Thirty-three institutions completed NI IV, and at its conclusion, the majority reported greater CLER readiness compared with baseline. Twenty-two (88.0%) institutions reported that NI IV had a great impact on advancing their efforts in the CLER area of their project focus, and 15 (62.5%) reported a great impact in other CLER focus areas. Opportunities to share progress with other teams and the national group meetings were reported to contribute to teams' success. Conclusion: The NI IV learning collaborative prepared institutions for CLER, suggesting successful integration of the clinical and educational enterprises. We propose that national learning collaboratives of GME-sponsoring health systems enable advancement of their education mission, leading ultimately to better healthcare outcomes. This learning model may be generalizable to newfound programs for academic medical centers

  7. Clinical profile of 93 cases of 46, XY disorders of sexual development in a referral center

    OpenAIRE

    Bianca Costa Mota; Luciana Mattos Barros Oliveira; Renata Lago; Paula Brito; Ana Karina Canguçú-Campinho; Ubirajara Barroso; Maria Betânia Pereira Toralles

    2015-01-01

    ABSTRACT The term DSD refers to disorders that affect the normal process of sexual development causing disagreement between chromosomal, gonadal and phenotypic sex, and this study aimed to describe the clinical profile of a group with DSD 46, XY joined on DSD Clinic of Hospital of Salvador, Bahia Clinics. It was a retrospective study of medical records of survey data of 93 patients with DSD 46, XY. Among the patients studied 50.5% had no defined etiology and 20.4% had androgen insensitivity s...

  8. In vitro activities of clinafloxacin against contemporary clinical bacterial isolates from 10 North American centers.

    Science.gov (United States)

    Fuchs, P C; Barry, A L; Brown, S D

    1998-05-01

    Clinafloxacin was more active than ciprofloxacin against 4,213 aerobic and facultative anaerobic bacterial isolates from 10 medical centers, as tested by broth microdilution and disk diffusion methods. The percentage of 201 anaerobes susceptible to clinafloxacin by broth microdilution was comparable to cefoxitin. Our data support the proposed disk diffusion interpretive criteria for aerobic bacteria with 5-microg clinafloxacin disks. PMID:9593166

  9. Early Clinical Experiences for Second-Year Student Pharmacists at an Academic Medical Center

    OpenAIRE

    McLaughlin, Jacqueline E.; Amerine, Lindsey B.; Chen, Sheh-Li; Luter, David N.; Arnall, Justin; Smith, Shayna; Roth, Mary T.; Rodgers, Philip T.; Williams, Dennis M.; Pinelli, Nicole R.

    2015-01-01

    Objective. To examine student outcomes associated with the Student Medication and Reconciliation Team (SMART) program, which was designed to provide second-year student pharmacists at the University of North Carolina (UNC) Eshelman School of Pharmacy direct patient care experience at UNC Medical Center.

  10. Clinical and immunogenetic characteristics of psoriatic arthritis: a single-center experience from South India

    OpenAIRE

    CB Mithun; Paul T Antony; Christina M Mariaselvam; Vir S Negi

    2013-01-01

    AimThe aim of this study was to determine the clinical characteristics and prevalence of HLA B27 in patients with psoriatic arthritis presenting to a tertiary care centre in South India. BackgroundAlthough the prevalence of psoriasis is high in India, there is paucity of data, especially on Ps A. Materials and methodsThis retrospective study included 141 patients satisfying the ClASsification criteria for Ps A (CASPAR). Demographic, clinical, and laboratory data of the patients were collected...

  11. Clinical characterization and NPHP1 mutations in nephronophthisis and associated ciliopathies: A single center experience

    OpenAIRE

    Soliman, Neveen A; Friedhelm Hildebrandt; Otto, Edgar A.; Nabhan, Marwa M; Allen, Susan J; Ahmed M Badr; Maha Sheba; Sawsan Fadda; Ghada Gawdat; Hassan El-Kiky

    2012-01-01

    Nephronophthisis (NPHP) is a recessive disorder of the kidney that is the leading genetic cause of end-stage renal failure in children. Egypt is a country with a high rate of consan-guineous marriages; yet, only a few studies have investigated the clinical and molecular charac-teristics of NPHP and related ciliopathies in the Egyptian population. We studied 20 children, from 17 independent families, fulfilling the clinical and the ultrasonographic criteria of NPHP. Analysis for a homozygous d...

  12. Clinical Characterization and NPHP1 Mutations in Nephronophthisis and Associated Ciliopathies: A Single Center Experience

    OpenAIRE

    Soliman, Neveen A; Hildebrandt, Friedhelm; Otto, Edgar A.; Nabhan, Marwa M; Allen, Susan J; Ahmed M Badr; Sheba, Maha; Fadda, Sawsan; Gawdat, Ghada; El-Kiky, Hassan

    2012-01-01

    Nephronophthisis (NPHP) is a recessive disorder of the kidney that is the leading genetic cause of end-stage renal failure in children. Egypt is a country with a high rate of consanguineous marriages; yet, only a few studies have investigated the clinical and molecular characteristics of NPHP and related ciliopathies in the Egyptian population. We studied 20 children, from 17 independent families, fulfilling the clinical and the ultrasonographic criteria of NPHP. Analysis for a homozygous del...

  13. Retrospective, Single Center Study of Clinical, Paraclinical and Natural Course of Infantile-Onset Pompe Disease

    Directory of Open Access Journals (Sweden)

    Noormohammad Noori

    2015-01-01

    Full Text Available Background: Infantile-onset Pompe disease is a rare genetic and lethal disorder which is caused by the lack of acid alpha-glucosidase activity (GAA. The aim of our study was to identify the demographic and clinical characteristics, and natural history of these patients. Materials and Methods: In this retrospective study, clinical file of 15 patients diagnosed with infantile-onset Pompe disease whose symptoms started before the age of 12 months were studied. Diagnosis was based on clinical history, physical examination and diagnostic parameters in chest X-ray, echocardiogram, electrocardiogram and biochemical tests after rule out the other metabolic and neuromuscular disorders. Results: Sixty percent of the patients were male and 40% were female. The mean age at the onset of symptoms was 78 days (range: 3-150 days. Most frequent clinical and paraclinical symptoms were cardiomegaly, hypotonia, hyporeflexia, macroglossia, failure to thrive, hepatomegaly, and feeding problems, respectively. The mean age at the time of death was 5.96 months (range: 4-8 months, and all patients died before one year of age. Muscle enzymes including AST, ALT, LDH, and CPK were elevated in all patients. Due to the lack of availability, enzyme replacement therapy was not possible for any patient. Conclusion: The study showed that despite the supportive measures and no specific treatment, the clinical course is not significantly different with similar studies and the overall prognosis of this form of disease is very poor and disappointing.

  14. Segmentation of age-related white matter changes in a clinical multi-center study

    DEFF Research Database (Denmark)

    Dyrby, Tim B.; Rostrup, E.; Baare, W.F.C.; van Straaten, E.C.W.; Barkhof, F.; Vrenken, H.; Ropele, S.; Schmidt, R.; Erkinjuntti, T.; Wahlund, L.O.; Pantoni, L.; Inzitari, D.; Paulson, O.B.; Hansen, Lars Kai; Waldemar, G.

    2008-01-01

    Leukoaraiosis And Disability (LADIS). Semi-manually delineated WMC were used for validating the segmentation produced by the neural networks. The neural network segmentation demonstrated high consistency between subjects and centers, making it a promising technique for large studies. For WMC volumes less than...... 10 ml, an increasing discrepancy between semi-manual and neural network segmentation was observed using the similarity index (SI) measure. The use of all three image modalities significantly improved cross-center generalizability compared to neural networks using the FLAIR image only. Expert......Age-related white matter changes (WMC) are thought to be a marker of vascular pathology, and have been associated with motor and cognitive deficits. In the present study, an optimized artificial neural network was used as an automatic segmentation method to produce probabilistic maps of WMC in a...

  15. Evaluation and Comparison of Clinical and Para- Clinical Diagnosis of Trichomonas Vaginitis in Women Referred to Shahroud City Health Care Centers

    Directory of Open Access Journals (Sweden)

    Nahid Bolbol-Haghighi

    2008-01-01

    Full Text Available Introduction: Trichomonas is a sexually transmitted disease and its agent is a flagellated parasite called trichomonas vaginitis. This is the third common reason of vaginities and 180 millions women at world and 2-3 millions at U.S suffer from it. Because of its high prevalence and expensive treatment, we decided to evaluate its clinical and para- clinical diagnosis. Methods: This is an analytic cross-sectional study and carried out on 300 women with signs of vaginitis infections and had indication for Pap smear which referred to shahrood city heath care centers. In this study we took two samples of secretion from both endocervix and exocervix by speculum spred them on two lame contemporaneous, and one sample from posterior koldosace secretions with cotton soup and entered to tube with sterilized physiological serum. Questionnaires were filled among patients by midwife. The cases were followed by taking Pap smear and wet smear, calturing and filling the second questionnaire. Finally, the results in medical, microbiological and cytological diagnosis were compared. The sensivity and specifity of each diagnostic method were evaluated using statistical methods. Results: Results of the study showed that the most outbreaks of trichomonas vaginitis were at age group between 21 to 35 (52.6% and the lowest prevalence was among women less than 20(5.3% years old. It is reported 78 cases of trichomonas in clinical examination, but none of culture medias has demonstrated trichomonas. Percentage of false positive at clinical diagnosis method was 26% more than culture method and 25.7 % more than wet smear and Pap smear methods. Conclusion: Paraclinic with clinical examination play an important role in diagnosis and treatment of vaginitis. Thus for preventing of unnecessary drug prescription and preventing it,s side effects, it is recommended para- clinical examination in suspect patients.

  16. Evaluation of the Dutch BRCA1/2 clinical genetic center referral criteria in an unselected early breast cancer population

    OpenAIRE

    van den Broek, Alexandra J.; de Ruiter, Karen; Van 't Veer, Laura J; Tollenaar, Rob A.E.M.; van Leeuwen, Flora E.; Verhoef, Senno; Schmidt, Marjanka K.

    2014-01-01

    In this study, we evaluated the diagnostic value of the Dutch Clinical Genetic Center (CGC) referral guidelines for BRCA1/2 mutation testing in 903 early breast cancer patients, unselected for family history, diagnosed in a cancer hospital before the age of 50 years in 1974–2002; most prevalent Dutch pathogenic BRCA1/2 mutations had been analyzed on coded DNA in a research setting. Forty-nine (5.4%) of the patients were proven to be BRCA1/2 mutation carriers. We found that 78% and 69% of BRCA...

  17. "Starting life together" is key to start-up of Montana birth center. Deaconess Billings Clinic uses a soft touch.

    Science.gov (United States)

    Botvin, J D

    2001-01-01

    Challenged by the requirements of managed care, Deaconess Billings Clinic resumed obstetrical services after 25 years. The resulting Family Birth Center is a "marketer's dream," with state-of-the-art facilities and an enviable model of care. The grand opening was highlighted by an open house, or "baby shower." The ongoing marketing campaign includes soft, sweet images of happy babies with their moms and dads. Memorable TV commercials emphasize the mother's comfort, the expertise of the medical staff, and the baby ... thoroughly enjoying the birth experience. PMID:11338363

  18. Partners in Excellence: Development of the Temple College Clinical Simulation Center

    Science.gov (United States)

    Coker, Neil

    2006-01-01

    Temple College (TC) is a comprehensive community college located in Temple, Texas. Temple also is home to Scott & White Hospital, Central Texas Veterans Health Care System, King's Daughters Hospital, and Texas A&M University College of Medicine's clinical campus. In the summer of 2001, TC's health-sciences programs were scattered across three…

  19. Clinical profile of 93 cases of 46, XY disorders of sexual development in a referral center.

    Science.gov (United States)

    Mota, Bianca Costa; Oliveira, Luciana Mattos Barros; Lago, Renata; Brito, Paula; Canguçú-Campinho, Ana Karina; Barroso, Ubirajara; Toralles, Maria Betânia Pereira

    2015-01-01

    The term DSD refers to disorders that affect the normal process of sexual development causing disagreement between chromosomal, gonadal and phenotypic sex, and this study aimed to describe the clinical profile of a group with DSD 46, XY joined on DSD Clinic of Hospital of Salvador, Bahia Clinics. It was a retrospective study of medical records of survey data of 93 patients with DSD 46, XY. Among the patients studied 50.5% had no defined etiology and 20.4% had androgen insensitivity syndrome (AIS), 63.4% had been initially recorded in males, 31 (33.3%) in females, being that in two it was necessary to reassignment. All patients with complete AIS pure gonadal dysgenesis and had female genitalia. Others have been diagnosed with genital ambiguity or severe hypospadias and cryptorchidism. The gonads were palpable at the first consultation in 75.3% of patients. It is important to establish an active surveillance program for these patients. The first assessment took place before the age of ten in more than 50% of cases, which shows that much needs to be done for medical education and community about the DSD. Because the phenotypic variability of sexual development disorders was noted that the clinical profile of patients studied ranged between different etiologies, including hindering the diagnostic conclusion of these individuals. PMID:26689524

  20. Clinical profile of 93 cases of 46, XY disorders of sexual development in a referral center

    Directory of Open Access Journals (Sweden)

    Bianca Costa Mota

    2015-10-01

    Full Text Available ABSTRACT The term DSD refers to disorders that affect the normal process of sexual development causing disagreement between chromosomal, gonadal and phenotypic sex, and this study aimed to describe the clinical profile of a group with DSD 46, XY joined on DSD Clinic of Hospital of Salvador, Bahia Clinics. It was a retrospective study of medical records of survey data of 93 patients with DSD 46, XY. Among the patients studied 50.5% had no defined etiology and 20.4% had androgen insensitivity syndrome (AIS, 63.4% had been initially recorded in males, 31 (33.3% in females, being that in two it was necessary to reassignment. All patients with complete AIS pure gonadal dysgenesis and had female genitalia. Others have been diagnosed with genital ambiguity or severe hypospadias and cryptorchidism. The gonads were palpable at the first consultation in 75.3% of patients. It is important to establish an active surveillance program for these patients. The first assessment took place before the age of ten in more than 50% of cases, which shows that much needs to be done for medical education and community about the DSD. Because the phenotypic variability of sexual development disorders was noted that the clinical profile of patients studied ranged between different etiologies, including hindering the diagnostic conclusion of these individuals.

  1. Clinical relevance of surgical site infection as defined by the criteria of the Centers for Disease Control and Prevention

    DEFF Research Database (Denmark)

    Henriksen, N A; Meyhoff, C S; Wetterslev, J;

    2010-01-01

    Surgical site infection (SSI) is a common complication after abdominal surgery and the Centers for Disease Control and Prevention (CDC) criteria are commonly used for diagnosis and surveillance. The aim of this study was to evaluate whether SSI diagnosed according to CDC is clinically relevant...... diagnosed with SSI and a matched control group (N=46) without SSI according to the CDC criteria after laparotomy. Two blinded experienced surgeons evaluated the hospital records and determined whether patients had CRSSI, based on the following criteria: antibiotic treatment, surgical intervention, prolonged...... hospital stay or referral to an intensive care unit for SSI. The rate of CRSSI was 38 of 54 (70%) in patients with CDC-diagnosed SSI and none in patients without a CDC-diagnosed SSI. Sixty-one percent of the CDC-diagnosed SSIs were superficial, of which 48% were considered clinically relevant...

  2. Clinical relevance of surgical site infection as defined by the criteria of the Centers for Disease Control and Prevention

    DEFF Research Database (Denmark)

    Henriksen, N A; Meyhoff, C S; Wetterslev, J;

    2010-01-01

    Surgical site infection (SSI) is a common complication after abdominal surgery and the Centers for Disease Control and Prevention (CDC) criteria are commonly used for diagnosis and surveillance. The aim of this study was to evaluate whether SSI diagnosed according to CDC is clinically relevant...... diagnosed with SSI and a matched control group (N=46) without SSI according to the CDC criteria after laparotomy. Two blinded experienced surgeons evaluated the hospital records and determined whether patients had CRSSI, based on the following criteria: antibiotic treatment, surgical intervention, prolonged...... hospital stay or referral to an intensive care unit for SSI. The rate of CRSSI was 38 of 54 (70%) in patients with CDC-diagnosed SSI and none in patients without a CDC-diagnosed SSI. Sixty-one percent of the CDC-diagnosed SSIs were superficial, of which 48% were considered clinically relevant. There was...

  3. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

    Science.gov (United States)

    Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

    2013-01-01

    New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies. PMID:20703765

  4. Clinical experience with telemetric intracranial pressure monitoring in a Danish neurosurgical center

    DEFF Research Database (Denmark)

    Lilja, Alexander; Andresen, Morten; Hadi, Amer;

    2014-01-01

    reading, number of ICP recording sessions (in relation to symptoms of increased ICP) and their clinical consequence. RESULTS: We included 21 patients in the evaluation (11 female and 10 male). Median age was 28 (2-83) years and median duration of disease was 11 (0-30) years. Eleven patients had various...... procedure related risks of repeated transducer insertions. MATERIALS AND METHODS: We identified all patients in our clinic with an implanted Raumedic(®) telemetric ICP probe (NEUROVENT(®)-P-tel). For each patient we identified diagnosis, indication for implantation, surgical complications, duration of ICP...... recording session was 154 (8-433) days. In total, 86 recording sessions were performed; 29 resulted in surgical shunt revision, 30 in change of acetazolamide dose or programmable valve setting, 20 required no action and 5 resulted in a new recording session. No surgical complications occurred, except for...

  5. Clinical process analysis and activity-based costing at a heart center.

    Science.gov (United States)

    Ridderstolpe, Lisa; Johansson, Andreas; Skau, Tommy; Rutberg, Hans; Ahlfeldt, Hans

    2002-08-01

    Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR) containing two interrelated parts, "ProcessGuide and CostControl," was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management. PMID:12118815

  6. Clinical Characteristics and Outcomes for Solitary Fibrous Tumor (SFT): A Single Center Experience

    OpenAIRE

    DeVito, Nicholas; Henderson, Evita; Han, Gang; Reed, Damon; Marilyn M Bui; Lavey, Robert; Robinson, Lary; Zager, Jonathan S.; Gonzalez, Ricardo J; Sondak, Vernon K.; Letson, G. Douglas; Conley, Anthony

    2015-01-01

    Solitary fibrous tumor (SFT) is a mesenchymal neoplasm of fibrous origin. The 2013 WHO classification of soft tissue tumors defines malignant forms as hypercellular, mitotically active (>4 mitosis/10 high-power fields), with cytological atypia, tumor necrosis, and/or infiltrative margins. With an IRB-approved protocol, we investigated patient records and clinicopathologic data from our Sarcoma Database to describe the clinical characteristics of both benign and malignant SFT. All pathology sp...

  7. Clinical factors affecting the outcome in postradioactive iodine (RAI) therapy patients - Philippine Heart Center experience

    International Nuclear Information System (INIS)

    Full text: Clinical factors such as patient's age, duration of the underlying autoimmune thyroid stimulus and anti-thyroid drug therapy may affect the outcome of patients who underwent RAI therapy. Objective: To evaluate the clinical factors affecting the outcome of RAI therapy. Methodology: Patients (n=41) with Graves' disease treated with anti-thyroid drugs were followed up after Radioactive Iodine therapy treatment. Thyroid scan, 2 and 24 hours radioactive iodine uptake were taken to compute for the therapy dose (120 uci) (computed thyroid weight in gms) (24-hour I 131 uptake). Patients were then divided into groups (Group 1= hypothyroid, Group 2= euthyroid, Group 3 hyperthyroid) based on their thyroid function results (FT3, FT4, TSH) after 2, 4, 6, 12 months post-therapy. Clinical and physiologic factors were then correlated with the outcome. Results: The population consisted of 41 patients (male=8, female=33) with an overall incidence of Group 1= 17%, Group 2= 54% and Group 3= 29% posttherapy. Factors such as age, with their means (Groups 134, 2= 39, 3=39 p= 0.42) and gland uptake (24-hour Groups 1= 53, 2= 61 358, p= 0.41) were not associated with the remission rate. Other factors that were related to the length of the disease such as duration of symptoms (Groups 121, 2=24, 3= 29 months p0.68), duration of medicine prior to RAI therapy (Group 1= 10, 2= 15, 3= 18 months p=0.306) and gland weight (Groups 1=40 2=42 3=46 grams p=0.78) tends to have a higher mean values in therapy failure patients. Conclusion: Clinical factors studied showed no significant differences among patients developing hypothyroid, euthyroid or hyperthyroid state. The data suggested that treatment failures in patients with Graves' disease could be improved by lessening the time interval between the diagnosis and radioactive iodine therapy. (author)

  8. Clinical characterization and NPHP1 mutations in nephronophthisis and associated ciliopathies: A single center experience

    Directory of Open Access Journals (Sweden)

    Neveen A Soliman

    2012-01-01

    Full Text Available Nephronophthisis (NPHP is a recessive disorder of the kidney that is the leading genetic cause of end-stage renal failure in children. Egypt is a country with a high rate of consan-guineous marriages; yet, only a few studies have investigated the clinical and molecular charac-teristics of NPHP and related ciliopathies in the Egyptian population. We studied 20 children, from 17 independent families, fulfilling the clinical and the ultrasonographic criteria of NPHP. Analysis for a homozygous deletion of the NPHP1 gene was performed by polymerase chain reaction on the genomic DNA of all patients. Patients were best categorized as 75% juvenile NPHP, 5% infantile NPHP, and 20% Joubert syndrome-related disorders (JSRD. The mean age at diagnosis was 87.5 + 45.4 months, which was significantly late as compared with the age at onset of symptoms, 43.8 ± 29.7 months (P <0.01. Homozygous NPHP1 deletions were detected in six patients from five of 17 (29.4% studied families. Our study demonstrates the clinical phenotype of NPHP and related disorders in Egyptian children. Also, we report that homozygous NPHP1 deletions account for 29.4% of NPHP in the studied families in this cohort, thereby confirming the diagnosis of type-1 NPHP. Moreover, our findings confirm that NPHP1 deletions can indeed be responsible for JSRD.

  9. Clinical Aspects of Thyrotoxicosis in 592 Patients: A Single Center Experience from Turkey

    Directory of Open Access Journals (Sweden)

    Serap Baydur Şahin

    2014-12-01

    Full Text Available Purpose: To determine the main causes of thyrotoxicosis and to compare the clinical and biochemical fetaures of the patients according to the underlying cause of thyrotoxicosis. Material and Method: Five hundred ninety-two patients, who were consecutively diagnosed with thyrotoxicosis, were retrospectively analysed. Symptoms of thyrotoxicosis, serum thyroid-stimulating hormone (TSH, free T3 and free T4 levels, anti-thyroglobulin autoantibody (TGAb, anti-thyroid peroxidase autoantibody (TPOAb and ultrasonographic features were recorded. To determine the cause of thyrotoxicosis, Tc-99m pertechnetate thyroid scintigraphy was performed in all patients except for pregnant women. The clinical and biochemical results were compared between the patients with different diagnosis of thyrotoxicosis. Results: 40.9% of patients were diagnosed with toxic multinodular goiter (TMNG. The other main causes of thyrotoxicosis were: Graves’ disease (GD (22%, thyroiditis (14.8%, gestational thyrotoxicosis (12.7%, and toxic adenoma (9.6%. The clinical presentation and severity of thyrotoxicosis varied according to the underlying cause. Weight loss was more frequently observed in patients with GD (p=0.0001, while cardiac arrhythmia dominated in patients with TMNG (p=0.0001. Moderate (27% or severe (23.9% thyrotoxicosis was more common in patients with GD than in patients with other forms of thyrotoxicosis (p=0.0001. Discussion: Toxic multinodular goiter is the most common cause of thyrotoxicosis in our region.

  10. Frequency and clinical manifestations of post-poliomyelitis syndrome in a brazilian tertiary care center

    Directory of Open Access Journals (Sweden)

    Abrahão Augusto Juviniano Quadros

    2012-08-01

    Full Text Available OBJECTIVE: To determine the frequency and clinical manifestations of patients with post-poliomyelitis syndrome (PPS in a Brazilian division of neuromuscular disorders. METHODS: A total of 167 patients with prior history of paralytic poliomyelitis was investigated for PPS, based on international diagnostic criteria. Other variables analyzed were: gender, race, age at poliomyelitis infection, age at PPS onset, and PPS symptoms. RESULTS: One hundred and twenty-nine patients presented PPS, corresponding to 77.2% of the studied population. 62.8% were women and 37.2% were men. Mean age of patients with PPS at onset of PPS symptoms was 39.9±9.69 years. Their main clinical manifestations were: new weakness in the previously affected limbs (69% and in the apparently not affected limbs (31%; joint pain (79.8%; fatigue (77.5%; muscle pain (76%; and cold intolerance (69.8%. CONCLUSIONS: Most patients of our sample presented PPS. In Brazil, PPS frequency and clinical features are quite similar to those of other countries.

  11. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

    OpenAIRE

    Eisenstein, Eric L.; Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

    2010-01-01

    New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators ...

  12. Practice effects in a longitudinal, multi-center Alzheimer’s disease prevention clinical trial

    Directory of Open Access Journals (Sweden)

    Abner Erin L

    2012-11-01

    Full Text Available Abstract Background Practice effects are a known threat to reliability and validity in clinical trials. Few studies have investigated the potential influence of practice on repeated screening measures in longitudinal clinical trials with a focus on dementia prevention. The current study investigates whether practice effects exist on a screening measure commonly used in aging research, the Memory Impairment Screen (MIS. Methods The PREADViSE trial is a clinical intervention study evaluating the efficacy of vitamin E and selenium for Alzheimer’s disease prevention. Participants are screened annually for incident dementia with the MIS. Participants with baseline and three consecutive follow-ups who made less than a perfect score at one or more assessments were included in the current analyses (N=1,803. An additional subset of participants with four consecutive assessments but who received the same version of the MIS at baseline and first follow-up (N=301 was also assessed to determine the effects of alternate forms on mitigating practice. We hypothesized that despite efforts to mitigate practice effects with alternate versions, MIS scores would improve with repeated screening. Linear mixed models were used to estimate mean MIS scores over time. Results Among men with four visits and alternating MIS versions, although there is little evidence of a significant practice effect at the first follow-up, mean scores clearly improve at the second and third follow-ups for all but the oldest participants. Unlike those who received alternate versions, men given the same version at first follow-up show significant practice effects. Conclusion While increases in the overall means were small, they represent a significant number of men whose scores improved with repeated testing. Such improvements could bias case ascertainment if not taken into account.

  13. Clinical Characteristics of patients with Diabetes Mellitus 2 of Family Health Center Chiguay.

    Directory of Open Access Journals (Sweden)

    Ignacio López H. Marco Mendoza E. Consuelo Rodríguez M. Lesly Álvarez C

    2009-07-01

    Full Text Available Introduction : Diabetes mellitus (DM has a national prevalence near 4.2% and the worldwide fluctuates between 2 and 5%. The complications are caused by poor metabolic control and hence also by the poor management of cardiovascular risk factors (CVRF, hence the importance of managing and reducing the CVRF, the main objective of control programs for DM. AIM: To characterize clinically to patients with DM2 who were cared for in the agenda of cardiovascular CESFAM Chiguay (commune of Chiguayante, region of Bio Bio during the first 9 months of 2008. PATIENT and method S: Observational descriptivestudy, non-probability sampling a retrospective study was observational and descriptive, reviewing the ballots of each tabcontrol chronic clinic patients enrolled in the program Cardiovascular(VCP from January to September 2008 in CESFAM “Chiguay.” Results : The study included 332 patients, of whom 67.77% were women and 32.23% men. Average age was 63.6 years. 47.59% were obese. 49.39% had a HbA1c levels at about 7%. 21.69% had an “optimal” control of LDL. 56.93% had blood pressure poorly controlled. Discussion : The most noticeable clinical and epidemiological characteristics of the diabetes type 2 found in our study were late aged dominance in females and obese. Almost 80% of the cases had higher levels of LDL and only around a half had good metabolic control, with HbA1c under7%. This could be explained because the studied subjects belongedmostly to a low socioeconomic status, which would lead to unbalanced diet, poor adherence to the treatment and poor understanding of their pathology.

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

    Directory of Open Access Journals (Sweden)

    Aslı Aytekin

    2015-12-01

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

  15. Use of a data warehouse at an academic medical center for clinical pathology quality improvement, education, and research

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski

    2015-01-01

    Full Text Available Background: Pathology data contained within the electronic health record (EHR, and laboratory information system (LIS of hospitals represents a potentially powerful resource to improve clinical care. However, existing reporting tools within commercial EHR and LIS software may not be able to efficiently and rapidly mine data for quality improvement and research applications. Materials and Methods: We present experience using a data warehouse produced collaboratively between an academic medical center and a private company. The data warehouse contains data from the EHR, LIS, admission/discharge/transfer system, and billing records and can be accessed using a self-service data access tool known as Starmaker. The Starmaker software allows users to use complex Boolean logic, include and exclude rules, unit conversion and reference scaling, and value aggregation using a straightforward visual interface. More complex queries can be achieved by users with experience with Structured Query Language. Queries can use biomedical ontologies such as Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine. Result: We present examples of successful searches using Starmaker, falling mostly in the realm of microbiology and clinical chemistry/toxicology. The searches were ones that were either very difficult or basically infeasible using reporting tools within the EHR and LIS used in the medical center. One of the main strengths of Starmaker searches is rapid results, with typical searches covering 5 years taking only 1-2 min. A "Run Count" feature quickly outputs the number of cases meeting criteria, allowing for refinement of searches before downloading patient-identifiable data. The Starmaker tool is available to pathology residents and fellows, with some using this tool for quality improvement and scholarly projects. Conclusion: A data warehouse has significant potential for improving utilization of clinical pathology testing

  16. Prevalence, Risk Factors, and Clinical Findings of Candidiasis and Trichomoniasis in Women Supported by Selected Health Centers of Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Sehhatie-Shafaie Fahimeh

    2014-10-01

    Full Text Available Objective: Vulvovaginitis candidiasis and trichomoniasis constitute at least 50% of infectious vaginitis cases. The aim of this study was to determine the prevalence, risk factors, and clinical findings of candidiasis and trichomoniasis in women supported by selected health centers of Tabriz, Iran. Materials and Methods: This was a cross-sectional study, in which 1000 women who had the study criteria were selected by random sampling. In addition, 12 health centers of Tabriz were selected for this study. A questionnaire was used to obtain their personal and reproductive information, checklist for clinical observations, and culture methods (sabouraud dextrose agar and diamond for diagnose vaginal infections. Results: The prevalence of candidiasis and trichomoniasis were 25.2 and 9.2%, respectively. Findings showed that candidiasis infection, history of diseases, vaginal pH, number of coitus, number of delivery, and number of vaginal delivery, breast feeding status, method of last delivery, and contraceptive methods are risk factors for candidacies. Moreover, age at marriage, personal health, sexual hygiene, and vaginal pH are risk factors for trichomoniasis. A statistically significant relationship was observed between candidiasis and clinical findings, such as pruritus, pruritus during coitus, burning sensation with coitus, dysuria in woman and her husband, dyspareunia, low abdominal pain, urinal symptoms, vaginal status, amount of discharge, consistency appearance, and color of discharges. Furthermore, a significant relationship was observed between trichomoniasis and dysuria, and appearance and color of vaginal discharge. Conclusion: Due to the high prevalence of candidiasis, trichomoniasis infections, and infected women as asymptomatic carriers, it seems necessary to pay more attention to these infections and make efforts for their prevention.

  17. Clinical characterization and NPHP1 mutations in nephronophthisis and associated ciliopathies: a single center experience.

    Science.gov (United States)

    Soliman, Neveen A; Hildebrandt, Friedhelm; Otto, Edgar A; Nabhan, Marwa M; Allen, Susan J; Badr, Ahmed M; Sheba, Maha; Fadda, Sawsan; Gawdat, Ghada; El-Kiky, Hassan

    2012-09-01

    Nephronophthisis (NPHP) is a recessive disorder of the kidney that is the leading genetic cause of end-stage renal failure in children. Egypt is a country with a high rate of consanguineous marriages; yet, only a few studies have investigated the clinical and molecular characteristics of NPHP and related ciliopathies in the Egyptian population. We studied 20 children, from 17 independent families, fulfilling the clinical and the ultrasonographic criteria of NPHP. Analysis for a homozygous deletion of the NPHP1 gene was performed by polymerase chain reaction on the genomic DNA of all patients. Patients were best categorized as 75% juvenile NPHP, 5% infantile NPHP, and 20% Joubert syndrome-related disorders (JSRD). The mean age at diagnosis was 87.5 + 45.4 months, which was significantly late as compared with the age at onset of symptoms, 43.8 ± 29.7 months (P Egyptian children. Also, we report that homozygous NPHP1 deletions account for 29.4% of NPHP in the studied families in this cohort, thereby confirming the diagnosis of type-1 NPHP. Moreover, our findings confirm that NPHP1 deletions can indeed be responsible for JSRD. PMID:22982934

  18. Clinical results of atrial fibrillation patients treated with cryoballoon ablation: A single center experience

    Directory of Open Access Journals (Sweden)

    Mesut Aydın

    2014-12-01

    Full Text Available Objectives: Atrial fibrillation (AF, the most common arrhythmia in clinical practice, is a major cause of stroke. Atrial fibrillation increases morbidity and mortality. Nowadays cryoablation therapy is being performed efficiently and safely worldwide. In this paper the clinical outcomes of the patients whom were treated with cryoablation were discussed. Methods: Between June 2012 and March 2014, patients with paroxysmal AF who were treated with cryoablation were included in the study. The medical records of the patients were retrospectively reviewed. Patients were called to receive information about the symptom recurrence. Results: Twelve patients were included in the study. Half of the patients were female. The mean age was 48 ± 15 years. Acute procedural success rate of cryoablation was 100%. In one patient transient right phrenic nerve injury occurred which was returned to normal after discontinuation of cryoablation therapy. One patient developed AF episode for 10 minutes in the 4th month of follow-up period. Conclusion: In patients with paroxysmal atrial fibrillation cryoablation effectively decrease symptoms consistent with the literature. J Clin Exp Invest 2014; 5 (4: 599-603

  19. Clinical characteristics of a group of adults with nodular lymphoid hyperplasia: A single center experience

    Institute of Scientific and Technical Information of China (English)

    Alberto Rubio-Tapia; Jorge Hernéndez-Calleros; Sagrario Trinidad-Hernández; Luis Uscanga

    2006-01-01

    AIM: To describe the clinical and histological characteristics of a group of adults with small-bowel nodular lymphoid hyperplasia (NLH).METHODS: Patients were searched for five years in pathology records of our institution. The biopsy material was reassessed using strict histopathological criteria.Clinical data were obtained from medical records.RESULTS: Small-bowel NLH was diagnosed in 18 cases.The female: male ratio was 2: 1. The most frequent symptoms were diarrhea (72%), involuntary weight loss (72%) and abdominal pain (61%). Nine patients (50%)had immunodeficiency. Small-bowel bacterial overgrowth was found in three (17%) cases. At small-bowel NLH diagnosis, three (17%) had associated lymphoma: two intestinal and one extra-intestinal lymphomas. In two patients with villous atrophy and anti-endomysial antibodies the diagnosis of celiac disease was established.Giardia lamblia infection was found in only one patientwith hypogammaglobulinemia (Herman's syndrome).CONCLUSIONS; NLH is uncommon in adult patients.Associated diseases are immunodeficiency and lymphoid tissue malignancies.

  20. Clinical results for stage III{center_dot}IV cancer of the tongue

    Energy Technology Data Exchange (ETDEWEB)

    Mitani, Hiroki; Kamata, Shin-etsu; Nigauri, Tomohiko; Yonekawa, Hiroyuki [Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital

    2003-04-01

    Our department has been treating patients with tongue cancer since 1946. Until the early 1980s, treatment for primary lesions consisted mainly of a small dose of radium irradiation, regardless of the clinical stage. The approximate 5-year survival rate for progressive tongue cancer with a staging of greater than T 3 was as low as 20.3% (N=137) between 1946 and 1970. Irradiation methods have since improved, and the resection-reconstruction method using a deltopectral skin flap had been introduced. In addition, a trend has emerged towards performing surgical treatment and reconstructions using a greater pectoral muscle skin flap. As a result, the approximate 5-year survival rate for T 3+T 4 tongue cancer improved to 37.0% (N=40) for the period between 1971 and 1980. In 1982, a reconstruction technique using a free skin flap with the goal of reconciling the preservation of function and an improvement in the clinical results was established. Treatment protocols have changed drastically since then, making it possible to perform an extended resection while maintaining the swallowing function. As a result, the approximate 5-year survival rate for T 3+T 4 tongue cancer has improved to 51.6% (N=126). This paper describes the clinical outcome for stage III and IV progressive tongue cancerstreated mainly by surgery over the past twenty years. The subjects included 192 cases of stage III or IV squamous cell carcinoma of the tongue; all of the subjects underwent radical operations between January 1981 and December 1999. The approximate 5-year survival rate (disease-specific survival rate) for stage III cancers was 65.3% (71.8%) (N=123), while that for stage IV cancers was 38.2% (40.0%) (N=69). The 5-year primary lesion control rate according to T classification was as follows: T 1, 100%, T 2, 83.8%, T 3, 81.7%; and T 4, 77.4%. The 5-year neck control rate was 77.1%. Our department, in principle, usually administers external irradiation at a dosage of 40 Gy. We histologically

  1. Clinical and immunogenetic characteristics of psoriatic arthritis: a single-center experience from South India

    Directory of Open Access Journals (Sweden)

    CB Mithun

    2013-02-01

    Full Text Available AimThe aim of this study was to determine the clinical characteristics and prevalence of HLA B27 in patients with psoriatic arthritis presenting to a tertiary care centre in South India. BackgroundAlthough the prevalence of psoriasis is high in India, there is paucity of data, especially on Ps A. Materials and methodsThis retrospective study included 141 patients satisfying the ClASsification criteria for Ps A (CASPAR. Demographic, clinical, and laboratory data of the patients were collected through personal interviews, clinical examination, appropriate investigations, and analysis of case records. HLA-B27 typing by PCR method was done for all patients. ResultsAmong the 141 patients, 89 subjects were males and 52 were females, and the male to female ratio was 1.7:1. Polyarthritis (n=51, 36.2% was the most common Ps A subtype noted during the study, followed by oligoarthritis (n=48, 34%, spondyloarthropathy (n=29, 20.6%, distal interphalangeal (DIP predominant arthritis (n=25, 7.8%, and arthritis mutilans (n=2, 1.4%. Arthritis preceded skin involvement in 9.2% (n=13 of the cases. Dactylitis was seen in 24.1% (n=34 of the patients. Extra-articular features like enthesitis (n=16, 11.3% and eye involvement (n=1, 0.7% were also observed. Deformities were seen in 32.6% (n=46 of the subjects. The most common type of psoriatic skin lesion noted was psoriasis vulgaris (n=119, 84.4%. Nail involvement was seen in 17.7% (n=25 of the patients and it was observed in all subjects with DIP predominant arthritis (100%. Family history of psoriasis was present in 11.3% (n=16 of the patients. The number of patients positive for HLA B27 was 16 (11.3%. Additionally, the antigen positivity was noted in 35.7% (n=10 of the patients with spondyloarthropathy. ConclusionPs A was more common in males. Polyarthritis and oligoarthritis were the most prevalent subtypes. The prevalence of HLA-B27 in our study population was 11.3% and was found to be strongly associated with

  2. Clinical features of Crohn disease concomitant with ankylosing spondylitis: A preliminary single-center study.

    Science.gov (United States)

    Liu, Song; Ding, Jie; Wang, Meng; Zhou, Wanqing; Feng, Min; Guan, Wenxian

    2016-07-01

    Extraintestinal manifestations (EIMs) cause increased morbidity and decreased quality of life in Crohn disease (CD). Ankylosing spondylitis (AS) belongs to EIMs. Very little is known on the clinical features of CD concomitant with AS. This study is to investigate the clinical features of CD patients with AS.We retrospectively collected all CD patients with AS in our hospital, and established a comparison group (CD without AS) with age, sex, and duration of Crohn disease matched. Clinical information was retrieved for comparison.Eight CD + AS patients were identified from 195 CD patients. Sixteen CD patients were randomly selected into comparison group. All CD + AS patients were male, HLA-B27 (+), and rheumatoid factor (-) with an average age of 40.8 ± 4.52 years. Significant correlation between disease activity of CD and AS was revealed (r = 0.857, P = 0.011). Significant correlation between disease activity of CD and functional limitation associated with AS was identified (r = 0.881, P < 0.01). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and globulin were positively correlated to Crohn disease activity index (CDAI), Bath AS disease activity index, and Bath AS functional index(BASFI) scores (r = 0.73-0.93, P < 0.05). Albumin was negatively associated with CDAI and BASFI (r = -0.73 to -0.91, P < 0.05). The ratio of albumin to globulin (Alb/Glo) was significantly related to all 3 scores (r = -0.81 to -0.91, P < 0.05).Male predominance with a 4.12% concomitant incidence of AS is observed in CD patients. Disease activity of CD correlates with disease activity of AS and functional limitation caused by AS. CRP, ESR, and Alb/Glo may serve as biomarkers for disease activity and functional limitation in CD patients concomitant with AS, although future studies are expected. PMID:27428240

  3. Sleep continuity scale in Alzheimer's disease (SCADS): application in daily clinical practice in an Italian center for dementia.

    Science.gov (United States)

    Manni, R; Sinforiani, E; Terzaghi, M; Rezzani, C; Zucchella, C

    2015-03-01

    Sleep disorders can occur in many neurodegenerative disorders; in a previous paper we constructed a scale investigating sleep discontinuity/fragmentation with the aim to obtain a rapidly and easily administered tool suitable for early identification and longitudinal monitoring of sleep disturbances in Alzheimer's disease (AD). We introduced this instrument in the daily clinical practice in a center for dementia; here we present the results of our experience. Two hundred and sixteen AD outpatients referred to the Alzheimer's Disease Assessment Unit at the IRCCS C. Mondino National Neurological Institute, Pavia, Italy, in the period October 2012 to March 2014 were administered the scale. The questionnaire global score was correlated with measures of cognitive, functional and behavioral impairment; a significant association was found with Mini-Mental State (p = 0.005), Activities of Daily Living (p = 0.01), Neuropsychiatric Inventory (p = 0.01) and Clinical Dementia Rating (p = 0.0005). The present data indicate that the previously validated questionnaire proves to be a suitable, rapid and easy to use tool in investigating sleep quality in AD in daily clinical practice. An early identification and longitudinal monitoring of sleep disturbances in AD may improve pharmacological and non-pharmacological interventions. PMID:25294429

  4. CLINICAL PROFILE OF HEMOPHILIA PATIENTS: A CROSS SECTIONAL STUDY AT A TERTIARY CARE CENTER IN INDIA

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    Ram Sunder

    2015-12-01

    Full Text Available The study was designed to determine clinical profile of haemophilia patients in North India. In this cross-sectional study, we obtained family history and clinical profile of 54 diagnosed severe haemophilia patients attending Haemophilia Treatment Centre, Children Hospital LLR Hospital, Kanpur, India, for factor replacement therapy. We also obtained blood samples to investigate for hepatitis B, HIV. In study we observed that majority of the patients having their first presentation in their infancy (70.3% and median age of first presentation was 11 months of age. Though haemophilia is a genetic disorder, family history was negative in majority of patients; (70.3% subcutaneous tissue was most frequent site for initial bleeds, but as age advances joints become frequently involved and hemarthrosis was commonest complication affecting 79.6% patients. Most common involved joint was knee joint (53.7%. This hemarthrosis is the major cause of morbidity affecting quality of life of patients. Due to cost of treatment, many times we have to transfuse blood and blood products which may lead to Transfusion Transmitted Infection (TTI. In our study prevalence of TTI was 1.85% and 3.70% for HIV and Hep. B respectively. We also observed that there was time lag of >1 month in 16.5% cases between onset of symptom and definitive diagnosis, which shows lack of awareness among doctors in community. In view of this high morbidity and TTIs, we emphasize the free availability of factor concentrates and prophylactic treatment should be followed instead of palliative treatment.

  5. Acute pancreatitis in pregnancy: a 6-year single center clinical experience

    Institute of Scientific and Technical Information of China (English)

    LI Hua-ping; HUANG Ya-juan; CHEN Xuan

    2011-01-01

    Background The acute abdomen remains a challenge for all obstetricians and physicians who take part in the care of women in pregnancy.To add substantially to our understanding of acute pancreatitis (AP) in pregnancy,in particular affirming the increased risks for mother and fetus associated with AP,we explored features of clinical manifestation and the strategy of management of this disease during pregnancy,and its effects on maternal and fetal outcomes.Methods A retrospective review of medical records of all pregnant patients diagnosed with AP admitted to the Department of Obstetrics and Gynecology,Sixth People's Hospital Affiliated to Shanghai Jiao Tong University between 2005 and 2010 was performed.Information was collected from presentation,management,and outcome from medical records.Results There were 11 cases in 2010,accounting for 44% of 25 cases.Among these cases,mild AP (MAP) occurred in 15 cases (60%),while the rest cases were severe AP (SAP) (40%).The major etiology of AP in pregnancy was due to gallstone and cholecystitis.Clinical features together with elevation of the plasma concentrations of pancreatic enzymes were the cornerstones of diagnosis.Positive conservative treatment was taken in most of the cases (21 cases,84%) with a favorable outcome.Seven cases of critically ill patients were monitored in intensive care unit,and 4 patients underwent surgical interventions.As a result,all of 25 patients had better prognosis,no maternal death was observed.There were 8 preterm labors and 2 fetal losses,accounting for the perinatal mortality of 8%.Fetal malformation was not observed.Conclusions While a pregnant woman suffers acute abdominal pain,early diagnosis and severity assessment of AP are very important.Conservative comprehensive treatment with intensive care is recommended.Surgical intervention should be performed as late as possible.

  6. Electronic data capture and DICOM data management in multi-center clinical trials

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    Haak, Daniel; Page, Charles-E.; Deserno, Thomas M.

    2016-03-01

    Providing eligibility, efficacy and security evaluation by quantitative and qualitative disease findings, medical imaging has become increasingly important in clinical trials. Here, subject's data is today captured in electronic case reports forms (eCRFs), which are offered by electronic data capture (EDC) systems. However, integration of subject's medical image data into eCRFs is insufficiently supported. Neither integration of subject's digital imaging and communications in medicine (DICOM) data, nor communication with picture archiving and communication systems (PACS), is possible. This aggravates the workflow of the study personnel, in special regarding studies with distributed data capture in multiple sites. Hence, in this work, a system architecture is presented, which connects an EDC system, a PACS and a DICOM viewer via the web access to DICOM objects (WADO) protocol. The architecture is implemented using the open source tools OpenClinica, DCM4CHEE and Weasis. The eCRF forms the primary endpoint for the study personnel, where subject's image data is stored and retrieved. Background communication with the PACS is completely hidden for the users. Data privacy and consistency is ensured by automatic de-identification and re-labelling of DICOM data with context information (e.g. study and subject identifiers), respectively. The system is exemplarily demonstrated in a clinical trial, where computer tomography (CT) data is de-centrally captured from the subjects and centrally read by a chief radiologists to decide on inclusion of the subjects in the trial. Errors, latency and costs in the EDC workflow are reduced, while, a research database is implicitly built up in the background.

  7. Clinical outcomes of liver transplantation for polycystic liver disease: a single center experience.

    Science.gov (United States)

    Chandok, Natasha; Uhanova, Julia; Marotta, Paul

    2010-01-01

    Polycystic liver disease (PLD) is a celiopathy characterized by progressive growth of multiple hepatic cysts. In a minority of patients, severe symptomatic hepatomegaly necessitates liver transplantation (LT). The purpose of this study is to describe the postoperative and long-term outcomes of all patients transplanted for PLD at our center. All patients who underwent LT for PLD were identified through our database. Using patient charts, data were extracted on patient demographics and medical history, postoperative surgical and medical complications, length of hospitalization, prevalence of chronic kidney failure, and patient and graft survival. Subjects were contacted in April 2010 to verify their survival and confirm their need, if any, for hemodialysis and/or kidney transplantation. Descriptive statistics for patient and graft survival were performed. From 1993 to 2010, 14 subjects underwent LT and 1 subject underwent combined kidney and LT; all subjects were female and the mean age was 49.0 years. 10 (66.7%) subjects had polycystic kidney disease. Patients experienced a high rate of vascular complications, including hepatic artery thrombosis (HAT) or stenosis in 3 (20%) and 2 (13.3%) subjects, respectively. One subject had early graft loss due to HAT and underwent re-transplantation. The mean length of hospitalization was 18.8 days. After a mean of 66.8 months of follow-up (3-200), 13 (86.7%) subjects are alive with satisfactory graft function, and no patients had renal failure. In conclusion, patients who underwent LT for PLD had a high rate of postoperative vascular complications. However, long-term patient and graft survival, and kidney function, is excellent. PMID:20720268

  8. CLINICAL PROFILE OF PATIENTS WITH DILATED CARDIOMYOPATHY IN A TERTIARY CARE CENTER IN NORTH EAST INDIA

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    Naruttam

    2014-07-01

    Full Text Available BACKGROUND: Dilated cardiomyopathy (DCM is a severe illness with high mortality in the young adult population in resource limited settings. In north-east part of India, clinicians still continue to face the challenges of identifying and treating the dilated cardiomyopathy to improve quality of life due to various reasons. In India, there have been few investigations focusing on the dilated cardiomyopathy patients. But from this part of the country, there is paucity of data. Therefore, the present study was undertaken to examine the clinical characteristics of dilated cardiomyopathy patients who presented to our hospital. MATERIALS AND METHODS: This prospective observational study was carried out in the Department of General Medicine, Jorhat Medical College and Hospital, Jorhat, Assam, from January 2013 to December 2013. Total 31 consecutive patients fulfilling the criteria of dilated cardiomyopathy were studied. Dilated Cardiomyopathy was diagnosed if enlarged left ventricle with decreased systolic function as measured by left ventricular ejection fraction characterized dilated cardiomyopathy. Patients were excluded from the study if they have one or more of the following; systemic hypertension (>160/100 mm Hg, evidence of coronary artery diseases, pericardial diseases, congenital heart disease, valvular heart diseases, cor pulmonale and rapid, sustained supraventricular tachycardia. Detailed inform consent from the patients and ethical permission from the concerned authorities were taken. RESULTS: Thirty one patients were diagnosed with dilated cardiomyopathy during the study period who fulfilled the inclusion and exclusion criteria of the study. Twenty-nine (92% of 31 patients presented with clinical features of congestive heart failure as their initial presentation and majority presented with dyspnea (70.97%, followed by palpitation (64.52%. The mean cardio thoracic ratio was (0.61. Majority of the patients (70.97% were in sinus rhythm and

  9. The Clinical Research Center for Depression Study: Baseline Characteristics of a Korean Long-Term Hospital-Based Observational Collaborative Prospective Cohort Study

    OpenAIRE

    Kim, Tae-Suk; Jeong, Seung Hee; Kim, Jung-Bum; Lee, Min-Soo; Kim, Jae-Min; Yim, Hyeon-Woo; Jun, Tae-Youn

    2010-01-01

    Objective The Clinical Research Center for Depression (CRESCEND) study is a 9-year observational collaborative prospective cohort study for the clinical outcomes in participants with depressive disorders in Korea. In this study, we examined the baseline characteristics of the depressive participants as the hospital-based cohort. Methods Participants were assessed using various instruments including the Clinical Global Impression scale, 17-item Hamilton Depression Rating Scale (HDRS-17), Hamil...

  10. Bacteriological profile and antibiotic susceptibility patterns of clinical isolates in a tertiary care cancer center

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    Vivek Bhat

    2016-01-01

    Full Text Available Introduction: This increased risk of bacterial infections in the cancer patient is further compounded by the rising trends of antibiotic resistance in commonly implicated organisms. In the Indian setting this is particularly true in case of Gram negative bacilli such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter spp. Increasing resistance among Gram positive organisms is also a matter of concern. The aim of this study was to document the common organisms isolated from bacterial infections in cancer patients and describe their antibiotic susceptibilities. Methods: We conducted a 6 month study of all isolates from blood, urine, skin/soft tissue and respiratory samples of patients received from medical and surgical oncology units in our hospital. All samples were processed as per standard microbiology laboratory operating procedures. Isolates were identified to species level and susceptibility tests were performed as per Clinical Laboratory Standards Institute (CLSI guidelines -2012. Results: A total of 285 specimens from medical oncology (114 and surgical oncology services (171 were cultured. Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter spp. were most commonly encountered. More than half of the Acinetobacter strains were resistant to carbapenems. Resistance in Klebsiella pneumoniae to cephalosporins, fluoroquinolones and carbapenems was >50%. Of the Staphylococcus aureus isolates 41.67% were methicillin resistant. Conclusion: There is, in general, a high level of antibiotic resistance among gram negative bacilli, particularly E. coli, Klebsiella pneumoniae and Acinetobacter spp. Resistance among Gram positives is not as acute, although the MRSA incidence is increasing.

  11. Evaluating the value of a web-based natural medicine clinical decision tool at an academic medical center

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    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.

  12. Clostridium difficile-associated diarrhea in the Clinical Center of Vojvodina, Serbia, in the period 2008 to 2012

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    Stefan-Mikić Sandra

    2014-01-01

    Full Text Available Clostridium difficile-associated diarrhea (CDAD has been recognized as the leading cause of diarrhea worldwide. In the last five years, it has become the leading cause of diarrhea in the Clinical Center of Vojvodina (CCV as well. The aim of this study was to determine the epidemiology and total cost of treatment for all patients with Clostridium difficile-associated diarrhea hospitalized at the Infectious Disease Clinic of the CCV; to analyze the costs of treatment with regard to therapeutic approach; to compare the costs of treatment in each year of the investigated period related to the number of patients, and to analyze the outcome of treatment. The study was retrospective, and the data were collected from the medical records of 472 patients with Clostridium difficile diarrhea treated from 2008 to 2012 and analyzed. Of the total 472 patients with CDAD, 54.23% were female and the average age was 65.84. A statistically significant majority of them had been previously treated in other hospitals and a minority in ambulatory settings (395 inpatients vs. 77 outpatients, p=0.000, p<0.05. Of the 395 previously hospitalized patients, most were from the Clinic of Urology of the CCV (58, 14.68%. When comparing therapeutic options, oral vancomycin was significantly more frequently used than other protocols. The average mortality rate during the study period was 6.51%. In this period, total hospital costs related to Clostridium difficile diarrhea in the Infectious Disease Clinic were $636,679.92. Implementation of infection-control measures and a restricted use of antibiotics would result in a great reduction in material costs.

  13. Etiology and clinical profile of patients with Cushing′s syndrome: A single center experience

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    Ariacherry C Ammini

    2014-01-01

    Full Text Available Background: There is little published literature on the profile of patients with Cushing′s syndrome (CS from India. The aim of this study was to compile data of CS patients treated at this hospital. Materials and Methods: Patients referred to the endocrine services of this hospital for diagnosis/treatment of CS from January 1985 to July 2012 were the subjects for this study. All patients had detailed medical history, physical examination and biochemical and hormonal assays (which changed with availability of tests and changing views. Assays for plasma adrenocorticotropic hormone (ACTH (late 90s, salivary cortisol estimation, IJV sampling for ACTH and corticotrophin releasing hormone stimulation tests were added on later. Imaging included computed tomography (CT, magnetic resonance imaging (since the late 80′s and 68 Ga DOTA-TOC/FDG PET-CT (2008. Results: Three hundred sixty-four patients (250 females, 114 males, age 6 months to 65 years, mean 28 years + 12 years were diagnosed to have CS during this period. Two hundred and ninety-three patients (80.5% were ACTH dependent (CD 215, ectopic ACTH syndrome 22, occult ACTH source 56 while 71 (19.5% were ACTH independent (adrenal carcinoma 36, adenoma 30, primary pigmented nodular adrenal disease 4, AIMAH 1. Pituitary macro adenoma was seen in 14% of the CD cases. The most common presenting complaints were hypertension and diabetes mellitus. A total of 63% patients complained of weight gain while 15% had lost weight. Myopathy, infections, skeletal fractures and psychiatric problems were the other common observations in our patients. Conclusion: The clinical spectrum was broad. CD was the most common cause for CS.

  14. Clinical and bacteriological profile of UTI patients attending a North Indian tertiary care center

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    Saif Quaiser

    2015-01-01

    Full Text Available Introduction: Urinary tract infection (UTI is a common cause of morbidity in patients attending our hospital. Recently UTI has become more complicated and difficult to treat because of appearance of pathogens with increasing resistance to the commonly used antimicrobial agents. Objectives: The main aim of the study was to determine the bacteriological profile and antibiotic susceptibility pattern of UTI patients attending our hospital. Materials and Methods: 1843 patients complaining of fever with or without urinary symptoms attending medicine and nephrology clinics of Jawaharlal Nehru Medical College Hospital, Aligarh from June 2012 to July 2014 were analysed. Clean catch mid-stream urine specimens collected from each subject were subjected to urine culture and sensitivity tests. Patients with age 15 to 85 years were included. Results: Significant bacteriuria was detected in 33.4% patients. Diabetes, obstructive uropathy, and previous instrumentation were the major risk factors identified. The most common pathogens isolated were Escherichia coli (52.4%, Klebsiella pneumoniae (12.3% and Citrobacter spp. (9.1%. Most susceptible antibiotic was Amikacin, Cefoperazone-sulbactum, Piperacillin-tazobactum and Nitrofurantoin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin (78.3%, Cefoperazone-sulbactum (72.8%, Piperacillin-tazobactum (70.5%, Gentamicin (69.3%, Nitrofurantoin (67.3%, Cefoperazone (64.1% and Ceftriaxone (61.6%. Conclusion: This study highlights the common pathogens causing UTI in our area and their antibiotic sensitivity patterns which could help clinicians in starting rational empirical antibiotic therapy for such patients while awaiting urine culture reports. This would significantly decrease the incidence of drug resistance and be more cost effective to the patients.

  15. Multi-centered Clinical Study on Effects of Nano-Amomi Paste in Treating Children's Anorexia

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    WU Min; LI Zhan; YU Jian-er; LU Wei-wei; NI Ju-xiu; XIA Yi-lin

    2007-01-01

    Objective:To assess the effect and safety of nano-Amoni Paste (nmAP) in the treatment of children's anorexia (AR).Methods:One hundred and eighty patients of AR were assigned accordlng to the randomized,double-blinded,double-simulated and parallel controlled principle to three groups,the treated group (TG),the positive control group (PCG) and the negative control group (NCG),60 in each group.The patients in TG were treated by sticking 1.5 ml of nmAP on the acupoint of Shenque (Ren 8) once a day and orally taking placebo liquid 10 ml twice a day;those in PCG and NGG treated with sticking paste of placebo on Ren 8,and oral taking of Shanmai Jianpi Oral Liquid (山麦健脾口服液) and placebo liquid respectively,10 ml each time twice per day.The course of treatment for all was 10 days,all patients were treated for 2 courses.Results:The total effective rate and the effective rate on cardinal symptom in TG was 85.0% and 95.0% respectively,that in PCG 86.2% and 96.55% and in NCG 45.5% and 65.45%,respectively,showing significant difference between groups (P<0.05).Comparison of the clinical manifestation before and after treatment showed significant improvement in volume of food intake,appetite,complexion and reduction of restlessness symptom (P<0.05) in all three groups,and there was no adverse reaction found in them.Conclusion:nmAP is an effective and safe remedy for treatment of Children's anorexia.

  16. IMRT for locally advanced anal cancer: clinical experience of the Montpellier Cancer Center

    International Nuclear Information System (INIS)

    To assess outcomes of patients with carcinoma of the anal canal (CAC) treated with intensity-modulated radiation therapy (IMRT). From August 2007 to January 2011, seventy-two patients suffering from CAC were treated with IMRT. Concurrent chemotherapy was added in case of locally advanced tumors. Radiation course consisted in delivering an initial plan to the PTV1 defined as the primary tumor and the risk area including pelvic and inguinal nodes. Forty-five Gy in daily 1.8 Gy-daily fractions were delivered five days a week. A second plan of 14.4-20 Gy to the primary tumor (PTV2) was administered in 1.8-2 Gy-daily fractions, 5 days a week. We present here the results of dosimetry, toxicities, and clinical outcome of the first 39 patients with a median follow-up of 24 months. Thirty-one women and eight men were included in the present analysis. Tumors were classified as stages I, II, III and IV in 2, 7, 27 and 2 patients, respectively. Median age was 59 years (range, 38-85). Radiotherapy alone (RT) or combined with chemotherapy (RCT) were delivered in 6 (15%) and 33 (85%) patients, respectively. Six patients (15%) required a treatment break ≥ 3 days, and median time for treatment break was 8 days (range, 3-14 days). Acute grade 3 gastrointestinal (GI) and genitourinary (GU) toxicities were seen in 10 and 5% of patients, respectively. Grade 4 toxicity was only hematologic and occurred in 12% patients receiving RCT. With a median follow-up of 24 months, no patient experienced any late grade 4 toxicity. The 2-year overall survival rate was 89%, the 2-year local relapse free survival was 77% and the 2-year colostomy-free survival rate was 85%. IMRT is well tolerated with acceptable treatment interruption allowing dose escalation

  17. Clinical course of a cohort of children with non-neurogenic daytime urinary incontinence symptoms followed at a tertiary center

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    Adrienne Lebl

    2016-04-01

    Full Text Available Abstract Objective: To characterize a cohort of children with non-neurogenic daytime urinary incontinence followed-up in a tertiary center. Methods: Retrospective analysis of 50 medical records of children who had attained bladder control or minimum age of 5 years, using a structured protocol that included lower urinary tract dysfunction symptoms, comorbidities, associated manifestations, physical examination, voiding diary, complementary tests, therapeutic options, and clinical outcome, in accordance with the 2006 and 2014 International Children's Continence Society standardizations. Results: Female patients represented 86.0% of this sample. Mean age was 7.9 years and mean follow-up was 4.7 years. Urgency (56.0%, urgency incontinence (56.0%, urinary retention (8.0%, nocturnal enuresis (70.0%, urinary tract infections (62.0%, constipation (62.0%, and fecal incontinence (16.0% were the most prevalent symptoms and comorbidities. Ultrasound examinations showed alterations in 53.0% of the cases; the urodynamic study showed alterations in 94.7%. At the last follow-up, 32.0% of patients persisted with urinary incontinence. When assessing the diagnostic methods, 85% concordance was observed between the predictive diagnosis of overactive bladder attained through medical history plus non-invasive exams and the diagnosis of detrusor overactivity achieved through the invasive urodynamic study. Conclusions: This subgroup of patients with clinical characteristics of an overactive bladder, with no history of urinary tract infection, and normal urinary tract ultrasound and uroflowmetry, could start treatment without invasive studies even at a tertiary center. Approximately one-third of the patients treated at the tertiary level remained refractory to treatment.

  18. Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical center: a clinical audit

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    Chen M

    2014-02-01

    Full Text Available Ming Chen,1 Kara C LaMattina,2 Thomas Patrianakos,2 Surendar Dwarakanathan2 1Department of Surgery, Division of Ophthalmology, University of Hawaii, Honolulu, HI, USA; 2Division of Ophthalmology, John H Stroger, Jr Hospital of Cook County, Chicago, IL, USA Purpose: To compare the complication rate of posterior capsule rupture (PCR with vitreous loss during phacoemulsification at an ambulatory surgical center with published results as a clinical audit for quality control. Methods: A retrospective chart review of 3,339 consecutive patients who underwent routine phacoemulsification by four experienced private practice surgeons from January 1, 2011 to June 30, 2012 at The Surgical Suites, Honolulu, HI, USA. All cases with PCR and vitreous loss were identified and selected for the study. Risk factors of this complication were further examined. Data were sent to John H Stroger Jr Hospital of Cook County, Division of Ophthalmology, for literature review, analysis, and write-up. Results: Twenty-three of the 3,339 cases incurred PCR and vitreous loss during phacoemulsification, for an incidence rate of 0.68%. Miosis, shallow chamber, restlessness, pseudoexfoliation syndrome, floppy iris syndrome, and zonulopathy were the main causes. In addition, surgeon volume (number of cases was inversely correlated with PCR. Conclusion: The rate of PCR with vitreous loss during phacoemulsification in this study may be lower than other published results done at academic centers. However, there was no compatible study available for comparison, as existing studies performed at academic centers included resident cases. This study identified risk factors for PCR/vitreous loss both preoperatively and postoperatively that may assist in application of preventive measures to decrease rates of PCR/vitreous loss. Keywords: phacoemulsification complications, posterior capsule rupture, vitreous loss, vitrectomy, miosis, pseudoexfoliation, floppy iris syndrome, zonulopathy

  19. Change in clinical indices following laser or scalpel treatment for periodontitis: A split-mouth, randomized, multi-center trial

    Science.gov (United States)

    Harris, David M.; Nicholson, Dawn M.; McCarthy, Delwin; Yukna, Raymond A.; Reynolds, Mark A.; Greenwell, Henry; Finley, James; McCawley, Thomas K.; Xenoudi, Pinelopi; Gregg, Robert H.

    2014-02-01

    Data are presented from a multi-center, prospective, longitudinal, clinical trial comparing four different treatments for periodontitis, (1) the LANAPTM protocol utilizing a FR pulsed-Nd:YAG laser; (2) flap surgery using the Modified Widman technique (MWF); (3) traditional scaling and root planing (SRP); and (4) coronal debridement (CD). Each treatment was randomized to a different quadrant. Fifty-one (54) subjects were recruited at five centers that included both private practice and university-based investigators. At 6-months and 12 months post-treatment the LANAPTM protocol and MWF yielded equivalent results based on changes in probing depths. The major difference observed between the two procedures was that patients reported significantly greater comfort following the LANAP™ procedure than following the MWF (P<0.001). There was greater reduction in bleeding in the LANAPTM quadrant than in the other three at both 6 and 12 months. Improvements following SRP were better than expected at 6 months and continued to improve, providing outcomes that were equivalent to both LANAPTM and MWF at 12 months. The improvement in the SRP quadrants suggests the hypothesis that an aspect of the LANAPTM protocol generated a significant, positive and unanticipated systemic (or trans-oral) effect on sub-gingival wound healing.

  20. Demographic and clinical profile of substance abusing women seeking treatment at a de-addiction center in north India

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    Naresh Nebhinani

    2013-01-01

    Full Text Available Background: In the recent decades increasing number of women have been seeking deaddiction services. Despite that the report data is very limited from India. Objectives: The present research aimed to study the demographic and clinical profile of women seeking deaddiction treatment at a tertiary care center in North India. Materials and Methods: Retrospective structured chart review of 100 women substance abusers seeking treatment at a deaddiction center between September 1978 and December 2011. Results: A typical case was of 36.3 years age, married (65%, urban (61%, nuclear family (59% based housewife (56%, with good to fair social support (69%. The commonest substance of abuse was tobacco (60%, followed by opioids (27%, alcohol (15%, and benzodiazepines (13%. The common reasons for initiation of substance use were to alleviate frustration or stress (49% and curiosity (37%. Family history of drug dependence (43%, comorbidity (25%, and impairments in health (74%, family (57%, and social domains (56% were common. Only a third of the sample paid one or more follow visit, and of those 58% were abstinent at the last follow-up. Significant predictors identified were being non-Hindu and higher educational years for abstinent status at follow-up. Conclusion: The common substances of abuse were tobacco, opioids, and alcohol and benzodiazepines; and family history of drug abuse and comorbidity were common. The follow-up and outcome were generally poor. This profile gives us some clues to address a hidden health problem of the community.

  1. Clinical Characteristics and Outcomes for Solitary Fibrous Tumor (SFT: A Single Center Experience.

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    Nicholas DeVito

    Full Text Available Solitary fibrous tumor (SFT is a mesenchymal neoplasm of fibrous origin. The 2013 WHO classification of soft tissue tumors defines malignant forms as hypercellular, mitotically active (>4 mitosis/10 high-power fields, with cytological atypia, tumor necrosis, and/or infiltrative margins. With an IRB-approved protocol, we investigated patient records and clinicopathologic data from our Sarcoma Database to describe the clinical characteristics of both benign and malignant SFT. All pathology specimens were reviewed by two pathologists. Descriptive statistics and univariate/multivariate survival analysis were performed. Patient records and Social Security Death Index were used to evaluate vital status. Of 82 patients, 47 (57% were women and 73 (89% were Caucasian. Median age was 62 years (range, 20 to 89. Thirty-two (39% patients succumbed to the disease. Primary tumor site was lung/pleura in 28 (34%, abdomen/pelvis in 23 (28%, extremity in 13 (16%, and head/neck in 9 (11% patients. Pathology was described as benign in 42 (51% and malignant in 40 (49% patients. Compared to benign SFT, malignant histology is associated with larger tumor size, higher mitotic counts, metastatic disease at diagnosis, and greater use of chemotherapy and radiation therapy. Gender, age, and tumor site were not significantly different between benign and malignant subtypes. By univariate analysis, only benign vs. malignant variant and complete resection positively impacted overall survival (P = 0.02 and P<0.0001, respectively. In the multivariable analysis of overall survival, receiving chemotherapy or not receiving surgery were two variables significantly associated with higher failure rate in overall survival: patients with chemotherapy vs. no chemotherapy (P = 0.003, HR = 4.55, with 95% CI: 1.68-12.34 and patients without surgery vs. with surgery (P = 0.005, HR = 25.49, with 95% CI: 2.62-247.57. Clear survival differences exist between benign and malignant SFT. While

  2. Epidemiology, Clinical Features and Outcome of Liver Abscess: A single Reference Center Experience in Qatar

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    Mushtak Talib Abbas

    2014-07-01

    Full Text Available Objective: To describe the etiology, clinical presentation, management and outcome of liver abscess in adult patients admitted at Hamad general hospital, Qatar. Methods: A cross sectional study was conducted to involve all adult patients who sequentially encountered episodes of liver abscess during the period from January 1, 2009, to December 31, 2010. Blood cultures were drawn from all patients in the first 24 hours after admission. In addition, all patients had stool examinations and indirect Hemagglutination test for Entameba histolytica. Aspiration of abscess was done under CT guidance and aspirated pus was sent for gram stain and culture. Results: In total, 67 patients were admitted with liver abscess; 56 patients with pyogenic liver abscess and 11 with amebic liver abscess. There were 61 (91% males and six (9% females and their mean age was 47.4 ± 18.5 years. Fever, abdominal pain and vomiting were the commonest presenting features. Of the 56 pyogenic liver abscess patients, four discharged against medical advice and seven refused all invasive procedures and were treated with antibiotics for six weeks. The remaining 44 (79% patients were treated with antibiotics and one or more invasive procedures, while one patient was treated surgically. The commonest organism isolated was Klebseilla pneumonia found in 21 patients (38%. The mean duration of hospitalization was 13.6 ± 8.1 days; the mean duration of antibiotic therapy was 34.7 ± 40.6 days, and one patient died. In contrast, all amebic liver abscess patients underwent ultrasound guided aspiration and showed good response to metronidazole treatment. Their mean duration of hospitalization was 7.7 ± 4.1 days, mean duration of therapy was 11.8 ± 2.1 days, and all patients were cured. Conclusion: Pyogenic liver abscess was more common than amebic liver abscess with Klebseilla pneumonia being the commonest organism. With good medical measures and early drainage of liver abscess, surgical

  3. Clinical spectrum and outcomes of crescentic glomerulonephritis: A single center experience

    Science.gov (United States)

    Rampelli, S. K.; Rajesh, N. G.; Srinivas, B. H.; Harichandra Kumar, K. T.; Swaminathan, R. P.; Priyamvada, P. S.

    2016-01-01

    There is limited data on the etiology, clinical and histopathological spectrum and outcomes of crescentic glomerulonephritis (CrGN) in adult Indian population. This prospective study was done to evaluate the etiology, clinicohistological patterns and predictors of outcome of CrGN in South Indian population. All the patients received standard protocol based immunosuppression in addition to supportive care. Immune-complex glomerulonephritis (ICGN) was the most common etiology (n = 31; 77.5%) followed by pauci-immune glomerulonephritis (PauciGN; n = 8; 20%) and anti-glomerular basement membrane disease (n = 1; 2.5%). The most common etiology of ICGN was IgA nephropathy (n = 11; 27.5%) followed by lupus nephritis (n = 7; 17.5%) and post-infectious glomerulonephritis (PIGN) (n = 7; 17.5%). The patients with PauciGN were significantly older compared to those with ICGN (44.5 ± 15 years vs. 31.8 ± 11 years; P = 0.01). The patients with PauciGN presented with significantly higher serum creatinine (9.7 ± 4.4 vs. 6.6 ± 3.3 mg/dl; P = 0.03). The histopathologic parameters of ICGN and PauciGN were comparable except for a higher proportion of sclerosed glomeruli in ICGN. At the end of 3 months follow-up, only two patients went into complete remission (5.4%). Majority of the patients had end-stage renal failure (48.6%) and were dialysis dependent and seven patients (18.9%) expired. There was no signifi difference in the renal survival (10.9 ± 1.9 vs. 9.6 ± 3.3 months) or patient survival (17.5 ± 2.1 vs. 17.3 ± 4.3 months). The parameters associated with adverse outcomes at 3 months were hypertension (odds ratio [OR]: 0.58; confidence interval [CI]: 0.36–0.94), need for renal replacement therapy (OR: 0.19; CI: 0.04–0.9), serum creatinine at admission (P = 0.019), estimated glomerular filtration rate (P = 0.022) and percentage of fibrocellular crescents (P = 0.022). PMID:27512296

  4. Improving clinical research and cancer care delivery in community settings: evaluating the NCI community cancer centers program

    Directory of Open Access Journals (Sweden)

    Fennell Mary L

    2009-09-01

    Full Text Available Abstract Background In this article, we describe the National Cancer Institute (NCI Community Cancer Centers Program (NCCCP pilot and the evaluation designed to assess its role, function, and relevance to the NCI's research mission. In doing so, we describe the evolution of and rationale for the NCCCP concept, participating sites' characteristics, its multi-faceted aims to enhance clinical research and quality of care in community settings, and the role of strategic partnerships, both within and outside of the NCCCP network, in achieving program objectives. Discussion The evaluation of the NCCCP is conceptualized as a mixed method multi-layered assessment of organizational innovation and performance which includes mapping the evolution of site development as a means of understanding the inter- and intra-organizational change in the pilot, and the application of specific evaluation metrics for assessing the implementation, operations, and performance of the NCCCP pilot. The assessment of the cost of the pilot as an additional means of informing the longer-term feasibility and sustainability of the program is also discussed. Summary The NCCCP is a major systems-level set of organizational innovations to enhance clinical research and care delivery in diverse communities across the United States. Assessment of the extent to which the program achieves its aims will depend on a full understanding of how individual, organizational, and environmental factors align (or fail to align to achieve these improvements, and at what cost.

  5. Clinical Outcomes of Myasthenia Gravis with Thymoma and Thymic Hyperplasia Undergoing Extended Transsternal Thymectomy: A Single-Center Experience

    Science.gov (United States)

    Nazarbaghi, Surena; Amiri-Nikpour, Mohammad Reza; Mahmodlou, Rahim; Arjmand, Nasim; Rezaei, Yousef

    2015-01-01

    Background: Despite the widespread use of thymectomy in myasthenia gravis (MG) patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1999 to December 2013, MG patients who underwent thymectomy were followed up. Out of 41 MG patients admitted in our center, 25 patients had undergone thymectomy adjunctive to pyridostigmine and prednisolone therapy postoperatively. The primary endpoints included improvement in individual diplopia, ptosis, dysphagia, dysarthria, dyspnea, and limb weakness. In addition, according to the MG Foundation of America (MGFA) criteria, response to therapy was defined as complete stable remission (CSR), pharmacologic remission (PR), and minimal manifestation (MM) as secondary endpoints. Results: Majority of the patients were male (60%) and the mean age of the patients was 32.2 ± 13.9 years. Fifteen (60%) and 10 patients (40%) had thymoma and thymic hyperplasia, respectively. All the patients were followed up during a mean period of of 86.9 ± 50.3 months (minimum 10 months and maximum 168 months). The rates of CSR, PR, and MM were comparable between the thymoma and thymic hyperplasia groups (P = 0.584). Based on the Kaplan Meier analysis, the probabilities of CSR, PR, and MM were not significantly different between patients with thymoma and thymic hyperplasia. Conclusion: The extended transsternal thymectomy, along with the postoperative regimen of pyridostigmine and prednisolone was associated with a high rate of clinical improvement among MG patients with thymoma or thymic hyperplasia. PMID:26713298

  6. Clinical outcomes of myasthenia gravis with thymoma and thymic hyperplasia undergoing extended transsternal thymectomy: A single-center experience

    Directory of Open Access Journals (Sweden)

    Surena Nazarbaghi

    2015-01-01

    Full Text Available Background: Despite the widespread use of thymectomy in myasthenia gravis (MG patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1999 to December 2013, MG patients who underwent thymectomy were followed up. Out of 41 MG patients admitted in our center, 25 patients had undergone thymectomy adjunctive to pyridostigmine and prednisolone therapy postoperatively. The primary endpoints included improvement in individual diplopia, ptosis, dysphagia, dysarthria, dyspnea, and limb weakness. In addition, according to the MG Foundation of America (MGFA criteria, response to therapy was defined as complete stable remission (CSR, pharmacologic remission (PR, and minimal manifestation (MM as secondary endpoints. Results: Majority of the patients were male (60% and the mean age of the patients was 32.2 ± 13.9 years. Fifteen (60% and 10 patients (40% had thymoma and thymic hyperplasia, respectively. All the patients were followed up during a mean period of of 86.9 ± 50.3 months (minimum 10 months and maximum 168 months. The rates of CSR, PR, and MM were comparable between the thymoma and thymic hyperplasia groups (P = 0.584. Based on the Kaplan Meier analysis, the probabilities of CSR, PR, and MM were not significantly different between patients with thymoma and thymic hyperplasia. Conclusion: The extended transsternal thymectomy, along with the postoperative regimen of pyridostigmine and prednisolone was associated with a high rate of clinical improvement among MG patients with thymoma or thymic hyperplasia.

  7. Risk factors, microbiological findings, and clinical outcomes in cases of microbial keratitis admitted to a tertiary referral center in ireland.

    LENUS (Irish Health Repository)

    Saeed, Ayman

    2012-02-01

    AIM: To identify the risk factors for, and to report the microbiological findings and clinical outcomes of, severe microbial keratitis (MK). METHODS: This was a retrospective study of all cases of presumed MK admitted to a tertiary referral center over a 2-year period (September 2001 to August 2003). Data recorded included demographic data, details relating to possible risk factors, results of microbiological studies, clinical findings at presentation, and clinical and visual outcomes. RESULTS: Ninety patients were admitted with a diagnosis of presumed MK during the study period. The mean age of patients was 45 +\\/- 32 years, and the male to female ratio was 47:43 (52.2%:47.7%). Predisposing risk factors for MK included contact lens wear (37; 41.1%), anterior segment disease (19; 21.1%), ocular trauma (13; 14.4%), systemic disease (5; 5.6%), and previous ocular surgery (1; 1.1%). Cultured organisms included gram-negative bacteria (17; 51.5%), gram-positive bacteria (11, 33.3%), acanthamoeba (2; 6.1%), and fungi (1; 3%). Visual acuity improved significantly after treatment [mean best-corrected visual acuity (+\\/-standard deviation) at presentation: 0.76 (+\\/-0.11); mean best-corrected visual acuity at last follow-up: 0.24 (+\\/-0.07); P < 0.001]. Secondary surgical procedures were required in 18 (20%) cases, and these included punctal cautery (1; 1.1%), tissue glue repair of corneal perforation (2; 2.2%), tarsorrhaphy (9; 9.9%), Botulinum toxin-induced ptosis (1; 1.1%), penetrating keratoplasty (3; 3.3%), and evisceration (2; 2.2%). CONCLUSIONS: Contact lens wear remains a significant risk factor for severe MK. MK remains a threat to vision and to the eye, but the majority of cases respond to prompt and appropriate antimicrobial therapy.

  8. Establishing the Morehouse School of Medicine (MSM) R-CENTER Clinical and Translational Research Web-Portal: The Role of Focus Groups

    OpenAIRE

    Quarshie, Alexander; Davis, Adam; Strayhorn, Gregory; Weaver, Carolyn; Delano, Cigdem; Winters, Kirby; Rice, Robert; Ofili, Elizabeth

    2011-01-01

    The Morehouse School of Medicine (MSM) Research Centers in Minority Institutions (RCMI) Center of Excellence in Clinical and Translational Research has developed a research web-portal to foster research development and collaborations. We describe the role of focus groups (FG). Research faculty and staff were organized into three groups by research interest. Each FG discussion had five steps: Brainstorming, Reporting, Card-sorting, Priority-setting, and Discussions. Integration of top prioriti...

  9. Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study

    Energy Technology Data Exchange (ETDEWEB)

    Amouyal, Gregory, E-mail: gregamouyal@hotmail.com; Thiounn, Nicolas, E-mail: nicolas.thiounn@aphp.fr; Pellerin, Olivier, E-mail: olivier.pellerin@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France); Yen-Ting, Lin, E-mail: ymerically@gmail.com [Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Interventional Radiology Department (France); Giudice, Costantino Del, E-mail: costantino.delgiudice@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France); Dean, Carole, E-mail: carole.dean@aphp.fr [Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Interventional Radiology Department (France); Pereira, Helena, E-mail: helena.pereira@aphp.fr [Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Clinical Research Unit (France); Chatellier, Gilles, E-mail: gilles.chatellier@aphp.fr; Sapoval, Marc, E-mail: marc.sapoval2@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France)

    2016-03-15

    BackgroundProstatic artery embolization (PAE) has been performed for a few years, but there is no report on PAE using the PErFecTED technique outside from the team that initiated this approach.ObjectiveThis single-center retrospective open label study reports our experience and clinical results on patients suffering from symptomatic BPH, who underwent PAE aiming at using the PErFecTED technique.Materials and MethodsWe treated 32 consecutive patients, mean age 65 (52–84 years old) between December 2013 and January 2015. Patients were referred for PAE after failure of medical treatment and refusal or contra-indication to surgery. They were treated using the PErFecTED technique, when feasible, with 300–500 µm calibrated microspheres (two-night hospital stay or outpatient procedure). Follow-up was performed at 3, 6, and 12 months.ResultsWe had a 100 % immediate technical success of embolization (68 % of feasibility of the PErFecTED technique) with no immediate complications. After a mean follow-up of 7.7 months, we observed a 78 % rate of clinical success. Mean IPSS decreased from 15.3 to 4.2 (p = .03), mean QoL from 5.4 to 2 (p = .03), mean Qmax increased from 9.2 to 19.2 (p = .25), mean prostatic volume decreased from 91 to 62 (p = .009) mL. There was no retrograde ejaculation and no major complication.ConclusionPAE using the PErFecTED technique is a safe and efficient technique to treat bothersome LUTS related to BPH. It is of interest to note that the PErFecTED technique cannot be performed in some cases for anatomical reasons.

  10. Clinical and Laboratory Characteristics of Dengue-Orientia tsutsugamushi co-Infection from a Tertiary Care Center in South India

    Science.gov (United States)

    Basheer, Aneesh; Iqbal, Nayyar; Mookkappan, Sudhagar; Anitha, Patricia; Nair, Shashikala; Kanungo, Reba; Kandasamy, Ravichandran

    2016-01-01

    Background Concurrent infection with multiple pathogens is common in tropics, posing diagnostic and treatment challenges. Although co-infections of dengue, malaria, leptospirosis and typhoid in various combinations have been described, data on dengue and scrub typhus co-infection is distinctly limited. Methodology This study was a retrospective analysis of dengue and scrub typhus co-infection diagnosed between January 2010 and July 2014 at a tertiary care center. Clinical and laboratory features of these cases were compared with age and gender-matched patients with isolated dengue fever and isolated scrub typhus. Positive test for dengue non-structural 1 (NS1) antigen was considered diagnostic of dengue whereas scrub typhus was diagnosed by IgM scrub antibodies demonstrated by ELISA. Results There were 6 cases of dengue-scrub co-infection during the review period which fitted clinical and laboratory profile with a mean age of 42.5 years. Fever, headache, and arthralgia were common. Normal hemoglobin, significant thrombocytopenia, transaminitis, and hypoalbuminemia were identified in these patients. Compared to patients with isolated dengue, those with co-infection had higher pulse rate, lower systolic blood pressure, normal leucocyte counts, higher levels of liver enzymes, greater prolongation of partial thromboplastin time (aPTT) and lower serum albumin. Co-infection was characterized by a lower nadir platelet count compared to scrub typhus, and lesser time to nadir platelet count and longer duration of hospital stay compared to either isolated dengue or scrub typhus. Conclusion Dengue-scrub typhus co-infection may be under-diagnosed in tropics, particularly confounded during dengue epidemics. Normal leukocyte counts, early drop in platelets and hypoalbuminemia in dengue patients could be clues to concurrent scrub typhus infection. Prompt recognition and treatment of scrub typhus in such cases may reduce unnecessary hospital stay and cost. PMID:27413521

  11. Clinical Results After Prostatic Artery Embolization Using the PErFecTED Technique: A Single-Center Study

    International Nuclear Information System (INIS)

    BackgroundProstatic artery embolization (PAE) has been performed for a few years, but there is no report on PAE using the PErFecTED technique outside from the team that initiated this approach.ObjectiveThis single-center retrospective open label study reports our experience and clinical results on patients suffering from symptomatic BPH, who underwent PAE aiming at using the PErFecTED technique.Materials and MethodsWe treated 32 consecutive patients, mean age 65 (52–84 years old) between December 2013 and January 2015. Patients were referred for PAE after failure of medical treatment and refusal or contra-indication to surgery. They were treated using the PErFecTED technique, when feasible, with 300–500 µm calibrated microspheres (two-night hospital stay or outpatient procedure). Follow-up was performed at 3, 6, and 12 months.ResultsWe had a 100 % immediate technical success of embolization (68 % of feasibility of the PErFecTED technique) with no immediate complications. After a mean follow-up of 7.7 months, we observed a 78 % rate of clinical success. Mean IPSS decreased from 15.3 to 4.2 (p = .03), mean QoL from 5.4 to 2 (p = .03), mean Qmax increased from 9.2 to 19.2 (p = .25), mean prostatic volume decreased from 91 to 62 (p = .009) mL. There was no retrograde ejaculation and no major complication.ConclusionPAE using the PErFecTED technique is a safe and efficient technique to treat bothersome LUTS related to BPH. It is of interest to note that the PErFecTED technique cannot be performed in some cases for anatomical reasons

  12. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    Energy Technology Data Exchange (ETDEWEB)

    Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E [Surgical Center-Neurophysiology Division of Medical Tecnology Department, Garrahan Children' s Hospital, Combate de los Pozos 1881, Buenos Aires (Argentina)

    2007-11-15

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center.

  13. Acne phototherapy using UV-free high-intensity narrow-band blue light: a three-center clinical study

    Science.gov (United States)

    Shalita, Alan R.; Harth, Yoram; Elman, Monica; Slatkine, Michael; Talpalariu, Gerry; Rosenberg, Yitzhak; Korman, Avner; Klein, Arieh

    2001-05-01

    Propionibacterium. acnes is a Gram positive, microaerophilic bacterium which takes a part in the pathogenesis of inflammatory acne. P. acnes is capable to produce high amounts endogenic porphyrins with no need of any trigger molecules. Light in the violet-blue range (407-420 nm) has been shown to exhibit a phototoxic effect on Propionibacterium acnes when irradiated in vitro. The purpose of our study was to test the clinical effects of a high intensity narrowband blue light source on papulo pustular acne. A total of 35 patients in 3 centers were treated twice a week with a high intensity metal halide lamp illuminating the entire face (20x20 cm2) or the back with visible light in the 407-420 nm range at an intensity of 90 mW/cm2 (CureLight Ltd.) for a total of 4 weeks. UV is totally cut off. In each treatment the patient was exposed to light for 8-15 minutes. After 8 treatments, 80% of the patients with mild to moderate papulo-pustular acne showed significant improvement at reducing the numbers of non- inflammatory, inflammatory and total facial lesions. Inflammatory lesion count decrease by a mean of 68%. No side effects to the treatment were noticed. In conclusion, full face or back illumination with the high intensity pure blue light we used exhibits a rapid significant decrease in acne lesions counts in 8 biweekly treatments.

  14. Methicillin-resistant Staphylococcus aureus nasal cariage among hospitalized patients and healthcare workers in the Clinical center of Serbia

    Directory of Open Access Journals (Sweden)

    Ćirković Ivana

    2014-01-01

    Full Text Available The aim of the present study was to provide the first comprehensive analysis of methicillin-resistant Staphylococcus aureus (MRSA carriage among patients and healthcare workers (HCWs in the largest healthcare facility in Serbia. Specimens from anterior nares obtained from 195 hospitalized patients and 105 HCWs were inoculated after broth enrichment onto chromogenic MRSA-ID medium. In total, 21 of 300 specimens yielded MRSA. Among hospitalized patients, 7.7% were colonized with MRSA, and 5.7% HCWs were colonized with MRSA. Five out of 21 (23.8% tested MRSA strains were classified as community-associated MRSA (CA-MRSA, and four of them were isolated from HCWs. The remaining 16 MRSA strains had characteristics of healthcare-associated MRSA (HA-MRSA, and two of them were isolated from HCWs. The HA-MRSA strains isolated from HCWs were indistinguishable from HA-MRSA of the same cluster isolated from patients. This finding reveals the circulation of HA-MRSA strains between patients and HCWs in the Clinical Center of Serbia. [Projekat Ministarstva nauke Republike Srbije, br. ON 175039

  15. Ocular Stem Cell Research from Basic Science to Clinical Application: A Report from Zhongshan Ophthalmic Center Ocular Stem Cell Symposium

    Directory of Open Access Journals (Sweden)

    Hong Ouyang

    2016-03-01

    Full Text Available Stem cells hold promise for treating a wide variety of diseases, including degenerative disorders of the eye. The eye is an ideal organ for stem cell therapy because of its relative immunological privilege, surgical accessibility, and its being a self-contained system. The eye also has many potential target diseases amenable to stem cell-based treatment, such as corneal limbal stem cell deficiency, glaucoma, age-related macular degeneration (AMD, and retinitis pigmentosa (RP. Among them, AMD and glaucoma are the two most common diseases, affecting over 200 million people worldwide. Recent results on the clinical trial of retinal pigment epithelial (RPE cells from human embryonic stem cells (hESCs and induced pluripotent stem cells (iPSCs in treating dry AMD and Stargardt’s disease in the US, Japan, England, and China have generated great excitement and hope. This marks the beginning of the ocular stem cell therapy era. The recent Zhongshan Ophthalmic Center Ocular Stem Cell Symposium discussed the potential applications of various stem cell types in stem cell-based therapies, drug discoveries and tissue engineering for treating ocular diseases.

  16. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo

    Science.gov (United States)

    Haliti, Naim R; Haliti, Fehim R; Koçani, Ferit K; Gashi, Ali A; Mrasori, Shefqet I; Hyseni, Valon I; Bytyqi, Samir I; Krasniqi, Lumnije L; Murtezani, Ardiana F; Krasniqi, Shaip L

    2015-01-01

    Background Because Kosovo has no reliable information on antimicrobial and analgesic use in dental practice, the survey reported here evaluated the antibiotic and analgesic prescriptions in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo (UDCCK). Methods The data of 2,442 registered patients for a 1-year period were screened and analyzed concerning antibiotic and analgesic use as per standards of rational prescription. Results Dentistry doctors prescribed antibiotics significantly more often than analgesics. Antibiotics were prescribed in 8.11% of all cases, while only 1.35% of total prescriptions were for analgesics. The total consumption of antibiotic drugs in the UDCCK was 4.53 Defined Daily Doses [DDD]/1,000 inhabitants/day, compared with only 0.216 DDD/1,000 inhabitants/day for analgesics. From a total number of 117 patients, 32 patients received combinations of two antibiotics. Conclusion Pharmacotherapy analysis showed that the prescription rates of antibiotics and analgesics in the UDCCK are not rational in terms of the qualitative aspects of treatment. For the qualitative improvement of prescription of these drug groups, we recommend the implementation of treatment guidelines following rational standards. PMID:26491336

  17. Ocular Stem Cell Research from Basic Science to Clinical Application: A Report from Zhongshan Ophthalmic Center Ocular Stem Cell Symposium

    Science.gov (United States)

    Ouyang, Hong; Goldberg, Jeffrey L.; Chen, Shuyi; Li, Wei; Xu, Guo-Tong; Li, Wei; Zhang, Kang; Nussenblatt, Robert B.; Liu, Yizhi; Xie, Ting; Chan, Chi-Chao; Zack, Donald J.

    2016-01-01

    Stem cells hold promise for treating a wide variety of diseases, including degenerative disorders of the eye. The eye is an ideal organ for stem cell therapy because of its relative immunological privilege, surgical accessibility, and its being a self-contained system. The eye also has many potential target diseases amenable to stem cell-based treatment, such as corneal limbal stem cell deficiency, glaucoma, age-related macular degeneration (AMD), and retinitis pigmentosa (RP). Among them, AMD and glaucoma are the two most common diseases, affecting over 200 million people worldwide. Recent results on the clinical trial of retinal pigment epithelial (RPE) cells from human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs) in treating dry AMD and Stargardt’s disease in the US, Japan, England, and China have generated great excitement and hope. This marks the beginning of the ocular stem cell therapy era. The recent Zhongshan Ophthalmic Center Ocular Stem Cell Symposium discussed the potential applications of various stem cell types in stem cell-based therapies, drug discoveries and tissue engineering for treating ocular diseases. PMID:27102165

  18. Clinical characteristics and prognostic factors of splenic abscess: A review of 67 cases in a single medical center of Taiwan

    Institute of Scientific and Technical Information of China (English)

    Kuo-Chin Chang; Chuan-Mo Lee; Tsung-Hui Hu; Seng-Kee Chuah; Chi-Sin Changchien; Tung-Lung Tsai; Sheng-Nan Lu; Yi-Chun Chiu; Yaw-Sen Chen; Chih-Chi Wang; Jui-Wei Lin

    2006-01-01

    AIM: To analyze 67 cases of splenic abscess in a medical center of Taiwan during a period of 19 years.METHODS: From January 1986 to December 2004, a total of 67 patients with splenic abscess were enrolled for the retrospective study. The clinical characteristics,underlying diseases, organism spectra, therapeutic methods, APACHE Ⅱ scores, and mortality rates were analyzed.RESULTS: There were 41 males and 26 females with the mean age of 54.1± 14.1 years. Multiple splenic abscesses (MSA) account for 28.4% and solitary splenic abscess in 71.6% of the patients. Twenty-six of sixtyseven patients (35.8%) had extrasplenic abscesses, with leading site of liver (34.6%). Microbiological cultures were positive in 58 patients (86.6%), with 71.8% in blood culture and 93.5% in abscess culture. Gram negative bacillus (GNB) infection predominated (55.2%),with leading pathogen ofKlebsiella pneumoniae (22.4%),followed by gram positive coccus (GPC) infection (31%).Splenectomy was performed in 26 patients (38.8%),percutaneous drainage or aspiration in 21 (31.3%),and antibiotic therapy alone in 20 patients (29.9%).Eventually, 12 of 67 patients expired (17.9 %). By statistics, spleen infected with GNB was likely to develop multiple abscesses compared with infection with GPC(P=0.036). Patients with GNB infection (P= 0.009) andmultiple abscesses (P= 0.011) experienced a higher mortality rate than patients with GPC infection and solitary abscess. The mean APACHE Ⅱ score of 12 expired patients (16.3 ±3.2) was significantly higher than that of the 55 survivals (7.2 ± 3.8) (P< 0.001).CONCLUSION: MSA, GNB infection, and high APACHEⅡ scores are poor prognostic factors. Early surgical intervention should be encouraged when these risk factors are present.

  19. Translational nutrition research at UC-Davis – the key role of the clinical and translational science center

    Science.gov (United States)

    To better understand the facility and equipment needs for human clinical nutrition research the New York Academy of Sciences presented a symposium. This paper is the result of that symposium and provides information into how clinical nutrition research is conducted at the Clinical and Translational ...

  20. Does Age at Onset of First Major Depressive Episode Indicate the Subtype of Major Depressive Disorder?: The Clinical Research Center for Depression Study

    OpenAIRE

    Park, Seon-Cheol; Hahn, Sang-Woo; Hwang, Tae-Yeon; Kim, Jae-Min; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jung-Bum; Yim, Hyeon-Woo; Park, Yong Chon

    2014-01-01

    Purpose The purpose of this study was to evaluate the effects of age at onset of the first major depressive episode on the clinical features of individuals with major depressive disorder (MDD) in a large cohort of Korean depressed patients. Materials and Methods We recruited 419 MDD patients of age over 18 years from the Clinical Research Center for Depression study in South Korea. At the start of the study, the onset age of the first major depressive episode was self-reported by the subjects...

  1. The level of microbial contamination and frequency of surgical site infections at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac

    OpenAIRE

    Grujović Zoran; Ilić Milena D.; Miličić Biljana

    2005-01-01

    Introduction. The level of microbial contamination is an important risk factor for surgical site infections. The aim of this study was to investigate the frequency of surgical site infections in regard to the level of microbial contamination at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac. Material and methods. This study included 474 patients who underwent surgery in the period from January 1, 2002 to December 31, 2002 at the Department...

  2. The Epidemiological and Clinical Assessment of Admitted Burned Pregnant Women in Shahid Mottahary Hospital Burn Center Between January 1998 and October 2003

    OpenAIRE

    A. Tavassoli-Ashrafi, M.D.; H. Khani, M.D.

    2007-01-01

    Background and purpose: Treatments of burn pregnant women is a difficult task because the vulnerable fetus is highly dependent on the health of the mother. This study was conducted to determine the epidemiology, etiology, clinical assessment and outcome of pregnant patients between January 1998 and October 2003.Materials and Methods: A 6-year retrospective descriptive study of burns in pregnant women hospitalized at Mottahary hospital (burn center) in Tehran was performed. A short structured ...

  3. Cytogenetic and Clinical Features in Children Suspected With Congenital Abnormalities in 1 Medical Center of Zhejiang Province From 2011 to 2014

    OpenAIRE

    Mao, Shujiong; Sun, Liying; Tu, Miaoying; Zou, Chaochun; Wang, Xiumin

    2015-01-01

    Abstract This study aimed to investigate the detection rate of chromosome abnormalities in children suspected with congenital disorders in 1 single center, identify any differences according to different classification criteria, and try to enlighten the medical professionals what clinical features should be transferred for cytogenetic analysis. From January 1, 2011 to March 31, 2014, children who were suspected with chromosomal disorders were included. All the cytogenetic analyses were perfor...

  4. Van Mother-Child Health and Family Planning Center Pap Smear Clinics of Information, Evaluation of Applicants

    OpenAIRE

    Sebahat Gucuk; Servet Alkan; Secil Arica; Aysegul Ates

    2011-01-01

    Objective: In this study of women admitted to our center with information on pap smear test, to evaluate the attitudes and behavior. Materials and Methods: This descriptive study of Van Mother-Child Health and Family Planning Center on a voluntary basis, women aged 15-49 were admitted to the control. The education level of participants, age at first marriage, before the presence of vaginal infection, the story, and motivations pap smear level of information availability, and a family history ...

  5. Clinical and Angioarchitectural Risk Factors Associated with Intracranial Hemorrhage in Dural Arteriovenous Fistulas: A Single-Center Retrospective Study

    OpenAIRE

    Li, Chuanhui; Wang, Yang; Li, Youxiang; Jiang, Chuhan; Yang, Xinjian; Wu, Zhongxue

    2015-01-01

    Purpose To investigate which clinical and angioarchitectural features were associated with the occurrence of intracranial hemorrhage in patients with intracranial dural arteriovenous fistulas (DAVFs). Materials and Methods We retrospectively reviewed the clinical and angioarchitectural features of 236 consecutive patients diagnosed with DAVF in our department from April 2009 to November 2013. Two groups of patients, with or without intracranial hemorrhage as clinical presentation at the initi...

  6. New insights into the clinical evaluation of hereditary transthyretin amyloidosis patients: a single center's experience

    OpenAIRE

    Suhr OB; Gustavsson S.; Heldestad V; Hörnsten R; Lindqvist P; Nordh E; Wiklund U

    2012-01-01

    Ole B Suhr,1 Sandra Gustavsson,1 Victoria Heldestad,2 Rolf Hörnsten,3 Per Lindqvist,1 Erik Nordh,2 Urban Wiklund41Department of Public Health and Clinical Medicine, 2Department of Pharmacology and Clinical Neuroscience, 3Department of Surgical and Perioperative Sciences, Clinical Physiology, Heart Centre, 4Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, SwedenAbstract: Over the last decade, new medical treatment modalities have eme...

  7. Cohesion and alliance between clinic and research, in a time-limited group for young adults in a mental health center: A study of clinical efficacy

    OpenAIRE

    Maria Teresa Gargano; Vittorio Lenzo; Giuseppa Salanitro; Savio Camizzi; Girolamo Lo Verso

    2014-01-01

    Currently, the clinical efficacy of psychodynamic group psychotherapy, is still poorly studied. Also some process variables, such as cohesion and alliance, are poorly investigated, despite the group-setting is widely used in italian public health system. Hence a progressive separation between the scientific work of empirical research and clinical practice conducted in the italian public health system. Starting from these premises, a single-case research was realized, whose results are describ...

  8. THE ATTITUDE TOWARDS TREATMENT OF CARDIOVASCULAR DISEASES: A SURVEY OF PATIENTS OF STATE OUTPATIENT CLINICS AND PRIVATE MEDICAL CENTERS

    Directory of Open Access Journals (Sweden)

    O. N. Semenova

    2015-09-01

    Full Text Available Aim. To study the differences in views on treatment among patients with cardiovascular diseases in state and private outpatient clinics, as well as the motivation for choosing one of these outpatient clinics.Material and methods. Anonymous and voluntary survey of cardiology patients (n=90 in 2 state (57.7% and 3 private outpatient clinics (42.2% was conducted in Saratov.Results. 33.3% of respondents were men; the median age was 65 years. Patients of state outpatient clinics were more likely to have retirement age (p=0.0008, low income (p=0.0006, history of hypertensive crises (p=0.0129 and chronic heart failure (p=0.0001. Patients of private outpatient clinics were more likely to have mental work (p=0.0001, higher education (p=0.0001, moderate income (p=0.0006. The difference in views on the disease and the attitude towards a doctor among patients of state and private clinics was shown.Conclusion. Patients of private outpatient clinics were more active, young, aimed at continuation of life. They are more likely to have higher education, mental work and moderate income. Patients of state outpatient clinics are "infatuated with their illness"; it is their “lifestyle”. Paternalistic model of communication with doctors is expressed in all the patients.

  9. A Multi-Center Prospective Derivation and Validation of a Clinical Prediction Tool for Severe Clostridium difficile Infection.

    LENUS (Irish Health Repository)

    Na, Xi

    2015-04-23

    Prediction of severe clinical outcomes in Clostridium difficile infection (CDI) is important to inform management decisions for optimum patient care. Currently, treatment recommendations for CDI vary based on disease severity but validated methods to predict severe disease are lacking. The aim of the study was to derive and validate a clinical prediction tool for severe outcomes in CDI.

  10. Clinical Outcomes of Myasthenia Gravis with Thymoma and Thymic Hyperplasia Undergoing Extended Transsternal Thymectomy: A Single-Center Experience

    OpenAIRE

    Surena Nazarbaghi; Mohammad Reza Amiri-Nikpour; Rahim Mahmodlou; Nasim Arjmand; Yousef Rezaei

    2015-01-01

    Background: Despite the widespread use of thymectomy in myasthenia gravis (MG) patients, it has remained controversial as to whether this procedure is of a similar efficacy and clinical outcome among MG patients with thymoma and thymic hyperplasia. Aim: We sought to determine the long-term clinical outcomes of MG patients who received extended transsternal thymectomy associated with pyridostigmine and prednisolone postoperatively. Materials and Methods: In a retrospective study from January 1...

  11. Improved Methods for the Clinical Manufacture of Proteins Used In Cancer Immunotherapy | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    Interleukin-15 (IL-15) is an immune system modulating protein (cytokine) that stimulates the proliferation and differentiation of T- lymphocytes.  In the clinical context, IL-15 is being investigated for use in the treatment of diseases such as cancer.  Manufacture of IL-15 for clinical use can be problematic. The National Cancer Institute seeks partners to co-develop or license methods that facilitate pharmaceutical purification and processing of Interleukin-15 (IL-15).

  12. Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009–2014: a single center experience

    OpenAIRE

    Kim, Hounyoung; Chai, Sun Myung; Ahn, Eun Hee; Lee, Mee-Hwa

    2016-01-01

    Objective To update information on the clinical and microbiologic characteristics of pediatric vulvovaginitis in Korean prepubertal girls. Methods A total of 120 girls (aged 0 to 9 years) with culture-confirmed pediatric vulvovaginitis, diagnosed between 2009 and 2014, were enrolled in the study. The epidemiologic and microbiologic characteristics, and clinical outcomes were assessed. Patients with sexual precocity, as well as those who were referred for suspected sexual abuse, were excluded....

  13. Practicing Patient-Centered Care: The Questions Clinically Excellent Physicians Use to Get to Know their Patients as Individuals

    OpenAIRE

    Hanyok, Laura A.; Hellmann, David B.; Cynthia Rand; Ziegelstein, Roy C

    2012-01-01

    Background and Objective:Background and Objective: Patient-centered care, which is dependent on knowing each patient as an individual, has been identified as a critical aspect of healthcare. The most effective and efficient methods to get to know patients as individuals have not been defined. Our aim was to identify questions and phrases that can be used by physicians to get to know their patients. Abstract: Methods:Methods: We surveyed 15 physicians who have been formally recognized for thei...

  14. Sociodemographic profile, clinical factors, and mode of attempt in suicide attempters in consultation liaison psychiatry in a tertiary care center

    OpenAIRE

    Santosh Ramdurg; Shrigopal Goyal; Prashant Goyal; Rajesh Sagar; Pratap Sharan

    2011-01-01

    Background: The objective was to study the sociodemographic data, psychiatric disorder, precipitating events, and mode of attempt in suicide attempted patients referred to consultation liaison psychiatric services. Settings and Design: A prospective study of 6-month duration was done in a tertiary care center in India. Materials and Methods: During the 6-month period all referrals were screened for the presence of suicide attempters in consultation liaison services. Those who fulfilled the cr...

  15. Synovial tissue sublining CD68 expression is a biomarker of therapeutic response in rheumatoid arthritis clinical trials: consistency across centers.

    LENUS (Irish Health Repository)

    Bresnihan, Barry

    2012-02-01

    OBJECTIVE: To determine whether the correlation between the mean change in disease activity and the mean change in synovial sublining (sl) CD68 expression could be demonstrated across different academic centers. METHODS: Synovial biopsies obtained at arthroscopy from patients with rheumatoid arthritis before and 160 days after rituximab therapy were selected and coded. Paired sections were processed independently at Amsterdam Medical Center (AMC) and at St. Vincent\\'s University Hospital (SVUH), Dublin. Digital image analysis (DIA) was employed at both centers to quantify sublining CD68 expression. RESULTS: After analysis of CD68sl expression at centers in 2 different countries, high levels of intracenter and intercenter agreement were observed. For the pooled sections stained at AMC, the correlation between 2 investigators was R = 0.942, p = 0.000, and for sections stained at SVUH, R = 0.899, p = 0.001. Similarly, the intracenter correlations for DeltaCD68sl expression after treatment were R = 0.998, p = 0.000, for sections stained at AMC and R = 0.880, p = 0.000, for sections stained at SVUH. The intercenter correlation for the pooled scores of sections stained at AMC was R = 0.85, p = 0.000, and for the sections stained at SVUH, R = 0.62, p = 0.001. The consistent correlation between DeltaDAS (Disease Activity Score) and DeltaCD68sl expression across different studies (Pearson correlation = 0.895, p < 0.001) was confirmed. The standardized response mean values for DeltaCD68sl, calculated from analyses at both AMC and SVUH, were consistently 0.5 or greater, indicating a moderate to high potential to detect change. CONCLUSION: The correlation between mean DeltaDAS and mean DeltaCD68sl expression was confirmed across 2 centers. Examination of serial biopsy samples can be used reliably to screen for interesting biological effects at the site of inflammation at an early stage of drug development.

  16. Escherichia coli Peritonitis in Peritoneal Dialysis: The Prevalence, Antibiotic Resistance and Clinical Outcomes in a South China Dialysis Center

    OpenAIRE

    FENG, XIAORAN; Yang, Xiao; Yi, Chunyan; Guo, Qunying; Mao, Haiping; Jiang, Zongpei; Li, Zhibin; Chen, Dongmei; Cui, Yingpeng; Yu, Xueqing

    2014-01-01

    ♦ Introduction: Escherichia coli (E. coli) peritonitis is a frequent, serious complication of peritoneal dialysis (PD). The extended-spectrum β-lactamase (ESBL)-producing E. coli peritonitis is associated with poorer prognosis and its incidence has been on continuous increase during the last decades. However, the clinical course and outcomes of E. coli peritonitis remain largely unclear.

  17. Clinical, patient-related, and economic outcomes of home-based high-dose hemodialysis versus conventional in-center hemodialysis

    Science.gov (United States)

    Mitsides, Nicos; Mitra, Sandip; Cornelis, Tom

    2016-01-01

    Despite technological advances in renal replacement therapy, the preservation of health and quality of life for individuals on dialysis still remains a challenge. The high morbidity and mortality in dialysis warrant further research and insight into the clinical domains of the technique and practice of this therapy. In the last 20 years, the focus of development in the field of hemodialysis (HD) has centered around adequate removal of urea and other associated toxins. High-dose HD offers an opportunity to improve mortality, morbidity, and quality of life of patients with end-stage kidney disease. However, the uptake of this modality is low, and the risk associated with the therapy is not fully understood. Recent studies have highlighted the evidence base and improved our understanding of this technique of dialysis. This article provides a review of high-dose and home HD, its clinical impact on patient outcome, and the controversies that exist. PMID:27462173

  18. 医院静脉用药调配中心的临床意义%Clinical significance of hospital pharmacy intravenous admixture center

    Institute of Scientific and Technical Information of China (English)

    邓永忠

    2015-01-01

    本文对静脉用药调配中心的临床作用进行总结,从提高临床护理工作效率、预防职业暴露,加强职业防护、安全用药、提升医院药师综合素质、搭建药护协作平台、经济社会效益等方面进行阐述。%Summary the clinical effect of intravenous drug allocation center, in order to improve the clinical nursing work efficiency, prevent the occupation exposure, strengthening occupation protection, safety, enhance the comprehensive quality of hospital pharmacists, build of medicine and nursing cooperation platform, economic and social benefit are expounded.

  19. Surgical treatment of 137 cases with chronic subdural hematoma at the university clinical center of Kosovo during the period 2008-2012

    Directory of Open Access Journals (Sweden)

    Agon Y Mekaj

    2015-01-01

    Full Text Available Background: Chronic subdural hematoma (CSDH is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo. Materials and Methods: This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008-2012. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Patients were analyzed in many aspects such as age, gender, etiological factors, clinical features, localization, diagnoses, methods of surgical interventions, recurrences and mortality of patients. Results: From 137 patients with CSDH, 106 (77.3% were males and 31 (22.7% females. Average age of patients was 62.85 years. Analyzed according to the decades, the highest number of causes with CSDH was between 70 and 79 years (46%. The head trauma has been responsible for CSDH in 88 patients (64.3%, while the main symptom was headache (92 patients or 67.1%. One burr-hole trepanation with closed drainage system has been used in majority of cases (in 101 patients or 73.7%. The recurrence of CSDH was 6.5%, whereas mortality 2.9%. Conclusion: CSDH is more common in elderly patients. The male-female ratio is 3.4:1. Like other authors we also think that treatment with one burr-hole and drainage is a method of choice, because of its simplicity and safety.

  20. Surgical treatment of 137 cases with chronic subdural hematoma at the university clinical center of Kosovo during the period 2008–2012

    Science.gov (United States)

    Mekaj, Agon Y.; Morina, Arsim A.; Mekaj, Ymer H.; Manxhuka-Kerliu, Suzana; Miftari, Ermira I.; Duci, Shkelzen B.; Hamza, Astrit R.; Gashi, Musli M.; Xhelaj, Mentor R.; Kelmendi, Fatos M.; Morina, Qamile Sh.

    2015-01-01

    Background: Chronic subdural hematoma (CSDH) is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo. Materials and Methods: This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008–2012. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Patients were analyzed in many aspects such as age, gender, etiological factors, clinical features, localization, diagnoses, methods of surgical interventions, recurrences and mortality of patients. Results: From 137 patients with CSDH, 106 (77.3%) were males and 31 (22.7%) females. Average age of patients was 62.85 years. Analyzed according to the decades, the highest number of causes with CSDH was between 70 and 79 years (46%). The head trauma has been responsible for CSDH in 88 patients (64.3%), while the main symptom was headache (92 patients or 67.1%). One burr-hole trepanation with closed drainage system has been used in majority of cases (in 101 patients or 73.7%). The recurrence of CSDH was 6.5%, whereas mortality 2.9%. Conclusion: CSDH is more common in elderly patients. The male-female ratio is 3.4:1. Like other authors we also think that treatment with one burr-hole and drainage is a method of choice, because of its simplicity and safety. PMID:25883478

  1. Clinical profile, evaluation, management and visual outcome of idiopathic intracranial hypertension in a neuro-ophthalmology clinic of a tertiary referral ophthalmic center in India

    Directory of Open Access Journals (Sweden)

    Ambika S

    2010-01-01

    Full Text Available Aim: To discuss the clinical features and management of patients who presented with optic disc edema and had features of presumed idiopathic intracranial hypertension (IIH. Materials and Methods: Case series of all patients diagnosed to have IIH from January 2000 to December 2003 in the neuro-ophthalmology clinic of a tertiary referral ophthalmic institution, were retrospectively analyzed. Analysis was done for 50/106 patients who fulfilled modified Dandy′s criteria and had optic disc edema and a minimal follow-up period of two years. Results: Most (40/50, 80% of the patients were females and the mean age of presentation for all the 50 patients was 32.89 years. Chief complaints were headache in 38 (76% patients, 24 (48% patients had transient visual obscuration, 24 (48% patients had reduced vision, 15 (30% patients had nausea, vomiting, 4 (8% patients had diplopia. Bilateral disc edema was seen in 46 (92% patients and unilateral disc edema in 4 (8% patients. 60 eyes had enlarged blind spot as the common visual field defect. Neuroimaging revealed prominent perioptic CSF spaces in 14 patients and empty sella in three patients. CSF opening pressure was 250-350 mm H2O (water in 39 patients and was > 350 mm H2O in 11 patients. Medical treatment was started for all patients; whereas 35 [70%] patients responded, 15 [30%] patients had to undergo LP shunt.

  2. Clinical features, neuroimaging and prognosis of adult patients with clinically diagnosed acute-onset encephalitis treated at a teaching neurology center in the Toyama area of Japan

    International Nuclear Information System (INIS)

    Although acute viral encephalitis (AVE) and acute disseminated encephalomyelitis (ADEM) are etiologically and pathologically distinct, a differential diagnosis between these two disorders is often difficult, especially if the patient exhibits a disturbance in consciousness. To identify useful clinical differences enabling a differential diagnosis to be made at an early stage, we retrospectively analyzed patients who had been admitted to our hospital within the past seven years because of acute-onset encephalitis with a disturbance in consciousness. Eleven adult patients were classified as having AVE, and 8 adult patients were classified as having ADEM within this period. The clinical characteristics of the two groups were then compared. Patients with AVE exhibited a disturbance in consciousness as their first neurological sign, whereas patients with ADEM initially showed focal signs like spastic paralysis, urinary disturbance and ataxia, which were followed by a disturbance in consciousness. ADEM is usually preceded by infection or vaccination, but obtaining a medical history from patients with disturbed consciousness is often difficult. Based on the present analysis, the initial manifestation of focal neurological signs may be very useful for distinguishing ADEM from AVE. (author)

  3. Clinical Features and Genetic Background of the Periodic Fever Syndrome with Aphthous Stomatitis, Pharyngitis, and Adenitis: A Single Center Longitudinal Study of 81 Patients

    Directory of Open Access Journals (Sweden)

    Daša Perko

    2015-01-01

    Full Text Available PFAPA syndrome is the most common autoinflammatory disorder in childhood with unknown etiology. The aim of our study was clinical evaluation of PFAPA patients from a single tertiary care center and to determine whether variations of AIM2, MEFV, NLRP3, and MVK genes are involved in PFAPA pathogenesis. Clinical and laboratory data of consecutive patients with PFAPA syndrome followed up at the University Children’s Hospital, Ljubljana, were collected from 2008 to 2014. All four genes were PCR amplified and directly sequenced. Eighty-one patients fulfilled criteria for PFAPA syndrome, 50 (63% boys and 31 (37% girls, with mean age at disease onset of 2.1 ± 1.5 years. Adenitis, pharyngitis, and aphthae were present in 94%, 98%, and 56%, respectively. Family history of recurrent fevers in childhood was positive in 78%. Nineteen variants were found in 17/62 (27% patients, 4 different variants in NLRP3 gene in 13 patients, and 6 different variants in MEFV gene in 5 patients, and 2 patients had 2 different variants. No variants of clinical significance were found in MVK and AIM2 genes. Our data suggest that PFAPA could be the result of multiple low-penetrant variants in different genes in combination with epigenetic and environmental factors leading to uniform clinical picture.

  4. 410 Epidemiological and Clinical Characteristics of Allergic Conjunctivitis Patients in a Reference Center of Mexico City

    OpenAIRE

    Robles-Contreras, Atzin; Ayala-Balboa, Julio; Alonso-Sánchez, Miguel E.; ESTRADA-GARCIA, IRIS; Jiménez-Martínez, Maria C.

    2012-01-01

    Background In our country (Mexico) there are few reports about epidemiological characteristics of allergic conjunctivitis patients; despite these studies give us some information about patient profile, in most cases these studies are not always comparable due to the use of different methodologies, that is, Include only a portion of the population (elderly, infants) or there are limited to one region of the city. The purpose of this study was to know the epidemiological and clinical characteri...

  5. Safety and efficacy of a novel disposable circumcision device: A pilot randomized controlled clinical trial at 2 centers

    OpenAIRE

    WANG, JINGEN; Zhou, Yongfei; Xia, Shuxia; Zhu, Zunwei; Jia, Linghua; Liu, Yong; Jiang, Min

    2014-01-01

    Background We evaluated the safety and efficacy of a novel disposable male circumcision (MC) device developed by Jiangxi-Yuansheng-Langhe Medical Instrument Co., Ltd. Material/Methods Adult male patients (n=120; mean age, 26.6 years) with redundant foreskin and/or phimosis were included in a randomized, multicenter pilot clinical trial from October 2011 to February 2012. Patients were divided into 2 groups and subjected to MC with a novel disposable device (Device Group) (n=60) or to conventi...

  6. Should we prelab? A student-centered look at the time-honored tradition of prelab in clinical nursing education.

    Science.gov (United States)

    Turner, Laureen; Keeler, Courtney

    2015-01-01

    This study explores clinical preparation (prelab) in nursing education from the student's perspective. More than half of the students surveyed (n = 296) believed prelab learning activities were important; however, they reported that prelab increases stress and decreases sleep quantity. Timing, stress, and anxiety were factors affecting student perception of prelab. The findings suggest that students receive diminishing returns on the time spent on prelab; nevertheless, prelab may enhance their learning and patient safety. PMID:25290962

  7. Clinical trial of neutron capture therapy for brain tumors at New England Medical Center and the Massachusetts Institute of Technology

    International Nuclear Information System (INIS)

    A proposal is submitted that is based on the conclusions of a NCT expert panel recently convened at BNL by the Department of Energy to evaluate the status of NCT and to recommend what preclinical tasks should be accomplished prior to a clinical study being undertaken. The proposal is for two years of preclinical research and preparations, followed in the third year by a pilot clinical trial of ten patients with grade-IV astrocytoma brain tumors, for whom the prognosis with existing treatment modalities is less than a 5% three-year survival rate. Preclinical tasks would include modifying the MIT Nuclear Reactor medical facility to produce an epithermal as well as the existing and highly thermalized neutron treatment beam; characterizing the transport behavior of these beams in both physical and mathematical models of the human head, and developing a treatment planning scheme for NCT; further development of the neutron-induced alpha-autoradiography track-etch method for measuring macro- and micro-distributions of B-10 uptake in tissues and blood; investigations into the B-10 cellular uptake pattern of human tumors; and examination of the nature of endothelial cell vascular damage in B-10-containing animals undergoing irradiation with neutrons. With the successful completion of the above preclinical tasks we feel we will be in a position to embark in the third year on a pilot clinical evaluation

  8. Establishing the Morehouse School of Medicine (MSM) R-CENTER clinical and translational research web-portal: the role of focus groups.

    Science.gov (United States)

    Quarshie, Alexander; Davis, Adam; Strayhorn, Gregory; Weaver, Carolyn; Delano, Cigdem; Winters, Kirby; Rice, Robert; Ofili, Elizabeth

    2011-01-01

    The Morehouse School of Medicine (MSM) Research Centers in Minority Institutions (RCMI) Center of Excellence in Clinical and Translational Research has developed a research web-portal to foster research development and collaborations. We describe the role of focus groups (FG). Research faculty and staff were organized into three groups by research interest. Each FG discussion had five steps: Brainstorming, Reporting, Card-sorting, Priority-setting, and Discussions. Integration of top priorities across each FG culminated in a final priority-setting step. Each FG generated 45 to 50 unique ideas during brainstorming that were categorized into 10 to 12 unique categories. Final priority-setting captured six top items for the initial design of the portal: ability to identify researchers working on similar research; common data management tools; access to clinical trials information; participant recruitment tools; secure access to research databases; and financial support. Focus groups allowed for a discovery period that generated common themes for the design and customization of the web-portal. PMID:22102312

  9. Clinical, patient-related, and economic outcomes of home-based high-dose hemodialysis versus conventional in-center hemodialysis

    Directory of Open Access Journals (Sweden)

    Mitsides N

    2016-07-01

    Full Text Available Nicos Mitsides,1,2 Sandip Mitra,1,2 Tom Cornelis3 1Department of Renal Medicine, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Center, Manchester, 2National Institute for Healthcare Research Devices for Dignity Healthcare Co-operative, Sheffield, UK; 3Department of Nephrology, Jessa Hospital, Hasselt, Belgium Abstract: Despite technological advances in renal replacement therapy, the preservation of health and quality of life for individuals on dialysis still remains a challenge. The high morbidity and mortality in dialysis warrant further research and insight into the clinical domains of the technique and practice of this therapy. In the last 20 years, the focus of development in the field of hemodialysis (HD has centered around adequate removal of urea and other associated toxins. High-dose HD offers an opportunity to improve mortality, morbidity, and quality of life of patients with end-stage kidney disease. However, the uptake of this modality is low, and the risk associated with the therapy is not fully understood. Recent studies have highlighted the evidence base and improved our understanding of this technique of dialysis. This article provides a review of high-dose and home HD, its clinical impact on patient outcome, and the controversies that exist. Keywords: hemodialysis, home dialysis, high dose, outcomes

  10. The accident of stereotaxic radiosurgery at the University hospital center of Toulouse. Expert report n.2. Dosimetric and clinical evaluation. Risk analysis

    International Nuclear Information System (INIS)

    The regional center of stereotaxic radiosurgery (C.R.R.S.) of the University hospital center (C.H.U.) of Toulouse is equipped since april 2006 with a Novalis accelerator (Brainlab) devoted to radiosurgery and intra skull stereotaxic radiotherapy.In april 2007, during an intercomparison of dosimetry files coming from various sites, the Brainlab society detects an anomaly. The analysis made by the society concludes to the use of an unsuited detector for the measurement of a dosimetry parameter during the accelerator initial calibration. Following this error, 145 patients (on 172 patients treated since the center opening) suffer of an overdose whom importance is variable. On the 26. june 2007 the Authority of nuclear safety (Asn) requires an expertise on the following points: checking of the experimental protocols of micro-beams calibration before and after correction of the dysfunction; analysis at the theoretical level of the neurological complications risk at long term for the exposed patients. The second point of this request is the subject of this report. It gives the synthesis of the whole of information, at the clinical and dosimetric level and outlines successively: the expertise methodology; the cohort of patients treated at the C.R.R.S.; the parameters of the risk analysis of neurological complications; the different risk analysis according the pathologies treated at the C.R.R.S.; the recommendations. (N.C.)

  11. XML Comparison of Knowledge and Practice of Private Clinical Laboratories and Educational Centers Staff in Shiraz about AIDS,2011

    Directory of Open Access Journals (Sweden)

    Rezaei MA

    2011-01-01

    Full Text Available Abstract Background and objectives: Acquired immune deficiency syndrome(AIDS is one of the most well-known disease in the world .It is not only A heaththrapeutic problem but also with politic ,social, cultural and economic aspects. Paying attention to high-risk groups such as Lab staff is important. we decided to study and compare the knowledge of public and private Laboratories staff. Material and Methods: This cross sectional study, descriptive-analytic,was conducted on 350 personnel of private laboratories and educational centers of Shiraz University of Medical Sciences,2011.We collected Information by using a questionnaire including three parts of demographic characteristic questions, questions about knowledge in different fields of AIDS and those related to the performance of personnel. The results were reported as tables and graphs and analyzed by ANOVA,t-test and square. Results: The data, in different areas of AIDS, in public and private laboratories are similar and the difference statistically is not significant. Regarding to symptoms and treatment, the knowledge of privale Lab staff is higher than stste ones and this difference is significant (P=0.01.As a whole,the results show the knowledge of staff about the transmission modes(92.7%,the pathologic agent(99.2%,at risk people (61.2%and preventive measure (53.1%.both group have good practice in wearing gloves and using disposable syringes.Regarding to disposing infectious waste material,private and state center practice are 92.6% and 77%,respectively. Conclusion: Based on the result,the knowledge relating to preventive procedures and at risk people of AIDS is not enough.Therefore;it is a necessity to hold in service training for Lab staff,stressing on disposing infectious waste materials. Key words: AIDS, laboratory personnel, knowledge, practice

  12. Van Mother-Child Health and Family Planning Center Pap Smear Clinics of Information, Evaluation of Applicants

    Directory of Open Access Journals (Sweden)

    Sebahat Gucuk

    2011-10-01

    Full Text Available Objective: In this study of women admitted to our center with information on pap smear test, to evaluate the attitudes and behavior. Materials and Methods: This descriptive study of Van Mother-Child Health and Family Planning Center on a voluntary basis, women aged 15-49 were admitted to the control. The education level of participants, age at first marriage, before the presence of vaginal infection, the story, and motivations pap smear level of information availability, and a family history of cancer, administered a questionnaire asking the state to have a regular income. Results: The study included 362 women with age and hear the pap smear test was significantly increased (p = 0.01. Working women and pap smear level of knowledge (p = 0.04 and pap smears than women not working for International rates significantly higher (p = 0.02. Treatment of vaginal infection at least once before to get there was a significant relationship between the pap smear motivations (p>0.05. Family history of gynecologic cancer or non-gynecologic cancer smears have significantly increased the level of motivations (p = 0.0001. Pap smear information, regular the economic income of those levels, significantly higher than those without regular income (p = 0.0001. Conclusion: We serve the region, with low socio-economic characteristics that are considered, gynecological examination by health workers or women from the home visits, pap smear test for what purpose and how often you get the work done and the importance of explaining and giving more space to this issue suggest that the written and visual media. Keywords: Pap smears, health care, education [TAF Prev Med Bull 2011; 10(5.000: 527-532

  13. Clinical profile, outcomes, and progression to type 2 diabetes among Indian women with gestational diabetes mellitus seen at a diabetes center in south India

    Directory of Open Access Journals (Sweden)

    Manni Mohanraj Mahalakshmi

    2014-01-01

    Full Text Available Aim: To describe the clinical profile, maternal and fetal outcomes, and the conversion rates to diabetes in women with gestational diabetes mellitus (GDM seen at a tertiary care diabetes center in urban south India. Materials and Methods: Clinical case records of 898 women with GDM seen between 1991 and 2011 were extracted from the Diabetes Electronic Medical Records (DEMR of a tertiary care diabetes center in Chennai, south India and their clinical profile was analyzed. Follow-up data of 174 GDM women was available. To determine the conversion rates to diabetes, oral glucose tolerance test (OGTT was done in these women. Glucose tolerance status postpartum was classified based on World Health Organization (WHO 2006 criteria. Results: The mean maternal age of the women was 29 ± 4 years and mean age of gestation at first visit were 24 ± 8.4 weeks. Seventy percent of the women had a family history of diabetes. Seventy-eight percent of the women delivered full-term babies and 65% underwent a cesarean section. The average weight gain during pregnancy was 10.0 ± 4.2 kg. Macrosomia was present in 17.9% of the babies, hypoglycemia in 10.4%, congenital anomalies in 4.3%, and the neonatal mortality rate was 1.9%. Mean follow-up duration of the 174 women of whom outcome data was available was 4.5 years. Out of the 174, 101 women who were followed-up developed diabetes, of whom half developed diabetes within 5 years and over 90%, within 10 years of the delivery. Conclusions: Progression to type 2 diabetes mellitus (T2DM in Indian women with GDM is rapid. There is an urgent need to develop standardized protocols for GDM care in India that can improve the maternal and fetal outcomes and help prevent future diabetes in women with GDM.

  14. Clinical characteristics of Clostridium difficile-associated diarrhea among patients in a tertiary care center in China

    Science.gov (United States)

    Li, Yongqiang; Huang, Yi; Li, Yuyuan; Nie, Yuqiang

    2016-01-01

    Objective: This study investigated the incidence, risk factors, and clinical characteristics of Clostridium difficile-associated diarrhea (CDAD) in Chinese patients. Methods: Fecal specimens of patients with antibiotic-associated diarrhea (AAD) were collected to test C. difficile toxin A and B using enzyme-linked fluorescent assay to identify CDAD. By adopting a nested case-control design, the matched people (ratio 1:3) without AAD were included as controls. Results: Out of 56,172 inpatients, 39,882 (71.0%) used antibiotics, 470 suffered from AAD, and 93 were diagnosed with CDAD. The incidence of nosocomial CDAD was 166 per 100,000. The proportion of CDAD in AAD was 19.8%. CDAD patients presented with more severe clinical manifestations and exhibited more concurrent illness. Logistic regression analysis showed the risk factors of CDAD: advanced age, nasogastric tube-feeding, high APACHE II scores, high level of serum C-reaction protein, low level of serum albumin, severe underlining disease or comorbidity, and number of antibiotic intake. Twenty-nine patients (31.2%) were cured with vancomycin, 54 (58.1%) were cured after dual therapy of vancomycin plus metronidazole, 7 (7.5%) died of underlying diseases aggravated with CDAD, and 3 (3.2%) were transferred to other hospitals for personal reasons. Conclusion: The incidence of nosocomial CDAD in China was high. Some risk factors could predispose CDAD. PMID:27375724

  15. Six-month healing success rates after endodontic treatment using the novel GentleWave™ System: The pure prospective multi-center clinical study

    Science.gov (United States)

    Le, Khang T.; Woo, Stacey M.; Rassoulian, Shahriar A.; McLachlan, Kimberly; Abbassi, Farah; Garland, Randy W.

    2016-01-01

    Background This prospective multi-center (PURE) clinical study evaluated healing rates for molars after root canal treatment employing the GentleWave® System (Sonendo, Inc., Laguna Hills, CA). Material and Methods Eighty-nine patients met the inclusion criteria and consented for this clinical study after referral for a root canal treatment. All enrolled patients were treated with the GentleWave System. Five endodontists performed the clinical procedures and follow-up evaluations. Pre-operative, intra-operative, and post-operative data were collected from the consented patients. Each patient was evaluated for clinical signs and symptoms. Two trained, blinded, and independent evaluators scored the subject tooth radiographs for apical periodontitis using the periapical index (PAI). The teeth classified as healing or healed were considered as a success and composed of a cumulative success rate of healing. Statistical analysis was performed by using the Fisher’s exact test, Pearson correlation, and multivariate logistic regression analyses of the pre-operative prognostic factors at 0.05 significance level. Results Seventy-seven patients were evaluated at six months with a follow-up rate of 86.5%. The cumulative success rate of healing was 97.4%. Eleven prognostic factors were identified using bivariate analyses. Using logistic analyses, the two prognostic significant variables that were directly correlated to healing were the pre-operative presence of periapical index (p value=0.016), and single treatment visits (p value=0.024). Conclusions In this six-month PURE clinical study, the cumulative success rate of healing was 97.4% when patients were treated with the GentleWave® System. Key words:Healing rate, root canal treatment, molar, GentleWave™, Sonendo®, Multisonic Ultracleaning™ . PMID:27398180

  16. Prevalence and clinical prognosis of heteroresistant vancomycin-intermediate Staphylococcus aureus in a tertiary care center in China

    Institute of Scientific and Technical Information of China (English)

    WANG Yan; HU Yun-jian; AI Xiao-man; XU Hong-tao; SUN Tie-ying

    2013-01-01

    Background The emergence of heteroresistant vancomycin-intermediate Staphylococcus aureus (hVISA) is increasingly challenging the methods for detection in diagnostic microbiology laboratories.However,the report of hVISA is rare in China.This study summarizes the prevalence and clinical features associated with hVlSA infections at our institution and the local impact they have on clinical outcome.Methods A total of 122 methicillin-resistant Staphylococcus aureus (MRSA) isolates which were of the causative pathogens were collected.One hundred and two patients for whom we had full information of MRSA pneumonia were included.Isolates of MRSA were collected using PCR to detect the mecA gene.Both Etest and macro Etest were performed to screen for hVISA.The Staphylococcal chromosome cassette mec (SCCmec) types were determined by multiplex PCR strategy.Logistic regression analysis was used to determine the risk factors.Results Among the 122 MRSA isolates collected,25 (20.5%) strains were identified as hVISA.There were 119 (97.5%)SCCmec Ⅲ isolates,two (1.6%) SCCmec Ⅱ isolates,and one (0.8%) SCCmec V isolate.The 30-day mortality of MRSA-hospital acquired pneumonia (HAP) was 37.3%,and 62.5% for hVISA-HAP.Vancomycin treatment was the independent risk factor of hVlSA.Factors independently associated with 30-day mortality in all patients were acute physiology and Chronic Health Evaluation (APACHE) Ⅱ score >20,multiple lobe lesions,and creatinine clearance rate (CCR) <15 ml/min.Conclusions The prevalence of hVISA is 20.5% at our institution.hVISA-HAP patients had a poor clinical outcome.Vancomycin treatment was the independent predictors for hVISA infection.Factors independently associated with 30-day mortality in all patients were APACHE Ⅱ score >20,multiple lobe lesions and CCR <15 ml/min.

  17. Dimensional approach to symptom factors of major depressive disorder in Koreans, using the Brief Psychiatric Rating Scale: the Clinical Research Center for Depression of South Korea study.

    Science.gov (United States)

    Park, Seon-Cheol; Jang, Eun Young; Kim, Daeho; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jae-Min; Kim, Jung-Bum; Jo, Sun-Jin; Park, Yong Chon

    2015-01-01

    Although major depressive disorder (MDD) has a variety of symptoms beyond the affective dimensions, the factor structure and contents of comprehensive psychiatric symptoms of this disorder have rarely been explored using the 18-item Brief Psychiatric Rating Scale (BPRS). We aimed to identify the factor structure of the 18-item BPRS in Korean MDD patients. A total of 258 MDD patients were recruited from a multicenter sample of the Clinical Research Center for Depression of South Korea study. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale), global severity (Clinical Global Impression of Severity Scale), suicidal ideation (Scale for Suicide Ideation), functioning (Social and Occupational Functioning Assessment Scale), and quality of life (World Health Organization Quality of Life Assessment-abbreviated version). Common factor analysis with oblique rotation was used to yield factor structure. A four-factor structure was designed and interpreted by the symptom dimensions to reflect mood disturbance, positive symptoms/apathy, bipolarity, and thought distortion/mannerism. These individual factors were also significantly correlated with clinical variables. The findings of this study support the view that the BPRS may be a promising measuring tool for the initial assessment of MDD patients. In addition, the four-factor structure of the BPRS may be useful in understanding the mood and psychotic characteristics of these patients. PMID:25600920

  18. A discrete system simulation study in scheduling and resource allocation for the John A. Burns School of Medicine Clinical Skills Center.

    Science.gov (United States)

    Glaspie, Henry W; Oshiro Wong, Celeste M

    2015-03-01

    The Center for Clinical Skills (CCS) at the University of Hawai'i's John A. Burns School of Medicine (JABSOM) trains medical students in a variety of medical practice education experiences aimed at improving patient care skills of history taking, physical examination, communication, and counseling. Increasing class sizes accentuate the need for efficient scheduling of faculty and students for clinical skills examinations. This research reports an application of a discrete simulation methodology, using a computerized commercial business simulation optimization software package Arena® by Rockwell Automation Inc, to model the flow of students through an objective structure clinical exam (OSCE) using the basic physical examination sequence (BPSE). The goal was to identify the most efficient scheduling of limited volunteer faculty resources to enable all student teams to complete the OSCE within the allocated 4 hours. The simulation models 11 two-person student teams, using resources of 10 examination rooms where physical examination skills are demonstrated on fellow student subjects and assessed by volunteer faculty. Multiple faculty availability models with constrained time parameters and other resources were evaluated. The results of the discrete event simulation suggest that there is no statistical difference in the baseline model and the alternative models with respect to faculty utilization, but statistically significant changes in student wait times. Two models significantly reduced student wait times without compromising faculty utilization. PMID:25821650

  19. The Epidemiological and Clinical Assessment of Admitted Burned Pregnant Women in Shahid Mottahary Hospital Burn Center Between January 1998 and October 2003

    Directory of Open Access Journals (Sweden)

    A. Tavassoli-Ashrafi, M.D.

    2007-09-01

    Full Text Available Background and purpose: Treatments of burn pregnant women is a difficult task because the vulnerable fetus is highly dependent on the health of the mother. This study was conducted to determine the epidemiology, etiology, clinical assessment and outcome of pregnant patients between January 1998 and October 2003.Materials and Methods: A 6-year retrospective descriptive study of burns in pregnant women hospitalized at Mottahary hospital (burn center in Tehran was performed. A short structured questionnaire was used to collect data. The questionnaire covered demographic information, etiology, clinical manifestations, and outcomes.Results: 74 (5% of the 1480 women of reproductive age who were admitted for burn treatment during this period were pregnant. The mean age of 74 patients was 22.54 years (SD = 4.78 with a range of 16-35. The majority of the women (50% were between 20 and 30 weeks of gestational age. The most common cause of burn was kerosene fire 52 (70%. Most of the women 50 (68% suffered from severe burns with TIBC>40%. 49 (66% mothers and 50 (67.5% died as a result of the burn damages. Conclusion: Burn size, TIBC, follow up of clinical manifestations for pregnant women, fetus and performance of proportional treatment protocols were the strongest predictor of mortality for mother and fetus.

  20. Phase III multi-center clinical study on 99mTc-GSA, a new agent for functional imaging of the liver

    International Nuclear Information System (INIS)

    A multi-center clinical study was performed in patinets with hepatic disorders to evaluate the clinical usefulness of 99mTc-DTPA-galactosyl serum albumin (99mTc-GSA), a new radiopharmaceutical which binds to asialoglycoprotein receptors on hepatocytes. The blood clearance and hepatic accumulation were evaluated on the basis of the dynamic data and serial hepatic images obtained for 20 min after 99mTc-GSA injection. The blood clearance and hepatic accumulation indices of 99mTc-GSA demonstrated the followings. In acute liver diseases, these indices reflected the clinical features of the disease and correlated with the laboratory test indices for the blood coagulation system. In chronic liver diseases, these indices changed in direct proportion to the progression of the hepatic disorder and correlated well with the conventional laboratory test results. In obstructive jaundice, these indices aided evaluation of the liver function despite the high serum bilirubin level. The indices reflected the change in the number of hepatocytes before and after hepatectomy. The scintigraphic findings with 99mTc-GSA permitted both functional and morphological evaluations of the liver and provide additional information compared with conventional liver scintigraphy. These results suggest that 99mTc-GSA scintigraphy may be useful for evaluating both the functional and morphology of the liver from a new viewpoint of receptor-mediated accumulation. (author)

  1. Phase III multi-center clinical study on sup 99m Tc-GSA, a new agent for functional imaging of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Torizuka, Kanji (Fukui Medical School, Matsuoka (Japan)); Ha-Kawa, Sang Kil; Kudo, Masatoshi (and others)

    1992-02-01

    A multi-center clinical study was performed in patinets with hepatic disorders to evaluate the clinical usefulness of {sup 99m}Tc-DTPA-galactosyl serum albumin ({sup 99m}Tc-GSA), a new radiopharmaceutical which binds to asialoglycoprotein receptors on hepatocytes. The blood clearance and hepatic accumulation were evaluated on the basis of the dynamic data and serial hepatic images obtained for 20 min after {sup 99m}Tc-GSA injection. The blood clearance and hepatic accumulation indices of {sup 99m}Tc-GSA demonstrated the followings. In acute liver diseases, these indices reflected the clinical features of the disease and correlated with the laboratory test indices for the blood coagulation system. In chronic liver diseases, these indices changed in direct proportion to the progression of the hepatic disorder and correlated well with the conventional laboratory test results. In obstructive jaundice, these indices aided evaluation of the liver function despite the high serum bilirubin level. The indices reflected the change in the number of hepatocytes before and after hepatectomy. The scintigraphic findings with {sup 99m}Tc-GSA permitted both functional and morphological evaluations of the liver and provide additional information compared with conventional liver scintigraphy. These results suggest that {sup 99m}Tc-GSA scintigraphy may be useful for evaluating both the functional and morphology of the liver from a new viewpoint of receptor-mediated accumulation. (author).

  2. Clinical characteristics and management of patients with early acute severe pancreatitis:Experience from a medical center in China

    Institute of Scientific and Technical Information of China (English)

    Hou-Quan Tao; Jing-Xia Zhang; Shou-Chun Zou

    2004-01-01

    AIM: To study clinical characteristics and management of patients with early severe acute pancreatitis (ESAP).METHODS: Data of 297 patients with severe acute pancreatitis (SAP) admitted to our hospital within 72 h after onset of symptoms from January 1991 to June 2003 were reviewed for the occurrence and development of early severe acute pancreatitis (ESAP). ESAP was defined as presence of organ dysfunction within 72 h after onset of symptoms. Sixtynine patients had ESAP, 228 patients without organ dysfunction within 72 h after onset of symptoms had SAR The clinical characteristics, incidence of organ dysfunction during hospitalization and prognosis between ESAP and SAP were compared.RESULTS: Impairment degree of pancreas (Balthazar CT class) in ESAP was more serious than that in SAP (5.31±0.68 vs 3.68±0.29, P<0.01). ESAP had a higher mortality than SAP (43.4% vs 2.6%, P<0.01), and a higher incidence of hypoxemia (85.5% vs 25%, P<0.01), pancreas infection (15.9% vs7.5% , P<0.05), abdominal compartment syndrome (ACS) (78.3% vs 23.2%, P<0.01) and multiple organ dysfunction syndrome (MODS)(78.3% vs 10.1%, P<0.01). In multiple logistic regression analysis, the main predisposing factors to ESAP were higher APACHE Ⅱ score, Balthazar CT class, MODS and hypoxemia.CONCLUSION: ESAP is characterised by MODS, severe pathological changes of pancreas, early hypoxemia and abdominal compartment syndrome. Given the poor prognosis of ESAP, these patients should be treated in specialized intensive care units with special measures such as close supervision, fluid resuscitation, improvement of hypoxemia, reduction of pancreatic secretion, elimination of inflammatory mediators, prevention and treatment of pancreatic infections.

  3. Substance-dependent women attending a de-addiction center in North India: Sociodemographic and clinical profile

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    Grover S

    2005-07-01

    Full Text Available Background: Treatment-seeking is limited in women substance abusers. Studying the sociodemographic and clinical profile of treatment-seeking substance-dependent women can help us to understand the problem better and respond appropriately in terms of primary and secondary prevention strategies. Aim: To study the sociodemographic and clinical profile of women attending a de-addiction centre in North India. Design and Methodology: Retrospective structured chart review of 35 women substance abusers. Results: The results indicated that a typical subject was urban (86%, married (63%, nuclear family (60%, based housewife (57%, educated up to school completion (54%, and having poor social support (57%. The common substances were opioids (60%, followed by alcohol (17%, and tobacco and benzodiazepines (11.5% each. The mean age at onset of substance use was 30.5 years, the mean duration of use was 9 years and mean duration to develop dependence was 5.5 years. The common reasons for initiating use were medical (63% and curiosity (34%. Comorbidity profile was: physical illness (34%, psychiatric illness (23% and dependence on another substance (14%. Only 20% had a family history of substance dependence. The social impairment ranged from 77% for social to 40% for financial and none for legal aspects. A typical subject had followed up 4.2 times in 8.4 months, while 54% were abstaining, 40% were continuing their substance dependence at the last follow up. Conclusions: The results suggest that the development of substance dependence in women is a combination of genetic, personal, and social vulnerability factors, including the drug culture of the social milieu and the poor social support. Comorbidity and impairment are common features.

  4. Clinical and microbiologic characteristics of vulvovaginitis in Korean prepubertal girls, 2009–2014: a single center experience

    Science.gov (United States)

    Kim, Hounyoung; Chai, Sun Myung; Ahn, Eun Hee

    2016-01-01

    Objective To update information on the clinical and microbiologic characteristics of pediatric vulvovaginitis in Korean prepubertal girls. Methods A total of 120 girls (aged 0 to 9 years) with culture-confirmed pediatric vulvovaginitis, diagnosed between 2009 and 2014, were enrolled in the study. The epidemiologic and microbiologic characteristics, and clinical outcomes were assessed. Patients with sexual precocity, as well as those who were referred for suspected sexual abuse, were excluded. Results Girls aged 4 to 6 years were at the highest risk of pediatric vulvovaginitis. Seasonal distribution indicated obvious peaks in summer and winter. Of the 120 subjects, specific pathogens were identified in the genital specimens in only 20 cases (16.7%). Streptococcus pyogenes (n=12, 60%) was the leading cause of specific vulvovaginitis. Haemophilus influenzae was isolated in one patient. No cases presented with enteric pathogens, such as Shigella or Yersinia. A history of recent upper respiratory tract infection, swimming, and bubble bath use was reported in 37.5%, 15.8%, and 10.0% of patients, respectively. Recent upper respiratory tract infection was not significantly correlated with the detection of respiratory pathogens in genital specimens (P>0.05). Of 104 patients who underwent perineal hygienic care, 80 (76.9%) showed improvement of symptoms without antibiotic treatment. Furthermore, the efficacy of hygienic care was not significantly different between patients with or without specific pathogens (P>0.05). Conclusion Specific pathogens were only found in 16.7% of pediatric vulvovaginitis cases. Our results indicate an excellent outcome with hygienic care, irrespective of the presence of specific pathogens. PMID:27004204

  5. Impact of Clinical Pharmacy Services on KAP and QOL in Cancer Patients: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Yan Wang

    2015-01-01

    Full Text Available This study was to evaluate the efficacy of pharmaceutical intervention (PI on chemotherapy knowledge-attitude-practice (KAP and quality of life (QOL in cancer patients. A prospective, randomized, controlled study was carried out at Oncology Ward in a tertiary hospital affiliated to Southern Medical University, China. Eligible patient was randomly assigned to pharmaceutical intervention (PI group or control group. Each patient in PI group was given information booklets and was given 30 min face-to-face medication education and psychological counseling by clinical pharmacists, 2 sessions per week for 2 months. Patients in control group only received conventional treatment. All participants were asked to complete a structured Chemotherapy KAP Questionnaire and QOL Questionnaire at pre- and poststudy time. A total of 149 cancer patients (77 in PI group and 72 in control group completed the study. The baseline scores of KAP and QOL in 2 groups were similar. At the end of study, only knowledge score was significantly increased; meanwhile no difference existed for attitude, practice, and QOL scores in control group; both KAP scores and QOL score were significantly increased in PI group. As for the between-group comparison, both KAP scores and QOL score in PI group were significantly higher than those in control group. In conclusion, pharmaceutical intervention has a positive role in increasing chemotherapy-related knowledge, improving patients’ positive emotions, dealing with chemotherapy adverse reactions, and improving the quality of life of patients.

  6. Comparison of biofilm formation in clinical isolates of Candida species in a tertiary care center, North India

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    Vivek Agwan

    2015-01-01

    Full Text Available Background and Objectives: Biofilms are colonies of microbial cells encased in a self-produced organic polymeric matrix. The biofilm production is more important for nonalbicans Candida (NAC; as C. albicans possess many other mechanisms to establish infections. Correct identification of Candida species has gained importance due to persistent rise in infections caused by NAC. We sought to isolate, identify Candida species in clinical isolates and study biofilm formation. Materials and Methods: Modified microtiter plate method was performed to study biofilm formation by isolates in Sabouraud's dextrose broth. It was then quantitatively assessed using a spectrophotometer. Biofilm formation was graded as negative, +1, +2, +3 and + 4 on the basis of percentage absorbance. Results: Biofilm formation was observed in 16 of 40 (40.0% isolates of C. albicans as compared to 39 of 78 (50.0% of isolates of NAC. Strong (+4 biofilm production was seen in maximum biofilm producers in C. tropicalis (12 of 27 followed by C. albicans (8 of 16. Total biofilm producers were significantly more among high vaginal swab isolates 63.2% (12 of 19 and urine isolates 59.2% (29 of 49, when compared to blood isolates 34.2% (13 of 38 as well as other isolates 27.5% (11 of 40. Interpretation and Conclusions: NAC species are qualitatively and quantitatively superior biofilm producers than C. albicans. Biofilm production is the most important virulence factor of NAC species and compared to other lesions, it is more significantly associated with luminal infections.

  7. Impact of Clinical Pharmacy Services on KAP and QOL in Cancer Patients: A Single-Center Experience.

    Science.gov (United States)

    Wang, Yan; Wu, Huimin; Xu, Feng

    2015-01-01

    This study was to evaluate the efficacy of pharmaceutical intervention (PI) on chemotherapy knowledge-attitude-practice (KAP) and quality of life (QOL) in cancer patients. A prospective, randomized, controlled study was carried out at Oncology Ward in a tertiary hospital affiliated to Southern Medical University, China. Eligible patient was randomly assigned to pharmaceutical intervention (PI) group or control group. Each patient in PI group was given information booklets and was given 30 min face-to-face medication education and psychological counseling by clinical pharmacists, 2 sessions per week for 2 months. Patients in control group only received conventional treatment. All participants were asked to complete a structured Chemotherapy KAP Questionnaire and QOL Questionnaire at pre- and poststudy time. A total of 149 cancer patients (77 in PI group and 72 in control group) completed the study. The baseline scores of KAP and QOL in 2 groups were similar. At the end of study, only knowledge score was significantly increased; meanwhile no difference existed for attitude, practice, and QOL scores in control group; both KAP scores and QOL score were significantly increased in PI group. As for the between-group comparison, both KAP scores and QOL score in PI group were significantly higher than those in control group. In conclusion, pharmaceutical intervention has a positive role in increasing chemotherapy-related knowledge, improving patients' positive emotions, dealing with chemotherapy adverse reactions, and improving the quality of life of patients. PMID:26697487

  8. Etiology and clinical profile of childhood optic nerve atrophy at a tertiary eye care center in South India

    Directory of Open Access Journals (Sweden)

    Supriya Chinta

    2014-01-01

    Full Text Available Background: Optic nerve atrophy is an important ophthalmological sign that may be associated with serious systemic conditions having a significant bearing on the overall morbidity of the child. Studies specific to etiology of childhood optic atrophy are scarce, this being the first such study from India to the best of our knowledge. Aim: The aim was to analyze the clinical features and etiology of diagnosed cases of optic nerve atrophy in children <16 years of age. Materials and Methods: Retrospective review of records of children diagnosed with optic nerve atrophy between the ages of 0 and 16 years from 2006 to 2011. Results: A total of 324 children (583 eyes were identified. Among these 160 (49% presented with defective vision, 71 (22% with strabismus, 18 (6% with only nystagmus. Rest had a combination of two or three of the above symptoms. Sixty-five patients (20% had a unilateral affection. Hypoxic ischemic encephalopathy seen in 133 patients (41% was the most frequent cause of childhood optic atrophy, followed by idiopathic in 98 (30%, hydrocephalus in 24 (7%, compressive etiology in 18 (5%, infective in 19 (6%, congenital in 6 (2%, inflammatory in 5 (2% patients, respectively. Conclusion: Hypoxic ischemic encephalopathy appears to be the most common cause of optic atrophy in children in this series. The most common presenting complaint was defective vision.

  9. Relationship between alcohol consumption and clinical manifestation of patients with fatty liver:a single-center study

    Institute of Scientific and Technical Information of China (English)

    Xiu-FangWang; MinYue

    2011-01-01

    BACKGROUND: Fatty liver is a common chronic liver disease worldwide. It is associated with an increasing morbidity in China in recent years. The aim of this study was to analyze the effect of drinking alcohol on the hemoglobin and biochemical values of patients with fatty liver. METHODS: We investigated the clinical and laboratory data of 669 patients with fatty liver. Of the 669 patients, 166 consumed alcohol more than 60 g per week for at least 2 years, and 503 did not have a history of long-term alcohol consumption. We further analyzed the relationship between alcohol consumption and clinicalcharacteristicsofthesepatients. RESULTS: The values of aspartate transaminase (AST), gamma-glutamyl transpeptidase (GGT), and hemoglobin in the long-term consumption group were significantly higher than those in the non long-term consumption group (P CONCLUSION: Alcohol consumption is associated with significantly increased values of AST, GGT, and hemoglobin in patients with fatty liver, suggesting their potential roles in hepatic steatosis.

  10. Evaluation of the effect of hand hygiene reminder signs on the use of antimicrobial hand gel in a clinical skills center.

    Science.gov (United States)

    Wearn, Andy; Bhoopatkar, Harsh; Nakatsuji, Miriam

    2015-01-01

    Hand hygiene is a critical element of patient care, which needs to be learned and reinforced to become an autonomous behavior. Previous studies have explored aspects of hand hygiene behavior in the clinical workplace, but not in controlled learning environments with health professional students. Development of good hand hygiene behavior requires a multi-faceted approach, including education, reinforcement, feedback and audit. Our study aimed to identify the effect of unannounced hand hygiene reminder signs on the use of antimicrobial hand gel in a clinical skills center. Year 2 MBChB students received practical learning regarding hand hygiene in their clinical skills sessions. Baseline hand gel use was measured using before and after weighing of the bottles. An A5 sign was created to remind the students to hand cleanse and was used as an unannounced intervention. In semester 2 (2012), the student groups were randomly allocated as intervention (signs) or control (no signs). Hand gel use at all sessions was measured. Data were compared between groups and over time. In total, 237 students attended the skills sessions twice during the study. Hand gel use was not significantly different between the two study arms. Overall use was low, typically 1-2 hand gel pumps per student per session. In addition, hand gel use fell over time. A visual reminder to cleanse hands did not appear to have any effect on behavior. These findings may have implications for their value in a clinical setting. Low overall use of hand gel may be context-dependent. Students are in a simulated environment and examine 'healthy' peers or actors. There may have been inconsistent tutor role-modeling or problems with the educational approach to the skill. Analysis at the level of the group, and not the individual, may have also limited our study. PMID:25682193

  11. Heterogeneity in Clinical Symptoms and Cognitive Functioning of Children with Hyperactivity-Impulsivity and Inattention: Dimensional and Person-Centered Perspectives

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    Gambin Małgorzata J.

    2016-06-01

    Full Text Available The goal of this study was to investigate heterogeneity in clinical symptoms and cognitive functioning among children with hyperactivity-impulsivity and inattention using a novel approach that combined dimensional and person-centered perspectives. Executive, verbal and visuo-spatial functioning, hyperactivity-impulsivity, inattention, externalizing and internalizing symptoms were examined in 102 children (37 girls and 65 boys at risk for ADHD and 62 children (31 girls and 31 boys not at risk for ADHD in the age range of 8–10 years. We extracted seven groups with various profiles of psychopathological symptoms and cognitive functioning. We propose that symptoms of inattention and hyperactivity-impulsivity in these groups are related to different cognitive and affective-motivational problems.

  12. 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. PMID:26377989

  13. Investigating the Prevalence of Pervasive Developmental Disorders According to Sex in a Sample of Iranian Children Referred to Medical-Rehabilitation Centers and Psychiatrics Clinics

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    K. Khushabi

    2006-04-01

    Full Text Available Introduction & Objective: According to significance of pervasive developmental disorders (PDD in children and the increasing rate of its prevalence in referred patients to clinic in recent years and due to absence of any report about the rate of PPD in our country, this study was carried out. The aim of this study was to determine the prevalence of PPD in a sample of Iranian children who referred to medical and rehabilitation centers.Materials & Methods: 248 children who referred to three medical-rehabilitation centers were participated in the research. Accessible sampling with diagnosis of PDD based on DSM-IV criteria was chosen. The obtained data were analyzed using descriptive statistics methods such as percent and frequency distribution. Results: Autistics disorder was most prevalent among pervasive developmental disorders. In this research Autistic disorder (proportion 4/1 to 1, Asperger disorder (proportion 3 to 1 and childhood disintegrative disease were more prevalent in boys than girls. Ret disorders was observed only in girls and pervasive developmental disease (NOS was seen in both sexes. Conclusion: The results showed that pervasive developmental disorders are 4 times more prevalent in boys than girls and the findings of this research were consistent with those of previous studies.

  14. Treatment of pediatric patients and young adults with particle therapy at the Heidelberg Ion Therapy Center (HIT): establishment of workflow and initial clinical data

    International Nuclear Information System (INIS)

    To report on establishment of workflow and clinical results of particle therapy at the Heidelberg Ion Therapy Center. We treated 36 pediatric patients (aged 21 or younger) with particle therapy at HIT. Median age was 12 years (range 2-21 years), five patients (14%) were younger than 5 years of age. Indications included pilocytic astrocytoma, parameningeal and orbital rhabdomyosarcoma, skull base and cervical chordoma, osteosarcoma and adenoid-cystic carcinoma (ACC), as well as one patient with an angiofibroma of the nasopharynx. For the treatment of small children, an anesthesia unit at HIT was established in cooperation with the Department of Anesthesiology. Treatment concepts depended on tumor type, staging, age of the patient, as well as availability of specific study protocols. In all patients, particle radiotherapy was well tolerated and no interruptions due to toxicity had to be undertaken. During follow-up, only mild toxicites were observed. Only one patient died of tumor progression: Carbon ion radiotherapy was performed as an individual treatment approach in a child with a skull base recurrence of the previously irradiated rhabdomyosarcoma. Besides this patient, tumor recurrence was observed in two additional patients. Clinical protocols have been generated to evaluate the real potential of particle therapy, also with respect to carbon ions in distinct pediatric patient populations. The strong cooperation between the pediatric department and the department of radiation oncology enable an interdisciplinary treatment and stream-lined workflow and acceptance of the treatment for the patients and their parents

  15. Immuno-histological assessment of sub-clinical acute and borderline rejection in renal allograft recipients: Data from a transplant center in India

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    Sonia Badwal

    2015-01-01

    Full Text Available This single-center study was carried out on living related and unrelated renal transplant recipients (RTRs to evaluate the usefulness of surveillance biopsies in monitoring stable renal allografts using immuno-histological markers for immune-activation. This is a prospective, longitudinal study. Protocol biopsies of 60 RTRs with stable graft function were evaluated at three, six and 12 months post-transplant. Immuno-histological evaluation was carried out using immune-activation markers (perforins, granzyme and interleukin-2R, phenotypic markers (CD-3 and CD-20, viral markers and C4d. The demographic and clinical profile was recorded for each patient. All cases of acute sub-clinical rejection (SCR were treated and borderline SCR cases were followed-up without treatment. SCR at three and six months post-transplant was evident in 16.7% and 3.7% of RTRs, respectively. Positive statistical association of SCR was seen with HLA-DR mismatches, whereas patients receiving induction therapy and tacrolimus-based immunosuppression exhibited a lower incidence of SCR. T cell phenotype with persistent expression of immune-activation markers exhibited positive statistical association with interstitial fibrosis and tubular atrophy at 12-month follow-up biopsy. The mean creatinine levels were significantly lower in the protocol biopsy group than the non-protocol biopsy group. No significant difference was found between the mean creatinine levels of the SCR group after treatment and the non-SCR cases within the protocol biopsy group. Early treatment of sub-clinical acute rejection leads to better functional outcomes. However, persistent immune-activation is associated with chronicity and may have implications on long-term graft survival.

  16. Immuno-histological assessment of sub-clinical acute and borderline rejection in renal allograft recipients: Data from a transplant center in India.

    Science.gov (United States)

    Badwal, Sonia; Kumar, Arun; Hooda, A K; Varma, P P

    2015-11-01

    This single-center study was carried out on living related and unrelated renal transplant recipients (RTRs) to evaluate the usefulness of surveillance biopsies in monitoring stable renal allografts using immuno-histological markers for immune-activation. This is a prospective, longitudinal study. Protocol biopsies of 60 RTRs with stable graft function were evaluated at three, six and 12 months post-transplant. Immuno-histological evaluation was carried out using immune-activation markers (perforins, granzyme and interleukin-2R), phenotypic markers (CD-3 and CD-20), viral markers and C4d. The demographic and clinical profile was recorded for each patient. All cases of acute sub-clinical rejection (SCR) were treated and borderline SCR cases were followed-up without treatment. SCR at three and six months post-transplant was evident in 16.7% and 3.7% of RTRs, respectively. Positive statistical association of SCR was seen with HLA-DR mismatches, whereas patients receiving induction therapy and tacrolimus-based immunosuppression exhibited a lower incidence of SCR. T cell phenotype with persistent expression of immune-activation markers exhibited positive statistical association with interstitial fibrosis and tubular atrophy at 12-month follow-up biopsy. The mean creatinine levels were significantly lower in the protocol biopsy group than the non-protocol biopsy group. No significant difference was found between the mean creatinine levels of the SCR group after treatment and the non-SCR cases within the protocol biopsy group. Early treatment of sub-clinical acute rejection leads to better functional outcomes. However, persistent immune-activation is associated with chronicity and may have implications on long-term graft survival. PMID:26586064

  17. Clinical profile and outcome of recent outbreak of influenza A H1N1 (swine flu at a tertiary care center in Hyderabad, Telangana

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    Kadadanamari Subbaramareddy Amaravathi

    2015-01-01

    Full Text Available Background: Swine influenza, also called swine flu, hog flu, and pig flu, is an infection caused by any one of the several types of swine influenza viruses. The World Health organization ( WHO raised a worldwide pandemic alert for swine flu on June 11, 2009 that was a first of its kind in the past 70 years. In India, the index cases were reported from Pune, Maharashtra. We witnessed a recent outbreak in India during late 2014 and early 2015. Methodology: A retrospective study was carried out to describe the clinical profile and outcome of the confirmed cases of swine flu who were admitted at our center between December 10, 2014 and May 11, 2015. The cases were confirmed by reverse transcriptase polymerase chain reaction (RT-PCR on respiratory specimens. Results: A total of 514 patients with symptoms suggestive of swine flu were tested for hemagglutinin type 1 and neuraminidase type 1 (H1N1 out of whom 88 were positive, which accounted for 17.12% positivity. The mean age was 31.15 years with a range of 11-90 years, with equal distribution among males and females (males: 45, females: 43. The epidemic peaked in the month of January (n = 44.50%. Fever (95.45% was the most common clinical manifestation followed by cough (85.22%, breathlessness (51.22%, and myalgia (50%. The majority were in category C (59.09% based on the severity of the illness. All the patients were hospitalized and treated with oseltamivir. Of all the positive patients, 39 (44.31% were advised home isolation after discharge for 5-7 days in view of the mild disease. Hypertension, diabetes, existing lung diseases, cardiovascular diseases, smoking habit, alcohol consumption, and pregnancy were found to be the major risk factors. Women in the third trimester of their pregnancy were found to be at a higher risk. Our study had an overall mortality of 14.77% (n = 13. Mortality was higher among pregnant women (n = 1/6, 16.66% compared to nonpregnant women (n = 5/37, 13.51%. Multiple organ

  18. A descriptive study of clinical, hematological, and biochemical parameters of inhalant users seeking treatment at a tertiary care center in India

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    Rizwana Quraishi

    2013-01-01

    Full Text Available Background: Inhalant (or solvent abuse is the purposeful inhalation of vapors or gases, intended to produce pleasurable psychoactive effects. There is a dearth of Indian studies on inhalant users. Aim: The present study aimed to describe the socio-demographic, clinical, and psychosocial characteristics of inhalant users visiting a Tertiary Care Center in North India. Materials and Methods: The study was a retrospective chart review for 50 inhalant users who sought treatment for the first time from the center over a period of 2 years. All patients seeking treatment for inhalant use at the center were evaluated by a psychiatrist. Results: Mean age of the sample was 17.16±4.09 years and majority comprised of children and adolescents (72.2%. There were only three girls (6%. Majority comprised of school drop-outs (82%, from lower socio-economic status (80%. Mean age of initiation of first substance was 14.13±4.27 years and inhalants were first drugs for 38%. Duration of inhalant use ranged between 1 month and 7.5 years. Use was mostly uninterrupted, and 88% were dependent users. Correction fluid was the commonest product, used by huffing or sniffing. A large majority (86% had used at least one other substance besides inhalants, and 8% reported involvement in high-risk sexual behaviors. Comorbid psychiatric disorder was seen in 8% of sample. Positive family history was observed in 30% of the sample. The mean hemoglobin of the sample was 11.88±0.60, with low hemoglobin in 25% of users. Neutrophils, lymphocytes, eosinophils, and monocytes were elevated beyond normal in 10.8%, 6.5%, 15.2%, and 7.5%, respectively. There was no evidence of leucopenia. Bilirubin and serum glutamic pyruvic transaminase was elevated in 6.6% and 13% of inhalant users, respectively. Conclusion: The study adds to the limited date available on the treatment-seeking inhalant users from Indian settings. There is a need to examine the pattern of inhalant use in larger samples

  19. Identification of Class-1 Integron and Various Β-Lactamase Classes among Clinical Isolates of Pseudomonas aeruginosa at Children's Medical Center Hospital

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    Hossein Fazeli

    2015-10-01

    Full Text Available Background: Pseudomonas aeruginosa is one of the most important oppor- tunistic pathogens responsible for various types of infections. Children suffer significant morbidity and mortality due to nosocomial infections. The aim of this study was to investigate the presence of Class-1 integron, blaBEL, blaPER, blaKPC, blaVIM, blaIMP and blaOXA-group-1  genes among P. aeruginosa isolates at Children's Medical Center Hospital in Iran and to determine phenotypic evi- dence of ESBL and MBL production.Methods: Antibiotic susceptibility tests were analyzed for 72 P. aeruginosa clinical isolates. Isolates were identified by using biochemical tests and con- firmed by PCR assay for oprL gene. ESBL and MBL producer isolates were identified  by phenotypic  tests (double disc synergy tests. Detection of β- lactamase genes and class-1 integron were performed by PCR method. Results: All of the isolates were susceptible to ceftazidime / clavulanate, me- ropenem, imipenem and ciprofloxacin. About 83.3% and 16.7% of isolates were  resistant  to  ceftazidime  and  amikacin  respectively.  Approximately,83.3% of isolates were considered as potential ESBL producers. None of the clinical isolates showed above β-lactamase genes. It seems that, the reason is the absence of class-1 integron in all of isolates. About 16.7% of strains were identified  as multidrug  resistant.  Fortunately,  all of the isolates were sus- ceptible to meropenem and imipenem which are effective against ESBL pro- ducing strains.Conclusion:  The absences of class-1 integron decreases the probability of acquired β-lactamase especially MBL. Thus, absolute susceptibility to carba- penems and ciprofloxacin among P. aeruginosa isolates in pediatric hospital has important implications for empirical antimicrobial therapy. It seems that these properties help to decrease mortality of nosocomial infections within children.

  20. Radiotherapy quality assurance review in a multi-center randomized trial of limited-disease small cell lung cancer: the Japan Clinical Oncology Group (JCOG) trial 0202

    International Nuclear Information System (INIS)

    The purpose of this study was to analyze the radiotherapy (RT) quality assurance (QA) assessment in Japan Clinical Oncology Group (JCOG) 0202, which was the first trial that required on-going RT QA review in the JCOG. JCOG 0202 was a multi-center phase III trial comparing two types of consolidation chemotherapy after concurrent chemoradiotherapy for limited-disease small cell lung cancer. RT requirements included a total dose of 45 Gy/30 fx (bis in die, BID/twice a day) without heterogeneity correction; elective nodal irradiation (ENI) of 30 Gy; at least 1 cm margin around the clinical target volume (CTV); and interfraction interval of 6 hours or longer. Dose constraints were defined in regards to the spinal cord and the lung. The QA assessment was classed as per protocol (PP), deviation acceptable (DA), violation unacceptable (VU), and incomplete/not evaluable (I/NE). A total of 283 cases were accrued, of which 204 were fully evaluable, excluding 79 I/NE cases. There were 18 VU in gross tumor volume (GTV) coverage (8% of 238 evaluated); 4 VU and 23 DA in elective nodal irradiation (ENI) (2% and 9% of 243 evaluated, respectively). Some VU were observed in organs at risk (1 VU in the lung and 5 VU in the spinal cord). Overall RT compliance (PP + DA) was 92% (187 of 204 fully evaluable). Comparison between the former and latter halves of the accrued cases revealed that the number of VU and DA had decreased. The results of the RT QA assessment in JCOG 0202 seemed to be acceptable, providing reliable results

  1. Treatment of pediatric patients and young adults with particle therapy at the Heidelberg Ion Therapy Center (HIT: establishment of workflow and initial clinical data

    Directory of Open Access Journals (Sweden)

    Combs Stephanie E

    2012-10-01

    Full Text Available Abstract Background To report on establishment of workflow and clinical results of particle therapy at the Heidelberg Ion Therapy Center. Materials and methods We treated 36 pediatric patients (aged 21 or younger with particle therapy at HIT. Median age was 12 years (range 2-21 years, five patients (14% were younger than 5 years of age. Indications included pilocytic astrocytoma, parameningeal and orbital rhabdomyosarcoma, skull base and cervical chordoma, osteosarcoma and adenoid-cystic carcinoma (ACC, as well as one patient with an angiofibroma of the nasopharynx. For the treatment of small children, an anesthesia unit at HIT was established in cooperation with the Department of Anesthesiology. Results Treatment concepts depended on tumor type, staging, age of the patient, as well as availability of specific study protocols. In all patients, particle radiotherapy was well tolerated and no interruptions due to toxicity had to be undertaken. During follow-up, only mild toxicites were observed. Only one patient died of tumor progression: Carbon ion radiotherapy was performed as an individual treatment approach in a child with a skull base recurrence of the previously irradiated rhabdomyosarcoma. Besides this patient, tumor recurrence was observed in two additional patients. Conclusion Clinical protocols have been generated to evaluate the real potential of particle therapy, also with respect to carbon ions in distinct pediatric patient populations. The strong cooperation between the pediatric department and the department of radiation oncology enable an interdisciplinary treatment and stream-lined workflow and acceptance of the treatment for the patients and their parents.

  2. Factor structure of the General Health Questionnaire-28 (GHQ-28 from infertile women attending the Yazd Research and Clinical Center for Infertility

    Directory of Open Access Journals (Sweden)

    Zahra Shayan

    2015-12-01

    Full Text Available Background: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. Objective: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. Materials and Methods: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. Results: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. Conclusion: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women.

  3. Circumcision with “no-flip Shang Ring” and “Dorsal Slit” methods for adult males: a single-centered, prospective, clinical study

    Science.gov (United States)

    Lei, Jun-Hao; Liu, Liang-Ren; Wei, Qiang; Xue, Wen-Ben; Song, Tu-Run; Yan, Shi-Bing; Yang, Lu; Han, Ping; Zhu, Yu-Chun

    2016-01-01

    This paper was aimed to compare the clinical effectiveness and safety of adult male circumcision using the Shang Ring™ (SR) with the no-flip technique compared with Dorsal Slit (DS) surgical method. A single-centered, prospective study was conducted at the West China Hospital, where patients were circumcised using the no-flip SR (n = 408) or the DS (n = 94) procedure. The adverse events (AEs) and satisfaction were recorded for both groups, and ring-removal time and percentage of delayed removals were recorded for the SR group. Finally, complete follow-up data were collected for 76.1% of patients (SR: n = 306; DS: n = 76). The average ring-removal time for the SR group was 17.62 ± 6.30 days. The operation time (P flip SR method was found to be superior to the DS method for its short operation time (<5 min), involving less pain, bleeding, infection, and resulting in a satisfactory appearance. However, the time for recovery from edema took longer, and patients may wear device for 2–3 weeks after the procedure. PMID:26585694

  4. LEADER surveillance program results for 2006: an activity and spectrum analysis of linezolid using clinical isolates from the United States (50 medical centers).

    Science.gov (United States)

    Jones, Ronald N; Fritsche, Thomas R; Sader, Helio S; Ross, James E

    2007-11-01

    Surveillance for emerging linezolid resistance among commonly occurring Gram-positive pathogens in the United States began with the 2002 ZAAPS program and more recently (2004) expanded as the LEADER program. The 2006 LEADER program processed 5374 strains from 50 medical centers (100 per site) located within the 9 US census regions; species and number tested by broth microdilution (% linezolid susceptible) included Staphylococcus aureus (2913, >99.9), coagulase-negative staphylococci (CoNSs) (808, 98.4), enterococci (547, 97.4), Streptococcus pneumoniae (546, 100.0), viridans group streptococci (189, 100.0), and beta-hemolytic streptococci (371, 100.0). In addition to 1 linezolid-nonsusceptible S. aureus, 3 strains were daptomycin-nonsusceptible, 4 were quinupristin/dalfopristin-intermediate, 2 were vancomycin-intermediate (vancomycin MIC values, 4 mug/mL), and all were methicillin-resistant S. aureus. Among the linezolid-resistant isolates (1 S. aureus, 13 CoNSs, 3 Enterococcus faecalis, and 10 Enterococcus faecium isolates), all but 3 Staphylococcus epidermidis isolates had the G2567T mutation. Overall, 99.55% of the tested 2006 LEADER program isolates remained susceptible to linezolid at current Clinical and Laboratory Standards Institute breakpoints. PMID:17720350

  5. The Frequency of Hearing Loss and Hearing Aid Prescription in the Clients of the Avesina Education and Health Center, Audiometry Clinic, 1377

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    Abbas Bastani

    2003-08-01

    Full Text Available Objective: Determining the frequency of hearing disorders and hearing aid using in the clients referring to the Avesina education and health center, audiometry clinic, 1377. Method and Material: This is an assesive-descriptive survey that conducted on more than 2053 (1234 males and 819 females who referred for audiometry after examination by a physician. Case history, otoscopy, PTA, speech and immittance audiometry were conducted for all the clients. The findings were expressed in tables and diagrams of frequency. The age and sex relationship. All types of hearing losses and the number of the hearing-impaired clients need a hearing aid were assessed. Findings: 56% of this population were hearing-impaired and 44% had normal hearing were hearing. 60% were males and 40% females. Of the hearing-impaired, 44% had SNHL, 35.6% CHL and 8.2% mixed hearing loss. The hearing aid was prescribed for 204 (83 females and121 males if they need that only 20 females and 32 males wear it. Conclusion: It this sample, SNHL is of higher frequency. According to this survey, the more the age, the more the hearing aid is accepted (85% of wearer are more than 49 the prevalence of the hearing impaired males are more than females (60% versus 40%. Only 25% of the hearing-impaired wear hearing aids.

  6. Clinical Data Center Based on Integration Platform%基于集成平台的临床数据中心

    Institute of Scientific and Technical Information of China (English)

    李玉杰

    2014-01-01

    基于集成平台的完整一体化医院信息系统是目前医院建设和发展的基础工程,医院各系统之间的整合,建立患者主索引、标准字典库和临床数据中心、数据交换平台和数据共享平台,是优化业务流程,提高工作效率,充分体现医院管理和业务特色的重要工作。%The hospital information system established on a complete integration platform is currently the basic project in the hospital information system construction and development. To embody the outstanding characteristics in hospital business management, the important work in information system construction is to optimize business processes and improve work efficiency. This includes integrating different administrative departments and establishing the prime patient index, standardized dictionary database, clinical data center, data exchange platform and data sharing platform.

  7. Pathways to Addiction: A Gender-Based Study on Drug Use in a Triangular Clinic and Drop-in Center, Kerman, Iran

    Directory of Open Access Journals (Sweden)

    Zolala

    2016-02-01

    Full Text Available Background Addiction is characterized differently among women and men, and they begin using drugs for different reasons and motives. Objectives The aim of the study was to explore the gendered experiences and patterns of illicit drug use initiation in an Iranian context. Patients and Methods A total of 29 participants (15 men and 14 women took part in in-depth interviews conducted at a HIV triangulation clinic (for men and women and drop-in-center for women in Kerman in 2011. Results The results of the study suggest that patterns of drug use are different among among Iranian men and women. Men often transit to drug use from cigarette smoking, whereas women’s drug use practices often begins with opium. Unlike women, men who used drugs were often single at their drug use debut. Conclusions Different patterns of first exposure to drug use among men and women highlight the role of gendered expectations and socio-cultural norms in shaping drug use experiences of people who use drugs and call for gender-specific harm reduction interventions.

  8. Perfil de sujeitos de pesquisa clínica em um centro ambulatorial independente Profile of clinical research subjects in an independent outpatient center

    Directory of Open Access Journals (Sweden)

    Paulo Gustavo Sampaio Lacativa

    2008-06-01

    Full Text Available Este artigo tem como objetivos avaliar a qualidade de atendimento de um centro de pesquisa clínica e o entendimento do termo de consentimento informado (TCLE; determinar os motivos da participação e detalhar níveis socioeconômicos. Foi feito um estudo transversal em centro de pesquisa ambulatorial, através de questionário auto-explicativo. Dos cem questionários avaliados, todos os sujeitos de pesquisa consideraram o centro como ótimo (86% ou bom (9%. A quase totalidade foi bem informada do conteúdo do TCLE e o conhecimento do direito "confidencialidade", comum a todos os TCLEs, foi seis vezes maior que " acesso aos dados", que não faz parte. Os principais motivos para participarem foram para "saber mais sobre a sua saúde" (59% e para "beneficiar outras pessoas no futuro" (47%. A principal faixa de renda salarial dos participantes foi entre dois e cinco salários mínimos (48% e a maioria (66% concluiu pelo menos até a 4º série do ensino fundamental. A população possui o mesmo perfil econômico do Rio de Janeiro, nível de escolaridade suficiente para assinar e compreender o que está assinando, conhecendo não só a existência do TCLE, mas demonstrando conhecer seu conteúdo. O motivo principal para participação é para autobenefício e por atitude altruísta.This paper assesses the quality of assistance in a clinical trial outpatient center as well as the patients´understanding of the informed consent (IC; determine the reasons why they participate and detail socio-economic levels. A cross-sectional study was adopted in a clinical trial outpatient center using a self-explanatory questionnaire. All 100 respondents considered the assistance at the center excellent (86% or good (9%. Almost all of them were well informed about the content of the IC. Their knowledge about the right to "confidentiality", present in all ICs, was 6 times higher than their knowledge about their right to "access the results", generally not included

  9. Study of various clinical and laboratory parameters among 178 patients affected by hooch tragedy in Ahmedabad, Gujarat (India: A single center experience

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    Bhavesh S Jarwani

    2013-01-01

    Full Text Available Introduction/Purpose: The outbreak of methanol poisoning described in this paper occurred in Ahmedabad, Gujarat, India in July 2009. Our intention is to share the experience of clinical features, laboratory investigations and their relation during this tragedy. Materials and Methods: Single center, retrospective study of clinical features and laboratory parameters of 178 cases of methanol toxicity treated at tertiary care hospital in Ahmedabad, Gujarat. Results: Maximum patients (39.8%, n = 45 were received in 48 h; Mean age of presentation was 41.9 ± 10.2 years. Most of them were men (175 out of 178. On presentation, 83% patients had gastro-intestinal symptoms, 46% had neurological symptoms, 73% had visual symptoms and 32% had dyspnoea. 62% had blurred vision, 10.5% had blindness. Patients with visual symptoms had high mean level of methanol (120.12 ± 23.12 vs. 55.43 ± 29.24, P = 0.014. On fundus examination 52.8% (n = 62 had bilateral hyperaemia of discs, 8.4% (n = 12 had bilateral disc pallor and 4.5% had papilledema (n = 5. Patients with hyperaemia of discs, discs pallor or papilledema, had higher mean methanol level (121.1 ± 32.2 mg% v/s 70.1 ± 23.2 mg%, P = 0.032. Mean of pH values was 7.17 ± 0.22 and bicarbonate was 12.3 ± 7.3 mmol/L. Both pH and bicarbonate levels correlated well with mortality and serum methanol level. Mean serum methanol level was 87.1 mg/dL, and correlated significantly with the mortality (53.1 ± 41 mg/dL v/s 121 ± 92 mg/dL, P value < 0.05. Conclusion: GI symptoms, neurological symptoms and breathlessness are important clue to ED physician for diagnose methanol poisoning. Visual symptoms and fundus findings correlate well with the methanol level. Arterial Blood Gas derived pH and bicarbonate levels correlate significantly with the methanol level and mortality.

  10. The clinical profile, management, and overall outcome of aneurysmal subarachnoid hemorrhage at the neurosurgical unit of a tertiary care center in India

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    Harsimrat Bir Singh Sodhi

    2014-01-01

    Full Text Available Background and Purpose: Several studies report good outcomes in selected patients of aneurysmal subarachnoid hemorrhage (aSAH. The purpose of our study is to project the clinical characteristics, management, and overall outcome of patients with aSAH presenting to a tertiary care center in India. Materials and Methods: A prospective study was conducted over a period of 10 months and all patients presenting with aSAH were studied. Patients presenting in all grades and managed with any type of intervention or managed conservatively were included to characterize their clinical and radiological profile at admission, during management, and at discharge. Outcome was assessed with the Glasgow Outcome Score (GOS at 3 months follow-up. Results: Out of the 482 patients [mean age: 51.3 (±13.5; M: F = 1:1], 330 patients were fit to be taken up for intervention of the ruptured aneurysm, while 152 patients were unfit for any intervention. At 3 months follow-up, good outcome (GOS 4 and 5 was observed in 159 (33%, poor outcome (GOS 2 and 3 in 53 (11%, and death in 219 (45.4% patients, while 51 patients (10.6% were lost to follow-up. Most (95% of the patients in the non-intervention group expired, and hence the high mortality rate, as we have analyzed the results of all patients of all grades, regardless of the treatment given. The predictors of poor outcome (GOS 1, 2, and 3 at 3 months follow-up, using multinomial regression model, were: World Federation of Neurological Surgeons (WFNS grade IV and V (at admission and after adequate resuscitation [odds ratio (OR: 35.1, 95% confidence interval (CI: 10.8-114.7] and presence of hypertension as a co-morbid illness [OR: 2.7, 95% CI: 1.6-5.6]. All patients showing acute infarction on computed tomography scan at presentation had a poor outcome. Conclusions: Despite recent advances in the treatment of patients with aSAH, the morbidity and mortality rates have failed to improve significantly in unselected patients and

  11. Executive Summary: Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.

    Science.gov (United States)

    Nahid, Payam; Dorman, Susan E; Alipanah, Narges; Barry, Pennan M; Brozek, Jan L; Cattamanchi, Adithya; Chaisson, Lelia H; Chaisson, Richard E; Daley, Charles L; Grzemska, Malgosia; Higashi, Julie M; Ho, Christine S; Hopewell, Philip C; Keshavjee, Salmaan A; Lienhardt, Christian; Menzies, Richard; Merrifield, Cynthia; Narita, Masahiro; O'Brien, Rick; Peloquin, Charles A; Raftery, Ann; Saukkonen, Jussi; Schaaf, H Simon; Sotgiu, Giovanni; Starke, Jeffrey R; Migliori, Giovanni Battista; Vernon, Andrew

    2016-10-01

    The American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America jointly sponsored the development of this guideline for the treatment of drug-susceptible tuberculosis, which is also endorsed by the European Respiratory Society and the US National Tuberculosis Controllers Association. Representatives from the American Academy of Pediatrics, the Canadian Thoracic Society, the International Union Against Tuberculosis and Lung Disease, and the World Health Organization also participated in the development of the guideline. This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis. For all recommendations, literature reviews were performed, followed by discussion by an expert committee according to the Grading of Recommendations, Assessment, Development and Evaluation methodology. Given the public health implications of prompt diagnosis and effective management of tuberculosis, empiric multidrug treatment is initiated in almost all situations in which active tuberculosis is suspected. Additional characteristics such as presence of comorbidities, severity of disease, and response to treatment influence management decisions. Specific recommendations on the use of case management strategies (including directly observed therapy), regimen and dosing selection in adults and children (daily vs intermittent), treatment of tuberculosis in the presence of HIV infection (duration of tuberculosis treatment and timing of initiation of antiretroviral therapy), as well as treatment of extrapulmonary disease (central nervous system, pericardial among other sites) are provided. The development of more potent and better-tolerated drug regimens, optimization of drug exposure for the

  12. Radiopharmaceutical activities administered for diagnostic procedures in nuclear medicine in the first six months of the gamma camera use in the Clinical Center of Montenegro - Podgorica

    International Nuclear Information System (INIS)

    Nuclear medicine procedures have carried out in the Clinical Center of Montenegro - Podgorica since 2006 by the dual-headed SPECT and Digital gamma camera NUCLINE Spirit DH-V. In the first six months of the gamma camera use (from September 2006 to March 2007) examinations of skeleton, kidneys, thyroid and lung were performed. For diagnostic skeletal imaging (102 patients) the radiopharmaceutical 99mTc-MDP is used, and administered activities were in the range from 555 to 740 MBq. For thyroid imaging (203 patients) 99mTc-pertechnetate is used, and administered activities were in the range (37-111) MBq. Lung imaging is performed for 3 patients, using 99mTc-MAA and administered activities in the range (111-185) MBq. Renal imaging is carried out for 72 patients: 42 dynamic studies of kidneys were performed with 99mTc-DTPA and administered activities from 207 to 282 MBq, and 30 static kidneys scintigraphies were performed using the radiopharmaceutical 99mTc-DMSA. 6 patients in the last mentioned group were children with year of birth between 2000 and 2006, and administered activities were from 16.6 to 55.5 MBq. In the same group, activities 28.5 MBq, 74.4 MBq and 120 MBq were administered to three patients with age between 6 and 18 years, and in the other cases, administered activities to the patients (adults) were in the range (59.2 to 196) MBq. The administered activities presented here are basis for further estimations of cumulated activity and absorbed dose to the various organs, which is useful for comparison of the average dose to patient organs in various nuclear medicine procedures and calculation of effective dose equivalent and total effective dose, significant for an estimation of potential risk due to the radioactivity administered to a patient during nuclear medicine procedures. It is very important for procedures optimization and improvement of the radiation protection. (author)

  13. Patterns of self-cutting: a preliminary study on differences in clinical implications between wrist- and arm-cutting using a Japanese juvenile detention center sample.

    Science.gov (United States)

    Matsumoto, Toshihiko; Yamaguchi, Akiko; Chiba, Yasuhiko; Asami, Takeshi; Iseki, Eizo; Hirayasu, Yoshio

    2004-08-01

    The present study was aimed to clarify the differences in clinical implications between wrist- and arm-cutting. Subjects were 201 delinquent adolescents (178 males and 23 females) who had been admitted to a detention center from February to March 2003. A self-reporting questionnaire and the Adolescent Dissociative Experience Scale (ADES) were given. Traumatic events and other self-injurious behavior were compared among four groups. In total, 33 (16.4%) subjects reported wrist- and/or arm-cutting. Of the females, 60.9% (n = 14) had experienced self cutting behaviors compared to 10.7% of males (n = 19). Subjects were divided into four groups; 'non-cutting' (NC: n = 168, 83.6%), 'wrist-cutting' (WC: n = 5, 2.5%), 'arm-cutting' (AC: n = 19, 9.5%), and 'wrist- and arm-cutting' (WAC: n = 9, 4.5%). WC, AC, and WAC groups reported early separation, bulling in school, and histories of sexual/physical abuse more frequently than NC group. WC and WAC groups reported suicidal ideation and suicide attempts more frequently than NC and AC groups. The ADES scores in AC and WAC groups were significantly higher than in those in NC group (P suicide idea more frequently than the AC group, while AC group self-cut due to anger expression more frequently than WC or WAC groups. Self-cutters experienced early separation, bullying in school, and sexual/physical abuse more frequently than-non-self-cutters. Arm-cutting behavior may predict dissociation, while wrist-cutting may involve with suicidality. PMID:15298650

  14. Clinical profile and outcome of acute kidney injury related to pregnancy in developing countries: a single-center study from India.

    Science.gov (United States)

    Godara, Suraj M; Kute, Vivek B; Trivedi, Hargovind L; Vanikar, Aruna V; Shah, Pankaj R; Gumber, Manoj R; Patel, Himanshu V; Gumber, Vandana M

    2014-07-01

    Acute kidney injury (AKI) is one of the most challenging and serious complications of pregnancy. We present our experience on the clinical profile and outcome of 57 patients with pregnancy-related AKI, of a total of 580 patients with AKI seen during the study period. This is a prospective single-center study in a civil hospital conducted from January to December 2010. The most common age group of the study patients was 20-25 years; 43.8% of the patients had received antenatal care. AKI was observed in the puerperium (n = 34), early pregnancy (n = 10) and late pregnancy (n = 13). The cause of AKI included puerperal sepsis (63.1%), pregnancy-induced hypertension (PIH) (33.33%), post-abortion (22.80%), ante-partum hemorrhage (APH) (14%) and post-partum hemorrhage (PPH) (8%). Complete, partial and no renal recovery was observed in 52.64%, 21.05% and 26.31% of the patients, respectively. Low platelet count and plasma fibrinogen and high bilirubin, D-dimer and activated partial thromboplast in time were observed more commonly in patients with partial recovery. Of the 57 patients, 50 received hemodialysis, three received peritoneal dialysis and seven patients were managed conservatively. A total of 13 patients developed cortical necrosis that was associated with sepsis in six, PPH and pre-eclampsia/eclampsia in three patients each and APH in one. Nine patients died, and the cause of death was septicemia in four, pre-eclampsia in three and APH and PPH in one patient each. In our study, puerperal sepsis was the most common etiological factor for pregnancy-related AKI. Prolonged oliguria or anuria were bad prognostic factors for renal recovery. Sepsis, thrombocytopenia, disseminated intra-vascular coagulation and liver involvement were associated with increased mortality. PMID:24969215

  15. Clinical profile and outcome of acute kidney injury related to pregnancy in developing countries: A single-center study from India

    Directory of Open Access Journals (Sweden)

    Suraj M Godara

    2014-01-01

    Full Text Available Acute kidney injury (AKI is one of the most challenging and serious complications of pregnancy. We present our experience on the clinical profile and outcome of 57 patients with pregnancy-related AKI, of a total of 580 patients with AKI seen during the study period. This is a prospective single-center study in a civil hospital conducted from January to December 2010. The most common age group of the study patients was 20-25 years; 43.8% of the patients had received antenatal care. AKI was observed in the puerperium (n = 34, early pregnancy (n = 10 and late pregnancy (n = 13. The cause of AKI included puerperal sepsis (63.1%, pregnancy-induced hypertension (PIH (33.33%, post-abortion (22.80%, ante-partum hemorrhage (APH (14% and post-partum hemorrhage (PPH (8%. Complete, partial and no renal recovery was observed in 52.64%, 21.05% and 26.31% of the patients, respectively. Low platelet count and plasma fibrinogen and high bilirubin, D-dimer and activated partial throm-boplastin time were observed more commonly in patients with partial recovery. Of the 57 patients, 50 received hemodialysis, three received peritoneal dialysis and seven patients were managed conserva-tively. A total of 13 patients developed cortical necrosis that was associated with sepsis in six, PPH and pre-eclampsia/eclampsia in three patients each and APH in one. Nine patients died, and the cause of death was septicemia in four, pre-eclampsia in three and APH and PPH in one patient each. In our study, puerperal sepsis was the most common etiological factor for pregnancy-related AKI. Prolonged oliguria or anuria were bad prognostic factors for renal recovery. Sepsis, thrombocytopenia, disseminated intra-vascular coagulation and liver involvement were associated with increased mortality.

  16. Mifepristone in Combination with Misoprostol vs. Low Dose Mifepristone Alone in Emergency Contraception: a Multi-center Double-blind Randomized Clinical Trial

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To compare the effectiveness and side effects of various low dose ofMi fepristone in combination with Misoprostol and low doses Mi fepristone alone in emer-gency contraceptionMaterials & Methods This is a multi-center double-blind randomized controlled clini-cal trial. A total of 899 healthy women were allocated into this study and were ran-domly divided into 3 groups. They were orally administrated with different emergen-cy contraceptives with 120 h after unprotected intercourse. Group Ⅰ (n = 300) was giv-en 25 mg Mifepristone plus 0. 2 mg Misoprostol after 24 h. Group Ⅱ (n = 299) wasgiven 10 mg Mifepristone plus 0. 2 mg Misoprostol after 24 h. Group Ⅲ (n = 300)was administrated with 10 mg Mifepristone alone. The effective rates in differentgroups were calculated with Dixon method.Results Altogether 11 pregnancies occurred, among which 2 cases were in Group Ⅰ, 2cases in Group Ⅱ, and 7 cases were in Grout Ⅲ. After correction with method fail-ure, there was only one case in Group Ⅰ, 0 case in Group Ⅱ, and 5 cases in Group Ⅲ.The contraceptive effectiveness in these groups was 95. 5%, 100% and 76. 9% respec-tively. The pregnancy rate was significantly lower in Group Ⅰ and Group Ⅱ than thatof Group Ⅲ (P< 0. 01). The side effects were slight and tolerable, and there was nosignificant difference between di fferent groups (P> 0. 05).Conclusion Use of low dose Mi fepristone (25 mg or 10 mg ) in combination with 0. 2mg Misoprostol was an effective, low side effects and safe treatment regimen foremergency contraception.

  17. Non-invasive cardiac assessment in high risk patients (The GROUND study: rationale, objectives and design of a multi-center randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Moll Frans L

    2008-08-01

    Full Text Available Abstract Background Peripheral arterial disease (PAD is a common disease associated with a considerably increased risk of future cardiovascular events and most of these patients will die from coronary artery disease (CAD. Screening for silent CAD has become an option with recent non-invasive developments in CT (computed tomography-angiography and MR (magnetic resonance stress testing. Screening in combination with more aggressive treatment may improve prognosis. Therefore we propose to study whether a cardiac imaging algorithm, using non-invasive imaging techniques followed by treatment will reduce the risk of cardiovascular disease in PAD patients free from cardiac symptoms. Design The GROUND study is designed as a prospective, multi-center, randomized clinical trial. Patients with peripheral arterial disease, but without symptomatic cardiac disease will be asked to participate. All patients receive a proper risk factor management before randomization. Half of the recruited patients will enter the 'control group' and only undergo CT calcium scoring. The other half of the recruited patients (index group will undergo the non invasive cardiac imaging algorithm followed by evidence-based treatment. First, patients are submitted to CT calcium scoring and CT angiography. Patients with a left main (or equivalent coronary artery stenosis of > 50% on CT will be referred to a cardiologist without further imaging. All other patients in this group will undergo dobutamine stress magnetic resonance (DSMR testing. Patients with a DSMR positive for ischemia will also be referred to a cardiologist. These patients are candidates for conventional coronary angiography and cardiac interventions (coronary artery bypass grafting (CABG or percutaneous cardiac interventions (PCI, if indicated. All participants of the trial will enter a 5 year follow up period for the occurrence of cardiovascular events. Sequential interim analysis will take place. Based on sample size

  18. Association between community health center and rural health clinic presence and county-level hospitalization rates for ambulatory care sensitive conditions: an analysis across eight US states

    Directory of Open Access Journals (Sweden)

    Laditka Sarah B

    2009-07-01

    Full Text Available Abstract Background Federally qualified community health centers (CHCs and rural health clinics (RHCs are intended to provide access to care for vulnerable populations. While some research has explored the effects of CHCs on population health, little information exists regarding RHC effects. We sought to clarify the contribution that CHCs and RHCs may make to the accessibility of primary health care, as measured by county-level rates of hospitalization for ambulatory care sensitive (ACS conditions. Methods We conducted an ecologic analysis of the relationship between facility presence and county-level hospitalization rates, using 2002 discharge data from eight states within the US (579 counties. Counties were categorized by facility availability: CHC(s only, RHC(s only, both (CHC and RHC, and neither. US Agency for Healthcare Research and Quality definitions were used to identify ACS diagnoses. Discharge rates were based on the individual's county of residence and were obtained by dividing ACS hospitalizations by the relevant county population. We calculated ACS rates separately for children, working age adults, and older individuals, and for uninsured children and working age adults. To ensure stable rates, we excluded counties having fewer than 1,000 residents in the child or working age adult categories, or 500 residents among those 65 and older. Multivariate Poisson analysis was used to calculate adjusted rate ratios. Results Among working age adults, rate ratio (RR comparing ACS hospitalization rates for CHC-only counties to those of counties with neither facility was 0.86 (95% Confidence Interval, CI, 0.78–0.95. Among older adults, the rate ratio for CHC-only counties compared to counties with neither facility was 0.84 (CI 0.81–0.87; for counties with both CHC and RHC present, the RR was 0.88 (CI 0.84–0.92. No CHC/RHC effects were found for children. No effects were found on estimated hospitalization rates among uninsured populations

  19. Late angiographic and clinical follow-up results of 100 consecutive aneurysms treated with Onyx reconstruction: largest single-center experience

    International Nuclear Information System (INIS)

    We present the long-term clinical and angiographic follow-up results of 100 consecutive intracranial aneurysms treated with Onyx liquid embolic system (MTI, Irvine, Calif.), either alone or combined with an adjunctive stent, in a single center. A total of 100 aneurysms in 94 patients were treated with endosaccular Onyx packing. Intracranial stenting was used adjunctively in 25 aneurysms including 19 during initial treatment and 6 during retreatment. All aneurysms except two were located in the internal carotid artery. Of the 100 aneurysms, 35 were giant or large/wide-necked, and 65 were small. Follow-up angiography was performed in all 91 surviving patients (96 aneurysms) at 3 and/or 6 months. Follow-up angiography was performed at 1, 2, 3, 4 and 5 years in 90, 41, 26, 6 and 2 patients, respectively. Overall, aneurysm recanalization was observed in 12 of 96 aneurysms with follow-up angiography (12.5%). All 12 were large or giant aneurysms, resulting in a 36% recanalization rate in the large and giant aneurysm group. One aneurysm out of 25 treated with the combination of a stent and Onyx showed recanalization. There was also no recanalization in the follow-up of small internal carotid artery aneurysms treated with balloon assistance only. At final follow-up, procedure- or device-related permanent neurological morbidity was present in eight patients (8.3%). There were two procedure-related and one disease-related (subarachnoid hemorrhage) deaths (mortality 3.2%). Delayed spontaneous asymptomatic occlusion of the parent vessel occurred in two patients, detected on routine follow-up. Onyx provides durable aneurysm occlusion with parent artery reconstruction resulting in perfectly stable 1-year to 5-year follow-up angiography both in small aneurysms treated with balloon assistance only (0% recanalization rate) and large or giant aneurysms treated with stent and Onyx combination (4% recanalization rate). Endosaccular Onyx packing with balloon assistance may not be

  20. [Surveillance of in vitro susceptibilities to levofloxacin and various antibacterial agents for 11,762 clinical isolates obtained from 69 centers in 2013].

    Science.gov (United States)

    Yamaguchi, Keizo; Tateda, Kazuhiro; Ohno, Akira; Ishii, Yoshikazu; Murakami, Hinako

    2016-02-01

    Antimicrobial susceptibility testing has been conducted continuously as postmarketing surveillance of levofloxacin (LVFX) since 1994. The present survey was undertaken to investigate in vitro susceptibilities of bacteria to 33 selected antibacterial agents, focusing on fluoroquinolones (FQs), using 11,762 clinical isolates for 19 species collected from 69 centers during 2013 in Japan. The common respiratory pathogens Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae continue to show a high susceptibility to FQs, while the percentage of macrolide-resistant S. pneumoniae was markedly increased to around 80%. With H. influenzae, the percentage of β-lactamase-negative ampicillin-resistant isolates had been increasing continuously from 2002, but no increase was observed from 2010 to 2013 (25.8% in 2002, 40.0% in 2004, 50.1% in 2007, 57.9% in 2010, and 57.1% in 2013). Most strains of Enterobacteriaceae showed a high susceptibility to FQs, but the isolation frequency of levofloxacin-resistant Escherichia coli including intermediate resistance was 34.4%, showing a continuous increase. Another Enterobacteriaceae member, Klebsiella pneumoniae, showed low resistance to FQs in contrast with E. coli. Regarding methicillin-resistant Staphylococcus aureus (MRSA), the percentage of FQ-susceptible isolates was low at 15.8-18.0%, with the exception of 55.3% susceptibility to sitafloxacin. On the other hand, methicillin-susceptible S. aureus (MSSA) isolates showed high susceptibility to FQs, at 87.0-99.3%. With Enterococcusfaecium, the percentage of FQ-susceptible isolates was 6.8-24.7%. The percentage of FQ-susceptible Pseudomonas aeruginosa was 83.4-89.3% among isolates derived from urinary tract infections (UTIs), while that from respiratory tract infections (RTIs) was 88.1-93.7%. This was summarized as susceptibility to FQs over 80% in both infections. A continuous decrease in FQ-resistant P. aeruginosa was noted, especially

  1. Participating in Clinical Trials

    Medline Plus

    Full Text Available Home > Health topics A-Z > Participating in Clinical Trials: About Clinical Trials In This Topic About Clinical Trials Risks ... centers across the country. The National Institutes of Health funds much of this basic research. Screening Trials ...

  2. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

    OpenAIRE

    Qing, Yunbo; Hu, Guijie; Chen, Qingyun; Peng, Hailun; Li, Kailan; Wei, Jinling; Yi, Yanhua

    2015-01-01

    Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-ba...

  3. Columbia-Presbyterian Medical Center Integrated Academic Information Management System (IAIMS) Outpatient Clinical Information System Implemented in a Faculty General Medicine Practice

    OpenAIRE

    Shea, Steven; Clark, Anthony S.; Clayton, Paul D.

    1990-01-01

    We describe a clinical information system for hospital-based ambulatory care implemented in the context of the institution's IAIMS Phase III effort. Key features of this application are physician data entry to maintain summary clinical profiles that include medication lists, problem lists, and preventive care, and integration with other components of the Clinical Information System at the levels of the database, the user interface, and data sharing. A goal of this application is to provide co...

  4. A 6-Year-Old Child with Severe Ebola Virus Disease: Laboratory-Guided Clinical Care in an Ebola Treatment Center in Guinea

    OpenAIRE

    Palich, Romain; Gala, Jean-Luc; Petitjean, Frédéric; Shepherd, Susan; Peyrouset, Olivier; Bing M Abdoul; Kinda, Moumouni; Danel, Christine; Augier, Augustin; Anglaret, Xavier; Malvy, Denis; Blackwell, Nicole; McElroy, Anita K.

    2016-01-01

    An unprecedented epidemic of Ebola virus disease has ravaged West Africa since December, 2013. The French nongovernmental organization Alliance for International Medical Action opened the N’zérékoré Ebola treatment center (ETC) on December 2nd, 2014. This center includes a laboratory managed by the Belgian organization B-Fast/B-Life. Between December 2nd, 2014, and February 7th, 2015, 130 patients were admitted, of whom 76 were confirmed to have Ebola virus disease (EVD), which was fatal in 6...

  5. Senior Centers

    Medline Plus

    Full Text Available ... to do as long as they can. Senior centers, adult day care, transportation, and meals programs are ... older adults to remain in their homes. Senior centers are places where older adults who live independently ...

  6. Excel Center

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Citigroup,one of the World top 500 companies,has now settled in Excel Center,Financial Street. The opening ceremony of Excel Center and the entry ceremony of Citigroup in the center were held on March 31.Government leaders of Xicheng District,the Excel CEO and the heads of Asia-Pacific Region leaders of Citibank all participated in the ceremony.

  7. Job center

    Science.gov (United States)

    To better meet the needs of AGU members, a program has been started to increase the effectiveness of the Job Center activity at the Spring and Fall Meetings. As a result, participation in the Job Center at the 1988 AGU Spring Meeting in Baltimore increased substantially compared to previous Spring Meetings. The number of employers, applicants, and interviews scheduled more than doubled compared to the 1987 Spring Job Center.In order to make the meeting Job Centers even better, a survey is being conducted of employers and applicants who participated in the 1988 Spring Job Center. Evaluation of this survey will be useful in continuing increased participation in and the effectiveness of the Job Center at the 1988 Fall Meeting. Past participants and those interested in the future of the Job Center are encouraged to forward comments and suggestions to AGU, Member Programs Division, 2000 Florida Ave., N.W., Washington, DC 20009.

  8. 创建一流临床技能中心培养创新型医学人才%Establishment of clinical skills center for training the creative ability of medical students

    Institute of Scientific and Technical Information of China (English)

    许杰州; 施楚君; 吴丽萍; 吴凡; 杨棉华; 黄东阳

    2008-01-01

    通过临床技能教学改革,达到培养创新型医学人才的目的 .汕头大学医学院通过更新教学理念,改革课程体系,建立多功能、全方位的临床技能中心等方法 ,培养既有扎实理论知识又有娴熟临床技能与思维能力的创新型医学人才.经过5年的实践,学生不但在专业知识、人文素质、临床技能水平、创新能力培养等方面取得了可喜的效果,而且得到了社会的良好评价和认可.%The objective of the study is to reform clinical skills education in order to develop creative ability of medical students. Update the education idea, reform the teaching program and set up an excellent clinical skills training center in order to develop creative ability of medical students who are good at clinical skills, critical clinical thinking and consolidated medical knowledge following 5 years practice. The students were obviously promoted in many aspects, including professional knowledge, quality of humanity, clinical skills and creative ability.

  9. The Self-Assessment of Role-Performance and Activities of Daily Living Abilities (SARA™): Development and Clinical Utility of a Client-Centered Screening Tool and Outcome Measure.

    Science.gov (United States)

    Watkins, Sarah L; Lounsbury, Peggy A; Fleming-Castaldy, Rita P

    2016-01-01

    This article describes the development and use of the Self-Assessment of Role-performance and activities of daily living Abilities (SARA™), a standardized client-centered index of functional abilities. Developed in four phases, this article describes the initial development, pilot testing and revision, examination of psychometric properties, and finalization. Pilot studies found the SARA™ to be reliable, valid, and responsive to change. The use of the SARA™ in clinical practice and for outcome monitoring promotes client-centered goal setting and client-valued rehabilitation. It is a viable alternative to deficit-focused measures. The SARA™ is a promising new tool that warrants increased utilization and further research. PMID:26115016

  10. Clinical, patient-related, and economic outcomes of home-based high-dose hemodialysis versus conventional in-center hemodialysis

    OpenAIRE

    Mitsides N; Mitra S.; Cornelis T

    2016-01-01

    Nicos Mitsides,1,2 Sandip Mitra,1,2 Tom Cornelis3 1Department of Renal Medicine, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Center, Manchester, 2National Institute for Healthcare Research Devices for Dignity Healthcare Co-operative, Sheffield, UK; 3Department of Nephrology, Jessa Hospital, Hasselt, Belgium Abstract: Despite technological advances in renal replacement therapy, the preservation of health and qual...

  11. Clinical approach in the management of oral chronic graft-versus-host disease (cGVHD) in a series of specialized medical centers

    DEFF Research Database (Denmark)

    Elad, Sharon; Jensen, Siri Beier; Raber-Durlacher, Judith E; Mouradian, Nancy; Correa, Elvira M P; Schubert, Mark M; Blijlevens, Nicole M A; Epstein, Joel B; Saunders, Deborah P; Waltimo, Tuomas; Yarom, Noam; Zadik, Yehuda; Brennan, Michael T

    2015-01-01

    GVHD patients, diagnostic and evaluation methods in their practice, preferred treatment strategies for mucosal and salivary gland involvement, and preventive measures. RESULTS: Twelve responders, representing 12 sites, stated that they treat oral cGVHD patients on a regular basis. This fraction of responders...... was confirmed by another online survey. Eleven out of the 12 providers were dentists. Seventy-five percent of the providers did not use biopsy in order to diagnose oral cGVHD. The NIH scale for the clinical assessment was used sporadically. The first-line topical treatment for oral mucosal cGVHD was......BACKGROUND: The oral cavity is frequently affected in chronic graft-versus-host disease (cGVHD), with variable clinical presentations. The literature on the effective management of patients suffering from oral cGVHD is limited. OBJECTIVE: The objective of this study was to assess the clinical...

  12. AIDS Clinical Trials Group Network

    Science.gov (United States)

    ... Center Statistical and Data Management Center Glossaries Sites Clinical Trials About the Trial Process Trials Open to Enrollment Recent Study Results Access to Published Data Clinical Trials Resources Committees Executive Scientific Resource Community General Information ...

  13. Functional Centering

    CERN Document Server

    Hahn, M

    1996-01-01

    Based on empirical evidence from a free word order language (German) we propose a fundamental revision of the principles guiding the ordering of discourse entities in the forward-looking centers within the centering model. We claim that grammatical role criteria should be replaced by indicators of the functional information structure of the utterances, i.e., the distinction between context-bound and unbound discourse elements. This claim is backed up by an empirical evaluation of functional centering.

  14. An Organizational Informatics Analysis of Colorectal, Breast, and Cervical Cancer Screening Clinical Decision Support and Information Systems within Community Health Centers

    Science.gov (United States)

    Carney, Timothy Jay

    2012-01-01

    A study design has been developed that employs a dual modeling approach to identify factors associated with facility-level cancer screening improvement and how this is mediated by the use of clinical decision support. This dual modeling approach combines principles of (1) Health Informatics, (2) Cancer Prevention and Control, (3) Health Services…

  15. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

    Directory of Open Access Journals (Sweden)

    Yunbo Qing

    2015-07-01

    Full Text Available Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs, the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Results: Among 4,669 medical students, 1,523 (33% had a positive attitude and 2,574 (55% had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Conclusion: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  16. Distribution center

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    Distribution center is a logistics link fulfill physical distribution as its main functionGenerally speaking, it's a large and hiahly automated center destined to receive goods from various plants and suppliers,take orders,fill them efficiently,and deliver goods to customers as quickly as possible.

  17. A retrospective, multi-center cohort study evaluating the severity- related effects of cerebrolysin treatment on clinical outcomes in traumatic brain injury.

    Science.gov (United States)

    Muresanu, Dafin F; Ciurea, Alexandru V; Gorgan, Radu M; Gheorghita, Eva; Florian, Stefan I; Stan, Horatiu; Blaga, Alin; Ianovici, Nicolai; Iencean, Stefan M; Turliuc, Dana; Davidescu, Horia B; Mihalache, Cornel; Brehar, Felix M; Mihaescu, Anca S; Mardare, Dinu C; Anghelescu, Aurelian; Chiparus, Carmen; Lapadat, Magdalena; Pruna, Viorel; Mohan, Dumitru; Costea, Constantin; Costea, Daniel; Palade, Claudiu; Bucur, Narcisa; Figueroa, Jesus; Alvarez, Anton

    2015-01-01

    Traumatic brain injury (TBI) is a leading cause of death and disability for which there is currently no effective drug therapy available. Because drugs targeting a single TBI pathological pathway have failed to show clinical efficacy to date, pleiotropic agents with effects on multiple mechanisms of secondary brain damage could represent an effective option to improve brain recovery and clinical outcome in TBI patients. In this multicenter retrospective study, we investigated severity-related efficacy and safety of the add-on therapy with two concentrations (20 ml/day or 30 ml/day) of Cerebrolysin (EVER Neuro Pharma, Austria) in TBI patients. Adjunctive treatment with Cerrebrolysin started within 48 hours after TBI and clinical outcomes were ranked according to the Glasgow Outcome Scale and the Modified Rankin Disability Score at 10 and 30 days post-TBI. Analyses of efficacy were performed separately for subgroups of patients with mild, moderate or severe TBI according to Glasgow Coma Scale scores at admission. Compared to standard medical care alone (control group), both doses of Cerebrolysin were associated with improved clinical outcome scores at 10 days post-TBI in mild patients and at 10 and 30 days in moderate and severe cases. A dose-dependent effect of Cerebrolysin on TBI recovery was supported by the dose-related differences and the significant correlations with treatment duration observed for outcome measures. The safety and tolerability of Cerebrolysin in TBI patients was very good. In conclusion, the results of this large retrospective study revealed that early Cerebrolysin treatment is safe and is associated to improved TBI outcome. PMID:25924999

  18. Implementation of a Theory-based, Non-clinical Patient Navigator Program to Address Barriers in an Urban Cancer Center Setting

    OpenAIRE

    FLEISHER, LINDA; Miller, Suzanne M.; Crookes, Danielle; Kandadai, Venk; Wen, Kuang Yi; Slamon, Rachel E.; Chaivous, Jeanne

    2012-01-01

    Cancer patients face a myriad of psychosocial and practical issues. Especially challenging is the time from an initial diagnosis to the onset of treatment and patient navigation services are important to guide patients, especially underserved populations, through this maze of uncertainty. Here we report on the Pennsylvania Patient Navigator Demonstration Project (PaPND) designed to evaluate the acceptability, feasibility, and impact of a culturally and linguistically appropriate non-clinical ...

  19. A Clinical Scoring Algorithm for Determination of the Risk of Tuberculosis in HIV-Infected Adults: A Cohort Study Performed at Ethiopian Health Centers

    OpenAIRE

    Balcha, T. T.; Skogmar, S.; Sturegård, E.; Schön, T.; Winqvist, N.; Reepalu, A.; Jemal, Z. H.; Tibesso, G.; Björk, J; Björkman, P.

    2014-01-01

    Background  The World Health Organization (WHO) tuberculosis (TB) symptom screening instrument (WHO-TB) can identify human immunodeficiency virus (HIV)-infected individuals at low risk of tuberculosis (TB); however, many patients report WHO-TB symptoms and require further TB investigations. We hypothesized that further clinical scoring could classify subjects with a positive WHO-TB screening result (WHO-TB+) for the likelihood of TB. Methods  HIV-infected adults eligible to initiate antiretro...

  20. External audit of clinical practice and medical decision making in a new Asian oncology center: Results and implications for both developing and developed nations

    International Nuclear Information System (INIS)

    Purpose: The external audit of oncologist clinical practice is increasingly important because of the incorporation of audits into national maintenance of certification (MOC) programs. However, there are few reports of external audits of oncology practice or decision making. Our institution (The Cancer Institute, Singapore) was asked to externally audit an oncology department in a developing Asian nation, providing a unique opportunity to explore the feasibility of such a process. Methods and Materials: We audited 100 randomly selected patients simulated for radiotherapy in 2003, using a previously reported audit instrument assessing clinical documentation/quality assurance and medical decision making. Results: Clinical documentation/quality assurance, decision making, and overall performance criteria were adequate 74.4%, 88.3%, and 80.2% of the time, respectively. Overall 52.0% of cases received suboptimal management. Multivariate analysis revealed palliative intent was associated with improved documentation/clinical quality assurance (p = 0.07), decision making (p 0.007), overall performance (p = 0.003), and optimal treatment rates (p 0.07); non-small-cell lung cancer or central nervous system primary sites were associated with better decision making (p = 0.001), overall performance (p = 0.03), and optimal treatment rates (p = 0.002). Conclusions: Despite the poor results, the external audit had several benefits. It identified learning needs for future targeting, and the auditor provided facilitating feedback to address systematic errors identified. Our experience was also helpful in refining our national revalidation audit instrument. The feasibility of the external audit supports the consideration of including audit in national MOC programs

  1. A multi-center randomized proof-of-concept clinical trial applying [¹⁸F]FDG-PET for evaluation of metabolic therapy with rosiglitazone XR in mild to moderate Alzheimer's disease.

    Science.gov (United States)

    Tzimopoulou, Sofia; Cunningham, Vincent J; Nichols, Thomas E; Searle, Graham; Bird, Nick P; Mistry, Prafull; Dixon, Ian J; Hallett, William A; Whitcher, Brandon; Brown, Andrew P; Zvartau-Hind, Marina; Lotay, Narinder; Lai, Robert Y K; Castiglia, Mary; Jeter, Barbara; Matthews, Julian C; Chen, Kewei; Bandy, Dan; Reiman, Eric M; Gold, Michael; Rabiner, Eugenii A; Matthews, Paul M

    2010-01-01

    Here we report the first multi-center clinical trial in Alzheimer's disease (AD) using fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) measures of brain glucose metabolism as the primary outcome. We contrasted effects of 12 months treatment with the PPARγ agonist Rosiglitazone XR versus placebo in 80 mild to moderate AD patients. Secondary objectives included testing for reduction in the progression of brain atrophy and improvement in cognition. Active treatment was associated with a sustained but not statistically significant trend from the first month for higher mean values in Kiindex and CMRgluindex, novel quantitative indices related to the combined forward rate constant for [18F]FDG uptake and to the rate of cerebral glucose utilization, respectively. However, neither these nor another analytical approach recently validated using data from the Alzheimer's Disease Neuroimaging Initiative indicated that active treatment decreased the progression of decline in brain glucose metabolism. Rates of brain atrophy were similar between active and placebo groups and measures of cognition also did not suggest clear group differences. Our study demonstrates the feasibility of using [18F]FDG-PET as part of a multi-center therapeutics trial. It suggests that Rosiglitazone is associated with an early increase in whole brain glucose metabolism, but not with any biological or clinical evidence for slowing progression over a 1 year follow up in the symptomatic stages of AD. PMID:20930300

  2. Radiologic Predictors for Clinical Stage IA Lung Adenocarcinoma with Ground Glass Components: A Multi-Center Study of Long-Term Outcomes.

    Directory of Open Access Journals (Sweden)

    Zhao Li

    Full Text Available This study was to define preoperative predictors from radiologic findings for the pathologic risk groups based on long-term surgical outcomes, in the aim to help guide individualized patient management.We retrospectively reviewed 321 consecutive patients with clinical stage IA lung adenocarcinoma with ground glass component on computed tomography (CT scanning. Pathologic diagnosis for resection specimens was based on the 2011 IASLC/ATS/ERS classification of lung adenocarcinoma. Patients were classified into different pathologic risk grading groups based on their lymph node status, local regional recurrence and overall survival. Radiologic characteristics of the pulmonary nodules were re-evaluated by reconstructed three-dimension CT (3D-CT. Univariate and multivariate analysis identifies independent radiologic predictors from tumor diameter, total volume (TV, average CT value (AVG, and solid-to-tumor (S/T ratio. Receiver operating characteristic curves (ROC studies were carried out to determine the cutoff value(s for the predictor(s. Univariate cox regression model was used to determine the clinical significance of the above findings.A total of 321 patients with clinical stage IA lung adenocarcinoma with ground glass components were included in our study. Patients were classified into two pathologic low- and high- risk groups based on their distinguished surgical outcomes. A total of 134 patients fell into the low-risk group. Univariate and multivariate analyses identified AVG (HR: 32.210, 95% CI: 3.020-79.689, P<0.001 and S/T ratio (HR: 12.212, 95% CI: 5.441-27.408, P<0.001 as independent predictors for pathologic risk grading. ROC curves studies suggested the optimal cut-off values for AVG and S/T ratio were-198 (area under the curve [AUC] 0.921, 2.9 (AUC 0.996 and 54% (AUC 0.907, respectively. The tumor diameter and TV were excluded for the low AUCs (0.778 and 0.767. Both the cutoff values of AVG and S/T ratio were correlated with pathologic

  3. Implementation of a Theory-based, Non-clinical Patient Navigator Program to Address Barriers in an Urban Cancer Center Setting.

    Science.gov (United States)

    Fleisher, Linda; Miller, Suzanne M; Crookes, Danielle; Kandadai, Venk; Wen, Kuang Yi; Slamon, Rachel E; Chaivous, Jeanne

    2012-06-01

    Cancer patients face a myriad of psychosocial and practical issues. Especially challenging is the time from an initial diagnosis to the onset of treatment and patient navigation services are important to guide patients, especially underserved populations, through this maze of uncertainty. Here we report on the Pennsylvania Patient Navigator Demonstration Project (PaPND) designed to evaluate the acceptability, feasibility, and impact of a culturally and linguistically appropriate non-clinical navigator program. The development of the project, based on behavioral theory and community-based participatory research principles, is described. Forty-four cancer patients from diverse backgrounds participated, which included a baseline assessment, navigation services, and a four week and twelve week follow-up assessment. On average, participants experienced 1.8 barriers with transportation and insurance issues the most common barriers. The majority (56%) of the barriers required more than an hour of the navigator's time to address, with insurance, transportation and caregiver/support issues requiring the most time. Overall patients were fairly satisfied with the navigation services. The findings showed improvement patient's stress-related thoughts, cognition (understanding of their disease), expectancies and beliefs or values/goals, as well as self-efficacy of managing cancer related issues from the baseline to follow-up assessments. The evaluation results suggest that providing and connecting cancer patients to appropriate information to improve their understanding of their diagnosis and recommended treatments needs to be addressed, and where the integration of non-clinical and clinical navigation is essential. In addition, more attention to the assessment of psychosocial issues, such as the patients' emotional worries, and more comprehensive training in these areas would enhance navigation programs. PMID:25383260

  4. The Clinical Features and Predictive Risk Factors for Reoperation in Patients With Perianal Crohn Diseases; A Multi-Center Study of a Korean Inflammatory Bowel Disease Study Group

    Science.gov (United States)

    Lee, Jae Bum; Yoon, Seo-Gue; Park, Kyu Joo; Lee, Kang Young; Kim, Dae Dong; Yoon, Sang Nam

    2015-01-01

    Purpose Perianal lesions are common in Crohn disease, but their clinical course is unpredictable. Nevertheless, predicting the clinical course after surgery for perianal Crohn disease (PCD) is important because repeated operations may decrease patient's quality of life. The aim of this study was to predict the risk of reoperation in patients with PCD. Methods From September 1994 to February 2010, 377 patients with PCD were recruited in twelve major tertiary university-affiliated hospitals and two specialized colorectal hospitals in Korea. Data on the patient's demographics, clinical features, and surgical outcomes were analyzed. Results Among 377 patients, 227 patients were ultimately included in the study. Among the 227 patients, 64 patients underwent at least one reoperation. The median period of reoperation following the first perianal surgery was 94 months. Overall 3-year, 5-year, and 10-year cumulative rates of reoperation-free individuals were 68.8%, 61.2%, and 50.5%, respectively. In multivariate analysis (Cox-regression hazard model), reoperation was significantly correlated with an age of onset less than 20 years (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.07-3.48; P = 0.03), history of abdominal surgery (HR, 1.99; 95% CI, 1.08-3.64; P = 0.03), and the type of surgery. Among types of surgery, fistulotomy or fistulectomy was associated with a decreased incidence of reoperation in comparison with incision and drainage (HR, 0.19; 95% CI, 0.09-0.42; P < 0.001). Conclusion Young age of onset and a history of abdominal surgery were associated with a high risk of reoperation for PCD, and the risk of reoperation were relatively low in fistulotomy or fistulectomy procedures. PMID:26576395

  5. Senior Centers

    Medline Plus

    Full Text Available ... variety of social and recreational activities. [Karen Albers] We provide a wide variety of activities -- physical, health, ... senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, tap dancing, ballroom dancing, ...

  6. Senior Centers

    Medline Plus

    Full Text Available ... transportation, and meals programs are long-term care services available in the community which make it easier ... about senior centers and other long-term care services available in your community, contact the Eldercare Locator ...

  7. Senior Centers

    Medline Plus

    Full Text Available ... Karen Albers] We provide a wide variety of activities -- physical, health, mental health programs with Senior Plus, cognitive ... of games. [Narrator] Many senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, ...

  8. Senior Centers

    Medline Plus

    Full Text Available [Narrator] Living independently at home is something many older adults would like to do as long as they can. Senior centers, adult day care, transportation, and meals programs are ...

  9. Senior Centers

    Medline Plus

    Full Text Available ... Living independently at home is something many older adults would like to do as long as they can. Senior centers, adult day care, transportation, and meals programs are long- ...

  10. Senior Centers

    Medline Plus

    Full Text Available ... of games. [Narrator] Many senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, ... chi, tap dancing, ballroom dancing, square dancing, chair exercise, arthritis classes, yoga, and lots of dancing. [Narrator] ...

  11. Senior Centers

    Medline Plus

    Full Text Available ... something many older adults would like to do as long as they can. Senior centers, adult day care, transportation, ... adults who live independently can go to find a variety of social and recreational activities. [Karen Albers] ...

  12. High grade anal intraepithelial neoplasia among HIV-1-infected men screening for a multi-center clinical trial of a human papillomavirus vaccine

    Science.gov (United States)

    Wilkin, Timothy; Lee, Jeannette Y.; Lensing, Shelly Y.; Stier, Elizabeth A.; Goldstone, Stephen E.; Berry, J. Michael; Jay, Naomi; Aboulafia, David M.; Einstein, Mark H.; Saah, Alfred; Mitsuyasu, Ronald T.; Palefsky, Joel M.

    2013-01-01

    Purpose High-grade anal intraepithelial neoplasia (HGAIN) is the precursor lesion to invasive anal cancer. HPV vaccination holds great promise for preventing anal cancer. Methods We examined 235 HIV-1-infected men screening for participation in a multi-site clinical trial of a quadrivalent HPV vaccine. All participants had anal swabs obtained for HPV testing and cytology, and high resolution anoscopy with biopsies of visible lesions to assess for HGAIN. Results HPV 16 and 18 were detected in 23% and 10%, respectively; abnormal anal cytology was found in 56% and HGAIN in 30%. HGAIN prevalence was significantly higher in those with HPV 16 detection compared to those without (38% vs. 17%, P=.01). Use of antiretroviral therapy, nadir and current CD4+ cell count were not associated with abnormal anal cytology or HGAIN. Conclusion HGAIN is highly prevalent in HIV-infected men. Further studies are needed on treatment and prevention of HGAIN. PMID:23611828

  13. Sexual Abuse and its Relation to Chronic Pain among Women from a Methadone Maintenance Clinic versus a Sexual Abuse Treatment Center.

    Science.gov (United States)

    Peles, Einat; Seligman, Zivya; Bloch, Miki; Potik, David; Sason, Anat; Schreiber, Shaul; Adelson, Miriam

    2016-01-01

    To determine the effect of sexual abuse history on chronic pain and its relation to opioid addiction and methadone maintenance treatment (MMT), we studied current women MMT patients, and women patients from a sexual abuse treatment center with no history of opioid addiction. Questionnaires included Chronic Pain, Chronic Severe Pain, the Yale-Brown Obsessive Compulsive Scale, the Dissociative Experiences Scale (DES), and the Structured Interview for Disorders of Extreme Stress (complex-PTSD). Chronic severe pain was most prevalent among sexually abused women with no history of opioid addiction (64% of 25), followed by sexually abused MMT women (30.9% of 68), and MMT women with no history of sexual abuse (25% of 8, p = 0.01). Pain severity correlated with dissociation and complex-PTSD scores. The sexually abused non-MMT women had higher rates of high dissociation scores (DES ≥ 30) and complex-PTSD, but fewer obsessive-compulsive disorder symptoms (scored ≥16) than the MMT sexually abused women. Chronic pain was found to be highly prevalent among sexually abused women, independent of being methadone-maintained with an addiction history. The high known prevalence of chronic pain among MMT patients, which may be attributable to opioid-induced hyperalgesia, may partially reflect the sexual abuse history, and should be targeted in future studies evaluating pain indices. PMID:27430532

  14. The Frequency of blaVIM, blaIMP, blaKPC and blaNDM Carbapenemase Genes in Clinical Isolates of Klebsiella Pneumoniae in Kermanshah Medical Centers

    Directory of Open Access Journals (Sweden)

    A Zare

    2015-11-01

    Full Text Available Background: Carbapenemase genes have been spread among strains of Klebsiella pneumoniae that make them resistant to carbapenems. Hence, the present study aimed to study the prevalence of carbapenmase genes within K. pneumoniae isolates in Kermanshah medical centers. Methods: Sixty isolates of K. pneumoniae were collected and identified using API kit. Then, antibiotic susceptibility of isolates was determined using a disk diffusion method. The carbapenems-resistant isolates were screened for carbapenemases production using the Modified Hodge Test (MHT. The carbapenemase genes of blaVIM, blaIMP, KPC and blaNDM were detected by PCR test . Results: Out of 60 isolates, 4 isolates were resistant to carbapenem antibiotics, but only one isolate was demonstrated to be positive for carbapenemases by MHT phenotypic testing. The gene of blaVIM was detected in three isolates by PCR, though other genes were not found in the isolates. Within the isolates, 6.67% and 100% were resistant to carbapenem and ampicillin, respectively. Conclusion: The study findings revealed that dissemination rate of carbapenemase genes was not reported to be high among isolates of K. pneumoniae in Kermanshah. Only blaVIM gene was probably more frequent than other tested genes. Since most isolates examined in this study were susceptible to carbapenem antibiotics, these antibiotics are still regarded as effective drugs against infections caused by K. pneumoniae.

  15. Clinical characteristics and favorable long-term outcomes for patients with idiopathic inflammatory myopathies: a retrospective single center study in China

    Directory of Open Access Journals (Sweden)

    Shu Xiao

    2011-11-01

    Full Text Available Abstract Background Little is known about the clinical features and true survival risk factors in Chinese Han population. We conducted the current study to investigate the clinical features, long-term outcome and true potential indicators associated with mortality of idiopathic inflammatory myopathies (IIM in China. Methods We restrospectvely investigated 188 patients diagnosed with IIM at our hospital from January 1986 to April 2009. The primary outcome was determined with mortality. The secondary outcomes for survival patients were organ damage and disease activity, health status, and disability, which were assessed with Myositis Damage Index, Myositis Disease Activity Assessment Visual Analogue Scales, Health Assessment Questionnaire Disability Index, and the Modified Rankin Scale, respectively. Potential prognostic factors for mortality were analyzed with the multivariate Cox regression model. Results Mean age at disease onset was 43.8 ± 15.8 years and male to female ratio was 1:2.1 in this cohort. The 1-, 5-, 10-, 15- and 20-year survival rates were 93.6%, 88.7%, 81%, 73.6% and 65.6%. The independent predicators for mortality were age at disease onset [hazard ratio (HR:1.05, 95% CI 1.02 - 1.08], presence of cancer (HR:3.68, 95%CI 1.39 - 9.74, and elevated IgA level at diagnosis (HR:2.80, 95% CI 1.16-6.74. At the end of the follow-up, 29 patients manifested drug withdrawal within an average 4.1 years (range 0.5-15.2 year, most patients (85.9% had no disease activity and 130 patients (83.4% had no disability. Conclusions The long-term outcomes of IIM patients in our cohort have improved dramatically. Those patients most likely to survive had a high chance of reaching stable disease status, and obtained long-term or possibly permanent remission to a large extent.

  16. How Effective Are Clinical Pathways With and Without Online Peer-Review? An Analysis of Bone Metastases Pathway in a Large, Integrated National Cancer Institute–Designated Comprehensive Cancer Center Network

    International Nuclear Information System (INIS)

    Purpose: Clinical pathways are an important tool used to manage the quality in health care by standardizing processes. This study evaluated the impact of the implementation of a peer-reviewed clinical pathway in a large, integrated National Cancer Institute–Designated Comprehensive Cancer Center Network. Methods: In 2003, we implemented a clinical pathway for the management of bone metastases with palliative radiation therapy. In 2009, we required the entry of management decisions into an online tool that records pathway choices. The pathway specified 1 or 5 fractions for symptomatic bone metastases with the option of 10–14 fractions for certain clinical situations. The data were obtained from 13 integrated sites (3 central academic, 10 community locations) from 2003 through 2010. Results: In this study, 7905 sites were treated with 64% of courses delivered in community practice and 36% in academic locations. Academic practices were more likely than community practices to treat with 1–5 fractions (63% vs. 23%; p < 0.0001). The number of delivered fractions decreased gradually from 2003 to 2010 for both academic and community practices (p < 0.0001); however, greater numbers of fractions were selected more often in community practices (p < 0.0001). Using multivariate logistic regression, we found that a significantly greater selection of 1–5 fractions developed after implementation online pathway monitoring (2009) with an odds ratio of 1.2 (confidence interval, 1.1–1.4) for community and 1.3 (confidence interval, 1.1–1.6) for academic practices. The mean number of fractions also decreased after online peer review from 6.3 to 6.0 for academic (p = 0.07) and 9.4 to 9.0 for community practices (p < 0.0001). Conclusion: This is one of the first studies to examine the efficacy of a clinical pathway for radiation oncology in an integrated cancer network. Clinical pathway implementation appears to be effective in changing patterns of care, particularly with

  17. How Effective Are Clinical Pathways With and Without Online Peer-Review? An Analysis of Bone Metastases Pathway in a Large, Integrated National Cancer Institute-Designated Comprehensive Cancer Center Network

    Energy Technology Data Exchange (ETDEWEB)

    Beriwal, Sushil, E-mail: beriwals@upmc.edu [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Rajagopalan, Malolan S.; Flickinger, John C.; Rakfal, Susan M. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States); Rodgers, Edwin [Via Oncology, Pittsburgh, PA (United States); Heron, Dwight E. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)

    2012-07-15

    Purpose: Clinical pathways are an important tool used to manage the quality in health care by standardizing processes. This study evaluated the impact of the implementation of a peer-reviewed clinical pathway in a large, integrated National Cancer Institute-Designated Comprehensive Cancer Center Network. Methods: In 2003, we implemented a clinical pathway for the management of bone metastases with palliative radiation therapy. In 2009, we required the entry of management decisions into an online tool that records pathway choices. The pathway specified 1 or 5 fractions for symptomatic bone metastases with the option of 10-14 fractions for certain clinical situations. The data were obtained from 13 integrated sites (3 central academic, 10 community locations) from 2003 through 2010. Results: In this study, 7905 sites were treated with 64% of courses delivered in community practice and 36% in academic locations. Academic practices were more likely than community practices to treat with 1-5 fractions (63% vs. 23%; p < 0.0001). The number of delivered fractions decreased gradually from 2003 to 2010 for both academic and community practices (p < 0.0001); however, greater numbers of fractions were selected more often in community practices (p < 0.0001). Using multivariate logistic regression, we found that a significantly greater selection of 1-5 fractions developed after implementation online pathway monitoring (2009) with an odds ratio of 1.2 (confidence interval, 1.1-1.4) for community and 1.3 (confidence interval, 1.1-1.6) for academic practices. The mean number of fractions also decreased after online peer review from 6.3 to 6.0 for academic (p = 0.07) and 9.4 to 9.0 for community practices (p < 0.0001). Conclusion: This is one of the first studies to examine the efficacy of a clinical pathway for radiation oncology in an integrated cancer network. Clinical pathway implementation appears to be effective in changing patterns of care, particularly with online clinical

  18. A Survey on Prevalence of Ocular Complications and It’s Risk Factors in Diabetic Patients of Diabetic Center of Nader Kazemi Clinic Shiraz- Iran 1998-2010

    Directory of Open Access Journals (Sweden)

    SM Kashfi

    2014-03-01

    Full Text Available Background & Objective: With respect to an increase in diabetes prevalence, and the likelihood of ocular complications among them, this study was conducted to investigate the prevalence and risk factors and incidence of the ocular complications in patients of Nader Kazemi, Shiraz Diabetic center from 1998 to 2010.Materials & Methods: In a cross sectional study , subjects were selected based on a systematic random sampling to investigate the incidence of the ocular complications and the influence of factors such as age, sex, types of diabetes, job, education, blood triglyceride (TG and cholesterol level, Family history of diabetes, history of hypertension, history of participation in educational classes, methods of treatment, duration of diabetes and fasting blood sugar were considered on them.Results: Ocular complications were found among 229 diabetic patients (32.6%. patients having type II diabetic have more ocular complications comparing with patients with type I diabetes (P<0. 005. Factors such as job (P=0. 022, history of participation in educational classes (P<0. 001, education (P<0. 001, family history of diabetes (P<0. 001, blood triglyceride (TG (P=0. 021, duration of diabetes(P<0. 001,age (P<0. 001, method of treatment(P<0. 001and fasting blood sugar (P<0. 001 had a significant relationship with the occurrence of ocular complication. However, other risk factors such as hypertension,gender and cholesterol levels were not statistically significant relationship with the occurrence of ocular complication.Conclusion: Given the prevalence of ocular complications, educating diabetics’ patients can have a significant influence in reducing the occurrence of ocular complications.

  19. Percutaneous Lung Thermal Ablation of Non-surgical Clinical N0 Non-small Cell Lung Cancer: Results of Eight Years’ Experience in 87 Patients from Two Centers

    International Nuclear Information System (INIS)

    PurposeTo evaluate the survival outcomes of percutaneous thermal ablation (RFA + microwaves) for patients presenting N0 non-small-cell lung cancer (NSCLC) ineligible for surgery.Materials and MethodsEighty-seven patients from two comprehensive cancer centers were included. Eighty-two patients were treated with RFA electrodes and five with microwave antenna. Overall survival (OS) and disease-free survival (DFS) were estimated and predictive factors of local tumor progression, OS and DFS identified and compared by univariate and multivariate analysesResultsMedian follow-up was 30.5 months (interquartile range 16.7–51) and tumor size was 21 mm (range 10–54 mm). Treatment was incomplete for 14 patients with a local tumor progression of 11.5, 18.3, and 21.1 % at 1, 2, and 3 years, respectively. Two patients presented with neurological (grade III or IV) complications, and one died of respiratory and multivisceral failure as a result of the procedure at 29 days. In univariate analysis, increasing tumor size (P = 0.003) was the only predictive factor related to risk of local tumor progression. 5-year OS and DFS were 58.1 and 27.9 %, respectively. Sex (P = 0.044), pathology (P = 0.032), and tumor size >2 cm (P = 0.046) were prognostic factors for DFS. In multivariate analysis, pathology (P = 0.033) and tumor size >2 cm (P = 0.032) were independent prognostic factors for DFS.ConclusionsOversized and overlapping ablation of N0 NSCLC was well tolerated, effective, with few local tumor progressions, even over long-term follow-up. Increasing tumor size was the main prognostic factor linked to OS, DFS, and local tumor progression

  20. Percutaneous Lung Thermal Ablation of Non-surgical Clinical N0 Non-small Cell Lung Cancer: Results of Eight Years’ Experience in 87 Patients from Two Centers

    Energy Technology Data Exchange (ETDEWEB)

    Palussiere, Jean, E-mail: J.Palussiere@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Interventional Radiology (France); Lagarde, Philippe, E-mail: P.Lagarde@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Center, Radiation Oncology Department (France); Aupérin, Anne, E-mail: auperin@igr.fr [Institut Gustave-Roussy, Unit of Biostatistics and Epidemiology (France); Deschamps, Frédéric, E-mail: frederic.deschamps@igr.fr [Institut Gustave-Roussy, Department of Interventional Radiology (France); Chomy, François, E-mail: F.Chomy@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Center, Department of medical oncology (France); Baere, Thierry de, E-mail: debaere@igr.fr [Institut Gustave-Roussy, Department of Interventional Radiology (France)

    2015-02-15

    PurposeTo evaluate the survival outcomes of percutaneous thermal ablation (RFA + microwaves) for patients presenting N0 non-small-cell lung cancer (NSCLC) ineligible for surgery.Materials and MethodsEighty-seven patients from two comprehensive cancer centers were included. Eighty-two patients were treated with RFA electrodes and five with microwave antenna. Overall survival (OS) and disease-free survival (DFS) were estimated and predictive factors of local tumor progression, OS and DFS identified and compared by univariate and multivariate analysesResultsMedian follow-up was 30.5 months (interquartile range 16.7–51) and tumor size was 21 mm (range 10–54 mm). Treatment was incomplete for 14 patients with a local tumor progression of 11.5, 18.3, and 21.1 % at 1, 2, and 3 years, respectively. Two patients presented with neurological (grade III or IV) complications, and one died of respiratory and multivisceral failure as a result of the procedure at 29 days. In univariate analysis, increasing tumor size (P = 0.003) was the only predictive factor related to risk of local tumor progression. 5-year OS and DFS were 58.1 and 27.9 %, respectively. Sex (P = 0.044), pathology (P = 0.032), and tumor size >2 cm (P = 0.046) were prognostic factors for DFS. In multivariate analysis, pathology (P = 0.033) and tumor size >2 cm (P = 0.032) were independent prognostic factors for DFS.ConclusionsOversized and overlapping ablation of N0 NSCLC was well tolerated, effective, with few local tumor progressions, even over long-term follow-up. Increasing tumor size was the main prognostic factor linked to OS, DFS, and local tumor progression.

  1. Conceptual models for Mental Distress among HIV-infected and uninfected individuals: A contribution to clinical practice and research in primary-health-care centers in Zambia

    Directory of Open Access Journals (Sweden)

    Tuba Mary

    2011-01-01

    Full Text Available Abstract Background Mental distress is common in primary care and overrepresented among Human Immunodeficiency virus (HIV-infected individuals, but access to effective treatment is limited, particularly in developing countries. Explanatory models (EM are contextualised explanations of illnesses and treatments framed within a given society and are important in understanding an individual's perspective on the illness. Although individual variations are important in determining help-seeking and treatment behaviour patterns, the ability to cope with an illness and quality of life, the role of explanatory models in shaping treatment preferences is undervalued. The aim was to identify explanatory models employed by HIV-infected and uninfected individuals and to compare them with those employed by local health care providers. Furthermore, we aimed to build a theoretical model linking the perception of mental distress to treatment preferences and coping mechanisms. Methods Qualitative investigation nested in a cross-sectional validation study of 28 (male and female attendees at four primary care clinics in Lusaka, Zambia, between December 2008 and May 2009. Consecutive clinic attendees were sampled on random days and conceptual models of mental distress were examined, using semi-structured interviews, in order to develop a taxonomic model in which each category was associated with a unique pattern of symptoms, treatment preferences and coping strategies. Results Mental distress was expressed primarily as somatic complaints including headaches, perturbed sleep and autonomic symptoms. Economic difficulties and interpersonal relationship problems were the most common causal models among uninfected individuals. Newly diagnosed HIV patients presented with a high degree of hopelessness and did not value seeking help for their symptoms. Patients not receiving anti-retroviral drugs (ARV questioned their effectiveness and were equivocal about seeking help

  2. Deferiprone versus deferoxamine in sickle cell disease: results from a 5-year long-term Italian multi-center randomized clinical trial.

    Science.gov (United States)

    Calvaruso, Giusi; Vitrano, Angela; Di Maggio, Rosario; Ballas, Samir; Steinberg, Martin H; Rigano, Paolo; Sacco, Massimiliano; Telfer, Paul; Renda, Disma; Barone, Rita; Maggio, Aurelio

    2014-12-01

    Blood transfusion and iron chelation currently represent a supportive therapy to manage anemia, vasculopathy and vaso-occlusion crises in Sickle-Cell-Disease. Here we describe the first 5-year long-term randomized clinical trial comparing Deferiprone versus Deferoxamine in patients with Sickle-Cell-Disease. The results of this study show that Deferiprone has the same effectiveness as Deferoxamine in decreasing body iron burden, measured as repeated measurements of serum ferritin concentrations on the same patient over 5-years and analyzed according to the linear mixed-effects model (LMM) (p=0.822). Both chelators are able to decrease, significantly, serum ferritin concentrations, during 5-years, without any effect on safety (p=0.005). Moreover, although the basal serum ferritin levels were higher in transfused compared with non-transfused group (p=0.031), the changes over time in serum ferritin levels were not statistically significantly different between transfused and non-transfused cohort of patients (p=0.389). Kaplan-Meier curve, during 5-years of study, suggests that Deferiprone does not alter survival in comparison with Deferoxamine (p=0.38). In conclusion, long-term iron chelation therapy with Deferiprone was associated with efficacy and safety similar to that of Deferoxamine. Therefore, in patients with Sickle-Cell-Disease, Deferiprone may represent an effective long-term treatment option. PMID:24814618

  3. Non-tuberculous mycobacteria I: one year clinical isolates identification in Tertiary Hospital Aids Reference Center, Rio de Janeiro, Brazil, in pre highly active antiretroviral therapy era

    Directory of Open Access Journals (Sweden)

    Ferreira Rosa Maria Carvalho

    2002-01-01

    Full Text Available The aim of this study was to determine the prevalence of non-tuberculous mycobacteria (NTM isolates at University Hospital, Reference Center for Aids in Rio de Janeiro, Brazil, during one year. We used standard biochemical tests for species identification and IS1245 PCR amplification was applied as a Mycobacterium avium specific identification marker. Four hundred and four specimens from 233 patients yielded acid-fast bacilli growth. M. tuberculosis was identified in 85% of the patients and NTM in 15%. NTM disseminated infection was a common event correlated with human immunodeficiency virus (HIV infected patients and only in HIV negative patients the source of NTM was non sterile site. M. avium complex (MAC was biochemically identified in 57.8% (49/83 of NTM isolates, most of them from sterile sites (75.5%, and in 94% (46/49 the IS 1245 marker specific for M. avium was present. Twenty NTM strains showed a MAC biochemical pattern with the exception of a urease-positive (99% of MAC are urease-negative, however IS1245 was detected in 96% of the strains leading to their identification as M. avium. In this group differences in NTM source was not significant. The second most frequently isolated NTM was identified as M. scrofulaceum (7.2%, followed by M. terrae (3.6%, M. gordonae (2.4%, M. chelonae (1.2%, M. fortuitum (1.2% and one strain which could not be identified. All were IS1245 negative except for one strain identified as M. scrofulaceum. It is interesting to note that non-sterile sites were the major source of these isolates (92.8%. Our finding indicated that M. avium is still the major atypical species among in the MAC isolates recovered from Brazilian Aids patients without highty active antiretroviral therapy schema. Some discrepancies were seen between the identification methods and further investigations must be done to better characterize NTM isolates using other phenotypic and genotypic methods.

  4. CT Imaging Findings and Their Relevance to the Clinical Outcomes After Stent Graft Repair of Penetrating Aortic Ulcers: Six-year, Single-center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ji Hoon [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology (Korea, Republic of); Angle, John F.; Park, Auh Whan; Anderson, Curtis; Sabri, Saher S.; Turba, Ulku C. [University of Virginia Health System, Division of Angiography, Interventional Radiology and Special Procedures, Department of Radiology (United States); Kern, John A.; Cherry, Kenneth J. [University of Virginia Health System, Department of Surgery (United States); Matsumoto, Alan H., E-mail: ahm4d@virginia.edu [University of Virginia Health System, Division of Angiography, Interventional Radiology and Special Procedures, Department of Radiology (United States)

    2012-12-15

    Purpose: To present the computed tomographic (CT) imaging findings and their relevance to clinical outcomes related to stent graft placement in patients with penetrating aortic ulcers (PAUs). Methods: Medical and imaging records and imaging studies were reviewed for consecutive patients who underwent stent graft repair of a PAU. The distribution and characteristics of the PAU, technical success of stent graft repair, procedure-related complications, associated aortic wall abnormalities, and outcomes of the PAUs at follow-up CT scans were evaluated. Results: Fifteen patients underwent endovascular treatment for PAU. A total of 87% of the PAUs were in the proximal (n = 8) or distal (n = 5) descending thoracic aorta. There was a broad spectrum of PAU depth (mean, 7.9 {+-} 5.6 mm; range 1.5-25.0 mm) and diameter (mean, 13.5 {+-} 9.7 mm; range 2.2-41.0 mm). Atherosclerosis of the thoracic aorta and intramural hematoma were associated in 53 and 93% of the patients, respectively. Technical success was achieved in 100%. Two or more stent grafts were used in five patients. Endoleaks were observed in two patients within 2 weeks of the procedure, both of which resolved spontaneously. At follow-up CT scanning, regression and thrombosis of the PAUs were observed in all patients. The average patient survival was 61.8 months, with an overall mortality of 13% (2 of 15) at follow-up. Neither death was related to the endograft device or the PAU. Conclusion: Endovascular stent graft placement was safe and effective in causing regression and thrombosis of PAUs in this small series of patients. Two or more stent grafts were used in five patients (33%) with associated long-segmental atherosclerotic changes of the thoracic aorta or intramural hematoma.

  5. Toward standard HER2 testing of endometrial serous carcinoma: 4-year experience at a large academic center and recommendations for clinical practice.

    Science.gov (United States)

    Buza, Natalia; English, Diana P; Santin, Alessandro D; Hui, Pei

    2013-12-01

    HER2 overexpression and/or amplification have been reported in endometrial serous carcinoma, suggesting that HER2 may be a promising therapeutic target. However, there is considerable variation in the reported rates of HER2 overexpression and amplification, likely--at least in part--resulting from variability in the testing methods, interpretation, and scoring criteria used. Unlike in breast and gastric cancer, currently there are no established guidelines for HER2 testing in endometrial carcinoma. A total of 108 endometrial carcinoma cases--85 pure serous carcinomas and 23 mixed endometrial carcinomas with serous component--were identified over a 4-year period. All H&E and HER2 immunohistochemical slides were reviewed and HER2 FISH results (available on 52 cases) were retrieved from pathology reports. HER2 immunohistochemical scores were assigned according to the FDA criteria and the current breast ASCO/CAP scoring criteria. Clinical information was retrieved from the patients' medical records. Thirty-eight cases (35%) showed HER2 overexpression and/or gene amplification, 20 of which (53%) had significant heterogeneity of protein expression by immunohistochemistry. Lack of apical membrane staining resulting in a lateral/basolateral staining pattern was observed in the majority of HER2-positive tumors. Five of the HER2-positive cases (13%) demonstrated discrepant immunohistochemical scores when using the FDA versus ASCO/CAP scoring system. The overall concordance rate between HER2 immunohistochemistry and FISH was 75% (39/52) when using the FDA criteria, compared with 81% (42/52) by the ASCO/CAP scoring system. In conclusion, in this largest comprehensive study, 35% of endometrial serous carcinoma harbors HER2 protein overexpression and/or gene amplification, over half of which demonstrate significant heterogeneity of protein expression. The current breast ASCO/CAP scoring criteria provide the highest concordance between immunohistochemistry and FISH. Assessment of

  6. Senior Centers

    Medline Plus

    Full Text Available ... provide a wide variety of activities -- physical, health, mental health programs with Senior Plus, cognitive programs, a wide variety of general activities, billiards, Bingo, lots of games. [Narrator] Many senior centers also offer exercise programs. [Karen Albers] We offer aerobics, tai chi, ...

  7. Hastings Center

    Science.gov (United States)

    ... BLOG We have long had the ability, we humans, to work outside the bounds of evolution. Dairy cattle, maize, and all sorts of dog ... intervention. However, in the past, the scope of human intervention was rather… Read more Share: ... Evolution? Read more HASTINGS NEWS Hastings Center research scholar ...

  8. Senior Centers

    Medline Plus

    Full Text Available ... dancing. [Narrator] These centers can provide entree to new activities and expand a person’s social contacts. [Karen ... meeting all their interests and introducing them to new things; whether it’s an arts and crafts project, ...

  9. Senior Centers

    Medline Plus

    Full Text Available ... transportation, and meals programs are long-term care services available in the community which make it easier for older adults to ... about senior centers and other long-term care services available in your community, contact the Eldercare Locator at 1-800-677- ...

  10. Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID: protocol for a randomized clinical multi-center trial

    Directory of Open Access Journals (Sweden)

    Seiler Christoph

    2011-03-01

    Full Text Available Abstract Background Fractures of the distal radius represent the most common fracture in elderly patients, and often indicate the onset of symptomatic osteoporosis. A variety of treatment options is available, including closed reduction and plaster casting, K-wire-stabilization, external fixation and open reduction and internal fixation (ORIF with volar locked plating. The latter is widely promoted by clinicians and hardware manufacturers. Closed reduction and cast stabilization for six weeks is a simple, convenient, and ubiquitously available intervention. In contrast, ORIF requires hospitalization, but allows for functional rehabilitation. Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting. Methods/Design ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool. The primary objective is to determine differences in the Short Form 36 (SF-36 Physical Component Score (PCS between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery, as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture

  11. Comparison of Clinical Outcomes of Surgery Followed by Local Brain Radiotherapy and Surgery Followed by Whole Brain Radiotherapy in Patients With Single Brain Metastasis: Single-Center Retrospective Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Kenji [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Narita, Yoshitaka, E-mail: yonarita@ncc.go.jp [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Miyakita, Yasuji; Ohno, Makoto [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Sumi, Minako; Mayahara, Hiroshi [Division of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Kayama, Takamasa; Shibui, Soichiro [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan)

    2011-11-15

    Purpose: Data comparing the clinical outcomes of local brain radiotherapy (LBRT) and whole brain RT (WBRT) in patients with a single brain metastasis after tumor removal are limited. Patients and Methods: A retrospective analysis was performed to compare the patterns of treatment failure, cause of death, progression-free survival, median survival time, and Karnofsky performance status for long-term survivors among patients who underwent surgery followed by either LBRT or WBRT between 1990 and 2008 at the National Cancer Center Hospital. Results: A total of 130 consecutive patients were identified. The median progression-free survival period among the patients who received postoperative LBRT (n = 64) and WBRT (n = 66) was 9.7 and 11.5 months, respectively (p = .75). The local recurrence rates (LBRT, 9.4% vs. WBRT, 12.1%) and intracranial new metastasis rate (LBRT, 42.2% vs. WBRT, 33.3%) were similar in each arm. The incidence of leptomeningeal metastasis was also equivalent (LBRT, 9.4% vs. WBRT, 10.6%). The median survival time for the LBRT and WBRT patients was 13.9 and 16.7 months, respectively (p = .88). A neurologic cause of death was noted in 35.6% of the patients in the LBRT group and 36.7% of the WBRT group (p = .99). The Karnofsky performance status at 2 years was comparable between the two groups. Conclusions: The clinical outcomes of LBRT and WBRT were similar. A prospective evaluation is warranted.

  12. The Effect of Family-Centered Psycho-Education on Mental Health and Quality of Life of Families of Adolescents with Bipolar Mood Disorder: A Randomized Controlled Clinical Trial

    Science.gov (United States)

    Sharif, Farkhondeh; Mahmoudi, Asyeh; Shooshtari, Ali Alavi; Vossoughi, Mehrdad

    2016-01-01

    Background: Bipolar Mood Disorder (BMD) is a type of mood disorder which is associated with various disabilities. The family members of the patients with BMD experience many difficulties and pressures during the periods of treatment, rehabilitation and recovery and their quality of life (QOL) is threatened. In the present study, we aimed to evaluate the effect of family-centered education on mental health and QOL of families with adolescents suffering from BMD. Methods: In this randomized controlled clinical trial performed on 40 families which were mostly mothers of the adolescents with BMD referred to the psychiatric clinics affiliated to Shiraz University of Medical Sciences during 2012-13. They were randomly assigned to intervention and control groups. Results: The results of single factor multivariate ANOVA/single-factor multivariate analysis of variance and Bonferroni post hoc tests showed that the interaction between the variables of group and time was significant (Padolescents with Bipolar Mood Disorder. Trial Registration Number: IRCT201304202812N15 PMID:27382589

  13. Comparison of Clinical Outcomes of Surgery Followed by Local Brain Radiotherapy and Surgery Followed by Whole Brain Radiotherapy in Patients With Single Brain Metastasis: Single-Center Retrospective Analysis

    International Nuclear Information System (INIS)

    Purpose: Data comparing the clinical outcomes of local brain radiotherapy (LBRT) and whole brain RT (WBRT) in patients with a single brain metastasis after tumor removal are limited. Patients and Methods: A retrospective analysis was performed to compare the patterns of treatment failure, cause of death, progression-free survival, median survival time, and Karnofsky performance status for long-term survivors among patients who underwent surgery followed by either LBRT or WBRT between 1990 and 2008 at the National Cancer Center Hospital. Results: A total of 130 consecutive patients were identified. The median progression-free survival period among the patients who received postoperative LBRT (n = 64) and WBRT (n = 66) was 9.7 and 11.5 months, respectively (p = .75). The local recurrence rates (LBRT, 9.4% vs. WBRT, 12.1%) and intracranial new metastasis rate (LBRT, 42.2% vs. WBRT, 33.3%) were similar in each arm. The incidence of leptomeningeal metastasis was also equivalent (LBRT, 9.4% vs. WBRT, 10.6%). The median survival time for the LBRT and WBRT patients was 13.9 and 16.7 months, respectively (p = .88). A neurologic cause of death was noted in 35.6% of the patients in the LBRT group and 36.7% of the WBRT group (p = .99). The Karnofsky performance status at 2 years was comparable between the two groups. Conclusions: The clinical outcomes of LBRT and WBRT were similar. A prospective evaluation is warranted.

  14. Presence of the Panton-Valentine Leukocidin Genes in Methicillin-Resistant Staphylococcus aureus Is Associated with Severity and Clinical Outcome of Hospital-Acquired Pneumonia in a Single Center Study in China.

    Science.gov (United States)

    Zhang, Chuanling; Guo, Liang; Chu, Xu; Shen, Limeng; Guo, Yuanyu; Dong, Huali; Mao, Jianfeng; van der Veen, Stijn

    2016-01-01

    The Panton-Valentine leukocidin (PVL) genes of methicillin-resistant Staphylococcus aureus (MRSA) have previously been associated with severe infections. Here, the impact of the PVL genes on severity of disease and clinical outcome of patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP) due to MRSA was investigated in a single center observational study in a hospital in China. HAP due to MRSA was diagnosed in 100 patients and 13 of the patients were PVL positive, while VAP was diagnosed in 5 patients and 2 were PVL positive. The PVL positive patient group showed a significantly higher Acute Physiology and Chronic Health Evaluation (APACHE) II score (14.3 ±7.8 vs. 10.1 ±4.7, P = 0.005) and significantly more patients with CRP levels >80 mg/L (8/15 vs. 12/90, P = 0.006) or WBC counts >15x109/L (7/15 vs. 12/90, P = 0.006), indicating that the severity of disease is affected by the presence of the PVL genes. The outcome of the study was defined by 30-day mortality. Four (27%) of the PVL positive patients and four (4%) of the PVL negative patients died within 30 days (P = 0.01, Fisher exact test). Kaplan-Meier survival curves were generated for the PVL positive and PVL negative patient groups, which differed significantly (P = 0.003). Among the patients that died, the mean interval between diagnosis and death was shorter for the PVL positive patients (9.3 ±5.6 vs. 40.8 ±6.6 days, P = 0.013). Further analysis within the HAP and VAP patient groups showed that the presence of PVL in MRSA impacted the severity of disease and clinical outcome of HAP, but for VAP the number of patients included in the study was too low. In conclusion, in this single center study in a Chinese hospital the presence of the PVL genes in MRSA impacted the severity of disease and clinical outcome in patients with HAP due to MRSA. PMID:27249225

  15. Comparison of long-term clinical outcome after successful implantation of FIREBIRD and CYPHER sirolimus-eluting stents in daily clinical practice:analysis of a large single-center registry

    Institute of Scientific and Technical Information of China (English)

    XU Bo; LIU Hai-bo; WU Yong-jian; CHEN Jue; YUAN Jin-qing; YOU Shi-jie; LI Wei; GAO Run-lin; DOU Ke-fei; YANG Yue-jin; CHEN Ji-lin; QIAO Shu-bin; WANG Yang; LI Jian-jun; QIN Xue-wen; YAO Min

    2011-01-01

    Background Recent data have shown that sirolimus-eluting stents (SES) reduced not only the incidences of restenosis but also of target vessel revascularization (TVR). CYPHER and FIREBIRD stents are both widely used SES in China.However,comparative data concerning differences in long-term safety and efficacy regarding CYPHER and FIREBIRD stents in the Chinese population are still not available.Methods From April 2004 to October 2006,3979 consecutive patients who underwent successful SES (FIREBIRD 2274;CYPHER 1705) implantation were prospectively enrolled into this study. All enrolled patients were divided into two groups based on stent type. Follow-up data,including death,myocardial infarction (MI),thrombosis,target lesion revascularization (TLR),TVR,and major adverse cardiac events (MACE,the composite of death,MI,and TVR) were obtained at 24 months. Cox's proportional-hazards models were used to assess relative risks of all the outcomemeasures between the two groups before and after propensity match.Results Unadjusted clinical outcomes demonstrated higher TVR (hazard ratio (HR) 1.78,95%Cl 1.26-2.50) and MACE (HR 1.40,95%C/1.08-1.82) for patients treated with FIREBIRD SES. After propensity match,the results showed a non-significant trend towards superiority of the CYPHER stent in all the analyzed parameters,however,no significant differences were found for all events at 24 months between FIREBIRD and CYPHER groups,and all thrombosis rates by Academic Research Consortium (ARC) definition were comparable between the two groups.Conclusions In this large,real-world population,the use of domestic FIREBIRD SES in China was associated with nearly the same safety and efficacy versus the imported CYPHER SES. FIREBIRD SES can be taken as an alternative for CYPHER SES in daily practice.

  16. Centered Pyramids

    OpenAIRE

    Brigger, P.; F. Müller; Illgner, K.; Unser, M.

    1999-01-01

    Quadtree-like pyramids have the advantage of resulting in a multiresolution representation where each pyramid node has four unambiguous parents. Such a centered topology guarantees a clearly defined up-projection of labels. This concept has been successfully and extensively used in applications of contour detection, object recognition and segmentation. Unfortunately, the quadtree-like type of pyramid has poor approximation powers because of the employed piecewise-constant image model. This pa...

  17. IRASM Center

    International Nuclear Information System (INIS)

    IRASM is a national center for radiation processing developed around an industrial Co60 gamma irradiator. Being a department in an R and D national institute, IRASM Center is dealing with radiation treatment, pre/post microbiological control, validation of irradiation sterilization, detection of irradiated foodstuffs. Training is available for operators of new irradiation facilities focused on radiation technologies, dosimetry, sterilization, food treatment, conservation by irradiation of cultural heritage, quality assurance. Expertise on proper choosing the plastics for packaging versus dose is offered to the potential clients. IRASM Center is also involved in interdisciplinary applied research like chitosan treatment, sterile male technique or implementation of irradiation step in production of pharmaceuticals. All important activities: irradiation treatment, dosimetry, microbiology, detection of irradiated food, radioprotection, nuclear safety, physical protection. are performed in accordance with the proper standards in the frame of a certified quality management system. In this way Co60 industrial sources, a byproduct of certain nuclear power plants like Candu type, appear to be the key of a large technical and R and D domain. (authors)

  18. The Poison Control Center--Its Role

    Science.gov (United States)

    Manoguerra, Anthony S.

    1976-01-01

    Poison Control Centers are being utilized by more schools of pharmacy each year as training sites for students. This paper discusses what such a center is, its services, changes anticipated in the poison center system in the next several years and how they may influence pharmacy education, specifically as it relates to clinical toxicology.…

  19. Spina Bifida Clinic Directory

    Science.gov (United States)

    ... 798,163.html Back to top Missouri Children’s Mercy Hospital & Clinics Spinal Defects Clinic (pediatric only-will ... 234-3790 or (816) 234 3005 www.childrens-mercy.org/ Cardinal Glennon Children’s Medical Center Myelomeningocele Clinic ( ...

  20. Department of Defense, Deployment Health Clinical Center

    Science.gov (United States)

    ... Psychological Health Policy Library Search psychological health and deployment-related policies and directives, including service-specific policies, published by the Defense Department, Congress ...

  1. Clinical applications of sequencing take center stage

    OpenAIRE

    Glusman, Gustavo

    2013-01-01

    A report on the Advances in Genome Biology and Technology (AGBT) meeting, Marco Island, Florida, USA, February 20-23, 2013. This year's Advances in Genome Biology and Technology (AGBT) meeting reflected the current state of 'next generation' sequencing (NGS) technologies: significantly reduced competition and innovation, and a strong focus on standardization and application. Announcements of technological breakthroughs - a hallmark of previous AGBT meetings - were markedly absent, but existin...

  2. National Health Information Center

    Science.gov (United States)

    ... ODPHP National Health Information Center National Health Information Center The National Health Information Center (NHIC) is sponsored ... interest View the NHO calendar . Federal Health Information Centers and Clearinghouses Federal Health Information Centers and Clearinghouses ...

  3. Clinical usefulness and cost-effectiveness of FDG-PET in the staging and follow up of patients with gynecological malignancies. An analysis based on multi-center survey

    International Nuclear Information System (INIS)

    Multi-center survey has been conducted about the diagnostic ability of FDG-PET for patients with gynecological malignancies. A total of 304 cases (122 cases for staging, 182 cases for the diagnosis of recurrence) were collected from 5 institutions. FDG-PET showed high diagnostic ability in both preoperative staging and the detection of recurrence, and occasionally afforded better information than conventional morphological imaging modalities such as CT and MRI did. Furthermore, with the use of FDG-PET, unsuspected lesions were detected in 10.7% of the cases for preoperative staging and in 33.9% of the cases for diagnosing recurrence, and the therapeutic strategy was changed in 8.9% of the staging cases and 35.1% of the recurrent cases. Especially in cases where image finding was not diagnostic and also in cases where recurrence was clinically suspected but not evident by morphological imaging modalities, FDG-PET was proven to afford important information for the management of the patients and can yield cost-effectiveness by obviating unnecessary surgery and invasive procedures. (author)

  4. Centering research

    DEFF Research Database (Denmark)

    Katan, Lina Hauge; Baarts, Charlotte

    share as the common aim of both research and education. Despite some similarities, we find that how the two groups engage in and benefit from reading and writing diverges significantly. Thus we have even more reason to believe that centering practice-based teaching on these aspects of research is a good......’ exercises tend to dominate the common understandings of research-based learning. Here we address a specific area of inquiry overlooked by previous studies: whether and how reading, thinking and writing indeed share the same learning potentials as the practical foundation for research-based teaching....... In the humanities and social sciences, integrated acts of reading, writing and thinking account for an obvious and substantial overlap in student and researcher practices, creating a clear opportunity for research-based teaching. Moreover, our empirical data point to reading, thinking and writing as quintessential...

  5. 75 FR 12554 - Clinical Laboratory Improvement Advisory Committee: Notice of Charter Renewal

    Science.gov (United States)

    2010-03-16

    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory...-463) of October 6, 1972, that the Clinical Laboratory Improvement Advisory Committee, Centers for..., Clinical Laboratory Improvement Advisory Committee, Centers for Disease Control and Prevention,...

  6. Achieving lipid goals with rosuvastatin compared with simvastatin in high risk patients in real clinical practice: a randomized, open-label, parallel-group, multi-center study: the DISCOVERY-Beta study

    Directory of Open Access Journals (Sweden)

    Toivo Laks

    2008-09-01

    Full Text Available Toivo Laks1, Ester Keba2, Mariann Leiner3, Eero Merilind4, Mall Petersen5, Sirje Reinmets6, Sille Väli7, Terje Sööt8, Karin Otter81Clinic of Internal Medicine, North-Estonia Regional Hospital, Tallinn, Estonia; 2Clinic of Internal Medicine, Viljandi County Hospital, Viljandi, Estonia; 3Mustamäe Family Doctors Centre, Tallinn, Estonia; 4Nõmme Family Doctors Centre, Tallinn, Estonia; 5Saku Health Centre, Saku, Estonia; 6Kristiine Family Doctors, Tallinn, Estonia; 7Family Doctor Sille Väli, Kuressaare, Estonia; 8AstraZeneca, Tallinn, EstoniaAbstract: The aim of this multi-center, open-label, randomized, parallel-group trial was to compare the efficacy of rosuvastatin with that of simvastatin in achieving the 1998 European Atherosclerosis Society (EAS lipid treatment goals. 504 patients (≥18 years with primary hypercholesterolemia and a 10-year cardiovascular (CV risk >20% or history of coronary heart disease (CHD or other established atherosclerotic disease were randomized in a 2:1 ratio to receive rosuvastatin 10 mg or simvastatin 20 mg once daily for 12 weeks. A significantly higher proportion of patients achieved 1998 EAS low-density lipoprotein cholesterol (LDL-C goal after 12 weeks of treatment with rosuvastatin 10 mg compared to simvastatin 20 mg (64 vs 51.5%, p < 0.01. Similarly, significantly more patients achieved the 1998 EAS total cholesterol (TC goal and the 2003 EAS LDL-C and TC goals (p < 0.001 with rosuvastatin 10 mg compared with simvastatin 20 mg. The incidence of adverse events and the proportion of patients who discontinued study treatment were similar between treatment groups. In conclusion, in the DISCOVERY-Beta Study in patients with primary hypercholesterolemia greater proportion of patients in the rosuvastatin 10 mg group achieved the EAS LDL-C treatment goal compared with the simvastatin 20 mg group. Drug tolerability was similar across both treatment groups.Keywords: hypercholesterolemia, low-density lipoprotein

  7. Effects of raloxifene hydrochloride on bone mineral density, bone metabolism and serum lipids in Chinese postmenopausal women with osteoporosis:a multi-center, randomized, placebo-controlled clinical trial

    Institute of Scientific and Technical Information of China (English)

    LIU Jian-li刘建立; LIU Hui刘慧; CHEN Xiao-ping陈小平; LIU Yu-juan刘玉娟; Abie Ekangaki; ZHENG Yi-man郑以漫; Adolfo Diez-Perez; Kristine Harper; ZHU Han-min朱汉民; HUANG Qi-ren黄琪仁; ZHANG Zhong-lan张忠兰; LI Hui-lin李慧林; QIN Yue-juan秦跃娟; ZHANG Ying张颖; WEI Dao-lin魏道林; LU Jing-hui陆敬辉

    2004-01-01

    Background Raloxifene has been approved for prevention and treatment of postmenopausal osteoporosis in Caucasian women. It also has some positive effects on serum lipids in Caucasians. The objective of this study was to determine the effect of raloxifene hydrochloride on lumbar spine and total hip bone mineral density (BMD), bone metabolism, and serum lipids in Chinese postmenopausal women with osteoporosis.Methods This was a multi-center, randomized, double-blind, placebo-controlled clinical trial in which 204 postmenopausal Chinese women with osteoporosis were assigned to receive raloxifene (60 mg) or placebo treatment daily for 12 months. BMD, serum bone metabolism markers, and serum lipids were measured before and after drug administration. BMD was measured by Dual-Energy X-Ray Absorptiometry (DEXA) and bone metabolism markers were analyzed by one-step enzyme-linked immunosorbent assay. Serum lipids were measured by enzymatic analysis.Results At the end of the 12-month study, lumbar spine BMD increased in both groups with a mean increase of (3.3±4.8) % in the raloxifene group and (1.0±4.9) % in the placebo group (P0.05). In the raloxifene group, the median decreases in the biochemical markers of bone metabolism serum osteocalcin and C-telopeptide were 41.7% and 61.5%, respectively. These changes were statistically significant compared with those in the placebo group (10.6% and 35.6%, P<0.001, respectively). Both total cholesterol and low-density lipoprotein cholesterol decreased significantly in the raloxifene group compared with those in the placebo group (P<0.001, respectively) and there was no significant effect of raloxifene on high-density lipoprotein cholesterol and triglycerides compared with placebo. Conclusions Raloxifene 60 mg/d for 12 months significantly increases lumbar spine and total hip BMD, significantly decreases bone turnover, and has favourable effects on serum lipids in Chinese postmenopausal women with osteoporosis.

  8. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... In This Topic About Clinical Trials Risks and Benefits Terms to Know Finding a Clinical Trial Informed ... years of experiments in the laboratory and in animals before they even ... this early research occurs at universities and medical centers across the ...

  9. Call Center ist nicht gleich Call Center

    OpenAIRE

    Baumgartner, Marc; Udris, Ivars

    2005-01-01

    Untersuchungen in 14 Schweizer Call Centers erbrachten vier Call Center-Typen, die sich hinsichtlich Arbeitstätigkeiten und Kommunikationsrichtung voneinander unterscheiden: (a) Beratungs- und Beschwerdemanagement, (b) Informationsmanagement, (c) Auftragsmanagement und (d) Kunden- und Kampagnenmanagement. Dies hat auch Auswirkungen auf die Personalstruktur, -selektion und -entwicklung der Call Center. Es wird der Frage nachgegangen, welche Kompetenzanforderungen in den unterschiedlichen Call ...

  10. Rationale and design of the ETN-STEP (Early administration of Tirofiban in mid to high risk patients with non-ST elevation acute coronary syndrome referred for percutaneous coronary intervention) project: A multi-center, randomized, controlled clinic trial in Chinese patients

    OpenAIRE

    Li, Jian-ping; Liu, Qun; Huo, Yong

    2012-01-01

    As a member of Glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors, Tirofiban had been shown to improve myocardial reperfusion and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI), but the optimal timing of administration of Tirofiban remains unclear. In order to compare the effects of upstream versus downstream administration of Tirofiban in Chinese patients with mid to high risk, non-ST elevation acute coronary syndrome (ACS) referred for PCI, a multi-center, ran...

  11. Transplant Center Search Form

    Science.gov (United States)

    ... Your Story Give Us Feedback - A + A Transplant Center Search Form Welcome to the Blood & Marrow Transplant ... centers for patients with a particular disease. Transplant Center login Username: * Password: * Request new password Join BMT ...

  12. Womens Business Center

    Data.gov (United States)

    Small Business Administration — Women's Business Centers (WBCs) represent a national network of nearly 100 educational centers throughout the United States and its territories, which are designed...

  13. 77 FR 62246 - Center for Scientific Review; Notice of Closed Meetings

    Science.gov (United States)

    2012-10-12

    ... grant applications. Place: Embassy Suites Washington DC--Convention Center, 900 10th Street NW... HUMAN SERVICES National Institutes of Health Center for Scientific Review; Notice of Closed Meetings... Committee: Center for Scientific Review Special Emphasis Panel Clinical and Translational...

  14. 口服补充新型肠内营养的多中心临床研究%Muti-center clinical researches of new oral enteral nutrition in patients

    Institute of Scientific and Technical Information of China (English)

    王蕾蕾; 何芳; 叶丽佳; 胡桂芬; 陈秋霞; 张片红

    2015-01-01

    Objective The aim of this study was to understand nutritional status in hospitalized patients with collagen-based medical foods and standard enteral nutrition by muti-center clinical researches, and provide scientiifc reference for medical foods. Methods 6 units joint in this research. we collected 74 patients, patients were divided into two groups ( group with standard enteral nutrition and group with collagen-based medical foods) according to random number table, add 1673.6kJ(400 kcal)/d in 21 days, detect medical indicators ,laboratory examination and gastrointestinal reaction before and after the research.Results NRS2002 has signiifcantly decreased and ALB has signiifcantly increased after using enteral nutrition (P0.025). Conclusions The new type of enteral nutrition preparations and standard enteral nutrition preparations can effectively improve the nutritional status of patients.%目的:通过多中心随机对照的临床试验研究,探讨以胶原蛋白为基质的肠内营养制剂与标准型肠内营养制剂对患者营养状况的影响,判断新型肠内营养制剂的临床应用效果。方法本研究共6家医疗单位共同参与,共收集74例,随机分为对照组(标准肠内营养)及干预组(以胶原蛋白为基质的肠内营养),口服补充1673.6kJ(400kcal)/d,持续21天,检测研究开始前后患者体格指标、营养相关指标及安全性指标。结果组内比较显示两组患者食用肠内营养制剂后营养风险筛查NRS 2002评分显著下降(P<0.025),血白蛋白较食用前显著增高(P<0.025),组间比较显示对照组与干预组体格指标、营养相关指标及安全性指标均无统计学差异(P>0.025)。结论新型肠内营养制剂与标准型肠内营养制剂均可以有效改善患者的营养状况。

  15. Inmunodeficiencias humorales: Un estudio en tres Centros de Inmunología Clínica de adultos en la Ciudad de Buenos Aires Antibody deficiencies: A survey from three Clinical Immunology Centers for adults in Buenos Aires City

    Directory of Open Access Journals (Sweden)

    Diego S. Fernández Romero

    2011-08-01

    infections of the respiratory tract. The aim of our study was to describe the clinical characteristics of 128 patients with suspected or confirmed AD who were referred to 3 immunodeficiency centers for adults, from June 2004 to December 2009. Three of these patients (2.3% consulted for recurrent infections only once, without sufficient data for a proper classification, and were excluded. Of the remaining 125 patients, in 21 (16.8% AD was excluded, 8 cases (6.4% were diagnosed with sec ondary antibody immunodeficiency (SAD and 96 (76.8% with primary antibody immunodeficiency (PAD. SAD causes were: one renal failure, one phenytoin use, two monoclonal gammopathy and four B cell lymphoma. The causes of these 96 PAD were: 57 common variable immunodeficiency, 12 X-linked agammaglobulinaemia, 10 selective IgA deficiency, seven IgG1 deficiency, three hyper- IgM syndrome, three IgM deficiency, two X-linked proliferative syndrome, one Good syndrome and one antibody functional deficiency. Sixty-seven patients were in follow up at the time of completion of the study, 25 of them were on follow up at the beginning of the study. Among the 58 patients with indication of gamma globulin replacement therapy, 54 were in treatment at the end of the study. In four patients the initial diagnosis of PAD was not confirmed.

  16. Integrative Medicine Program- MD Anderson Cancer Center

    OpenAIRE

    Lee, Richard T.

    2012-01-01

    The Integrative Medicine Program at MD Anderson Cancer Center was first established in 1998.  Our mission is to empower patients with cancer and their families to become active partners in their own physical, psycho-spiritual, and social health through personalized education and evidenced-based clinical care to optimize health, quality of life, and clinical outcomes across the cancer continuum.  The program consists of three main components: clinical care, research, and education.  The Integr...

  17. Integrative Medicine Program- MD Anderson Cancer Center

    Directory of Open Access Journals (Sweden)

    Richard T Lee

    2012-06-01

    Full Text Available The Integrative Medicine Program at MD Anderson Cancer Center was first established in 1998.  Our mission is to empower patients with cancer and their families to become active partners in their own physical, psycho-spiritual, and social health through personalized education and evidenced-based clinical care to optimize health, quality of life, and clinical outcomes across the cancer continuum.  The program consists of three main components: clinical care, research, and education.  The Integrative Medicine Center provides clinical services to patients through individual and group programs.  The clinical philosophy of the center is to work collaboratively with the oncology teams to build comprehensive and integrative care plans that are personalized, evidence-based, and safe with the goal of improving clinical outcomes.  The individual services comprise of integrative oncology consultation, acupuncture, meditation, music therapy, nutrition, and oncology massage.  The center also provides a variety of group programs including meditation, yoga, tai chi, cooking classes and others.  Over the past 13 years, over 70,000 patients and families have participated in services and programs offered by the center.  The research portfolio focuses on three main areas: mind-body interventions, acupuncture, and meditation.  This lecture will focus on providing an overview of the Integrative Medicine Program at MD Anderson with a focus on the clinical services provided.  Participants will learn about the integrative clinical model and how this is applied to the care of cancer patients at MD Anderson Cancer Center.  Current and future research topics will be discussed as well as patient cases.

  18. Student Success Center Toolkit

    Science.gov (United States)

    Jobs For the Future, 2014

    2014-01-01

    "Student Success Center Toolkit" is a compilation of materials organized to assist Student Success Center directors as they staff, launch, operate, and sustain Centers. The toolkit features materials created and used by existing Centers, such as staffing and budgeting templates, launch materials, sample meeting agendas, and fundraising…

  19. Comparison of long-term clinical outcome between patients with chronic versus acute type B aortic dissection treated by implantation of a stent graft: a single-center report

    Directory of Open Access Journals (Sweden)

    Chen SL

    2013-04-01

    Full Text Available Shao-Liang Chen, Jian-Cheng Zhu, Xiao-Bo Li, Fei Ye, Jun-Jie Zhang, Zhi-Zhong Liu, Nai-Liang Tian, Song Lin, Cheng-Yu Lv Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China Background: Stent grafting for treatment of type B aortic dissection has been extensively used. However, the difference in the long-term clinical outcome between patients with chronic versus acute type B aortic dissection remains unknown. This study aimed to analyze the difference in long-term clinical outcome after endovascular repair for patients with chronic (93% complete false-lumen thrombosis. Untreated tear and type I endoleak were predictors of clinical events during follow-up. Conclusion: Comparable long-term clinical results were achieved in patients with chronic or acute type B aortic dissection after implantation of a stent graft. Keywords: aortic dissection, endovascular repair, procedure-related events, propensity score matching

  20. Meeting Report for the UCLA Center for East-West Medicine 2006 Annual Conference:Integration of Traditional Chinese Medicine and Western Medicine——Research and Clinical Applications

    Institute of Scientific and Technical Information of China (English)

    Ryan Abbott; Weijun Zhang

    2007-01-01

    @@ This is the meeting report for the 2006 UCLA Center for East-West Medicine (CEWM) annual conference held at the UCLA Jules Stein auditorium on Saturday,October 28th.The event began with registration and a continental breakfast that allowed participants the opportunity to meet one another and discuss their experiences with integrative medicine.

  1. Achieving lipid goals with rosuvastatin compared with simvastatin in high risk patients in real clinical practice: a randomized, open-label, parallel-group, multi-center study: the DISCOVERY-Beta study

    OpenAIRE

    Laks, Toivo

    2008-01-01

    Toivo Laks1, Ester Keba2, Mariann Leiner3, Eero Merilind4, Mall Petersen5, Sirje Reinmets6, Sille Väli7, Terje Sööt8, Karin Otter81Clinic of Internal Medicine, North-Estonia Regional Hospital, Tallinn, Estonia; 2Clinic of Internal Medicine, Viljandi County Hospital, Viljandi, Estonia; 3Mustamäe Family Doctors Centre, Tallinn, Estonia; 4Nõmme Family Doctors Centre, Tallinn, Estonia; 5Saku Health Centre, Saku, Estonia; 6Kristiine Family Doctors, Ta...

  2. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Topics News & Resources Intramural Research Public Health Topics Education & Awareness Resources Contact The Health Information Center Health ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural ...

  3. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Topics News & Resources Intramural Research Public Health Topics Education & Awareness Resources Contact The Health Information Center Health ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education ... Funding Training & Career Development Division of Intramural ...

  4. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Awareness Resources Contact The Health Information Center Health Professionals Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting ...

  5. Checklist for clinical readiness published

    Science.gov (United States)

    Scientists from NCI, together with collaborators from outside academic centers, have developed a checklist of criteria to evaluate the readiness of complex molecular tests that will guide decisions made during clinical trials. The checklist focuses on tes

  6. Types of Treatment: Clinical Trials

    Science.gov (United States)

    ... Previous Article Palliative Care Next Article How a Clinical Trial Works Follow us Subscribe to a newsletter This field is required ... Fundraising Disclosure Refund Policy Work for LLS Contact Us Email Subscription Center

  7. Alzheimer's Disease Research Centers

    Science.gov (United States)

    ... Plan National Alzheimer's Project Act (NAPA) About ADEAR Alzheimer's Disease Research Centers The National Institute on Aging ... Repository for Alzheimer's Disease ADC Directory Arizona Arizona Alzheimer’s Disease Center/Sun Health Research Institute Eric Reiman, ...

  8. New Mexico Convention Centers

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — This dataset provides an initial version of the locations of convention centers in New Mexico, in point form, with limited attributes, compiled using available data...

  9. Day Care Centers

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of day care centers for 50 states and Washington D.C. and Puerto Rico. The dataset only includes center based day care locations...

  10. Tornadoes: A Center Approach.

    Science.gov (United States)

    Christman-Rothlein, Liz; Meinbach, Anita M.

    1981-01-01

    Information is given on how to put together a learning center. Discusses information and activity packets for a complete learning center on tornadoes including objectives, directions, materials, photographs of physical arrangements, and posttest. (DC)

  11. Center for Functional Nanomaterials

    Data.gov (United States)

    Federal Laboratory Consortium — The Center for Functional Nanomaterials (CFN) explores the unique properties of materials and processes at the nanoscale. The CFN is a user-oriented research center...

  12. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Safety Education Centers OnSafety Blog Neighborhood Safety Network Community Outreach Resource Center CO Poster Contest Toy Recall ... of the external site as its information collection practices may differ from ours. Linking to this external ...

  13. America's Blood Centers

    Science.gov (United States)

    ... or less. Please donate now! Full Stoplight Report America's Blood Centers is... FEATURED TODAY Support the Foundation ... purchase will be donated to the Foundation for America's Blood Centers! Simply Click Here! "We Are" This ...

  14. Hydrologic Engineering Center

    Data.gov (United States)

    Federal Laboratory Consortium — The Hydrologic Engineering Center (HEC), an organization within the Institute for Water Resources, is the designated Center of Expertise for the U.S. Army Corps of...

  15. RSW Cell Centered Grids

    Data.gov (United States)

    National Aeronautics and Space Administration — New cell centered grids are generated to complement the node-centered ones uploaded. Six tarballs containing the coarse, medium, and fine mixed-element and pure...

  16. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Home / Safety Education / Safety Education Centers En Español Carbon Monoxide Information Center The Invisible Killer Carbon monoxide, also known as CO, is called the "Invisible ...

  17. BKG Data Center

    Science.gov (United States)

    Thorandt, Volkmar; Wojdziak, Reiner

    2013-01-01

    This report summarizes the activities and background information of the IVS Data Center for the year 2012. Included is information about functions, structure, technical equipment, and staff members of the BKG Data Center.

  18. ACTS data center

    Science.gov (United States)

    Syed, Ali; Vogel, Wolfhard J.

    1993-01-01

    Viewgraphs on ACTS Data Center status report are included. Topics covered include: ACTS Data Center Functions; data flow overview; PPD flow; RAW data flow; data compression; PPD distribution; RAW Data Archival; PPD Audit; and data analysis.

  19. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Education / Safety Education Centers En Español Carbon Monoxide Information Center The Invisible Killer Carbon monoxide, also known ... Install one and check its batteries regularly. View Information About CO Alarms Other CO Topics Safety Tips ...

  20. National Farm Medicine Center

    Science.gov (United States)

    ... Staff Agricultural Health and Safety Core Units Children's Center Cultivate Newsletter Journal of Agromedicine Milestones Auction of ... Farm Medicine, Rural Health & Safety National Farm Medicine Center Established in 1981 in response to occupational health ...

  1. Transplant Center Directory

    Science.gov (United States)

    ... mission. Learn more. My Account News Search Transplant Center Search Use the tools below to find a ... or enter your diagnosis to search for transplant centers. Select state(s) (optional) Enter diagnosis (optional) Please select ...

  2. NIST Diffusion Data Center

    Science.gov (United States)

    NIST Diffusion Data Center (Web, free access)   The NIST Diffusion Data Center is a collection of over 14,100 international papers, theses, and government reports on diffusion published before 1980.

  3. Center of buoyancy definition

    International Nuclear Information System (INIS)

    The center of buoyancy of an arbitrary shaped body is defined in analogy to the center of gravity. The definitions of the buoyant force and center of buoyancy in terms of integrals over the area of the body are converted to volume integrals and shown to have simple intuitive interpretations

  4. Data center cooling method

    Science.gov (United States)

    Chainer, Timothy J.; Dang, Hien P.; Parida, Pritish R.; Schultz, Mark D.; Sharma, Arun

    2015-08-11

    A method aspect for removing heat from a data center may use liquid coolant cooled without vapor compression refrigeration on a liquid cooled information technology equipment rack. The method may also include regulating liquid coolant flow to the data center through a range of liquid coolant flow values with a controller-apparatus based upon information technology equipment temperature threshold of the data center.

  5. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... to find out if an experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or prevent a disease. A clinical trial may compare experimental products or ... universities and medical centers across the country. The National Institutes of ...

  6. PACS strategy for imaging centers.

    Science.gov (United States)

    Bedel, Victoria; Zdanowicz, Mark

    2004-01-01

    Picture archiving and communications systems (PACS) have been available in imaging centers for many years, but they often were less functional, were not well integrated into patient information systems, and lacked the network backbone to implement a system. As modalities are replaced and technology improves, the ability and time for an imaging center to acquire, integrate, and utilize PACS has arrived. However, each imaging center must determine why it should invest in PACS. A business plan is the fundamental need. Each imaging center must understand its target market, growth rate, and staffing plans. Additional considerations lie in current and future modality availability, the need for offsite delivery of images and reports, and the potential need for remote transmission of images. These issues must be identified and prioritized. A multidisciplinary team is essential. The most successful PACS implementation begins with complete involvement from all levels. The team should be comprised of people with complementary skills who are committed to a common purpose, set of performance goals, and approach for which they hold themselves mutually accountable. The team must jointly decide on the project's objectives. These objectives fall under 4 categories: clinical, service, financial, and performance. PACS must be considered a tool to help accomplish each objective. The imaging center must determine its top priorities, then translate them into a technology "wish list." The center can then list those pieces of technology that are most important and prioritize them. There are even more considerations for connecting multiple imaging centers. The team must create a comprehensive request for proposal (RFP) and determine the vendors that will receive the document. Once the RFP responses have been received and the vendor has been selected, an effective training plan must be executed. Training plans should be competency-based, ensuring comfort and competency among all staff. Upon

  7. Positive predictive value of non-invasive prenatal screening for fetal chromosome disorders using cell-free DNA in maternal serum: independent clinical experience of a tertiary referral center

    OpenAIRE

    Neufeld-Kaiser, Whitney A.; Cheng, Edith Y.; Liu, Yajuan J

    2015-01-01

    Background Non-invasive prenatal screening (NIPS) for fetal chromosome abnormalities using cell-free deoxyribonucleic acid (cfDNA) in maternal serum has significantly influenced prenatal diagnosis of fetal aneuploidies since becoming clinically available in the fall of 2011. High sensitivity and specificity have been reported in multiple publications, nearly all of which have been sponsored by the commercial performing laboratories. Once results are returned, positive and negative predictive ...

  8. No predictive effect of body mass index on clinical response in patients with rheumatoid arthritis after 24 weeks of biological disease-modifying antirheumatic drugs: a single-center study.

    Science.gov (United States)

    Kim, Seong-Kyu; Choe, Jung-Yoon; Park, Sung-Hoon; Lee, Hwajeong

    2016-05-01

    The aim of this study was to determine whether body mass index (BMI) is associated with clinical response to biologics in patients with rheumatoid arthritis (RA). We enrolled 68 patients with RA who were treated with biological disease-modifying antirheumatic drugs (bDMARDs). Biologics included abatacept, tocilizumab, and tumor necrosis factor-α (TNF-α) blockers (etanercept and adalimumab). Baseline BMI (kg/m(2)) was classified as normal (BMI < 23.0), overweight (23.0 ≤ BMI < 25.0), or obese (BMI ≥ 25.0). Improvement of disease activity score 28 (DAS28) and achievement of the European League Against Rheumatism (EULAR) remission and responses between baseline and 24 weeks were our measures of clinical improvement. Mean baseline BMI before treatment with bDMARDs in patients with RA was 22.2 (SD 3.6). DAS28-ESR and DAS28-CRP were significantly reduced from baseline after 24 weeks of treatment with bDMARDs (p < 0.001 of both). ∆DAS28-ESR and ∆DAS28-CRP were not found among patients with normal, overweight, or obese BMI (p = 0.133 and p = 0.255, respectively) nor were EULAR responses or EULAR remission (p = 0.540 and p = 0.957, respectively). Logistic regression analysis showed no relationship of BMI with EULAR clinical responses (p = 0.093 for good response and p = 0.878 for EULAR remission). This study reveals that BMI is not a predictive factor of clinical response to bDMARDs in patients with RA. PMID:26932795

  9. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available U.S. Department of Health & Human Services National Institutes of Health Contact Us Get Email Alerts Font Size Accessible Search ... Health Topics Education & Awareness Resources Contact The Health Information Center ... Transfer Clinical Trials What Are Clinical Trials? Children & ...

  10. 76 FR 82299 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2011-12-30

    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory... following: activities of the Coordinating Council on the Clinical Laboratory Workforce; laboratory...), regarding the need for, and the nature of, revisions to the standards under which clinical laboratories...

  11. 76 FR 5379 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2011-01-31

    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory... Clinical Laboratory Workforce; the National Institutes of Health Genetic Test Registry design and responses..., revisions to the standards under which clinical laboratories are regulated; the impact on medical...

  12. 78 FR 6330 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2013-01-30

    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory... related to improvement in clinical laboratory quality and laboratory medicine practice and specific... laboratory services; revisions to the standards under which clinical laboratories are regulated; the...

  13. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang-Moo; Hong, S. W.; Choi, C. W.; Yang, S. D.; Choi, J. S.; Kweon, O. J. et al. [Korea Cancer Center Hospital, Seoul (Korea)

    2000-12-01

    PET gives various metabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 1,327 cases of PET images were obtained, which resulted total income of 829,770,000won. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18} in a day. Manpower should be added for the second PET operation and RI production. 10 figs., 4 tabs. (Author)

  14. Satellite medical centers project

    Science.gov (United States)

    Aggarwal, Arvind

    2002-08-01

    World class health care for common man at low affordable cost: anywhere, anytime The project envisages to set up a national network of satellite Medical centers. Each SMC would be manned by doctors, nurses and technicians, six doctors, six nurses, six technicians would be required to provide 24 hour cover, each SMC would operate 24 hours x 7 days. It would be equipped with the Digital telemedicine devices for capturing clinical patient information and investigations in the form of voice, images and data and create an audiovisual text file - a virtual Digital patient. Through the broad band connectivity the virtual patient can be sent to the central hub, manned by specialists, specialists from several specialists sitting together can view the virtual patient and provide a specialized opinion, they can see the virtual patient, see the examination on line through video conference or even PCs, talk to the patient and the doctor at the SMC and controlle capturing of information during examination and investigations of the patient at the SMC - thus creating a virtual Digital consultant at the SMC. Central hub shall be connected to the doctors and consultants in remote locations or tertiary care hospitals any where in the world, thus creating a virtual hub the hierarchical system shall provide upgradation of knowledge to thedoctors in central hub and smc and thus continued medical education and benefit the patient thru the world class treatment in the smc located at his door step. SMC shall be set up by franchisee who shall get safe business opportunity with high returns, patients shall get Low cost user friendly worldclass health care anywhere anytime, Doctors can get better meaningful selfemplyment with better earnings, flexibility of working time and place. SMC shall provide a wide variety of services from primary care to world class Global consultation for difficult patients.

  15. Communication Skills of Nurses and Clinical Departments in Disinfection Supply Center%消毒供应中心护士与临床科室的沟通技巧

    Institute of Scientific and Technical Information of China (English)

    洪丽云

    2016-01-01

    Objective To explore the skills of communication between nurses and clinical departments in disinfection sup-ply room. Methods In our hospital supply room nurses in 30 cases of investigation, understand its and problems existing in the clinical departments of communication, and the traditional communication nursing mode for rectification, and the exist-ing problems are analyzed and discussed, finally make effective improvement measures. Results To make a series of cor-rective measures through the investigation and study, effectively increase the quality and enthusiasm of the nursing staff. Conclusion Through the clinical and supply room nurses in the problem of the existing problems, effectively improve the exchange relationship, improve the efficiency of work.%目的:探究消毒供应室护士与临床科室进行沟通的技巧。方法对在该院供应室工作的在职护士30例进行调查,了解其与临床科室沟通中存在的问题,并对其传统沟通护理模式进行整改,并对存在的问题进行分析与讨论,最终做出有效的改进措施。结果经过调查研究总结做出的一系列整改措施,有效地增加了护理人员的工作质量及积极性。结论通过对临床及供应室护士存在的问题进行干预后,有效改善了交流关系,提高了工作效率。

  16. Baseline Serum Osteopontin Levels Predict the Clinical Effectiveness of Tocilizumab but Not Infliximab in Biologic-Naïve Patients with Rheumatoid Arthritis: A Single-Center Prospective Study at 1 Year (the Keio First-Bio Cohort Study)

    Science.gov (United States)

    Izumi, Keisuke; Kaneko, Yuko; Hashizume, Misato; Yoshimoto, Keiko; Takeuchi, Tsutomu

    2015-01-01

    Objective To explore the baseline predictors of clinical effectiveness after tocilizumab or infliximab treatment in biologic-naïve rheumatoid arthritis patients. Methods Consecutive biologic-naïve patients with rheumatoid arthritis initiating infliximab (n = 57) or tocilizumab (n = 70) treatment were included in our prospective cohort study. Our cohort started in February 2010, and the patients observed for at least 1 year as of April 2013 were analysed. We assessed baseline variables including patients' characteristics (age, sex, disease duration, prednisolone dose, methotrexate dose, other disease-modifying antirheumatic drug use, Clinical Disease Activity Index [CDAI]) and serum biomarker levels (C-reactive protein, immunoglobulin M-rheumatoid factor, anti-cyclic citrullinated protein/peptide antibodies, interferon-γ, interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, IL-17, tumor necrosis factor-α, soluble intercellular adhesion molecule-1, bone alkaline phosphatase, osteonectin, osteopontin) to extract factors associated with clinical remission (CDAI≤2.8) at 1 year using univariate analyses, and the extracted factors were entered into a multivariate logistic regression model. Similar analyses were also performed for Simplified Disease Activity Index (SDAI) remission (≤3.3) and Disease Activity Score with 28 joint counts, erythrocyte sedimentation rate (DAS28-ESR) remission (<2.6). Results There were no significant differences in the baseline characteristics except for methotrexate use between the groups. In the multivariate analyses, the low baseline osteopontin levels (OR 0.9145, 95% CI 0.8399–0.9857) were identified as predictors of CDAI remission in the tocilizumab group, whereas no predictors of CDAI remission were found in the infliximab group. Similar results were obtained when using SDAI and DAS28-ESR remission criteria. Conclusion Baseline low serum osteopontin levels predict clinical remission 1 year after tocilizumab treatment and not

  17. A single center, open, randomized study investigating the clinical safety and the endothelial modulating effects of a prostacyclin analog in combination with eptifibatide in patients having undergone primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction

    DEFF Research Database (Denmark)

    Holmvang, Lene; Ostrowski, Sisse Rye; Dridi, Nadia Paarup;

    2012-01-01

    Treatment with the endothelial modulator prostacyclin may be beneficial in patients with endothelial dysfunction. The primary aim of the present pilot study was to evaluate the safety and the potential endothelial modulating affect of the prostacyclin analog iloprost in patients with a recent ST...... segment elevation myocardial infarction (STEMI). Seventeen patients were randomized to either 24h of iloprost infusion in combination with low dose eptifibatide infusion or saline infusion+eptifibatide. The study was randomized and open labeled. None of the patients experienced any bleeding complications...... activated endothelium in patients with a recent STEMI. ClinicalTrials.gov: NCT01179776....

  18. Clinical efficacy of antazoline in rapid cardioversion of paroxysmal atrial fibrillation -- a protocol of a single center, randomized, double-blind, placebo-controlled study (the AnPAF Study

    Directory of Open Access Journals (Sweden)

    Farkowski Michal M

    2012-09-01

    Full Text Available Abstract Background Rapid conversion of atrial fibrillation (AF to sinus rhythm may be achieved by the administration of class IA, IC and III antiarrhythmic drugs or vernakalant hydrochloride. However, that treatment may be related to potential pro-arrhythmia, lack of efficacy or the exceptionally high cost of a compound used. Antazoline is a first generation antihistaminic agent with chinidin-like properties. When administered intravenously, antazoline exerts a strong antiarrhythmic effect on supraventricular arrhythmia, especially on AF, facilitating rapid conversion to sinus rhythm. Despite a relative lack of published data antazoline has been marketed in Poland and widely used in cardiology wards and emergency rooms for many years due to its efficacy, safety and rapid onset of action within minutes of administration. Methods/design A randomized, double blind, placebo-controlled, superiority clinical trial was designed to assess clinical efficacy of antazoline in rapid conversion of AF to sinus rhythm. Eligible patients will present AF lasting less than 43 hours, will be in stable cardio-pulmonary condition and will have no prior history of advanced heart failure or significant valvular disease. Long-term antiarrhythmic therapy is not considered an exclusion criterion. Subjects who fulfill selection criteria will be randomly assigned to receive intravenously either antazoline or placebo in divided doses and observed for 1.5 hours after conversion to sinus rhythm or after the last i.v. bolus. Primary end point will be the conversion of AF to sinus rhythm confirmed in an electrocardiogram (ECG during the observation period. Secondary end points will be comprised of time to conversion and return of AF during the observation period. Special consideration will be given to the observation of any adverse events. A sample size of 80 patients was calculated based on the following assumptions: two-tailed test, a type I error of 0.01, a power of 90

  19. Relativistic Guiding Center Equations

    Energy Technology Data Exchange (ETDEWEB)

    White, R. B. [PPPL; Gobbin, M. [Euratom-ENEA Association

    2014-10-01

    In toroidal fusion devices it is relatively easy that electrons achieve relativistic velocities, so to simulate runaway electrons and other high energy phenomena a nonrelativistic guiding center formalism is not sufficient. Relativistic guiding center equations including flute mode time dependent field perturbations are derived. The same variables as used in a previous nonrelativistic guiding center code are adopted, so that a straightforward modifications of those equations can produce a relativistic version.

  20. CLINICAL BIOCHEMISTRY

    Science.gov (United States)

    Assessment of the health status of animals through measurement of cellular, biochemical, and macromolecular constituents in blood, secretions, and excretions has been variously referred to as clinical chemistry, clinical biochemistry, or clinical pathology. he genesis of this dis...

  1. Airline Operation Center Workstation

    Data.gov (United States)

    Department of Transportation — The Airline Operation Center Workstation (AOC Workstation) represents equipment available to users of the National Airspace system, outside of the FAA, that enables...

  2. Chemical Security Analysis Center

    Data.gov (United States)

    Federal Laboratory Consortium — In 2006, by Presidential Directive, DHS established the Chemical Security Analysis Center (CSAC) to identify and assess chemical threats and vulnerabilities in the...

  3. Small Business Development Center

    Data.gov (United States)

    Small Business Administration — Small Business Development Centers (SBDCs) provide assistance to small businesses and aspiring entrepreneurs throughout the United States and its territories. SBDCs...

  4. Electron Microscopy Center (EMC)

    Data.gov (United States)

    Federal Laboratory Consortium — The Electron Microscopy Center (EMC) at Argonne National Laboratory develops and maintains unique capabilities for electron beam characterization and applies those...

  5. Center for Deployment Psychology

    Data.gov (United States)

    Federal Laboratory Consortium — The Center for Deployment Psychology was developed to promote the education of psychologists and other behavioral health specialists about issues pertaining to the...

  6. Data Center at NICT

    Science.gov (United States)

    Ichikawa, Ryuichi; Sekido, Mamoru

    2013-01-01

    The Data Center at the National Institute of Information and Communications Technology (NICT) archives and releases the databases and analysis results processed at the Correlator and the Analysis Center at NICT. Regular VLBI sessions of the Key Stone Project VLBI Network were the primary objective of the Data Center. These regular sessions continued until the end of November 2001. In addition to the Key Stone Project VLBI sessions, NICT has been conducting geodetic VLBI sessions for various purposes, and these data are also archived and released by the Data Center.

  7. Test Control Center (TCC)

    Data.gov (United States)

    Federal Laboratory Consortium — The Test Control Center (TCC) provides a consolidated facility for planning, coordinating, controlling, monitoring, and analyzing distributed test events. ,The TCC...

  8. Environmental Modeling Center

    Data.gov (United States)

    Federal Laboratory Consortium — The Environmental Modeling Center provides the computational tools to perform geostatistical analysis, to model ground water and atmospheric releases for comparison...

  9. Reengineering Academic Medical Centers: Reengineering Academic Values?

    Science.gov (United States)

    Korn, David

    1996-01-01

    Discussion of academic medical centers (AMCs) looks at: change due to heavy federal funding in recent decades; adverse consequences, including deemphasis on education in favor of research and clinical service delivery, and discrepancies between AMC internal and external labor markets; and challenges to medical education in research, education, and…

  10. Utilization of an Academic Nursing Center.

    Science.gov (United States)

    Cole, Frank L.; Mackey, Thomas

    1996-01-01

    Using data from an academic nursing center that cared for 3,263 patients over eight months, diseases were classified using International Classification of Diseases codes, and procedures were classified using Current Procedural Terminology codes. Patterns of health care emerged, with implications for clinical teaching. (SK)

  11. Point of Care Tools im Vergleich des Universitätsklinikums Hamburg-Eppendorf (UKE: UpToDate, ClinicalResource@Ovid/Clin-eguide und Dynamed / Point of Care Tools in comparison at the University Medical Center Hamburg-Eppendorf: UpToDate, ClinicalResource@Ovid and Dynamed

    Directory of Open Access Journals (Sweden)

    Menn, Elke

    2006-09-01

    Full Text Available Point of Care Tools are used for clinical decision making – UpToDate is also used in continuing medical education. These databases compile only evidence-based knowledge which is updated regularly. Using Point of Care Tools promises to improve clinical outcomes. UpToDate has been used at the University Hospital Hamburg-Eppendorf for the last four years. In a recent trial the use of ClinicalResource@Ovid/Clin-eguide and Dynamed has been evaluated in comparison with UpToDate.

  12. 以学生为中心的耳鼻咽喉头颈外科学本科临床教学体系构建及意义%Construction of student-centered learning system for undergraduate clinical training in otolaryngology-head and neck surgery

    Institute of Scientific and Technical Information of China (English)

    钟诚; 张学渊; 姜振东; 魏运军; 袁伟

    2013-01-01

    对本科医学生耳鼻咽喉头颈外科学临床学习阶段的教学实践加以总结,提出以学生为中心的教学策略并应用于教学过程.构建涵盖教学理念整体化、教学手段形象化、教学目标多元化、教学方式互动化的四个框架,采用内镜、多媒体等形式教学,设定不同的教学目标,实施不同的临床教学策略,推动学生综合素质和临床能力发展.%The author proposed student-centered learning system in otolaryngology-head and neck surgery for undergraduate clinical training after exploration and intentions.Four mutual impacted frames were built including integration of teaching philosophy,visualization of training methods,diversification of educational targets and interaction of training courses.Endoscopic navigated learning and multimedia aided training were applied,respective teaching purposes were set and various clinical training courses were introduced to students in their learning of otolaryngology,which were believed to help develop more medical talents with higher comprehensive qualities and better clinical skills.

  13. Funding Opportunity: Genomic Data Centers

    Science.gov (United States)

    Funding Opportunity CCG, Funding Opportunity Center for Cancer Genomics, CCG, Center for Cancer Genomics, CCG RFA, Center for cancer genomics rfa, genomic data analysis network, genomic data analysis network centers,

  14. HRSA: Find a Health Center

    Science.gov (United States)

    ... Please, try later. Close × Note To HRSA Health Centers: HRSA Health Center Grantees and Look-Alikes, please ... to save your changes. Close About HRSA Health Centers HRSA Health Centers care for you, even if ...

  15. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Consumers Businesses Contact CPSC Website Design Feedback Consumers: Español Businesses: Español , 中文 , Tiếng Việt Connect with Us : Twitter YouTube ... Safely Home / Safety Education / Safety Education Centers En Español Carbon Monoxide Information Center The Invisible Killer Carbon ...

  16. About the ADEAR Center

    Science.gov (United States)

    ... and news updates How to Contact the ADEAR Center Call toll-free at: 1-800-438-4380 (8: ... To give you the best possible service, ADEAR Center staff abide by the following customer service standards: We will answer your telephone calls promptly between 8:30 a.m. and 5: ...

  17. From Periphery To Center

    DEFF Research Database (Denmark)

    Carré, David

    2014-01-01

    notions of Center/Periphery. As Hermans (2001) proposed, center and periphery are not fixed ‘I-positions’ of the self; in this vein, these notions are explored as relevant theoretical tools for addressing the developmental trajectories involved in the construction of scientific identities. In sum, the...

  18. Simple Machine Science Centers

    Science.gov (United States)

    Chessin, Debby

    2007-01-01

    Science centers can engage students; accommodate different learning styles and individual interests; help students become independent and confident learners; and encourage social skills among students. In this article, the author worked with third-grade students as they completed activities at learning centers during a week-long unit on simple…

  19. Technology Information Center

    International Nuclear Information System (INIS)

    A Transportation Technology Center (TTC) has been established at Sandia to address the transportation of nuclear waste and spent fuel. The Technology Information Center (TIC) acts as TTC's clearing house for nuclear material transportation information. TIC's activities are divided into three activities: public information, policy information, and technical information. Some of the uses of TIC's activities are briefly outlined

  20. Call Center Capacity Planning

    DEFF Research Database (Denmark)

    Nielsen, Thomas Bang

    The main topics of the thesis are theoretical and applied queueing theory within a call center setting. Call centers have in recent years become the main means of communication between customers and companies, and between citizens and public institutions. The extensively computerized infrastructure...

  1. Protocol for the BAG-RECALL clinical trial: a prospective, multi-center, randomized, controlled trial to determine whether a bispectral index-guided protocol is superior to an anesthesia gas-guided protocol in reducing intraoperative awareness with explicit recall in high risk surgical patients

    Directory of Open Access Journals (Sweden)

    Villafranca Alex

    2009-11-01

    Full Text Available Abstract Background Awareness with explicit recall of intra-operative events is a rare and distressing complication that may lead to severe psychological symptoms. Candidate depth of anesthesia monitors have been developed, partly with the aim of preventing this complication. Despite conflicting results from clinical trials and the lack of incisive validation, such monitors have enjoyed widespread clinical adoption, in particular the bispectral index. The American Society of Anesthesiologists has called for adequately powered and rigorously designed clinical trials to determine whether the use of such monitors decreases the incidence of awareness in various settings. The aim of this study is to determine with increased precision whether incorporating the bispectral index into a structured general anesthesia protocol decreases the incidence of awareness with explicit recall among a subset of surgical patients at increased risk for awareness and scheduled to receive an inhalation gas-based general anesthetic. Methods/Design BAG-RECALL is a multi-center, randomized, controlled clinical trial, in which 6,000 patients are being assigned to bispectral index-guided anesthesia (target range, 40 to 60 or end-tidal anesthetic gas-guided anesthesia (target range, 0.7 to 1.3 age-adjusted minimum alveolar concentration. Postoperatively, patients are being assessed for explicit recall at two intervals (0 to 72 hours, and 30 days after extubation. The primary outcome of the trial is awareness with explicit recall. Secondary outcomes include postoperative mortality, psychological symptoms, intensive care and hospital length of stay, average anesthetic gas administration, postoperative pain and nausea and vomiting, duration of stay in the recovery area, intra-operative dreaming, and postoperative delirium. Discussion This trial has been designed to complement two other clinical trials: B-Unaware and MACS (ClinicalTrials.gov numbers, NCT00281489 and NCT00689091

  2. Relative Lyapunov Center Bifurcations

    DEFF Research Database (Denmark)

    Wulff, Claudia; Schilder, Frank

    2014-01-01

    Relative equilibria (REs) and relative periodic orbits (RPOs) are ubiquitous in symmetric Hamiltonian systems and occur, for example, in celestial mechanics, molecular dynamics, and rigid body motion. REs are equilibria, and RPOs are periodic orbits of the symmetry reduced system. Relative Lyapunov...... center bifurcations are bifurcations of RPOs from REs corresponding to Lyapunov center bifurcations of the symmetry reduced dynamics. In this paper we first prove a relative Lyapunov center theorem by combining recent results on the persistence of RPOs in Hamiltonian systems with a symmetric Lyapunov...... center theorem of Montaldi, Roberts, and Stewart. We then develop numerical methods for the detection of relative Lyapunov center bifurcations along branches of RPOs and for their computation. We apply our methods to Lagrangian REs of the N-body problem....

  3. The Center for Healthy Weight: an academic medical center response to childhood obesity

    OpenAIRE

    Robinson, T N; Kemby, K M

    2012-01-01

    Childhood obesity represents a worldwide medical and public health challenge. Academic medical centers cannot avoid the effects of the obesity epidemic, and must adopt strategies for their academic, clinical and public policy responses to childhood obesity. The Center for Healthy Weight at Stanford University and Lucile Packard Children's Hospital at Stanford provides an example and model of one such strategy. The design provides both breadth and depth through six cores: Research, Patient Car...

  4. A Survey on Prevalence of Ocular Complications and It’s Risk Factors in Diabetic Patients Referred to Diabetic Center of Nader Kazemi Clinic Shiraz- Iran 1998-2010

    Directory of Open Access Journals (Sweden)

    ali khani jeihooni

    2014-03-01

    Full Text Available Background & Objective: With respect to increasing prevalence of diabetes, the chance for incidence of ocular complications among diabetics, this study was conducted to investigate the prevalence and risk factors for the incidence of the ocular complications in the patients referred to the Nader Kazemi Shiraz Diabetic center from 1998 to 2010.Materials & Methods: In a cross sectional study , subjects were selected based on a systematic random sampling to investigate the incidence of the ocular complications and factors influencing like wise age, sex, type of diabet, job, education, blood triglyceride (TG and cholesterol level, Family history of diabetes, history of hypertension, history of participation in educational classes, method of treatment, duration of diabetes and fasting blood sugar were considered.Results: Ocular complications were found among 229 diabetic patients (32.6%. Ocular complications of type II diabetic patients than in patients with type I diabetes (P<0. 005. Factors such as job(P=0. 022, history of participation in educational classes(P<0. 001, education(P<0. 001, Family history of diabetes(P<0. 001, blood triglyceride (TG (P=0. 021, duration of diabetes(P<0. 001,age (P<0. 001, method of treatment(P<0. 001and fasting blood sugar (P<0. 001 had a significant relationship with the occurrence of ocular complication. But other risk factors such as hypertension, gender and cholesterol levels were not statistically significant relationship with the occurrence of ocular complication.Conclusion: Given the prevalence of ocular complications, continuing education on the disease of diabetes complications, it can have a role in reducing the occurrence of ocular complications.

  5. Clinical biophysics

    Energy Technology Data Exchange (ETDEWEB)

    Anbar, M.; Spangler, R.A.; Scott, P.

    1985-01-01

    Chapters are included on clinical decision making, principles of biomedical engineering, computers and their medical uses, clinical radiobiology, diagnostic x-ray radiology, clinical applications of ultrasonics, nuclear medicine, NMR imaging, diagnostic imaging, bioelectric techniques in diagnosis and therapy, biophysical aspects of the clinical laboratory, and biophysical aspects of modern surgery.

  6. Energy efficient data centers

    Energy Technology Data Exchange (ETDEWEB)

    Tschudi, William; Xu, Tengfang; Sartor, Dale; Koomey, Jon; Nordman, Bruce; Sezgen, Osman

    2004-03-30

    Data Center facilities, prevalent in many industries and institutions are essential to California's economy. Energy intensive data centers are crucial to California's industries, and many other institutions (such as universities) in the state, and they play an important role in the constantly evolving communications industry. To better understand the impact of the energy requirements and energy efficiency improvement potential in these facilities, the California Energy Commission's PIER Industrial Program initiated this project with two primary focus areas: First, to characterize current data center electricity use; and secondly, to develop a research ''roadmap'' defining and prioritizing possible future public interest research and deployment efforts that would improve energy efficiency. Although there are many opinions concerning the energy intensity of data centers and the aggregate effect on California's electrical power systems, there is very little publicly available information. Through this project, actual energy consumption at its end use was measured in a number of data centers. This benchmark data was documented in case study reports, along with site-specific energy efficiency recommendations. Additionally, other data center energy benchmarks were obtained through synergistic projects, prior PG&E studies, and industry contacts. In total, energy benchmarks for sixteen data centers were obtained. For this project, a broad definition of ''data center'' was adopted which included internet hosting, corporate, institutional, governmental, educational and other miscellaneous data centers. Typically these facilities require specialized infrastructure to provide high quality power and cooling for IT equipment. All of these data center types were considered in the development of an estimate of the total power consumption in California. Finally, a research ''roadmap'' was developed

  7. Clinical Effect of Antioxidant Glasses Containing Extracts of Medicinal Plants in Patients with Dry Eye Disease: A Multi-Center, Prospective, Randomized, Double-Blind, Placebo-Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Won Choi

    Full Text Available To investigate the clinical efficacy and safety of wearable antioxidant glasses containing extracts of medicinal plants in patients with mild dry eye disease (DED.Fifty patients with mild DED were randomly assigned to wear either extracts of antioxidant medicinal plants containing (N = 25 or placebo glasses (N = 25. Patients wore the glasses for 15 min three times daily. The ocular surface disease index (OSDI score, tear film break up time (BUT, and Schirmer's test were evaluated and compared within the group and between the groups at baseline, 4 weeks, and 8 weeks after treatment.OSDI score and tear film BUT were significantly improved in the treatment group at 4 and 8 weeks after wearing glasses (all P < 0.001. Compared to the placebo group, the OSDI scores were significantly lower in the treatment group at 8 weeks (P = 0.007. The results of the Schirmer's test showed significant improvement in the treatment group at 4 weeks (P = 0.035, however there were no significant differences between the other groups or within the groups. No adverse events were reported during the study.Antioxidant glasses containing extracts of medicinal plants were effective in improving in DED both subjectively and objectively. Wearing antioxidants glasses might be a safe and adjunctive therapeutic option for DED.ISRCTN registry 71217488.

  8. User-centered design

    International Nuclear Information System (INIS)

    The simplification philosophy, as an example, that both of EPRI-URD and EUR emphasize is treated mostly for the cost reduction of the nuclear power plants, but not for the simplification of the structure of user's tasks, which is one of the principles of user-centered design. A user-centered design is a philosophy based on the needs and interests of the user, with an emphasis on making products usable and understandable. However, the nuclear power plants offered these days by which the predominant reactor vendors are hardly user-centered but still designer-centered or technology-centered in viewpoint of fulfilling user requirements. The main goal of user-centered design is that user requirements are elicited correctly, reflected properly into the system requirements, and verified thoroughly by the tests. Starting from the user requirements throughout to the final test, each requirement should be traceable. That's why requirement traceability is a key to the user-centered design, and main theme of a requirement management program, which is suggested to be added into EPRI-URD and EUR in the section of Design Process. (author)

  9. Fusion engineering design center

    International Nuclear Information System (INIS)

    In the spring of 1985, the Department of Energy (DOE) directed the Design Center to take a lead responsibility in assessing the engineering feasibility of a very compact tokamak experiment with copper coils. Following this assessment, the Design Center studied the Ignitor concept at the request of DOE and arrived at a design configuration. Many features of this configuration have been incorporated into the national baseline conceptual design for a Compact Ignition Tokamak (CIT). The Design Center continued to participate in the mirror program by contributing to the Minimars design effort, a two-year program to develop and describe an attractive tandem mirror reactor concept. The Design Center's principal role is in configuration definition of the candidate concepts. The Design Center continues to lead the engineering activities for the International Tokamak Reactor program. Advanced commercial tokamaks were studied by the Design Center as part of the Tokamak Power Systems Studies project coordinated by the DOE Office of Fusion Energy. The Design Center also provided design integration of the US effort. A cost accounting system that is applicable to all magnetic fusion reactor design studies was developed and applied to different confinement concepts and types of projects. The system provides the structure for development of a fusion cost database and validated cost estimating procedures

  10. Lens auto-centering

    Science.gov (United States)

    Lamontagne, Frédéric; Desnoyers, Nichola; Doucet, Michel; Côté, Patrice; Gauvin, Jonny; Anctil, Geneviève; Tremblay, Mathieu

    2015-09-01

    In a typical optical system, optical elements usually need to be precisely positioned and aligned to perform the correct optical function. This positioning and alignment involves securing the optical element in a holder or mount. Proper centering of an optical element with respect to the holder is a delicate operation that generally requires tight manufacturing tolerances or active alignment, resulting in costly optical assemblies. To optimize optical performance and minimize manufacturing cost, there is a need for a lens mounting method that could relax manufacturing tolerance, reduce assembly time and provide high centering accuracy. This paper presents a patent pending lens mounting method developed at INO that can be compared to the drop-in technique for its simplicity while providing the level of accuracy close to that achievable with techniques using a centering machine (usually innovative auto-centering method is based on the use of geometrical relationship between the lens diameter, the lens radius of curvature and the thread angle of the retaining ring. The autocentering principle and centering test results performed on real optical assemblies are presented. In addition to the low assembly time, high centering accuracy, and environmental robustness, the INO auto-centering method has the advantage of relaxing lens and barrel bore diameter tolerances as well as lens wedge tolerances. The use of this novel lens mounting method significantly reduces manufacturing and assembly costs for high performance optical systems. Large volume productions would especially benefit from this advancement in precision lens mounting, potentially providing a drastic cost reduction.

  11. Integrating clinical research into clinical decision making

    Directory of Open Access Journals (Sweden)

    Mark R Tonelli

    2011-01-01

    Full Text Available Evidence-based medicine has placed a general priority on knowledge gained from clinical research for clinical decision making. However, knowledge derived from empiric, population-based research, while valued for its ability to limit bias, is not directly applicable to the care of individual patients. The gap between clinical research and individual patient care centers on the fact that empiric research is not generally designed to answer questions of direct relevance to individual patients. Clinicians must utilize other forms of medical knowledge, including pathophysiologic rationale and clinical experience, in order to arrive at the best medical decision for a particular patient. In addition, clinicians must also elucidate and account for the goals and values of individual patients as well as barriers and facilitators of care inherent in the system in which they practice. Evidence-based guidelines and protocols, then, can never be prescriptive. Clinicians must continue to rely on clinical judgment, negotiating potentially conflicting warrants for action, in an effort to arrive at the best decision for a particular patient.

  12. Clinical Growth: An Evolutionary Concept Analysis.

    Science.gov (United States)

    Barkimer, Jessica

    2016-01-01

    Clinical growth is an essential component of nursing education, although challenging to evaluate. Considering the paradigm shift toward constructivism and student-centered learning, clinical growth requires an examination within contemporary practices. A concept analysis of clinical growth in nursing education produced defining attributes, antecedents, and consequences. Attributes included higher-level thinking, socialization, skill development, self-reflection, self-investment, interpersonal communication, and linking theory to practice. Identification of critical attributes allows educators to adapt to student-centered learning in the clinical environment. These findings allow educators to determine significant research questions, develop situation-specific theories, and identify strategies to enhance student learning in the clinical environment. PMID:27490885

  13. The Clinical Application and Role of Telemedicine Consultation in Xinjiang Region-A Single Center Experience with 56,665 Cases%5.6万余例远程医疗咨询临床资料分析

    Institute of Scientific and Technical Information of China (English)

    李勇; 修燕; 温浩

    2015-01-01

    effective medical treatment and of economizing medical materials .In Xinjiang, specialty distribution of telemedicine was in accorded with sequence of both regular disease and severe disease spectrum. The proportion of critical patients among telemedicine system stadily increased and tertiary center transferring rate decreased, which reflected telemedicine becomes as a green channel to diagnose emergent patients and it enhances the abilities of curing people with critical disease. Conclusion:As an energy saving technology, telemedicine becomes Chinese main path way of modern medical communicating which firms the new orders of medical reforming to improve the line of medical system which still needs us to put effort.

  14. Status of center dominance in various center gauges

    OpenAIRE

    Faber, M; Greensite, J.; Olejnik, S.

    2002-01-01

    We review arguments for center dominance in center gauges where vortex locations are correctly identified. We introduce an appealing interpretation of the maximal center gauge, discuss problems with Gribov copies, and a cure to the problems through the direct Laplacian center gauge. We study correlations between direct and indirect Laplacian center gauges.

  15. Center for Contaminated Sediments

    Data.gov (United States)

    Federal Laboratory Consortium — The U.S. Army Corps of Engineers Center for Contaminated Sediments serves as a clearinghouse for technology and expertise concerned with contaminated sediments. The...

  16. HUD Homeownership Centers

    Data.gov (United States)

    Department of Housing and Urban Development — HUD Homeownership Centers (HOCs) insure single family Federal Housing Administration (FHA) mortgages and oversee the selling of HUD homes. FHA has four...

  17. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Chairman Commissioners Contact Information Agency Reports Legislative Affairs Job Opportunities Inspector General Safety Guides Safety Education Centers OnSafety Blog Neighborhood Safety Network Community Outreach ...

  18. National Pesticide Information Center

    Science.gov (United States)

    National Pesticide Information Center npic@ace.orst.edu 1.800.858.7378 Index A B C D E F ... Your Pest Control Your Pest Integrated Pest Management Pesticide Ingredients Active Ingredients Other/Inert Ingredients Pesticide Products ...

  19. ADVANCED DATA CENTER ECONOMY

    OpenAIRE

    Sukhov, R.; Amzarakov, M.; Isaev, E.

    2013-01-01

    The article addresses basic Data Centers (DC) drivers of price and engineering, which specify rules and price evaluation for creation and further operation. DC energy efficiency concept, its influence on DC initial price, operation costs and Total Cost of Ownership.

  20. Center Innovation Fund Program

    Data.gov (United States)

    National Aeronautics and Space Administration — To stimulate and encourage creativity and innovation within the NASA Centers. The activities are envisioned to fall within the scope of NASA Space Technology or...

  1. FEMA Disaster Recovery Centers

    Data.gov (United States)

    Department of Homeland Security — This is a search site for FEMA's Disaster Recovery Centers (DRC). A DRC is a readily accessible facility or mobile office set up by FEMA where applicants may go for...

  2. National Automotive Center - NAC

    Data.gov (United States)

    Federal Laboratory Consortium — Encouraged by the advantages of collaboration, the U.S. Army Tank Automotive Research, Development and Engineering Center (TARDEC) worked with the Secretary of the...

  3. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Safety Network Community Outreach Resource Center CO Poster Contest Toy Recall Statistics Pool Safely Home / Safety Education / ... VIDEO CPSC announces winners of carbon monoxide poster contest View the blog SAFETY GUIDE Clues You Can ...

  4. USU Patient Simulation Center

    Data.gov (United States)

    Federal Laboratory Consortium — he National Capital Area (NCA) Medical Simulation Center is a state-of-the-art training facility located near the main USU campus. It uses simulated patients (i.e.,...

  5. Accredited Birth Centers

    Science.gov (United States)

    ... 717-933-9743 Accredited since January 2016 100 Bright Eyes Midwifery and Wild Rivers Women's Health Accredited ... Birthing Center-Cedar Park Accredited 1130 Cottonwood Creek Trail Building D Suite 2 Cedar Park, TX 78613 ...

  6. Reliability Centered Maintenance - Methodologies

    Science.gov (United States)

    Kammerer, Catherine C.

    2009-01-01

    Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

  7. Advanced Missile Signature Center

    Data.gov (United States)

    Federal Laboratory Consortium — The Advanced Missile Signature Center (AMSC) is a national facility supporting the Missile Defense Agency (MDA) and other DoD programs and customers with analysis,...

  8. CNPC International Research Center

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ CNPC International Research Center (CNPCIRC), jointly managed by CNODC and RIPED of China National Petroleum Corporation (CNPC), was established in 1999 for providing technical research support to all the overseas oil and gas projects of CNPC.

  9. Health Center Controlled Network

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Health Center Controlled Network (HCCN) tool is a locator tool designed to make data and information concerning HCCN resources more easily available to our...

  10. Poison Control Centers

    Science.gov (United States)

    ... King St., Suite 510 Alexandria, VA 22314 Online http://www.aapcc.org/ Email not for emergency use. ... Poison Center" in the memo line. Donate online: http://bit.ly/1HDxdHb Tucson, AZ 85721 Online http:// ...

  11. Hazardous Waste Research Center

    Data.gov (United States)

    Federal Laboratory Consortium — A full-service research and evaluation center equipped with safety equipment, a high-bay pilot studies area, and a large-scale pilot studies facility The U.S. Army...

  12. World Trade Center

    Index Scriptorium Estoniae

    2006-01-01

    Esilinastus katastroofifilm "World Trade Center" : stsenarist Andrea Berloff : režissöör Oliver Stone : kunstnik Jan Roelfs : osades Nicholas Cage, Michael Pena, Stephen Dorff jpt : Ameerika Ühendriigid 2006. Ka filmi prototüüpidest

  13. Cooperative Tagging Center (CTC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Cooperative Tagging Center (CTC) began as the Cooperative Game Fish Tagging Program (GTP) at Woods Hole Oceanographic Institute (WHOI) in 1954. The GTP was...

  14. Clinical and Biochemical Data of Adult Thalassemia Major patients (TM) with Multiple Endocrine Complications (MEC) versus TM Patients with Normal Endocrine Functions: A long-term Retrospective Study (40 years) in a Tertiary Care Center in Italy

    Science.gov (United States)

    De Sanctis, Vincenzo; Elsedfy, Heba; Soliman, Ashraf T.; Elhakim, Ihab Zaki; Kattamis, Christos; Soliman, Nada A.; Elalaily, Rania

    2016-01-01

    Introduction It is well known that the older generation of adult TM patients has a higher incidence of morbidities and co-morbidities. At present, little information is available on adult TM patients with multiple endocrine complications (MEC). The main objectives of this longitudinal retrospective survey were: 1) to establish the incidence and progression of MEC (3 or more) in TM patients; 2) to compare the clinical, laboratory and imaging data to a sex and age-matched group of TM patients without MEC; 3) to assess the influence of iron overload represented by serum ferritin (peak and mean annual value at the last endocrine observation). Patients and methods The study was started in January 1974 and was completed by the same physician at the end of December 2015. The registry database of the regularly followed TM patients from diagnosis included 145 adults (> 18 years). All TM patients were of Italian ethnic origin. Eleven out of 145 patients (7.5 %) developed MEC. Twenty-four other patients (12 females and 12 males) had a normal endocrine function (16.5 %) and served as controls. Results In our survey, four important, relevant aspects emerged in the MEC group. These included the late age at the start of chelation therapy with desferrioxamine mesylate (DFO); the higher serum ferritin peak (8521.8 ± 5958.9 vs 3575.2 ± 1801.4 ng/ml); the upper proportion of splenectomized (81.8 % vs. 28.5%) patients and poor compliance registered mainly during the peripubertal and pubertal age (72.7 % vs.16.6 %) in TM patients developing MEC versus those without endocrine complications. Furthermore, a negative correlation was observed in all TM patients between LIC and final height (r: −0.424; p = 0.031). Conclusions Our study supports the view that simultaneous involvement of more than one endocrine gland is not uncommon (7.5 %). It mainly occurred in TM patients who started chelation therapy with DFO late in life and who had irregular/poor compliance to treatment. Therefore

  15. CLINICAL AND BIOCHEMICAL DATA OF ADULT THALASSEMIA MAJOR PATIENTS (TM WITH MULTIPLE ENDOCRINE COMPLICATIONS (MEC VERSUS TM PATIENTS WITH NORMAL ENDOCRINE FUNCTIONS: A RETROSPECTIVE LONG-TERM STUDY (40 YEARS IN A TERTIARY CARE CENTER IN ITALY

    Directory of Open Access Journals (Sweden)

    Vincenzo De Sanctis

    2016-04-01

    Full Text Available Abstract. Introduction: It is well known that the older generation of adult TM patients has a higher incidence of morbidities and co-morbidities. At present, little information is available on adult TM patients with multiple endocrine complications (MEC. The main objectives of this longitudinal retrospective survey were: 1 to establish the incidence and progression of MEC (3 or more in TM patients; 2 to compare the clinical, laboratory and imaging data to a sex and age-matched group of TM patients without MEC; 3 to assess the influence of iron overload represented by serum ferritin (peak and mean annual value at the last endocrine observation. Patients and Methods: The study was started in January 1974 and was completed by the same physician at the end of December 2015. The registry database of the regularly followed TM patients from diagnosis included 145 adults (> 18 years. All TM patients were of Italian ethnic origin. Eleven out of 145 patients (7.5 % developed MEC. Twenty-four other patients (12 females and 12 males had a normal endocrine function (16.5 % and served as controls. Results: In our survey, four important, relevant aspects emerged in the MEC group. These included the late age at the start of chelation therapy with desferrioxamine mesylate (DFO; the higher serum ferritin peak (8521.8 ± 5958.9 vs 3575.2± 1801.4 ng/ml ; the higher percentage of splenectomized (81.8 % vs. 28.5% patients and poor compliance registered mainly during the peripubertal and pubertal age (72.7 % vs.16.6 % in TM patients developing MEC versus those without endocrine complications. Furthermore, a negative correlation was observed in all TM patients between LIC and final height (r: -0.424; p= 0.031. Conclusions: Our study supports the view that simultaneous involvement of more than one endocrine gland is not uncommon (7.5 %. It mainly occurred in TM patients who started chelation therapy with DFO late in life and who had irregular/poor compliance to

  16. A comparison of field-only electronic portal imaging hard copies with double exposure port films in radiation therapy treatment setup confirmation to determine its clinical application in a radiotherapy center

    International Nuclear Information System (INIS)

    Purpose: To determine in which treatment sites field-only hard copy electronic portal images (EPI) captured during a treatment exposure could replace traditional double exposed port films in a busy radiation oncology department. Methods and Materials: The three linear accelerators in the William Buckland Radiotherapy Centre (WBRC) at the Alfred Hospital in Melbourne are each equipped with an electronic portal imaging device (EPID). These devices can be used daily on all patients where the treatment fields are within the size constraint of the cassette, for example, less than 25 x 25 cm. Port films using radiographic film in hard cassettes were previously considered the standard method of field placement verification. After the radiation therapists were trained in all program aspects of capturing, enhancing, and producing hard copies of EPIs, a study was developed to evaluate the possibility of replacing port films with EPI hard copies within the established departmental procedures. Comparison of EPI hard copy with the simulator film and the port film of the same field was carried out by the radiation oncologist specialists. Seventy-eight comparison sets were generated and grouped into seven anatomical regions for evaluation by the radiation oncologist specialist responsible for each particular region. The outcome decision was the preferred imaging option. Where no preference was stated, EPI became the modality of choice, as it increased the efficiency of work practice. Results: The results indicate that field-only EPI can be considered to be at least as clinically useful for treatment verification in the following sites: breast, chest, hip, spine, and large pelvic fields. Port films using a standard, double exposure technique were considered necessary for partial brain fields, small pelvis fields, extremities, and radical head and neck fields. Conclusion: The quality of field-only images captured using an EPID has been favorably assessed to be equivalent to, or an

  17. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Moo; Hong, Song W.; Choi, Chang W.; Yang, Seong Dae [Korea Cancer Center Hospital, Seoul (Korea)

    1997-12-01

    PET gives various methabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 250 cases of PET images were obtained, which resulted total income of 180,000,000 won. 50,000,000 won was deposited for the 1998 PET clinical research. Second year PET clinical research should be managed under unified project. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18}FDG in a day purchase of HPLC pump and {sup 68}Ga pin source which was delayed due to economic crisis, should be done early in 1998. (author). 2 figs., 3 tabs.

  18. The Galactic Center

    OpenAIRE

    R. Genzel; Karas, V.

    2007-01-01

    In the past decade high resolution measurements in the infrared employing adaptive optics imaging on 10m telescopes have allowed determining the three dimensional orbits stars within ten light hours of the compact radio source at the center of the Milky Way. These observations show the presence of a three million solar mass black hole in Sagittarius A* beyond any reasonable doubt. The Galactic Center thus constitutes the best astrophysical evidence for the existence of black holes which have ...

  19. Oil Reserve Center Established

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Like other countries,China has started to grow its strategic oil reserve in case oil supplies are cut On December 18,2007,the National Development and Reform Commission(NDRC),China’s top economic planner,announced that the national oil reserve center has been officially launched.The supervisory system over the oil reserves has three levels: the energy department of the NDRC,the oil reserve center,and the reserve bases.

  20. Clinical Trials

    Science.gov (United States)

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  1. 脑蛋白水解物联合九味镇心颗粒治疗儿童多动症的临床疗效及安全性观察%Clinical efficacy and safety of treatment of children with ADHD brain proteinhydrolyzate joint Jiuwei town center particles

    Institute of Scientific and Technical Information of China (English)

    罗斌; 庞红艳; 蒋清秀; 刘兴兰

    2015-01-01

    Objective To explore the joint brain protein hydrolyzate Jiuwei town center particles ADHD treatment efficacy and safety.Methods 90 cases were selected from March 2013 to March 2014 to participate in a medical examination at the hospital and diagnosed with ADHD as children of school-age children as research subjects.According to a random number table method,45 cases were randomly divided into observation group and control group 45 cases.Observed among children with brain protein hydrolyzate group taking combined oral granules Jiuwei town center for treatment,nine of the control group were taken to the town center particles taste treat.Comparison of the clinical efficacy of two groups of children after treatment,ADHD index and incidence of adverse reactions.Results After treatment,the clinical efficacy of two groups of children,including markedly,valid and invalid comparison cases are statistically significant differences (P<0.05).Treatment of children in the observation group was significantly higher total efficiency (P<0.05).Hyperactivity in children with index scores were observed after treatment hyperactivity index score decreased significantly,and the decline is greater than in the control group of children with hyperactivity index score (P<0.05).Conclusion Brain protein hydrolyzate joint Jiuwei town center particle treatment of children with ADHD significant clinical effect,can effectively improve concentration in children,children with sensitive emotions ease;while mild side effects,with some security,it is worth promoting.%目的 探究脑蛋白水解物联合九味镇心颗粒治疗儿童多动症的临床疗效及安全性.方法 选取2013年3月至2014年3月于我院参与体检并确诊为儿童多动症的90例学龄期患儿作为研究对象.按照随机数表法随机分为观察组45例和对照组45例.其中观察组患儿采取脑蛋白水解物口服液联合九味镇心颗粒进行治疗,对照组单纯采取九味镇心颗粒进行治

  2. Reinventing the academic health center.

    Science.gov (United States)

    Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D

    2005-11-01

    Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives. PMID:16249294

  3. Construction of ethics in clinical research: clinical trials registration

    Directory of Open Access Journals (Sweden)

    C. A. Caramori

    2007-01-01

    Full Text Available Scientific development that has been achieved through decades finds in clinical research a great possibility of translating findings to human health application. Evidence given by clinical trials allows everyone to have access to the best health services. However, the millionaire world of pharmaceutical industries has stained clinical research with doubt and improbability. Study results (fruits of controlled clinical trials and scientific publications (selective, manipulated and with wrong conclusions led to an inappropriate clinical practice, favoring the involved economic aspect. In 2005, the International Committee of Medical Journal Editors (ICMJE, supported by the World Association of Medical Editors, started demanding as a requisite for publication that all clinical trials be registered at the database ClinicalTrials.gov. In 2006, the World Health Organization (WHO created the International Clinical Trial Registry Platform (ICTRP, which gathers several registry centers from all over the world, and required that all researchers and pharmaceutical industries register clinical trials. Such obligatory registration has progressed and will extend to all scientific journals indexed in all worldwide databases. Registration of clinical trials means another step of clinical research towards transparency, ethics and impartiality, resulting in real evidence to the forthcoming changes in clinical practice as well as in the health situation.

  4. UCSF Center for HIV Information

    Science.gov (United States)

    ... Program For providers and patients VA National Viral Hepatitis Program For providers and patients TARGET Center Technical assistance tools for the Ryan White Community AETC National Resource Center Education and training for clinicians UCSF-Gladstone Center for ...

  5. Clinical Research and Clinical Trials

    Science.gov (United States)

    ... Meetings, Conferences & Events Partnering & Donating to the NICHD Staff Directory ... Clinical Research Skip sharing on social media links Share this: Page Content Clinical research is research that directly involves a ...

  6. Virginia Tech Center for Autism Research - Susan White perspective

    OpenAIRE

    White, Susan

    2012-01-01

    Highlights of the autism research of Susan White, Psychology professor and the co-director of the VT Autism clinic, are explained. Topics include anxiety, treatment development, ASD in adults, and biomarker pursuit. Fit of research of the clinic to the Center for Autism Research is explained, with potential for leadership in technology applications, environmental considerations, and interdisciplinary work.

  7. Patient-centered Care.

    Science.gov (United States)

    Reynolds, April

    2009-01-01

    Patient-centered care focuses on the patient and the individual's particular health care needs. The goal of patient-centered health care is to empower patients to become active participants in their care. This requires that physicians, radiologic technologists and other health care providers develop good communication skills and address patient needs effectively. Patient-centered care also requires that the health care provider become a patient advocate and strive to provide care that not only is effective but also safe. For radiologic technologists, patient-centered care encompasses principles such as the as low as reasonably achievable (ALARA) concept and contrast media safety. Patient-centered care is associated with a higher rate of patient satisfaction, adherence to suggested lifestyle changes and prescribed treatment, better outcomes and more cost-effective care. This article is a Directed Reading. Your access to Directed Reading quizzes for continuing education credit is determined by your area of interest. For access to other quizzes, go to www.asrt.org/store. According to one theory, most patients judge the quality of their healthcare much like they rate an airplane flight. They assume that the airplane is technically viable and is being piloted by competent people. Criteria for judging a particular airline are personal and include aspects like comfort, friendly service and on-time schedules. Similarly, patients judge the standard of their healthcare on nontechnical aspects, such as a healthcare practitioner's communication and "soft skills." Most are unable to evaluate a practitioner's level of technical skill or training, so the qualities they can assess become of the utmost importance in satisfying patients and providing patient-centered care.(1). PMID:19901351

  8. 42 CFR 482.80 - Condition of participation: Data submission, clinical experience, and outcome requirements for...

    Science.gov (United States)

    2010-10-01

    ...) Standard: Clinical experience. To be considered for initial approval, an organ-specific transplant center..., clinical experience, and outcome requirements for initial approval of transplant centers. 482.80 Section... Hospitals Transplant Center Data Submission, Clinical Experience, and Outcome Requirements §...

  9. Center for Botanical Interaction Studies

    Data.gov (United States)

    Federal Laboratory Consortium — Research Area: Dietary Supplements, Herbs, Antioxidants Program:Centers for Dietary Supplements Research: Botanicals Description:This center will look at safety and...

  10. Xichang Satellite Launch Center

    Institute of Scientific and Technical Information of China (English)

    LiuJie

    2004-01-01

    Xichang Satellite Launch Center(XSLC) is mainly for geosynchronous orbit launches. The main purpose of XSLC is to launch spacecraft, such as broadcasting,communications and meteorological satellites, into geo-stationary orbit.Most of the commercial satellite launches of Long March vehicles have been from Xichang Satellite Launch Center. With 20 years' development,XSLC can launch 5 kinds of launch vehicles and send satellites into geostationary orbit and polar orbit. In the future, moon exploration satellites will also be launched from XSLC.

  11. User Centered Design

    DEFF Research Database (Denmark)

    Egbert, Maria; Matthews, Ben

    The interdisciplinary approach of User Centered Design is presented here with a focus on innovation in the design and use of hearing technologies as well as on the potential of innovation in interaction. This approach is geared towards developing new products, systems, technologies and practices...... based on an understanding of why so few persons with hearing loss use the highly advanced hearing technologies. In integrating Conversation Analysis (“CA”), audiology and User Centered Design, three disciplines which are collaborating together for the first time, we are addressing the following...

  12. Sociodemographic and clinical characteristics of a diabetic population at a primary level health care center Características sociodemográficas y clínicas de una población diabética en el nivel primario de atención a la salud Características sociodemográficas e clínicas de portadores de diabetes em um serviço de atenção básica à saúde

    OpenAIRE

    Liudmila Miyar Otero; Maria Lúcia Zanetti; Carla Regina de Souza Teixeira

    2007-01-01

    This study aimed to analyze the social-demographic, clinical and life habits characteristics of a diabetic population being treated in the primary level of a healthcare center. A total of 52 diabetic patients, enrolled, in 2006, in a Research and Extension Center linked to a University in Sao Paulo, participated in the study. The data were collected through interviews, using appropriated forms, after the patients consent. The results showed other illness associated to diabetes and an unsatisf...

  13. Mammascintigraphy: fundamentals, protocols, clinical application

    International Nuclear Information System (INIS)

    Radiopharmaceuticals, methods and results of clinical application of mammascintigraphy are reviewed. The main advantage of mammascintigraphy is its higher (at least 90%) specificity in comparison with X-ray mammography, possibility of using it in patients with X-ray dense gland, predicting cancer metastases and follow-up of tumor regression during chemotherapy. Mammascintigraphy is an effective reliable method of accurate diagnosis of breast cancer, which should be introduced in clinical practice of Russian breast cancer control centers as soon as possible

  14. Economics of data center optics

    Science.gov (United States)

    Huff, Lisa

    2016-03-01

    Traffic to and from data centers is now reaching Zettabytes/year. Even the smallest of businesses now rely on data centers for revenue generation. And, the largest data centers today are orders of magnitude larger than the supercomputing centers of a few years ago. Until quite recently, for most data center managers, optical data centers were nice to dream about, but not really essential. Today, the all-optical data center - perhaps even an all-single mode fiber (SMF) data center is something that even managers of medium-sized data centers should be considering. Economical transceivers are the key to increased adoption of data center optics. An analysis of current and near future data center optics economics will be discussed in this paper.

  15. 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...

  16. Three Media Center Solutions.

    Science.gov (United States)

    Jadwin, Peggy

    1996-01-01

    An Illinois school district's multiyear, comprehensive plan requires the renovation of each school to accommodate state-of-the-art and future audiovisual and computer technology. A major part of each renovation is the school's media center. Five of the district's 13 schools have been renovated, with remaining schools set to be upgraded in phases…

  17. Starting a sleep center.

    Science.gov (United States)

    Epstein, Lawrence J; Valentine, Paul S

    2010-05-01

    The demand for sleep medicine services has grown tremendously during the last decade and will likely continue. To date, growth in demand has been met by growth in the number of new sleep centers. The need for more new centers will be dependent on market drivers that include increasing regulatory requirements, personnel shortages, integration of home sleep testing, changes in reimbursement, a shift in emphasis from diagnostics to treatment, and an increased consumer focus on sleep. The decision to open a new center should be based on understanding the market dynamics, completing a market analysis, and developing a business plan. The business plan should include an overview of the facility, a personnel and organizational structure, an evaluation of the business environment, a financial plan, a description of services provided, and a strategy for obtaining, managing, and extending a referral base. Implementation of the business plan and successful operation require ongoing planning and monitoring of operational parameters. The need for new sleep centers will likely continue, but the shifting market dynamics indicate a greater need for understanding the marketplace and careful planning. PMID:20442123

  18. vCenter troubleshooting

    CERN Document Server

    Mills, Chuck

    2015-01-01

    The book is designed for the competent vCenter administrator or anyone who is responsible for the vSphere environment. It can be used as a guide by vSphere architects and VMware consultants for a successful vSphere solution. You should have good knowledge and an understanding of core elements and applications of the vSphere environment.

  19. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... Flickr SlideShare All Pages & Documents Recalls & News Releases Home Recalls CPSC Recall API Recall Lawsuits Recalls by ... CO Poster Contest Toy Recall Statistics Pool Safely Home / Safety Education / Safety Education Centers En Español Carbon ...

  20. DISABILITY STATISTICS CENTER

    Science.gov (United States)

    The purpose of the Disability Statistics Center is to produce and disseminate statistical information on disability and the status of people with disabilities in American society and to establish and monitor indicators of how conditions are changing over time to meet their health...

  1. Carolinas Energy Career Center

    Energy Technology Data Exchange (ETDEWEB)

    Classens, Anver; Hooper, Dick; Johnson, Bruce

    2013-03-31

    Central Piedmont Community College (CPCC), located in Charlotte, North Carolina, established the Carolinas Energy Career Center (Center) - a comprehensive training entity to meet the dynamic needs of the Charlotte region's energy workforce. The Center provides training for high-demand careers in both conventional energy (fossil) and renewable energy (nuclear and solar technologies/energy efficiency). CPCC completed four tasks that will position the Center as a leading resource for energy career training in the Southeast: • Development and Pilot of a New Advanced Welding Curriculum, • Program Enhancement of Non-Destructive Examination (NDE) Technology, • Student Support through implementation of a model targeted toward Energy and STEM Careers to support student learning, • Project Management and Reporting. As a result of DOE funding support, CPCC achieved the following outcomes: • Increased capacity to serve and train students in emerging energy industry careers; • Developed new courses and curricula to support emerging energy industry careers; • Established new training/laboratory resources; • Generated a pool of highly qualified, technically skilled workers to support the growing energy industry sector.

  2. Carbon Monoxide Information Center

    Medline Plus

    Full Text Available ... an Unsafe Product Consumers Businesses Contact CPSC Website Design Feedback Consumers: Español Businesses: Español , 中文 , Tiếng Việt ... Chairman Commissioners Contact Information Agency Reports Legislative Affairs Job Opportunities Inspector General Safety Guides Safety Education Centers ...

  3. Precision Joining Center

    Energy Technology Data Exchange (ETDEWEB)

    Powell, J.W.; Westphal, D.A.

    1991-08-01

    A workshop to obtain input from industry on the establishment of the Precision Joining Center (PJC) was held on July 10--12, 1991. The PJC is a center for training Joining Technologists in advanced joining techniques and concepts in order to promote the competitiveness of US industry. The center will be established as part of the DOE Defense Programs Technology Commercialization Initiative, and operated by EG G Rocky Flats in cooperation with the American Welding Society and the Colorado School of Mines Center for Welding and Joining Research. The overall objectives of the workshop were to validate the need for a Joining Technologists to fill the gap between the welding operator and the welding engineer, and to assure that the PJC will train individuals to satisfy that need. The consensus of the workshop participants was that the Joining Technologist is a necessary position in industry, and is currently used, with some variation, by many companies. It was agreed that the PJC core curriculum, as presented, would produce a Joining Technologist of value to industries that use precision joining techniques. The advantage of the PJC would be to train the Joining Technologist much more quickly and more completely. The proposed emphasis of the PJC curriculum on equipment intensive and hands-on training was judged to be essential.

  4. INTERMOUNTAIN INDUSTRIAL ASSESSMENT CENTER

    Energy Technology Data Exchange (ETDEWEB)

    MELINDA KRAHENBUHL

    2010-05-28

    The U. S. Department of Energy’s Intermountain Industrial Assessment Center (IIAC) at the University of Utah has been providing eligible small- and medium-sized manufacturers with no-cost plant assessments since 2001, offering cost-effective recommendations for improvements in the areas of energy efficiency, pollution prevention, and productivity improvement.

  5. The Rural Information Center.

    Science.gov (United States)

    John, Patricia La Caille

    1989-01-01

    Describes the events that led to the creation of the Rural Information Center (RIC), a joint venture between the Extension Service and the National Agricultural Library to provide information to government officials involved in rural development. The databases accessed by RIC are described, and plans for a gateway system and network of all…

  6. Vocabulary at the Center

    Science.gov (United States)

    Benjamin, Amy; Crow, John T.

    2009-01-01

    In "Vocabulary at the Center," Amy Benjamin and John T. Crow identify the most effective methods for extending the use of new words--in every grade level and across all subjects. This book shows teachers how to use context-driven exercises to incorporate new words into other areas of study. This book contains information about the authors, an…

  7. 76 FR 39879 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2011-07-07

    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory... to the standards under which clinical laboratories are regulated; the impact on medical and laboratory practice of proposed revisions to the standards; and the modification of the standards...

  8. 75 FR 39028 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

    Science.gov (United States)

    2010-07-07

    ... HUMAN SERVICES Centers for Disease Control and Prevention Clinical Laboratory Improvement Advisory... standards under which clinical laboratories are regulated; the impact on medical and laboratory practice of... laboratory information; and consideration of proposals from the CLIAC proficiency testing workgroup....

  9. Ebola outbreak in Conakry, Guinea: Epidemiological, clinical, and outcome features

    OpenAIRE

    Barry, M; Traoré, F A; Sako, F B; Kpamy, D O; Bah, E I; Poncin, M; S. Keita; Cisse, M; Touré, A.

    2014-01-01

    The authors studied the epidemiological, clinical, and outcome features of the Ebola virus disease in patients hospitalized at the Ebola treatment center (ETC) in Conakry to identify clinical factors associated with death.

  10. Costs and Clinical Quality Among Medicare Beneficiaries..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors of Costs and Clinical Quality Among Medicare Beneficiaries - Associations with Health Center Penetration of Low-Income Residents, published in Volume 4,...

  11. American Overseas Research Centers Program

    Science.gov (United States)

    Office of Postsecondary Education, US Department of Education, 2012

    2012-01-01

    The American Overseas Research Centers Program provides grants to overseas research centers that are consortia of U.S. institutions of higher education to enable the centers to promote postgraduate research, exchanges, and area studies. Eligible applicants are those consortia of U.S. institutions of higher education centers that: (1) Receive more…

  12. Frecuencia de virus respiratorios y características clínicas de niños que acuden a un hospital en México Frequency of respiratory viruses and clinical characteristics in children attending a care center in Mexico City

    Directory of Open Access Journals (Sweden)

    Rosa María Wong-Chew

    2010-12-01

    Full Text Available OBJETIVO. Describir la frecuencia de virus respiratorios y características clínicas en niños con cuadros respiratorios de un hospital de tercer nivel en México. MATERIAL Y MÉTODOS. Se incluyeron niños con diagnóstico de infección respiratoria y un resultado positivo por inmunofluorescencia de enero 2004 a octubre 2006. RESULTADOS. De 986 muestras nasofaríngeas, 138 (14% fueron positivas. La frecuencia fue: 80% virus sincicial respiratorio (VSR, 8% parainfluenza 1, 5% parainfluenza3, 2% adenovirus, 2% influenza A, 1% parainfluenza 2 y 1% influenza B. CONCLUSIONES. La frecuencia de virus respiratorios fue de 14%. El VSR se identificó asociado con más frecuencia, a neumonía y bronquiolitis en menores de 3 años.OBJECTIVE. To describe the frequency of respiratory viruses and clinical characteristics in children with respiratory signs and symptoms in a tertiary care center in Mexico. MATERIAL AND METHODS. Patients with a clinical diagnosis of respiratory infection and a positive immunofluorescence result (Light Diagnostics from January 2004 to October 2006 were included. RESULTS. From the 986 nashopharyngeal samples, 138 (14% were positive by immunofluorescence. The frequency was: 80% RSV, 8% parainfluenza 1, 5% parainfluenza 3, 2% adenovirus, 2% influenza A, 1% parainfluenza 2 and 1% influenza B. CONCLUSIONS. Respiratory viruses were detected in 14% of samples tested. RSV was the most frequently identified virus and was associated with pneumonia and bronchiolitis in children younger than 3 years old.

  13. Application Center 2000

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ 在NET Enterprise Servers中,Application Center 2000扮演着企业管理电子商务分布式应用程序的重要角色.ApplicationCenter 2000是可以建立在Windows 2000上的网站应用程序,能够有效率地管理、降低企业成本.它也是一个向外拓展的技术,且通过丛集服务(Cluster Service),可随需求增加其扩展性与可用性,以此降低随之而来的高成本和管理方式,以及提供配置(Deploy)丛集服务器的能力.

  14. Implicit Human Centered Tagging

    OpenAIRE

    Pantic, Maja; Vinciarelli, Alessandro

    2009-01-01

    Tagging is the annotation of multimedia data with userspecified keywords known as tags, with the aim of facilitating fast and accurate data retrieval based on these tags. In contrast to this process, also referred to as explicit tagging, implicit human-centered tagging (IHCT) refers to exploiting the information on user's nonverbal reactions (e.g., facial expressions like smiles or head gestures like shakes) to multimedia data, with which he or she interacts, to assign new or improve the exis...

  15. 4 Exhibition Centers

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    China's convention and exhibition industry has grown rapidly in recent years, with some of the nation's key cities becoming hubs of internationally renowned expositions, spurred by the construction of new exhibition centers.In 2003, a total of 3,298 conventions and exhibitions were held in China, up from 3,075 in the previous year. The number is estimated to have hit 4,000 in 2004.

  16. Equestrian Competition Center

    OpenAIRE

    Canedy, Nicholas P

    2008-01-01

    This thesis explores the possibilities of using varied long span glue-laminated arches to create a dynamic structural enclosure over an expansive open surface. It investigates using arches that increase and decrease in height and span width, while varying in their lean. When combined with a fabric enclosure, they create a roof that constantly changes. The idea is to create a world class equestrian center that is visually exciting from both the interior and exterior, rather than...

  17. COMPUTATIONAL SCIENCE CENTER

    Energy Technology Data Exchange (ETDEWEB)

    DAVENPORT,J.

    2004-11-01

    The Brookhaven Computational Science Center brings together researchers in biology, chemistry, physics, and medicine with applied mathematicians and computer scientists to exploit the remarkable opportunities for scientific discovery which have been enabled by modern computers. These opportunities are especially great in computational biology and nanoscience, but extend throughout science and technology and include for example, nuclear and high energy physics, astrophysics, materials and chemical science, sustainable energy, environment, and homeland security.

  18. Using a computerized patient record to reengineer an outpatient clinic.

    OpenAIRE

    Borowitz, S M

    1994-01-01

    By employing process flow analysis and work redesign techniques during the design and implementation of a computerized patient record in the pediatric outpatient clinics at the University of Virginia Health Sciences Center, we have developed a database of clinical observations while simultaneously shortening the time that patients spend waiting in the pediatric clinics and decreasing the number of support staff employed within the clinics.

  19. Perfil clínico-epidemiológico dos pacientes diagnosticados com hanseníase em um centro de referência na região nordeste do Brasil Clinical and epidemiological profile of patients diagnosed with leprosy in a reference center in the notheast of Brazil

    Directory of Open Access Journals (Sweden)

    Cícero Cláudio Dias Gomes

    2005-12-01

    Full Text Available FUNDAMENTOS: A hanseníase permanece sério problema de saúde pública mundial. O conhecimento das características epidemiológicas da doença é importante ferramenta para o controle da endemia. OBJETIVO: Descrever as características clínicas e epidemiológicas dos pacientes diagnosticados com hanseníase no ano de 2004 em um centro de referência da Região Nordeste do Brasil. MÉTODO: Foram avaliados prontuários de pacientes que deram entrada no registro ativo do Centro de Dermatologia Dona Libânia, em Fortaleza, Ceará, no período de janeiro a dezembro de 2004. RESULTADOS: dos 967 casos que deram entrada nesse Centro naquele ano, 909 foram casos novos. Cerca de 7,7% eram pacientes entre zero e 14 anos de idade, e a distribuição por gênero foi de 483 (49,95% homens e 484 (50,05% mulheres. A maioria apresentava a forma clínica dimorfa (54,6%, sendo 82,2% dos pacientes provenientes de Fortaleza, CE. Foi realizada a avaliação do grau de incapacidades no diagnóstico em 94,2% dos pacientes, com 21,7% apresentando grau diferente de zero no diagnóstico. CONCLUSÃO: Com base nos resultados obtidos, constatou-se a presença de elevado percentual (7,7% de casos detectados em menores de 15 anos, associado a baixo percentual (5,8% de pacientes diagnosticados na forma indeterminada e elevado percentual (21,7% de casos com incapacidade ao diagnóstico.BACKGROUND: Leprosy continues to represent a serious public health problem worldwide. Knowledge of epidemiological characteristics of the disease is an important tool for the endemy control. OBJECTIVES: To describe the clinical and epidemiological characteristics of patients diagnosed with leprosy during 2004, in a Reference Center in the Northeast of Brazil. METHODS: We analyzed the records referring to patients who entered de active register of the Center of Dermatology Dona Libânia, in Fortaleza, Ceará, from January to december 2004. RESULTS: Out of 967 cases that entered this Center in

  20. Clinical Research

    DEFF Research Database (Denmark)

    Christensen, Irene

    2016-01-01

    This paper is about the logic of problem solving and the production of scientific knowledge through the utilisation of clinical research perspective. Ramp-up effectiveness, productivity, efficiency and organizational excellence are topics that continue to engage research and will continue doing so...... for years to come. This paper seeks to provide insights into ramp-up management studies through providing an agenda for conducting collaborative clinical research and extend this area by proposing how clinical research could be designed and executed in the Ramp- up management setting....

  1. Solar Technology Center

    Energy Technology Data Exchange (ETDEWEB)

    Boehm, Bob

    2011-04-27

    The Department of Energy, Golden Field Office, awarded a grant to the UNLV Research Foundation (UNLVRF) on August 1, 2005 to develop a solar and renewable energy information center. The Solar Technology Center (STC) is to be developed in two phases, with Phase I consisting of all activities necessary to determine feasibility of the project, including design and engineering, identification of land access issues and permitting necessary to determine project viability without permanently disturbing the project site, and completion of a National Environmental Policy Act (NEPA) Environmental Assessment. Phase II is the installation of infrastructure and related structures, which leads to commencement of operations of the STC. The STC is located in the Boulder City designated 3,000-acre Eldorado Valley Energy Zone, approximately 15 miles southwest of downtown Boulder City and fronting on Eldorado Valley Drive. The 33-acre vacant parcel has been leased to the Nevada Test Site Development Corporation (NTSDC) by Boulder City to accommodate a planned facility that will be synergistic with present and planned energy projects in the Zone. The parcel will be developed by the UNLVRF. The NTSDC is the economic development arm of the UNLVRF. UNLVRF will be the entity responsible for overseeing the lease and the development project to assure compliance with the lease stipulations established by Boulder City. The STC will be operated and maintained by University of Nevada, Las Vegas (UNLV) and its Center for Energy Research (UNLV-CER). Land parcels in the Eldorado Valley Energy Zone near the 33-acre lease are committed to the construction and operation of an electrical grid connected solar energy production facility. Other projects supporting renewable and solar technologies have been developed within the energy zone, with several more developments in the horizon.

  2. Financing a Simulation Center.

    Science.gov (United States)

    Tsuda, Shawn; Mohsin, Adnan; Jones, Daniel

    2015-08-01

    As simulation-based training has become established within medical and health professional disciplines, skills training laboratories have become a standard in surgery training programs. In 2008, the American College of Surgeons and Association of Program Directors in Surgery developed a simulation-based surgical skills curriculum; the Residency Review Committee for Surgery of the Accreditation Council for Graduate Medical Education mandated access to skills laboratories for all surgery programs. Establishing a surgical skills laboratory and adapting the training curriculum requires a significant amount of resources. This article discusses the financial aspects of establishing a training center, from funding opportunities to budgeting considerations. PMID:26210971

  3. The MAGIC Data Center

    OpenAIRE

    Reichardt, Ignasi; Rico, Javier; Carmona, Emiliano; Contreras, Jose Luis; Cortina, Juan; Firpo, Roger; Font, Lluis; Moralejo, Abelardo; Nieto, Daniel; Oya, Igor; Reyes, Raquel de los

    2009-01-01

    The MAGIC I telescope produces currently around 100TByte of raw data per year that is calibrated and reduced on-site at the Observatorio del Roque de los Muchachos (La Palma). Since February 2007 most of the data have been stored and further processed in the Port d'Informacio Cientifica (PIC), Barcelona. This facility, which supports the GRID Tier 1 center for LHC in Spain, provides resources to give the entire MAGIC Collaboration access to the reduced telescope data. It is expected that the ...

  4. COMPUTATIONAL SCIENCE CENTER

    Energy Technology Data Exchange (ETDEWEB)

    DAVENPORT, J.

    2005-11-01

    The Brookhaven Computational Science Center brings together researchers in biology, chemistry, physics, and medicine with applied mathematicians and computer scientists to exploit the remarkable opportunities for scientific discovery which have been enabled by modern computers. These opportunities are especially great in computational biology and nanoscience, but extend throughout science and technology and include, for example, nuclear and high energy physics, astrophysics, materials and chemical science, sustainable energy, environment, and homeland security. To achieve our goals we have established a close alliance with applied mathematicians and computer scientists at Stony Brook and Columbia Universities.

  5. The Ontology of Clinical Research (OCRe): An Informatics Foundation for the Science of Clinical Research

    OpenAIRE

    Sim, Ida; Tu, Samson W.; Carini, Simona; Lehmann, Harold P.; Pollock, Brad H.; Peleg, Mor; Wittkowski, Knut M.

    2013-01-01

    To date, the scientific process for generating, interpreting, and applying knowledge has received less informatics attention than operational processes for conducting clinical studies. The activities of these scientific processes — the science of clinical research — are centered on the study protocol, which is the abstract representation of the scientific design of a clinical study. The Ontology of Clinical Research (OCRe) is an OWL 2 model of the entities and relationships of study design pr...

  6. 42 CFR 440.90 - Clinic services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Clinic services. 440.90 Section 440.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.90 Clinic services....

  7. Recombination luminescence from H centers and conversion of H centers into I centers in alkali iodides

    International Nuclear Information System (INIS)

    The study is aimed at the search for H-plus-electron centers of luminescence and the investigation of the conversion of H- into I centers by the luminescence of H-plus-electron centers in alkali iodide crystals. KI, RbI and NaI crystals were studied at 12 K. H and F centers were created by irradiation with ultraviolet light corresponding to the absorption band of anion excitons. Then the excitation of electron centers by red light irradiation was followed. The spectra of stimulated recombination luminescence were studied. The luminescence of H-plus- electron centers had been observed and the conclusion was made that this center was formed on immobile H centers. In case of stable H centers the optically stimulated conversion of H centers into I centers occurs. The assumption is advanced on the spontaneous annihilation of near placed unstable F, H centers which leads to the creation of H-plus-electron luminescence centers and to the spontaneous H-I-centers conversion

  8. Developing physician leaders in academic medical centers.

    Science.gov (United States)

    Bachrach, D J

    1997-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management; intramurally conducted courses in leadership skill development, management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. While part one of this series, which appeared in Volume 43, No. 6 of Medical Group Management Journal addressed, "The changing role of physician leaders at academic medical centers," part 2 will examine as a case study the faculty leadership development program at the University of Texas M.D. Anderson Cancer Center. These two articles were prepared by the author from his research into, and the presentation of a thesis entitled. "The importance of leadership training and development for physicians in academic medical centers in an increasingly complex health care environment," prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in this College.* PMID:10164266

  9. National Center on Family Homelessness

    Science.gov (United States)

    ... You are here Home National Center on Family Homelessness Center A staggering 2.5 million children are ... raise awareness of the current state of child homelessness in the United States, documents the number of ...

  10. Oceans and Human Health Center

    Science.gov (United States)

    ... through a deeper understanding of the causes of ocean-related health threats About Find out more about our Center ... research taking place at the University of Miami Oceans & Human Health Center More Gallery Check out our photo and ...

  11. Center for Beam Physics, 1992

    Energy Technology Data Exchange (ETDEWEB)

    1993-06-01

    This report contains the following information on the center for beam physics: Facilities; Organizational Chart; Roster; Profiles of Staff; Affiliates; Center Publications (1991--1993); and 1992 Summary of Activities.

  12. Italy INAF Data Center Report

    Science.gov (United States)

    Negusini, M.; Sarti, P.

    2013-01-01

    This report summarizes the activities of the Italian INAF VLBI Data Center. Our Data Center is located in Bologna, Italy and belongs to the Institute of Radioastronomy, which is part of the National Institute of Astrophysics.

  13. Dialysis centers - what to expect

    Science.gov (United States)

    ... what to expect; Renal replacement therapy - dialysis centers; End-stage renal disease - dialysis centers; Kidney failure - dialysis ... swells and the hand on that side feels cold Your hand gets cold, numb, or weak Also ...

  14. Contact Center Manager Administration (CCMA)

    Data.gov (United States)

    Social Security Administration — CCMA is the server that provides a browser-based tool for contact center administrators and supervisors. It is used to manage and configure contact center resources...

  15. Center for Beam Physics, 1992

    International Nuclear Information System (INIS)

    This report contains the following information on the center for beam physics: Facilities; Organizational Chart; Roster; Profiles of Staff; Affiliates; Center Publications (1991--1993); and 1992 Summary of Activities

  16. Center to Advance Palliative Care

    Science.gov (United States)

    ... Discussion Forum The IPAL Project Palliative Care Leadership Centers (PCLC) Member Resources National Seminar Quick Links Certification ... a Job Manage Job Posts About About The Center to Advance Palliative Care (CAPC) is a national ...

  17. Sustainable Biofuels Development Center

    Energy Technology Data Exchange (ETDEWEB)

    Reardon, Kenneth F. [Colorado State Univ., Fort Collins, CO (United States)

    2015-03-01

    The mission of the Sustainable Bioenergy Development Center (SBDC) is to enhance the capability of America’s bioenergy industry to produce transportation fuels and chemical feedstocks on a large scale, with significant energy yields, at competitive cost, through sustainable production techniques. Research within the SBDC is organized in five areas: (1) Development of Sustainable Crops and Agricultural Strategies, (2) Improvement of Biomass Processing Technologies, (3) Biofuel Characterization and Engine Adaptation, (4) Production of Byproducts for Sustainable Biorefining, and (5) Sustainability Assessment, including evaluation of the ecosystem/climate change implication of center research and evaluation of the policy implications of widespread production and utilization of bioenergy. The overall goal of this project is to develop new sustainable bioenergy-related technologies. To achieve that goal, three specific activities were supported with DOE funds: bioenergy-related research initiation projects, bioenergy research and education via support of undergraduate and graduate students, and Research Support Activities (equipment purchases, travel to attend bioenergy conferences, and seminars). Numerous research findings in diverse fields related to bioenergy were produced from these activities and are summarized in this report.

  18. Rapid guiding center calculations

    International Nuclear Information System (INIS)

    Premature loss of high energy particles, and in particular fusion alpha particles, is very deleterious in a fusion reactor. Because of this it is necessary to make long-time simulations, on the order of the alpha particle slowing down time, with a number of test particles sufficient to give predictions with reasonable statistical accuracy. Furthermore it is desirable to do this for a large number of equilibria with different characteristic magnetic field ripple, to best optimize engineering designs. In addition, modification of the particle distribution due to magnetohydrodynamic (MHD) modes such as the saw tooth mode present in the plasma can be important, and this effect requires additional simulation. Thus the large number of necessary simulations means any increase of computing speed in guiding center codes is an important improvement in predictive capability. Previous guiding center codes using numerical equilibria such as ORBIT evaluated the local field strength and ripple magnitude using Lagrangian interpolation on a grid. Evaluation of these quantities four times per time step (using a fourth order Runge-Kutta routine) constitutes the major computational effort of the code. In the present work the authors represent the field quantities through an expansion in terms of pseudo-cartesian coordinates formed from the magnetic coordinates. The simplicity of the representation gives four important advantages over previous methods

  19. The MAGIC Data Center

    CERN Document Server

    Reichardt, Ignasi; Carmona, Emiliano; Contreras, Jose Luis; Cortina, Juan; Firpo, Roger; Font, Lluis; Moralejo, Abelardo; Nieto, Daniel; Oya, Igor; Reyes, Raquel de los

    2009-01-01

    The MAGIC I telescope produces currently around 100TByte of raw data per year that is calibrated and reduced on-site at the Observatorio del Roque de los Muchachos (La Palma). Since February 2007 most of the data have been stored and further processed in the Port d'Informacio Cientifica (PIC), Barcelona. This facility, which supports the GRID Tier 1 center for LHC in Spain, provides resources to give the entire MAGIC Collaboration access to the reduced telescope data. It is expected that the data volume will increase by a factor 3 after the start-up of the second telescope, MAGIC II. The project to improve the MAGIC Data Center to meet these requirements is presented. In addition, we discuss the production of high level data products that will allow a more flexible analysis and will contribute to the international network of astronomical data (European Virtual Observatory). For this purpose, we will have to develop a new software able to adapt the analysis process to different data taking conditions, such as ...

  20. Patient-centered Radiology.

    Science.gov (United States)

    Itri, Jason N

    2015-10-01

    Patient-centered care (ie, care organized around the patient) is a model in which health care providers partner with patients and families to identify and satisfy patients' needs and preferences. In this model, providers respect patients' values and preferences, address their emotional and social needs, and involve them and their families in decision making. Radiologists have traditionally been characterized as "doctor-to-doctor" consultants who are distanced from patients and work within a culture that does not value patient centeredness. As medicine becomes more patient driven and the trajectory of health care is toward increasing patient self-reliance, radiologists must change the perception that they are merely consultants and become more active participants in patient care by embracing greater patient interaction. The traditional business model for radiology practices, which devalues interaction between patients and radiologists, must be transformed into a patient-centered model in which radiologists are reintegrated into direct patient care and imaging processes are reorganized around patients' needs and preferences. Expanding radiology's core assets to include direct patient care may be the most effective deterrent to the threat of commoditization. As the assault on the growth of Medicare spending continues, with medical imaging as a highly visible target, radiologists must adapt to the changing landscape by focusing on their most important consumer: the patient. This may yield substantial benefits in the form of improved quality and patient safety, reduced costs, higher-value care, improved patient outcomes, and greater patient and provider satisfaction. PMID:26466190