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Sample records for clinical evaluation study

  1. Ceftriaxone: in vitro studies and clinical evaluation.

    OpenAIRE

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

    1982-01-01

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

  2. Evaluation of dermatologic emergeny patients: An unicentral prospective clinical study

    Directory of Open Access Journals (Sweden)

    Adem Köşlü

    2009-12-01

    Full Text Available Background and Design: The definition of emergent diseases includes potentially risky diseases that need urgent medical intervention. Diagnostic and therapeutic processes are managed mostly at ourpatient setting in dermatology. Therefore, it is unclear that which diseases are real emergencies and which patients apply urgently. There are a few studies assessing this topic. Our aim was to evaluate patients referred to our clinic urgently, and to review the concept of ‘‘real dermatologic emergency’’ by comparing dermatologic emergency patients and outpatients. Material and Method: A total of 800 patients (400 urgent patients, 400 outpatients were included. Demographic features, complaints, disease duration and severity, whether the disease occurs for the first time were questionned, application time and diagnosis were recorded. The opinions of patients and physicians were inquired about why they thought that the disease was emergent. Results: Most common skin diseases were acute urticaria-angioedema, contact dermatitis, and insect bite in emergency patients; acne vulgaris, verruca and tinea pedis in outpatients. Itching was more common in emergency patients. Emergency patients' complaints were more severe than those of outpatients. Patients who experience disease first time applied to emergency service more than others. Emergency patients had a shorter disease duration than outpatients. Patients and physicians revealed different reasons and criteria about the urgency of the diseases. 93.5% of patients and 49% of physicians thought that existing disease was emergent. Conclusion: Our data reveal that the concept of dermatologic emergency is unsettled. It changes according to socio-cultural, personal features and to the present health system. Determination of the main criteria of the definition of “dermatologic urgent”, and training of dermatologists, emergency centers’physicians and also of patients in this regard seem to be a necessity

  3. Clinical study evaluating efficacy of praziquantel in clonorchiasis.

    OpenAIRE

    Yangco, B G; Lerma, C.; Lyman, G H; Price, D L

    1987-01-01

    In 74 patients with clonorchiasis, the efficacy and safety of praziquantel was evaluated in a two-phase study: a double-blind, randomized controlled trial of praziquantel versus placebo (42 patients) and an open study (32 patients). All but one of the patients were Laotians. The intensity of clonorchiasis was light in 85% (63 of 74) and moderate in 15% (11 of 74) of the patients. Cure based on our established criteria was noted in 67 of 67 patients (100%) treated with praziquantel at a dose o...

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

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    Zhijuan Liu

    2013-04-01

    Full Text Available In this study, we study on the nursing clinical teachers' comprehensive quality evaluation model on the basis of fuzzy mathematics. First, it obtains the nursing clinical teachers' comprehensive quality evaluation index framework by making use of Delphi method. Then, it constructs the comprehensive quality evaluation hierarchy model by applying the analytic hierarchy process, to obtain the weight for each index, based on which to establish fuzzy comprehensive evaluation model, thus acquiring new method for nursing clinical teachers' comprehensive quality evaluation. Examples have proven the feasibility and effectiveness of this method.

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

    Science.gov (United States)

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

    2011-01-01

    We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series…

  6. An evaluation of the clinical potential of tissue diffraction studies

    Science.gov (United States)

    Speller, R.; Abuchi, S.; Zheng, Y.; Vassiljev, N.; Konstantinidis, A.; Griffiths, J.

    2015-09-01

    Medical imaging is a long established part of patient management in the treatment of disease. However, in most cases it only provides anatomical detail and does not provide any form of tissue characterisation. This is particularly true for X-ray imaging. Recent studies on tissue diffraction have shown that true molecular signatures can be derived for different tissue types. Breast cancer samples and liver tissue have been studied. It has been shown that diffraction profiles can be traced away from the primary tumour in excised breast tissue samples and that potentially 3mm fat nodules in liver tissue can be identified in patients at acceptable doses.

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

    Science.gov (United States)

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

    2016-01-01

    Background: Clinical evaluations as fundamental method to prove the efficiency of restorative materials. Aim: This study evaluated the clinical performance of restorative systems during 2 years of clinical service. Materials and Methods: This study assessed the clinical performance of restorative systems (Filtek Z250 and P60), during 2 years of clinical service, using the US Public Health Service system. The randomized and double-blind study comprising thirty volunteers. The restorations were evaluated at baseline, 6, 12, and 24 months. It was used the following criteria: marginal discoloration (MD), marginal integrity (MI), superficial texture (ST), wear (W), postoperative sensitivity (PS) and recurrent caries (RC). Results: Statistic analysis was performed using Fisher's and McNemar's exact tests and Pearsons's Chi-square in a significance level of 5%. The results at baseline and 24 months for Group I were: MD – 100, 100%; MI – 100, 88.6%; ST – 100, 94.3%; W – 100, 94.3%; PS – 100, 100%; RC – 100, 100%, of alpha scores; Group II: MD – 100, 97.1%; MI – 100, 91.4%; ST – 100, 94.3%; W – 100, 91.4%; PS – 100, 100%; RC – 100, 100%, of alpha scores. It was observed no statistical difference in the evaluated criteria and period. Conclusions: After 24 months of evaluation, both restorative systems exhibited acceptable clinical performance.

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

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    C. Joseph

    2012-12-01

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

  9. Clinical evaluation of direct composite restoration done for midline diastema closure – long-term study

    OpenAIRE

    Prabhu, R.; S Bhaskaran; Geetha Prabhu, K. R.; M A Eswaran; Phanikrishna, G.; Deepthi, B.

    2015-01-01

    Purpose of the Study: The aim of this study was to evaluate clinically the performance of composite resin used to restore midline diastema between the maxillary and mandibular central incisors. Methodology: Direct composite restorations were done for 45 patients with midline diastema between the maxillary and mandibular central incisors. Standard protocols were followed for the placement of composite resin for the diastema closure, and recall visits were made for every 6 months for a period o...

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

    Science.gov (United States)

    Ku, Ya-Lie

    2015-01-01

    This case study evaluated creative thinking of RN-BSN students in the course of clinical case study and practicum. Study design used quantitative and qualitative evaluations of creative thinking of RN-BSN students by triangulation method in the course of clinical case study and practicum. Sixty RN-BSN students self-perceived the changing levels of…

  11. Evaluation of clinical practice guidelines.

    OpenAIRE

    Basinski, A S

    1995-01-01

    Compared with the current focus on the development of clinical practice guidelines the effort devoted to their evaluation is meagre. Yet the ultimate success of guidelines depends on routine evaluation. Three types of evaluation are identified: evaluation of guidelines under development and before dissemination and implementation, evaluation of health care programs in which guidelines play a central role, and scientific evaluation, through studies that provide the scientific knowledge base fo...

  12. Evaluation of Clinical and Ultrasonographic Parameters in Psoriatic Arthritis Patients Treated with Adalimumab: A Retrospective Study

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    M. Teoli

    2012-01-01

    Full Text Available Objectives. The aim of this study was to evaluate clinical and US-PD parameters in PsA during adalimumab treatment. Methods. A retrospective study has been conducted in forty patients affected by moderate-to-severe peripheral PsA. Clinical, laboratory, and US-PD evaluations were performed at baseline, after 4, 12, and 24 weeks of treatment. They included erythrocyte sedimentation rate (ESR, C-reactive protein (CRP, visual analogue scale (VAS, Health Assessment Questionnaire (HAQ modified for Spondyloarthritis, Psoriasis Area Severity Index (PASI score, the 28-joint Disease Activity Score (DAS 28, and US-PD assessment. US-PD findings were scored according to a semiquantitative scale (ranging 0–3 for synovial proliferation (SP, joint effusion (SE, bone erosions (BE, and PD. Results. Data obtained for clinical, laboratory findings and US-PD evaluation showed statistical significant improvement in all the measures performed except for BE. A significant parallel decrease in SE, SP, and PD values were demonstrated. Conclusion. This study demonstrated that US-PD is a valid technique in monitoring the response to adalimumab in moderate-to-severe PsA.

  13. Clinical evaluation of direct composite restoration done for midline diastema closure – long-term study

    Science.gov (United States)

    Prabhu, R.; Bhaskaran, S.; Geetha Prabhu, K. R.; Eswaran, M. A.; Phanikrishna, G.; Deepthi, B.

    2015-01-01

    Purpose of the Study: The aim of this study was to evaluate clinically the performance of composite resin used to restore midline diastema between the maxillary and mandibular central incisors. Methodology: Direct composite restorations were done for 45 patients with midline diastema between the maxillary and mandibular central incisors. Standard protocols were followed for the placement of composite resin for the diastema closure, and recall visits were made for every 6 months for a period of 60 months for evaluation of the success of these restorations made. Qualified dental personnel examined the restorations made. Results: Clinical evaluations were done after the restorations had been in place for an average of 6 months. Results indicate that none of the restorations were totally lost, and resulting in a 91% overall retention rate for the period of 60 months. About 62% of the restorations made had no noticeable color difference with that of the adjacent tooth, and gingival health indicated 73% of the sample was without any signs of inflammation. Conclusions: Composites restored for diastemas exhibit satisfactory survival rates placed with recommended placement protocols and without occlusal loading. PMID:26538917

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

    OpenAIRE

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

    2014-01-01

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

  15. STRUCTURED CLINICAL EVALUATION

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    Arabela Maria Barbosa Sampaio

    2014-05-01

    Full Text Available In a world experiencing profound technological and socio-political changes in areas of knowledge and capacity, healthcare can not remain static. A new kind of professional is required, whose practice is based on ethics, scientific standards, integrity, citizenship, and health promotion, who develops skills beyond healthcare, such as decision making, communication,leadership, management, and continuing education. No single method can assess all of these elements (knowledge, skills, and attitudes, and only a combination of methods is able to produce a valid evaluation. An alternative method exists: structured clinical assessments based on observation of "to do, or how to do" that aim to complete this evaluation by focusing attention on the performance of specific skills. In order to broaden the scope of evaluation methods that have been used in health education, this article, a literature review, intends to offer readers an overview of the diverse types of structured clinical evaluation, emphasizing Objective Structured Clinical Examination, the most widely used in Brazil, with a goal of advancing opportunities for health professionals to make use of this evaluative tool.

  16. CLINICAL STUDY TO EVALUATE DIABETIC ULCER SEVERITY SCORE (DUSS IN DIABETIC FOOT ULCER

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    Harindranath

    2015-12-01

    Full Text Available iabetic Ulcer Severity Score is one of the latest simple wound based score, completely a clinical score which needs to be evaluated for its effectiveness in predicting the outcome of foot ulcers in patients with diabetes. METHODS A total of 226 diabetic patients with foot ulcers treated as outpatient or admitted patients from 1st January to 31st December 2014 were included in the study and was followed till complete healing of ulcer or amputation or for a minimum period of 6 months. Those patients who lost for followup before 6 months were excluded from study. Necessary data was collected and DUSS was calculated at the start of treatment. RESULTS AND CONCLUSION In our study, patients with score 3 had higher risk (40% for minor amputation and those with score 4 had higher risk (21% for major amputation overall. Patients with score 4 had 37% risk for minor amputation. Higher the score higher is the risk for amputation and lesser the chance of healing. DUSS scoring system provides an easy diagnostic tool for predicting probability of healing or amputation by combining four clinically assessable wound based parameters namely presence or absence of pedal pulses, probing to bone, wound location and presence or absence of multiple ulcers. Study groups can be stratified depending on severity of ulcers and thus can help provide a simple, streamlined approach in clinical setting without need of any advanced investigative tool, but it does not alter the procedure of wound management. The scoring system can be easily applied to clinical practice.

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

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    Hartung Daniel M

    2012-12-01

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

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

    LENUS (Irish Health Repository)

    Markey, G C

    2010-06-24

    We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series of assessments in a 25-week teaching programme. Over time, several clinicians from a pool of 16 surgical consultants and registrars evaluated each student by direct observation. A structured rating form was used for assessment data. Variance component analysis (VCA), internal consistency and inter-rater agreement were used to estimate reliability. The predictive and convergent validity of COPE in relation to summative OSCE, long case, and overall final examination was estimated. Median number of COPE assessments per student was 7. Generalisability of a mean score over 7 COPE assessments was 0.66, equal to that of an 8 x 7.5 min station final OSCE. Internal consistency was 0.88-0.97 and inter-rater agreement 0.82. Significant correlations were observed with OSCE performance (R = 0.55 disattenuated) and long case (R = 0.47 disattenuated). Convergent validity was 0.81 by VCA. Overall final examination performance was linearly related to mean COPE score with standard error 3.7%. COPE permitted efficient serial assessment of a large cohort of final year students in a real world setting. Its psychometric quality compared well with conventional assessments and with other direct observation instruments as reported in the literature. Effect on learning, and translation to clinical care, are directions for future research.

  19. Safety Evaluation of CNS Administered Biologics-Study Design, Data Interpretation, and Translation to the Clinic.

    Science.gov (United States)

    Vuillemenot, Brian R; Korte, Sven; Wright, Teresa L; Adams, Eric L; Boyd, Robert B; Butt, Mark T

    2016-07-01

    Many central nervous system (CNS) diseases are inadequately treated by systemically administered therapies due to the blood brain barrier (BBB), which prevents achieving adequate drug concentrations at sites of action. Due to the increasing prevalence of neurodegenerative diseases and the inability of most systemically administered therapies to cross the BBB, direct CNS delivery will likely play an increasing role in treatment. Administration of large molecules, cells, viral vectors, oligonucleotides, and other novel therapies directly to the CNS via the subarachnoid space, ventricular system, or parenchyma overcomes this obstacle. Clinical experience with direct CNS administration of small molecule therapies suggests that this approach may be efficacious for the treatment of neurodegenerative disorders using biological therapies. Risks of administration into the brain tissue or cerebrospinal fluid include local damage from implantation of the delivery system and/or administration of the therapeutic and reactions affecting the CNS. Preclinical safety studies on CNS administered compounds must differentiate between the effects of the test article, the delivery device, and/or the vehicle, and assess exacerbations of reactions due to combinations of effects. Animal models characterized for safety assessment of CNS administered therapeutics have enabled human trials, but interpretation can be challenging. This manuscript outlines the challenges of preclinical intrathecal/intracerebroventricular/intraparenchymal studies, evaluation of results, considerations for special endpoints, and translation of preclinical findings to enable first-in-human trials. Recommendations will be made based on the authors' collective experience with conducting these studies to enable clinical development of CNS-administered biologics. PMID:27354708

  20. Evaluation of mineral trioxide aggregate as root canal sealer: A clinical study

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    Sophia Thakur

    2013-01-01

    Full Text Available Aim: The aim of this study was to compare the clinical and radiological outcome of mineral trioxide aggregate (MTA or epoxy resin as a root canal sealer compared with zinc oxide eugenol sealer. Materials and Methods: 45 single rooted teeth with periapical index Score 2 or more were allotted to three groups with 15 teeth in each group. Root canal treatment was performed in two visits and obturated with Gutta-percha as obturating material and zinc oxide eugenol as sealer in Group 1, epoxy resin as sealer in Group 2 and MTA mixed with propylene glycol as sealer in Group 3. Visual analog scale, periapical index and VixWin digital Pro image analysis software were used for evaluation. The quantitative data was analyzed by t-test and analysis of variance. Ordinal data was analyzed by Wilcoxon′s signed rank test, Mann-Whitney and Kruskall-Wallis test. Results: Results suggested that there exists no statistically significant difference in clinical or radiological outcome of root canal therapy with three different types of sealers used in this study. Conclusions: MTA could be used as a root canal sealer with equal effectiveness compared with epoxy resin and zinc oxide eugenol sealers. Further long-term studies should be carried out to prove the effectiveness.

  1. Educating Parents About Pediatric Research: Children and Clinical Studies Website Qualitative Evaluation.

    Science.gov (United States)

    Marceau, Lisa D; Welch, Lisa C; Pemberton, Victoria L; Pearson, Gail D

    2016-07-01

    A gap in information about pediatric clinical trials exists, and parents remain uncertain about what is involved in research studies involving children. We aimed to understand parent perspectives about pediatric clinical research after viewing the online Children and Clinical Studies (CaCS) program. Using a qualitative descriptive study design, we conducted focus groups with parents and phone interviews with physicians. Three themes emerged providing approaches to improve parent's understanding of clinical research by including strategies where parents (a) hear from parents like themselves to learn about pediatric research, (b) receive general clinical research information to complement study-specific details, and (c) are provided more information about the role of healthy child volunteers. Parents found the website a valuable tool that would help them make a decision about what it means to participate in research. This tool can assist parents, providers, and researchers by connecting general information with study-specific information. PMID:26711142

  2. Experimental and clinical studies of hepatic blood flow evaluation by dynamic CT

    International Nuclear Information System (INIS)

    Dynamic CT of the liver were applied to a method of hepatic blood flow evaluation. The timedensity curve of the liver and the aorta after intravenous bolus injection of contrast medium were evaluated, devising a new potential index for a relative liver blood flow from the aorta (Aorto-Hepatic (A-H) ratio); hepatic peak density was expressed as percentage to aortic peak density and was divided by the peak time difference between the aorta and the liver. In experimental studies, two animal models for decreased hepatic blood flow were prepared, one with hepatic arterial embolization and the other with superior mesenteric vein ligation. The A-H ratios in both groups were well correlated to the decrease of blood flow of the liver, indicating that the A-H ratio could express not only the arterial but also the portal blood flow. In clinical studies, dynamic CT scans were performed in 69 patients, including 50 cases of the liver cirrhosis with hepatoma, 10 cases of liver cirrhosis and 9 cases of normal liver. The A-H ratio of normal liver was 0.63 ± 0.11, while in cirrhosis the ratio was 0.21 ± 0.06 and cirrhosis with hepatoma the ratio was 0.27 ± 0.09. The ratio was well correlated to the degrees of the diseases, and also the ratio was correlated to the hepatic function reserve in some degrees. From this results, it was strongly suggested that the A-H ratio would become an useful index of blood perfusion to the liver parenchyma, providing adjunctive parameter to determine resectability of the liver, indication for hepatic arterial embolization, or evaluation of the course of chronic liver diseases. (author)

  3. Controlled clinical studies of air pollutant exposure: evaluating scientific information in relation to air quality standards.

    OpenAIRE

    Hackney, J D; Linn, W S

    1983-01-01

    In controlled clinical studies, volunteers are deliberately exposed to specific air pollutants under conditions simulating ambient exposures, and health-related responses are documented. Studies of the health risks of air pollution need to be scientifically rigorous and clearly relevant to "real-world" pollution exposures. Their results should be confirmed by independent replication if they are to be used as a basis for air quality regulations. Well-designed controlled clinical studies readil...

  4. A CLINICAL STUDY ON SURGICAL MANAGEMENT OF TIBIAL PLATEAU FRACTURES - FUNCTIONAL AND RADIOLOGICAL EVALUATION

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    Bhavani

    2015-10-01

    Full Text Available BACKGROUND: Tremendous advance in mechanization and fastness of travel have been accompanied by steep increase in number and severity of fractures and those of tibial plateau are no exception. Knee being one of the major weight bearing joints of the body, fractures around it will be of paramount importance. AIM OF STUDY: This study is to analyze the functional outcome of CRIF or ORIF with or without bone grafting in tibial plateau fractures in adults. MATERIALS AND METHODS: 30 cases of tibial plateau fractures treated by various modalities were studied from 1 - 8 - 2012 to 31 - 1 - 2014 at our institution and followed for a minimum of 6 months. Fractures were evaluated using Modified Rasmussen’s Clinical, Radiological grading system. RESULTS : The selected patients were evaluated thoroughly and after the relevant investigations, were taken for surgery. The fractures were classified as per the SCHATZKER’S types and operated accordingly with CRIF with Percutaneous cannulated cancellous screws, ORIF with buttress plate/LCP with or without bone grafting. Immobilization of fractures continued for 3 weeks by POP slab. Early range of motion was then started. Weight bearing up to 6 - 8 weeks was not allowed. The full weight bearing deferred until 12 weeks or complete fracture union . The knee range of motion was excellent to very good, gait and weight bearing after complete union was satisfactory, knee stiffness in 3 cases , wound dehiscence and infection in 1 case and non - union in none of our cases was noted. CONCLUSION: Functional outcome is better in operatively treated tibial plateau fractures in adults, because it gives excellent anatomical reduction and rigid fixation to restore articular congruity and early motion thereby preventing knee stiffness.

  5. Clinical Evaluation of Radionuclide Esophageal Transit Studies using Liquid and Solid Foods

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Jae Gol; Lee, Min Jae; Song, Chi Wook; Hyun, Jin Hai; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1995-03-15

    The author performed radionuclide esophageal transit studies(RETS) with liquid and solid boluses using the same day protocol in 90 normal controls and 164 patients with various primary esophageal motility disorders who were diagnosed by manometric criteria and clinical courses. The authors calculated mean esophageal transit time(MTT) and mean residual retention(MRR) in each of the liquid and solid studies, and classified time-activity curve(TAC) patterns. The normal criteria of RETS with liquid bolus were MTT<24 sec, MRR<9%, and the TAC pattern that showed rapid declining slope and flat low residual(Type 1). The normal criteria of RETS with solid bolus were MTT<35 sec, MRR<9% and TAC of type 1. With these normal criteria, the sensitivity and the specificity of the liquid study were 62.2% and 97.8%, respectively. The sensitivity increased to 75.4% with the solid study. The author also found that the RETS was highly reproducible. The achalasia typically showed no effective emptying of both liquid and solid boluses during the whole study period, and was well differentiated by its extremely long transit time and high retention from the other motility disorders. The diffuse esophageal spasm(DES) and nonspecific esophageal motility disorder(NEMD) showed intermediate delay in transit time and increased retention. In the groups of hypertensive lower esophageal sphincter(LES), hypotensive LES and nutcracker, there noted no significant difference with the normal control group in terms of MTT and MRR. The DES and NEMD could be more easily identified by solid studies that showed more marked delay in MTT and increased MRR as compared with the liquid study. In conclusion, esophageal scintigraphy is a safe, noninvasive and physiologic method for the evaluation of esophageal emptying.

  6. Clinical Evaluation of Radionuclide Esophageal Transit Studies using Liquid and Solid Foods

    International Nuclear Information System (INIS)

    The author performed radionuclide esophageal transit studies(RETS) with liquid and solid boluses using the same day protocol in 90 normal controls and 164 patients with various primary esophageal motility disorders who were diagnosed by manometric criteria and clinical courses. The authors calculated mean esophageal transit time(MTT) and mean residual retention(MRR) in each of the liquid and solid studies, and classified time-activity curve(TAC) patterns. The normal criteria of RETS with liquid bolus were MTT<24 sec, MRR<9%, and the TAC pattern that showed rapid declining slope and flat low residual(Type 1). The normal criteria of RETS with solid bolus were MTT<35 sec, MRR<9% and TAC of type 1. With these normal criteria, the sensitivity and the specificity of the liquid study were 62.2% and 97.8%, respectively. The sensitivity increased to 75.4% with the solid study. The author also found that the RETS was highly reproducible. The achalasia typically showed no effective emptying of both liquid and solid boluses during the whole study period, and was well differentiated by its extremely long transit time and high retention from the other motility disorders. The diffuse esophageal spasm(DES) and nonspecific esophageal motility disorder(NEMD) showed intermediate delay in transit time and increased retention. In the groups of hypertensive lower esophageal sphincter(LES), hypotensive LES and nutcracker, there noted no significant difference with the normal control group in terms of MTT and MRR. The DES and NEMD could be more easily identified by solid studies that showed more marked delay in MTT and increased MRR as compared with the liquid study. In conclusion, esophageal scintigraphy is a safe, noninvasive and physiologic method for the evaluation of esophageal emptying.

  7. Clinical evaluation of the biological width following surgical crown-lengthening procedure: A prospective study

    Directory of Open Access Journals (Sweden)

    Shobha K

    2010-01-01

    Full Text Available Background and Objectives: The purpose of this study was to evaluate the positional changes of the periodontal tissues, particularly the biological width, following surgical crown-lengthening in human subjects. Materials and Methods: A clinical trial study involving 15 patients was carried out for a period of 6 months. Sites were divided into 3 groups: treated (TT sites, adjacent (AD sites and nonadjacent (NAD sites. Free gingival margin [FGM], attachment level, pocket depth, bone level, biological width [BW] were recorded at baseline, 1, 3 and 6 months. Direct bone level after flap reflection was recorded before and after osseous resection at baseline only. Level of osseous crest was lowered based on BW, and supracrestal tooth structure needed using a combination of rotary and hand instruments. Statistical Analysis: Student t test and ANOVA were used. Results: Overall, apical displacement of FGM at TT, AD and NAD sites was statistically significant compared to baseline. The apical displacement of FGM at TT site was more when compared to that at AD and NAD sites at 3 and 6 months. The BW at the TT site was smaller at 1, 3 and 6 months compared to that at baseline. However, at all sites, BW was reestablished to the baseline value at the end of 6 months. Interpretation and Conclusion: The BW at TT sites was reestablished to its original vertical dimension by 6 months. In addition, a consistent 2-mm gain of coronal tooth structure was observed at the 1, 3 and 6-month examinations.

  8. Clinical Evaluation of Small Diameter Straumann Implants in Partially Edentulous Patients: A 5-Year Retrospective Study

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    S. OZER

    2011-06-01

    Full Text Available Objective: The aim of the present study was to retrospectively evaluate small-diameter (3.3 mm Straumann® dental implants placed in the maxilla or the mandible over a period of 5 years in function.Materials and Methods: Twenty- eight partially edentulous patients received a total of 48 implants over a 5-year period. After the standard healing period (3 to 6 months, the implants were restored with single-tooth prostheses or fixed partial dentures. All patients were followed according to a strict maintenance program with regular recalls. The cumulative survival rates of implants were analyzed and prosthetic complications were assessed.Results: After 5 years of function, one single 10-mm-long implant in the maxillary premolar region was lost because of recurrent peri-implant infection in a female patient. Two single 10-mm-long maxillary implants placed in the posterior region were lost due to body fracture. The cumulative 5-year survival rate of the implants was 93.75 %. The most common prosthetic complication was loosening of the occlusal screw.Conclusion: Within the limited observation period and the number of patients included in this study, it may be concluded that the use of small-diameter implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, it should be noted that fatigue fracture may occur.

  9. Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study

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    Ricardo Tristão-Sá

    2012-12-01

    Full Text Available INTRODUCTION: To analyze the liver dysfunction and evolution of signs and symptoms in adult dengue patients during a two-month follow-up period. METHODS: A prospective cohort study was conducted in Campos dos Goytacazes, Rio de Janeiro, Brazil, from January to July, 2008. The evolution of laboratory and clinical manifestations of 90 adult dengue patients was evaluated in five scheduled visits within a two-month follow-up period. Twenty controls were enrolled for the analysis of liver function. Patients with hepatitis B, hepatitis C, those known to be human immunodeficiency virus (HIV seropositive and pregnant women were excluded from the study. RESULTS: At the end of the second month following diagnosis, we observed that symptoms persisted in 33.3% (30/90 of dengue patients. We also observed that, 57.7% (15/26 of the symptoms persisted at the end of the second month. The most persistent symptoms were arthralgia, fatigue, weakness, adynamia, anorexia, taste alteration, and hair loss. Prior dengue virus (DENV infection did not predispose patients to a longer duration of symptoms. Among hepatic functions, transaminases had the most remarkable elevation and in some cases remained elevated up to the second month after the disease onset. Alanine aminotransferase (ALT levels overcame aspartate aminotransferase (AST during the convalescent period. Male patients were more severely affected than females. CONCLUSIONS: Dengue fever may present a wide number of symptoms and elevated liver transaminases at the end of the second month.

  10. EVALUATION OF GUDUCHI YOGA IN THE MANAGEMENT OF VATARAKTA (GOUTY ARTHRITIS: A CLINICAL STUDY

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    Shivaprasad Huded

    2013-10-01

    Full Text Available Vatarakta is one of the main articular diseases, which is characterized by severe pain, tenderness, inflammation and burning sensation in the affected joints. It is a tridoshaja vyadhi, with vata pradhanyata and rakta as main dushya. Sedentary lifestyle is one of the etiological factors of Vatarakta. The etiology and symptomatology of Gout is very much similar to that of Vatarakta. Gout is a pathological reaction of joint or periarticular tissues which results from deposition of monosodium urate monohydrate crystals in joints and tissues. In Ayurvedic classics, although we find plenty of dravyas for joint disorders, the area of joint diseases management still remains to be elusive. Hence the present clinical study aims to evaluate the efficacy of combined effect of 'Guduchi extract and cucumber juice extract' in the management of Vatarakta (Gouty arthritis. In the present study, 20 patients fulfilling the diagnostic criteria of Vatarakta and who met the American College of Rheumatology (ACR criteria for acute Gouty arthritis were selected. Detailed profile which incorporated relevant data like symptomatology, physical signs and investigation reports were considered for assessment criteria. The ‘Guduchi Yoga’ (Aqueous extract of Guduchi and Trapusha was administered to patients of either sex in the dosage of 1 g BID with lukewarm water after food for 12 weeks (3 months. After the course of therapy for 12 weeks, symptomatic improvement was observed with statistically significant results (P < 0.001 along with attainment of normal serum uric acid levels followed by feeling of general wellbeing. From the present study it can be concluded that the combined effect of Guduchi and Trapusha extracts showed promising results in the management of vatarakta.

  11. Evaluation of the Young Children with Neurodevelopmental Disability: A Prospective Study at Hamadan University of Medical Sciences Clinics

    OpenAIRE

    FAYYAZI, Afshin; Leila KHEZRIAN; Zohreh KHERADMAND; DAMADI, Somayeh; Ali KHAJEH

    2013-01-01

    How to Cite This Article: Fayyazi A, Kheizrian L, Kheradmand Z, Damadi S, Khajeh A. Evaluation of the Young Children with Neurodevelopmental Disability: A Prospective Study at Hamadan University of Medical Sciences Clinics. Iran J Child Neurol. 2013 Winter; 7 (1):29-33. ObjectiveDevelopmental impairment is a common problem in children health that occurs in approximately 5–10% of the childhood population. The aim of this study was to determine the etiologic yield of subspecialists’ evaluation ...

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

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    Yusof Maryati Mohd

    2012-12-01

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

  13. The Evaluation Of Clinical Competence

    OpenAIRE

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

    1980-01-01

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

  14. Effectiveness of insecticidal nets on uncomplicated clinical malaria: a case–control study for operational evaluation

    OpenAIRE

    Damien, Georgia Barikissou; Djènontin, Armel; Chaffa, Evelyne; Yamadjako, Sandra; Drame, Papa Makhtar; Ndille, Emmanuel Elanga; Henry, Marie-Claire; Corbel, Vincent; Remoué, Franck; Rogier, Christophe

    2016-01-01

    Background: In a context of large-scale implementation of malaria vector control tools, such as the distribution of long-lasting insecticide nets (LLIN), it is necessary to regularly assess whether strategies are progressing as expected and then evaluate their effectiveness. The present study used the case-control approach to evaluate the effectiveness of LLIN 42 months after national wide distribution. This study design offers an alternative to cohort study and randomized control trial as it...

  15. Evaluation of a prototype interactive consent program for pediatric clinical trials: a pilot study

    OpenAIRE

    Tait, Alan R.; Voepel-Lewis, Terri; McGonegal, Maureen; Levine, Robert

    2011-01-01

    Standard written methods of presenting research information may be difficult for many parents and children to understand. This pilot study was designed to examine the use of a novel prototype interactive consent program for describing a hypothetical pediatric asthma trial to parents and children. Parents and children were interviewed to examine their baseline understanding of key elements of a clinical trial, eg, randomization, placebo, and blinding. Subjects then reviewed age-appropriate ver...

  16. Clinical evaluation of 99mTc-Technegas in pulmonary ventilation study

    International Nuclear Information System (INIS)

    To evaluate the clinical usefulness and the possibility of using 99mTc-Technegas (99mTc), the pulmonary distribution of 99mTc was assessed in 40 patients with various pulmonary diseases and compared with 81mKr gas (81mKr) and 99mTc-MAA. In 24 patients, the 99mTc was inhaled several times during deep inspiration with a breath hold in the supine position. In 16 patients, ventilation images were acquired during tidal breathing or deeper breathing without a breath hold. In all patients, a continuous inhalation of 81mKr was made after the inhalation of 99mTc. Then 99mTc-MAA was administered intravenously. Histograms of the frequency distribution of the ventilation-perfusion (V/Q) ratio for anterior, posterior and superimposed images were constructed with the obtained ventilation images of 99mTc or 81mKr and perfusion images of 99mTc-MAA. After the region of interest had been set to include the entire lungs, the V/Q ratio for each pixel in the region was calculated using a 128 x 128 matrix. In a comparative study with 81mKr, 99mTc showed a similar distribution to that of 81mKr in most patients, although some patients with obstructive disease showed small region of high-count density in the lung. 99mTc-SPECT showed the increased basal deposition that was seen at the back of lung in 8 of 9 patients with breath hold and in 8 of 13 patients without breath hold. This deposition difference was considered to be caused by the difference in inhalation method and the effect of gravity. In comparison of the proportion of V/Q counts, there was a significant positive correlation between 99mTc and 81mKr in breath hold patients for anterior images, posterior images, and superimposed images. In 16 patients without breath hold, a correlation was acquired as well as using breath hold for anterior images, posterior images, and superimposed images. (K.H.)

  17. Evaluation of the Young Children with Neurodevelopmental Disability: A Prospective Study at Hamadan University of Medical Sciences Clinics

    Directory of Open Access Journals (Sweden)

    Afshin FAYYAZI

    2013-01-01

    Full Text Available ObjectiveDevelopmental impairment is a common problem in children health that occurs in approximately 5–10% of the childhood population. The aim of this study was to determine the etiologic yield of subspecialists’ evaluation of young children with developmental disability.Materials & MethodsAll children aged between 2 months and 5 years referred over a 15-month period to Hamadan University of Medical Sciences subspecialty services for initial evaluation of a suspected developmental Disability, were enrolled in the present study. Diagnostic yield was determined after the completion of clinical assessments and laboratory tests requested by the evaluating physician.ResultsA total of 198 children (129 boys and 69 girls were eligible for our study.108 children had global developmental delay and 90 children had isolated developmental delay. Approximately ¼ of all patients did not have any specific etiology for developmental disability. Cerebral palsy (CP was the most common clinical syndrome in all patients (41.4%. Hypoxic ischemic encephalopathy (13.8%, brain dysgenesis (13%, genetic disorder (13%, and neurodegenerative diseases (11% were determined in more than one half of all children with global developmental disability. in our study, “developmental speech delay” was the common cause of isolated speech delay.ConclusionDetermination of an underlying etiology is an essential part of specialty evaluation of young children with developmental disability. The results of this study were similar closely to the results of other studies.

  18. Study, development and clinical evaluation of a per-operative γ imager

    International Nuclear Information System (INIS)

    The precise localization and complete surgical ablation of tumors are one of the most important procedures in cancer treatment. In that context, the use, in operating room, of light hand-held detectors associated to radiopharmaceutical compounds for tumor labelling, plays a significant role in assisting surgeons in real-time detection of lesion. The POCI gamma imaging probe (Per-Operative Compact Imager), which is presented here, is precisely dedicated to improve the radio-guided operative cancer surgery efficiency by bringing a new tool discriminating between healthy and pathological tissues. To match the specifications of intra-operative detection, we chose to build our camera around an intensified position sensitive diode which appeared to be particularly suitable to achieve a high resolution small size imager. The optimal geometry of two gamma detection head modules, composed of parallel hole collimators and scintillation crystals, was then investigated by numerical simulations. From these technological solutions, a first prototype of POCI with a 24 mm diameter field of view has been developed. Its characterization has put forward a millimeter spatial resolution and a detection efficiency comparable to that of clinical gamma cameras and in agreement with the numerical predictions. Finally, in collaboration with Gustave Roussy, a first clinical evaluation of the POCI camera has been performed for sentinel ganglion pre-operative localization in patients afflicted by malignant melanomas or breast cancers. The preliminary results have already shown that the performances of POCI are compatible with intraoperative imaging purposes and suggest how this camera can boost the success rate of tumor removal surgeries for other cancerous diseases. (author)

  19. Biograft-HT ® as a bone graft material in the treatment of periodontal vertical defects and its clinical and radiological evaluation: Clinical study

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    Chandrashekar K

    2009-01-01

    Full Text Available Aim: To determine the efficacy of Biograft-HT® as a bone graft material in the treatment of vertical defects in generalized chronic periodontitis patients and their clinical and radiological evaluation. Patients and Methods: Twenty patients diagnosed with generalized chronic periodontitis having two or more vertical defects were selected for this study. Clinical parameters like plaque index, gingival index, probing pocket depth and clinical attachment levels were recorded at different points of time over six months. Radiographic evaluation included the depth of the bone defect and the percentage of bone defect fill and was carried out for both the groups at baseline, three months and six months. After recording clinical parameters and administering phase -1 therapy, the sites were randomly treated either with Biograft- HT® or open flap debridement only. Results: At the end of six months there was a significant reduction in the plaque and gingival scores in both test and control groups. There was 64% decrease in probing pocket depth for the test site as compared to 54.52% decrease seen for the control group. Similarly there was an 84.82% gain in clinical attachment level from the baseline to six months post operatively for the experimental group in comparison to 68.83% gain for the control group. Furthermore, 43.57% bone fill was observed for the experimental site whereas only 17.98% of bone fill was evident in the control site. Conclusion: Biograft -HT improves healing outcomes, leads to a reduction of probing depth, a resolution of osseous defects and a gain in clinical attachment, compared with open flap debridement by itself.

  20. Evaluation of an artificial intelligence guided inverse planning system: Clinical case study

    International Nuclear Information System (INIS)

    Purpose: An artificial intelligence (AI) guided method for parameter adjustment of inverse planning was implemented on a commercial inverse treatment planning system. For evaluation purpose, four typical clinical cases were tested and the results from both plans achieved by automated and manual methods were compared. Methods and materials: The procedure of parameter adjustment mainly consists of three major loops. Each loop is in charge of modifying parameters of one category, which is carried out by a specially customized fuzzy inference system. A physician prescribed multiple constraints for a selected volume were adopted to account for the tradeoff between prescription dose to the PTV and dose-volume constraints for critical organs. The searching process for an optimal parameter combination began with the first constraint, and proceeds to the next until a plan with acceptable dose was achieved. The initial setup of the plan parameters was the same for each case and was adjusted independently by both manual and automated methods. After the parameters of one category were updated, the intensity maps of all fields were re-optimized and the plan dose was subsequently re-calculated. When final plan arrived, the dose statistics were calculated from both plans and compared. Results: For planned target volume (PTV), the dose for 95% volume is up to 10% higher in plans using the automated method than those using the manual method. For critical organs, an average decrease of the plan dose was achieved. However, the automated method cannot improve the plan dose for some critical organs due to limitations of the inference rules currently employed. For normal tissue, there was no significant difference between plan doses achieved by either automated or manual method. Conclusion: With the application of AI-guided method, the basic parameter adjustment task can be accomplished automatically and a comparable plan dose was achieved in comparison with that achieved by the manual

  1. Clinical evaluation of Kr-81m inhalation study through a dead space

    International Nuclear Information System (INIS)

    A new inhalation technique of 81mKr gas was applied to evaluate the pathophysiological abnormality of ventilation. 81mKr gas (370 MBq) was continuously supplied into a mouth piece directly (without dead space), VE, or through a dead space of 500 ml, VL, in 110 subjects with various lung diseases. Subjects were divided in four groups by a combination of distribution patterns of 81mKr gas obtained by these two inhalation techniques. Group 1: No ventilatory defect in both techniques. Group 2: Defects larger in VE than VL. Group 3: Defects larger in VL than VE. Group 4: no remarkable difference in defects in both techniques. Cases of group 1 were normal in pulmonary function test and chest X-ray. Finding of group 2 reflects early airway closure. This group consisted of cases in remission of bronchial asthma, small air way disease and pulmonary congestion. In group 3, restrictive disease and obstructive disease, especially emphysema, were included. Patients with severe obstructive disease and organized change of pulmonary parenchyma were belonged in group 4. In ventilation study with 81mKr gas, a combined study of inhalation technique through a dead space and by direct infusion may be useful to evaluate a pathophysiological change of various pulmonary diseases. (author)

  2. Portable handheld diffuse reflectance spectroscopy system for clinical evaluation of skin: a pilot study in psoriasis patients.

    Science.gov (United States)

    Tzeng, Shih-Yu; Guo, Jean-Yan; Yang, Chao-Chun; Hsu, Chao-Kai; Huang, Hung Ji; Chou, Shih-Jie; Hwang, Chi-Hung; Tseng, Sheng-Hao

    2016-02-01

    Diffuse reflectance spectroscopy (DRS) has been utilized to study biological tissues for a variety of applications. However, many DRS systems are not designed for handheld use and/or relatively expensive which limit the extensive clinical use of this technique. In this paper, we report a handheld, low-cost DRS system consisting of a light source, optical switch, and a spectrometer, that can precisely quantify the optical properties of tissue samples in the clinical setting. The handheld DRS system was employed to determine the skin chromophore concentrations, absorption and scattering properties of 11 patients with psoriasis. The measurement results were compared to the clinical severity of psoriasis as evaluated by dermatologist using PASI (Psoriasis Area and Severity Index) scores. Our statistical analyses indicated that the handheld DRS system could be a useful non-invasive tool for objective evaluation of the severity of psoriasis. It is expected that the handheld system can be used for the objective evaluation and monitoring of various skin diseases such as keloid and psoriasis. PMID:26977366

  3. Clinical evaluation of magnetic resonance imaging in coronary heart disease: The CE-MARC study

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    Sculpher Mark

    2009-07-01

    Full Text Available Abstract Background Several investigations are currently available to establish the diagnosis of coronary heart disease (CHD. Of these, cardiovascular magnetic resonance (CMR offers the greatest information from a single test, allowing the assessment of myocardial function, perfusion, viability and coronary artery anatomy. However, data from large scale studies that prospectively evaluate the diagnostic accuracy of multi-parametric CMR for the detection of CHD in unselected populations are lacking, and there are few data on the performance of CMR compared with current diagnostic tests, its prognostic value and cost-effectiveness. Methods/design This is a prospective diagnostic accuracy cohort study of 750 patients referred to a cardiologist with suspected CHD. Exercise tolerance testing (ETT will be preformed if patients are physically able. Recruited patients will then undergo CMR and single photon emission tomography (SPECT followed in all patients by invasive X-ray coronary angiography. The order of the CMR and SPECT tests will be randomised. The CMR study will comprise rest and adenosine stress perfusion, cine imaging, late gadolinium enhancement and whole-heart MR coronary angiography. SPECT will use a gated stress/rest protocol. The primary objective of the study is to determine the diagnostic accuracy of CMR in detecting significant coronary stenosis, as defined by X-ray coronary angiography. Secondary objectives include an assessment of the prognostic value of CMR imaging, a comparison of its diagnostic accuracy against SPECT and ETT, and an assessment of cost-effectiveness. Discussion The CE-MARC study is a prospective, diagnostic accuracy cohort study of 750 patients assessing the performance of a multi-parametric CMR study in detecting CHD using invasive X-ray coronary angiography as the reference standard and comparing it with ETT and SPECT. Trial Registration Current Controlled Trials ISRCTN77246133

  4. Consequences of overutilization and underutilization of thrombolytic therapy in clinical practice. TRACE Study Group. TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Ottesen, M M; Køber, L; Jørgensen, S;

    2001-01-01

    OBJECTIVES: The aim of this study was to evaluate the consequences, measured as mortality and in-hospital stroke, of the use of thrombolytic therapy among patients with acute myocardial infarction (AMI), who do not fulfill accepted criteria or who have contraindications to thrombolytic therapy (i.......e., overutilization) and among patients who are withheld thrombolytic treatment despite fulfilling indications and having no contraindications (i.e., underutilization). BACKGROUND: The implementation of treatment with thrombolysis in clinical practice is not in accordance with the accepted criteria from randomized...... studies. The consequence has been over- and underutilization of thrombolytic therapy among patients with AMI in clinical practice. The outcome of overutilization of thrombolytic therapy has not been described previously. METHODS: We examined 6,676 consecutive patients admitted to the hospital with an AMI...

  5. Clinical and radiographic evaluation of zinc oxide with aloe vera as an obturating material in pulpectomy: An in vivo study

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    Abhishek Khairwa

    2014-01-01

    Full Text Available Background: Pulp therapy for pulpally involved primary teeth continues to be a challenge to clinicians. One of the major areas of continued research is in the area of finding obturating materials to suit the specific properties of these teeth. Zinc oxide eugenol is used frequently in pulpectomy for the obturation of the primary teeth. Aims: To evaluate clinically and radiographically a mixture of zinc oxide eugenol and aloe vera as an obturating material. Materials and Methods: A total of 50 children, aged between 4 and 9 years, who were screened for unilateral or bilateral carious deciduous molars were studied. Out of these, 15 children were randomly selected for endodontic treatment. Obturation was done with a mixture of zinc oxide powder and aloe vera gel. Clinical and radiographic evaluation was done after 7 days, 1 month, 3 months, 6 months, and 9 months. The data were statistically analyzed. Results and Conclusion: Endodontic treatment using a mixture of zinc oxide powder and aloe vera gel in primary teeth has shown good clinical and radiographic success. A detailed observational study with longer follow-up will highlight the benefits of aloe vera in primary teeth as an obturating medium.

  6. Clinical and immunological evaluation of anti-apoptosis protein, survivin-derived peptide vaccine in phase I clinical study for patients with advanced or recurrent breast cancer

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    Asanuma Hiroko

    2008-05-01

    Full Text Available Abstract Background We previously reported that survivin-2B, a splicing variant of survivin, was expressed in various types of tumors and that survivin-2B peptide might serve as a potent immunogenic cancer vaccine. The objective of this study was to examine the toxicity of and to clinically and immunologically evaluate survivin-2B peptide in a phase I clinical study for patients with advanced or recurrent breast cancer. Methods We set up two protocols. In the first protocol, 10 patients were vaccinated with escalating doses (0.1–1.0 mg of survivin-2B peptide alone 4 times every 2 weeks. In the second protocol, 4 patients were vaccinated with the peptide at a dose of 1.0 mg mixed with IFA 4 times every 2 weeks. Results In the first protocol, no adverse events were observed during or after vaccination. In the second protocol, two patients had induration at the injection site. One patient had general malaise (grade 1, and another had general malaise (grade 1 and fever (grade 1. Peptide vaccination was well tolerated in all patients. In the first protocol, tumor marker levels increased in 8 patients, slightly decreased in 1 patient and were within the normal range during this clinical trial in 1 patient. With regard to tumor size, two patients were considered to have stable disease (SD. Immunologically, in 3 of the 10 patients (30%, an increase of the peptide-specific CTL frequency was detected. In the second protocol, an increase of the peptide-specific CTL frequency was detected in all 4 patients (100%, although there were no significant beneficial clinical responses. ELISPOT assay showed peptide-specific IFN-γ responses in 2 patients in whom the peptide-specific CTL frequency in tetramer staining also was increased in both protocols. Conclusion This phase I clinical study revealed that survivin-2B peptide vaccination was well tolerated. The vaccination with survivin-2B peptide mixed with IFA increased the frequency of peptide-specific CTL more

  7. Use of 3D MR reconstructions in the evaluation of glenoid bone loss: a clinical study

    International Nuclear Information System (INIS)

    To assess the ability of 3D MR shoulder reconstructions to accurately quantify glenoid bone loss in the clinical setting using findings at the time of arthroscopy as the gold standard. Retrospective review of patients with MR shoulder studies that included 3D MR reconstructions (3D MR) produced using an axial Dixon 3D-T1W-FLASH sequence at our institution was conducted with the following inclusion criteria: history of anterior shoulder dislocation, arthroscopy (OR) performed within 6 months of the MRI, and an estimate of glenoid bone loss made in the OR using the bare-spot method. Two musculoskeletal radiologists produced estimates of bone loss along the glenoid width, measured in mm and %, on 3D MR using the best-fit circle method, which were then compared to the OR measurements. There were a total of 15 patients (13 men, two women; mean age, 28, range, 19-51 years). There was no significant difference, on average, between the MRI (mean 3.4 mm/12.6 %; range, 0-30 %) and OR (mean, 12.7 %; range, 0-30 %) measurements of glenoid bone loss (p = 0.767). A 95 % confidence interval for the mean absolute error extended from 0.45-2.21 %, implying that, when averaged over all patients, the true mean absolute error of the MRI measurements relative to the OR measurements is expected to be less than 2.21 %. Inter-reader agreement between the two readers had an IC of 0.92 and CC of 0.90 in terms of percentage of bone loss. 3D MR reconstructions of the shoulder can be used to accurately measure glenoid bone loss. (orig.)

  8. Use of 3D MR reconstructions in the evaluation of glenoid bone loss: a clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Gyftopoulos, Soterios; Beltran, Luis S.; Yemin, Avner; Recht, Michael P. [NYU Langone Medical Center, Department of Radiology, New York, NY (United States); Strauss, Eric; Meislin, Robert; Jazrawi, Laith [NYU Langone Medical Center, Center for Musculoskeletal Care, Department of Orthopaedic Surgery, New York, NY (United States)

    2014-02-15

    To assess the ability of 3D MR shoulder reconstructions to accurately quantify glenoid bone loss in the clinical setting using findings at the time of arthroscopy as the gold standard. Retrospective review of patients with MR shoulder studies that included 3D MR reconstructions (3D MR) produced using an axial Dixon 3D-T1W-FLASH sequence at our institution was conducted with the following inclusion criteria: history of anterior shoulder dislocation, arthroscopy (OR) performed within 6 months of the MRI, and an estimate of glenoid bone loss made in the OR using the bare-spot method. Two musculoskeletal radiologists produced estimates of bone loss along the glenoid width, measured in mm and %, on 3D MR using the best-fit circle method, which were then compared to the OR measurements. There were a total of 15 patients (13 men, two women; mean age, 28, range, 19-51 years). There was no significant difference, on average, between the MRI (mean 3.4 mm/12.6 %; range, 0-30 %) and OR (mean, 12.7 %; range, 0-30 %) measurements of glenoid bone loss (p = 0.767). A 95 % confidence interval for the mean absolute error extended from 0.45-2.21 %, implying that, when averaged over all patients, the true mean absolute error of the MRI measurements relative to the OR measurements is expected to be less than 2.21 %. Inter-reader agreement between the two readers had an IC of 0.92 and CC of 0.90 in terms of percentage of bone loss. 3D MR reconstructions of the shoulder can be used to accurately measure glenoid bone loss. (orig.)

  9. Evaluation of magnocellular pathway abnormalities in schizophrenia: a frequency doubling technology study and clinical implications

    Directory of Open Access Journals (Sweden)

    Fabiana Benites Vaz de Lima

    2013-04-01

    Full Text Available BACKGROUND: Visual processing deficits have been reported for patients with schizophrenia. Previous studies demonstrated differences in early-stage processing of schizophrenics, although the nature, extent, and localization of the disturbance are unknown. The magnocellular and parvocellular visual pathways are associated with transient and sustained channels, but their respective contributions to schizophrenia-related visual deficits remains controversial. PURPOSE: The aim of this study was to evaluate magnocellular dysfunction in schizophrenia using frequency doubling technology. METHODS: Thirty-one patients with schizophrenia and 34 healthy volunteers were examined. Frequency doubling technology testing was performed in one session, consisting of a 15-minute screening strategy followed by the C-20 program for frequency doubling technology. RESULTS: Schizophrenic patients showed lower global mean sensitivity (30,97 ± 2,25 dB compared with controls (32,17 ± 3,08 dB, p<0.009. Although there was no difference in the delta sensitivity of hemispheres, there was a difference in sensitivity analysis of the fibers crossing the optic chiasm, with lower mean sensitivity in the patient group (28,80 dB versus controls (30,66 dB. The difference was higher in fibers that do not cross the optic chiasm, with lower mean sensitivity in patients (27,61 dB versus controls (30,26 dB, p<0.005. CONCLUSIONS: Our results suggest that there are differences between global sensitivity and fiber sensitivity measured by frequency doubling technology. The different sensitivity of fibers that do not cross the optic chiasm is consistent with most current etiological hypotheses for schizophrenia. The decreased sensitivity responses in the optic radiations may significantly contribute to research assessing early-stage visual processing deficits for patients with schizophrenia.

  10. Studies on the traditional herbal anthelmintic Chenopodium ambrosioides L.: ethnopharmacological evaluation and clinical field trials.

    Science.gov (United States)

    Kliks, M M

    1985-01-01

    Infusions and decoctions of the leaves, roots and inflorescences of the herbaceous shrub Chenopodium ambrosioides (American wormseed, goosefoot, epazote, paico) and related species indigenous to the New World have been used for centuries as dietary condiments and as traditional anthelmintics by native peoples for the treatment of intestinal worms. Commercial preparations of oil of chenopodium and its active constituent, ascaridol, obtained by steam distillation, have been and continue to be, used with considerable success in mass treatment campaigns. Ethnopharmacological studies in a community of Mayan subsistence farmers in Chiapas, Mexico, confirmed that decoctions containing up to 300 mg of dry plant material per kg body weight (MGKGW) were widely used and traditionally highly regarded in the treatment of ascariasis. However, therapeutic doses of up to 6000 MGKGW of powdered, dried plant had no significant anthelmintic effect on the adults of Necator, Trichuris of Ascaris. Gas-liquid chromatographic analyses of plant samples used consistently demonstrated the presence of ascaridol in the expected amounts. Possible origins of subjective belief in the efficacy of C. ambrosioides as used, may be related to the positive association of spontaneous, or peristalsis-induced passage of senescent worms immediately following a therapeutic episode. It is also possible that in the past varieties of the plant containing much more ascaridol were used. The results of these controlled field studies did not sustain widely held traditional beliefs, nor the value of therapeutic practices regarding this plant. It is, therefore, essential that all indigenous ethnomedical practices be objectively evaluated for efficacy and safety using appropriate protocols before being considered for adoptation or promotion in health care programs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3906906

  11. Clinical evaluation of removable partial dentures on the periodontal health of abutment teeth: a retrospective study.

    Science.gov (United States)

    Dula, Linda J; Ahmedi, Enis F; Lila-Krasniqi, Zana D; Shala, Kujtim Sh

    2015-01-01

    The aim of this retrospective study was to evaluate the effect of removable partial dentures in periodontal abutment teeth in relation to the type of denture support and design of RPD in a five-year worn period. Methods : A total of 64 patients with removable partial dentures (RPDs), participated in this study. It were examined ninety-one RPDs. There were seventy-five RPDs with clasp-retained and sixteenth were RPDs with attachments. There were 28 females and 36 males, aged between 40-64 years, 41 maxillary and 50 mandible RPDs. For each subjects the following data were collected: denture design, denture support, and Kennedy classification. Abutment teeth were assessed for plaque index (PI), calculus index (CI), blending on probing (BOP), probing depth (PD), gingival recession (GR), tooth mobility (TM). Level of significance was set at p<0.05. Results : According to denture support of RPD, BOP, PD, PI, GR, CI and TM-index showed no statistically significant difference. Based on the denture design of RPD's, BOP, PD, PI, CI, and TM-index proved no statistically significant difference. Except GR-index according to denture design confirmed statistically significant difference in RPD with clasp p<0.01. The higher values of all periodontal parameter as BOP, PD, PI, CI and TM were in patients with RPD's with claps comparing with RPD's with attachment. Conclusion : RPD's with clasp increased level of gingival inflammation in regions covered by the dentures and below the clasp arms in abutment teeth. PMID:25926896

  12. Comparative photographic evaluation of various geometric and mathematical proportions of maxillary anterior teeth: A clinical study

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    Vineet S Agrawal

    2016-01-01

    Full Text Available Aim: This study aimed to investigate the existence of the golden proportion, recurring esthetic dental (RED proportion and golden percentage between the frontal view widths of the maxillary anterior natural dentition among students of Indian origin by the aid of digital photography. Materials and Methods: This study was conducted with 80 dental students (41 female and 39 male, with ages ranging from 20 to 23 years. Students whose natural smile did not develop any visual tension with regard to the study′s and their own criteria were selected as having an esthetic smile. Photographs were taken, and the mesiodistal widths of six maxillary anterior teeth were measured digitally using software. Once the measurements were recorded three different theories of proportion were applied and statistical analysis was done. Results: The golden proportion, i.e., 62% RED proportion and golden percentage were not observed in the subjects. According to the subjects evaluated, the average width of the maxillary lateral incisor was 72% of the frontal view width of the central incisor. The average width of the canine was 84% of the frontal view width of the lateral incisor. Conclusion: The golden proportion and RED proportion were not observed in the natural smiles of subjects who were deemed to have an esthetic smile. The values proposed for the golden percentage theory were not observed in subjects with an esthetic smile. Average frontal view percentage widths of the maxillary anterior dentition exist and can be useful in predicting naturally occurring widths in smiles deemed to be esthetic in a specific population.

  13. Exploring the key performance areas and assessment criteria for the evaluation of students’ clinical performance: a delphi study

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    C. Joseph

    2011-02-01

    Full Text Available Background: evaluating  students’ clinical  performance  is  an integral part of the quality assurance in a physiotherapy curriculum, however, the objectivity during clinical examination have been questioned on numerous occasions.  The  aim  of  this  study  was  to  explore  the  essential  key  clinical performance areas and the associated assessment criteria in order to develop a reliable clinical assessment form.Methods: A Delphi study was used to obtain consensus on the development of a reliable clinical performance assessment tool. The study population consisted of  purposively  selected  academic  physiotherapy  staff  from  the  University  of Western Cape as well as supervisors and clinicians involved in the examination of  physiotherapy  students  from  the  three  Universities  in  the  Western Cape.  Findings  from  the  Delphi  rounds  were analysed  descriptively. Fifty  percent  or  higher  agreement  on  an  element  was  interpreted  as  an  acceptable  level of consensus.Results: Eight key performance areas were identified with five assessment criteria per key performance area as well as the weighting per area. It was evident that evaluators differed on the expectations of physiotherapy students as well as the criteria used to assess them.Conclusions: The Delphi panel contributed to the formulation of a clinical assessment form through the identification of  relevant  key  performance  areas  and  assessment  criteria  as  they  relate  to undergraduate  physiotherapy  training. Consensus on both aspects was reached following discussion and calculation of mean ranking sores.Implications: This process of reaching consensus in determining clear criteria for measuring key performance areas contributes to the objectivity of the process of examinations.

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

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    Full Text Available ... Children & Clinical Studies NHLBI Trials Clinical Trial Websites Children and Clinical Studies Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to ...

  15. COMPARATIVE STUDY BETWEEN CONVENTIONAL CLINICAL EXAMINATION (CCE V / S OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE AS AN EVALUATION TOOL FOR MBBS STUDENTS

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    Sreedevi

    2015-05-01

    Full Text Available BACK GROUND: In India, there has been a considerable rethink on the curriculum of medical education, specially, on the teaching and assessment methodology. Subjective assessment is slowly giving way to objective structured assessment. The aim of undergoing clinical ex amination is to assess the students learning skill, knowledge, professionalism and attitude avoiding examiners variability and bias. OSCE has been advocated as it overcomes the flaws of conventional clinical examination. OBJECTIVE: To find out effective, E valuation tool where the assessment is Structured, Competency based, In - depth testing of skills is done, And higher levels of Millers Pyramid is tested. Method: A comparative study was conducted in Tagore Medical College and Hospital among the 9 th Semester students. Scores obtained under both the methods were compared using statistical methods. After undergoing both the examination, feedback was collected to assess the attitude of the students towards both the methods. RESULTS: By quantitative analysis, t he two - tailed P value is 0.000 which is considered to be extremely statistically significant. So, the null hypothesis was rejected. So, there is strong reason to believe that students are able to score better under a better examination methodology. By qualit ative analysis, attitude of the students towards OSCE method was better than CCE method. CONCLUSION: It is proved that Objective structured clinical examination a statistically significant better evaluation tool with comparison to conventional examination and it can be included in the undergraduate assessment method.

  16. Evaluation of adjuvant chemoradiation therapy for ampullary adenocarcinoma: the Johns Hopkins Hospital - Mayo Clinic collaborative study

    International Nuclear Information System (INIS)

    The role of adjuvant chemoradiation therapy for ampullary carcinoma is unknown. Previous literature suggests that certain populations with high risk factors for recurrence may benefit from adjuvant chemoradiation. We combined the experience of two institutions to better delineate which patients may benefit from adjuvant chemoradiation. Patients who underwent curative surgery for ampullary carcinoma at the Johns Hopkins Hospital (n = 290; 1992-2007) and at the Mayo Clinic (n = 130; 1977-2005) were reviewed. Patients with <60 days of follow-up, metastatic disease at surgery, or insufficient pathologic data were excluded. The final combined study consisted of 186 patients (n = 104 Johns Hopkins, n = 82 Mayo). Most patients received 5-FU based chemoradiation with conformal radiation. Cox proportional hazards models were used for survival analysis. Median overall-survival was 39.9 months with 2- and 5-year survival rates of 62.4% and 39.1%. On univariate analysis, adverse prognostic factors for overall survival included T3/T4 stage disease (RR = 1.86, p = 0.002), node positive status (RR = 3.18, p < 0.001), and poor histological grade (RR = 1.69, p = 0.011). Patients who received adjuvant chemoradiation (n = 66) vs. surgery alone (n = 120) showed a higher rate of T3/T4 stage disease (57.6% vs. 30.8%, P < 0.001), lymph node involvement (72.7% vs. 30.0%, P < 0.001), and close or positive margins (4.6% vs. 0.0%, P = 0.019). Five year survival rates among node negative and node positive patients were 58.7% and 18.4% respectively. When compared with surgery alone, use of adjuvant chemoradiation improved survival among node positive patients (mOS 32.1 vs. 15.7 mos, 5 yr OS: 27.5% vs. 5.9%; RR = 0.47, P = 0.004). After adjusting for adverse prognostic factors on multivariate analysis, patients treated with adjuvant chemoradiation demonstrated a significant survival benefit (RR = 0.40, P < 0.001). Disease relapse occurred in 37.1% of all patients, most commonly metastatic

  17. Evaluation of the efficiency of biofield diagnostic system in breast cancer detection using clinical study results and classifiers.

    Science.gov (United States)

    Subbhuraam, Vinitha Sree; Ng, E Y K; Kaw, G; Acharya U, Rajendra; Chong, B K

    2012-02-01

    The division of breast cancer cells results in regions of electrical depolarisation within the breast. These regions extend to the skin surface from where diagnostic information can be obtained through measurements of the skin surface electropotentials using sensors. This technique is used by the Biofield Diagnostic System (BDS) to detect the presence of malignancy. This paper evaluates the efficiency of BDS in breast cancer detection and also evaluates the use of classifiers for improving the accuracy of BDS. 182 women scheduled for either mammography or ultrasound or both tests participated in the BDS clinical study conducted at Tan Tock Seng hospital, Singapore. Using the BDS index obtained from the BDS examination and the level of suspicion score obtained from mammography/ultrasound results, the final BDS result was deciphered. BDS demonstrated high values for sensitivity (96.23%), specificity (93.80%), and accuracy (94.51%). Also, we have studied the performance of five supervised learning based classifiers (back propagation network, probabilistic neural network, linear discriminant analysis, support vector machines, and a fuzzy classifier), by feeding selected features from the collected dataset. The clinical study results show that BDS can help physicians to differentiate benign and malignant breast lesions, and thereby, aid in making better biopsy recommendations. PMID:20703753

  18. Teaching clinically experienced physicians communication skills: a review of evaluation studies.

    OpenAIRE

    Hulsman, R.L.; Ros, W J G; Winnubst, J.A.M.; Bensing, J.M.

    1999-01-01

    Interest in the teaching of communication skills in medical schools has increased since the early seventies but, despite this growing interest, relatively limited curricular time is spent on the teaching of communication skills. The limited attention to the teaching of these skills applies even more to the physicians' clinical years, when attention becomes highly focused on biomedical and technical competence. Continuing training after medical school is necessary to refresh knowledge and skil...

  19. Clinical evaluation of renal function study using I-123 orthoiodohippurate (I-123 OIH) in patients with obstructive uropathy

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    Okada, Junichi; Uchiyama, Guio (Yamanashi University School of Medicine (Japan)); Katsurai, Hiroshi; Uno, Koichi; Uematsu, Sadao

    1984-06-01

    Functional images and regional renograms using I-123 OIH were evaluated by comparing with patients' clinical courses, intravenous pyelographies and Creatinine clearances. Twenty-one patients with obstructive uropathy were studied. Functional images were processed in three parameters of Tmax, T 1/2 and ERBF (effective renal blood flow). ERBF images were composed of regional counts in early blood flow phase of renograms. Regional renograms were produced on renal parenchyma and pelvis. ERBF images represented the functioning distributions of renal tissue after the surgery and the recoveries in the renal parenchyma. Tmax and T 1/2 images and pelvic regional renograms showed the good correlations with IVP findings which presented the dilatation of pelvis and the delay of excretion. Parenchymal regional renograms showed the poor correlations with Creatinine clearances and caused sometimes errors in ROI settings. The evaluation of renal function only by the parenchymal regional renogram seemed to be inappropriated.

  20. Clinical evaluation of renal function study using I-123 orthoiodohippurate (I-123 OIH) in patients with obstructive uropathy

    International Nuclear Information System (INIS)

    Functional images and regional renograms using I-123 OIH were evaluated by comparing with patients' clinical courses, intravenous pyelographies and Creatinine clearances. Twenty-one patients with obstructive uropathy were studied. Functional images were processed in three parameters of Tmax, T 1/2 and ERBF (effective renal blood flow). ERBF images were composed of regional counts in early blood flow phase of renograms. Regional renograms were produced on renal parenchyma and pelvis. ERBF images represented the functioning distributions of renal tissue after the surgery and the recoveries in the renal parenchyma. Tmax and T 1/2 images and pelvic regional renograms showed the good correlations with IVP findings which presented the dilatation of pelvis and the delay of excretion. Parenchymal regional renograms showed the poor correlations with Creatinine clearances and caused sometimes errors in ROI settings. The evaluation of renal function only by the parenchymal regional renogram seemed to be inappropriated. (author)

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

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    Full Text Available ... Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & Clinical Studies NHLBI Trials Clinical Trial Websites ...

  2. Developments in statistical evaluation of clinical trials

    CERN Document Server

    Oud, Johan; Ghidey, Wendimagegn

    2014-01-01

    This book describes various ways of approaching and interpreting the data produced by clinical trial studies, with a special emphasis on the essential role that biostatistics plays in clinical trials. Over the past few decades the role of statistics in the evaluation and interpretation of clinical data has become of paramount importance. As a result the standards of clinical study design, conduct and interpretation have undergone substantial improvement. The book includes 18 carefully reviewed chapters on recent developments in clinical trials and their statistical evaluation, with each chapter providing one or more examples involving typical data sets, enabling readers to apply the proposed procedures. The chapters employ a uniform style to enhance comparability between the approaches.

  3. Clinical evaluation of contemporary oxygenators.

    Science.gov (United States)

    Stanzel, Roger D P; Henderson, Mark

    2016-01-01

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

  4. Evaluation of a classical unani pharmacopeial formulation safoof-e-muhazzil in hyperlipidemia: A randomized, standard controlled clinical study

    Directory of Open Access Journals (Sweden)

    Umar Jahangir

    2014-01-01

    Full Text Available Aim of the Study: The aim of the following study is to evaluate the efficacy and tolerability of a compound Unani formulation in hyperlipidemia on clinical and biochemical parameters. Materials and Methods: A total of 90 patients with total cholesterol level of 220 mg/dl and above were included. In Group ′A′ thirty patients with total cholesterol 243.5 ± 5.294 mg/dl received Unani formulation safoof-e-muhazzil (SM in its classical powder form 5 g twice daily orally, in Group ′B′ thirty patients with total cholesterol 234 ± 3.822 mg/dl received the SM but in compressed tablet form in the same dosage and in Group ′C′ 30 patients with total cholesterol 242.7 ± 5.563 mg/dl received atorvastatin 10 mg as a standard control. Follow-up was carried out on second, fourth and 6th week and patients were evaluated on clinical as well as biochemical parameters. Results: Group A before treatment had mean total cholesterol of 243.5 ± 5.294 mg/dl which decreased significantly after treatment to 225.6 ± 5.953 mg/dl (P 0.5 relief in palpitation and 26.17% (P < 0.001 relief in dyspnea post-treatment. Group B fatigue decreased significantly by 18.14% (P < 0.01, palpitation by 22.91% (P < 0.01 and dyspnea by 20.46% (P < 0.01. In Group C a non-significant increase of 2.2% was observed in fatigue post-treatment, palpitation decreased by 10.22% non-significantly and dyspnea decreased significantly by 17.64% (P < 0.001. Results indicate that the test drug safely and effectively ameliorates the clinical condition of patients with hyperlipidemia while decreasing cholesterol level as well.

  5. Clinical Evaluation of Anemia in Geriatric Patients - A Cross Sectional Study Conducted At Tertiary Care Hospital

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    Sfurti Mann, Amit Kumar, Shiv Kumar Singh, Surbhi Katyal, Gaurav Chopra, Sanjeev Kumar Varma

    2014-01-01

    Methods: After taking informed written consent, patients were subjected to a detailed history, thorough clinical examination and various relevant investigations including bone marrow examination and radiological means. Result: 42 patients (70% were male and 18 patients (30% were female. Maximum number of patients, 24 (40% were in the age group 65-69 years. Out of which 15 (62.5% were male and 9 (37.5% were female. Conclusion: Among all the patients (irrespective of age groups and types of anemia, ACD was found to be most common (41.67%, followed by IDA (35%, MDS (5%, Megaloblastic anemia (3.34%, myelofibrosis and haemolytic anemia (3.34% each and aplastic anemia (1.67%.

  6. Evaluation of the safety and efficacy of pregabalin in older patients with neuropathic pain: results from a pooled analysis of 11 clinical studies

    OpenAIRE

    Zlateva Gergana; Murphy T; Semel David; Cheung Raymond; Emir Birol

    2010-01-01

    Abstract Background Older patients are typically underrepresented in clinical trials of medications for chronic pain. A post hoc analysis of multiple clinical studies of pregabalin in patients with painful diabetic peripheral neuropathy (DPN) or postherpetic neuralgia (PHN) was conducted to evaluate the efficacy and safety of pregabalin in older patients. Methods Data from 11 double-blind, randomized, placebo-controlled clinical studies of pregabalin in patients with DPN or PHN were pooled. E...

  7. Clinical and radiographic evaluation of pulpectomies using three root canal filling materials: An in-vivo study

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    Ramar K

    2010-03-01

    Full Text Available Various root canal filling materials are used to preserve a pulpally involved carious primary tooth. But there is no single material so far available to fulfill all the requirements of an ideal root canal filling material for a primary tooth. Hence this study was undertaken to evaluate clinically and radiographically the efficacy of three obturating materials - Calcium hydroxide with Iodoform (METAPEX, Zinc Oxide Eugenol with Iodoform (RC FILL and Zinc Oxide Eugenol and Calcium hydroxide with Iodoform (ENDOFLAS for a period of 9 months. Results show ENDOFLAS gave an overall success rate of 95.1%, METAPEX - 90.5% and RC FILL - 84.7%. In our study, we conclude that ENDOFLAS, a mixture of Zinc Oxide Eugenol and Calcium hydroxide with Iodoform fulfills most of the required properties of an ideal root canal filling for primary teeth.

  8. Clinical evaluation of carbon fiber reinforced carbon endodontic post, glass fiber reinforced post with cast post and core: A one year comparative clinical study

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    Preethi G

    2008-01-01

    Full Text Available Aim: Restoring endodontically treated teeth is one of the major treatments provided by the dental practitioner. Selection and proper use of restorative materials continues to be a source of frustration for many clinicians. There is controversy surrounding the most suitable choice of restorative material and the placement method that will result in the highest probability of successful treatment. This clinical study compares two different varieties of fiber posts and one cast post and core in terms of mobility of crown margin under finger pressure, recurrent caries detected at the crown margin, fracture of the restoration, fracture of the root and periapical and periodontal pathology requiring crown removal over the period of 12months as evaluated by clinical and radiographical examination. Materials and Methods: 30 root canal treated, single rooted maxillary anterior teeth of 25 patients in the age range of 18-60 years where a post retained crown was indicated were selected for the study between January 2007 and August 2007; and prepared in a standard clinical manner. It was divided into 3 groups of 10 teeth in each group. After post space preparation, the Carbon fiber and Glass fiber reinforced posts were cemented with Scotch bond multipurpose plus bonding agent and RelyX adhesive resin cement in the first and second groups respectively. The Cast post and cores were cemented with Zinc Phosphate cement in the third group. Following post- cementation, the preparation was further refined and a rubber base impression was taken for metal-ceramic crowns which was cemented with Zinc Phosphate cement. A baseline periapical radiograph was taken once each crown was cemented. All patients were evaluated after one week (baseline, 3 months, 6 months and one year for following characteristics mobility of crown margin under finger pressure, recurrent caries detected at the crown margin, fracture of the restoration, fracture of the root and periapical and

  9. A combined approach of bedside clinical examination and flexible endoscopic evaluation of swallowing in poststroke dysphagia: A pilot study

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    Sureshkumar Radhakrishnan

    2013-01-01

    Full Text Available Background: As with most neurologic conditions, stroke involves impairment of the swallowing mechanism. This could be a spectrum of issues, the worst of which is aspiration. At the same time, the prolonged presence of a naso-gastric tube (NGT has its own morbidity. Flexible endoscopic evaluation of swallowing (FEES is one reliable method to assess the structural and functional status of the oropharynx and larynx, during the swallowing process. Objective: To study the utility of FEES in decision-making with respect to resumption of oral intake in stroke patients. To document the findings of FEES in stroke patients, and to look for correlations between these and the site of stroke. Materials and Methods: Protocol insertion of naso-gastric tube in all stroke patients, at presentation. Initial assessment by a neurologist and swallowing therapist, depending on cognitive status of the patient. All patients underwent MRI Brain with diffusion weighted sequences. After detailed clinical examination, they underwent swallow exercises under the supervision of a trained swallowing therapist. The decision to remove NGT was taken clinically by the combined decision of neurologist and swallowing therapist. Then all patients underwent FEES by the ENT surgeon. The final decision for NGT removal was taken as per the FEES findings. Result: Sixteen stroke patients underwent the FEES procedure during a period of six months. The oropharyngeal and laryngeal findings varied depending on the area of stroke involvement. Of these, change in decision regarding swallowing rehabilitation or NGT removal was needed in four patients, following the FEES findings. Conclusions: FEES is an easy, efficient and reliable method to evaluate the swallowing status in stroke patients. In combination with good bedside clinical examination and swallow exercises, it can be a good tool in assessing patients with post- stroke dysphagia. Post-stroke rehabilitation and prevention of aspiration

  10. Evaluation of the Young Children with Neurodevelopmental Disability: A Prospective Study at Hamadan University of Medical Sciences Clinics

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    Afshin FAYYAZI

    2013-02-01

    Full Text Available How to Cite This Article: Fayyazi A, Kheizrian L, Kheradmand Z, Damadi S, Khajeh A. Evaluation of the Young Children with Neurodevelopmental Disability: A Prospective Study at Hamadan University of Medical Sciences Clinics. Iran J Child Neurol. 2013 Winter; 7 (1:29-33. ObjectiveDevelopmental impairment is a common problem in children health that occurs in approximately 5–10% of the childhood population. The aim of this study was to determine the etiologic yield of subspecialists’ evaluation of young children with developmental disability.Materials & MethodsAll children aged between 2 months and 5 years referred over a 15-month period to Hamadan University of Medical Sciences subspecialty services for initial evaluation of a suspected developmental Disability, were enrolled in the present study. Diagnostic yield was determined after the completion of clinical assessments and laboratory tests requested by the evaluating physician.ResultsA total of 198 children (129 boys and 69 girls were eligible for our study.108 children had global developmental delay and 90 children had isolated developmental delay. Approximately ¼ of all patients did not have any specific etiology for developmental disability. Cerebral palsy (CP was the most common clinical syndrome in all patients (41.4%. Hypoxic ischemic encephalopathy (13.8%, brain dysgenesis (13%, genetic disorder (13%, and  neurodegenerative  diseases  (11%  were  determined  in  more  than one half of all children with global developmental disability. in our study, “developmental speech delay” was the common cause of isolated speech delay.ConclusionDetermination of an underlying etiology is an essential part of specialty evaluation of young children with developmental disability. The results of this study were similar closely to the results of other studies. ReferencesBernard LM. Current Management in Child Neurology. 3rd ed. London: BC Decker Inc; 2005. pp. 3-8 and 246-50.Cleary M A

  11. Evaluation of Study and Patient Characteristics of Clinical Studies in Primary Progressive Multiple Sclerosis: A Systematic Review.

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    T Ziemssen

    Full Text Available So far, clinical studies in primary progressive MS (PPMS have failed to meet their primary efficacy endpoints. To some extent this might be attributable to the choice of assessments or to the selection of the study population.The aim of this study was to identify outcome influencing factors by analyzing the design and methods of previous randomized studies in PPMS patients without restriction to intervention or comparator.A systematic literature search was conducted in MEDLINE, EMBASE, BIOSIS and the COCHRANE Central Register of Controlled Trials (inception to February 2015. Keywords included PPMS, primary progressive multiple sclerosis and chronic progressive multiple sclerosis. Randomized, controlled trials of at least one year's duration were selected if they included only patients with PPMS or if they reported sufficient PPMS subgroup data. No restrictions with respect to intervention or comparator were applied. Study quality was assessed by a biometrics expert. Relevant baseline characteristics and outcomes were extracted and compared.Of 52 PPMS studies identified, four were selected. Inclusion criteria were notably different among studies with respect to both the definition of PPMS and the requirements for the presence of disability progression at enrolment. Differences between the study populations included the baseline lesion load, pretreatment status and disease duration. The rate of disease progression may also be an important factor, as all but one of the studies included a large proportion of patients with a low progression rate. In addition, the endpoints specified could not detect progression adequately.Optimal PPMS study methods involve appropriate patient selection, especially regarding the PPMS phenotype and progression rate. Functional composite endpoints might be more sensitive than single endpoints in capturing progression.

  12. An evaluation of structural changes in diabetic neuropathy. Clinical study with magnetic resonance imaging (MRI)

    International Nuclear Information System (INIS)

    To investigate changes in tissue hydration and structural changes in diabetic patients using an MRI scanner (SIGNA 1.5-Tesla) with an extremity coil, spin-lattice relaxation time (T1 value), cross-sectional area, and coefficient of variation (CV value) of signal intensities of the sural nerve, respectively, were determined as indexes of nerve edema, nerve swelling or shrinkage and structural change, and were calculated in normal subjects (normal group, n=7) and diabetic patients (diabetic group, n=33). T1 value of the sural nerve, but not muscle or adipose tissue, was significantly prolonged in diabetic group (1000±273 vs 702±324 msec, P1 values were positively correlated with glycemic control (fasting plasma glucose: r=40, HbA1c: r=0.35) (P<0.05) and negatively correlated with motor nerve conduction velocity (r=-0.42, P<0.01). These findings indicate that MRI is of value in the objective evaluation of structural changes in diabetic neuropathy. (author)

  13. OBSTRUCTIVE JAUNDICE: A CLINICAL STUDY

    OpenAIRE

    Antony,; Rasool Syed

    2016-01-01

    BACKGROUND Jaundice is a frequent manifestation of biliary tract disorders and evaluation of obstructive jaundice is a common problem faced by general surgeons. Obstructive jaundice of varied aetiology is one of the main cause of hospital admissions. Hence, comprehensive study of aetiology, clinical presentation, management of obstructive jaundice is important in management of these patients. AIMS AND OBJECTIVES  Study the clinical history and presentation of obstructiv...

  14. CLINICAL STUDY TO EVALUATE THE MATERNAL AND PERINATAL OUTCOME OF PREGNANCIES WITH POLYHYDRAMNIOS

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    Sudha

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND : Due to active involvement of fetal system in regulation of amn iotic fluid volume, AFI has been identified as indicator of intrauterine fetal status. USG has revolutionized the process of assessment of amniotic fluid thus becoming an integral part of fetal surveillance . Polyhydramnios is an obstetrical condition assoc iated with significant perinatal and maternal morbidity and mortality. In a low resource health facility as India with poor coverage of antenatal care and malnutrition it still becomes more important to screen pregnancies for such high risk factors. AIMS: 1. To study incidence of polyhydramnios. 2. To identify major etiological factors of polyhydramnios. 3. To study perinatal outcome. SETTINGS AND DESIGN: A hospital based cross section study for duration from 1 st May 2009 to 31 st October 2010. MATERIAL & ME THOD: All the cases identified as polyhydramnios according to AFI in four pocket were included in the study. The cases identified as having polyhydramnios but not delivered at the facility were excluded. OBSERVATION: Incidence of polyhydramnios is 0.72% of the total antenatal cases, multiparous ie, 52% more than primiparous cases. Majority were unbooked (77.3% 63% were from rural set up. 76% belonged to low socio economic status. Majority 66% of the cases had their 1 st antenatal visit at term. Increased in cidence of operative delivery was seen in the study. Associated maternal factors found with polyhydramnios were gestation hypertension (8.4%, preeclampsia (2.9%, eclampsia (2.9%, anaemia (11%, twins (8.4%, malpresentation (5%, RH negative factor (3.7 %, and diabetes (1.9%. Fetal complication include prematurity 21.6%, IUFT 20.7%, congenital malformation 21.6%, cord prolapse 3.7%, birth asphyxia 1.9%. Most common congenital anomaly was anencephaly i.e., 11%. CONCLUSION : The study gives us the underst anding of the impact of polyhydramnios on the maternal and fetal outcome. Our study demonstrate s

  15. COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF THREE METHODS FOR PROXIMAL CARIES DIAGNOSIS – A CLINICAL STUDY.

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    Mirela Marinova-Takorova

    2014-06-01

    Full Text Available Aim: The aim of the presented study is to compare the effectiveness of the diagnosis with a dental microscope, laser fluorescence (DIAGNOcam and X-ray examination in proximal caries diagnosis. Material and methods: Thirty-eight adult patients were examined. They were first examined with a dental mirror and a probe, under magnification 6.4 times. After that a diagnosis with DIAGNOcam was performed. Bitewing X-ray images were administered. The data from the three diagnostic methods was compared using SPSS 16 package of Windows. The lesions that were diagnosed as involving dentin were then excavated which served as a confirmation of the diagnosis. Results: The results of the study showed that dentinal lesions were detected with a high degree of correlation with all three diagnostic methods. The visual examination seriously underestimated lesions involving only enamel. In these cases there was a good correlation between laser fluorescence and X-ray data. Conclusions: Based on the conducted study we could conclude that the diagnosis of proximal caries with DIAGNOcam is equivalent to X-ray, both being more accurate in cases with early lesions, compared to visual diagnosis.

  16. Clinical laboratory evaluation of the Abbott MS-2 automated antimicrobial susceptibility testing system: report of a collaborative study.

    OpenAIRE

    Thornsberry, C; Anhalt, J P; Washington, J A; McCarthy, L R; Schoenknecht, F D; Sherris, J. C.; Spencer, H J

    1980-01-01

    The MS-2 system (Abbott Diagnostics, Division of Abbott Laboratories, Dallas, Tex.) was evaluated for its efficacy in determining the susceptibilities of both clinical and selected challenge (nonfastidious, facultative, and aerobic) isolates. The MS-2 results were compared with standard Kirby-Bauer disk diffusion and microdilution results by using fresh clinical isolates. For gram-positive isolates other than enterococci, overall agreement between MS-2 and reference results was 93 to 98%. Wit...

  17. Evaluation of three different agents for in-office treatment of dentinal hypersensitivity: A controlled clinical study

    OpenAIRE

    Shruti A Patil; Balaram D Naik; Suma, R.

    2015-01-01

    Context: Dentin desensitizers are used for in-office treatment of dentinal hypersensitivity. They block the open tubules and bring about a reduction in hypersensitivity. Aim: The aim was to evaluate and compare the clinical effectiveness of a dentin desensitizer, a combination of a dentin desensitizer + adhesive and one-bottle self-etching adhesive for in-office treatment of dentin hypersensitivity. Settings and Design: Institutional, prospective double-blind parallel clinical design....

  18. PROMIS--Prostate MR imaging study: A paired validating cohort study evaluating the role of multi-parametric MRI in men with clinical suspicion of prostate cancer.

    OpenAIRE

    El-Shater Bosaily, A.; Parker, C.; Brown, L. C.; Gabe, R; Hindley, R. G.; Kaplan, R; Emberton, M.; Ahmed, H. U.; PROMIS Group

    2015-01-01

    BACKGROUND: Transrectal ultrasound-guided prostate biopsies are prone to detection errors. Multi-parametric MRI (MP-MRI) may improve the diagnostic pathway. METHODS: PROMIS is a prospective validating paired-cohort study that meets criteria for level 1 evidence in diagnostic test evaluation. PROMIS will investigate whether multi-parametric (MP)-MRI can discriminate between men with and without clinically-significant prostate cancer who are at risk prior to first biopsy. Up to 714 men will hav...

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

    Medline Plus

    Full Text Available ... NHLBI Trials Clinical Trial Websites Children and Clinical Studies Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to accept medicines and ...

  20. EVALUATION OF CLINICALLY PALPABLE BREAST LUMPS WITH DIGITAL MAMMOGRAPHY, SONOGRAPHY AND FNAC : CASE STUDY

    Directory of Open Access Journals (Sweden)

    Sunny

    2015-02-01

    Full Text Available Breast cancer is the second leading cause of cancer deaths in women today (After lung cancer and is the most common cancer among women, excluding non - invasive non - melanoma skin cancers. Worldwide, breast cancer comprises 22.9% of invasive cancers in women and 16% of all female cancers. 1 Mammography has been the basic imaging method in breast diagnostics, and the only to ol suitable for screening. 2 breast cancer Mammography is still the first line of the imaging investigation. USG has emerge as the most important adjunct to mammography in patients with breast lumps and normal or inconclusive mammographic findings. This is the prospective study on 50 patients reporting with complaints of breast lump in surgical OPD at Mahatma Gandhi Hospital, Sitapura, Jaipur.

  1. Basic and clinical evaluation of our newly developed radiographic orthopantomography in studying the TMJ

    Energy Technology Data Exchange (ETDEWEB)

    Takagi, Sumio

    1987-03-01

    Temporomandibular arthrosis has been reported in many fields: oral surgery, dental prosthetics, otolaryngology, radiology, psychosomatic medicine etc... Roentgenographic examination plays an important role in the diagnosis of temporomandibular arthrosis. There have been studies on various types of roentgenography of the temporomandibular joint, but because its anatomical morphology is so complicated that it is difficult to obtain an adequate roentgenograph. Thus, no definite method of roentgenography has been clearly established. We developed a new method of roentgenography that takes advantage of the characteristics of orthopantomography, and analyzed our results statistically. The following results were obtained: 1) As conditions for roentgenography, the optimal tube voltage was 60 -- 75 KVp, but this varied according to sex and age; the optimal tube current was 15 mA. 2) The optimal position of the head in the anteroposterior position was 10 mm in front of the standard point, and that in the vertical position was the central part of the film. 3) The optimal position of the head was reached when the OM line was horizontal. 4) On the basis of the data obtained from these basic experiments, images from standard roentgenography were compared statistically with those from the modified method of Schuller in patients with temporomandibular arthrosis. There was a significant difference between the images. These results demonstrated that this method of roentgenography may be useful in standardizing X-ray procedures, provides images of temporomandibular arthrosis of high reproductive quality, suggesting that this method may be adequate for more definitive diagnoses.

  2. A basic and clinical evaluation of our newly developed radiographic orthopantomography in studying the TMJ

    International Nuclear Information System (INIS)

    Temporomandibular arthrosis has been reported in many fields: oral surgery, dental prosthetics, otolaryngology, radiology, psychosomatic medicine etc... Roentgenographic examination plays an important role in the diagnosis of temporomandibular arthrosis. There have been studies on various types of roentgenography of the temporomandibular joint, but because its anatomical morphology is so complicated that it is difficult to obtain an adequate roentgenograph. Thus, no definite method of roentgenography has been clearly established. We developed a new method of roentgenography that takes advantage of the characteristics of orthopantomography, and analyzed our results statistically. The following results were obtained: 1) As conditions for roentgenography, the optimal tube voltage was 60 ∼ 75 KVp, but this varied according to sex and age; the optimal tube current was 15 mA. 2) The optimal position of the head in the anteroposterior position was 10 mm in front of the standard point, and that in the vertical position was the central part of the film. 3) The optimal position of the head was reached when the OM line was horizontal. 4) On the basis of the data obtained from these basic experiments, images from standard roentgenography were compared statistically with those from the modified method of Schuller in patients with temporomandibular arthrosis. There was a significant difference between the images (P < 0.01). These results demonstrated that this method of roentgenography may be useful in standardizing X-ray procedures, provides images of temporomandibular arthrosis of high reproductive quality, suggesting that this method may be adequate for more definitive diagnoses. (author)

  3. Clinical evaluation of β-TCP in the treatment of lacunar bone defects: A prospective, randomized controlled study

    International Nuclear Information System (INIS)

    The aim of this study was to investigate the potential wide application of beta tricalcium phosphate (β-TCP) only for bone defects as compared to allograft. 95 patients with a solitary bone cyst were randomly assigned to the treatment. A new radiographic scoring system was employed to calculate the biodegradation of bone graft and to evaluate the influence of multiple factors. At an average of 28.43 months after surgery, a radiographic semi-quantitative analysis revealed that the degradation rates of β-TCP and the allograft were comparable (p > 0.05). Age, complication, packing methods and granule diameters have a significant influence on β-TCP degradation. The loose packing method and 3–5 mm granule size should be employed in clinical practice. A histological analysis of biopsy showed that β-TCP supported the growth of fibrous tissue, vascular tissue, as well as bone tissue into the implants. The results proved that single β-TCP is an advantageous alternative to allografts for lacunar bone defect repair and would well guide the design and clinical application of the β-TCP. - Highlights: ► Single beta-TCP was used only for bone defect as compared to allograft. ► Beta-TCP shows similar performance as allografts in degradation rates. ► Age, complication, packing methods and granules diameters influence beta-TCP degradation. ► Loose packing method should be employed in clinical practice. ► The degradation of the beta-TCP tends to be better in young patients

  4. Hyperacuity test to evaluate vision through dense cataracts: research preliminary to a clinical study in India

    Science.gov (United States)

    Enoch, Jay M.; Giraldez, Maria J.; Huang, Doahua; Hirose, Hiroshi; Knowles, Richard A.; Namperumalsamy, P.; LaBree, Lauri; Azen, Stanley P.

    1995-03-01

    Using high luminance point-of-light stimuli, Vernier judgments can be made in the presence of markedly degraded retinal imagery. Without coaching, observers perform center-of-gravity assessments of relative locations of degraded point images. We seek to defined, presurgery, individuals who will derive the most benefit from advanced cataract removal (a form of triage), and to determine which of two cataractous eyes has the better postsurgical visual prognosis. There are incredible and growing backlogs of patients with severe cataracts (and other dense media opacities) in the developing world, and generally, limited resources are available for provision of health care. Postcataract surgical failure rates for good visual function are often high, and only one eye is operated on in over 95% of indigent patients treated. Prior to initiating advanced studies in the developing world, at Berkeley we conducted preliminary research on Vernier acuity test techniques on normal adult subjects. We sought to determine the number of repeat trials necessary; to compare a two-point and a three-point Vernier display; to determine the shape of the measured response function at large gap separations between test points (required when testing advanced cataract patients); to assess the effect(s) of a broad range of uncorrected refractive errors on outcomes; and to consider means to minimize refraction-based errors. From these and prior data and analyses, we defined a protocol for use in the developing world. Using a newly designed and rugged precision instrument, these tests were repeated on an advanced cataract population at Aravind Eye Hospital in Madurai, India. Although we had much prior experience in India, the initial protocol required major revision on site. Necessary changes in test methods and analytical approaches were made, and next stages in this program were planned. And a new and simple gap `visual acuity' (gap `VA') test was added to the protocol, which greatly facilitated

  5. Evaluation of lioxasol for the treatment of accidental local radiation injuries: an experimental and clinical study

    International Nuclear Information System (INIS)

    The Chernobyl accident caused the development of Acute Radiation Syndrome (ARS) in 134 individuals, these were either treated at Hospital 6 (Moscow) or in hospitals in Kiev. Local radiation injuries (LRI) were found in 54 patients from the 108 ARS patients treated in Moscow over the acute period; 2 additional patients from this group had combined radiation and thermal skin injuries (the total number of LRI patients was 56). The effectiveness of Lioxasol, an ethyl alcohol based product containing 2-alliloxoethanol, was investigated in these patients. The treatment group was composed of 8 survivors of ARS with a second degree LRI caused by relatively uniform gamma-beta exposure. The control group was composed of 8 patients suffering from ARS also of second degree (7 patients) or first degree (1 patient) reactions caused by external, relatively uniform, gamma-beta exposure between 1956 and 1970. The time of re-epithelisation in the treated group was 25.4±3.1 days after irradiation. This was slightly shorter than the 28.3±4.9 days in the control group. However, this difference was not statistically significant (p>0.05). The effectiveness of Lioxasol was further studied on pig skin. Multiple sites in the same animal were irradiated with 22.5 mm diameter 90Sr/90Y plaques. The time of onset of moist desquamation and the subsequent healing times were used as end points. Following a single dose of 35 Gy, a dose known to produce moist desquamation in all irradiated sites, Lioxasol was applied topically twice a day. Lioxasol treatment (twice daily), which started the day after irradiation, delayed the time of onset of moist desquamation significantly from 5.1±0.2 weeks to 5.5±0.2 weeks. However, the most marked effect was on the number of sites that healed within 3 weeks of the first appearance of moist desquamation. This was 80±10.3% for sites treated with lioxasol whereas in untreated sites only 26.7±11.4% of the irradiated fields were healed by this time (p3H

  6. Improving clinical communication of students with English as a second language (ESL) using online technology: a small scale evaluation study.

    Science.gov (United States)

    Rogan, Fran; San Miguel, Caroline

    2013-09-01

    Increasingly, students with English as a second language (ESL) are enrolled in nursing degrees in English speaking countries (Wang et al., 2008). However, they may be at risk of clinical practice failure due to communication difficulties associated with unfamiliar linguistic and cultural factors (Guhde, 2003). This paper describes and evaluates an innovation to assist ESL nursing students at an Australian university develop their clinical communication skills and practice readiness by providing online learning resources, using podcast and vodcast technology, that blend with classroom activities and facilitate flexible and independent learning. The innovation builds on an intensive clinical language workshop program called 'Clinically Speaking' which has evolved through a cyclical process of ongoing research to produce resources in response to students' learning needs. Whilst uptake of the resources was modest, students of ESL as well as English speaking backgrounds (ESB) found the resources improved their clinical preparation and confidence by increasing their understanding of expectations, clinical language and communication skills. The innovation, developed with a modest budget, shows potential in developing ESL and ESB students' readiness for clinical communication, enabling them to engage in clinical practice to develop competency standards required of nursing graduates and registration authorities. PMID:23337389

  7. Quality of written narrative feedback and reflection in a modified mini-clinical evaluation exercise: an observational study

    NARCIS (Netherlands)

    Pelgrim, E.A.M.; Kramer, A.W.M.; Mokkink, H.G.A.; Vleuten, C.P.M. van der

    2012-01-01

    ABSTRACT: BACKGROUND: Research has shown that narrative feedback, (self) reflections and a plan to undertake and evaluate improvements are key factors for effective feedback on clinical performance. We investigated the quantity of narrative comments comprising feedback (by trainers), self-reflection

  8. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen

    2008-01-01

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

  9. CLINICAL STUDIES ON AMOEBIASIS AND GIARDIASIS EVALUATING THE EFFICACY OF KUTAJA (HOLARRHENA ANTIDYSENTERICA) IN ENTAMOEBA HISTOLYTICA CYST PASSERS

    OpenAIRE

    Singh, K. P.

    1986-01-01

    The clinical study records the clinical presentations of forty cases with amoebias and / or giardiasis including the efficacy of Kutaja (Holarrhena antidysenterica) in intestinal amoebiasis. E. H. Cyst passers also have symptoms like loose motions, constipation, flatulence, abdominal cramping, diminished appetite and mucus in stools. Patients with giardiasis have more tendency to diarrhoea and flatulence with no mucus in stools. 70 per cent good response was observed in E. H. Cyst passers whe...

  10. Good clinical practice in clinical interventional studies

    OpenAIRE

    Pieterse, Herman; Diamant, Zuzana

    2014-01-01

    Good clinical practice (GCP) guidelines should always be implemented and obeyed in clinical interventional studies. In this mini-review, we will address several burning questions relating to GCP in a concise ‘frequently asked questions’ format.While compliance to current rules and regulations is our mission, we also wish to play devil’s advocate attempting to translate the rules into sizeable chunks using a high dose of common sense.Keywords: clinical interventional studies; quality; safety; ...

  11. Experimental evaluation of clinical colon anastomotic leakage

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian

    2014-01-01

    , ischemia and insufficient surgical technique have been suggested to play a central role. Animal models are valuable means to evaluate pathophysiological mechanisms and may be used to test preventive measures aiming at reducing the risk of anastomotic leakage, such as external anastomotic coating. The aim...... leakage. STUDY 1: This study is a systematic review using the databases MEDLINE and Rex. MEDLINE was searched up to October 2010 to identify studies on experimental animal models of clinical colon anastomotic leakage. From the Rex database, textbooks on surgical aspects as well as gastrointestinal...... physiology and anatomy of experimental animals were identified. The results indicated that the mouse and the pig are the best suited animals to evaluate clinical anastomotic leakage. However, the pig model is less validated and more costly to use compared with the mouse. Most frequently, rats are used as...

  12. Evaluation of a controlled, national collaboration study on a clinical pharmacy service of screening for risk medications

    DEFF Research Database (Denmark)

    Kjeldsen, Lene Juel; Clemmensen, Marianne Hald; Kronborg, Christian;

    2014-01-01

    Background Risk medications are frequently associated with adverse events and hospitalisations. Objective To evaluate a risk medication screening service for in-patients at Danish hospitals. Setting Danish hospitals. Methods The study was designed as a controlled, prospective intervention study. ...

  13. Prolactinomas: clinical studies

    OpenAIRE

    Kars, Marleen

    2008-01-01

    Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An increased risk of cardiac valve disease has been reported in patients treated with cabergoline for Parkinson’s disease. Stimulation of serotonin receptors on cardiac valves by dopamine agonists re...

  14. A prospective, comparative study of ventilation-perfusion scintigraphy and clinical evaluation versus digital subtraction angiography in acute pulmonary thromboembolism

    International Nuclear Information System (INIS)

    Patients with symptoms of acute pulmonary thromboembolism (APE) of short duration were investigated with digital subtraction angiography (DSA) and ventilation/perfusion lung scintigraphy (V/Q scan), and a standardised clinical evaluation was performed. Forty-six angiograms (96%) were diagnostic at the segmental level and were used as reference. In all V/Q scans classified as normal or of high probability for APE, a complete agreement with DSA was found. In scan categories with low or intermediate probability, where the incidence of APE was 32%, there was considerable inter-observer disagreement. Clinical assessment alone was of limited value, but in patients with low clinical suspicion no APE was found. The results indicate that normal and high probability V/Q scans are very reliable for excluding and identifying APE, respectively, but also that fairly large APE cannot be diagnosed with lung scanning. Subdivision of V/Q scans into more than three categories (normal, high probability and inconclusive) seems to be of no practical value. Using a pulsed sequence technique, high frame rate and central injection, DSA is a valuable clinical tool for diagnosing APE down to the segmental level. (orig.)

  15. CLINICAL STUDY AND EVALUATION OF COMMUNITY ACQUIRED PNEUMONIA, SEVERITY ASSESSMENT BY CURB 65 AND PNEUMONIA SEVERITY INDEX (PSI)

    OpenAIRE

    Umesh Varma; Sundar Ra; Yugandhar; Satya Sri

    2015-01-01

    The study was carried out in ASRAM hospital, eluru, over a period of 2 years from August 2012 to august 2014. The study was designated as prospective, observational, cohort study, which includes 100 cases of CAP selected on the basis of full filling the inclusion and exclusion criteria. Community acquired pneumonia continues to be a common clinical problem especially in elderly people. Males were more commonly affected than females but it was statistically not significant. Communi...

  16. Periodic paralysis: clinical evaluation in 20 patients

    OpenAIRE

    Célia Harumi Tengan; Acary S. Bulle de Oliveira; Alberto Alain Gabbai

    1994-01-01

    Twenty patients with periodic paralysis were evaluated and the aspects studied included epidemiological data, clinical manifestations, ancillary tests, treatment and evolution. Sixteen patients had the hypokalemic form (5 familiar, 5 sporadic, 5 thyrotoxic and 1 secondary). No patient with the normokalemic form was detected. Predominance of men was found (14 patients), especially in the cases with hyperthyroidism (5 patients). No thyrotoxic patient was of oriental origin. Only 4 patients had ...

  17. Topical ascorbic acid on photoaged skin. Clinical, topographical and ultrastructural evaluation: double-blind study vs. placebo.

    Science.gov (United States)

    Humbert, Philippe G; Haftek, Marek; Creidi, Pierre; Lapière, Charles; Nusgens, Betty; Richard, Alain; Schmitt, Daniel; Rougier, André; Zahouani, Hassan

    2003-06-01

    Vitamin C is known for its antioxidant potential and activity in the collagen biosynthetic pathway. Photoprotective properties of topically applied vitamin C have also been demonstrated, placing this molecule as a potential candidate for use in the prevention and treatment of skin ageing. A topically applied cream containing 5% vitamin C and its excipient were tested on healthy female volunteers presenting with photoaged skin on their low-neck and arms in view to evaluate efficacy and safety of such treatment. A double-blind, randomized trial was performed over a 6-month period, comparing the action of the vitamin C cream vs. excipient on photoaged skin. Clinical assessments included evaluation at the beginning and after 3 and 6 months of daily treatment. They were performed by the investigator and compared with the volunteer self assessment. Skin relief parameters were determined on silicone rubber replicas performed at the same time-points. Cutaneous biopsies were obtained at the end of the trial and investigated using immunohistochemistry and electron microscopy. Clinical examination by a dermatologist as well as self-assessment by the volunteers disclosed a significant improvement, in terms of the 'global score', on the vitamin C-treated side compared with the control. A highly significant increase in the density of skin microrelief and a decrease of the deep furrows were demonstrated. Ultrastructural evidence of the elastic tissue repair was also obtained and well corroborated the favorable results of the clinical and skin surface examinations. Topical application of 5% vitamin C cream was an effective and well-tolerated treatment. It led to a clinically apparent improvement of the photodamaged skin and induced modifications of skin relief and ultrastructure, suggesting a positive influence of topical vitamin C on parameters characteristic for sun-induced skin ageing. PMID:12823436

  18. A pilot study to evaluate the safety and clinical performance of Leucopatch, an autologous, additive-free, platelet-rich fibrin for the treatment of recalcitrant chronic wounds

    DEFF Research Database (Denmark)

    Jørgensen, Bo; Karlsmark, Tonny; Vogensen, Hanne;

    2011-01-01

    This prospective, uncontrolled pilot study evaluated the safety and clinical performance of Leucopatch an additive-free, autologous platelet-rich fibrin in the treatment of recalcitrant chronic wounds. Fifteen patients, with 16 lower extremity chronic wounds of varying etiologies were treated...

  19. Evaluation of mid- and long-term consequences, clinical and social performance in Chernobyl acute radiation syndrome patients in a multi-centre clinical follow-up study

    International Nuclear Information System (INIS)

    Since the Chernobyl accident in 1986 nearly all survivors (n=199) of 237 patients with suspected acute radiation syndrome (ARS) underwent regular follow-up investigations in the scientific centres in Kiev and in Moscow. In a close collaboration with these centres we investigate the health status of this population in a five step approach. An integral part of this approach to patient evaluation and analysis of the mid- and long-term consequences of the Chernobyl accident is a 'Questionnaire for clinical, laboratory and functional follow-up of radiation-exposed persons', developed with these centres. Beyond this project we report as an interim some results of analyses performed by the scientific centers in Kiev and in Moscow about disorders of the cardiovascular system and the digestive tract, formation of cataract, generalized and local skin injuries and/or disorders as well as for a subpopulation (n=89) the Karnofsky performance score and working ability

  20. Phase 2 clinical study of 123I-IBF, a dopamine D2 receptor imaging agent, to evaluate clinical efficacy and safety in Parkinson's disease and Parkinson syndromes

    International Nuclear Information System (INIS)

    A Phase 2 multicenter trial of 123I-IBF, (S)-5-iodo-7-N-[(1-ethyl-2-pyrrolidinyl)methyl] carboxamido-2,3-dihydrobenzofuran, was conducted to evaluate its clinical efficacy and safety in 158 patients with Parkinson's disease (PD) or Parkinson syndromes (PS). SPECT data were acquired at two hours (2H-SPECT), after intravenous injection of 123I-IBF (167 MBq). Additional SPECT scan at three hours (3H-SPECT) and dynamic SPECT scan at most until one hour were performed when possible. No severe side effects due to 123I-IBF injection were observed. The sensitivity, specificity and accuracy for discriminating PS from PD using the striatal specific binding count-to-frontal cortex count ratio (St/Fc-1) in 3H-SPECT were 72.7%, 81.0% and 78.1% in 64 clinically definite cases (i.e., typical cases), respectively. The putamen-to-caudate ratios were significantly lower in striatonigral degeneration compared with those in PD. The contralateral-to-ipsilateral ratios against the symptomatic side of tremor and/or rigidity in the patients with PD (Hoehn and Yahr I) were significantly higher than the left-to-right ratios in the normal controls. St/Fc-1 in 3H-SPECT was significantly lower in the patients showing a poor response to levodopa than in those showing a good response. The dopamine D2 receptor binding potential (k3/k4), obtained by dynamic SPECT based on compartment model analysis, correlated well with the striatal specific binding count-to-occipital cortex count ratio. These results suggest that 123I-IBF is a promising agent for differential diagnosis and pathophysiological evaluation of PD and PS. (author)

  1. Chronic diarrhea. Diagnosis and clinical evaluation

    International Nuclear Information System (INIS)

    Chronic diarrhea is a syndrome of great clinical complexity, which is frequently encountered by general physicians, internists and gastroenterologists. Differential diagnosis is very broad and sometime finding the precise cause can be difficult, expensive and frustration. Literature published about this topic lack, in general, adequate controlled studies and for this reason recommendations for diagnostic evaluation and treatment are based upon series of cases, experience of the institutions or expert opinion and not on reasonable evidence. On the other hand, many of the classical diagnostic tests that have survived until now were designed over physiologic foundations and have not been validated extensively with the precision of a clinical test. This limits its acceptance, application and standardization in the daily practice. There is not a general agreement about diagnosis and treatment of chronic diarrhea and many of the experts divert recommendation about their recommendations. The purpose of this paper is to define some general guidelines about the clinical evaluation of patients with chronic diarrhea that lead us to a rational approach based upon clinical trials and the appropriate use of the many different tests

  2. A comparative evaluation of the efficacy of probiotic and chlorhexidine mouthrinses on clinical inflammatory parameters of gingivitis: A randomized controlled clinical study

    Directory of Open Access Journals (Sweden)

    Purnima Vidyesh Nadkerny

    2015-01-01

    Full Text Available Background: The aim of our clinical trial was to assess and compare the antiplaque and anti-inflammatory potential of a probiotic mouthwash with 0.2% chlorhexidine and saline. Materials and Methods: A randomized parallel group study was designed for a period of 4 weeks on 45 systemically healthy subjects between 20 and 30 years having chronic gingivitis. The study population was divided into three groups. Group A - 15 subjects were advised experimental (probiotic mouthwash. Group B - 15 subjects were advised positive control (chlorhexidine mouthwash and Group C - 15 subjects into a negative control group (normal saline. Oral prophylaxis was done for all groups at baseline. After the proper oral hygiene instructions, all the three groups were instructed to rinse their mouth with 10 ml of their respective mouthrinse, undiluted for 1 min twice daily, 30 min after brushing. Clinical parameters such as plaque index (PI, gingival index (GI, and oral hygiene index simplified (OHI-S were assessed at baseline, 2 weeks and 4 weeks, respectively. Results: At day 28, the PI, GI, and OHI-S were significantly reduced by all treatment modalities ranking probiotic and chlorhexidine is greater than saline. Conclusion: The probiotic mouthrinses tested was effectively used as an adjunct to mechanical plaque control in the prevention of plaque and gingivitis. Thus, the probiotic mouthrinse has a great therapeutic potential.

  3. Clinical Evaluation of Success of Primary Teeth Pulpotomy Using Mineral Trioxide Aggregate®, Laser and BiodentineTM- an In Vivo Study

    Science.gov (United States)

    Prasad, Madhu Ghanshyam; Vasa, Aron Arun Kumar; Divya, Gaddam; Thakur, Mukesh Singh; Saujanya, Kanithi

    2015-01-01

    Introduction Pulpotomy technique basically consists of removing the coronal pulp and fixing the radicular pulp with a medicament. It is the most widely accepted clinical procedure for treating primary teeth with coronal pulp inflammation caused by caries with no involvement of the radicular pulp. Aim To evaluate the success and efficacy of Mineral Trioxide Aggregate (MTA), Lasers and Biodentine as pulpotomy agents both clinically and radiographically. Materials and Methods In the present study, 60 primary molars in children whose pulpal status warranted pulpotomy were selected and randomly assigned into three groups that included MTA, Laser and Biodentine allocating 20 teeth to each group. The pulpotomy procedure was then performed on all selected teeth followed by restoration with stainless steel crowns. Later the patients were recalled for 3 months and 6 months for clinical and radiographic evaluation. Results Statistical analysis was done using Fisher exact test to determine pair wise comparison of three agents with respect to clinical and radiographic criteria. Kruskal-Wallis ANOVA, Mc Nemars test was applied to evaluate the efficacy of each agent between 3 months and 6 months. The results showed that maximum success rate was found in MTA group. However, the comparison between three groups was statistically not significant (pBiodentine are equally efficient with similar clinical/radiographic success and hence can be considered as alternatives to Formocresol. PMID:26023640

  4. 46, XX male: a case study of clinical, hormonal and molecular cytogenetic evaluation of sex development disorder

    International Nuclear Information System (INIS)

    Disorders of sex development (DSD) create medical and social dilemma. Maleness with XX genotype is a rare genetic condition affecting one in 24,000 new-born males. The XX male syndrome is a varied condition characterized by a spectrum of clinical presentation. ranging from normal male genitalia to ambiguous sex. Chromosomal anomalies are important cause of lack of development in secondary sexual characteristics, delayed puberty, miscarriage, infertility and other associated problems. An individual having ambiguous sex may have lifelong impact on social, psychological and sexual functions. The present case study describes the hormonal, clinical and molecular cytogenetics data of sex development disorders in a patient who was phenotypically male but cytogenetic analysis revealed 46.XX. (author)

  5. Comparative evaluation of natural curcumin and synthetic chlorhexidine in the management of chronic periodontitis as a local drug delivery: A clinical and microbiological study

    OpenAIRE

    V.Anitha; Rajesh, P.; Shanmugam, M.; B Meena Priya; Prabhu, S.; V Shivakumar

    2015-01-01

    Background of the Study: The aim of this study is to evaluate the efficacy of natural curcumin in the management of chronic periodontitis as local drug delivery in comparison to synthetic chlorhexidine, which is the gold standard. Materials and Methods: Thirty chronic periodontitis patients with an age range of 20-50 years with probing pocket depth (PPD) of 4-6 mm were included. Curcumin and chlorhexidine gel was applied in the contralateral disease sites at baseline and day 15. The clinic...

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

    OpenAIRE

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

    2012-01-01

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

  7. Uncovering a clinical portrait of sluggish cognitive tempo within an evaluation for attention-deficit/hyperactivity disorder: A case study.

    Science.gov (United States)

    Becker, Stephen P; Ciesielski, Heather A; Rood, Jennifer E; Froehlich, Tanya E; Garner, Annie A; Tamm, Leanne; Epstein, Jeffery N

    2016-01-01

    Despite the burgeoning scientific literature examining the sluggish cognitive tempo (SCT) construct, very little is known about the clinical presentation of SCT. In clinical cases where SCT is suspected, it is critical to carefully assess not only for attention-deficit/hyperactivity disorder (ADHD) but also for other comorbidities that may account for the SCT-related behaviors, especially internalizing symptoms and sleep problems. The current case study provides a clinical description of SCT in a 7-year-old girl, offering a real-life portrait of SCT while also providing an opportunity to qualitatively differentiate between SCT and ADHD, other psychopathologies (e.g. depression, anxiety), and potentially related domains of functioning (e.g. sleep, executive functioning [EF]). "Jessica" was described by herself, parents, and teacher as being much slower than her peers in completing schoolwork, despite standardized testing showing Jessica to have above average intelligence and academic achievement. Jessica's parents completed rating scales indicating high levels of SCT symptoms and daytime sleepiness, as well as mildly elevated EF deficits. More research is needed to determine how to best conceptualize, assess, and treat SCT, and Jessica's case underscores the importance of further work in this area. PMID:25326531

  8. Clinical characteristics and evaluation of LDL-cholesterol treatment of the Spanish Familial Hypercholesterolemia Longitudinal Cohort Study (SAFEHEART)

    Science.gov (United States)

    Familial hypercholesterolemia (FH) patients are at high risk for premature coronary heart disease (CHD). Despite the use of statins, most patients do not achieve an optimal LDL-cholesterol goal. The aims of this study are to describe baseline characteristics and to evaluate Lipid Lowering Therapy (L...

  9. Evaluation of the Success Criteria for Zirconia Dental Implants: A Four-Year Clinical and Radiological Study

    Directory of Open Access Journals (Sweden)

    Andrea Enrico Borgonovo

    2013-01-01

    Full Text Available Objectives. The aim was to evaluate survival and success rates, soft tissue health, and radiographic marginal bone loss (MBL of zirconia implants placed in the esthetic and posterior areas of the jaws and in association with multiple or single implant restorations after at least 6 months of definitive restoration. Material and Methods. 35 one-piece zirconium implants were utilized for single or partially edentulous ridges rehabilitation. All implants received immediate temporary restorations and six months after surgery were definitively restored. Every 6 months after implant placement, a clinical-radiographic evaluation was performed. For each radiograph, the measurements of MBL were calculated. Results. The results showed that the mean MBL at 48-month followup was 1.631 mm. The mean MBL during the first year of loading was not more significant for implants placed in the first molar regions than for those positioned in other areas. Moreover, no differences in marginal bone level changes were revealed for multiple and single implants, whereas MBL in the first year was observed to be slightly greater for implants placed in the maxilla than for those placed in the mandible. Conclusion. Zirconia showed a good marginal bone preservation that could be correlated with one-piece morphology and characteristics of zirconia implants.

  10. Uncertainty sources in radiopharmaceuticals clinical studies

    International Nuclear Information System (INIS)

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

  11. RANDOMIZED, DOUBLE-BLIND, PLACEBO CONTROLLED CLINICAL STUDY TO EVALUATE THE EFFECTS OF GARCINIA CAPLETS IN OBESE SUBJECTS

    OpenAIRE

    Tripathy P.C.; Karmahapatra P B.; Palaniyamma D.

    2013-01-01

    Obesity and its concomitant health risks are among the most common conditions managed by health care practitioners. The limited long-term effectiveness of conventional weight management has led to researching alternative medicine and one which is widely accepted is the herbal products by virtue of its safety in long term use. The study was conducted to evaluate effect of caplet of Garcinia extract with reference to reduction in BMI and skin fold thickness in obese individuals. This study was ...

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

    Medline Plus

    Full Text Available ... E-Newsletters About NHLBI Organization NHLBI Director Budget, Planning, & Legislative Advisory ... Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often ...

  13. Method for evaluating performance of clinical pharmacists.

    Science.gov (United States)

    Schumock, G T; Leister, K A; Edwards, D; Wareham, P S; Burkhart, V D

    1990-01-01

    A performance-evaluation process that satisfies Joint Commission on Accreditation of Healthcare Organizations criteria and state policies is described. A three-part, criteria-based, weighted performance-evaluation tool specific for clinical pharmacists was designed for use in two institutions affiliated with the University of Washington. The three parts are self-appraisal and goal setting, peer evaluation, and supervisory evaluation. Objective criteria within each section were weighted to reflect the relative importance of that characteristic to the job that the clinical pharmacist performs. The performance score for each criterion is multiplied by the weighted value to produce an outcome score. The peer evaluation and self-appraisal/goal-setting parts of the evaluation are completed before the formal performance-evaluation interview. The supervisory evaluation is completed during the interview. For this evaluation, supervisors use both the standard university employee performance evaluation form and a set of specific criteria applicable to the clinical pharmacists in these institutions. The first performance evaluations done under this new system were conducted in May 1989. Pharmacists believed that the new system was more objective and allowed more interchange between the manager and the pharmacist. The peer-evaluation part of the system was seen as extremely constructive. This three-part, criteria-based system for evaluation of the job performance of clinical pharmacists could easily be adopted by other pharmacy departments. PMID:2301420

  14. Clinical evaluation in periodontitis patient after curettage

    Directory of Open Access Journals (Sweden)

    Widowati Witjaksono

    2006-09-01

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

  15. Clinical evaluation of chitotriosidase enzyme activity in Gaucher and Niemann Pick A/B diseases: A retrospective study from India.

    Science.gov (United States)

    Kadali, Srilatha; Kolusu, Anusha; Sunkara, Satish; Gummadi, Maheshwar Reddy; Undamatla, Jayanthi

    2016-06-01

    Plasma chitotriosidase originates from activated macrophages and is reported to be elevated in many Lysosomal Storage Disorders. Measurement of this enzyme activity has been an available tool for monitoring therapy of Gaucher disease. The degree of elevation of chitotriosidase is useful for differential diagnosis of Gaucher disease and Niemann Pick A/B. However the potential utility of this chitotriosidase assay depends on the frequency of deficient chitotriosidase activity in a particular population. We therefore aim to study the clinical utility of this assay Gaucher and Niemann Pick A/B diseases in the backdrop of chitotriosidase deficiency in our population. The study comprises 173 patients with clinical suspicion of either Gaucher disease (n=108) or Niemann Pick A/B (n=65) and 92 healthy controls. The plasma samples of controls, Gaucher disease, and Niemann Pick A/B showed chitotriosidase deficiency of 12%, 25% and 27% respectively. The degree of elevation of chitotriosidase in Gaucher disease and Niemann Pick A/B patients is 40-326 (11,325.7±6395.4nmol/h/ml) and 7-22 folds (1192.5±463.0nmol/h/ml) respectively. In view of these findings of distinguishable fold elevation of chitotriosidase in Gaucher disease or Niemann Pick A/B, it can be a potential surrogate differential diagnostic marker for these groups of diseases, except in the patients in whom this enzyme is deficient. PMID:26975750

  16. Scaling-Up Access to Antiretroviral Therapy for Children: A Cohort Study Evaluating Care and Treatment at Mobile and Hospital-Affiliated HIV Clinics in Rural Zambia

    OpenAIRE

    van Dijk, Janneke H.; Moss, William J; Hamangaba, Francis; Munsanje, Bornface; Sutcliffe, Catherine G.

    2014-01-01

    Background Travel time and distance are barriers to care for HIV-infected children in rural sub-Saharan Africa. Decentralization of care is one strategy to scale-up access to antiretroviral therapy (ART), but few programs have been evaluated. We compared outcomes for children receiving care in mobile and hospital-affiliated HIV clinics in rural Zambia. Methods Outcomes were measured within an ongoing cohort study of HIV-infected children seeking care at Macha Hospital, Zambia from 2007 to 201...

  17. A comparative evaluation of atrigel delivery system (10% doxycycline hyclate) Atridox with scaling and root planing and combination therapy in treatment of periodontitis: A clinical study

    OpenAIRE

    Javali, Mukhatar Ahmed; Vandana, K. L.

    2012-01-01

    Background: Local delivery of antimicrobial has resulted in good clinical outcome along with scaling and root planing. The present study is carried out to evaluate and compare the efficacy of local delivery of 10% doxycycline hyclate in adjunct to scaling and root planing in the treatment of periodontitis. Materials and Methods: A randomized crossover split mouth design was performed, a total number of 130 sites from 4 patients, 63 sites from patients with aggressive periodontitis and 67 site...

  18. Clinical simulation as an evaluation method in health informatics

    DEFF Research Database (Denmark)

    Jensen, Sanne

    2016-01-01

    work practice including other technology and organizational structure. Clinical simulation is ideal for proactive evaluation of new technology for clinical work practice. Clinical simulations involve real end-users as they simulate the use of technology in realistic environments performing realistic...... tasks. Clinical simulation study assesses effects on clinical workflow and enables identification and evaluation of patient safety hazards before implementation at a hospital. Clinical simulation also offers an opportunity to create a space in which healthcare professionals working in different...... locations or sectors can meet and exchange knowledge about work practices and requirement needs. This contribution will discuss benefits and challenges of using clinical simulation, and will describe how clinical simulation fits into classical usability studies, how patient safety may benefit by use of...

  19. Study on the evaluation of the clinical effects of traditional chinese medicine in heart failure by complex intervention: protocol of SECETCM-HF

    Directory of Open Access Journals (Sweden)

    Jia Xiuli

    2009-12-01

    Full Text Available Abstract Background Experts in Traditional Chinese Medicine (TCM have studied the TCM subject of the pathogenesis of heart failure (HF for several decades. As a result, the general idea is ben deficiency and biao excess. However, the clinical evaluation system which combined the TCM and western medicine in HF has not been developed yet. The objective is to establish the evaluation index system for the integration of TCM and western medicine. The evaluation indexes which include TCM items will specify the research design and methods. Methods Nine medical centers in different cities in China will participate in the trial. A population of 340 patients with HF will be enrolled through a central randomized system for different test groups. Group A will be treated with only western medicine, while group B with western and Chinese medicine together. The study will last for 12 months from the date of enrollment. The cardiovascular death will be the primary outcome. Discussion By putting the protocol into practice, the clinical effects of TCM for HF will be identified scientifically, objectively as well as rationally. The proper index system which built in the study will be helpful for the clinical effect expression of HF by integrated medicine in future. Trial Registration ChiCTR-TRC-00000059

  20. Evaluation of a Rheumatology Transition Clinic

    OpenAIRE

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

    2015-01-01

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

  1. Clinical evaluation, imaging studies, indications for cytologic study and preprocedural requirements for duct brushing studies and pancreatic fine-needle aspiration: The Papanicolaou Society of Cytopathology Guidelines

    Directory of Open Access Journals (Sweden)

    Douglas Adler

    2014-01-01

    Full Text Available The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreaticobiliary cytology including indications for endoscopic ultrasound (EUS and fine-needle aspiration (FNA biopsy, techniques for EUS-FNA, terminology and nomenclature to be used for pancreaticobiliary disease, ancillary testing and postbiopsy management. All documents are based on expertise of the authors, literature review, discussions of the draft document at national and international meetings and synthesis of online comments of the draft document. This document selectively presents the results of these discussions. This document summarizes recommendations for the clinical and imaging work-up of pancreatic and biliary tract lesions along with indications for cytologic study of these lesions. Prebrushing and FNA requirements are also discussed.

  2. Clinical Studies with Epothilones

    Science.gov (United States)

    Altmann, Karl-Heinz

    As indicated in previous chapters, epothilone research so far has delivered seven new chemical entities that have been advanced to clinical trials in humans (Fig. 1). However, the amount of clinical data publicly available at this time strongly varies between individual compounds, depending on their development stage, but also on the general publication policy of the developing company. The compound that has been most comprehensively characterized in the clinical literature is ixabepilone (BMS-247550), for which trial results have been described in a number of articles in peer-reviewed journals and which has been granted FDA approval for two clinical indications on Oct. 16, 2007. For all other compounds, most of the information on clinical trials is available only in abstract form. In all these cases it remains uncertain, whether the content of these abstracts fully reflects the content of the subsequent (poster or oral) presentations at the corresponding meeting; in fact, it seems likely that additional data will have been included in the actual meeting presentations that may not have been available at the time of abstract submission. As this is unknown to the author, such additional information cannot be considered in this chapter, which is solely based on information documented in accessible abstracts or journal publications. It should also be kept in mind that the interpretation of data from ongoing clinical trials or forward looking statements based on data from completed trials are always preliminary in character.

  3. An evaluation of service utilization among male to female transgender youth: qualitative study of a clinic-based sample.

    Science.gov (United States)

    Corliss, Heather L; Belzer, Marvin; Forbes, Catherine; Wilson, Erin C

    2007-01-01

    This qualitative study examined experiences with health and social service institutions and experiences related to education, employment, and other social networks among 18 ethnically diverse, male to female (MTF) transgender youth aged 16 to 24 years. Participants were recruited from a youth health clinic where they were receiving services for their transgender/transsexual identity. In-depth, semi-structured interviews explored youths' patterns of service utilization, reasons for seeking care, beliefs about the usefulness of services received, experiences with service providers, barriers to care, and suggestions for improving services tailored to them. Similar to other studies with this population, participants described a multitude of health and social risk experiences as well as complex needs related to healthcare, education, employment, housing, personal relationships, and safety. Results suggest a mixed pattern of both positive and negative experiences within the medical, social and mental health services arenas. To improve support for transgender youth and assist in their positive development, it is essential to improve and expand the availability of culturally competent and effective services for this population. PMID:19835041

  4. Clinical evaluation of dengue and identification of risk factors for severe disease : protocol for a multicentre study in 8 countries

    NARCIS (Netherlands)

    Jaenisch, Thomas; Tam, Dong Thi Hoai; Kieu, Nguyen Tan Thanh; Van Ngoc, Tran; Nam, Nguyen Tran; Van Kinh, Nguyen; Yacoub, Sophie; Chanpheaktra, Ngoun; Kumar, Varun; See, Lucy Lum Chai; Sathar, Jameela; Sandoval, Ernesto Pleités; Alfaro, Gabriela Maria Marón; Laksono, Ida Safitri; Mahendradhata, Yodi; Sarker, Malabika; Ahmed, Firoz; Caprara, Andrea; Benevides, Bruno Souza; Marques, Ernesto T A; Magalhaes, Tereza; Brasil, Patricia; Netto, Marco; Tami, Adriana; Bethencourt, Sarah E; Guzman, Maria; Simmons, Cameron; Quyen, Nguyen Thanh Ha; Merson, Laura; Dung, Nguyen Thi Phuong; Beck, Dorothea; Wirths, Marius; Wolbers, Marcel; Lam, Phung Khanh; Rosenberger, Kerstin; Wills, Bridget

    2016-01-01

    BACKGROUND: The burden of dengue continues to increase globally, with an estimated 100 million clinically apparent infections occurring each year. Although most dengue infections are asymptomatic, patients can present with a wide spectrum of clinical symptoms ranging from mild febrile illness throug

  5. CLINICAL STUDY AND EVALUATION OF COMMUNITY ACQUIRED PNEUMONIA, SEVERITY ASSESSMENT BY CURB 65 AND PNEUMONIA SEVERITY INDEX (PSI

    Directory of Open Access Journals (Sweden)

    Umesh Varma

    2015-10-01

    Full Text Available The study was carried out in ASRAM hospital, eluru, over a period of 2 years from August 2012 to august 2014. The study was designated as prospective, observational, cohort study, which includes 100 cases of CAP selected on the basis of full filling the inclusion and exclusion criteria. Community acquired pneumonia continues to be a common clinical problem especially in elderly people. Males were more commonly affected than females but it was statistically not significant. Community acquired pneumonia is one of the common diagnosis in patients admitted in ICU and Emergency settings.DM and COPD are the most common co morbidities followed by rhinitis and smoking is the commonest risk factor for CAP. Cough, fever and expectoration are common and classical symptoms of pneumonia and significant number of patients with CAP can present with GI symptoms. Tachycardia, Tachypnea, Altered Mental Status, Hypotension, Cyanosis, acidosis, low albumin levels are few signs which indicate that illness is severe and critical and crepitations over chest on auscultation was the most common finding. Mean duration of stay was 8.99 days indicating it can cause significant loss in the form of economic loss if earning member of family is affected. Duration of stay was also prolonged in patients who are aged 65 and above, in patients who are undernourished, in patients with COPD and in patients who were treated with antibiotics prior to hospitalization but statistically these findings were not significant. In radiography Lower zones are most common site of involvement followed by mid and upper zones, Right lower zone was most common among all. Neutrophilic leucocytosis was the most common finding in haemogram. Gram positive organisms were more commonly seen than gram negative organisms on sputum gram‘s staining. Complications noticed were aNeed for ventilatory support both invasive or Non Invasive, bNeed for inotropic support for septic shock, cRenal failure and need

  6. Clinical Evaluation of Specific Oral Manifestations in Pediatric Patients with Ascertained versus Potential Coeliac Disease: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Ennio Bramanti

    2014-01-01

    Full Text Available Patients involved on coeliac disease (CD have atypical symptoms and often remain undiagnosed. Specific oral manifestations are effective risk indicators of CD and for this reason an early diagnosis with a consequent better prognosis can be performed by the dentist. There are not researches analysing the frequency of these oral manifestations in potential coeliac patients. The aim of this study is to investigate the oral hard and soft tissue lesions in potential and ascertained coeliac children in comparison with healthy controls. 50 ascertained children, 21 potential coeliac patients, and 54 controls were recruited and the oral examination was performed. The overall oral lesions were more frequently present in CD patients than in controls. The prevalence of oral soft tissue lesions was 62% in ascertained coeliac, 76.2% in potential coeliac patients, and 12.96% in controls (P<0.05. Clinical dental delayed eruption was observed in 38% of the ascertained coeliac and 42.5% of the potential coeliac versus 11.11% of the controls (P<0.05. The prevalence of specific enamel defects (SED was 48% in ascertained coeliac and 19% in potential coeliac versus 0% in controls (P<0.05; OR=3.923. The SED seem to be genetically related to the histological damage and villous atrophy.

  7. AN OPEN LABLE CLINICAL STUDY TO EVALUATE EFFECT OF JUICE OF TINOSPORA CORDIFOLIA LINN. ON GROWTH OF CHILDREN

    Directory of Open Access Journals (Sweden)

    Patil Y. R.

    2012-02-01

    Full Text Available Guduchi is being used as a rejuvenating herb in Ayurveda and other system of medicine since many decades. Guduchi is prescribed as a monoherbal as well as polyherbal formulation. The herb has free radical scavenging properties against reactive oxygen and nitrogen. Due to its Rasayana (free radical scavenging property it was decided to evaluate efficacy of its juice in growth of children by comparing with standard growth charts developed by National centre for health statistics. 30 Children of age group 6 to 8 years were recruited in the trial. Children were assessed and evaluated on the basis of objective and subjective parameters at interval of 15 days for 3 months. Mean weight of children at baseline of study was 19.99 ± 1.59 kg and was increased moderately to 20.64 ± 1.57 kg (at 12th wk. Mean score of skin luster was 0.43 ± 0.5 and it was increased significantly to 1.17 ± 0.37. Diet intake of these children at baseline was 0.467 ± 0.51 and in was increased significantly to 1.63 ± 0.48. These findings suggest that juice of Tinospora cordifolia is an effective, safe, and herbal formulation for the children growth.

  8. Comparative evaluation of subgingival plaque microflora in pregnant and non-pregnant women: A clinical and microbiologic study

    Directory of Open Access Journals (Sweden)

    Rishi Emmatty

    2013-01-01

    Full Text Available Context: Gingival changes in pregnancy have been attributed to changes in the subgingival biofilm related to hormonal variations. Aims: To evaluate the subgingival plaque microflora in pregnant and nonpregnant women to determine if pregnancy induces any alterations in the subgingival plaque and to associate these changes with changes in periodontal status. Settings and Design: Thirty pregnant and 10 nonpregnant women within the age group of 20-35 years having a probing pocket depth (PPD of 3-4 mm were included in the study. The pregnant women were equally divided into 3 groups of 10, each belonging to I, II, and III trimester. Materials and Methods: Plaque index, gingival index, PPD, and microbiologic evaluation for specific bacterial counts for Prevotella intermedia, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, and Fusobacterium nucleatum were carried out for all subjects. Statistical Analysis: Mann-Whitney U test. Results: Increase in gingival inflammation was observed in II and III trimester as compared with I trimester and control. Plaque scores did not show any significant difference between pregnant and nonpregnant women. Specific bacterial examination revealed an increase in proportion of P. intermedia in pregnant women of both II and III trimester as compared with I trimester and nonpregnant women. Conclusions: A definite increase in proportions of P. intermedia occurs in subgingival plaque microflora in pregnancy that may be responsible for the exaggerated gingival response.

  9. Study, development and clinical evaluation of a per-operative {gamma} imager; Etude, developpement et evaluation clinique d`un imageur {gamma} per-operatoire

    Energy Technology Data Exchange (ETDEWEB)

    Menard, Laurent [Inst. de Physique Nucleaire, Paris-11 Univ., 91 - Orsay (France)

    1999-01-19

    The precise localization and complete surgical ablation of tumors are one of the most important procedures in cancer treatment. In that context, the use, in operating room, of light hand-held detectors associated to radiopharmaceutical compounds for tumor labelling, plays a significant role in assisting surgeons in real-time detection of lesion. The POCI gamma imaging probe (Per-Operative Compact Imager), which is presented here, is precisely dedicated to improve the radio-guided operative cancer surgery efficiency by bringing a new tool discriminating between healthy and pathological tissues. To match the specifications of intra-operative detection, we chose to build our camera around an intensified position sensitive diode which appeared to be particularly suitable to achieve a high resolution small size imager. The optimal geometry of two gamma detection head modules, composed of parallel hole collimators and scintillation crystals, was then investigated by numerical simulations. From these technological solutions, a first prototype of POCI with a 24 mm diameter field of view has been developed. Its characterization has put forward a millimeter spatial resolution and a detection efficiency comparable to that of clinical gamma cameras and in agreement with the numerical predictions. Finally, in collaboration with Gustave Roussy, a first clinical evaluation of the POCI camera has been performed for sentinel ganglion pre-operative localization in patients afflicted by malignant melanomas or breast cancers. The preliminary results have already shown that the performances of POCI are compatible with intraoperative imaging purposes and suggest how this camera can boost the success rate of tumor removal surgeries for other cancerous diseases. (author) 100 refs., 67 figs., 11 tabs.

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

    Science.gov (United States)

    Nair, B K; Nair, C H

    1975-05-01

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

  11. Subjective vs. objective evaluation of gallbladder opacification during oral cholecystography in comparative clinical trials: implications for studies involving visual assessment

    International Nuclear Information System (INIS)

    Radiographs and CT images taken during oral cholecystography in dogs were interpreted in an independent, blind fashion by three radiologists on two occasions and visual assessment of gallbladder density compared to the actual CT values. While there was significant intra- and inter-observer variation, the mean scores for the observers' interpretations of both radiographs and prints correlated well with the actual CT values (p > 0.05). In five out of six comparisons between first and second readings, the observers gave a lower score on the second reading. The considerable variation reflects the problems inherent in subjective evaluation of agents that produce small but measurable differences in radiographic density. Studies involving such subjective data have to be carefully designed in order to obtain meaningful results

  12. Subjective vs. objective evaluation of gallbladder opacification during oral cholecystography in comparative clinical trials: implications for studies involving visual assessment

    Energy Technology Data Exchange (ETDEWEB)

    Fon, G.T. (Univ. of Arizona Coll. of Medicine, Tucson); Hunter, T.B.; Berk, R.N.; Patton, D.D.; Capp, M.P.

    1982-07-01

    Radiographs and CT images taken during oral cholecystography in dogs were interpreted in an independent, blind fashion by three radiologists on two occasions and visual assessment of gallbladder density compared to the actual CT values. While there was significant intra- and inter-observer variation, the mean scores for the observers' interpretations of both radiographs and prints correlated well with the actual CT values (p > 0.05). In five out of six comparisons between first and second readings, the observers gave a lower score on the second reading. The considerable variation reflects the problems inherent in subjective evaluation of agents that produce small but measurable differences in radiographic density. Studies involving such subjective data have to be carefully designed in order to obtain meaningful results.

  13. Clinical Evaluation of Suvarnaprashana Samskara

    Directory of Open Access Journals (Sweden)

    Lode Dattatraya Somaji

    2014-05-01

    Full Text Available Suvarnaprashana means to administer suvarna in liquid form with the help of honey, ghee and some nervine medicines. Suvarnaprashana has been extensively described in main reference books i.e. brihatrayi granthas. Sushruta, Vagbhata, kashyapa has mentioned its uses in detail. Its review of literature and recent research, publications has been sought in present study. Details about suvarna guna karma has been described by vagbhata i.e. suvarna is brihana, snigdha, madhura(rasa vipaka, visha doshahara, sheeta (cold, and kashayam with rasayan property.

  14. A CLINICAL STUDY FOR EVALUATING EARLY RADIOTHERAPY EFFECT IN PATIENTS WITH BRAIN TUMOR USING 99Tcm-HL91 SPECT

    Institute of Scientific and Technical Information of China (English)

    ZHAO Ming; ZHANG Yong-xue; ZHANG Cheng-gang; LAN Sheng-min; WANG Zhong-min; ZHANG Xiu-fu

    2006-01-01

    Objective: The purpose of this study was to evaluate the early radiotherapy effect using 99Tcm-HL91 SPECT in patients with brain tumors. Methods: Twenty-one patients with brain tumors who were treated by radiotherapy were studied. KPS grade, tumor size on 99Tcm-HL91 SPECT , tumor size on MRI, and ratio of T/N (tumor counts/sec over normal brain tissue counts/sec) were investigated before ,during and after radiotherapy. Results: The average tumor size on 99Tcm-HL91 SPECT and MRI was 11.34(5.88 cm2, 9.46(5.66 cm2, respectively before radiotherapy. The tumor size on 99Tcm-HL91 SPECT was not in accordance with to that on MRI (P<0.05). KPS grade, tumor size on 99Tcm-HL91 SPECT and ratio of T/N had significance differences before, during and after radiotherapy (P<0.05), but the tumor size on MRI imaging had no significance differences before, during and after radiotherapy (P>0.05). The rate of symptom improvement was 80% during radiotherapy and 100% after radiotherapy. The rates of imaging remission based on the brain tumor size on 99Tcm-HL91 SPECT, MRI and T/N were 75%, 15%, and 80%, respectively during radiotherapy. The agreement rates between imaging remission diagnosed by those three methods and symptom improvement were 70%, 40%, and 60% respectively during radiotherapy. The rates of imaging remission based on the brain tumor sizes on 99Tcm-HL91 SPECT, MRI and T/N were 100%, 25%, and 95% respectively after radiotherapy. The agreement rates between imaging remission diagnosed by those three methods and symptoms improvement were 100%, 20%, and 95% respectively after radiotherapy. Conclusion: The tumor size on 99Tcm-HL91 SPECT is a valuable tool for evaluating early radiotherapy effect of brain tumor in process of radiotherapy. T/N is not a feasible method in evaluating radiotherapy effect of brain tumor because it may show elevation unrelated to the curative effect during radiotherapy.

  15. Clinical evaluation of double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts:a prospective, randomized and controlled study

    Institute of Scientific and Technical Information of China (English)

    WANG Jian-quan; AO Ying-fang; YU Chang-long; LIU Ping; XU Yan; CHEN Lin-xin

    2009-01-01

    Background In clinical studies there is still a lot of controversy about the increased anterior and rotational stability between double-bundle (DB) and single-bundle (SB) anterior cruciate ligament (ACL) reconstruction. The aim of this study was to evaluate the clinical results of four-tunnel DB ACL reconstruction.Methods Sixty-four consecutive patients with ACL ruptures from May 2005 to May 2006 were randomly assigned into two groups: 32 cases for SB ACL reconstruction and 32 cases for DB ACL reconstruction. Clinical data, including KT 2000, Biodex test, Lysholm score, Tegner score and IKDC score, were prospectively collected until at least 10 months post-operative.Results The average values of KT 2000 were (1.47±1.17) mm and (1.68±1.14) mm for the SB and DB ACL reconstruction groups at 30° of knee flexion (P >0.05), and were (1.04±0.98) mm and (1.13±0.98) mm at 90° of knee flexion (P>0.05). There were also no significant differences in Lysholm score, Tegner score, IKDC score and Biodex test scores between the two groups (P>0.05). The operation time of DB ACL reconstruction was 20 minutes longer than the SB ACL reconstruction (P<0.05)Conclusion Double bundle ACL reconstructions have no obvious clinical advantages over single bundle ACL reconstructions.

  16. Evaluation of HTR polymer (Bioplant® HTR® as a bone graft material in the treatment of interproximal vertical bony defects: A clinical and radiological study

    Directory of Open Access Journals (Sweden)

    Prakash Shobha

    2010-01-01

    Full Text Available Background and Objectives : Bone grafting is the most common form of regenerative therapy. Several bone substitutes have been used in clinical periodontal therapy to encourage bone formation. The present study has been undertaken to evaluate the efficacy of hard tissue replacement polymer (Bioplant® HTR® as a bone graft material in the treatment of interproximal vertical bony defects in human beings, both clinically and radiologically. Materials and Methods : Five chronic periodontitis patients were selected with 16 sites assigned randomly into control (open debridement alone and experimental (open flap debridement plus Bioplant® HTR® groups. Clinical measurements like plaque index (PI, gingival index (GI, probing pocket depth (PPD, clinical attachment level (CAL, gingival margin position (GMP assessment was done at 0, 3 and 6 months and radiographic assessment at 0 and 6 month. Statistical analysis was performed using Wilcoxon′s signed Rank test and Mann-whitney U-test. Results : There were statistically no significant (P=1.00 changes in Plaque index and Gingival Index scores in both the groups from baseline to six months post surgery. Statistically significant (P< 0.05 reduction in Probing Pocket Depth was seen on comparison between the groups. In relation to the hard tissue changes, significant results were seen with respect to change in alveolar crest and percentage of original defect resolved. Comparison of results from six to 12 months following similar treatments showed no significant differences or advantages to having a clinical evaluation period longer than 6 months post surgically (Yukna 1999. Interpretation and Conclusion : Bioplant® HTR® material is a biocompatible, easy to handle and a beneficial grafting material for the treatment of periodontal osseous defects.

  17. Electronic portal imaging device detection of radioopaque markers for the evaluation of prostate position during megavoltage irradiation: a clinical study

    International Nuclear Information System (INIS)

    Purpose: This study was designed to assess daily prostatic apex motion relative to pelvic bone structures during megavoltage irradiation. Methods and Materials: Radioopaque markers were implanted under ultrasound guidance near the prostatic apex of 11 patients with localized prostatic carcinoma. Patients were subsequently treated with a four field-box technique at a beam energy of 23 MV. During treatment, on-line images were obtained with an electronic portal imaging device (EPID). The marker was easily identified, even on unprocessed images, and the distance between the marker and a bony landmark was measured. Timelapse movies were also reviewed. After the completion of treatment, a transcrectal ultrasound examination was performed in 8 of 11 patients, to verify the position of the marker. Results: We acquired over 900 digital portal images and analyzed posterioanterior and right lateral views. The quality of portal images obtained with megavoltage irradiation was good. It was possible to evaluate pelvic bone structures even without image histogram equalization. Moreover, the radioopaque marker was easily visible on every online portal image. The review of timelapse movies showed important interfraction motion of the marker while bone structures remained stable. We measured the position of the marker for each fraction. Marker displacements up to 1.6 cm were measured between 2 consecutive days of treatment. Important marker motions were predominantly in the posteroanterior and cephalocaudal directions. In eight patients, we verified the position of the marker relative to the prostatic apex with ultrasound at the end of the treatments. The marker remained in the trapezoid zone. Intratreatment images reviewed in two cases showed no change in marker position. Our results, obtained during the treatment courses, indicate similar or larger prostate motions than previously observed in studies that used intertreatment x-ray films and CT images. Marker implantation under

  18. Evaluation of fixed orthodontic patients\\\\\\' compliance in the clinic of Shiraz dental school: A cross-sectional study

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    Hooman Zarif Najafi

    2014-06-01

    Full Text Available   Background and Aims: Orthodontic patients’ cooperation is a determining factor in treatment outcomes. The aim of this study was to evaluate the relationship between patient cooperation during orthodontic treatment with variables such as age, sex, life setting, treatment duration and functional and social discomfort experienced.   Materials and Methods: Specimens were consisted of 100 orthodontic patients (36 males and 64 females between 13-35 years old (average age: 22.57±1.69 years. Patients’ demographic traits, treatment duration andfunctional-social discomfort by the orthodontic treatment were evaluated using a questionnaire answered by the patients or their parents. The degree of patient cooperation was assessed by the modified cooperation questionnaire (Orthodontic Patient Cooperation Scale [OPCS] which was completed by an orthodontist. Data were analyzed using One-way ANOVA, T-test, intraclass correlation coefficient and Pearson Correlation.   Results: No significant difference was found between the cooperation of male and female patients (P=0.867 and also between the cooperation of the patients who lived in the urban and rural setting (P=0.613. Treatment duration and compliance showed a low negative correlation which was not statistically significant (r=-0.155, P=0.127. Functional-social discomfort and compliance showed a low negative correlation which was not statistically significant (r=-0.118, P=0.244. No significant correlations were found between the compliance and age (r=0.002, P=0.988; and also the treatment duration and functional-social discomfort experienced(r=0.164, P=0.105.   Conclusion: Patient compliance appears to be a complex issue that cannot easily be predicted only by factors such as age, gender, life setting, treatment duration and functional-social discomfort experienced.

  19. EPID detection of radio-opaque markers for the evaluation of prostate position during megavoltage irradiation: a clinical study

    International Nuclear Information System (INIS)

    than previous published data using intertreatment X-ray films and CT images. Marker implantation under transrectal ultrasound was well tolerated. Patients presented no fever or urogenital infection. Conclusions: Radio-opaque marker in combination with electronic portal imaging give a direct evaluation of prostatic motion during radiation treatment. As shown in previous studies, prostatic motion is independent of the bony structures. The motions observed are predominantly in the antero-posterior and cephalo-caudal directions. Prostate motion during treatment is important and must be considered especially when using conformal therapy

  20. A study of familial MELAS: Evaluation of A3243G mutation, clinical phenotype, and magnetic resonance spectroscopy-monitored progression

    Directory of Open Access Journals (Sweden)

    Chunnuan Chen

    2012-01-01

    Full Text Available The clinical manifestations of mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes syndrome (MELAS syndrome are nonspecific and can easily be misdiagnosed. Magnetic resonance spectroscopy (MRS-based detection of lactate in the brain has been found to be of diagnostic help in MELAS syndrome, however, the issue of whether MRS features vary by stage remains unresolved. We assessed the causative mutation and radiological features of a family of MELAS. Four of the family members harbored the A3243G mutation, probably of maternal inheritance. However, the clinical phenotypic expression was different in these patients. MRS showed a lactate peak, decreased N-acetylaspartate, choline, and creatine, which became more pronounced with progression of the disease, demonstrating that brain-MRS-based detection of lactate may be a suitable way to monitor the progression and treatment of MELAS.

  1. Evaluating the Perceptual and Pathophysiological Consequences of Auditory Deprivation in Early Postnatal Life: A Comparison of Basic and Clinical Studies

    OpenAIRE

    Whitton, Jonathon P.; Polley, Daniel B.

    2011-01-01

    Decades of clinical and basic research in visual system development have shown that degraded or imbalanced visual inputs can induce a long-lasting visual impairment called amblyopia. In the auditory domain, it is well established that inducing a conductive hearing loss (CHL) in young laboratory animals is associated with a panoply of central auditory system irregularities, ranging from cellular morphology to behavior. Human auditory deprivation, in the form of otitis media (OM), is tremendous...

  2. The clinical application study of bone marrow immunoscintigraphy using 99Tcm-BW250/183 in evaluating patients with aplastic anemia

    International Nuclear Information System (INIS)

    Objective: To study the clinical value of bone marrow immunoscintigraphy for evaluation of patients with aplastic anemia. Methods: Twelve patients with aplastic anemia underwent bone marrow immunoscintigraphy using 99Tcm labelled anti-granulocyte monoclonal antibody BW250/183, 10 of them also underwent bone marrow imaging using 99Tcm-sulfur colloid (SC) 2 - 3 days later. The semiquantitative indexes of bone marrow immunoscintigraphy of the patients were compared with those of control patients. Results: Bone marrow immunoscintigraphy was superior to 99Tcm-SC bone marrow imaging. In patients with aplastic anemia, the accumulation of 99Tcm-BW250/183 in bone marrow and spleen was lower and in liver and kidney was higher than those of control patients. Nine patients were found with multiple focal accumulation in bone marrow. Conclusion: Bone marrow immunoscintigraphy with 99Tcm-BW250/183 plays an important role in evaluating patients with aplastic anemia

  3. CLINICAL STUDY ON ACUTE PANCREATITIS

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    Suhaib Rehaman

    2015-07-01

    Full Text Available INTRODUCTION : Early diagnosis and severity evaluation on patients with acute pancreatitis are very important due to its potential morbidity and mortality. Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualized. Sev eral clinical, laboratory and radiologic factors and many scoring systems have been proposed for outcome prediction. AIMS AND OBJECTIVES: To study the symptomatology, clinical presentation and management in pancreatitis . To study the severity of acute panc reatitis according to Glasgow Scale . METHODS: Present study includes consecutive 38 patients hospitalized in CSI Holdsworth Memorial Hospital over the period of 2 years. All patients were thoroughly investigated and were stratified according to the Glasgow criteria. Data was collected on complications, investigations and interventions undertaken, outcome, duration of stay in hospital and ICU. STATISTICAL ANALYSIS USED: Descriptive, Chi square tests, Crosstabs (Contingency coefficient analysis . RESULTS : Mean age of presentation in our study was 43.1 years. There was a male predominance accounting for 68.4% compared to 31.6% females. Alcohol was the main etiological factor in about 50% of the patients. Sensitivity to S. amylase was about 100%. Accuracy of USG abdomen in diagnosing pancreatitis was about 88.5%. Ascitis was the commonest complication seen in 13.2%. Mean duration of hospital stay was 6.2 days. The patient were stratified according to Glasgow scoring system into mild (0 - 3 and severe (>3 panc reatitis. In our study 32 people were graded with mild pancreatitis, all improved and in 6 people who were graded with severe pancreatitis, 83.3 % improved and 2.6% expired because of complications. Test statistics showed Contingency coefficient 0.355 and P 0.019 (NS. CONCLUSION : Glasgow scoring system remains a valid predicting system for the outcome in patients with acute pancreatitis. It is simple easy to apply with

  4. Evaluation of several ultrasonography scoring systems for synovitis and comparison to clinical examination: results from a prospective multicentre study of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Dougados, Maxime; Jousse-Joulin, Sandrine; Mistretta, Frederic; d'Agostino, Maria-Antonietta; Backhaus, Marina; Bentin, Jacques; Chalès, Gérard; Chary-Valckenaere, Isabelle; Conaghan, Philip; Etchepare, Fabien; Gaudin, Philippe; Grassi, Walter; van der Heijde, Désirée; Sellam, Jérémie; Naredo, Esperanza; Szkudlarek, Marcin; Wakefield, Richard; Saraux, Alain

    2010-01-01

    To evaluate different global ultrasonographic (US) synovitis scoring systems as potential outcome measures of rheumatoid arthritis (RA) according to the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) filter....

  5. Randomized, controlled clinical study to evaluate efficacy of novel indigenously designed controlled release flurbiprofen gel system for management of periodontal diseases

    Directory of Open Access Journals (Sweden)

    Neeraj C Deshpande

    2013-01-01

    Full Text Available Background: This randomized, controlled clinical study was planned to evaluate the use of anti-inflammatory drug flurbiprofen in the form of locally delivered controlled release gel in the treatment of periodontal disease. Materials and Methods: The flurbiprofen gel was indigenously prepared in the concentration of 0.3%. The 30 patients with localized periodontal pockets measuring ≥5 mm were randomly divided into three groups. The groups received flurbiprofen gel, flurbiprofen gel after prophylaxis, and placebo gel after oral prophylaxis, respectively. The clinical parameters for plaque and gingival inflammation were evaluated at baseline, 7 th day, and 14 th day. Results: The results of the study suggested the statistically significant ( P < 0.05 improvement in the gingival status of the patients with the use of flurbiprofen gel as an adjunct to scaling and root planing as compared to oral prophylaxis or gel alone. Conclusion: The data demonstrated that the additional use of local drug delivery of flurbiprofen through gel media enhances the positive effects of scaling and root planing and helps in faster resolution of the inflammation.

  6. A phase IIa randomized controlled pilot study evaluating the safety and clinical outcomes following the use of rhGDF-5/β-TCP in regenerative periodontal therapy.

    Science.gov (United States)

    Windisch, Péter; Stavropoulos, Andreas; Molnár, Bálint; Szendröi-Kiss, Dóra; Szilágyi, Emese; Rosta, Péter; Horváth, Attila; Capsius, Björn; Wikesjö, Ulf M E; Sculean, Anton

    2012-08-01

    To present the safety profile, the early healing phase and the clinical outcomes at 24 weeks following treatment of human intrabony defects with open flap debridement (OFD) alone or with OFD and rhGDF-5 adsorbed onto a particulate β-tricalcium phosphate (β-TCP) carrier. Twenty chronic periodontitis patients, each with at least one tooth exhibiting a probing depth ≥6 mm and an associated intrabony defect ≥4 mm entered the study. Ten subjects (one defect/patient) were randomized to receive OFD alone (control) and ten subjects OFD combined with rhGDF-5/β-TCP. Blood samples were collected at screening, and at weeks 2 and 24 to evaluate routine hematology and clinical chemistry, rhGDF-5 plasma levels, and antirhGDF-5 antibody formation. Plaque and gingival indices, bleeding on probing, probing depth, clinical attachment level, and radiographs were recorded pre- and 24 weeks postsurgery. Comparable safety profiles were found in the two treatment groups. Neither antirhGDF-5 antibody formation nor relevant rhGDF-5 plasma levels were detected in any patient. At 6 months, treatment with OFD + rhGDF-5/β-TCP resulted in higher but statistically not significant PD reduction (3.7 ± 1.2 vs. 3.1 ± 1.8 mm; p = 0.26) and CAL gain (3.2 ± 1.7 vs. 1.7 ± 2.2 mm; p = 0.14) compared to OFD alone. In the tested concentration, the use of rhGDF-5/β-TCP appeared to be safe and the material possesses a sound biological rationale. Thus, further adequately powered, randomized controlled clinical trials are warranted to confirm the clinical relevance of this new approach in regenerative periodontal therapy. rhGDF-5/β-TCP may represent a promising new techology in regenerative periodontal therapy. PMID:21887500

  7. Quality evaluation of controlled clinical information service trials.

    OpenAIRE

    Balas, E A; Austin, S. M.; Brown, G.D.; Mitchell, J. A.

    1993-01-01

    Randomized controlled clinical trials are increasingly accepted as tools of computer technology assessment and, therefore, quality evaluation of trials has great theoretical and practical significance. The purpose of this study was to assist the design of evaluation studies and synthesis of published results by developing and validating an easy-to-use quality scoring method. The development of the new scoring system was based on the available quality evaluation methods and the analysis of 19 ...

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

    Science.gov (United States)

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

    2014-07-01

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

  9. Comparative evaluation of free gingival graft and AlloDerm® in enhancing the width of attached gingival: A clinical study

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    Chitra Agarwal

    2015-01-01

    Full Text Available Background: The presence of an adequate width of keratinized tissue is important to maintain a healthy dentogingival junction. In case of inadequate width of attached gingiva, the gingival augmentation procedure has been performed classically using the patient's own masticatory mucosa and more recently, using an acellular dermal allograft as the donor material. Aims: The aim of the clinical study was to evaluate and compare the effectiveness of free gingival graft (FGG and acellular dermal matrix (ADM allograft in the ability to increase the zone of attached gingiva. Materials and Methods: Fifteen patients with 30 sites showing the inadequate width of attached gingiva (≤1 mm were enrolled for the split-mouth study. The width of keratinized gingiva and other clinical parameters were recorded at baseline and 12th month postoperatively. Statistical Analysis: The difference in clinical parameters within the group was assessed by Wilcoxon signed rank test. However, Mann–Whitney U-test was used to analyze the differences between test and control groups. Results: The width of attached gingiva increased significantly (P < 0.01 following both the treatments but comparatively lesser gain with ADM allograft (2.13 mm vs. 4.8 mm. ADM site had significantly more shrinkage (76.6% than FGG site (49.7%. Though FGG was found to be more effective, clinicians can prefer ADM allograft because of its certain advantages over the FGG. Conclusion: ADM allograft has resulted in sufficient increase in width of attached gingiva although lesser than FGG. Considering the disadvantages of FGG, it can be concluded that ADM allograft can be used as an alternative to FGG in increasing width of attached gingival in certain clinical situations.

  10. AN OPEN LABLE CLINICAL STUDY TO EVALUATE EFFECT OF JUICE OF TINOSPORA CORDIFOLIA LINN. ON GROWTH OF CHILDREN

    OpenAIRE

    Patil Y. R.

    2012-01-01

    Guduchi is being used as a rejuvenating herb in Ayurveda and other system of medicine since many decades. Guduchi is prescribed as a monoherbal as well as polyherbal formulation. The herb has free radical scavenging properties against reactive oxygen and nitrogen. Due to its Rasayana (free radical scavenging property) it was decided to evaluate efficacy of its juice in growth of children by comparing with standard growth charts developed by National centre for health statistics. 30 Children o...

  11. Topical ascorbic acid on photoaged skin. Clinical, topographical and ultrastructural evaluation: double-blind study vs. placebo.

    OpenAIRE

    Humbert, Philippe G; Haftek, Marek; Creidi, Pierre; Lapiere, Charles; Nusgens, Betty; Richard, Alain; Schmitt, Daniel; Rougier, Andre; Zahouani, Hassan

    2003-01-01

    Vitamin C is known for its antioxidant potential and activity in the collagen biosynthetic pathway. Photoprotective properties of topically applied vitamin C have also been demonstrated, placing this molecule as a potential candidate for use in the prevention and treatment of skin ageing. A topically applied cream containing 5% vitamin C and its excipient were tested on healthy female volunteers presenting with photoaged skin on their low-neck and arms in view to evaluate efficacy and safety ...

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

    Medline Plus

    Full Text Available ... Clinical Studies Children have often had to accept medicines and treatments based on what is known to ... children's health with the goal to develop treatments, drugs, and devices specific to children. Resources for a ...

  13. Periodic paralysis: clinical evaluation in 20 patients

    Directory of Open Access Journals (Sweden)

    Célia Harumi Tengan

    1994-12-01

    Full Text Available Twenty patients with periodic paralysis were evaluated and the aspects studied included epidemiological data, clinical manifestations, ancillary tests, treatment and evolution. Sixteen patients had the hypokalemic form (5 familiar, 5 sporadic, 5 thyrotoxic and 1 secondary. No patient with the normokalemic form was detected. Predominance of men was found (14 patients, especially in the cases with hyperthyroidism (5 patients. No thyrotoxic patient was of oriental origin. Only 4 patients had the hyperkalemic form (3 familiar, 1 sporadic. Attacks of paralysis began during the first decade in the hyperkalemic form and up to the third decade in the hypokalemic. In both forms the attacks occurred preferentially in the morning with rest after exercise being the most important precipitating factor. Seventy five percent of the hyperkalemic patients referred brief attacks (<12 hours. Longer attacks were referred by 43% of the hypokalemic patients. The majority of the attacks manifested with a generalized weakness mainly in legs, and its frequency was variable. Creatinokinase was evaluated in 10 patients and 8 of them had levels that varied from 1,1 to 5 times normal. Electromyography was done in 6 patients and myotonic phenomenon was the only abnormality detected in 2 patients. Carbonic anhydrase inhibitors, especially acetazolamide, were used for prophylactic treatment in 9 pacients with good results in all. Although periodic paralysis may be considered a benign disease we found respiratory distress in 5 patients, permanent myopathy in 1, electrocardiographic abnormalities during crises in 4; death during paralysis occurred in 2. Therefore correct diagnosis and immediate treatment are crucial. This study shows that hyperthyroidism is an important cause of periodic paralysis in our country, even in non oriental patients. Hence endocrine investigation is mandatory since this kind of periodic paralysis will only be abated after return to the euthyroid state.

  14. Magnetic resonance imaging. Multicentre study for a clinical and economic evaluation. Summary. Kernspintomographie. Multizentrische Studie zur klinischen und oekonomischen Evaluierung. Kurzfassung

    Energy Technology Data Exchange (ETDEWEB)

    Beer, A.; Bielke, G.; Bockenheimer, S.; Brenner, G.; Dieringer, H.; Esswein, H.; Hopf, H.; Koch, H.; Meves, M.; Nagel, F.; Oberstein, A.; Ostheimer, E.; Pfaff, M.; Schlaps, D.; Schopka, H.J.; Seiderer, M.

    1990-01-01

    The study investigates three points of main interest: (1) The clinical efficacy of MR imaging as a routine method, if possible to be assessed in comparison to comparable imaging methods, and referring to a broad spectrum of available types of equipment and modes of operation, to be expressed in terms of diagnostic value and indication of therapy. (2) Specific economic aspects, considering different sites of operation and application conditions. (3) Results of clinical application with regard to individual cases (patient careers), in order to establish a nationwide basis for economic cost-benefit assessment of this diagnostic tool. Another aspect taken into account whenever available data allow so, is substitutional or additional application of MR imaging. The survey is performed on the basis of data accumulated by more than 21.000 MR examinations, and of data describing the application environment, furnished by 25 users from university hospitals, general hospitals, or private practice. (orig./HP).

  15. Understanding clinical nursing education: An exploratory study.

    Science.gov (United States)

    Dahlke, Sherry; O'Connor, Maureen; Hannesson, Teresa; Cheetham, Karleen

    2016-03-01

    Clinical experiences are recognized as a critical aspect of nursing education, highlighting the importance of the perspectives of those providing clinical instruction. The aim of this mixed methods descriptive study was to discover the knowledge and guidance needs of preceptors and clinical faculty who provide clinical instruction to Bachelor of Science in Nursing (BSN) students. Fifteen clinical faculty and 17 preceptors were surveyed using a questionnaire developed and piloted by the researchers. Although preceptors and clinical faculty reported a high level of knowledge and confidence in their ability to guide student nurses, they also identified the need for additional support for their teaching roles. Analysis of the qualitative data provided insights into what helped and what hindered clinical instruction, as well as what could enhance clinical instruction. The development, implementation, and evaluation of formal education and mentorship processes for preceptors and clinical faculty are recommended in order to meet these knowledge and guidance gaps. Further research is also needed to explore how to clinical instruction could be tailored to the capacity of those engaged in the experiences and to clinical environments. PMID:26775165

  16. A comparative evaluation of the blood clot, platelet-rich plasma, and platelet-rich fibrin in regeneration of necrotic immature permanent teeth: A clinical study

    Directory of Open Access Journals (Sweden)

    Isha Narang

    2015-01-01

    Full Text Available Introduction: This study was designed as a clinical trial to evaluate and compare the regenerative potential of platelet-rich fibrin (PRF, platelet-rich plasma (PRP, and blood clot in immature necrotic permanent teeth with or without associated apical periodontitis. Methods: Access preparation was done under rubber dam isolation. Copious irrigation was done with 2.5% NaOCl and triple antibiotic paste was placed as an intracanal medicament. After 4 weeks, the cases were divided into four groups with five patients in each group. The study design had three test arms and one control arm. Group I in which mineral trioxide aggregate apexification was carried out and it was kept as control group to evaluate the regenerative potential of blood clot and platelet concentrates, Group II in which blood clot was used as scaffold in the canal, Group III in PRF was used as scaffold, and Group IV in which PRP carried on collagen was used as a scaffold. Results: The clinical and radiographic evaluation after 6 and 18 months was done by two independent observers who were blinded from the groups. The scoring was done as: None score was denoted by, Fair by 1, Good by 2, and Excellent by 3. The data were then analyzed statistically by Fisher′s exact test using Statistics and Data 11.1(PRP Using harvest Smart PReP2 which showed statistically significant values in Group III as compared to other Groups. Conclusion: PRF has huge potential to accelerate the growth characteristics in immature necrotic permanent teeth as compared to PRP and blood clot.

  17. Preliminary Evaluation of Clinical and Angiographic Outcomes with Biodegradable Polymer Coated Sirolimus-Eluting Stent in De Novo Coronary Artery Disease: Results of the MANIPAL-FLEX Study.

    Science.gov (United States)

    Shetty, Ranjan; Prajapati, Jayesh; Pai, Umesh; Shetty, Kiran

    2016-01-01

    Objective. The objective of the MANIPAL-FLEX study was to evaluate the feasibility, preliminary safety, and efficacy of the Supraflex sirolimus-eluting stent (SES) implantation, in de novo coronary artery disease, using clinical and quantitative coronary angiography (QCA) follow-ups. Methods. This was a prospective, nonrandomized, multicenter, single-arm study that enrolled 189 patients with de novo coronary artery disease who were treated with the Supraflex SES. Of 189 patients enrolled, the first 61 consecutive patients who consented to a 9-month follow-up evaluation by QCA, irrespective of presence of symptoms, were to be followed up with angiography at 9 months. The primary endpoint of the study was target lesion failure (TLF), including cardiac death, myocardial infarction, and target lesion revascularization during 12-month follow-up after the index procedure. Results. The mean age of the study population was 58 ± 11 years, with 51.3% (97/189) of hypertensive patients. Total of 66 lesions, analyzed by offline QCA, showed good scaffolding of the target vessel with in-stent late lumen loss at 9 months of 0.18 ± 0.23 mm. The observed TLF at 30-day, 6-month, and 12-month follow-up were 2 (1.1%), 6 (3.2%), and 10 (5.3%), respectively. Conclusion. This study provides preliminary evidence for the feasibility, safety, and efficacy of the Supraflex sirolimus-eluting stent. PMID:27597929

  18. CLINICAL EVALUATION OF SELECTED COLOURING HERBALS IN SAVARNIKARAN

    Directory of Open Access Journals (Sweden)

    Wadikar Sujata Surendra

    2013-03-01

    Full Text Available A Clinical study on "Clinical Evaluation of Selected Colouring Herbals in Savarnikaran" was carried out at shalya tantra dept. of M.A.Podar Hospital, Worli, Mumbai 18. The prime aim of the study is to make available an effective, alternative colouring cosmetic preparations which will be useful in post burn, post acne and post wound colour morbidity.Ayurvedic herbal drugs are abundant, easily available and cost effective but their use is not observed in all forms. The trial drug is prepared in powder-paste, oil and ointment form. Further the efficacy of the different preparation is also evaluated separately. Cosmetic aspect of ayurvedic surgery is neglected, here we attempt to bring this aspect in routine practice.Total number of 40 patients were studied in this clinical study.Observations were documented through specially designed clinical record form and relevant conclusions were drawn.

  19. Evaluation of absolute left ventricular volume by gated equilibrium blood pool scintigraphy using count-based method. Clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Anno, Hirofumi; Takeuchi, Akira; Ejiri, Kazutaka

    1987-12-01

    In order to estimate the absolute left ventricular volume (LVV) and the cradiac output (CO), gated equilibrium blood pool scintigraphy was performed. CO by radionuclide (RN) method was compared with CO simultaneously measured by thermodilution method (TDM) using Swan-Ganz catheter in 22 patients with cardiac diseases. To improve these determinations by RN, LVV using the count-based method was corrected by each of four transmission factors (TF1 = 1, TF2 (water) = e/sup -0.15d/, TF3 = e/sup -0.13d/ and TF4 = 1 - (1 - e/sup -0.125d/)/sup 1.26/ d: depth). We compared CO by RN with by TDM. CO by RN was significantly correlated with TDM: TF1 (CO (RN) = 0.23 x CO (TDM) + 0.08, r = 0.628, p < 0.002), TF (CO (RN) = 1.10 x CO (TDM) - 0.47, r = 0.914, p < 0.001), TF3 (CO (RN) = 0.89 x CO (TDM) - 0.30, r = 0.912, p < 0.001), and TF4 (CO (RN) = 0.71 x CO (TDM) - 0.23, r = 0.911, p < 0.001), respectively. These results indicate that the linear sttenuation correction is necessary and sufficient for accurate measurement of LVV and CO by RN using count-based method in clinical use.

  20. Clinical evaluation of XaraColl®, a bupivacaine-collagen implant, for postoperative analgesia in two multicenter, randomized, double-blind, placebo-controlled pilot studies

    Directory of Open Access Journals (Sweden)

    Cusack SL

    2012-06-01

    Full Text Available Susan L Cusack,1 Mark Jaros,2 Michael Kuss,3 Harold S Minkowitz,4 Peter Winkle,5 Lisa Hemsen61Cusack Pharmaceutical Consulting, Burlington, NJ, 2Summit Analytical, Denver, CO, USA; 3Premier Research Group, Austin, TX, USA; 4Memorial Hermann Memorial City Medical Center, Houston, TX, USA; 5Advanced Clinical Research Institute, Anaheim, CA, USA; 6Innocoll Technologies, Athlone, IrelandBackground: XaraColl®, a collagen-based implant that delivers bupivacaine to the site of surgical trauma, is under development for postoperative analgesia. Because of differing patient attitudes to postoperative pain control and the inability to assess baseline pain, standard clinical methods for evaluating analgesic efficacy are compromised and justify application of novel integrated approaches.Methods: We conducted two independent, multicenter, double-blind, placebo-controlled studies in men undergoing unilateral inguinal hernioplasty by open laparotomy to evaluate the safety and efficacy of XaraColl at different doses (100 mg and 200 mg of bupivacaine hydrochloride; study 1 and 2, respectively. Enrolled patients (50 in study 1 and 53 in study 2 were randomized to receive active or placebo implants in a 1:1 ratio. Postoperative pain intensity and use of supplementary opioid medication were recorded through 72 hours. Safety was assessed through 30 days. The principal efficacy variables were the summed pain intensity (SPI, total use of opioid analgesia (TOpA, and an integrated endpoint (I-SPI-TOpA. Each variable was analyzed at 24, 48, and 72 hours after implantation. A pooled analysis of both studies was also performed retrospectively.Results: Through 24 and 48 hours, XaraColl-treated patients experienced significantly less pain in study 1 (P < 0.001 and P = 0.012, respectively whereas they took significantly less opioid analgesia in study 2 (P = 0.004 and P = 0.042, respectively. Over the same time intervals in the pooled analysis, treated patients experienced

  1. Comparison of methods for evaluating radiolabelled Annexin A5 uptake in pre-clinical PET oncological studies

    International Nuclear Information System (INIS)

    Purpose: The uptakes of radiolabel led AnnexinA5 (AnxA5) and a size-matched control protein in experimental tumours were evaluated by kinetic analyses and compared with standard uptake values (SUVs) to investigate whether the method of analysis may impact on the conclusions that can be drawn. Procedures: PET scans of the 11C-labelled proteins performed in untreated and doxorubicin-treated mice with head and neck carcinoma xenografts were retrospectively analysed. The appropriateness of using the Logan graphical analyses for reversibly binding radiotracers in these models was evaluated and confirmed. Distribution volume ratios (DVRs) of the regions of interest to reference muscle tissue were compared to those based on the image-derived input function from arterial blood. SUVs were calculated in the same individuals. Results: DVRs based on reference muscle tissue gave results similar to those based on the arterial blood and may be preferred since they are simpler to calculate. In the inter-group comparisons of baseline versus chemotherapy treatment or AnxA5 versus control protein, differences in DVR quantifications had a 20- to 40-fold higher statistical significance than differences in SUVs. As quantified using the control protein, the amount of free ligand in the vascular space of tumours may be large due to enhanced permeability and retention (EPR) contributions at baseline and affected during treatment, which has implications for quantifications of the specifically bound radioligand. Conclusions: These results demonstrate that the quantification method as well as the controls used can be important for interpreting the uptake in tumours of the medium-sized protein ligand AnxA5 and its use in monitoring the effects of therapy on cell death in the tumours. Advances in knowledge and implications for patient care: These results provide additional support for the recognition that more detailed investigations on the effects of the tumour microenvironment on the

  2. Evaluation of Cefixime-Clavulanate Combination by Comparative Disk Diffusion Method in Klebsiella pneumoniae Clinical Isolates-An In-Vitro Study

    Directory of Open Access Journals (Sweden)

    Gajul S.V

    2015-04-01

    Full Text Available Background: Resistance to cephalosporins due to β-lactamases is a major concern worldwide. However recent trend is to use β-lactamase inhibitor combinations. Potential combination is cefiximeclavulanate. Objective: Present study aims at the comparative evaluation of Fixed-Dose Combination (FDC of cefixime‑clavulanate and cefixime-alone in Klebsiella pneumoniae clinical isolates. Material and Methods: Study included 200 clinical isolates of K. pneumoniae. The Comparative Antimicrobial Susceptibility Test (AST of cefixime‑clavulanate (5µg/10µg combination and cefixime-alone(5µg was done by measurement and comparison of zone of lysis produced by both. All values were expressed in mean ± SD. Paired‘t’ test was used to determine statistical difference between different groups under study. P values < 0.05 were considered statistically significant. Isolates were tested for ExtendedSpectrum β-lactamase (ESBL, AmpC β-lactamase (AmpC and metallo β-lactamase (MBL production by Clinical Laboratory Standards Institute - Phenotypic Disk Confirmatory Test (CLSI-PDCT, AmpC β-lactamase sterile disk test and Imipenem-Ethylene Di-amine Tetracetic Acid – Double disk synergy test (Imipenem-EDTA DDST respectively. Results: Comparative AST resulted in statistically significant (P < 0.001 increased zones in cefixime‑clavulanate combination than cefixime-alone in all isolates studied. When zones were evaluated separately only in three β-lactamase producing isolates; cefiximeclavulanate combination showed much higher zones in ESBL-producers (n=30 (P < 0.001, but not in AmpC-producers (n=32 (P = 0.5559 and MBLproducers (n=06 (P = 0.7815. Conclusion: Present study demonstrates the best bactericidal killing effect of cefixime-clavulanate compared to cefixime-alone. It is also of therapeutic significance in the treatment of infections caused by K. pneumoniae producing ESBLs. We recommend comparative AST method when commercially available newer

  3. Reversal of dental fluorosis: A clinical study

    OpenAIRE

    Dhaval N Mehta; Shah, Jigna

    2013-01-01

    Aim: This study was conducted to evaluate the clinical reversal of dental fluorosis with various combinations of calcium, vitamin D3, and ascorbic acid, along with changes in levels of certain biochemical parameters concerned with dental fluorosis. The role of fluoride level of drinking water in the etiology of dental fluorosis and the prevalence of dental fluorosis in both dentitions and teeth were also assessed. Materials and Methods: A total number of 50 patients with clinical features of ...

  4. Evaluating clinical dermatology practice in medical undergraduates.

    Science.gov (United States)

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

    2014-06-01

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

  5. A comparative study to evaluate the discrepancy in condylar guidance values between two commercially available arcon and non-arcon articulators: A clinical study

    OpenAIRE

    Mukesh Kumar Goyal; Shelly Goyal

    2011-01-01

    Aim: The purpose of this study was comparative evaluation of sagittal condylar values of arcon and non-arcon articulators with cephalometric readings and to determine the amount of discrepancy in sagittal condylar guidance values between arcon and non-arcon articulators using same protrusive record. Materials and Methods: Twenty subjects in the age group of 19-35 years, free from temporomandibular joint dysfunction, and occlusal disharmony, with healthy dentition participated in the study...

  6. Clinical study of GFR and split renal GFR in evaluating the glomerular function in patients with type 2 diabetes

    International Nuclear Information System (INIS)

    Objective: To assess glomerular filtration function in patients with type 2 diabetes by glomerular filtration rate (GFR) and split GFR, namely left GFR (LGFR) and right GFR (RGFR). Methods: Fifty-one patients with type 2 diabetes were classified by urine albumin analysis into three groups, normalalbuminuria group (NA), microalbuminuria group(MA) and macroalbuminuria group (MAA) . Twelve patients without diabetes were included into control group. 99Tcm-DTPA renography was performed on all these cases. GFR and split GFR were calculated by Gates formula. Results: 1) GFR, LGFR and RGFR of NA group were lower than that of the control group. 2) GFR, LGFR and RGFR were significantly correlated with the urine albumin level (r=-0.457, -0.412, -0.424, respectively, P all < 0.01). 3) In all 51 cases, there were 5 cases whose GFR were normal while split GFR were abnormal. Conclusions: 1) GFR and split GFR measurement can detect the incipient damage of glomerular function more sensitively than urine albumin analysis and show the degree of the damage correctly. 2) Split GFR measurement can improve the evaluation of the glomerular function in type 2 diabetes patients

  7. Clinical study to evaluate the Brinhaniya effect of Vidarikandadi Yog to enhance the sport performance in children

    Directory of Open Access Journals (Sweden)

    Nilesh Manohar Ingle

    2013-01-01

    Full Text Available Background: Sport science studies applications of scientific principles and techniques with the aim of improving sports performance. Objective: Present research work was carried out with the aim to enhance the sport performance of children. Materials and Methods: Randomized double blind placebo controlled study was conducted in children involved in sports to assess the efficacy of trial drug "Vidarikandadi Yog". Total of 72 healthy students were selected for the study after screening 412 students. Out of them, 60 students completed the study. The students were randomly divided into two groups. Group A (Vidarikandadi Yog comprising of 38 and Group B (placebo of 34 students. The trial drug "Vidarikandadi Yog" was given in the dose of 200 mg/kg/day in two divided doses for 2 months with milk and follow up was conducted fortnightly. Results: The study revealed the statistically significant results for weight and chest circumference, whereas highly significant results were obtained for muscular strength and endurance assessment parameters (Push-up Test, Sit-up Test, and Hand Grip Strength Test. Change in Ruler Drop Test was not significant. Results were significant for cardio-respiratory parameters (Resting Heart Rate, Resting Respiratory Rate, and Harvard Step Test. Conclusion: Vidarikandadi Yog is a potential drug for enhancing the sport performance due to its Brinhaneeya effect.

  8. Clinical evaluation of the intraoral fluoride releasing system in radiation-induced xerostomic subjects. Part 2: Phase I study.

    Science.gov (United States)

    Chambers, Mark S; Mellberg, James R; Keene, Harris J; Bouwsma, Otis J; Garden, Adam S; Sipos, Tibor; Fleming, Terence J

    2006-10-01

    Radiation-induced xerostomia can result in the rapid onset and progression of dental caries in head and neck cancer patients. Topically applied fluorides have been successfully used to inhibit the formation of dental caries in this population. However, because intensive daily self-application is required, compliance is an issue. The intraoral fluoride-releasing system (IFRS) containing a sodium fluoride core is a newly developed, sustained-release, passive drug delivery system that does not require patient involvement except for periodic replacement, thus reducing the effect of patient compliance on its effectiveness in dental caries prevention. Twenty-two head and neck cancer patients from U. T. M. D. Anderson Cancer Center, with radiation-induced xerostomia, were entered into a pilot study to contrast the daily home use of a 0.4% stannous fluoride-gel-containing tray (control group) to IFRS (study group) with respect to tolerability and adherence, and to obtain information on relative caries preventive efficacy. Participants were stratified on the basis of radiation exposure and randomly assigned to treatment with either IFRS or stannous fluoride gel. Patients in both groups were fitted with two IFRS retainers and also were instructed to use a 1100-ppm fluoride conventional sodium fluoride dentifrice twice daily. The study was conducted as a single-blinded, parallel-cell trial. Pre-existing carious lesions were restored prior to the beginning of the study. The efficacy variable was determined by the mean number of new or recurrent decayed surfaces. Patients were examined for caries 4, 8, 12, 24, 36, and 48 weeks after initiation of treatment. Reports of adverse reactions were based on information volunteered by patients and that were elicited during interviews. At baseline, the resting and stimulated salivary flow rates (g/5min) were significantly greater in the control group than in the study group (pIFRS groups during the study period. The rate of new or

  9. An Evaluation of Microbial Profile in Halitosis with Tongue Coating Using PCR (Polymerase Chain Reaction)- A Clinical and Microbiological Study

    OpenAIRE

    Kamaraj R., Dinesh; Bhushan, Kala S.; K.L., Vandana

    2014-01-01

    Background: Medline search using key words halitosis, tongue coating, polymerase chain reaction, microbial profile did not reveal any study. Hence, the purpose of the present investigation was to assess the malodor using the organoleptic method and tanita device; to quantify odoriferous microorganisms using Polymerase Chain Reaction technique in chronic periodontitis patients.

  10. Evaluation of Anti-Inflammatory Effects of Curcumin Gel as an Adjunct to Scaling and Root Planing: A Clinical Study

    OpenAIRE

    Anuradha, B R; Bai, Yendluri Durga; Sailaja, Sambhana; Sudhakar, Jaradoddi; M Priyanka; Deepika, V

    2015-01-01

    Background: Complete removal of irritants is not possible with mechanical therapy alone. Adjunctive use of systemic administration of antibiotics results in the distribution of drug throughout the body, which can give rise to toxicity. Curcumin (diferuloylmethane), a constituent of Curcuma longa plant, which possess antioxidant, anti-inflammatory, anti-carcinogenic, anti-microbial, anti-hyper algesic and hypocholesterolemic properties. The aim of the present study is to compare the effects of...

  11. An evaluation of the parents under pressure programme: a study protocol for an RCT into its clinical and cost effectiveness

    OpenAIRE

    Barlow, Jane; Sembi, Sukhdev; Gardner, Frances; Macdonald, Geraldine; Petrou, Stavros; Parsons, Helen; Harnett, Paul; Dawe, Sharon

    2013-01-01

    Background Many babies in the UK are born to drug-dependent parents, and dependence on psychoactive drugs during the postnatal period is associated with high rates of child maltreatment, with around a quarter of these children being subject to a child protection plan. Parents who are dependent on psychoactive drugs are at risk of a wide range of parenting problems, and studies have found reduced sensitivity and responsiveness to both the infant’s physical and emotional needs. The poor outcome...

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

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

  13. [Evaluation of the safety of antitussive agents during respiratory rehabilitation. A clinical study of L-dropropizine].

    Science.gov (United States)

    Bejor, M; Arrigo, A

    1990-06-30

    This study proves that L-dropropizine, a new peripheral antitussive drug, does not hinder the positive and useful effect of cough. This is particularly the case of physiokinesis in chronic obstructive lung disease patients. To quantify results, the respiratory voluntary muscles have been examined by surface electromyography and the peak expiratory flow has been registered by a computer-assisted device. By analysing the curves obtained relating the intensity of muscle contraction to expiratory flow, i.e. the muscle work exerted, no difference has been found after L-dropropizine and placebo. Statistical analysis evidenced increase in maximal peak expiratory flow and decrease in muscle work with both therapies. Both were significant (Student's test for paired data: p less than 0.01) in attaining functional improvement. Levodropropizine does not seem to impair the efficacy of cough elicited as part of respiratory clearance mechanisms. PMID:2147884

  14. Efficacy of sealing proximal early active lesions: an 18-month clinical study evaluated by conventional and subtraction radiography.

    Science.gov (United States)

    Martignon, S; Ekstrand, K R; Ellwood, R

    2006-01-01

    This study assessed the efficacy of sealing proximal lesions on adult patients using a split-mouth design. Eighty-two 15- to 39-year-olds from the Dental Faculties in Copenhagen and Bogotá participated, each having 2 or more proximal lesions in the following radiographic stages: (1) lesion restricted to the outer half of enamel; (2) lesion from the inner half of enamel including the enamel dentine junction, and (3) lesion restricted to the outer third of dentine. Standardized geometrically aligned baseline and follow-up radiographs were obtained. One randomly selected lesion (test) in each patient was sealed with 1 of 2 resins. The patients were instructed to floss all the proximal lesions 3 times per week. The baseline to 18 months difference in caries lesion progression status was assessed using 3 methods: (1) radiographs were independently assessed visually; (2) radiographs were read in pairs, and (3) using subtraction radiography of digitized images. A total of 72 subjects finished the study (12.2% dropout). The compliance concerning flossing was poor (15%). For the repeated examinations kappa was 0.84 for the visual examination, 0.44 for the paired readings and 0.84 for the subtraction examination. Two test lesions and 1 control lesion were restored. For the independent radiograph assessment method 10 and 26% progressed in the test and control group, respectively (p > 0.05); with the paired radiograph method the corresponding data were 22% in the test and 47% in the control groups (p floss, and subtraction radiography appeared to be the most sensitive method for assessing lesion progression. PMID:16946605

  15. Clinical and Radiographic Evaluation of Patients Treated with ITI Dental Implants and Evaluation of their Satisfaction

    OpenAIRE

    M Rismanchian; A Fazel

    2007-01-01

    Introduction: Dental implants are used increasingly in educational and clinical centers due to their ability to provide esthetic and function in patients. The aim of this study was to evaluate patients treated with ITI Dental implants clinically and radiographically, and also evaluate their satisfaction from esthetic and practical point of view.Methods and Materials: In this analytical descriptive retrospective study, 318 ITI Dental implants were placed for 107 patients (male and females). Im...

  16. Assessment of Crohn's disease activity by Doppler sonography of the superior mesenteric artery, clinical evaluation and the Crohn's Disease activity index: A prospective study

    International Nuclear Information System (INIS)

    AIM: Recent data have shown that superior mesenteric artery (SMA) flow rates are significantly increased in active Crohn's disease, suggesting that SMA flow may be a useful, non-invasive index of disease activity. The aim of this prospective study was to evaluate the use of SMA Doppler sonography as an indicator of Crohn's disease activity and to compare with clinical evaluation and the Crohn's disease activity index (CDAI). MATERIALS AND METHODS: Patients with active Crohn's (n = 19), inactive Crohn's (n = 17) and control subjects (n = 17) were evaluated. Categorization of disease activity was based on a reference standard. CDAI scores were also calculated independently. The SMA flow parameters evaluated were resistive index, pulsatility index, end diastolic velocity, peak systolic velocity, time averaged maximum velocity, cross-sectional area and maximum flow volume. RESULTS: Using a three-group ANOVA for each of peak systolic velocity (PSV) (P = 0.01), end-diastolic velocity (EDV) (P = 0.04), pulsatility index (PI) (P = 0.003), time-averaged maximum velocity (TAMV) (P = 0.05), and maximum flow volume (TAMV.CSA) (P = 0.01), there was a significant effect of group. Using post-hoc tests, only EDV (P = 0.01), TAMV (P = 0.02) and TAMV.CSA (P 0.003) were significantly different between active and inactive Crohn's disease, though with considerable overlap of values for EDV and TAMV. The mean CDAI scores were significantly different between patients with active Crohn's (287) and inactive Crohn's (71) (P = 0.0001) and correlated well with the reference standard. CONCLUSION: Only three of several parameters previously described as allowing Crohn's disease activity assessment actually did so in our study. However, for two of these parameters (EDV, TAMV), there was overlap between the measurements in the active and inactive groups, thus limiting the ability to discriminate disease activity in practice. The degree of overlap for maximum flow volume (TAMV.CSA) between active

  17. Material Performance and Animal Clinical Studies on Performance-Optimized Hwangtoh Mixed Mortar and Concrete to Evaluate Their Mechanical Properties and Health Benefits

    Directory of Open Access Journals (Sweden)

    Bon-Min Koo

    2015-09-01

    Full Text Available In this study, the amount of cement used in a concrete mix is minimized to reduce the toxic effects on users by adjusting the concrete mixture contents. The reduction of cement is achieved by using various admixtures (ground granulated blast-furnace slag, flyash, ordinary Portland cement, and activated Hwangtoh powder. To apply the mix to construction, material property tests such as compressive strength, slump, and pH are performed. Preliminary experimental results showed that the Hwangtoh concrete could be used as a healthy construction material. Also, the health issues and effects of Hwangtoh mortar are quantitatively evaluated through an animal clinical test. Mice are placed in Hwangtoh mortar and cement mortar cages to record their activity. For the test, five cages are made with Hwangtoh and ordinary Portland cement mortar floors, using Hwangtoh powder replacement ratios of 20%, 40%, 60%, and 80% of the normal cement mortar mixing ratio, and two cages are made with Hwangtoh mortar living quarters. The activity parameter measurements included weight, food intake, water intake, residential space selection, breeding activity, and aggression. The study results can be used to evaluate the benefits of using Hwangtoh as a cement replacing admixture for lifestyle, health and sustainability.

  18. Evaluation of acute bacterial rhino sinusitis in asthma patients based on clinical parameters and imaging studies, together with ear, nose and throat examination

    Energy Technology Data Exchange (ETDEWEB)

    Faure, Alecsandra Calil Moises; Santoro, Ilka Lopes; Lederman, Henrique Manoel; Fernandes, Ana Luisa Godoy [Federal University of Sao Paulo (UNIFESP/EPM), SP (Brazil). School of Medicine from Sao Paulo. Dept. of Internal Medicine]. E-mail: analgf@terra.com.br; analuisa@pneumo.epm.br; Weckx, Luc Louis Maurice [Federal University of Sao Paulo (UNIFESP/EPM), SP (Brazil). School of Medicine from Sao Paulo. Otorhinolaryngology; Fernandes, Artur da Rocha Correa [Federal University of Sao Paulo (UNIFESP/EPM), SP (Brazil). School of Medicine from Sao Paulo. Dept. of Diagnostic Imaging

    2008-06-15

    Objective: To evaluate paranasal sinuses in patients with stable or acute asthma in order to determine the prevalence of acute bacterial rhinosinusitis. Methods: A cross-sectional study including 30 patients with acute asthma (73% females) treated in the emergency room and 30 patients with stable asthma (80% females) regularly monitored as outpatients. All patients completed a questionnaire on respiratory signs and symptoms and were submitted to ear, nose and throat (ENT) examination, as well as to X-ray and computed tomography (CT) imaging of the sinuses. Results: Based on the clinical diagnosis, the prevalence of acute bacterial rhinosinusitis was 40% in the patients with acute asthma and 3% in those with stable asthma. The ENT examination findings and the imaging findings in isolation were not useful to confirm the diagnosis. Conclusions: In themselves, ENT examination findings, X-ray findings and CT findings were not useful for the diagnosis of acute bacterial rhinosinusitis. Our results provide further evidence that a clinical diagnosis of bacterial rhinosinusitis should be made with caution. (author)

  19. Evaluation of acute bacterial rhino sinusitis in asthma patients based on clinical parameters and imaging studies, together with ear, nose and throat examination

    International Nuclear Information System (INIS)

    Objective: To evaluate paranasal sinuses in patients with stable or acute asthma in order to determine the prevalence of acute bacterial rhinosinusitis. Methods: A cross-sectional study including 30 patients with acute asthma (73% females) treated in the emergency room and 30 patients with stable asthma (80% females) regularly monitored as outpatients. All patients completed a questionnaire on respiratory signs and symptoms and were submitted to ear, nose and throat (ENT) examination, as well as to X-ray and computed tomography (CT) imaging of the sinuses. Results: Based on the clinical diagnosis, the prevalence of acute bacterial rhinosinusitis was 40% in the patients with acute asthma and 3% in those with stable asthma. The ENT examination findings and the imaging findings in isolation were not useful to confirm the diagnosis. Conclusions: In themselves, ENT examination findings, X-ray findings and CT findings were not useful for the diagnosis of acute bacterial rhinosinusitis. Our results provide further evidence that a clinical diagnosis of bacterial rhinosinusitis should be made with caution. (author)

  20. Evaluation of the clinical usefulness of modulated Arc treatment

    OpenAIRE

    Lee, Young Kyu; Jang, Hong Seok; Kim, Yeon Sil; Choi, Byung Ock; Nam, Sang Hee; Park, Hyeong Wook; Kim, Shin Wook; Shin, Hun Joo; Lee, Jae Choon; Kim, Ji Na; PARK, SUNG KWANG; Kim, Jin Young; Kang, Young-Nam

    2015-01-01

    The purpose of this study is to evaluate the clinical usefulness of modulated arc (mARC) treatment techniques. The mARC treatment plans of the non-small cell lung cancer (NSCLC) patients were performed in order to verify the clinical usefulness of mARC. A pre study was conducted to find the most competent plan condition of mARC treatment and the usefulness of mARC treatment plan was evaluated by comparing it with the other Arc treatment plans such as Tomotherapy and RapidArc. In the case of m...

  1. Clinical and MRI evaluation of tuberculous meningitis

    International Nuclear Information System (INIS)

    Objective: To evaluate the relationship of clinical and magnetic resonance imaging (MRI) findings in patients with tuberculous meningitis (TBM), and to improve the understanding of TBM. Methods: The clinical and MRI findings in 42 patients with confirmed TBM were analyzed retrospectively. MRI examination was performed using a 1 Tesla system, including SE T1WI and T2WI. Intravenous contrast was injected in 29 patients, and follow-up scans were performed on 17 patients. Results: Of 24 patients with early TBM, MRI was abnormal in 5(21%) with slight Tl-hypointense meningeal (4) or ependymal thickening (1). MRI on 33/35 (94%) patients with late stage TBM was abnormal with T1 hypointensity and T2 hyperintensity including meningeal thickening (19), mild surrounding brain edema (10), nodules (11), tuberculoma (5) and abscess (2). There was significant plaque-like, nodular or rim enhancement with surrounding brain edema. Conclusion: Tuberculous meningitis has minimal clinical and MRI findings in the early phase and significant clinical and MRI findings in the late phase. The enhanced scan may help to detect the abnormality. (authors)

  2. Evaluation of the safety and efficacy of pregabalin in older patients with neuropathic pain: results from a pooled analysis of 11 clinical studies

    Directory of Open Access Journals (Sweden)

    Zlateva Gergana

    2010-11-01

    Full Text Available Abstract Background Older patients are typically underrepresented in clinical trials of medications for chronic pain. A post hoc analysis of multiple clinical studies of pregabalin in patients with painful diabetic peripheral neuropathy (DPN or postherpetic neuralgia (PHN was conducted to evaluate the efficacy and safety of pregabalin in older patients. Methods Data from 11 double-blind, randomized, placebo-controlled clinical studies of pregabalin in patients with DPN or PHN were pooled. Efficacy outcomes included change in Daily Pain Rating Scale score, ≥30% and ≥50% responders, and endpoint pain score ≤3. Safety was based on adverse events (AEs. Primary efficacy was analyzed by analysis of covariance with terms for treatment, age category, protocol, baseline pain, and treatment-by-age category interaction. Results 2516 patients (white, n = 2344 [93.2%]; men, n = 1347 [53.5%]; PHN, n = 1003 [39.9%]; pregabalin, n = 1595 were included in the analysis. Patients were grouped by age: 18 to 64 years (n = 1236, 65 to 74 years (n = 766, and ≥75 years (n = 514. Baseline mean pain and sleep interference scores were comparable across treatment and age groups. Significant improvements in endpoint mean pain were observed for all pregabalin dosages versus placebo in all age groups (p ≤ 0.0009, except for the lowest dosage (150 mg/day in the youngest age group. Clinically meaningful pain relief, defined as ≥30% and ≥50% pain response, was observed in all age groups. The most common AEs were dizziness, somnolence, peripheral edema, asthenia, dry mouth, weight gain, and infections. The relative risks for these AEs increased with pregabalin dose, but did not appear related to older age or type of neuropathic pain. Conclusions Pregabalin (150-600 mg/day significantly reduced pain in older patients (age ≥65 years with neuropathic pain and improvements in pain were comparable to those observed in younger patients. Titration of pregabalin to the

  3. A pilot study to evaluate the role of the Spinal Cord Impairment Pressure Ulcer Monitoring Tool (SCI-PUMT) in clinical decisions for pressure ulcer treatment.

    Science.gov (United States)

    Thomason, Susan S; Graves, Barbara Ann; Madaris, Linda

    2014-12-01

    The Spinal Cord Impairment Pressure Ulcer Monitoring Tool (SCI-PUMT) was designed to assess pressure ulcer (PrU) healing in the spinal cord impaired (SCI) population. The tool contains 7 variables: wound surface area, depth, edges, tunneling, undermining, exudate type, and necrotic tissue amount. A 2-phased, quantitative pilot study based on the Theory of Reasoned Action and Theory of Planned Behavior was conducted at a large SCI/Disorders Center in the Department of Veterans Affairs (VA). In the first phase of the study, a convenience sample of 5 physicians, 3 advanced practice registered nurses, and 3 certified wound care nurses (CWCN) was surveyed using a 2-part questionnaire to assess use of the SCI-PUMT instrument, its anticipated improvement in PrU assessment, and intent to use the SCI-PUMT in clinical practice. Attitudes, subjective norms, perceived behavioral controls, and barriers related to the intent to use the SCI-PUMT were evaluated using a 5-point Likert scale (range: 1= extremely likely, 5 = extremely unlikely). In the second phase of the study, the electronic health records (EHR) of 24 veterans (with 30 PrUs) who had at least 2 completed SCI-PUMT scores during a 4-week period were used to evaluate whether an association existed between magnitudes of change of total SCI-PUMT scores and ordered changes in PrU treatment. The overall mean score for intent to use SCI-PUMT was 1.80 (SD 0.75). The least favorable scores were for convenience and motivation to use the SCI-PUMT. Analysis of EHR data showed no significant difference in magnitudes of change in the SCI-PUMT score and changes in PrU treatment recommendations made by the CWCNs. The significance was not affected regardless of an increase or no change in the score (χ2 with 1 degree of freedom = 1.158, P = 0.282) or for a decrease in the score (χ2 with 1 degree of freedom = 0.5, P = 0.478). In this pilot study, the expressed intent to use the SCI-PUMT in making clinical decisions was generally

  4. Evaluation of anti-microbial activity of spore powder of Ganoderma lucidum on clinical isolates of Prevotella intermedia: A pilot study

    Directory of Open Access Journals (Sweden)

    Ranganath N Nayak

    2015-01-01

    Full Text Available Aim: This study aimed at evaluating the anti-microbial activity of spore powder of Ganoderma lucidum on Prevotella intermedia isolated from subgingival plaque from chronic periodontitis patients. Settings and Design: Written informed consent was obtained from each subject enrolled in the study. The Institutional Ethics Committee granted the ethical clearance for the study. Materials and Methods: This study included 20 patients diagnosed with chronic periodontitis. Pooled subgingival plaque samples were collected using sterile curettes from the deepest sites of periodontal pockets. The collected samples were then transported in 1 mL of reduced transport fluid. The organisms were cultured and confirmed. These organisms were then used for minimum inhibitory concentration (MIC procedure. Statistical Analysis: Mean of the MIC value obtained was calculated. Results: Thirteen out of the 20 clinical samples were tested that showed sensitivity at various concentrations. Five samples showed sensitivity at all concentrations. Twelve samples showed sensitivity at 8 mcg/ml. Eleven samples showed sensitivity at 4 mcg/ml, 8 samples showed sensitivity at 2 mcg/ml, and 5 samples showed sensitivity even at 1 mcg/ml. Mean MIC value of G. lucidum spore powder for P. intermedia obtained was 3.62 mcg/ml. Conclusion: G. lucidum with its multipotential bioactivity could be used as an anti-microbial, in conjunction with conventional therapy in periodontal disease.

  5. Two-Dimensional Cutting (TDC Vitrectome: In Vitro Flow Assessment and Prospective Clinical Study Evaluating Core Vitrectomy Efficiency versus Standard Vitrectome

    Directory of Open Access Journals (Sweden)

    Mitrofanis Pavlidis

    2016-01-01

    Full Text Available Purpose. To evaluate comparative aspiration flow performance and also vitrectomy operating time efficiency using a double-cutting open port vitreous cutting system incorporated in a two-dimensional cutting (TDC, DORC International vitrectome design versus standard vitreous cutter. Methods. In vitro investigations compared aspiration flow rates in artificial vitreous humor at varying cutter speeds and vacuum levels using a TDC vitrectome and a standard vitrectome across different aspiration pump systems. A prospective single-centre clinical study evaluated duration of core vitrectomy in 80 patients with macular pucker undergoing 25-gauge or 27-gauge vitrectomy using either a TDC vitrectome at 16,000 cuts per minute (cpm or standard single-cut vitrectome, combined with a Valve Timing intelligence (VTi pump system (EVA, DORC International. Results. Aspiration flow rates remained constant independent of TDC vitrectome cut rate, while flow rates decreased linearly at higher cutter speeds using a classic single-blade vitrectome. Mean duration of core vitrectomy surgeries using a TDC vitreous cutter system was significantly (p<0.001 shorter than the mean duration of core vitrectomy procedures using a single-cut vitrectome of the same diameter (reduction range, 34%–50%. Conclusion. Vitrectomy surgery performed using a TDC vitrectome was faster than core vitrectomy utilizing a standard single-action vitrectome at similar cut speeds.

  6. Two-Dimensional Cutting (TDC) Vitrectome: In Vitro Flow Assessment and Prospective Clinical Study Evaluating Core Vitrectomy Efficiency versus Standard Vitrectome.

    Science.gov (United States)

    Pavlidis, Mitrofanis

    2016-01-01

    Purpose. To evaluate comparative aspiration flow performance and also vitrectomy operating time efficiency using a double-cutting open port vitreous cutting system incorporated in a two-dimensional cutting (TDC, DORC International) vitrectome design versus standard vitreous cutter. Methods. In vitro investigations compared aspiration flow rates in artificial vitreous humor at varying cutter speeds and vacuum levels using a TDC vitrectome and a standard vitrectome across different aspiration pump systems. A prospective single-centre clinical study evaluated duration of core vitrectomy in 80 patients with macular pucker undergoing 25-gauge or 27-gauge vitrectomy using either a TDC vitrectome at 16,000 cuts per minute (cpm) or standard single-cut vitrectome, combined with a Valve Timing intelligence (VTi) pump system (EVA, DORC International). Results. Aspiration flow rates remained constant independent of TDC vitrectome cut rate, while flow rates decreased linearly at higher cutter speeds using a classic single-blade vitrectome. Mean duration of core vitrectomy surgeries using a TDC vitreous cutter system was significantly (p vitrectomy procedures using a single-cut vitrectome of the same diameter (reduction range, 34%-50%). Conclusion. Vitrectomy surgery performed using a TDC vitrectome was faster than core vitrectomy utilizing a standard single-action vitrectome at similar cut speeds. PMID:27190635

  7. Comparative evaluation of the effectiveness of electronic dental anesthesia with 2% lignocaine in various minor pediatric dental procedures: A clinical study

    Directory of Open Access Journals (Sweden)

    Abhishek Dhindsa

    2011-01-01

    Full Text Available One of the most distressing aspects of dentistry for pediatric patients is the fear and anxiety caused by the dental environment, particularly the dental injection. The application and induction of local anesthetics has always been a difficult task, and this demands an alternative method that is convenient and effective. Electronic dental anesthesia, based on the principal of transcutaneous electric nerve stimulation (TENS, promises to be a viable mode of pain control during various pediatric clinical procedures. Therefore, the aim of the present study was to evaluate the effectiveness of TENS and to compare its efficacy with 2% lignocaine during various minor pediatric dental procedures. Pain, comfort and effectiveness of both the anesthetics were evaluated using various scales and no significant difference was observed between 2% lignocaine and TENS in the various pain scales, while TENS was perceived to be significantly effective in comfort and efficacy as judged by the operator and quite comfortable as judged by the patient himself/herself.

  8. Atomic force microscopy and scanning electron microscopy evaluation of efficacy of scaling and root planing using magnification: A randomized controlled clinical study

    Directory of Open Access Journals (Sweden)

    Ranjana Mohan

    2013-01-01

    Full Text Available Aim: A randomized controlled clinical study was undertaken to evaluate the effectiveness of scaling and root planing (SRP by using Magnifying Loupes (ML and dental operating microscope (DOM. Materials and Methods: A total of 90 human teeth scheduled for extraction from 18 patients aged between 25 and 65 years suffering from generalized chronic severe periodontitis were randomly assigned to three treatment groups. Group 1 consisted SRP performed without using magnification (unaided, Group 2-SRP with ML and Group 3-SRP with DOM. Following extractions, samples were prepared for (i evaluation of surface topography by atomic force microscopy, (ii presence of smear layer, debris by scanning electron microscopy (iii elemental analysis by energy dispersive X-ray analysis. Data was subjected to statistical analysis using analysis of variance, post-hoc (Tukey-HSD and Chi-square test. Results: Statistically significant (P < 0.001 difference was found among the different treatment groups. Group 3 was the best while Group 1 was the least effective technique for SRP. Order of efficacy in terms of the surface was found to be - Palatal < Lingual < Distal ≅ Mesial < Buccal. Efficiency in mandibular to maxillary teeth was found to be significant (P < 0.05, also anterior to posterior teeth (P < 0.05. Conclusion: Magnification tools significantly enhance the efficacy of supragingival and subgingival SRP.

  9. Clinical evaluation of 413 Thalassemic patients

    Directory of Open Access Journals (Sweden)

    Korosdari Gh.H

    2000-08-01

    Full Text Available Thalassemia is the most prevalent genetic disorder in Iran and around the world and these patients need regular careful care. The present study reports results of routine examination of patients visited Thalassemia clinic of Tehran. Data about clinical and laboratory examinations of 413 Thalassemic were extracted and analyzed. The prevalence of heart complications, diabetes, growth retardation, delayed puberty and primary and secondary amenorrhea was 9%, 8%, 21.3%, 3.1% and 6.3%, respectively. 44% didn't have secondary sex characteristics. Splenectomy had been done for 67.2% of cases. HBsAg, HBsAb and HBcAb were positive in 1.9%, 57.4% and 43%, respectively. We concluded that blood transfusion standards in this clinic was acceptable, whereas because of poor knowledge, iron chelating is unfavorable.

  10. Evaluation of the reliability and validity of the Medical Outcomes Study sleep scale in patients with painful diabetic peripheral neuropathy during an international clinical trial

    Directory of Open Access Journals (Sweden)

    Hays Ron D

    2008-12-01

    Full Text Available Abstract Background Sleep is an important element of functioning and well-being. The Medical Outcomes Study Sleep Scale (MOS-Sleep includes 12 items assessing sleep disturbance, sleep adequacy, somnolence, quantity of sleep, snoring, and awakening short of breath or with a headache. A sleep problems index, grouping items from each of the former domains, is also available. This study evaluates the psychometric properties of MOS-Sleep Scale in a painful diabetic peripheral neuropathic population based on a clinical trial conducted in six countries. Methods Clinical data and health-related quality of life data were collected at baseline and after 12 weeks of follow-up. Overall, 396 patients were included in the analysis. Psychometric properties of the MOS-Sleep were assessed in the overall population and per country when the sample size was sufficient. Internal consistency reliability was assessed by Cronbach's alpha; the structure of the instrument was assessed by verifying item convergent and discriminant criteria; construct validity was evaluated by examining the relationships between MOS-Sleep scores and sleep interference and pain scores, and SF-36 scores; effect-sizes were used to assess the MOS-Sleep responsiveness. The study was conducted in compliance with United States Food and Drug Administration regulations for informed consent and protection of patient rights. Results Cronbach's alpha ranged from 0.71 to 0.81 for the multi-item dimensions and the sleep problems index. Item convergent and discriminant criteria were satisfied with item-scale correlations for hypothesized dimensions higher than 0.40 and tending to exceed the correlations of items with other dimensions, respectively. Taken individually, German, Polish and English language versions had good internal consistency reliability and dimension structure. Construct validity was supported with lower sleep adequacy score and greater sleep problems index scores associated with

  11. Hypersensitivity pneumonitis: Radiological, clinical and pathologic evaluation

    International Nuclear Information System (INIS)

    This paper is to evaluate radiological features of hypersensitivity pneumonitis, correlated with clinical and pathologic findings. Patients consisted of 2 men and 3 women, aged 23-51 years old (average 41). Diagnosis was based on the presence of suggestive clinical and radiological findings (chest radiography, high resolutional CT, gallium scintigraphy), and lung biopsy showing characteristic histological features. All patients complained of external dyspnea and three patients experienced coughing. On the pulmonary function test, four patients revealed restrictive pattern and one patients was normal. Results of bronchoalveolar lavage, available in four patients, revealed lymphocytosis in three patients and normal finding in one patients. Chest radiographs showed ground glass opacity or diffuse nodular densities. On the HRCT,diffuse nodular opacity and ground glass and opacity were seen in variable features. All 4 patients had diffuse increased uptake on the gallium scan. On lung biopsy, a combination of histologic findings showed cellular bronchiolitis, diffuse interstitial infiltrates and non-necrotizing granulomas, consistent with diagnosis of hypersensitivity pneumonitis. Hypersensitively pneumonitis could be diagnosed with these radiological, clinical and pathological findings

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  13. CLINICAL STUDY OF ANORECTAL MALFORMATIONS

    OpenAIRE

    Umesh; Sowmya,

    2015-01-01

    BACKGROUND: A norectal malformations are relatively encountered anomalies. Presentations may vary from mild to severe and bowel control is t he main concern. AIM: To study the modes of presentation , types of anomalies , associated anomalies , reliability of clinical signs and radiological investigations in the diagnosis and the prognosis and continence in the post - operative in relation to type of anomaly and associated anomaly (s)...

  14. Clinical Study on the Management of Huzaz/Abria (Dandruff) with a pharmacopoeal Preparation of a Unani Medicine and its Cosmetic Evaluation.

    Science.gov (United States)

    Shah, Altaf Hussain; Haji, Amanullah; Rather, Shameem Ahmad; Ahmad, Tanzeel; Ansari, Abdul Nasir; Soff, G

    2009-10-01

    Dandruff called Huzaz/Abria in Unani medicine is a common ailment in the world with easy options of treatment. Most of the treatment options have ignored the cosmetic aspect of hair. Unani medicine has got a vast array of drug formulation to evaluate the efficacy of Unani pharmacopoeal formulation in mild form of seborrhic dermatitis of scalp (dandruff). Its efficacy was compared with standard drug (2% ketakonazole shampoo). Patients were enrolled after ethical clearance and informed consent in the study. 30 patients were treated with Unani formulation and 20 patients with the standard drug. The assessment of various parameters like Itching, Scalp shedding, Erythema, Hair frizz, Hair combing ease, and Hair smoothness was made before and after 30 days. The assessments of the parameters were analyzed and compared using appropriate statistical tests. The study revealed that Unani formulation was equally effective as standard drug and the hair comesis was better than the standard drug as seen clinically, but was not statistically significant (p=0.576). PMID:22557347

  15. Epidemiological, clinical and sleep laboratory evaluations of insomnia

    Science.gov (United States)

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

    1975-01-01

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

  16. Towards clinical implementation of ultrafast combined kV-MV CBCT for IGRT of lung cancer. Evaluation of registration accuracy based on phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Arns, Anna; Blessing, Manuel; Fleckenstein, Jens; Stsepankou, Dzmitry; Boda-Heggemann, Judit; Simeonova-Chergou, Anna; Hesser, Juergen; Lohr, Frank; Wenz, Frederik; Wertz, Hansjoerg [University Medical Center Mannheim, University of Heidelberg, Department of Radiation Oncology, Mannheim (Germany)

    2016-05-15

    Combined kV-MV cone-beam CT (CBCT) is a promising approach to accelerate imaging for patients with lung tumors treated with deep inspiration breath-hold. During a single breath-hold (15 s), a 3D kV-MV CBCT can be acquired, thus minimizing motion artifacts and increasing patient comfort. Prior to clinical implementation, positioning accuracy was evaluated and compared to clinically established imaging techniques. An inhomogeneous thorax phantom with four tumor-mimicking inlays was imaged in 10 predefined positions and registered to a planning CT. Novel kV-MV CBCT imaging (90 arc) was compared to clinically established kV-chest CBCT (360 ) as well as nonclinical kV-CBCT and low-dose MV-CBCT (each 180 ). Manual registration, automatic registration provided by the manufacturer and an additional in-house developed manufacturer-independent framework based on the MATLAB registration toolkit were applied. Systematic setup error was reduced to 0.05 mm by high-precision phantom positioning with optical tracking. Stochastic mean displacement errors were 0.5 ± 0.3 mm in right-left, 0.4 ± 0.4 mm in anteroposterior and 0.0 ± 0.4 mm in craniocaudal directions for kV-MV CBCT with manual registration (maximum errors of no more than 1.4 mm). Clinical kV-chest CBCT resulted in mean errors of 0.2 mm (other modalities: 0.4-0.8 mm). Similar results were achieved with both automatic registration methods. The comparison study of repositioning accuracy between novel kV-MV CBCT and clinically established volume imaging demonstrated that registration accuracy is maintained below 1 mm. Since imaging time is reduced to one breath-hold, kV-MV CBCT is ideal for image guidance, e.g., in lung stereotactic ablative radiotherapy. (orig.) [German] Kombiniertes kV-MV-Cone-Beam-CT (CBCT) ist ein vielversprechender Ansatz zur Beschleunigung der Bildgebung bei Patienten mit Lungentumoren, die mit wiederholter Atemanhaltetechnik in tiefer Inspiration behandelt werden. Waehrend einer einzigen

  17. Expanded clinical evaluation of lovastatin (EXCEL) study results: III. Efficacy in modifying lipoproteins and implications for managing patients with moderate hypercholesterolemia.

    Science.gov (United States)

    Bradford, R H; Shear, C L; Chremos, A N; Franklin, F A; Nash, D T; Hurley, D P; Dujovne, C A; Pool, J L; Schnaper, H; Hesney, M

    1991-07-31

    In the multicenter, double-blind EXCEL (Expanded Clinical Evaluation of Lovastatin) study the efficacy of lovastatin in modifying plasma lipids and lipoproteins in 8,245 participants with moderate primary hypercholesterolemia was evaluated. Patients were randomly assigned to 48 weeks of treatment with diet and placebo or diet and lovastatin 20 or 40 mg once a day, or 20 or 40 mg twice a day. At all of these dosages, lovastatin produced substantial dose-dependent reductions in low-density-lipoprotein (LDL)-cholesterol levels, averaging 24% (20 mg/day) to 40% (80 mg/day). The magnitude of the effect of this lipoprotein was further reflected by the percentage of patients who achieved National Cholesterol Education Program (NCEP) goals. In the absence of coronary artery disease (CAD) or two other CAD risk factors, the LDL-cholesterol goal of 4.14 mmol/L (160 mg/dL) was attained by 22% of patients in the placebo group and between 81% (20 mg/day) and 96% (80 mg/day) of those treated with lovastatin. For those with CAD or at least two other CAD risk factors, the LDL-cholesterol goal of 3.36 mmol/L (130 mg/dL) was attained by 4% of placebo patients and between 38% (20 mg/day) and 83% (80 mg/day) of those treated with lovastatin. Lovastatin also increased high-density-lipoprotein cholesterol (7-10%) and decreased triglycerides (10-19%) in a dose-dependent manner. Thus, when used as an adjunct to a prudent diet, lovastatin produces favorable changes in the entire lipoprotein profile and is a highly effective agent for managing patients with primary hypercholesterolemia. PMID:1867232

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

    Medline Plus

    Full Text Available ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & ...

  19. Retrospective evaluation of a pharmacist-managed warfarin anticoagulation clinic.

    Science.gov (United States)

    Garabedian-Ruffalo, S M; Gray, D R; Sax, M J; Ruffalo, R L

    1985-02-01

    The effectiveness of a pharmacist-managed warfarin anticoagulation clinic in maintaining therapeutic prothrombin times and preventing hospitalizations secondary to inadequate control of anticoagulation was evaluated. Patients who had received warfarin sodium for at least one year before being referred to the anticoagulation clinic were studied using retrospective chart reviews. Clinical pharmacists provided patient education, monitored patients for hemorrhagic and thromboembolic complications, and adjusted warfarin sodium dosage to maintain therapeutic prothrombin times. The patients' primary physicians retained responsibility for overall care and were consulted by pharmacists regarding complications of anticoagulation and patient unreliability. The percentage of patients requiring hospitalization (39% versus 4%) and the percentage of prothrombin times outside the therapeutic range (35.8% versus 14.4%) were significantly higher during the preclinic phase (before referral to the clinic) than during the clinic phase. Eight patients were hospitalized for hemorrhagic complications and four for thromboembolism during the preclinic phase; only one hospitalization for hemorrhage occurred during the clinic phase. The warfarin anticoagulation clinic staffed by specially trained pharmacists provided improved therapy compared with treatment received by patients before their referral to the clinic. PMID:3976675

  20. Clinical Application and Evaluation of Pharmacogenomics in Tumor Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Feng Jifeng

    2014-01-01

    In the treatment of tumor patients, how to select the chemotherapy regimen with better efifcacy, less toxicity and expense is a difficult problem that perplexes clinical doctors for a long time. Pharmacogenetics is to study the influence of genetic factors on pharmacokinetics, whereas pharmacogenomics is to study the relationship between various gene mutations and drug efifcacy and safety. With molecular biology developing, pharmacogenetics and pharmacogenomics are considered to be essential in the reduction of adverse reactions, improvement of efficacy and realization of individualized treatment. In this article, the clinical application and evaluation of pharmacogenomics in tumor chemotherapy were primarily investigated.

  1. CLINICAL EVALUATION OF SELECTED COLOURING HERBALS IN SAVARNIKARAN

    OpenAIRE

    Wadikar Sujata Surendra; Reddy Govind R.

    2013-01-01

    A Clinical study on "Clinical Evaluation of Selected Colouring Herbals in Savarnikaran" was carried out at shalya tantra dept. of M.A.Podar Hospital, Worli, Mumbai 18. The prime aim of the study is to make available an effective, alternative colouring cosmetic preparations which will be useful in post burn, post acne and post wound colour morbidity.Ayurvedic herbal drugs are abundant, easily available and cost effective but their use is not observed in all forms. The trial drug is prepared in...

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

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Ram; Choi, Da Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Choi, Soon Chul; Bae, Kwang Hak; Lee, Sam Sun [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2012-09-15

    The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

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

    OpenAIRE

    Dasari, B.D.

    2006-01-01

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

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

    Science.gov (United States)

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

    1996-10-01

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

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

    OpenAIRE

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

    2015-01-01

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

  6. Comparative evaluation of a bioabsorbable collagen membrane and connective tissue graft in the treatment of localized gingival recession: A clinical study

    Directory of Open Access Journals (Sweden)

    Harsha Mysore Babu

    2011-01-01

    Full Text Available Background: Gingival recession (GR can result in root sensitivity, esthetic concern to the patient, and predilection to root caries. The purpose of this randomized clinical study was to evaluate (1 the effect of guided tissue regeneration (GTR procedure using a bioabsorbable collagen membrane, in comparison to autogenous subepithelial connective tissue graft (SCTG for root coverage in localized gingival recession defects; and (2 the change in width of keratinized gingiva following these two procedures. Materials and Methods: A total of 10 cases, showing at least two localized Miller′s Class I or Class II gingival recession, participated in this study. In a split mouth design, the pairs of defects were randomly assigned for treatment with either SCTG (SCTG Group or GTR-based collagen membrane (GTRC Group. Both the grafts were covered with coronally advanced flap. Recession depth (RD, recession width (RW, width of keratinized gingiva (KG, probing depth (PD, relative attachment level (RAL, plaque index (PI, and gingival index (GI were recorded at baseline, 3 and 6 months postoperatively. Results: Six months following root coverage procedures, the mean root coverage was found to be 84.84% ± 16.81% and 84.0% ± 15.19% in SCTG Group and GTRC Group, respectively. The mean keratinized gingival width increase was 1.50 ± 0.70 mm and 2.30 ± 0.67 mm in the SCTG and GTRC group, respectively, which was not statistically significant. Conclusion: It may be concluded that resorbable collagen membrane can be a reliable alternative to autogenous connective tissue graft in the treatment of gingival recession.

  7. A comparative study to evaluate the discrepancy in condylar guidance values between two commercially available arcon and non-arcon articulators: A clinical study

    Directory of Open Access Journals (Sweden)

    Mukesh Kumar Goyal

    2011-01-01

    Full Text Available Aim: The purpose of this study was comparative evaluation of sagittal condylar values of arcon and non-arcon articulators with cephalometric readings and to determine the amount of discrepancy in sagittal condylar guidance values between arcon and non-arcon articulators using same protrusive record. Materials and Methods: Twenty subjects in the age group of 19-35 years, free from temporomandibular joint dysfunction, and occlusal disharmony, with healthy dentition participated in the study. Hanau H2 (non-arcon type and Hanau Wide-Vue (arcon type articulators were programmed for sagittal condylar guidance values using the same protrusive record made in polysiloxane bite registration material with edge to edge degree of protrusion. The resultant values for both the articulators on either side were compared with values obtained from tracing of digital lateral cephalogram using Kodak Dental imaging Window software 6.6.3.0-C program. The tabulated data were subjected to statistical analysis, ANOVA (Fishers ′F′ test for group comparison, Tukey′s HSD test for inter-comparison, student′s unpaired ′t′ test for intra-group comparison, and level of significance (P was calculated using the same. Results: The mean sagittal condylar guidance values of the three different groups were found to be very highly significant (P=0.001 and highly significant (P=0.002 on the right and left sides respectively. There was a very highly significant difference (P=0.001 and highly significant difference (P=0.003 between the arcon and non-arcon group on the right and left side respectively. No significant difference was found between the arcon and cephalometric group (P=0.284 right, P=0.853 left and a statistically significant difference was found between the non-arcon and cephalometric group (P=0.049 right, P=0.015 left. On intragroup comparison there was no statistically significant difference in sagittal condylar values on the right and left sides. Conclusion

  8. Comprehensive non-clinical respiratory evaluation of promising new drugs

    International Nuclear Information System (INIS)

    The need to evaluate the potential for new drugs to produce adverse effects on respiratory function in non-clinical safety assessment is based on the known effects of drugs from a variety of pharmacological/therapeutic classes on the respiratory system, the life-threatening consequences of respiratory dysfunction, and compliance with world-wide regulatory safety guidelines. The objective of this article is to provide a brief overview of the functional disorders of the respiratory system and to present the strategy and techniques considered to be most appropriate for detecting and characterizing drug-induced respiratory disorders in non-clinical safety studies

  9. ["Re-evaluation upon suspected event" is an approach for post-marketing clinical study: lessons from adverse drug events related to Bupleuri Radix preparations].

    Science.gov (United States)

    Wu, Shu-Xin; Sun, Hong-Feng; Yang, Xiao-Hui; Long, Hong-Zhu; Ye, Zu-Guang; Ji, Shao-Liang; Zhang, Li

    2014-08-01

    We revisited the "Xiao Chaihu Decoction event (XCHDE)" occurred in late 1980s in Japan and the Bupleuri Radix related adverse drug reaction (ADR) reports in China After careful review, comparison, analysis and evaluation, we think the interstitial pneumonitis, drug induced Liver injury (DILI) and other severe adverse drug envents (ADEs) including death happened in Japan is probably results from multiple factors, including combinatory use of XCHDE with interferon, Kampo usage under modern medicine theory guidance, and use of XCHD on the basis of disease diagnosis instead of traditional Chinese syndrome complex differentiation. There are less ADE case reports related to XCHD preparation in China compared to Japan, mostly manifest with hypersensitivity responses of skin and perfuse perspiration. The symptoms of Radix Bupleuri injection related ADEs mainly manifest hypersensitivity-like response, 2 cases of intravenous infusion instead of intramuscular injection developed hypokalemia and renal failure. One case died from severe hypersensitivity shock. In Chinese literatures, there is no report of the interstitial pneumonitis and DILI associated with XCHDG in Japan. So far, there is no voluntary monitoring data and large sample clinical research data available. The author elaborated the classification of "reevaluation" and clarified "re-evaluation upon events" included the reaction to the suspected safety and efficacy events. Based on the current status of the clinical research on the Radix Bupleuri preparations, the author points out that post-marketing "re-evaluation upon suspected event" is not only a necessity of continuous evaluation of the safety, efficacy of drugs, it is also a necessity for providing objective clinical research data to share with the international and domestic drug administrations in the risk-benefit evaluation. It is also the unavoidable pathway to culture and push the excellent species and famous brands of TCM to the international market, in

  10. Clinical evaluation of digital cine imaging on coronary angiography

    International Nuclear Information System (INIS)

    Digital cine angio system was developed a few years ago and is used widely for cardiac examinations. However, the image quality of digital imaging in clinical examinations is seldom evaluated. We have attempted to evaluate the digital imaging in D.C.I. First, each segment of coronary arteries that is exposed in routine projection angle were visually evaluated. Second, regarding the appearance of the coronary arteries on the diaphragm we compared digital imaging with cine film. As a result, the image quality of the coronary arteries except for segments 7 to 10 (classified by A.H.A.) was evaluated as being good. Regarding the appearance of coronary arteries on a diaphragm, digital imaging was evaluated higher than cine film. In this report, the advantages of digital imaging in coronary angiography were studied. (author)

  11. Implementing Peer Evaluation of Clinical Teaching

    Science.gov (United States)

    Laske, Rita Ann

    2013-01-01

    Clinical education provides the nursing student opportunities to learn the practice of nursing. In the clinical setting, the nursing student applies classroom knowledge to the real patient care situation. The clinical instructor facilitates this important process by assisting students to integrate knowledge into their practice, improve their…

  12. [Clinical practice guideline: a complete geriatric evaluation].

    Science.gov (United States)

    Medina-Chávez, Juan Humberto; Torres-Arreola, Laura Del Pilar; Cortés-González, Rosa María; Durán-Gómez, Verónica; Martínez-Hernández, Fernando; Esquivel-Romero, Gustavo

    2011-01-01

    The care of elderly patients requires an evaluation that deserves a host of special considerations, such as biological aspects of aging, those related to activities of daily living and functionality, neuro-psychological conceptions, family dynamics and economic conditions. The growth of the aging population in our country is accompanied by an increase in chronic diseases and more individuals have greater vulnerability, requiring a more consumption of resources because of the high demand for services. This requires the incorporation of specialized care in the institutional system, which has caused serious consequences in the current health system, benefiting specialization and technology, but with a loss of an integrated and horizontal view of the patient. Therefore it is necessary to develop a practical tool that allows the family physician to identify and differentiate the geriatric population that requires specialized care from who does not, identifying problems that may improve and allow the design of strategies to improve health status and maintain functional autonomy of the elderly. Comprehensive Geriatric Assessment (CGA) is a fundamental tool for clinical practice of any medical care to the elderly. PMID:22176832

  13. Evaluation of the Effect of Probiotic (Inersan®) Alone, Combination of Probiotic with Doxycycline and Doxycycline Alone on Aggressive Periodontitis – A Clinical and Microbiological Study

    OpenAIRE

    Shah, Mishal Piyush; Gujjari, Sheela Kumar; Chandrasekhar, Veerendrakumar Siddhpur

    2013-01-01

    Introduction: The purpose of the present study was to evaluate the effect of a probiotic (Inersan®) alone, a combination of the probiotic with doxycycline and doxycycline alone on aggressive periodontitis patients.

  14. A four-year clinical evaluation of acid etched bridges

    International Nuclear Information System (INIS)

    Thirty six (36) three unit acid etched bridges (20 posterior and 16 anterior) were clinically evaluated in relation to retention, cracking in the porcelain and caries status of the abutment teeth. The results showed that after 4 years 26 bridges (72.2 %) were successfully retained, one porcalin facing had fractured and none of the abutments showed evidence of caries during the period of the study. (author)

  15. Are the outcomes of clinical pathways evidence-based? A critical appraisal of clinical pathway evaluation research

    OpenAIRE

    El Baz, N.; Middel, B.; van Dijk, J. P.; Oosterhof, A.; Boonstra, P.W.; Reijneveld, S.A.

    2007-01-01

    Aim and objective To evaluate the validity of study outcomes of published papers that report the effects of clinical pathways (CP). Method Systematic review based on two search strategies, including searching Medline, CINAHL, Embase, Psychinfo and Picarta from 1995 till 2005 and ISI Web of Knowledge (SM). We included randomized controlled or quasi-experimental studies evaluating the efficacy of clinical pathway application. Assessment of the methodological quality of the studies included rand...

  16. Postoperative MRI evaluation of anorectal malformations with clinical correlation

    International Nuclear Information System (INIS)

    Sixteen postoperative patients with anorectal malformation were evaluated by MRI, and the results compared with the clinical assessment. Patients were classified into three groups - good (group 1, n = 10), fair (group 2, n = 3) and poor (group 3, n = 3) - on the basis of Kelly's clinical score of incontinence. The degree of development of the puborectalis and external sphincter muscles and the levator hammock was evaluated on MRI in comparison with patients without anorectal disease. The proportions of fair or poor development of the muscles were 37% in group 1,22% in group 2 and 67% in group 3. Although fair or poor development of the muscles was seen more frequently in group 3, there was no statistically significant difference between groups. However, poorly developed muscles were seen only in patients with fair or poor clinical scores. The difference in the anorectal angle measured on sagittal MRI images between patients in group 1 and groups 2 or 3 was significant. Our study indicates that MRI evaluation based solely on muscle development can be misleading, and measurement of the anorectal angle should be included in the MRI evaluation. (orig.)

  17. Evaluation of the appropriateness of the preclinical phase (stage A and stage B) of heart failure Management in Outpatient clinics in Italy rationale and design of the 'VASTISSIMO' study.

    Science.gov (United States)

    Mureddu, Gian F; Nistri, Stefano; Faggiano, Pompilio; Fimiani, Biagio; Misuraca, Gianfranco; Maggi, Antonio; Gori, Anna M; Uguccioni, Massimo; Tavazzi, Luigi; Zito, Giovanni B

    2016-07-01

    Early detection of heart failure, when still preclinical, is fundamental. Therefore, it is important to assess whether preclinical heart failure management by cardiologists is adequate. The VASTISSIMO study ('EValuation of the AppropriateneSs of The preclInical phase (Stage A and Stage B) of heart failure Management in Outpatient clinics in Italy') is a prospective nationwide study aimed to evaluate the appropriateness of diagnosis and management of preclinical heart failure (stages A and B) by cardiologists working in outpatient clinics in Italy. Secondary goals are to verify if an online educational course for cardiologists can improve management of preclinical heart failure, and evaluate how well cardiologists are aware of patients' adherence to medications. The study involves 80 outpatient cardiology clinics distributed throughout Italy, affiliated either to the Hospital Cardiologists Association or to the Regional Association of Outpatient Cardiologists, and is designed with two phases of consecutive outpatient enrolment each lasting 1 month. In phase 1, physicians' awareness of the risk of heart failure and their decision-making process are recorded. Subsequently, half of the cardiologists are randomized to undergo an online educational course aimed to improve preclinical heart failure management through implementation of guideline recommendations. At the end of the course, all cardiologists are evaluated (phase 2) to see whether changes in clinical management have occurred in those who underwent the educational program versus those who did not. Patients' adherence to prescribed medications will be assessed through the Morisky Self-report Questionnaire. This study should provide valuable information about cardiologists' awareness of preclinical heart failure and the appropriateness of clinical practice in outpatient cardiology clinics in Italy. PMID:27028840

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

    Science.gov (United States)

    Vlak, Tonko

    2004-01-01

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

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

    Medline Plus

    Full Text Available ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting ...

  20. Clinical studies on cerebral infarction

    International Nuclear Information System (INIS)

    Hemorrhagic infarction (HI) is termed as the infarction in which a large part of the necrotic tissue is stippled with small hemorrhage. The pathogenetic mechanism of this disease still remains controversial. Cerebral infarction has long been divided into two subtypes-thrombosis and embolism-according to the pathogenetic mechanisms. Clinical studies were carried out in 31 cases of HI with cerebral thrombosis. CT findings of these cases were classified into five groups according to both size of low density area which indicates regions of infarction and distribution of arterial supply. The low density area of Type I-Type III were observed in the area of the middle cerebral artery. That of Type IV was observed in the area of the internal capsule and basal ganglia. That of Type V was observed in the area of the posterior cerebral artery. CT reveals two patterns of HI -pattern A and pattern B-. The CT finding of pattern A is appearance of high density area in the low density area. The CT finding of pattern B is appearance of iso density area in the low density area. rCBF was measured by 133Xe inhalation technique in 21 patients with CT type I, II and III. Thereafter, with regard to the various findings in CT, the clinical findings and CBF findings, a comparative study was carried out on these ten groups. From the results of present studies, it is concluded that sequential changes of CBF in cases with pattern A are different from those with pattern B, and that CBF measurement does not permit an estimation of a patient's chance for functionary recovery after a stroke in acute and subacute stage but permits estimation of functional outcome in chronic stage. (J.P.N.)

  1. CLINICAL STUDY OF ANORECTAL MALFORMATIONS

    Directory of Open Access Journals (Sweden)

    Umesh

    2015-01-01

    Full Text Available BACKGROUND: A norectal malformations are relatively encountered anomalies. Presentations may vary from mild to severe and bowel control is t he main concern. AIM: To study the modes of presentation , types of anomalies , associated anomalies , reliability of clinical signs and radiological investigations in the diagnosis and the prognosis and continence in the post - operative in relation to type of anomaly and associated anomaly (s. MATERIAL AND METHODS: 50 cases of anorectal malformations admit ted to Department of Paediatric Surgery , in Medical Coll ege and Research Institute , were included in the study. Data related to the objectives of the study were collected. RESULTS: Commonest mode of presentation was failure to pass meconium 50%. 59% of mal es had high anomalies , while 53% females had intermediate anomalies. The diagnosis of low anomaly was made clinically , while high and intermediate anomalies needed further investigations. Associated anomalies were noted in 46.6% of the cases. 71.42% of the se patients had either a high or intermediate ARM. All patients with high anomalies underwent a 3 stage procedure , while low anomalies underwent a single stage procedure followed by anal dilatations. Rectal mucosal prolapse (2 cases , wound infection (4 ca ses , stenosis (3 cases , retraction of neo anus (1 case was seen. All the patients with low anomalies had a good functional result post operatively , while 57% and 28% of patients with intermediate and high anomalies had good results. CONCLUSION : Anorectal malformations are common congenital anomalies. Males are more commonly affected (1.3:1. Low anomalies are the commonest lesions noted in both the sexes (36.67%. High anomalies are more frequent in males. Invertogram offer an accurate diagnosis for planning management in patients with anorectal malformations. Low anomalies have a better outcome following surgery. For intermediate and high anomalies a staged repair offers better results

  2. Evaluation of the results of a clinical study of X-ray specific activity of bilimin, a soviet radiopaque agent for oral cholecystography and cholecystoangiography

    International Nuclear Information System (INIS)

    The results of a clinical study of bilimin, a drug for oral X-ray examination of the bile tract are analysed. A good X-ray-specific activity of bilim which was no worse in contrast tnan identical foreign agents is emphasized. Among side-effects were short-term dyspepsia than disappeared without treatment. A conclusion has been made of a high diagnostic value and safety of bilimin

  3. Does accountability for reasonableness work? A protocol for a mixed methods study using an audit tool to evaluate the decision-making of clinical commissioning groups in England

    OpenAIRE

    Kieslich, Katharina; Littlejohns, Peter

    2015-01-01

    Introduction Clinical commissioning groups (CCGs) in England are tasked with making difficult decisions on which healthcare services to provide against the background of limited budgets. The question is how to ensure that these decisions are fair and legitimate. Accounts of what constitutes fair and legitimate priority setting in healthcare include Daniels’ and Sabin's accountability for reasonableness (A4R) and Clark's and Weale's framework for the identification of social values. This study...

  4. Recommendations for conducting controlled clinical studies of dental restorative materials. Science Committee Project 2/98--FDI World Dental Federation study design (Part I) and criteria for evaluation (Part II) of direct and indirect restorations including onlays and partial crowns.

    Science.gov (United States)

    Hickel, Reinhard; Roulet, Jean-François; Bayne, Stephen; Heintze, Siegward D; Mjör, Ivar A; Peters, Mathilde; Rousson, Valentin; Randall, Ros; Schmalz, Gottfried; Tyas, Martin; Vanherle, Guido

    2007-01-01

    About 35 years ago, Ryge provided a practical approach to the evaluation of the clinical performance of restorative materials. This systematic approach was soon universally accepted. While that methodology has served us well, a large number of scientific methodologies and more detailed questions have arisen that require more rigor. Current restorative materials have vastly improved clinical performance, and any changes over time are not easily detected by the limited sensitivity of the Ryge criteria in short-term clinical investigations. However, the clinical evaluation of restorations not only involves the restorative material per se but also different operative techniques. For instance, a composite resin may show good longevity data when applied in conventional cavities but not in modified operative approaches. Insensitivity, combined with the continually evolving and nonstandard investigator modifications of the categories, scales, and reporting methods, has created a body of literature that is extremely difficult to interpret meaningfully. In many cases, the insensitivity of the original Ryge methods leads to misinterpretation as good clinical performance. While there are many good features of the original system, it is now time to move on to a more contemporary one. The current review approaches this challenge in two ways: (1) a proposal for a modern clinical testing protocol for controlled clinical trials, and (2) an in-depth discussion of relevant clinical evaluation parameters, providing 84 references that are primarily related to issues or problems for clinical research trials. Together, these two parts offer a standard for the clinical testing of restorative materials/procedures and provide significant guidance for research teams in the design and conduct of contemporary clinical trials. Part 1 of the review considers the recruitment of subjects, restorations per subject, clinical events, validity versus bias, legal and regulatory aspects, rationales for

  5. Nail disorders in children, a clinical study

    Directory of Open Access Journals (Sweden)

    Ayşe Akbaş

    2016-04-01

    Full Text Available Introduction: Aims of the study to investigate the frequency and the nature ofnail disorders in children significant clinical data is available. Nail disorders although common in children in some parts of our country. This study was carried out to document the clinical and demographic pattern of nail disorders in a dermatology outpatient clinic of a pediatric hospital in Ankara, Turkey. Material and Methods: All consecutive patients a total of 3000 children from age 0-16 were admitted to dermatology outpatient clinic of Ankara Pediatric Hematology and Oncology Education and Research Hospital during January 2011 to December 2011 were studied and retrospectively evaluated for age, gender, drug use, diseases, systemic or genetic disorders and demographic features. Diagnostic evaluation results were noted and patients were categorized for demographic features and diagnosis. Results: These 133 patients (M: F 58:75, %44 vs 56, respectively were under 16 years of age and have 17 different dermatological disorders related with nail symptoms. Fifty three of (39,8% these patient were under 2 years of age, 31 (23.3% were between 3-5 years, 30 (22.5% were between 6-11 years old, 19 of 133 (14%, 2 were between 11-16 years of age. Through all of ages and independent of gender the most etiologies of nail disorders were, onychomadesis, paronychia, onycholysis, onychomycosis and systemic nail presentation of systemic dermatosis. Conclusion: Nail disorders are different in children than in adults. In our study, the first 5 years of age was found in 53% of nail disorders. Nail disorders are uncommon but may be seen as a part of a systemic disease and may be associated with cosmetic and psychologic problem.

  6. OPTIMIZATION OF SKIN TESTING .2. EVALUATION OF CONCENTRATION AND CUTOFF VALUES, AS COMPARED WITH RAST AND CLINICAL HISTORY, IN A MULTICENTER STUDY

    NARCIS (Netherlands)

    NIEMEIJER, NR; FLUKS, AF; DEMONCHY, JGR

    1993-01-01

    In this multicenter study we evaluated the results of a previous study (part I) in a relatively large Dutch patient population, using the two previously tested allergens (house-dust mite and grass pollen) and two other standardized allergens (tree pollen and cat dander). The obtained skin test resul

  7. 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 & ...

  8. A Clinical Study on Hypothyroidism

    International Nuclear Information System (INIS)

    A clinical study was made on 263 patients of hypothyroidism among the 5,970 patients of Various thyroid diseases diagnosed and treated at the Radioisotope Clinic and Laboratory, Seoul National University Hospital from May, 1960 to Aug, 1975. The results obtained with this study are as follows: 1) The etiological classification of hypothyroidism revealed 244 cases (93%) of primary hypothyroidism and 19 cases (7%) of secondary hypothyroidism. 2) The most frequent cause of the thyroprivic primary hypothyroidism was post radioiodine therapy with 109 cases (41.4%). 3) There were 37 cases (14%) of male and 226 cases (86%) of female, showing a ratio of 1 : 6. 4) The majority of patients were between the ages of 30 and 60 with the peak incidence (87 cases, 33%) in their fourth decades of lives. 5) The major symptoms and signs were weakness (97%), edema of face and extremities (92%); Decreased Achilles tendon reflex (87%), cold intolerance (82%), gain in weight (76%), constipation (58%) and cold skin (51%). 6) The cumulative incidence of hypothyroidism in patient treated with 131I (3-8 mci) was 7.2% at first year, 33.3% at tenth year and the 50% at fourteenth year and the annual increment was 2.9%. 7) The incidence of hypothyroidism related to the numbers of 131I therapy was not linear. 8) The diagnostic compatibilities of the various tests to hypothyroidism were TSH (100%), T4 (93.8%), 24-hour-RNIU (91.5%), ATR (86.7%), T3RU (66.1%) and BMR (64.9%).

  9. A randomized controlled clinical study to evaluate the effectiveness of an active moisturizing lotion with colloidal oatmeal skin protectant versus its vehicle for the relief of xerosis.

    Science.gov (United States)

    Kalaaji, Amer N; Wallo, Warren

    2014-10-01

    Xerosis is a common skin condition, occurring most often in the winter and in low relative humidity, which results in loss of moisture, cracking, and desquamation. Many emollient creams and lotions are available for use as preventive moisturizers. However, few controlled experiments have been published comparing the efficacy of active moisturizing products versus the vehicle used to deliver the products to the skin. Therefore, we conducted this randomized, double-blind, controlled clinical study to objectively compare a commercially available moisturizing product against its own vehicle. The active colloidal oatmeal moisturizer used in this study showed significant benefits versus its vehicle control in several dermatological parameters used to measure skin dryness. PMID:25607563

  10. Clinical studies in spinal surgery

    OpenAIRE

    Hanson, Beate; Kopjar, Branko

    2005-01-01

    There is a growing interest in applying evidence-based approaches also in orthopedic surgery. Despite many challenges to the validity of clinical trials in orthopedic surgery, it is possible to conduct well-designed trials in this field and to produce clinically important findings and reasonably valid conclusions about effectiveness, prognosis and diagnosis in orthopedic surgery. We describe the main principles for conducting clinical trials in this field as well as some of the most common er...

  11. A clinical study on the usefulness of CT and MRI imaging in evaluating differential diagnosis and the degree of dementia in vascular dementia

    International Nuclear Information System (INIS)

    In a retrospective review of 117 computed tomography (CT) scans and 56 magnetic resonance imaging (MRI) scans sequentially performed for dementia patients, CT and MRI were compared for assessment of the usefulness in the differential diagnosis and determination of the functional prognosis of vascular dementia. The correlation between CT findings and the degree of mental function was also examined. Since MRI had a higher sensitivity than CT in detecting small infarcts or lacunaes in the perforating area or white matter, it should differentiate vascular dementia from dementia of Alzheimer type. When both dementia of Alzheimer type was clinically diagnosed and infarct areas were detected on either CT or MRI, activity of daily living tended to be poor. Even when mixed type of dementia or vascular dementia was clinically diagnosed in spite of negative findings on either CT or MRI, troublesome behavior was frequently observed, posing the likelihood of dementia of Alzheimer type. The ability of CT and MRI to detect lesions was not correlated with the degree of dementia or aging, even if MRI was capable of detecting smaller lesions. CT was thus considered to be more specific modality for evaluating mental function. The size of lesions on CT was found to be more significant than the number and localization of lesions in determining the degree of dementia in the chronic stage of cerebrovascular disease. The ability of MRI to detect smaller lesions, as well as clinically determined ischemic scores, may assist in the diagnostic differentiation. Lesion size on CT may be an important factor for determining the degree of dementia and functional prognosis. (N.K.)

  12. MR-guidance – a clinical study to evaluate a shuttle- based MR-linac connection to provide MR-guided radiotherapy

    International Nuclear Information System (INIS)

    The purpose of this clinical study is to investigate the clinical feasibility and safety of a shuttle-based MR-linac connection to provide MR-guided radiotherapy. A total of 40 patients with an indication for a neoadjuvant, adjuvant or definitive radiation treatment will be recruited including tumors of the head and neck region, thorax, upper gastrointestinal tract and pelvic region. All study patients will receive standard therapy, i.e. highly conformal radiation techniques like CT-guided intensity-modulated radiotherapy (IMRT) with or without concomitant chemotherapy or other antitumor medication, and additionally daily short MR scans in treatment position with the same immobilisation equipment used for irradiation for position verification and imaging of the anatomical and functional changes during the course of radiotherapy. For daily position control, skin marks and a stereotactic frame will be used for both imaging modalities. Patient transfer between the MR device and the linear accelerator will be performed with a shuttle system which uses an air-bearing patient platform for both procedures. The daily acquired MR and CT data sets will be digitally registrated, correlated with the planning CT and compared with each other regarding translational and rotational errors. Aim of this clinical study is to establish a shuttle-based approach for realising MR-guided radiotherapy for certain clinical situations. Second objectives are to compare MR-guided radiotherapy with the gold standard of CT image guidance for quality assurance of radiotherapy, to establish an appropiate MR protocol therefore, and to assess the possibility of using MR-based image guidance not only for position verification but also for adaptive strategies in radiotherapy. Compared to CT, MRI might offer the advantage of providing IGRT without delivering an additional radiation dose to the patients and the possibility of optimisation of adaptive therapy strategies due to its superior soft tissue

  13. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  15. A CLINICAL STUDY OF BENIGN LESIONS OF PINNA

    OpenAIRE

    Srirangaprasad; Praveen; Shivanagouda; Ritesh; Nagaraj; George K.; Moby

    2016-01-01

    BACKGROUND AND OBJECTIVES To study the clinical aspects of benign lesions of pinna and to evaluate aetiopathological factors, prevalence and management options. METHODS The study included 115 patients during the period from January 2013 to December 2013. The selection criteria included patients presenting with swellings of pinna which included keloids, seromas, sebaceous cyst, preauricular sinus, haemangioma, dermoid and neurofibroma. A detailed clinical history regar...

  16. Clinical and postextraction evaluation of periodontal disease indicators

    Directory of Open Access Journals (Sweden)

    Rajashri Kolte

    2016-01-01

    Full Text Available Background: Clinical attachment level is the most frequently used and acceptable parameter in monitoring periodontal status in diseased individual and denotes patterns of periodontal destruction. Awareness of root morphology and the condition of the periodontal tissues is essential for reliable periodontal pocket probing and for effective debridement of root surfaces. Clinically, it is challenging to observe exact nature of complex periodontal attachment loss. The aim of the present study was to evaluate patterns of periodontal destruction based on vertical and horizontal attachment loss. Materials and Methods: A total of 200 extracted teeth were obtained from chronic periodontitis patients. Prior to extraction, clinical measurements were recorded and after extraction, the teeth were stained with crystal violet. Root length, vertical and horizontal attachment loss were measured using digital caliper. Results: There was a significant difference between clinical attachment level and vertical attachment loss for both maxillary and mandibular teeth. Mean vertical attachment loss varied between 5.17 mm and 9.17 mm. Interproximal surfaces exhibited statistically significant vertical attachment loss in both maxillary and mandibular dentition. Results indicated that vertical attachment loss was more severe with teeth belonging to the anterior sextant whereas the horizontal attachment loss was more pronounced with posterior teeth. Conclusion: Both vertical and horizontal attachment loss were observed in all periodontally involved teeth. There was a difference in clinical measurements and actual periodontal status denoted by postextraction staining. These findings have an impact on determining the prognosis and appropriate treatment plan for patients.

  17. Clinical and postextraction evaluation of periodontal disease indicators

    Science.gov (United States)

    Kolte, Rajashri; Kolte, Abhay; Wattamwar, Pooja

    2016-01-01

    Background: Clinical attachment level is the most frequently used and acceptable parameter in monitoring periodontal status in diseased individual and denotes patterns of periodontal destruction. Awareness of root morphology and the condition of the periodontal tissues is essential for reliable periodontal pocket probing and for effective debridement of root surfaces. Clinically, it is challenging to observe exact nature of complex periodontal attachment loss. The aim of the present study was to evaluate patterns of periodontal destruction based on vertical and horizontal attachment loss. Materials and Methods: A total of 200 extracted teeth were obtained from chronic periodontitis patients. Prior to extraction, clinical measurements were recorded and after extraction, the teeth were stained with crystal violet. Root length, vertical and horizontal attachment loss were measured using digital caliper. Results: There was a significant difference between clinical attachment level and vertical attachment loss for both maxillary and mandibular teeth. Mean vertical attachment loss varied between 5.17 mm and 9.17 mm. Interproximal surfaces exhibited statistically significant vertical attachment loss in both maxillary and mandibular dentition. Results indicated that vertical attachment loss was more severe with teeth belonging to the anterior sextant whereas the horizontal attachment loss was more pronounced with posterior teeth. Conclusion: Both vertical and horizontal attachment loss were observed in all periodontally involved teeth. There was a difference in clinical measurements and actual periodontal status denoted by postextraction staining. These findings have an impact on determining the prognosis and appropriate treatment plan for patients. PMID:27143828

  18. Neurofibromatosis: Evaluation of Clinical Features of 11 Cases

    Directory of Open Access Journals (Sweden)

    Gülşen Akoğlu

    2013-12-01

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

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

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    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 ...

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

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    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 ...

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

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    Full Text Available ... children's health with the goal to develop treatments, drugs, and devices specific to children. Resources for a Wide Range of Audiences The Children and Clinical ... and Postcards ...

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

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

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    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 ...

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

    Directory of Open Access Journals (Sweden)

    S.A. Arias

    2013-12-01

    Full Text Available The aim of this study was to modify canine coxofemoral prostheses and the clinical evaluation of the implantation. Fifteen canine hips and femora of cadavers were used in order to study the surface points of modification in prostheses and develop a perforation guide. Femoral stems and acetabular components were perforated and coated with biphasic calcium phosphate layer. Twelve young adult male mongrel dogs were implanted with coxofemoral prostheses. Six were operated upon and implanted with cemented canine modular hip prostheses, establishing the control group. The remaining six were implanted with a novel design of cementless porous tricalcic phosphate-hydroxyapatite coated hip prostheses. Clinical and orthopedic performance, complications, and thigh muscular hypotrophy were assessed up to the 120th post-operatory day. After 120 days, animals with cementless prostheses had similar clinical and orthopedic performance compared to the cemented group despite the increased pain thigh hypotrophy. Animals that underwent cementless hip prosthesis evidenced more pain, compared to animals with cemented hip prosthesis that required longer recuperation time. No luxations, two fractures and two isquiatic neurapraxies were identified in the course of the study. Using both the cemented and the bioactive coated cementless model were suitable to dogs, showing clinical satisfactory results. Osseointegration and biological fixation were observed in the animals with the modified cementless hip prosthesis.

  5. Evaluation of medication treatment for Alzheimer's disease on clinical evidence

    Directory of Open Access Journals (Sweden)

    Meng-qiu LI

    2014-03-01

    Full Text Available Objective To formulate the best treatment plan for Alzheimer's disease patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Alzheimer's disease, donepezil, rivastigmine, galantamine, memantine, rosiglitazone, etc. were defined as retrieval words. PubMed, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure (CNKI databases were used with applying of manual searching. Systematic reviews, randomized controlled trials (RCT, controlled clinical trials and case-observation studies were collected and evaluated by Jadad Scale. Results After screening, 33 selected resources included 14 systematic reviews, 14 randomized controlled trials, 4 controlled clinical trials and 1 case-observation study. According to Jadad Scale, total 28 articles were evaluated to be high quality (12 with score 4, 10 score 5, 6 score 7, and 5 were low quality with score 3. It was summarized as follows: 1 Alzheimer's disease is a progressive neurodegenerative disease for which no cure exists. To date, only symptomatic treatments with cholinesterase inhibitors (donepezil, rivastigmine, galantamine and an N-methyl-D-aspartate (NMDA receptor noncompetitive antagonist (memantine, are effective and well tolerated to counterbalance the neurotransmitter disturbance, but cannot limit or impact on disease progression. 2 Disease modifying drug is an potential agent, with persistent effect on slowing the progression of structural damage, and can be detected even after withdrawing the treatment. Many types of disease modifying drugs are undergoing clinical trials. Conclusions Using evidence-based medicine methods can provide best clinical evidence on Alzheimer's disease treatment. doi: 10.3969/j.issn.1672-6731.2014.03.009

  6. Evaluation of plitidepsin in patients with primary myelofibrosis and post polycythemia vera/essential thrombocythemia myelofibrosis: results of preclinical studies and a phase II clinical trial

    International Nuclear Information System (INIS)

    Previous data established that plitidepsin, a cyclic depsipeptide, exerted activity in a mouse model of myelofibrosis (MF). New preclinical experiments reported herein found that low nanomolar plitidepsin concentrations potently inhibited the proliferation of JAK2V617F-mutated cell lines and reduced colony formation by CD34+ cells of individuals with MF, at least in part through modulation of p27 levels. Cells of MF patients had significantly reduced p27 content, that were modestly increased upon plitidepsin exposure. On these premise, an exploratory phase II trial evaluated plitidepsin 5 mg/m2 3-h intravenous infusion administered on days 1 and 15 every 4 weeks (q4wk). Response rate (RR) according to the International Working Group for Myelofibrosis Research and Treatment consensus criteria was 9.1% (95% CI, 0.2–41.3%) in 11 evaluable patients during the first trial stage. The single responder achieved a red cell transfusion independence and stable disease was reported in nine additional patients (81.8%). Eight patients underwent a short-lasting improvement of splenomegaly. In conclusion, plitidepsin 5 mg/m2 3-h infusion q4wk was well tolerated but had a modest activity in patients with primary, post-polycythaemia vera or post-essential thrombocythaemia MF. Therefore, this trial was prematurely terminated and we concluded that further clinical trials with plitidepsin as single agent in MF are not warranted

  7. Evaluation of the reliability and validity of the Medical Outcomes Study sleep scale in patients with painful diabetic peripheral neuropathy during an international clinical trial

    OpenAIRE

    Hays Ron D; Guillemin Isabelle; Martin Susan; Viala-Danten Muriel

    2008-01-01

    Abstract Background Sleep is an important element of functioning and well-being. The Medical Outcomes Study Sleep Scale (MOS-Sleep) includes 12 items assessing sleep disturbance, sleep adequacy, somnolence, quantity of sleep, snoring, and awakening short of breath or with a headache. A sleep problems index, grouping items from each of the former domains, is also available. This study evaluates the psychometric properties of MOS-Sleep Scale in a painful diabetic peripheral neuropathic populati...

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

    Science.gov (United States)

    Jiang, Silis Y; Weng, Chunhua

    2014-01-01

    Clinical trials are fundamental to the advancement of medicine but constantly face recruitment difficulties. Various clinical trial search engines have been designed to help health consumers identify trials for which they may be eligible. Unfortunately, knowledge of the usefulness and usability of their designs remains scarce. In this study, we used mixed methods, including time-motion analysis, think-aloud protocol, and survey, to evaluate five popular clinical trial search engines with 11 users. Differences in user preferences and time spent on each system were observed and correlated with user characteristics. In general, searching for applicable trials using these systems is a cognitively demanding task. Our results show that user perceptions of these systems are multifactorial. The survey indicated eTACTS being the generally preferred system, but this finding did not persist among all mixed methods. This study confirms the value of mixed-methods for a comprehensive system evaluation. Future system designers must be aware that different users groups expect different functionalities. PMID:25954590

  9. Clinical Evaluation of Superficial Fungal Infections in Children

    Directory of Open Access Journals (Sweden)

    Ragıp Ertaş

    2015-12-01

    Full Text Available Objective: This retrospective study was referred to evaluate 51 cases of superficial mycoses, referred to our Pediatric Dermatology outpatient clinic in one year. Methods: We reviewed following data for all patients: age, gender, accompanied diseases, clinical types, localization and treatment. Superficial mycotic infections were diagnosed on the basis of clinical picture, direct microscopy and some of them were confirmed by fungal cultures. Results: Our patients comprised 33 boys (64.7% and 18 girls (35.3%, with an average age of 6.2 years (range 4 months to 17 years. Eighteen patients (35.3% had dermatophytes on the scalp. Clinical forms, in the order of frequency, were: tinea capitis profunda in 10 patients (19.6%, tinea capitis superficialis in 8 patients (15.8%, tinea unguium in 8 patients (15.8%. Tinea capitis (35.3% was the most frequent form of dermatomycosis. The most common symptom was the pruritus. Thirty (58% patients were treated with local antimycotics and 21 (42% patients were treated with systemic terbinafine or itraconazole. Conclusion: In this study it was found that, tinea capitis was the most frequent form of dermatomycosis and onychomycosis in children are not uncommon as it is mentioned. The data also suggest that topical antifungal agents may be effective and well-tolerated in the treatment of onychomycosis and tinea capitis in children.

  10. Evaluation of vitamin B 12 deficiency in various clinical condition

    International Nuclear Information System (INIS)

    Low levels of vitamin B 12 have been associated with several clinical conditions. However no single symptom or group of symptoms can be made responsible. Reported causes of deficiency among older population are hematologic or neurological, followed by gastrointestinal and possibly vascular symptoms. The present prospective observational study was, hence, initiated to evaluate the underlying clinical condition or symptoms associated with vitamin B12 deficiency. The study was prospective observational and carried out on 121 patients (males, n=63 and females, n=58) for the period from January 1, 2004 to January 24, 2007. Age ranges were between 16 - 70 years, and categorized as > 60 yrs and < 60 years. All blood parameters were analyzed by standardized methods on automated analyzers. The deficiency was found to be more prevalent in males and increased from 52.06% to 58.10% in individuals with vitamin B12 <150 pg/ml. Mal nourishment was noted among the most subjects and weakness and anemia were frequent clinical findings (35.55%, n=43, 14%, n=51). Other clinical conditions were neuropsychiatric. Whereas less frequent findings were paraesthesia and gastrointestinal symptoms. Hypertension was more prevalent in vitamin B12 deficient individuals followed by diabetes, dementia, stroke, ischemic heart disease and Parkinson's disease. (author)

  11. Nerve damage in leprosy: An electrophysiological evaluation of ulnar and median nerves in patients with clinical neural deficits: A pilot study

    Directory of Open Access Journals (Sweden)

    Sumit Kar

    2013-01-01

    Full Text Available Background : Leprosy involves peripheral nerves sooner or later in the course of the disease leading to gross deformities and disabilities. Sadly, by the time it becomes clinically apparent, the nerve damage is already quite advanced. However, if the preclinical damage is detected early in the course of disease, it can be prevented to a large extent. Materials and Methods: We conducted an electrophysiological pilot study on 10 patients with clinically manifest leprosy, in the Dermatology Department of Mahatma Gandhi Institute of Medical Sciences, Sewagram. This study was done to assess the nerve conduction velocity, amplitude and latency of ulnar and median nerves. Results and Conclusion: We found reduced conduction velocities besides changes in latency and amplitude in the affected nerves. Changes in sensory nerve conduction were more pronounced. Also, sensory latencies and amplitude changes were more severe than motor latencies and amplitude in those presenting with muscle palsies. However, further studies are going on to identify parameters to detect early nerve damage in leprosy.

  12. A clinical study of retinoblastoma

    Directory of Open Access Journals (Sweden)

    L Subha

    2015-01-01

    Full Text Available Aim: The aim was to analyze general incidence, age incidence, laterality, common mode of presentation, staging of the tumor, radiological evidence, histopathological confirmation, management and follow-up of cases, which were diagnosed as retinoblastoma. Design: Interventional case series study from April 1997 to March 2000. Materials and Methods: Detailed history regarding the symptoms such as white reflex, watering, pain, redness, protrusion of eyeball, squint, hyphema, and defective vision were obtained. Family history regarding consanguinity between parents, health of the siblings and other relatives were recorded. Ocular examination included vision, pupillary reaction, detailed fundus examination, ocular tension, and corneal diameter. Investigations included X-ray orbit and skull, computed tomography scan orbit and brain, B-scan orbit, serum and aqueous lactate dehydrogenase; enucleated eyes were subjected to holoprosencephaly (HPE. Enucleation, radiotherapy, cryotherapy and chemotherapy were modalities of treatment. The empty socket and the other apparently normal eye were examined carefully at each visit. Results: The incidence of retinoblastoma is less when compared to other diseases of the eye. There was no sex predilection. Most of the cases diagnosed were sporadic and unilateral. Age of onset is earlier for bilateral cases than unilateral cases. Consanguinity bears close relationship with bilateral involvement. Predominant clinical sign is white reflex in the pupillary area. Majority of cases presented in the second stage of the disease. Enucleation plays a greater role in the management of retinoblastoma. HPE should include several sections of the optic nerve to find out skip lesions.

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

    OpenAIRE

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

    2010-01-01

    Background The aim of this study was to evaluate the efficacy and safety of herbal dental cream in comparison to fluoride dental cream. Objectives Clinical evaluation of a novel herbal dental cream in plaque formation: a double-blind, randomized, controlled clinical trial. Methods One hundred and two patients with established dental plaque were randomly assigned to either herbal dental group or fluoride dental group for six weeks in a double-blind design. Improvement in plaque index, oral hyg...

  14. Evaluating the Clinical Utility of the Medical Symptom Validity Test (MSVT): A Clinical Series.

    Science.gov (United States)

    Suesse, Mareike; Wong, Vivien W C; Stamper, Laura L; Carpenter, Katherine N; Scott, Richard B

    2015-01-01

    Performance validity tests (PVTs) are not widely used beyond medico-legal contexts in the UK. A UK survey suggests clinicians have reservations about their accuracy in clinical settings. This study sought to explore the validity of PVTs in an acute adult neuropsychology setting and to establish a potential "false positive" (FP) base rate. Failures on the Medical Symptom Validity Test (MSVT) in a consecutive clinical series of 405 patients were evaluated systematically and allocated to groups depending on clinical context. All failures were checked against the test's "dementia profile". Of the 405 participants, 329 passed the MSVT (81.2%), while 76 participants (18.8%) failed based on standard criteria. A 5.2% rate of potentially 'unexplained' failures was found. Other reasons for failure were classified as: presumed malingered neurocognitive dysfunction (4.6%), dementia/significant cognitive impairment (3.7%), technical/visual problems (1.8%), and "unexplained failure" with contributory factors (2.4%). These results suggest test specificity between 0.95 and 0.90. Most of the clinically significantly impaired patients matched the dementia profile (86.7%). Our results support the sensitivity, but not the specificity, of the dementia profile. However, approximately 1 in 20 patients failed the MSVT despite an otherwise unremarkable neuropsychological presentation; moreover, mood and pain may affect MSVT performance. Clinical implications for interpreting test scores are discussed. PMID:25798743

  15. The Clinical Evaluation of Parkinson's Tremor

    NARCIS (Netherlands)

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

    2015-01-01

    Parkinson's disease harbours many different tremors that differ in distribution, frequency, and context in which they occur. A good clinical tremor assessment is important for weighing up possible differential diagnoses of Parkinson's disease, but also to measure the severity of the tremor as a basi

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

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  17. Evaluation of febrile neutropenic patients hospitalized in a hematology clinic

    Institute of Scientific and Technical Information of China (English)

    M ucahit Goruk; Mehmet Sinan Dal; Tuba Dal; Abdullah Karakus; Recep Tekin; Nida Ozcan; Orhan Ayyildiz

    2015-01-01

    Objective: To evaluate the febrile neutropenic patients with hematological malignancies hospitalized in hematology clinic with poor hygiene standards. Methods: A total of 124 patients with hematological malignancies (69 male, 55 female) hospitalized in hematology clinic with poor hygiene conditions depending on hospital conditions, between January 2007 and December 2010, were evaluated, retrospectively. Results: In this study, 250 febrile neutropenia episodes developing in 124 hospitalized patients were evaluated. Of the patients, 69 were men (56%) and 55 women (44%). A total of 40 patients (32%) had acute myeloid leukemia, 25 (20%) acute lymphoblastic leukemia, 19 (15%) non-Hodgkin's lymphoma, 10 (8%) multiple myeloma, and 8 (8%) chronic myeloid leukemia. In our study, 56 patients (22%) were diagnosed as pneumonia, 38 (15%) invasive aspergillosis, 38 (15%) sepsis, 16 (6%) typhlitis, 9 (4%) mucormy-cosis, and 4 (2%) urinary tract infection. Gram-positive cocci were isolated from 52%(n = 20), while Gram-negative bacilli 42%(n = 16) and yeasts from 6% (n = 2) of the sepsis patients, respectively. The most frequently isolated Gram-positive bacteria were methicillin-resistant coagulase-negative staphylococci (n=18), while the most frequently isolated Gram-negative bacteria was Escherichia coli (n=10). Conclusions: Febrile neutropenia is still a problem in patients with hematological ma-lignancies. The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy. Infection control pro-cedures should be applied for preventing infections and transmissions.

  18. A mixed methods study to evaluate the clinical and cost-effectiveness of a self-managed exercise programme versus usual physiotherapy for chronic rotator cuff disorders: protocol for the SELF study

    Directory of Open Access Journals (Sweden)

    Littlewood Chris

    2012-04-01

    Full Text Available Abstract Background Shoulder pain is the third most common reason for consultation with a physiotherapist and up to 26% of the general population might be expected to experience an episode at any one time. Disorders of the shoulder muscles and tendons (rotator cuff are thought to be the commonest cause of this pain. The long-term outcome is frequently poor despite treatment. This means that many patients are exposed to more invasive treatment, e.g. surgery, and/or long-term pain and disability. Patients with this disorder typically receive a course of physiotherapy which might include a range of treatments. Specifically the value of exercise against gravity or resistance (loaded exercise in the treatment of tendon disorders is promising but appears to be under-used. Loaded exercise in other areas of the body has been favourably evaluated but further investigation is needed to evaluate the impact of these exercises in the shoulder and particularly the role of home based or supervised exercise versus usual treatment requiring clinic attendance. Methods/Design A single-centre pragmatic unblinded parallel group randomised controlled trial will evaluate the effectiveness of a self-managed loaded exercise programme versus usual clinic based physiotherapy. A total of 210 study participants with a primary complaint of shoulder pain suggestive of a rotator cuff disorder will be recruited from NHS physiotherapy waiting lists and allocated to receive a programme of self-managed exercise or usual physiotherapy using a process of block randomisation with sealed opaque envelopes. Baseline assessment for shoulder pain, function and quality of life will be undertaken with the Shoulder Pain & Disability Index, the Patient Specific Functional Scale and the SF-36. Follow-up evaluations will be completed at 3, 6 and 12 months by postal questionnaire. Both interventions will be delivered by NHS Physiotherapist’s. An economic analysis will be conducted from an

  19. Clinical Evaluation of a New-Formula Shampoo for Scalp Seborrheic Dermatitis Containing Extract of Rosa centifolia Petals and Epigallocatechin Gallate: A Randomized, Double-Blind, Controlled Study

    OpenAIRE

    Kim, Yu Ri; Kim, Jeong-Hwan; Shin, Hong-Ju; Choe, Yong Beom; AHN, KYU JOONG; Lee, Yang Won

    2014-01-01

    Background Scalp seborrheic dermatitis is a chronic type of inflammatory dermatosis that is associated with sebum secretion and proliferation of Malassezia species. Ketoconazole or zinc-pyrithione shampoos are common treatments for scalp seborrheic dermatitis. However, shampoos comprising different compounds are required to provide patients with a wider range of treatment options. Objective This study was designed to evaluate a new-formula shampoo that contains natural ingredients-including e...

  20. Clinical evaluation of synthetic aperture sequential beamforming

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  1. A child's nightmare. Mum comes and comforts her child. Attachment evaluation as a guide in the assessment and treatment in a clinical case study

    Directory of Open Access Journals (Sweden)

    Silvia eSalcuni

    2014-08-01

    Full Text Available There is a gap between proposed theoretical attachment theory frameworks, measures of attachment in the assessment phase and their relationship with changes in outcome after a psychodynamic oriented psychotherapy. Based on a clinical case study of a young woman with Panic Attack Disorder, this paper examined psychotherapy outcome findings comparing initial and post-treatment assessments, according to the mental functioning in S and M-axis of the Psychodynamic Diagnostic Manual (PDM. Treatment planning and post-treatment changes were described with the main aim to illustrate from a clinical point of view why a psycho-dynamic approach, with specific attention to an attachment theory stance, was considered the treatment of choice for this patient. The Symptom Check List 90 Revised (SCL-90-R and the Shedler-Westen Assessment Procedure (SWAP–200 were administered to detect patient’s symptomatic perception and clinician’s diagnostic points of view, respectively; the Adult Attachment Interview (AAI and the Adult Attachment Projective Picture System (AAP were also administered as to pay attention to patient’s unconscious internal organization and changes in defense processes. A qualitative description of how the treatment unfolded was included. Findings highlight the important contribution of attachment theory in a 22-month psychodynamic psychotherapy framework, promoting resolution of patient’s symptoms and adjustment.

  2. "A child's nightmare. Mum comes and comforts her child." Attachment evaluation as a guide in the assessment and treatment in a clinical case study.

    Science.gov (United States)

    Salcuni, Silvia; Di Riso, Daniela; Lis, Adriana

    2014-01-01

    There is a gap between proposed theoretical attachment theory frameworks, measures of attachment in the assessment phase and their relationship with changes in outcome after a psychodynamic oriented psychotherapy. Based on a clinical case study of a young woman with Panic Attack Disorder, this paper examined psychotherapy outcome findings comparing initial and post-treatment assessments, according to the mental functioning in S and M-axis of the psychodynamic diagnostic manual. Treatment planning and post-treatment changes were described with the main aim to illustrate from a clinical point of view why a psycho-dynamic approach, with specific attention to an "attachment theory stance," was considered the treatment of choice for this patient. The Symptom Check List 90 Revised (SCL-90-R) and the Shedler-Westen Assessment Procedure (SWAP-200) were administered to detect patient's symptomatic perception and clinician's diagnostic points of view, respectively; the Adult Attachment Interview and the Adult Attachment Projective Picture System (AAP) were also administered as to pay attention to patient's unconscious internal organization and changes in defense processes. A qualitative description of how the treatment unfolded was included. Findings highlight the important contribution of attachment theory in a 22-month psychodynamic psychotherapy framework, promoting resolution of patient's symptoms and adjustment. PMID:25191293

  3. Clinical Evaluation of Effects of Chronic Resveratrol Supplementation on Cerebrovascular Function, Cognition, Mood, Physical Function and General Well-Being in Postmenopausal Women—Rationale and Study Design

    Directory of Open Access Journals (Sweden)

    Hamish Michael Evans

    2016-03-01

    Full Text Available Background: This methodological paper presents both a scientific rationale and a methodological approach for investigating the effects of resveratrol supplementation on mood and cognitive performance in postmenopausal women. Postmenopausal women have an increased risk of cognitive decline and dementia, which may be at least partly due to loss of beneficial effects of estrogen on the cerebrovasculature. We hypothesise that resveratrol, a phytoestrogen, may counteract this risk by enhancing cerebrovascular function and improving regional blood flow in response to cognitive demands. A clinical trial was designed to test this hypothesis. Method: Healthy postmenopausal women were recruited to participate in a randomised, double-blind, placebo-controlled (parallel comparison dietary intervention trial to evaluate the effects of resveratrol supplementation (75 mg twice daily on cognition, cerebrovascular responsiveness to cognitive tasks and overall well-being. They performed the following tests at baseline and after 14 weeks of supplementation: Rey Auditory Verbal Learning Test, Cambridge Semantic Memory Battery, the Double Span and the Trail Making Task. Cerebrovascular function was assessed simultaneously by monitoring blood flow velocity in the middle cerebral arteries using transcranial Doppler ultrasound. Conclusion: This trial provides a model approach to demonstrate that, by optimising circulatory function in the brain, resveratrol and other vasoactive nutrients may enhance mood and cognition and ameliorate the risk of developing dementia in postmenopausal women and other at-risk populations.

  4. Preliminary Clinical Study of Real-time Three-dimensional Echocardiographic Volume-time Curve in Evaluating Left Ventricular Diastolic Function

    Institute of Scientific and Technical Information of China (English)

    FEI Hongwen; HE Yale; HOU Yueshuang; XU Yan; HUANG Xinsheng; FENG Bixia

    2007-01-01

    The volume-time curve change in patients with normal left ventricular (LV) diastolic function and diastolic dysfunction was evaluated by real-time three-dimensional echocardiography (RT3DE). LV diastolic dysfunction was defined by E'<A' in pulse-wave tissue Doppler for inter-ventricular septal (IVS) of mitral annulus. In 24 patients with LV diastolic dysfunction, including 12 patients with delayed relaxation (delayed relaxation group) and 12 patients with pseudo-normal function (pseudo-normal group) and 24 normal volunteers (control group), data of full-volume image were acquired by real-time three-dimensional echocardiography and subjected to volume-time curve analysis. EDV (end-diastolic volume), ESV (end-systolic volume), LVEF (left ventricular ejection fraction), PER (peak ejection rate), PFR (peak filling rate) from RT3DE were examined in the three groups. Compared to the control group, PFR (diastolic filling index of RT3DE) was significantly reduced in the delayed relaxation group and pseudo-normal group (P<0.05). There were no significant differences in EDV, ESV, LVEF, PER (P>0.05). It is concluded that PFR, as a diastolic filling index of RT3DE, can reflect the early diastolic function and serve as a new non-invasive, quick and accurate tool for clinical assessment of LV diastolic function.

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

    Science.gov (United States)

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

    2016-01-01

    Clinical training is of paramount importance in nursing education and clinical evaluation is one of the most challenging responsibilities of nursing faculty. The use of objective tools and criteria and involvement of the students in the evaluation process are some techniques to facilitate quality learning in the clinical setting. Aim: The aim of…

  6. A clinical and radiological evaluation of the relative efficacy of demineralized freeze-dried bone allograft versus anorganic bovine bone xenograft in the treatment of human infrabony periodontal defects: A 6 months follow-up study

    Directory of Open Access Journals (Sweden)

    Vikram Blaggana

    2014-01-01

    Full Text Available Background: The ultimate goal of periodontal therapy entails regeneration of the periodontal tissues lost as a consequence of periodontitis. Predictable correction of vertical osseous defects has however posed as a constant therapeutic challenge. The aim of our present study is to evaluate the relative efficacy of demineralized freeze-dried bone allograft (DFDBA vs anorganic bovine bone xenograft (ABBX in the treatment of human infrabony periodontal defects. Materials and Methods: 15 patients with 30 bilaterally symmetrical defect sites in either of the arches, in the age group of 25-50 years were selected as part of split-mouth study design. Defect-A (right side was grafted with DFDBA while Defect-B (left side was grafted with ABBX. Various clinical and radiographic parameters viz. probing depth(PD, clinical attachment level(CAL and linear bone fill were recorded preoperatively, 12- & 24-weeks postoperatively. Results: Both defect-A & defect-B sites exhibited a highly significant reduction in probing depth, and gain in clinical attachment level and linear bone fill at 12-weeks & at the end of 24-weeks. Comparative evaluation between the study groups revealed a statistically non-significant reduction in probing depth (P<0.1 and mean gain in linear bone fill (P<0.1. However, there was a statistically significant gain in clinical attachment level (P <0.05 in Defect-A (CD=0.356 as compared to Defect-B (CD=0.346. Conclusions: Within the limits of this study, both the materials viz. ABBX and DFDBA are beneficial for the treatment of periodontal infrabony defects. Both the materials were found to be equally effective in all respects except the gain in attachment level, which was found to be more with DFDBA. Long-term studies are suggested to evaluate further the relative efficacy of the two grafts.

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

    Directory of Open Access Journals (Sweden)

    MM Chabeli

    2001-09-01

    Full Text Available The South African Qualifications Authority, and the South African Nursing Council are in pursuit of quality nursing education to enable the learners to practise as independent and autonomous practitioners. The educational programme should focus on the facilitation of critical and reflective thinking skills that will help the learner to make rational decisions and solve problems. A way of achieving this level of functioning is the use of assessment and evaluation methods that measure the learners’ clinical competence holistically. This article is focused on the perceptions of twenty nurse educators, purposively selected from three Nursing Colleges affiliated to a university in Gauteng, regarding the use of OSCE (Objective Structured Clinical Examination as a clinical evaluation method within a qualitative and descriptive research strategy. Three focus group interviews were conducted in different sessions. A descriptive content analysis was used. Trustworthiness was ensured by using Lincoln and Guba’s model (1985. The results revealed both positive and negative aspects of OSCE as a clinical evaluation method with regard to: administrative aspects; evaluators; learners; procedures/instruments and evaluation. The conclusion drawn from the related findings is that OSCE does not measure the learners’ clinical competence holistically. It is therefore recommended that the identified negative perception be taken as challenges faced by nurse educators and that the positive aspects be strengthened. One way of meeting these recommendations is the use of varied alternative methods for clinical assessment and evaluation that focus on the holistic measurement of the learners’ clinical competence.

  8. Evaluation of leak current of clinical electrometers

    International Nuclear Information System (INIS)

    The present work shows the evaluation of two electrometers model Victoreen used in radiotherapy. The performance of the electrometers was proven using a source of current, built inside the work frame arcal 34, and using like reference the norm iec 60371. The results of the tests of leakage, displacement of the zero and linealty of the electrometers are presented

  9. Evaluation of Clinical Features of Female Patients with Macroprolactinemia

    Directory of Open Access Journals (Sweden)

    Göksun Ayvaz

    2011-09-01

    Full Text Available Aim: Macroprolactin is a high-molecular-weight form of prolactin. It has been suggested that macroprolactin has no clinical importance because of its decreased or limited bioactivity. Although screening for macroprolactinemia is recommended especially in patients with idiopathic hyperprolactinemia; recent studies reported that patients with macroprolactinemia may have some hyperprolactinemia symptoms. Currently, the causes of the symptoms as well as the treatment and follow-up of this group of patients are not clear. In our study, we aimed to retrospectively evaluate and compare the clinical characteristics and gonadal hormone levels of patients with macroprolactinemia and hyperprolactinemia.Materials and Methods: Forty patients with macroprolactinemia and 15 patients with hyperprolactinemia who referred to Obstetrics and Gynecology Hospital were examined.Results: We observed that the patients with macroprolactinemia had similar menstrual disturbances (oligomenorrhea/amenorrhea to the patients with hyperprolactinemia. There was no statistically significant difference between the two groups with respect to FSH, LH and estradiol levels. The frequencies of galactorrhea (p=0.002, headache (p=0.04 and positive radiological finding (p=0.001 were higher in patients with hyperprolactinemia. Infertility rate was found to be increased in women with macroprolactinemia (p=0.02.Conclusion: Patients with macroprolactinemia may have very similar clinic symptoms to those with hyperprolactinemia. Therefore, macroprolactin levels should be measured regardless of the symptoms of hyperprolactinemia in patients with elevated prolactin levels. Türk Jem 2011; 15: 62-5

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

    Science.gov (United States)

    Gerlach, Trevor J; Estrada, Amara H; Sosa, Ivan S; Powell, Melanie; Maisenbacher, Herbert W; de Wit, Martine; Ball, Ray L; Walsh, Michael T

    2013-06-01

    Antemortem studies pertaining to the manatee cardiovascular and cardiopulmonary systems are limited despite reports of cardiac disease in postmortem specimens. The objective of this project was to develop a technique for echocardiography in the Florida manatee (Trichechus manatus latirostris). Because of their unique anatomy, a ventral approach was employed by use of an echocardiography table designed specifically for this study. Fourteen clinically healthy, free-ranging and captive Florida manatees underwent echocardiography between the fall of 2011 and winter of 2012. Eight females and six males of various age categories were included in the study. Clear visualization of all valves and chambers was accomplished, and length and width measurements of the left atrium, peak aortic flow velocity, and ejection fraction percentage were calculated in most animals. Abnormalities observed during the study included atrioventricular regurgitation and severe right-atrial enlargement. Based on the results of this study, echocardiography in the Florida manatee is possible, which has both clinical and research implications in larger epidemiologic studies evaluating diseases of the cardiopulmonary and cardiovascular systems. PMID:23805547

  11. Plantago ovata: Clinical study of overuse.

    Science.gov (United States)

    Agha, Rukh-e-Nasreen; Saeed, Aftab; Nazar, Halima

    2016-03-01

    The objective of the study was to undertake evidence-base study to evaluate clinical manifestation of the over-estimated use of herbal drug Plantago ovata and to compare it with placebo for the efficacy and adverse effects. The patients of both genders were included. Blood urea, creatinine, ALT, Serum B12, CP, ESR and liver function tests were performed. The data was statistically analyzed in both groups for differential symptomatology. In anorexia test verses control results showed that Plantago ovata husk and placebo showed the affected ratio as 81 percent and 50 percent, correspondingly. Whereas in clinical performance of heart burning, pain in epigastrium, low libido, body pain, dyspepsia, fever, burning sensation in palm and sole in test drug showed affected response as adverse effect 90%, 88% and as control drug, 36%, 29%, 22%, 25%, 38%, 30%, 33%, 57%, respectively. The results were highly marked in test drug i.e. in comparison with placebo. This is clearly evident from data analysis that effect observed in test arm is far more superior hence null hypothesis was rejected clearly. Similarly serological and biochemical reports study i.e. (ALT, Vit. B1 and Vit A) revealed that there is no hepatotoxic and neurotoxic effect found in both the drugs. PMID:27087080

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

    OpenAIRE

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

    2014-01-01

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

  13. Evaluation of the clinical usefulness of modulated arc treatment

    Science.gov (United States)

    Lee, Young Kyu; Jang, Hong Seok; Kim, Yeon Sil; Choi, Byung Ock; Kang, Young-Nam; Nam, Sang Hee; Park, Hyeong Wook; Kim, Shin Wook; Shin, Hun Joo; Lee, Jae Choon; Kim, Ji Na; Park, Sung Kwang; Kim, Jin Young

    2015-07-01

    The purpose of this study is to evaluate the clinical usefulness of modulated arc (mARC) treatment techniques. The mARC treatment plans for non-small-cell lung cancer (NSCLC) patients were made in order to verify the clinical usefulness of mARC. A pre-study was conducted to find the best plan condition for mARC treatment, and the usefulness of the mARC treatment plan was evaluated by comparing it with other Arc treatment plans such as tomotherapy and RapidArc plans. In the case of mARC, the optimal condition for the mARC plan was determined by comparing the dosimetric performance of the mARC plans developed by using various parameters, which included the photon energy (6 MV, 10 MV), the optimization point angle (6°- 10°intervals), and the total number of segments (36 - 59 segments). The best dosimetric performance of mARC was observed at a 10 MV photon energy, a point angle 6 degrees, and 59 segments. The treatment plans for the three different techniques were compared by using the following parameters: the conformity index (CI), homogeneity index (HI), the target coverage, the dose to the OARs, the number of monitor units (MU), the beam on time, and the normal tissue complication probability (NTCP). As a result, the three different treatment techniques showed similar target coverages. The mARC plan had the lowest V20 (volume of lung receiving > 20 Gy) and MU per fraction compared with both the RapidArc and the tomotherapy plans. The mARC plan reduced the beam on time as well. Therefore, the results of this study provide satisfactory evidence that the mARC technique can be considered as a useful clinical technique for radiation treatment.

  14. Evaluation of the clinical usefulness of modulated Arc treatment

    CERN Document Server

    Lee, Young Kyu; Kim, Yeon Sil; Choi, Byung Ock; Nam, Sang Hee; Park, Hyeong Wook; Kim, Shin Wook; Shin, Hun Joo; Lee, Jae Choon; Kim, Ji Na; Park, Sung Kwang; Kim, Jin Young; Kang, Young-Nam

    2015-01-01

    The purpose of this study is to evaluate the clinical usefulness of modulated arc (mARC) treatment techniques. The mARC treatment plans of the non-small cell lung cancer (NSCLC) patients were performed in order to verify the clinical usefulness of mARC. A pre study was conducted to find the most competent plan condition of mARC treatment and the usefulness of mARC treatment plan was evaluated by comparing it with the other Arc treatment plans such as Tomotherapy and RapidArc. In the case of mARC, the optimal condition for the mARC plan was determined by comparing the dosimetric performance of the mARC plans with the use of various parameters. The various parameters includes the photon energies (6 MV, 10 MV), optimization point angle (6{\\deg}-10{\\deg} intervals), and total segment number (36-59 segment). The best dosimetric performance of mARC was observed at 10 MV photon energy and the point angle 6 degree, and 59 segments. The each treatment plans of three different techniques were compared with the followin...

  15. One hospital's clinical evaluation of brushless scrubbing.

    Science.gov (United States)

    Berman, Mara

    2004-02-01

    BRUSHLESS SCRUBBING rapidly is becoming an accepted method for surgical hand scrubbing. AN EVALUATION was undertaken at an acute care hospital in the southeastern United States to examine brushless scrubbing before laminectomy, craniotomy, and colectomy procedures. PATIENTS DID NOT SHOW an increase in postoperative surgical site infections when the brushless scrubbing product was used. SATISFACTION AND COMPLIANCE among users of the product was positive. PMID:15002831

  16. Evaluation of electronic biopsy for clinical diagnosis in virtual colonoscopy

    Science.gov (United States)

    Marino, Joseph; Du, Wei; Barish, Matthew; Li, Ellen; Zhu, Wei; Kaufman, Arie

    2011-03-01

    Virtual colonoscopy provides techniques not available in optical colonoscopy, an exciting one being the ability to perform an electronic biopsy. An electronic biopsy image is created using ray-casting volume rendering of the CT data with a translucent transfer function mapping higher densities to red and lower densities to blue. The resulting image allows the physician to gain insight into the internal structure of polyps. Benign tissue and adenomas can be differentiated; the former will appear as homogeneously blue and the latter as irregular red structures. Although this technique is now common, is included with clinical systems, and has been used successfully for computer aided detection, there has so far been no study to evaluate the effectiveness of a physician using electronic biopsy in determining the pathological state of a polyp. We present here such a study, wherein an experienced radiologist ranked polyps based on electronic biopsy alone per scan (supine and prone), as well as both combined. Our results show a correct identification 77% of the time using prone or supine images alone, and 80% accuracy using both. Using ROC analysis based on this study with one reader and a modest sample size, the combined score is not significantly higher than using a single electronic biopsy image alone. However, our analysis indicates a trend of superiority for the combined ranking that deserves a follow-up confirmatory study with a larger sample and more readers. This study yields hope that an improved electronic biopsy technique could become a primary clinical diagnosis method.

  17. The evaluation of the role of teleradiotherapy in palliative treatment of patients with inoperable, non-small cell lung cancer (clinical randomized study)

    International Nuclear Information System (INIS)

    The results of randomized clinical study carried out at the Center of Oncology in Cracow between 1992 and 1996 in the group of 216 patients with locally advanced unresectable non-small cell lung cancer, not suitable for curative radiotherapy, asymptomatic or having only minimal symptoms related to intrathoratic tumor, are presented. 71 patients received the tumor dose of 50 Gy in 25 fractions over 5 weeks, 73 patients received dose 20 Gy in 5 fractions over 5 days, repeated in 4 week time after the first series, and 72 patients primarily received only the best possible symptomatic care. The analysis of our randomized study showed that palliative thoracic radiotherapy significantly improved mean survival time from 6 to 10 months, 12-month survival from 11.1 % to 37.5%, 24-month survival from 0% to 12.5%. From two investigated alternative fractionation schedules safer and more effective was irradiation with the tumor dose of 50 Gy in 25 fractions over 5 weeks. (author)

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

    Science.gov (United States)

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

    2016-04-01

    This paper explored concepts, definitions and theoretical perspectives evaluating clinical competence during nursing education. The questions were: (i) How is clinical competence evaluated? and (ii) What is evaluated? An integrative review of 19 original research articles from 2009 to 2013 was performed. Results showed that evaluation tools were used in 14, observations in 2 and reflecting writing in 3 studies. The students participated in all but one evaluation alone or together with peers, faculty members or preceptors. Three themes were found: (i) professional practice with a caring perspective; (ii) clinical skills and reflective practice; and (iii) cognitive, affective and psychomotor skills both with a nursing perspective. This review shows an emphasis on structured methods with a risk reducing nursing to tasks and skills why combinations with qualitative evaluations are recommended. A holistic view of competence dominated and in designing evaluations, explicit perspectives and operationalized definitions of clinical competence became evident. PMID:26369943

  19. Clinical evaluation of autologous platelet-rich fibrin in the treatment of multiple adjacent gingival recession defects: a 12-month study.

    Science.gov (United States)

    Tunalι, Mustafa; Özdemir, Hakan; Arabacι, Taner; Gürbüzer, Bahadir; Pikdöken, Levent; Firatli, Erhan

    2015-01-01

    Leukocyte- and platelet-rich fibrin (L-PRF) belongs to a new generation of platelet concentrates. There are limited numbers of studies focused on the use of L-PRF in gingival recession defects. This study evaluated the safety and effectiveness of using L-PRF membranes as a substitute for free connective tissue grafts (CTGs) as a treatment method for gingival recession defects. A total of 44 Miller Class I/II gingival recessions that were bilateral, adjacent, and greater than 3 mm in size were selected. Each recession site was randomly assigned to the test group (L-PRF) or the control group (CTG). After 12 months, root coverage was 76.63% and 77.36% in the L-PRF and CTG groups, respectively. It is suggested that L-PRF membrane may be an alternative graft material for treating multiple adjacent recessions greater than 3 mm in size without a requirement for additional surgery. PMID:25734713

  20. Long-term clinical evaluation of endodontically treated teeth by 15 F CO2 laser microprobe: three years clinical follow-up of 1512 root canals--in-vivo study

    Science.gov (United States)

    Kesler, Gavriel; Koren, Rumelia; Kesler, Anat; Hay, Nissim; Gal, Rivka

    1999-05-01

    The purpose of this study was to determine the efficiency of 15 F CO2 laser microprobe, in cases of periapical lesions, by eliminating the pathological reaction caused by certain species of bacteria, reduction of reinfection and stimulation of osteogenesis in the periapical region. Until now, no suitable delivery fiber existed for CO2 laser endodontic radiation in the apical region where it is most difficult to eliminate the pulp tissue using conventional methods. To overcome this problem, Sharplan laser designed a microprobe that reaches closer to the apex, distributing the energy density to a smaller area of the root canal, thus favorably increasing the thermal effects. The study was conducted on 900 teeth, divided in two groups. 468 were new case, carefully selected according to strict parameters such as: wide periapical translucency over 1mm, supported by digital x-ray, with a lesion of 3mm and more. All root canals were mechanically prepared in the conventional method up to size 35, Physiological saline solution served as finding solution and were treated by 15 F CO2 laser microprobe for 60 pulses repeatedly. The temperature at the surrounding tissue of the root did not exceed 38 degrees C filling of the canal was possible at the same appointment, without antibiotical treatment. 432 of the cases, which were referred to us by other dentists, after an unsuccessful treatment according to the classical therapy, were treated by the same laser therapy. Follow up was performed by clinical examination, and digital x-ray taken, during and after treatment as well as after 3, 6, 9, 12 month. The result demonstrate 98% success rate in both study groups, according to objective criteria for a successful treatment such as: reduction of apical translucency after 2- 6 months, freedom form clinical complains, and no need for periapical surgery.

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

    Science.gov (United States)

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

    2014-01-01

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

  2. Comparative evaluation of the relative efficacy of the free mucosal graft and periosteal fenestration for increasing the vestibular depth - A clinical study

    Directory of Open Access Journals (Sweden)

    Nisha Yadav

    2014-01-01

    Full Text Available Purpose: The aim of the present study was to compare the periosteal fenestration (PF and free mucosal graft (FMG techniques in mandibular anterior region to increase the vestibular depth. Methodology: A total of 20 systemically healthy cases (10 patients in each group with shallow vestibular depth and reduced width of attached gingiva in lower anterior region were included in the present study. Clinical parameters recorded included Gingival index (GI, Plaque index (PI, Oral hygiene index simplified (OHI S, Vestibular depth (VD, width of attached gingiva and post operative discomfort. Findings: The results at the end of 3 months showed that the mean GI, PI, OHI S decreased significantly and remained low throughout the study period. The mean gain in percentage of vestibular depth at the end of 3 months for group 1(PF was 48.4% with relapse of 7.2% from the baseline. For group 2 (FMG, the mean gain in percentage of vestibular depth at the end of 3 months for was 50% with relapse of 6.2% from the baseline. The mean gain in percentage of attached gingiva at 3 months for group 1 and 2 was 65.9% and 74%, respectively. In comparison of group 1 and 2, group 2 showed better results in terms of increasing the vestibular depth and attached gingiva than group 1 although the intergroup comparison was not statistically significant. Conclusion: When aim of the clinician is to treat a patient with shallow vestibule together with reduced width of attached gingiva, the use of periosteal fenestration yields similar results to that of FMG.

  3. A RANDOMIZED CLINICAL STUDY TO EVALUATE THE EFFECT OF INTRAVENOUS MAGNESIUM SULPHATE FOR POSTOPERATIVE PAIN RELIEF IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Jitendra

    2015-09-01

    Full Text Available BACKGROUND : In this randomized, double - blind, prospective study, we have evaluated the effect of i.v. infusion of magnesium sulphate during spinal anaesthesia, for postoperative pain relief in patients undergoing lower segment caesarean section. AIM : A comparative evaluation of intravenous magnesium sulphate for prevention of postoperative pain relief in lower segment caesarean section under spinal anaesthesia” . METHODS AND MATERIAL S : 60 female patients of ASA grade I and II of the age group 20 - 40 yrs., posted for lower segment caesarean section under spinal anaesthesia were selected after pre anaesthetic fitness. Randomly patient were divided into two groups (n=30 patients each group NS, and group MS to receive 100ml of 0.9% Normal saline and Magnesium sulphate 50mg kg - 1 in 100ml of 0.9% Normal saline respectively to be given over 15 min, 60min after performing spinal anaesthesia. After surgery, rescue analgesia in form of inj. tramadol 100 mg i.v was provided for the patients. The Postoperative pain scores, Rescue analgesic consumption, and incidences of sedation, shivering, dysrhythmia, bradycardia, and hypotension evaluated immediately after surgery, and at 30 min, 1, 2, 3, hrs. After surgery. STATISTICAL ANALYSIS: Results were expressed as mean and standard deviation. P value of <0.05 was considered statistically significant. RESULTS: IV Magnesium sulphate 50 mg kg - 1 bolus significantly prolonged duration of analgesia, superior quality of analgesia ( L ower VAS and significant reduction in postoperative analgesic requirement than normal saline under spinal anaesthesia. No significant hemodynamic and respiratory instability occurred with Magnesium Sulphate use. CONCLUSION: I.V. magnesium sulphate administration during spinal anaesthesia improves postoperative analge sia without any notable complications.

  4. Feasibility study to assess clinical applications of 3-T cine MRI coupled with synchronous audio recording during speech in evaluation of velopharyngeal insufficiency in children

    Energy Technology Data Exchange (ETDEWEB)

    Sagar, Pallavi; Nimkin, Katherine [Massachusetts General Hospital, Department of Radiology, Division of Pediatric Radiology, Boston, MA (United States)

    2014-08-16

    In the past decade, there has been increased utilization of magnetic resonance imaging (MRI) in evaluating and understanding velopharyngeal insufficiency (VPI). To our knowledge, none of the prior studies with MRI has simultaneously linked the audio recordings of speech during cine MRI acquisition with the corresponding images and created a video for evaluating VPI. To develop an MRI protocol with static and cine sequences during phonation to evaluate for VPI in children and compare the findings to nasopharyngoscopy and videofluoroscopy. Five children, ages 8-16 years, with known VPI, who had previously undergone nasopharyngoscopy and videofluoroscopy, were included. MRI examination was performed on a 3-T Siemens scanner. Anatomical data was obtained using an isotropic T2-weighted 3-D SPACE sequence with multiplanar reformation capability. Dynamic data was obtained using 2-D FLASH cine sequences of the airway in three imaging planes during phonation. Audio recordings were captured by a MRI compatible optical microphone. All five cases had MRI and nasopharyngoscopy and four had videofluoroscopy performed. VPI was identified by MRI in all five patients. The location and severity of the velopharyngeal gap, closure pattern, velar size and shape and levator veli palatini (LVP) muscle were identified in all patients. MRI was superior in visualizing the integrity of the LVP muscle. MRI was unable to identify hemipalatal weakness in one case. In a case of stress-induced VPI, occurring only during clarinet playing, cine MRI demonstrated discordant findings of a velopharyngeal gap during phonatory tasks but not with instrument playing. Overall, there was satisfactory correlation among MRI, nasopharyngoscopy and videofluoroscopy findings. Cine MRI of the airway during speech is a noninvasive, well-tolerated diagnostic imaging tool that has the potential to serve as a guide prior to and after surgical correction of VPI. MRI provided superior anatomical detail of the levator

  5. Feasibility study to assess clinical applications of 3-T cine MRI coupled with synchronous audio recording during speech in evaluation of velopharyngeal insufficiency in children

    International Nuclear Information System (INIS)

    In the past decade, there has been increased utilization of magnetic resonance imaging (MRI) in evaluating and understanding velopharyngeal insufficiency (VPI). To our knowledge, none of the prior studies with MRI has simultaneously linked the audio recordings of speech during cine MRI acquisition with the corresponding images and created a video for evaluating VPI. To develop an MRI protocol with static and cine sequences during phonation to evaluate for VPI in children and compare the findings to nasopharyngoscopy and videofluoroscopy. Five children, ages 8-16 years, with known VPI, who had previously undergone nasopharyngoscopy and videofluoroscopy, were included. MRI examination was performed on a 3-T Siemens scanner. Anatomical data was obtained using an isotropic T2-weighted 3-D SPACE sequence with multiplanar reformation capability. Dynamic data was obtained using 2-D FLASH cine sequences of the airway in three imaging planes during phonation. Audio recordings were captured by a MRI compatible optical microphone. All five cases had MRI and nasopharyngoscopy and four had videofluoroscopy performed. VPI was identified by MRI in all five patients. The location and severity of the velopharyngeal gap, closure pattern, velar size and shape and levator veli palatini (LVP) muscle were identified in all patients. MRI was superior in visualizing the integrity of the LVP muscle. MRI was unable to identify hemipalatal weakness in one case. In a case of stress-induced VPI, occurring only during clarinet playing, cine MRI demonstrated discordant findings of a velopharyngeal gap during phonatory tasks but not with instrument playing. Overall, there was satisfactory correlation among MRI, nasopharyngoscopy and videofluoroscopy findings. Cine MRI of the airway during speech is a noninvasive, well-tolerated diagnostic imaging tool that has the potential to serve as a guide prior to and after surgical correction of VPI. MRI provided superior anatomical detail of the levator

  6. Universal protocol for alopecia areata clinical studies.

    Science.gov (United States)

    Mesinkovska, Natasha A; Bergfeld, Wilma F

    2013-12-01

    Within the area of alopecia areata research, there is an obvious need for well-designed clinical trials of therapeutic agents. The National Alopecia Areata Foundation (NAAF) has created an initiative for the development of a unified protocol with guidelines for clinical studies. The NAAF universal protocol represents a joint effort of clinicians and investigators with experience in treating alopecia areata. This protocol will serve as a tremendous resource to facilitate future clinical studies. PMID:24326554

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

    OpenAIRE

    2014-01-01

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

  8. Radiological evaluation of swallowing and clinical patterns of systemic sclerosis

    International Nuclear Information System (INIS)

    Fifty-one patients with systemic sclerosis (scleroderma) were studied by means of videofluoroscopy in order to evaluate the abnormalities in the oral-pharyngeal and esophageal phases of deglutition and to correlate the radiological patterns with the clinical features of the disease. Thirteen patients (25.5%) exhibited swallowing disorders such as oral leakage, retention, penetration, mild or moderate aspiration and abnormal upper esophageal sphincter behavior. These dysfunctions were more evident in patients with esophageal motility abnormalities. A normal radiological pattern in the esophagus was not associated with swallowing alterations. Remarkably, patients with oral-pharyngeal disorders had a higher incidence of lung diseases. Forty-five patients (88%) exhibited disorders of the esophageal phase of deglutition, such as mild or severe motility abnormalities or hiatal hernia, gastro-esophageal reflux, reflux esophagitis, and stricture. Radiological findings in the esophagus can be abnormal in the early stages of the disease. On the other hand, the radiological pattern of esophageal motility can be occasionally negative in advanced or extensive disease. This indicates a discrepancy between clinical symptoms and radiological picture of the esophagus. The radiological examination of the oral-pharyngeal and esophageal phases of deglutition is important in patients with scleroderma in order to evaluate visceral involvement, motility disorders, and risk of aspiration. Such radiological information can be useful in preventing esophagitis and pulmonary complications

  9. Clinical evaluation of serial CT scan

    International Nuclear Information System (INIS)

    Dynamic CT of abdominal organs was performed in a few cases, and movement of contrast medium in abdominal organs, the capacity of abdominal dynamic CT to visualize vascular cavity less than middle size, and the evaluation of abdominal dynamic CT in the diagnosis of malignant tumor were reported. After 50 ml of 60% meglumine iotalamate was injected into cubital vein in 15 seconds (3.3 ml/sec.), it was clarified by the first scan after the injection that contrast medium enough to visualize vascular cavity of 2 mm in diameter existed in vessels. That is, SOMATOM SD can visualize the intravascular phase of the contrast by the first or the second scan after the injection. Abdominal dynamic CT was very useful for the diagnosis of abdominal malignant tumor. (Tsunoda, M.)

  10. Clinical and radiological evaluation of ARDS

    International Nuclear Information System (INIS)

    Thirty patients under long-term artificial respiration being at risk of or suffering from ARDS were observed on the intensive care unit right from the beginning of treatment. In all cases, the lungs were visualised by means of computed tomography. Computed tomography of the lungs provided valuable information as to the pulmonal distribution of ARDS-related changes. In gradually developing acute respiratory insufficiency caused by parenchymal changes that start from the paravertebral regions CT scans also permitted the so-called 'silent period' to be ascertained that is always seen to escape radiological detection. Comparative evaluations confirmed the diagnostic superiority of computed tomography to conventional X-ray procedures and arterial blood gas analysis in those ARDS patients where the tissue changes begin in the dorsal sections of the lungs. (orig./MBC)

  11. Evaluation of Stream Mining Classifiers for Real-Time Clinical Decision Support System: A Case Study of Blood Glucose Prediction in Diabetes Therapy

    Directory of Open Access Journals (Sweden)

    Simon Fong

    2013-01-01

    Full Text Available Earlier on, a conceptual design on the real-time clinical decision support system (rt-CDSS with data stream mining was proposed and published. The new system is introduced that can analyze medical data streams and can make real-time prediction. This system is based on a stream mining algorithm called VFDT. The VFDT is extended with the capability of using pointers to allow the decision tree to remember the mapping relationship between leaf nodes and the history records. In this paper, which is a sequel to the rt-CDSS design, several popular machine learning algorithms are investigated for their suitability to be a candidate in the implementation of classifier at the rt-CDSS. A classifier essentially needs to accurately map the events inputted to the system into one of the several predefined classes of assessments, such that the rt-CDSS can follow up with the prescribed remedies being recommended to the clinicians. For a real-time system like rt-CDSS, the major technological challenges lie in the capability of the classifier to process, analyze and classify the dynamic input data, quickly and upmost reliably. An experimental comparison is conducted. This paper contributes to the insight of choosing and embedding a stream mining classifier into rt-CDSS with a case study of diabetes therapy.

  12. A randomized clinical study for comparative evaluation of Aloe Vera and 0.2% chlorhexidine gluconate mouthwash efficacy on de-novo plaque formation

    Science.gov (United States)

    Chhina, Shivjot; Singh, Avnish; Menon, Ipseeta; Singh, Rickypal; Sharma, Anubhav; Aggarwal, Vartika

    2016-01-01

    Objective: To comparatively assess the antiplaque efficacy of Aloe vera mouthwash and 0.2% chlorhexidine gluconate mouthwash on de novo plaque formation. Materials and Methods: This was a randomized, single blind, parallel, controlled clinical study with 90 healthy participants, with mean age of 27.19 ± 12.08 years. After thorough oral prophylaxis, participants were instructed to discontinue mechanical plaque control. Participants were divided randomly into three groups; pure Aloe vera mouthwash was dispensed to the test group; control group received 0.2% chlorhexidine gluconate mouthwash; in Placebo group, flavored distilled water was used as oral rinse twice daily. Effect on 4-day de novo plaque formation was assessed by comparing pre-rinsing Quigley Hein Modified Plaque Scores were analyzed statistically using analysis of variance and Student's t-test. Results: Post-rinsing control group showed the least plaque score which was comparable to the test group. Both the control group and test group showed significant difference with the placebo group. Conclusions: Herbal mouthwash containing Aloe vera mouthwash has comparable antiplaque efficacy as the gold standard 0.2% chlorhexidine gluconate with fewer side effects and can be considered as an alternative. PMID:27382543

  13. Economic utility of Cea-scan ; (acetobromo) immunoscintigraphy in the evaluation of patients with colorectal cancer: a retrospective financial analysis based on published clinical studies

    International Nuclear Information System (INIS)

    The aim of this analysis was to evaluate whether or not the added cost of immunoscintigraphy with Cea-Scan (arcitumomab) to routine anatomic imaging, can reduce the overall cost of patient management in patients with colorectal cancer. Methods: Two hundred ten (210) colorectal cancer patients underwent preoperative CT and immunoscintigraphy. The ability of CT alone and combined with immunoscintigraphy to preoperatively assess the resectability status of each patient was evaluated. Costs included were: total cost of administering and interpreting both imaging studies, total surgical costs, and the costs of false positives and false negatives (with respect to determination of resectability). An outcomes table was constructed to incorporate economic possibilities for each patient sub-group. Results: Immunoscintigraphy with arcitumomab reduced the overall cost of patient management by approximately $5,000 per patient, primarily due to those patients whom CT incorrectly indicated as resectable. Conclusion: This analysis indicates that the addition of immunoscintigraphy to the preoperative workup of patients diagnosed with colorectal cancer decreases the overall cost significantly (Au)

  14. Clinical evaluation of pivmecillinam in intractable urinary-tract infections with complications. A comparative study with amoxicillin by a randomized double-blind technique.

    Science.gov (United States)

    Ishigami, J; Tanikaze, S; Miyazaki, S; Ono, S; Kuroda, M; Hirooka, K; Mita, T; Sugimoto, M; Kuroda, K; Nakatsuka, E; Suemitsu, H; Tomioka, S; Takahashi, Y; Hara, S; Terasoma, K; Tanaka, K; Ueharaguchi, H; Hikosaka, K; Yasumuro, T; Kaneda, K; Akita, Y; Okano, H; Kobayashi, M; Kataoka, N

    1977-11-01

    A comparative study was made by the double-blind technique in order to make clear the usefulness of pivmecillinam in the treatment of intractable complicated urinary-tract infections using amoxicillin as a reference drug. Pivmecillinam was given in dosage of 400 mg (potency) per day which was one-fifth the dose of amoxicillin 2,000 mg (potency) per day. In global judgement, pivmecillinam was found superior to amoxicillin. It showed a "significant" superiority over amoxicillin for the treatment of, among others, the urinary-tract infections after prostatectomy, which are intractable diseases. When evaluated by symptoms, pivmecillinam improved bacteriuria "significantly" better than amoxicillin. When seen by causative organisms, the pivmecillinam treatment was "significantly" superior to the amoxicillin treatment against E. coli infections. Pivmecillinam was active against amoxicillin-resistant E. coli. Incidence of adverse reactions was less frequent with pivmecillinam than with amoxicillin. These results indicate that pivmecillinam is a drug of high usefulness for the treatment of intractable complicated urinary-tract infections when evaluated using amoxicillin as a reference drug. PMID:201786

  15. Evaluation of febrile neutropenic patients hospitalized in a hematology clinic

    Institute of Scientific and Technical Information of China (English)

    Mcahit; Grk; Mehmet; Sinan; Dal; Tuba; Dal; Abdullah; Karakus; Recep; Tekin; Nida; zcan; Orhan; Ayyildiz

    2015-01-01

    Objective:To evaluate the febrile neutropenic patients with hematological malignancies hospitalized in hematology clinic with poor hygiene standards.Methods:A total of 124 patients with hematological malignancies(69 male,55 female)hospitalized in hematology clinic with poor hygiene conditions depending on hospital conditions,between January 2007 and December 2010,were evaluated,retrospectively.Results:In this study,250 febrile neutropenia episodes developing in 124 hospitalized patients were evaluated.Of the patients,69 were men(56%)and 55 women(44%).A total of 40 patients(32%)had acute myeloid leukemia,25(20%)acute lymphoblastic leukemia,19(15%)non-Hodgkin’s lymphoma,10(8%)multiple myeloma,and 8(8%)chronic myeloid leukemia.In our study,56 patients(22%)were diagnosed as pneumonia,38(15%)invasive aspergillosis,38(15%)sepsis,16(6%)typhlitis,9(4%)mucormycosis,and 4(2%)urinary tract infection.Gram-positive cocci were isolated from 52%(n=20),while Gram-negative bacilli 42%(n=16)and yeasts from 6%(n=2)of the sepsis patients,respectively.The most frequently isolated Gram-positive bacteria were methicillin-resistant coagulase-negative staphylococci(n=18),while the most frequently isolated Gram-negative bacteria was Escherichia coli(n=10).Conclusions:Febrile neutropenia is still a problem in patients with hematological malignancies.The documentation of the flora and detection of causative agents of infections in each unit would help to decide appropriate empirical therapy.Infection control procedures should be applied for preventing infections and transmissions.

  16. Photovoltaic evaluation study

    Science.gov (United States)

    Johnson, G.; Heikkilae, M.; Melasuo, T.; Spanner, S.

    Realizing the value and potential of PV-power as well as the growing need for increased cooperation and sharing of knowledge in the field of photovoltaics, FINNIDA and UNICEF decided to undertake a study of selected PV-projects. There were two main objectives for the study: To gather, compile, evaluate and share information on the photovoltaic technology appropriate to developing countries, and to promote the interest and competence of Finnish research institutes, consultants and manufacturers in photovoltaic development. For this purpose a joint evaluation of significant, primarily UN-supported projects providing for the basic needs of rural communities was undertaken. The Gambia and Kenya offered a variety of such projects, and were chosen as target countries for the study. The projects were chosen to be both comparable and complimentary. In the Gambia, the main subject was a partially integrated health and telecommunications project, but a long-operating drinking water pumping system was also studied. In Kenya, a health project in the Turkana area was examined, and also a large scale water pumping installation for fish farming. Field visits were made in order to verify and supplement the data gathered through document research and earlier investigations. Individual data gathering sheets for the project form the core of this study and are intended to give the necessary information in an organized and accessible format. The findings could practically be condensed into one sentence: PV-systems work very well, if properly designed and installed, but the resources and requirements of the recipients must be considered to a higher degree.

  17. Clinical Evaluation of Inpatients with Acute Urticaria

    Directory of Open Access Journals (Sweden)

    Ayşe Serap

    2011-12-01

    Full Text Available Background and Design: To determine the clinical and etiological features of inpatients with acute urticaria and angioedema and to assess the need for laboratory tests. Material and Methods: We recruited 105 patients with acute urticaria and angioedema who were admitted to our inpatient unit. The lesions and the characteristics of the patients were analyzed. Routine diagnostic tests including complete blood count, thyroid function tests, hepatitis panel, stool parasite, total IgE levels, cultures, erythrocyte sedimentation rate, C-reactive protein, anti-nuclear antibody, and posterior anterior lung X-ray were ordered. A psychiatric consultation was obtained, when needed. The results were analyzed with SPSS 15.0 statistical software.Results: Among 105 patients, 28 (26.7% had urticaria, 7 (6.7% had angioedema, and 70 (66.7% suffered from both urticaria and angioedema. The most common accompanying symptoms were itching (91.4% and burning (34.3%. The most common systemic symptoms were fatigue (15.2% and headache (12.4%. The lesions usually appeared in the evening hours (24.8%. Twenty-five patients were waking up due to itching during the night. Some lesions were associated with physical activities. Systemic diseases accompanied the lesions in 12 patients (11%. In terms of etiological factors, 33 patients (22.5% had infections. Food- related lesions were encountered in 14 (13% patients. Thirty patients (28.5% had history of medication use. Stress was detected in 37.1% of the patients; anxiety was diagnosed in 3% of patients. The stool was positive for parasites in 10 (9% patients. Conclusion: Acute urticaria is a benign disorder. Although the underlying cause of urticaria can not always be identified, infections and medications are the most common causes. A comprehensive and detailed history is very important to discover the underlying cause. The diagnostic tests should be ordered according to the patient’s history. Conducting diagnostic tests

  18. Experimental and clinical studies on CT lymphography

    International Nuclear Information System (INIS)

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

  19. Development and evaluation of a clinical note section header terminology.

    Science.gov (United States)

    Denny, Joshua C; Miller, Randolph A; Johnson, Kevin B; Spickard, Anderson

    2008-01-01

    Clinical documentation is often expressed in natural language text, yet providers often use common organizations that segment these notes in sections, such as history of present illness or physical examination. We developed a hierarchical section header terminology, supporting mappings to LOINC and other vocabularies; it contained 1109 concepts and 4332 synonyms. Physicians evaluated it compared to LOINC and the Evaluation and Management billing schema using a randomly selected corpus of history and physical notes. Evaluated documents contained a median of 54 sections and 27 major sections. There were 16,196 total sections in the evaluation note corpus. The terminology contained 99.9% of the clinical sections; LOINC matched 77% of section header concepts and 20% of section header strings in those documents. The section terminology may enable better clinical note understanding and interoperability. Future development and integration into natural language processing systems is needed. PMID:18999303

  20. Turning guidelines into clinical practice : Findings from an implementation study

    OpenAIRE

    Forsner, Tord

    2010-01-01

    Aim: The general aim of this thesis is to describe factors of importance when implementing clinical guidelines in psychiatry, and more specifically contribute to a better understanding of the implementation process. The specific aims are: Study I, to investigate a tailored implementation programme for implementing clinical guidelines for depression and suicidal patients, and to evaluate the compliance to guidelines after 6 months. In Study II, to further investigate complian...

  1. An evaluation of a periodontal plastic surgical procedure for the reconstruction of interdental papillae in maxillary anterior region: A clinical study

    Directory of Open Access Journals (Sweden)

    Madhuri Lokhande Sawai

    2012-01-01

    Full Text Available Background: In today′s world, people are very much aware about their looks and personality. They are getting more concerned about the esthetics and thus are not ready to compromise the appearance of black holes, especially in the anterior region of the mouth. Various techniques like orthodontic correction, prosthetic veneers and various periodontal surgical methods have been used to cover these unaesthetic open embrasures. In the present study, a variant technique given by Beagle in 1992 was used to cover these open gingival embrasures. The technique uses a gingival flap from the labial aspect to close the open gingival embrasures thus solving the problem of black holes. Aims and Objectives: This clinical study was aimed to reconstruct the lost or blunted interdental papillae with gingival tissue for esthetic purpose and for maintaining oral health with the objective to determine the extent to which the procedure can revert the maxillary esthetics. Materials and Methods: The patients selected were those who were having a complaint of at least one black hole in the maxillary anterior region with grade ′0′ or ′1′ type of contour of interdental tissues. A total of 39 open embrasures were surgically closed using this technique. Various indices were taken pre-surgically and then again post surgically. Results: Plaque index and gingival index showed an initial increase in the scores at the end of 1 week. Later, there was a gradual fall till the end of the study. Bleeding index significantly increased at the end of 12 weeks ( P<0.001 but reduced to insignificant levels at the end of 24 weeks ( P<0.09. The sulcus depth increased by about 1.19 mm. There was improvement in the contour of interdental tissues in 51% of cases and in 38.46% the interdental papillae completely obliterated the open embrasures. Conclusion: The surgical technique used here for reconstruction of interdental papilla was fairly successful. However, use of bone grafts or

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

    OpenAIRE

    Wagner, Kay Cimpl; Byrd, Gary D.

    2004-01-01

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

  3. Clinical studies of biomarkers in suicide prediction

    OpenAIRE

    Jokinen, Jussi

    2007-01-01

    Suicide is a major clinical problem in psychiatry and suicidal behaviours can be seen as a nosological entity per se. Predicting suicide is difficult due to its low base-rate and the limited specificity of clinical predictors. Prospective biological studies suggest that dysfunctions in the hypothalamo pituitary adrenal (HPA) axis and the serotonergic system have predictive power for suicide in mood disorders. Suicide attempt is the most robust clinical predictor making suici...

  4. Statistical Issues in TBI Clinical Studies

    Directory of Open Access Journals (Sweden)

    Paul eRapp

    2013-11-01

    Full Text Available The identification and longitudinal assessment of traumatic brain injury presents several challenges. Because these injuries can have subtle effects, efforts to find quantitative physiological measures that can be used to characterize traumatic brain injury are receiving increased attention. The results of this research must be considered with care. Six reasons for cautious assessment are outlined in this paper. None of the issues raised here are new. They are standard elements in the technical literature that describes the mathematical analysis of clinical data. The purpose of this paper is to draw attention to these issues because they need to be considered when clinicians evaluate the usefulness of this research. In some instances these points are demonstrated by simulation studies of diagnostic processes. We take as an additional objective the explicit presentation of the mathematical methods used to reach these conclusions. This material is in the appendices. The following points are made:1. A statistically significant separation of a clinical population from a control population does not ensure a successful diagnostic procedure.2. Adding more variables to a diagnostic discrimination can, in some instances, actually reduce classification accuracy.3. A high sensitivity and specificity in a TBI versus control population classification does not ensure diagnostic successes when the method is applied in a more general neuropsychiatric population. 4. Evaluation of treatment effectiveness must recognize that high variability is a pronounced characteristic of an injured central nervous system and that results can be confounded by either disease progression or spontaneous recovery. A large pre-treatment versus post-treatment effect size does not, of itself, establish a successful treatment.5. A procedure for discriminating between treatment responders and nonresponders requires, minimally, a two phase investigation. This procedure must include a

  5. HERPESE ZOSTER: A CLINICAL STUDY

    OpenAIRE

    Omprakash; Geeta; Dinesh Chandra; Kavitha; Arora; Sudheer

    2014-01-01

    The study was conducted between August 2012 and July 2013 at the dermatology department of OPD,116 cases studied with personal, present, past, family history, examined thoroughly, done all necessary investigations, taken opinion of other faculties where ever necessary . All the patients were reviewed weekly for 1 month and monthly for two more months. Patients 76 were males and 40 were females. Out of of 116 cases, 75 (64.6%) had definite history of chicken pox. In this study interesting diff...

  6. Assessment of [18F]-fluoroacetate PET/CT as a tumor-imaging modality. Preclinical study in healthy volunteers and clinical evaluation in patients with liver tumor

    International Nuclear Information System (INIS)

    Although [18F]-FDG is a useful oncologic PET tracer, FDG uptake is known to be low in a certain type of hepatocellular carcinoma (HCC). [18F]-fluoroacetate (18F-FACE) is an [18F] fluorinated acetate, which is known to be converted into fatty acids, incorporated in membrane and is expected to be a promising oncologic PET tracer. The aim of this study was to evaluate the usefulness of 18F-FACE as an oncologic PET tracer in preclinical study in healthy volunteers and in patients with liver tumors. Twenty-four healthy volunteers (age 48.2 ± 12.9 years old; 15 male and 9 female) and ten patients with liver tumor (age 72.1 ± 7.0 years old; 6 male and 4 female) were included. We performed whole-body static PET/CT scan using 18F-FACE (n=34) and 18F-FDG (n=5 for volunteers, n=8 for patients) on each day, respectively. Qualitative analysis and quantitative analysis of tumors (5 HCCs, 1 cholangiocellular carcinoma, 4 metastatic tumors from colon cancer and P-NET) were performed using SUVmax and tumor-to-normal liver ratio (TNR). In healthy volunteers, 18F-FACE was metabolically stable in vivo and its biodistribution was almost similar to blood pool, basically uniformly independent of age and gender during PET scan time (up to 3 h). Normal physiological uptake of 18F-FACE at each organ including liver (SUVmean 1.8 ± 0.2) was lower than that of blood pool (SUVmean 2.3 ± 0.3) at 1 h after injection. Chronic inflammatory uptake around femur of post-operative state of femoral osteotomy and faint uptake of benign hemangioma were observed in a case of healthy volunteer. 18F-FACE (SUVmax 2.7 ± 0.6, TNR 1.5 ± 0.4) of liver tumors was significantly lower than those of 18F-FDG uptake (6.5 ± 4.2, 2.6 ± 1.7, respectively). In qualitative analysis, 18F-FDG was positive in 4 tumors (3 HCCs, 1 CCC) and negative in the other 6 tumors, while 18F-FACE was also positive in 4 tumors which were the same tumors with positive 18F-FDG uptake. Biodistribution of 18F-FACE was appropriate for

  7. A clinical evaluation of the ProNOVA XR polymer-free sirolimus eluting coronary stent system in the treatment of patients with de novo coronary artery lesions (EURONOVA XR I study)☆

    Science.gov (United States)

    Legutko, Jacek; Zasada, Wojciech; Kałuża, Grzegorz L.; Heba, Grzegorz; Rzeszutko, Lukasz; Jakala, Jacek; Dragan, Jacek; Klecha, Artur; Giszterowicz, Dawid; Dobrowolski, Wojciech; Partyka, Łukasz; Jayaraman, Swaminathan; Dudek, Dariusz

    2013-01-01

    Aims Evaluation of safety and efficacy of ProNOVA XR, a new generation of polymer-free sirolimus eluting stents (SES), utilizing a pharmaceutical excipient for timed release of sirolimus from the XR platform. Methods and results Safety and efficacy of ProNOVA XR coronary stent system was examined in EURONOVA prospective, single arm, multi-center registry of 50 patients with de novo native coronary lesions up to 28 mm in length in arteries between 2.25 and 4 mm. At 6-month, in-stent late lumen loss by QCA was 0.45 ± 0.41 mm and in-stent neointimal volume obstruction in the IVUS sub-study was 14 ± 11%. One-year clinical follow-up revealed a favorable safety profile, with 2% of in-hospital MACE and 6.4% of MACE from hospital discharge up to 12 months (including 1 cardiac death >30 days after stent implantation and 2 TLRs). According to the ARC definition, there was no definite or probable stent thrombosis and 1 possible stent thrombosis (2%) up to 12 months of clinical follow-up. Conclusions In this preliminary evaluation, ProNOVA XR polymer-free sirolimus eluting stent system appeared safe with an early promise of adequate effectiveness in the treatment of de novo coronary lesions in up to 12 months of clinical, angiographic and IVUS follow-up. PMID:23992999

  8. HERPESE ZOSTER: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Omprakash

    2014-03-01

    Full Text Available The study was conducted between August 2012 and July 2013 at the dermatology department of OPD,116 cases studied with personal, present, past, family history, examined thoroughly, done all necessary investigations, taken opinion of other faculties where ever necessary . All the patients were reviewed weekly for 1 month and monthly for two more months. Patients 76 were males and 40 were females. Out of of 116 cases, 75 (64.6% had definite history of chicken pox. In this study interesting different to previous studies some features found . Prodromal sign neuralgic pain more in below 20 years. Males more infected. Cranial nerve more involved. Thorasic PHN more. Remaining all detailed study has explained below with routine features.

  9. Clinical evidence continuous medical education: a randomised educational trial of an open access e-learning program for transferring evidence-based information – ICEKUBE (Italian Clinical Evidence Knowledge Utilization Behaviour Evaluationstudy protocol

    Directory of Open Access Journals (Sweden)

    Satolli Roberto

    2008-07-01

    Full Text Available Abstract Background In an effort to ensure that all physicians have access to valid and reliable evidence on drug effectiveness, the Italian Drug Agency sponsored a free-access e-learning system, based on Clinical Evidence, called ECCE. Doctors have access to an electronic version and related clinical vignettes. Correct answers to the interactive vignettes provide Continuing Medical Education credits. The aims of this trial are to establish whether the e-learning program (ECCE increases physicians' basic knowledge about common clinical scenarios, and whether ECCE is superior to the passive diffusion of information through the printed version of Clinical Evidence. Design All Italian doctors naïve to ECCE will be randomised to three groups. Group one will have access to ECCE for Clinical Evidence chapters and vignettes lot A and will provide control data for Clinical Evidence chapters and vignettes lot B; group two vice versa; group three will receive the concise printed version of Clinical Evidence. There are in fact two designs: a before and after pragmatic trial utilising a two by two incomplete block design (group one versus group two and a classical design (group one and two versus group three. The primary outcome will be the retention of Clinical Evidence contents assessed from the scores for clinical vignettes selected from ECCE at least six months after the intervention. To avoid test-retest effects, we will randomly select vignettes out of lot A and lot B, avoiding repetitions. In order to preserve the comparability of lots, we will select vignettes with similar, optimal psychometric characteristics. Trial registration ISRCTN27453314

  10. Evaluating clinical teachers with the Maastricht clinical teaching questionnaire : How much 'teacher' is in student ratings?

    NARCIS (Netherlands)

    Boerboom, Tobias B. B.; Mainhard, Tim; Dolmans, Diana H. J. M.; Scherpbier, Albert J. J. A.; Van Beukelen, Peter; Jaarsma, A. D. (Debbie) C.

    2012-01-01

    Background: Students are a popular source of data to evaluate the performance of clinical teachers. Instruments to obtain student evaluations must have proven validity. One aspect of validity that often remains underexposed is the possibility of effects of between-student differences and teacher and

  11. Comparative evaluation of the new xTAG GPP multiplex assay in the laboratory diagnosis of acute gastroenteritis. Clinical assessment and potential application from a multicentre Italian study

    Directory of Open Access Journals (Sweden)

    C. Vocale

    2015-05-01

    Conclusions: The GPP assay can be considered a helpful tool for the detection of gastrointestinal pathogens, with a hands-on time of 5 h; it provides accurate data for the clinical management of hospitalized patients and for epidemiological surveillance.

  12. CLINICAL PHARMACOKINETIC STUDIES OF MIFEPRISTONE

    Institute of Scientific and Technical Information of China (English)

    XUNing; WUXi-Rui

    1989-01-01

    In ordcr to cxaminc thc pharmacokinetic charactcristics of mifcpristonc, manufactured by the Roussel-Uclaf Company, in Chincsee healthy volunteers and early pregnant womcn, the following two studies wcre carried out.

  13. Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

    Science.gov (United States)

    Auler, José Otavio C.; Torres, Marcelo L. A.; Cardoso, Mônica M.; Tebaldi, Thais C.; Schmidt, André P.; Kondo, Mario M.; Zugaib, Marcelo

    2010-01-01

    BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia. PMID:20835557

  14. Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

    Directory of Open Access Journals (Sweden)

    José Otavio Costa Auler Junior

    2010-06-01

    Full Text Available BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements, after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia, at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01. Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001 and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.

  15. Clinical evidence continuous medical education: a randomised educational trial of an open access e-learning program for transferring evidence-based information – ICEKUBE (Italian Clinical Evidence Knowledge Utilization Behaviour Evaluation) – study protocol

    OpenAIRE

    Satolli Roberto; Manfrini Roberto; Clivio Luca; Deligant Christian; Duca Piergiorgio; Compagnoni Anna; Sala Valeria; Cinquini Michela; Moschetti Ivan; Moja Lorenzo; Addis Antonio; Grimshaw Jeremy M; Dri Pietro; Liberati Alessandro

    2008-01-01

    Abstract Background In an effort to ensure that all physicians have access to valid and reliable evidence on drug effectiveness, the Italian Drug Agency sponsored a free-access e-learning system, based on Clinical Evidence, called ECCE. Doctors have access to an electronic version and related clinical vignettes. Correct answers to the interactive vignettes provide Continuing Medical Education credits. The aims of this trial are to establish whether the e-learning program (ECCE) increases phys...

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

    OpenAIRE

    1994-01-01

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

  17. Evaluation of PICO as a Knowledge Representation for Clinical Questions

    OpenAIRE

    Huang, Xiaoli; Lin, Jimmy; Demner-Fushman, Dina

    2006-01-01

    The paradigm of evidence-based medicine (EBM) recommends that physicians formulate clinical questions in terms of the problem/population, intervention, comparison, and outcome. Together, these elements comprise a PICO frame. Although this framework was developed to facilitate the formulation of clinical queries, the ability of PICO structures to represent physicians’ information needs has not been empirically investigated. This paper evaluates the adequacy and suitability of PICO frames as a ...

  18. Clinical laboratory evaluation of the automicrobic system Enterobacteriaceae biochemical card.

    OpenAIRE

    J.R. Davis; Stager, C E; Wende, R D; Qadri, S M

    1981-01-01

    The AutoMicrobic System Enterobacteriaceae Biochemical Card (AMS-EBC; Vitek Systems, Inc.) was evaluated in two clinical microbiology laboratories. A total of 502 consecutive clinical isolates representing members of the family Enterobacteriaceae were tested in parallel with the AMS-EBC, API 20E, and Enterotube II systems. Discrepancies between systems were resolved with the conventional methods of Edwards and Ewing (P. R. Edwards and W. H. Ewing [ed.], Identification of Enterobacteriaceae, 1...

  19. Evaluation of a pharmacist-managed anticoagulation clinic.

    Science.gov (United States)

    Cohen, I A; Hutchison, T A; Kirking, D M; Shue, M E

    1985-06-01

    Medical records were retrospectively analyzed to evaluate the success of a pharmacist-managed Anticoagulation Surveillance Clinic (ASC). The 78 patients in group I were followed by the ASC. The 17 patients in Group II were followed by other Veterans Administration Medical Center clinics. Demographic characteristics, warfarin indication and potentially complicating conditions were comparable between the groups. Group I patients had shorter intervals between visits to the clinic than Group II patients. Although not statistically different compared to Group II, Group I patients had better prothrombin time control. Group I patients also had fewer complications per treatment year (6.9% vs 9.0%) and received fewer potentially interacting drugs. The ASC was at least as successful as the other clinics in managing patients on warfarin, and results compared very favorably to those reported in the literature for other anticoagulation clinics. PMID:4019790

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

    Science.gov (United States)

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

    2002-11-01

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

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

    International Nuclear Information System (INIS)

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

  2. A clinical study to evaluate the efficacy of Trataka Yoga Kriya and eye exercises (non-pharmocological methods) in the management of Timira (Ammetropia and Presbyopia)

    OpenAIRE

    Gopinathan, G.; Dhiman, Kartar Singh; Manjusha, R.

    2012-01-01

    Timira is a disease that can be attributed to wide range of clinical conditions starting from mild blurring of vision and having potential risk of permanent vision loss. According to the involvement of Dhatus (body elements) the condition can be grouped into two stages. The initial stage or Uttana, where the involvement of Dhatus is limited to Rasa, Rakta (blood), and Mamsa Dhatu (muscle tissue). When the Doshas are localized in the first and second Patala refractive error do happen and in pr...

  3. Primary gout in Shantou: a clinical and epidemiological study

    Institute of Scientific and Technical Information of China (English)

    曾庆馀; 王庆文; 陈韧; 肖征宇; 黄少弼; 许敬才

    2003-01-01

    Objective To evaluate the prevalence of primary gout in the Shantou area, China, and to understand its clinical features. Methods Samples from three surveys of the Chenghai across ten years were studied. Clinical, laboratory and radiology data of 419 cases of primary gout were collected and analyzed. Conclusions The prevalence of primary gout in Shantou area has been increasing in the last ten years. Changes in diet and lifestyle may be responsible for this rapid increase.

  4. CLINICAL STUDY OF DUODENAL PERFORATION

    Directory of Open Access Journals (Sweden)

    Sambasiva Rao

    2016-04-01

    Full Text Available BACKGROUND The duodenal injury can pose a formidable challenge to the surgeon and failure to manage it properly may have devastating results. Over the centuries, there was little to offer the patient of acute abdomen beyond cupping, purgation and enemas, all of which did more harm than good. It was not until 1884 that Mikulicz made an attempt to repair a perforation. Recent statistics indicate roughly 10% of population develop gastric or duodenal ulcer in life time. Roughly 1-3% of population above the age of 20 years have some degree of peptic ulcer activity during any annual period. A detailed history with regards to the signs and symptoms of the patient, a meticulous examination, radiological and biochemical investigations help to arrive at a correct preoperative diagnosis. In this study, a sincere effort has been put to understand the demographic patterns, to understand the underlying aetiology and to understand the effectiveness of the standard methods of investigation and treatment in use today. METHODS This is a 24 months prospective study i.e., from September 2011 to September 2013 carried out at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation. The study included the patients presenting to Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation to emergency ward with signs and symptoms of hollow viscus perforation. The sample size included 30 cases of duodenal perforation. RESULTS Duodenal ulcer perforation commonly occurs in the age group of 30-60 years, but it can occur in any age group. Majority of the patients were male. Smoking and alcohol consumption were risk factors in most cases (53.3% for the causation of duodenal ulcer perforation. Sudden onset of abdominal pain, situated at epigastrium and right hypochondrium was a constant symptom (100%. Vomiting, constipation and fever were not so common. CONCLUSION The emergency surgical management for perforated duodenal ulcer is by

  5. 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…

  6. Neurofibromatosis: Evaluation of Clinical Features of 11 Cases

    OpenAIRE

    Gülşen Akoğlu; Ali Serhan Gazyağcı; İbrahim Kutluer

    2013-01-01

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

  7. The feasibility and clinical application of flat-panel detector computer tomography in evaluating cerebral blood volume: an initial prospective study

    International Nuclear Information System (INIS)

    Objective: To investigate the feasibility and clinical value of the determination of cerebral blood volume (CBV) map by using flat-panel detector computer tomography (FDCT) angiography system. Methods: A prospective self-control clinical trial was conducted in 20 patients with cerebral ischemia who were encountered during the period from June 2010 to March 2011. All the patients were diagnosed as cerebral ischemic diseases and were scheduled to take interventional procedures. All patients underwent cerebral perfusion computer tomography (PCT) and CBV map exam which was performed by flat-panel detector computer tomography (FDCT-CBV). The CBV values obtained by the two exam types were analyzed and compared with each other by using statistic methods. Results: All PCT and FDCT-CBV exams were successfully accomplished in all the twenty patients. A significant correlation existed between the CBV images and CBV values obtained by the two exam types. The correlation coefficient was 0.68 (P<0.01). The Bland-Altman analysis showed a mean difference of -0.25±2.79 between FDCT-CBV and PCT-CBV, indicating that FDCT-CBV values were only slightly lower than those of PCT-CBV. Conclusion: CBV exam by using flat-panel detector angiography system is clinically feasible and the results of FDCT-CBV is comparable to those of PCT-CBV. As the FDCT-CBV can offer functional images of the whole brain within the catheter lab, this technique is very helpful in making the reasonable operation plan and in improving the safety of endovascular procedures in neurosurgery. (authors)

  8. Clinical study of the stunned myocardium

    International Nuclear Information System (INIS)

    Clinical features of 37 cases of stunned myocardium were studied. Mean duration of asynergy was 22.6±15.7 days. In all 11 cases of unstable angina without any significant serum creatine kinase leakage, the duration of asynergy was within 14 days. Related coronary lesions were reperfused (spontaneously or by interventional therapy) to TIMI grade II or higher. Transient Q waves were observed in 39% of all cases. Negative T waves tended to be prolonged, and persisted after disappearance of asynergy in 74% of all cases. 201Tl uptake in the stunned area varied widely between individual cases (ranging from 'absent' to 'normal'), although it became normal in all cases in the chronic stage. Maldistribution of 99mTc-pyrophosphate (PYP) to the endocardial side of the stunned area was observed in 33%. In 186 cases of acute coronary syndrome, we studied whether or not reversibility of ischemia-disturbed myocardium could be predicted by simultaneous dual isotope SPECT, and found that 201Tl-uptake in the chronic stage significantly improved in the region showing absence of 99mTc-PYP accumulation or maldistribution of 99mTc-PYP to the endocardial side, while reversibility of the region showing transmural 99mTc-PYP accumulation and a dought pattern was poor. Ischemia-associated myocardial damage recovered to various degrees, and dual isotope SPECT was useful in evaluating the reversibility of such damage already at the acute stage. (author)

  9. MR enterography to evaluate sub-clinical intestinal inflammation in children with spondyloarthritis

    OpenAIRE

    Stoll Matthew L; Patel Ashish S; Punaro Marilynn; Dempsey-Robertson Molly

    2012-01-01

    Abstract Background Magnetic resonance enterography (MRE) is an established tool to evaluate for changes associated with inflammatory bowel disease (IBD), but has not been studied in sub-clinical IBD. We sought to evaluate the use of MRE in children with spondyloarthritis (SpA), who are at risk of having sub-clinical gut inflammation. Methods Children with juvenile idiopathic arthritis (JIA) with evidence of intestinal inflammation as evidence by an abnormal fecal calprotectin assay were offe...

  10. Development and Evaluation of a Clinical Note Section Header Terminology

    OpenAIRE

    Denny, Joshua C.; Miller, Randolph A; Johnson, Kevin B; Spickard, Anderson

    2008-01-01

    Clinical documentation is often expressed in natural language text, yet providers often use common organizations that segment these notes in sections, such as “history of present illness” or “physical examination.” We developed a hierarchical section header terminology, supporting mappings to LOINC and other vocabularies; it contained 1109 concepts and 4332 synonyms. Physicians evaluated it compared to LOINC and the Evaluation and Management billing schema using a randomly selected corpus of ...

  11. The Role and Interpretation of Pilot Studies in Clinical Research

    OpenAIRE

    Leon, Andrew C.; Davis, Lori L.; Kraemer, Helena C.

    2010-01-01

    Pilot studies represent a fundamental phase of the research process. The purpose of conducting a pilot study is to examine the feasibility of an approach that is intended to be used in a larger scale study. The roles and limitations of pilot studies are described here using a clinical trial as an example. A pilot study can be used to evaluate the feasibility of recruitment, randomization, retention, assessment procedures, new methods, and implementation of the novel intervention.

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

    Science.gov (United States)

    Lomboy, Jason R; Coward, Robert M

    2016-09-01

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

  13. Uremic pruritus. Clinical and experimental studies.

    Science.gov (United States)

    Ståhle-Bäckdahl, M

    1989-01-01

    The aim of the study was to investigate clinical aspects of pruritus in maintenance hemodialysis patients and to evaluate factors of putative pathogenic importance. 60-65% of the patients in a maintenance hemodialysis program during a two-year period suffered from itching. Patients with pruritus tended to have been on dialysis treatment longer than those without pruritus (p = 0.05), otherwise there was no difference in clinical data or routine laboratory tests. Measurement of itch intensity continuously over one week in 28 patients using a computerized method showed that itching peaked at night after two days without dialysis, was relatively high during treatment and lowest during the day following dialysis. Our results suggest that the accumulation of pruritogens between dialysis sessions influences the intensity of itching. Most patients had "dry" skin. Recording of the stratum corneum water content by measurement of electrical capacitance, in 31 patients (19 with pruritus) and 12 controls, disclosed no significant difference between dialysis patients and controls, but a tendency that pruritic patients had a lower water content than the other subjects. In different body areas, there was a positive correlation in all groups between the clinical estimation of xerosis and hydration. Serum concentrations of parathyroid hormone (PTH) were significantly higher in dialysis patients with pruritus than in those without, but there was no correlation between the degree of symptoms and the PTH level. Indirect immunohistochemistry revealed no immunoreactivity for different parts of the PTH molecule in skin biopsies from uremic patients. Intradermal injections of PTH fragments did not evoke itching or other cutaneous reactions in patients or controls. Our results do not support PTH as a peripheral mediator of uremic itching. Flare reactions induced by intradermal histamine injections were significantly smaller in 26 dialysis patients (18 with pruritus) than in 9 healthy

  14. Evaluation of the regenerative potential of 25% doxycycline-loaded biodegradable membrane vs biodegradable membrane alone in the treatment of human periodontal infrabony defects: A clinical and radiological study

    Directory of Open Access Journals (Sweden)

    Chaturvedi Rashi

    2008-01-01

    Full Text Available Background: Microbial colonization of the barrier membranes used for guided tissue regeneration is inevitable and can lead to delayed healing. Aims: Antimicrobial coating of the membrane with 25% doxycycline paste has been attempted to prevent infection and achieve enhanced regeneration in periodontal infrabony defects. Materials and Methods: Twenty-four patients with 2-walled or 3-walled infrabony defects were selected and randomly divided into two equal groups. Infrabony defects of group A were treated with a biodegradable membrane coated with 25% doxycycline while those of group B were treated with membrane alone. Clinical assessment of probing depth and attachment level and radiographic evaluation of the defect depth was done preoperatively and at 12 and 24 weeks postoperatively. Statistical Analysis: The relative efficacy of the two treatment modalities were evaluated using the paired Student′s t- test and the comparative evaluation between the two groups was done using the independent Student′s t -test. Results: Both the groups exhibited a highly significant reduction in probing depth and gain in clinical attachment level and linear bone fill at the end of 24 weeks. Comparative evaluation between the two study groups revealed a significant reduction in probing depth ( P = 0.016 FNx01 and linear bone fill ( P = 0.02 FNx01 in group A as compared to group B. Mean gain in attachment level was greater for group A than for group B but the difference was statistically nonsignificant ( P = 0.065 NS . Conclusions: The results suggest that doxycycline is beneficial in reducing membrane-associated infection and can potentiate regeneration through host modulation.

  15. Two-Dimensional Cutting (TDC) Vitrectome: In Vitro Flow Assessment and Prospective Clinical Study Evaluating Core Vitrectomy Efficiency versus Standard Vitrectome

    OpenAIRE

    Mitrofanis Pavlidis

    2016-01-01

    Purpose. To evaluate comparative aspiration flow performance and also vitrectomy operating time efficiency using a double-cutting open port vitreous cutting system incorporated in a two-dimensional cutting (TDC, DORC International) vitrectome design versus standard vitreous cutter. Methods. In vitro investigations compared aspiration flow rates in artificial vitreous humor at varying cutter speeds and vacuum levels using a TDC vitrectome and a standard vitrectome across different aspiration p...

  16. Clinical Study on the Management of Huzaz/Abria (Dandruff) with a pharmacopoeal Preparation of a Unani Medicine and its Cosmetic Evaluation

    OpenAIRE

    Shah, Altaf Hussain; Haji, Amanullah; Rather, Shameem Ahmad; Ahmad, Tanzeel; Ansari, Abdul Nasir; Soff, G.

    2009-01-01

    Dandruff called Huzaz/Abria in Unani medicine is a common ailment in the world with easy options of treatment. Most of the treatment options have ignored the cosmetic aspect of hair. Unani medicine has got a vast array of drug formulation to evaluate the efficacy of Unani pharmacopoeal formulation in mild form of seborrhic dermatitis of scalp (dandruff). Its efficacy was compared with standard drug (2% ketakonazole shampoo). Patients were enrolled after ethical clearance and informed consent ...

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

    Science.gov (United States)

    Renshaw, Rebecca L.

    2010-01-01

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

  18. Evaluation of effectiveness of hyaluronic acid in combination with bioresorbable membrane (poly lactic acid-poly glycolic acid for the treatment of infrabony defects in humans: A clinical and radiographic study

    Directory of Open Access Journals (Sweden)

    Bhumika Sehdev

    2016-01-01

    Full Text Available Background: The combination of biomaterials, bone graft substitutes along with guided tissue regeneration (GTR has been shown to be an effective modality of periodontal regenerative therapy for infrabony defects. Therefore, the present randomized controlled clinical study was undertaken to evaluate the effectiveness of hyaluronic acid (HA in combination with bioresorbable membrane for the treatment of human infrabony defects. Materials and Methods: Twenty four infrabony defects in 20 systemically healthy patients were randomly assigned to test (HA in combination with bioresorbable membrane and control (bioresorbable membrane alone treatment groups. Probing pocket depth (PPD, relative attachment level, and relative gingival margin level were measured with a computerized Florida disc probe at baseline and at 6 months follow-up. Radiographic measurements were also evaluated at baseline and at 6 months of postsurgery. Results: At 6 months, the mean reduction in PPD in test group and control group was 4.52 mm and 2.97 mm, respectively. Significantly higher clinical attachment level with a gain of 2.20 mm was found in the test group as compared to control group. In addition, statistically significant greater reduction of radiographic defect depth was observed in the test group. Conclusion: Regenerative approach using hyaloss in combination with GTR for the treatment of human infrabony defects resulted in a significant added benefit in terms of CAL gains, PPD reductions and radiographic defect fill, as well as LBG, compared to the GTR alone.

  19. Evaluation of effectiveness of hyaluronic acid in combination with bioresorbable membrane (poly lactic acid-poly glycolic acid) for the treatment of infrabony defects in humans: A clinical and radiographic study

    Science.gov (United States)

    Sehdev, Bhumika; Bhongade, Manohar Laxmanrao; Ganji, Kiran Kumar

    2016-01-01

    Background: The combination of biomaterials, bone graft substitutes along with guided tissue regeneration (GTR) has been shown to be an effective modality of periodontal regenerative therapy for infrabony defects. Therefore, the present randomized controlled clinical study was undertaken to evaluate the effectiveness of hyaluronic acid (HA) in combination with bioresorbable membrane for the treatment of human infrabony defects. Materials and Methods: Twenty four infrabony defects in 20 systemically healthy patients were randomly assigned to test (HA in combination with bioresorbable membrane) and control (bioresorbable membrane alone) treatment groups. Probing pocket depth (PPD), relative attachment level, and relative gingival margin level were measured with a computerized Florida disc probe at baseline and at 6 months follow-up. Radiographic measurements were also evaluated at baseline and at 6 months of postsurgery. Results: At 6 months, the mean reduction in PPD in test group and control group was 4.52 mm and 2.97 mm, respectively. Significantly higher clinical attachment level with a gain of 2.20 mm was found in the test group as compared to control group. In addition, statistically significant greater reduction of radiographic defect depth was observed in the test group. Conclusion: Regenerative approach using hyaloss in combination with GTR for the treatment of human infrabony defects resulted in a significant added benefit in terms of CAL gains, PPD reductions and radiographic defect fill, as well as LBG, compared to the GTR alone. PMID:27041838

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

    Science.gov (United States)

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

    2014-01-01

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

  1. Systematic evaluation of the clinical effects of supportive mistletoe treatment within chemo- and/or radiotherapy protocols and long-term mistletoe application in nonmetastatic colorectal carcinoma: multicenter, controlled, observational cohort study.

    Science.gov (United States)

    Friedel, Walter E; Matthes, Harald; Bock, Paul R; Zänker, Kurt S

    2009-01-01

    In Europe, patients with colorectal carcinoma (CRC) frequently receive mistletoe extracts to improve quality of life and survival. This study was designed to evaluate supportive treatment with mistletoe extract Iscador (ISC) in nonmetastatic CRC patients under routine clinical conditions and to create well-founded hypotheses for future prospective clinical studies. The design of a multicenter, controlled, retrospective, observational cohort study with parallel groups met the Good Epidemiological Practice rules. Anonymous unselected standardized data from eligible patients with surgically treated stage I-III CRC and adjuvant therapy (AT) or conventional aftercare were included. End points were adjuvant therapy-related adverse reactions (AT-ADRs), symptoms, and disease-free survival (DFS). The results were adjusted for confounder effects. Eight hundred four (429 ISC vs 375 control) CRC patients from 26 centers were observed for a median of 58 versus 51 months; the median ISC therapy lasted 52 months. ISC patients showed fewer AT-ADRs (19% vs 48%, p controls. ISC was well tolerated without life-threatening ADRs, drug interactions, or tumor enhancement. These results suggest a beneficial effect of supportive care ISC therapy within AT protocols and long-term ISC treatment in stage I-III CRC patients, particularly improvement in AT-ADRs and symptoms and possible extension of DFS. PMID:19883529

  2. Clinical evaluation of GEM 21S® and a collagen membrane with a coronally advanced flap as a root coverage procedure in the treatment of gingival recession defects: A comparative study

    OpenAIRE

    Preetinder Singh; Suresh, D. K.

    2012-01-01

    Aim: Clinical evaluation of efficacy of rhPDGF-BB plus beta tricalcium phosphate (GEM 21S ® ) along with a collagen membrane in root coverage using a coronally advanced flap. Materials and Methods: This human case series evaluated the clinical outcome of rhPDGF-BB with beta-tricalcium phosphate (GEM 21S®) and a collagen membrane in the treatment of recession defects using a coronally advanced flap. Patients were followed postoperatively, and healing was evaluated at 1, 3, and 6 months, with r...

  3. Embedding clinical interventions into observational studies.

    Science.gov (United States)

    Newman, Anne B; Avilés-Santa, M Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm James; Krucoff, Mitchell; Kuller, Lewis H; Lewis, Cora E; Robinson, Jennifer G; Taylor, Herman; Treviño, Roberto P; Weintraub, William

    2016-01-01

    Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. PMID:26611435

  4. Clinical and radiological evaluation of impaction of supernumerary teeth

    OpenAIRE

    Tuna, Elif-Bahar; Kurklu, Esma; Gencay, Koray; Ak, Gulsum

    2013-01-01

    Abstract Objective: To describe the clinical and radiological features of children with inverted supernumerary teeth. Study Design: Thirty eight patients with inverted supernumerary teeth (ST) were enrolled in this descriptive and restrospective study. Data from patient records including age, gender, status of dentition, number of ST, number of ST in inverted position, coexistence of ST in inverted and normal direction of eruption, location, orientation, morphology, clinical...

  5. Clinical and radiological evaluation of inverse impaction of supernumerary teeth

    OpenAIRE

    Tuna, Elif B.; Kurklu, Esma; Gencay, Koray; Ak, Gulsum

    2013-01-01

    Objective: To describe the clinical and radiological features of children with inverted supernumerary teeth. Study Design: Thirty eight patients with inverted supernumerary teeth (ST) were enrolled in this descriptive and restrospective study. Data from patient records including age, gender, status of dentition, number of ST, number of ST in inverted position, coexistence of ST in inverted and normal direction of eruption, location, orientation, morphology, clinical complications, management ...

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

    DEFF Research Database (Denmark)

    Lifson, A; Rahme, FS; Belloso, WH; Dragsted, Ulrik Bak; El-Sadr, WM; Gatell, JM; Hoy, JF; Krum, EA; Nelson, R; Pedersen, C; Pett, SL; Davey, RT

    2006-01-01

    adjudication between reviewers before diagnostic certainty was assigned. CONCLUSION: Important requirements for HIV trials using clinical endpoints include objective definitions of "confirmed" and "probable," a formal reporting process with adequate information and supporting source documentation, evaluation......PURPOSE: The processes for reporting and review of progression of HIV disease clinical endpoints are described for two large phase III international clinical trials. METHOD: SILCAAT and ESPRIT are multicenter randomized HIV trials evaluating the impact of interleukin-2 on disease progression and...... death in HIV-infected patients receiving antiretroviral therapy. We report definitions used for HIV progression of disease endpoints, procedures for site reporting of such events, processes for independent review of reported events by an Endpoint Review Committee (ERC), and the procedure for...

  7. PPB | What is a Clinical Study

    Science.gov (United States)

    The Pleuropulmonary blastoma (PPB) DICER1 Syndrome Study ‹an observational clinical research study‹is enrolling children with PPB and their families. In an observational study, investigators assess health outcomes in groups of participants according to a protocol or research plan.

  8. The clinical & neurophysiological study of leprosy

    OpenAIRE

    Cabalar, Murat; Yayla, Vildan; Ulutas, Samiye; Senadim, Songul; Oktar, Ayla Culha

    2014-01-01

    Objectives: The aim of this study was to evaluate neurological and neurophysiological features of leprosy. Methods: Seventy seven hospitalized leprosy patients (52 male, 25 female) were examined neurological and neurophysiologically between 2010 and 2012. Standard procedures were performed for evaluating sensory and motor conduction studies to all patients. Motor studies were carried out on median, ulnar, tibial and common peroneal nerves. Sensory studies were carried out on median, ulnar and...

  9. Assessment of abdominal aortic aneurysms using a cone-beam CT system. An experimental phantom study and an initial clinical evaluation before and after stent-graft treatment in patients with an abdominal aortic aneurysm

    International Nuclear Information System (INIS)

    The aim of this study is to conduct a quantitative analysis of cone-beam CT (CBCT) images using a phantom, and then to evaluate the clinical usefulness of CBCT in the assessment of abdominal aortic aneurysms (AAA) before and after stent-grafting, both qualitatively as well as quantitatively. The phantom used in this study was a rectangular plate made of an acrylic resin, which contained eight through-holes to mimic blood vessels. Each columnar cavity was filled with contrast media and the diameter of each was then measured using a cone-beam multiplanar reformation/curved planar reformation (CB-MPR/CPR) technique, and the results were compared with the corresponding results obtained by actual measurement. In the clinical assessment, nine patients with AAA (consisting only of males with an average age of 68 years old: 56-80) were enrolled. The clinical qualitative analysis of CBCT consisted of: for the pre-operative state, the shape of the aortic aneurysm, the relationship between the aneurysm and the aortic branches, and for the post-operative state, the shape of the stent and any endoleakage present. The clinical quantitative analysis of CBCT included, for the aneurysm, its inflection angle, its maximum diameter, the diameter of the proximal and distal necks, and the distance of these two necks from specific reference points. The quantitative analysis using the phantom showed no significant differences between the results based on CB-MPR/CPR and those obtained by actual measurement. In the clinical qualitative analysis three-dimensional CBCT (3D-CBCT) depicted the anatomical relationship between the aneurysm and the aortic branches well, an accomplishment that was not possible by conventional angiography. Cone-beam maximum intensity projection (CB-MIP) was as good in tracing the migration and deformation of the stent following endovascular intervention as plain radiograms and conventional angiograms. CB-MPR/CPR enabled us to obtain any cross-sectional image of the

  10. Erratum to "Clinical evaluation of the intraoral fluoride releasing system in radiation-induced xerostomic subjects. Part 2: Phase I study".

    Science.gov (United States)

    Chambers, Mark S; Fleming, Terence J; Toth, Béla B; Lemon, James C; Craven, Timothy E; Bouwsma, Otis J; Garden, Adam S; Espeland, Mark A; Keene, Harris J; Martin, Jack W; Sipos, Tibor

    2007-01-01

    Radiation-induced xerostomia can result in the rapid onset and progression of dental caries in head and neck cancer patients. Topically applied fluorides have been successfully used to inhibit the formation of dental caries in this population. However, because intensive daily self-application is required, compliance is an issue. The intraoral fluoride-releasing system (IFRS) containing a sodium fluoride core is a newly developed, sustained-release, passive drug delivery system that does not require patient involvement except for periodic replacement, thus reducing the effect of patient compliance on its effectiveness in dental caries prevention. Twenty-two head and neck cancer patients from U. T. M. D. Anderson Cancer Center, with radiation-induced xerostomia, were entered into a pilot study to contrast the daily home use of a 0.4% stannous fluoride-gel-containing tray (control group) to IFRS (study group) with respect to tolerability and adherence, and to obtain information on relative caries preventive efficacy. Participants were stratified on the basis of radiation exposure and randomly assigned to treatment with either IFRS or stannous fluoride gel. Patients in both groups were fitted with two IFRS retainers and also were instructed to use a 1100-ppm fluoride conventional sodium fluoride dentifrice twice daily. The study was conducted as a single-blinded, parallel-cell trial. Pre-existing carious lesions were restored prior to the beginning of the study. The efficacy variable was determined by the mean number of new or recurrent decayed surfaces. Patients were examined for caries 4, 8, 12, 24, 36, and 48 weeks after initiation of treatment. Reports of adverse reactions were based on information volunteered by patients and that were elicited during interviews. At baseline, the resting and stimulated salivary flow rates (g/5min) were significantly greater in the control group than in the study group (pIFRS groups during the study period. The rate of new or

  11. Advances in clinical study of curcumin.

    Science.gov (United States)

    Yang, Chunfen; Su, Xun; Liu, Anchang; Zhang, Lin; Yu, Aihua; Xi, Yanwei; Zhai, Guangxi

    2013-01-01

    Curcumin has been estimated as a potential agent for many diseases and attracted great attention owing to its various pharmacological activities, including anti-cancer, and anti-inflammatory. Now curcumin is being applied to a number of patients with breast cancer, rheumatoid arthritis, Alzheimer's disease, colorectal cancer, psoriatic, etc. Several clinical trials have stated that curcumin is safe enough and effective. The objective of this article was to summarize the clinical studies of curcumin, and give a reference for future studies. PMID:23116307

  12. A comparative infection study of pigeon and avian paramyxovirus type 1 viruses in pigeons: Evaluation of clinical signs, virus shedding and seroconversion

    NARCIS (Netherlands)

    Dortmans, J.C.F.M.; Koch, G.; Rottier, P.J.M.; Peeters, B.P.H.

    2011-01-01

    The pathogenesis of pigeon paramyxovirus type 1 (PPMV-1) isolate AV324/96 and of its recombinant derivative, rgAV324, was studied in pigeons. For comparison, the virulent chicken virus FL-Herts, which is a recombinant derivative of strain Herts/33, was also included. After inoculation by the combine

  13. A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. Trandolapril Cardiac Evaluation (TRACE) Study Group

    DEFF Research Database (Denmark)

    Køber, L; Torp-Pedersen, C; Carlsen, J E;

    1995-01-01

    BACKGROUND. Treatment with angiotensin-converting-enzyme (ACE) inhibitors reduces mortality among survivors of acute myocardial infarction, but whether to use ACE inhibitors in all patients or only in selected patients is uncertain. METHODS. We screened 6676 consecutive patients with 7001......, and the development of severe heart failure. That mortality was reduced in a randomized study enrolling 25 percent of consecutive patients screened should encourage the selective use of ACE inhibition after myocardial infarction....

  14. A clinical and radiographic study to evaluate the rate of retraction of maxillary canine using nickel-titanium closed coil spring with two different bracket systems

    OpenAIRE

    P Adarsh Reddy; Ramachandra Prabhakar; Swati Saraswata Acharya; Karthikeyan, M.K

    2014-01-01

    Objectives: This study compares the efficiency of self-ligating brackets with the conventional preadjusted edgewise (PEA) brackets during maxillary canine retraction using nickel-titanium closed coil springs. Materials and Methods: The sample comprised of 20 healthy patients (10 males and 10 females), within age groups 16-26 years (mean, 20 years) having Class I malocclusion with bimaxillary protrusion. All patients underwent bilateral extraction of the maxillary first bicuspids and retractio...

  15. Evaluation of different imaging chains in clinical chest radiography

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-11-01

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

  16. Clinical evaluation of desensitizing treatments for cervical dentin hypersensitivity

    Directory of Open Access Journals (Sweden)

    Ana Cecilia Corrêa Aranha

    2009-09-01

    Full Text Available The aim of this study was to compare different treatments for dentin hypersensitivity in a 6-month follow-up. One hundred and one teeth exhibiting non carious cervical lesions were selected. The assessment method used to quantify sensitivity was the cold air syringe, recorded by the visual analogue scale (VAS, prior to treatment (baseline, immediately after topical treatment, after 1 week, 1, 3 and 6 months. Teeth were randomly assigned to five groups (n = 20: G1: Gluma Desensitizer (GD; G2: Seal&Protect (SP; G3: Oxa-gel (OG; G4: Fluoride (F; G5: Low intensity laser-LILT (660 nm/3.8 J/cm²/15 mW. Analysis was based on the non-parametric Kruskal-Wallis test that demonstrated statistical differences immediately after the treatment (p = 0.0165. To observe the individual effects of each treatment, data was submitted to Friedman test. It was observed that GD and SP showed immediate effect after application. Reduction in the pain level throughout the six-month follow-up was also observed. In contrast, LILT presented a gradual reduction of hypersensitivity. OG and F showed effects as of the first and third month respectively. It can be concluded that, after the 6-month clinical evaluation, all therapies showed lower VAS sensitivity values compared with baseline, independently of their different modes of action.

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

    Directory of Open Access Journals (Sweden)

    Jangle Vidya Muralidhar

    2012-10-01

    Full Text Available Urolithiasis, a presence of calculi single or multiple in renal or urinary tracks is a clinical entity which has been universally accepted as problematic condition regarding its treatment in all systems of medical science. There is no known drug therapy at present which dissolves or fragments the calculi by changing lithogenic potential of particular person. Urinary calculi disease has been described in detail under the heading of Ashmari in Ayurvedic texts. Ashmari is one of the few surgical conditions which have been given very prominent place in Ayurveda by Acharya Sushruta and Various herbs like Kulattha (Dolicos Biflorus, Gokshura (Tribulus Terrestris, Apamarga (Achyranthes Aspera, Pashanbheda (Berginia Lingulata and Varuna (Crataeva Nurvela etc. and herbomineral compounds are described which are effective against urolithiasis by dissolving calculi thus facilitating their expulsion. This study was aimed to evaluate Ashmaribhedana property of “Kulatthadi yoga” in Mutrashmari to make an effective, long lasting, cost effective, authentic alternative & easily available conservative management of Mutrashmari. After observation, it was found that Kulatthadi Yoga is effective in Kapha-Vataja Mutrashmari & control group shows significant result in Mutrashmari.

  18. Marketing and clinical trials: a case study

    Directory of Open Access Journals (Sweden)

    Entwistle Vikki A

    2007-11-01

    Full Text Available Abstract Background Publicly funded clinical trials require a substantial commitment of time and money. To ensure that sufficient numbers of patients are recruited it is essential that they address important questions in a rigorous manner and are managed well, adopting effective marketing strategies. Methods Using methods of analysis drawn from management studies, this paper presents a structured assessment framework or reference model, derived from a case analysis of the MRC's CRASH trial, of 12 factors that may affect the success of the marketing and sales activities associated with clinical trials. Results The case study demonstrates that trials need various categories of people to buy in – hence, to be successful, trialists must embrace marketing strategies to some extent. Conclusion The performance of future clinical trials could be enhanced if trialists routinely considered these factors.

  19. Radiological Evaluation of Temporomandibular Joint Disorders Followed by Clinical Symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Won; You Dong Soo [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1989-11-15

    The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4 : 1. 2. The most common clinical findings was the pain on open mouth position (42.43%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. 7. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.

  20. Radiological Evaluation of Temporomandibular Joint Disorders Followed by Clinical Symptoms

    International Nuclear Information System (INIS)

    The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4 : 1. 2. The most common clinical findings was the pain on open mouth position (42.43%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. 7. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.

  1. A comparative study on efficacy of different treatment modalities of oral submucous fibrosis evaluated by clinical staging in population of Southern Rajasthan

    Directory of Open Access Journals (Sweden)

    Saurabh Goel

    2015-01-01

    Full Text Available Aim: To compare the efficacy of oral lycopene and injection betamethasone with control group in the management of oral submucous fibrosis. Materials and Methods: A hospital based longitudinal study, conducted on 270 patients over a period of 2 years (September 2010-September 2012. Results: Out of 270 cases 223 (82.59% were males and 47 (17.40% were females which showed a male predominance and the ratio was 5:1. In stage I it was found that both the test groups, i.e., injection betamethasone and capsule lycopene had a significant improvement in mouth opening than control group. In stage II, it was found that the test group injection betamethasone showed 24 better results as compared to capsule lycopene this could be because of better accessibility of the fibrotic bands for injecting betamethasone solution at the site of the lesion and showed highly significant difference (P < 0.0001. In stage III, it was found that the capsule lycopene showed better results as compared to injection betamethasone and the difference was highly significant (P < 0.0001. This could be because of restricted mouth opening and inability to reach the site for injecting betamethasone solution. Conclusion: It is evident from the study that capsule lycopene and injection betamethasone hold good promise in the treatment of this multifactorial crippling disease.

  2. Clinical evaluation of GEM 21S® and a collagen membrane with a coronally advanced flap as a root coverage procedure in the treatment of gingival recession defects: A comparative study

    Directory of Open Access Journals (Sweden)

    Preetinder Singh

    2012-01-01

    Full Text Available Aim: Clinical evaluation of efficacy of rhPDGF-BB plus beta tricalcium phosphate (GEM 21S ® along with a collagen membrane in root coverage using a coronally advanced flap. Materials and Methods: This human case series evaluated the clinical outcome of rhPDGF-BB with beta-tricalcium phosphate (GEM 21S® and a collagen membrane in the treatment of recession defects using a coronally advanced flap. Patients were followed postoperatively, and healing was evaluated at 1, 3, and 6 months, with recession depth as the primary outcome measure. Results : This pioneer case series revealed a favorable tissue response to GEM 21S® and collagen membrane from both clinical and esthetic point of view in regenerative periodontal surgery.

  3. Humanizing Oral Health Care through Continuing Education on Social Determinants of Health: Evaluative Case Study of a Canadian Private Dental Clinic.

    Science.gov (United States)

    Lévesque, Martine; Levine, Alissa; Bedos, Christophe

    2016-01-01

    Primary care practitioners are frequently unprepared to take into account the effects of social determinants on underprivileged patients' health and health management. To address this issue among dental professionals, an original onsite continuing education (CE) course on poverty was co-developed by researchers, dental professionals, and community organizations. Integrating patient narratives and a short film, course material aims to elicit critical reflection and provide coaching for practice improvements. A qualitative case study conducted with a large Montreal Canada dental team reveals CE course participants' newfound understandings and increased sensitivity to the causes of poverty and the nature of life on welfare. Participants also describe revised interpretations of certain patient behaviors, subtle changes in communication with patients and improved equity in appointment-giving policy. Unintended outcomes include reinforced judgment and a tendency to moralize certain patient categories. Implications for health professional educators, researchers, and dental regulatory authorities are discussed. PMID:27524746

  4. A clinical and radiographic study to evaluate the rate of retraction of maxillary canine using nickel-titanium closed coil spring with two different bracket systems

    Directory of Open Access Journals (Sweden)

    P Adarsh Reddy

    2014-01-01

    Full Text Available Objectives: This study compares the efficiency of self-ligating brackets with the conventional preadjusted edgewise (PEA brackets during maxillary canine retraction using nickel-titanium closed coil springs. Materials and Methods: The sample comprised of 20 healthy patients (10 males and 10 females, within age groups 16-26 years (mean, 20 years having Class I malocclusion with bimaxillary protrusion. All patients underwent bilateral extraction of the maxillary first bicuspids and retraction of the maxillary canines with fixed self-ligating brackets (3M Smart clip and PEA appliance (3M Gemini. The initial records included standard intra- and extra-oral photographs, study models, lateral cephalograms, and panoramic radiographs. Results: The mean distal movement of canines in self-ligating brackets was 0.89 mm/mo with standard deviation of 0.255 and in preadjusted edgewise brackets, the mean distal movement of canines was 0.87 mm/mo with standard deviation of 0.214. The mean tipping of canine in self-ligating brackets was 7.45 ± 1.050(0 and in PEA brackets it was 7.70° ± 1.21°. The mean rotation of canine in self-ligating brackets was 7.65° ± 3.47° and in preadjusted edgewise appliance it was 12.30° ± 3.08°. Conclusion: The rates of distal movement of the maxillary canines were similar with both conventional and self-ligating brackets. Rotation of the maxillary canines during retraction was minimized with self-ligating brackets in comparison to conventional bracket systems.

  5. Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy in high myopia: a prospective clinical study

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    Fotouhi Akbar

    2004-09-01

    Full Text Available Abstract Background To study the effect of prophylactic application of mitomycin-C on haze formation in photorefractive keratectomy (PRK for high myopia. Methods Fifty-four eyes of 28 myopic patients were enrolled in this prospective study. All eyes were operated by PRK followed by 0.02% mitomycin-C application for two minutes and washed with 20 ml normal saline afterwards. All eyes were examined thoroughly on the first 7 days and one month after surgery; 48 eyes (88.9% at 3 and 6 months postoperatively. Hanna grading (in the scale of 0 to 4+ was used for assessment of corneal haze. Results The mean spherical equivalent refraction (SE was -7.08 diopters (D ± 1.11 (SD preoperatively. Six months after surgery, 37 eyes (77.1% achieved an uncorrected visual acuity (UCVA of 20/20 or better, all eyes had a UCVA of 20/40 or better and 45 (93.7% eyes had an SE within ± 1.00D. One month postoperatively, 2 eyes (3.7% had grade 0.5+ of haze, while at 3 and 6 months after surgery no visited eye had haze at all. All eyes had a best corrected visual acuity (BCVA of 20/40 or better and there were no lost lines in BCVA by 6 months after surgery. In spatial frequencies of 6 and 12 cycles per degree contrast sensitivity had decreased immediately after PRK and it had increased 1.5 lines by the 6th postoperative month compared to the preoperative data. Conclusions The results show the efficacy of mitomycin-C in preventing corneal haze after treatment of high myopia with PRK. This method- PRK + mitomycin-C – can be considered an alternative treatment for myopic patients whose corneal thicknesses are inadequate for laser in situ keratomileusis (LASIK. However, the results should be confirmed in longer follow-ups.

  6. Clinical study on evaluation of anti-cataract effect of Triphaladi Ghana Vati and Elaneer Kuzhambu Anjana in Timira (immature cataract)

    Science.gov (United States)

    Bhati, Hitesh; Manjusha, R.

    2015-01-01

    Introduction: Senile cataract is the leading cause of blindness according to the World Health Report, 1998. Till date no accepted medical treatment is available for cataract. In Ayurveda visual disturbances are described in the context of Timira, Kacha and Linganasha. Timira is an early stage characterized by blurring of vision and Linganasha is end stage where complete loss of vision occurs. Ancient scholars have advocated different Anjana application and oral medications in the Timira and Kacha stage. Aim: To study the efficacy of test drugs Triphaladi Ghana Vati and Elaneer Kuzhambu Anjana in immature cataract. Materials and Methods: In this trial patients having Senile Immature Cataract were randomized with equal probability to one of the two treatment Groups A and B (n = 20 each). In Group A Triphaladi Ghana Vati 500 mg internally for 3 months and in Group B Triphaladi Ghana Vati 500 mg internally and Elaneer Kuzhambu Anjana for local application were given. Assessment was done on the basis of blurring of vision, visualization of nonexisting things, difficulty in bright light and dim light or night vision, distant visual acuity, pinhole vision, best corrected visual acuity and cataract grading on slit lamp. Results: Both groups showed statistically significant changes in blurring of vision, difficulty in glare, daytime and bright light, distant visual activity, pinhole vision, and best-corrected visual acuity. Group B also showed significant changes in difficulty in night time, visualization of nonexisting things and in nuclear cataract. Conclusion: The study establishes that test drugs can reduce and control the progress of immature cataract, and combined therapy was found more effective. Chakshushya Rasayana, early diagnosis and proper management on Doshic lines can prevent arrest or delay senile cataract.

  7. Musculoskeletal demands on flamenco dancers: a clinical and biomechanical study.

    Science.gov (United States)

    Bejjani, F J; Halpern, N; Pio, A; Dominguez, R; Voloshin, A; Frankel, V H

    1988-04-01

    The flamenco dancer acts on the floor like a drummer. The percussive footwork and vibration patterns created during dancing impose unusual demands on the musculoskeletal system. This study investigated the clinical and biomechanical aspects of this task. Using the electrodynogram and skin-mounted accelerometers, foot pressures as well as hip and knee vibrations were recorded in 10 female dancers after a thorough clinical evaluation. A health questionnaire was also distributed to 29 dancers. Foot pressures and acceleration data reveal the percussive nature of the dance. Some clinical findings, like calluses, are related to pressure distribution. Urogenital disorders, as well as back and neck pain, may be related to the vibrations generated by the flamenco dance form. The hip joint seems to absorb most of the impacts. "Vibration-pressure" diagrams are suggested as a useful tool for evaluating a dancer's biomechanical behavior, as well as the effect of floors and footwear on this behavior. PMID:3366430

  8. Case Studies: Windows onto Clinical Supervision.

    Science.gov (United States)

    Nolan, Jim; And Others

    1993-01-01

    By examining the structures and activities common to six case studies of clinical teacher supervision, this article identifies five conditions that facilitate changes in teacher thinking and behavior: development of a supportive, collegial relationship; teacher control over supervision products; continuity over time; focused, descriptive records…

  9. Comparative evaluation of a dentifrice containing calcium sodium phosphosilicate to a dentifrice containing potassium nitrate for dentinal hypersensitivity: A clinical study

    Directory of Open Access Journals (Sweden)

    Tanya Satyapal

    2014-01-01

    Full Text Available Background: Calcium sodium phosphosilicate is a recently introduced desensitizing agent which acts by occluding the dentinal tubules and also resists acid decalcification. This study was designed to assess the efficacy of a new toothpaste containing 5% calcium sodium phosphosilicate for the treatment of dentinal hypersensitivity and also compare it with 5% potassium nitrate. Materials and Methods: Sixty patients with the chief complaint of dentinal hypersensitivity were enrolled and randomly divided into two groups. The visual analog scale (VAS scores were taken for water and air stimuli at baseline, 3 weeks after usage of the respective toothpaste, and 3 weeks after discontinuation of the respective toothpaste. Results: Both the groups showed reduction in hypersensitivity scores at 3 weeks and 6 weeks for air stimulus and cold water. The calcium sodium phosphosilicate group, however, showed significantly reduction in hypersensitivity compared to the potassium nitrate group at any time point for both measures of hypersensitivity. Conclusion: The 5% calcium sodium phosphosilicate group showed immense reduction in dentinal hypersensitivity symptoms. The 5% calcium sodium phosphosilicate showed prolonged effects even after discontinuation as compared to 5% potassium nitrate, due to its dentinal tubular occlusion property.

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

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H;

    2014-01-01

    MEASUREMENT PROPERTIES OF EXISTING CLINICAL ASSESSMENT METHODS EVALUATING SCAPULAR POSITIONING AND FUNCTION. A SYSTEMATIC REVIEW1,2Camilla Marie Larsen, 1,3Birgit Juul-Kristensen, 1,3Hans Lund, 1Karen Søgaard1Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark2...... of the available clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. METHODS A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in...... groups: Static positioning assessment (n=19), Semi-dynamic (n=13), and Dynamic functional assessment (n=22). Fifteen studies were excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health...

  11. Clinical and audiological evaluation of hearing impaired children

    Directory of Open Access Journals (Sweden)

    Zafarullah Beigh

    2012-01-01

    Full Text Available Daily activities, interpersonal relationship, employment, and general well being; among such skills, communication skills are essential to a successful life for all individuals. Such skills affect education, adequate hearing acuity is of paramount importance and acts as a prerequisite in the overall personality development of an individual. Hearing impairment at any age has serious effects on the day to day life of an individual and he/she feels handicapped socially, emotionally, and scholastically. A child stuck with this malady is a back bencher in the class, excommunicative, and absent-minded. This study was conducted in order to find out various causes of hearing impairment in children and to study role of various audiological and radiological tests in finding the cause of impaired hearing in children. Aims and Objectives: To assess the possible etiological causes of hearing impairment in children. Study role of various audiological tests in finding the cause of impaired hearing in children. Study Design: Prospective study. Materials and Methods: This study was conducted in the Department of ENT and HNS of government medical college Srinagar. A total of 150 children of age range 0-14 years visited our ENT Department with complaints of impaired hearing, but only 70 children who met the inclusion criteria of impaired hearing and defective/delayed speech were selected for this study. Results of initial evaluation by means of comprehensive clinical history and followed by proper thorough systemic physical examination from head to toe was performed. These hearing impaired children were subjected to various subjective and objective tests; pure tone audiometry and behavioral observation audiometry were performed for subjective tests and impedance audiometry, Oto-acoustic emissions (OAE, and brainstem evoked response audiometry (BERA were performed for objective tests. Results: Possible etiological cause on the basis of history were birth anoxia (2

  12. Evaluation of pharmacist clinical interventions in a Dutch hospital setting

    NARCIS (Netherlands)

    Bosma, Liesbeth; Jansman, Frank G. A.; Franken, Anton M.; Harting, Johannes W.; Van den Bemt, Patricia M. L. A.

    2008-01-01

    Objective Assessing the relevance of a clinically active pharmacist method compared to the traditional working method. Method The study was carried out in a general internal/gastro-enterology unit during two 8-weeks periods in 2004. It was an observational, non-randomized prospective study. Outcome

  13. Left ventricular noncompaction: Clinical-echocardiographic study

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    Nikolić Aleksandra

    2012-01-01

    Full Text Available Background/Aim. Left ventricular noncompaction (LVNC is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System. Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ± 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

  14. A CLINICAL STUDY OF STROKE IN YOUNG

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    Kumbha Thulasi Ram

    2015-02-01

    Full Text Available NTRIDUCTION : Stroke is one of the important causes of morbidity and mortality all over the world. Incidence of stroke steadily increases with age. Experts are concerned of the emerging stroke epidemic in India. Stroke affecting the young has potentially devastating consequence son the individual and his family. Certain risk factors are unique to the young. I t needs more studies for identification and modification of risk factors. The study aims to evaluate clinical features, risk factors, etiology and mortality of stroke in young patients. METHODS : 74 young patients satisfying the inclusion criteria were included in this study. A detailed history was taken from young stroke patients, systemic examination and required investigations were done. Data was collected in standardized proforma and analysed. RESULTS: Stroke in young accounts for 7.95% of stroke cases of all age groups. The mean age of the patients was 34.66 ± 7.48 years. Among 74 patients, 47(63.51% were male and 27(36.49% were female. Seizures, decreased consciousness, speech involvement and motor deficit were observed in 33.78%, 44.59%, 22.97% and 100% of cases respectively. 82.43% patients had ischemic and 17.57% patients had hemorrhagic stroke. Among ischemic stroke, large artery atherosclerosis was 16.21%, tuberculous meningoencephalitis with vasculitis was 16.21%, lacunar stroke was 10.81%, CVT was 10.81% and cardio embolic stroke was 6.76%. Smoking (59.45%, alcoholism (58.10%, hypertension (43.24%, coronary artery disease (8.10%, diabetes mellitus (10.81%, elevated total cholesterol (25.67%, elevated low density lipo proteins (22.97%, elevated triglycerides (27.02% and low HDL (22.97% were important risk factors. Carotid doppler was abnormal in 9.45% of patients. 6.76% patients had mitral stenosis in echocardiogram. Low protein C and protein S were found in 1.35% of patients. Eight (10.81% patients died during the hospital stay. INTERPRETATION AND CONCLUSIONS: The major risk

  15. A CLINICAL STUDY OF CHRONIC DEPRESSION

    OpenAIRE

    Singhal, S; Kumar, S.; Agarwal, A K

    1991-01-01

    SUMMARY Neurological status of chronic depressive states have not been resolved as yet. Recent classificatory systems ICD-X and DSM-III-R have included chronic depression under affective disorders and have done away with the category of neurotic depression. The present study was undertaken with the aims of (a) to study clinical variables associated with major subtypes of chronic depression (chronic major depression and dysthymia) and (b) to investigate personality characteristics and life eve...

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

    Science.gov (United States)

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

    2012-01-01

    Objective: Independent evaluators (IE) are used widely in clinical trials to make unbiased determinations of treatment response. By virtue of being kept blind to treatment condition, however, IEs are also kept unaware of many pertinent clinical details that are relevant for decisions about clinical improvement. In this study, agreement among…

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

    Science.gov (United States)

    Lee, Seon Ah

    2010-01-01

    The purpose of this study was to develop a tool to evaluate the quality of a clinical information system (CIS) conceived by nurses and conduct a pilot test with the developed tool as an initial assessment. CIS quality is required for successful implementation in information technology (IT) environments. The study started with the realization that…

  18. INVESTIGATE-I (INVasive Evaluation before Surgical Treatment of Incontinence Gives Added Therapeutic Effect?: study protocol for a mixed methods study to assess the feasibility of a future randomised controlled trial of the clinical utility of invasive urodynamic testing

    Directory of Open Access Journals (Sweden)

    Armstrong Natalie

    2011-07-01

    Full Text Available Abstract Background Urinary incontinence is an important health problem to the individual sufferer and to health services. Stress and stress predominant mixed urinary incontinence are increasingly managed by surgery due to advances in surgical techniques. Despite the lack of evidence for its clinical utility, most clinicians undertake invasive urodynamic testing (IUT to confirm a functional diagnosis of urodynamic stress incontinence before offering surgery for this condition. IUT is expensive, embarrassing and uncomfortable for women and carries a small risk. Recent systematic reviews have confirmed the lack of high quality evidence of effectiveness. The aim of this pilot study is to test the feasibility of a future definitive randomised control trial that would address whether IUT alters treatment decisions and treatment outcome in these women and would test its clinical and cost effectiveness. Methods/design This is a mixed methods pragmatic multicentre feasibility pilot study with four components:- (a A multicentre, external pilot randomised trial comparing basic clinical assessment with non-invasive tests and IUT. The outcome measures are rates of recruitment, randomisation and data completion. Data will be used to estimate sample size necessary for the definitive trial. (b Qualitative interviews of a purposively sampled sub-set of women eligible for the pilot trial will explore willingness to participate, be randomised and their overall trial experience. (c A national survey of clinicians to determine their views of IUT in this context, the main outcome being their willingness to randomise patients into the definitive trial. (d Qualitative interviews of a purposively sampled group of these clinicians will explore whether and how they use IUT to inform their decisions. Discussion The pilot trial will provide evidence of feasibility and acceptability and therefore inform the decision whether to proceed to the definitive trial. Results will

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

    OpenAIRE

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

    1997-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

    Seyhan Karaçavuş; Yunus Keser Yılmaz; Hasan Ekim

    2015-01-01

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

  2. Evaluation of clinical and laboratory predictors of fatality in patients with Hantavirus infection

    OpenAIRE

    Uğur Kostakoğlu; Gürdal Yılmaz; Serkan Volkan; Sevinç Kant Sökel1; Selçuk Kaya; İftihar Köksal

    2012-01-01

    Objectives: To determine the clinical and laboratory predictors of fatality among patients with Hantavirus infection.Materials and methods: A retrospective study was conducted on the patients with Hantavirus infection between April 2009and October 2011 at the Black Sea and the Mediterranean regions in Turkey. Demographic, clinical and laboratory findings offatal cases and non-fatal cases at the admission were compared.Results: Twenty-two patients with confirmed Hantavirus infection were evalu...

  3. Development, dissemination, implementation and evaluation of a clinical pathway for oxygen therapy

    OpenAIRE

    C Wong; Visram, F; Cook, D.; Griffith, L; Randall, J.; O Brien, B.; Higgins, D

    2000-01-01

    BACKGROUND: Oxygen is commonly administered to patients in hospital, but prescribing and monitoring of such therapy may be suboptimal. The objective of this study was to develop, disseminate, implement and evaluate a multidisciplinary clinical pathway for the administration of oxygen. METHODS: The authors developed a clinical pathway for the ordering, titration and discontinuation of oxygen, which was disseminated through teaching sessions, in-service training sessions and information posters...

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

    Directory of Open Access Journals (Sweden)

    Pandya J

    2010-01-01

    Full Text Available Background: Postgraduate specialities require a combination of knowledge and clinical skills. The internship year is less structured. Clinical and practical skills that are picked up during training are not well regulated and the impact is not assessed. In this study, we assessed knowledge and skills using objective structured clinical examination (OSCE. Aim: To evaluate the clinical skills of new first-year surgical residents using orientation programme and OSCE as a tool for assessment. Settings and Design: Observational study. Materials and Methods: Twenty new first-year surgical residents (10 each in 2008 and 2009 participated in a detailed structured orientation programme conducted over a period of 7 days. Clinically important topics and skills expected at this level (e.g., suturing, wound care etc. were covered. The programme was preceded by an OSCE to test pre-programme knowledge (the "pre-test". The questions were validated by senior department staff. A post-programme OSCE (the "post-test" helped to evaluate the change in clinical skill level brought about by the orientation programme. Statistical Analysis: Wilcoxson matched-pairs signed-ranks test. Results: Passing performance was achieved by all participants in both pre- and post-tests. Following the orientation programme, significant improvement was seen in tasks testing the psychomotor and cognitive domains. (P = 0.0001 and P = 0.0401, respectively. Overall reliability of the OSCE was found to be 0.7026 (Cronbach′s coefficient alpha. Conclusions: This study highlighted the lacunae in current internship training, especially for skill-based tasks. There is a need for universal inclusion of structured orientation programmes in the training of first-year residents. OSCE is a reliable, valid and effective method for the assessment of clinical skills.

  5. Design and evaluation of a bacterial clinical infectious diseases ontology.

    Science.gov (United States)

    Gordon, Claire L; Pouch, Stephanie; Cowell, Lindsay G; Boland, Mary Regina; Platt, Heather L; Goldfain, Albert; Weng, Chunhua

    2013-01-01

    With antimicrobial resistance increasing worldwide, there is a great need to use automated antimicrobial decision support systems (ADSSs) to lower antimicrobial resistance rates by promoting appropriate antimicrobial use. However, they are infrequently used mostly because of their poor interoperability with different health information technologies. Ontologies can augment portable ADSSs by providing an explicit knowledge representation for biomedical entities and their relationships, helping to standardize and integrate heterogeneous data resources. We developed a bacterial clinical infectious diseases ontology (BCIDO) using Protégé-OWL. BCIDO defines a controlled terminology for clinical infectious diseases along with domain knowledge commonly used in hospital settings for clinical infectious disease treatment decision-making. BCIDO has 599 classes and 2355 object properties. Terms were imported from or mapped to Systematized Nomenclature of Medicine, Unified Medical Language System, RxNorm and National Center for Bitechnology Information Organismal Classification where possible. Domain expert evaluation using the "laddering" technique, ontology visualization, and clinical notes and scenarios, confirmed the correctness and potential usefulness of BCIDO. PMID:24551353

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

    Institute of Scientific and Technical Information of China (English)

    梁繁荣; 李瑛

    2003-01-01

    Objective: To try to give an objective evaluation on the clinical research situation about acupuncturetreatment of facial paralysis in the past 50 years and try to provide a possible evidence for clinical practice. Methods:All papers are searched and assessed according to the international standards and clinical epidemiology. Results:There is no systematic review (SR) on acupuncture treatment of facial palsy in a total of 1021 articles enlisted in thepresent paper. Comparing with the quantity of the descriptive studies and expert opinions (constituting 84.84% ), thatof the randomized controlled trials (RCTs) and clinical controlled trials (CCTs) is smaller (constituting 15. 16%), be-sides, the quality of RCTs and CCTs is unsatisfactory. Conclusion: At present, the quantity and quality of studies withRCTs about acupuncture treatment of facial paralysis can't meet the need of clinical practice, and in order to improvethe therapeutic effect, a higher quality of RCTs and SR is required.

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

    Institute of Scientific and Technical Information of China (English)

    程剑华

    2002-01-01

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

  8. [Clinical studies of pediatric malabsorption syndromes].

    Science.gov (United States)

    Hosoyamada, Takashi

    2006-11-01

    Multiple cases with various types of pediatric malabsorption syndromes were evaluated. The clinical manifestations, laboratory findings, pathophysiology, and histopathological descriptions of each patient were analyzed in an effort to clear the pathogenesis of the malabsorption syndromes and the treatments were undertaken. The cases studied, included one patient with cystic fibrosis, two with lactose intolerance with lactosuria (Durand type), one with primary intestinal lymphangiectasia, two with familial hypobetalipoproteinemia, one with Hartnup disease, one with congenital chroride diarrhea, one with acrodermatitis enteropathica, one with intestinal nodular lymphoid hyperplasia (NLH), five with intractable diarrhea of early infancy and four with glycogenosis type Ia. Each case description and outcome is described below: 1. A 15-year-old Japanese boy with cystic fibrosis presented with severe symptoms, including pancreatic insufficiency, bronchiectasis, pneumothorax and hemoptysis. His prognosis was poor. Analysis of the CFTR genes of this patient revealed a homozygous large deletion from intron 16 to 17b. 2. In the sibling case of Durand type lactose intolerance, the subjects'disaccaridase activity of the small bowel, including lactase, were within normal limits. The results of per oral and per intraduodenal lactose tolerance tests confirmed lactosuria in both. These observations suggested, not only an abnormal gastric condition, but also duodenal and intestinal mucosal abnormal permeability of lactose. 3. In the case of primary intestinal lymphangiectasia, the subject had a lymphedematous right arm and hand, a grossly coarsened mucosal pattern of the upper gastrointestinal tract (identified via radiologic examination) and the presence of lymphangiectasia (confirmed via duodenal mucosal biopsy). The major laboratory findings were hypoalbuminemia, decreased immunoglobulin levels and lymphopenia resulting from loss of lymph fluid and protein into the gastro

  9. Evaluation of Clinical and Laboratory Data in Patients with Recurrent Infections and Suspected Immunodeficiency

    Directory of Open Access Journals (Sweden)

    Hamid Ahanchian

    2014-09-01

    Full Text Available Background: Frequent infections is among the most frequent clinical dilemmas for primary care physicians. Immunodeficiency disorders are a heterogeneous group of illnesses that predispose patients to the recurrent infections, autoimmunity and malignancies. The aim of this study was to evaluate the clinical and laboratory data collected for the final diagnosis of patients referred with recurrent infections and suspected immunodeficiency to a local immunodeficiency clinic.   Methods: This epidemiological study was carried out between April 2010 and September 2012 at the Immunodeficiency Clinic of Mashhad. All patients with clinical manifestations of immunodeficiency who were referred to our clinic during this period of time were included in this study. 41 patients aged from 10 months to 51 years, were evaluated. Results: Forty one patients, aged between 10 months and 51 years were evaluated. Eleven patients had a primary immunodeficiency, four cases had a secondary immunodeficiency, in three patients an underlying structural disease were found, eight patients were predisposed to recurrent infections as a result of allergies and finally, fifteen cases were found to be normal individuals.   Discussion: Most patients with recurrent infection have a normal immune system. Allergic disorders are the most common predisposing factor to recurrent infection. However, as immunodeficiency disorders are potentially serious, early diagnosis can improve the quality of life and outcome and prevent severe sequels in future.

  10. Clinical evaluation of joint scintigraphy in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Pertechnetate (sup(99m)TcO4-) joint scintigraphy was performed on 45 patients with rheumatoid arthritis, 3 with nonspecific arthritis and 6 normal subjects. 1) The sites of radioisotopic accumulation were generally in agreement with those of clinical involvement in rheumatoid arthritis. 2) By analysis of build-up curves in the wrist joint, tracer was found to be concentrated more rapidly in rheumatoid arthritis (T 1/2 = 0.67 min.) than in nonspecific arthritis (T 1/2 = 2.66 min.) 3) The degree of radioisotopic accumulation correlated well with the value of CRP and erythrocyte sedimentation rate. It could be cosidered that pertechnetate joint scintigraphy is useful for clinical evaluation of rheumatoid arthritis. (author)

  11. Clinical evaluation of 131I in treatment hyperthyroidism

    International Nuclear Information System (INIS)

    The clinical value of 131I in the treatment of hyperthyroidism is observed. The weight of the thyroid was evaluated by palpation, 131I was taken orally by one dose method. The dose was calculated by actual absorption of 131I/per gram of thyroid. 3 - 6 months after drug administration, the symptom, clinical manifestation and the serum hormone of the pituitary-hypothyroid axis were observed. In 105 cases, 80(76.2%) were nearly recovered, among them 16(15.2%) had hypothyroidism in the early period. The all over recovering rate was 91.4% in one dose, but 9(8.6%) were recurred and can be controlled at a second dose. Therefore 131I for the hyperthyroidism had a high recovering rate, low recurring rate and was very convenient. If prospect on the Chinese effort the controlled, the occurrence of hypothyroidism can be reduced to the acceptable level

  12. 78 FR 5816 - Guidance for Industry on Clinical Pharmacogenomics: Premarket Evaluation in Early-Phase Clinical...

    Science.gov (United States)

    2013-01-28

    ... (phase 3) that are needed to support marketing approval can be efficiently designed. Across the drug... effects in specific subgroups (i.e., use in study enrichment strategies). On February 18, 2011 (76 FR 9583... and how genomic principles should be considered and applied in early-phase clinical studies to...

  13. SPLENOMEGALY IN MALARIA : A CLINICAL AND ULTRASONOGRAPHIC STUDY

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    Gopal

    2015-08-01

    Full Text Available Malaria is a protozoan disease, transmitted by the bite of the infected Anopheles mosquito. There are four species of plasmodia causing the disease, but the two causing the morbidity and mortality are the plasmodium falciparum and the vivax. The disease invariably causes splenomegaly, which can be evaluated and assessed for the better prognosis of the patient. The study shows the evaluation of splenomegaly, both clinically and USG examination. AIMS AND OBJECTIVES: The main aim of this study is to show the prevalence of splenomegaly in malaria and compare with USG examination. MATERIAL AND METHODS: The patients included in the study were suffering from malaria (smear positive belonging to the age group of 15 to 70 years, at Chhattisgarh Institute of Medical Sciences, Bilaspur (CG. The time span of the study was 1 year. Measurement of splenic enlargement was done, both clinical and with ultrasound. The observations were tabulated and assessed. The patients excluded were those having fever and splenomegaly resulting from tropical disease. RESULTS: The USG examination to detect splenomegaly in cases of malaria, is more sensitive and specific as compared to the clinical examination. CONCLUSION: I t is recommended that splenomegaly in malaria should be detected by USG examination as compared to clinical examination.

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

    Science.gov (United States)

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

    1990-11-01

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

  15. Asthma and coagulation: A clinical and pathophysiological evaluation

    NARCIS (Netherlands)

    C.J. Majoor

    2016-01-01

    In clinical practice pulmonologists have suspected that pulmonary embolisms occur more often in patients with asthma. To confirm this suspicion, a study was initiated to investigate the incidence of venous thromboembolic events in patients with asthma compared to the general population. In addition,

  16. Hepatic encephalopathy: clinical and experimental studies

    OpenAIRE

    Rijt, Carin

    1991-01-01

    textabstractThe pathogenesis of hepatic encephalopathy is still unsolved. Therapy, therefore, is often insufficient. For the development of effective, new therapies insight into the disease-inducing substrates and the mechanisms of its toxic actions in the central nervous system ·are required. For both studies on pathogenesis and therapy of hepatic encephalopathy, methods for the quantitation of its severity are needed. For the measurement of hepatic encephalopathy clinical grading, conventio...

  17. Marketing and clinical trials: a case study

    OpenAIRE

    Entwistle Vikki A; Snowdon Claire; Garcia Jo; Knight Rosemary C; Shakur Haleema; Elbourne Diana R; Roberts Ian; Francis David; McDonald Alison M; Grant Adrian M; Campbell Marion K

    2007-01-01

    Abstract Background Publicly funded clinical trials require a substantial commitment of time and money. To ensure that sufficient numbers of patients are recruited it is essential that they address important questions in a rigorous manner and are managed well, adopting effective marketing strategies. Methods Using methods of analysis drawn from management studies, this paper presents a structured assessment framework or reference model, derived from a case analysis of the MRC's CRASH trial, o...

  18. A systematic review of studies comparing diagnostic clinical prediction rules with clinical judgment.

    Directory of Open Access Journals (Sweden)

    Sharon Sanders

    Full Text Available Diagnostic clinical prediction rules (CPRs are developed to improve diagnosis or decrease diagnostic testing. Whether, and in what situations diagnostic CPRs improve upon clinical judgment is unclear.We searched MEDLINE, Embase and CINAHL, with supplementary citation and reference checking for studies comparing CPRs and clinical judgment against a current objective reference standard. We report 1 the proportion of study participants classified as not having disease who hence may avoid further testing and or treatment and 2 the proportion, among those classified as not having disease, who do (missed diagnoses by both approaches. 31 studies of 13 medical conditions were included, with 46 comparisons between CPRs and clinical judgment. In 2 comparisons (4%, CPRs reduced the proportion of missed diagnoses, but this was offset by classifying a larger proportion of study participants as having disease (more false positives. In 36 comparisons (78% the proportion of diagnoses missed by CPRs and clinical judgment was similar, and in 9 of these, the CPRs classified a larger proportion of participants as not having disease (fewer false positives. In 8 comparisons (17% the proportion of diagnoses missed by the CPRs was greater. This was offset by classifying a smaller proportion of participants as having the disease (fewer false positives in 2 comparisons. There were no comparisons where the CPR missed a smaller proportion of diagnoses than clinical judgment and classified more participants as not having the disease. The design of the included studies allows evaluation of CPRs when their results are applied independently of clinical judgment. The performance of CPRs, when implemented by clinicians as a support to their judgment may be different.In the limited studies to date, CPRs are rarely superior to clinical judgment and there is generally a trade-off between the proportion classified as not having disease and the proportion of missed diagnoses

  19. A prospective 9-month human clinical evaluation of Laser-Assisted New Attachment Procedure (LANAP) therapy.

    Science.gov (United States)

    Nevins, Marc; Kim, Soo-Woo; Camelo, Marcelo; Martin, Ignacio Sanz; Kim, David; Nevins, Myron

    2014-01-01

    This investigation was designed and implemented as a single-center, prospective study to evaluate the clinical response to the Laser-Assisted New Attachment Procedure (LANAP). Eight patients with advanced periodontitis were enrolled and treated with full-mouth LANAP therapy and monitored for 9 months. Fullmouth clinical measurements, including clinical attachment level (CAL), probing depth (PD), and recession, were provided at baseline and after 9 months of healing by a single calibrated examiner, including a total of 930 sites and 444 sites with initial PD equal to or greater than 5 mm. Clinical results for the 930 sites measured pre- and postoperatively revealed that mean PD was reduced from 4.62 ± 2.29 mm to 3.14 ± 1.48 mm after 9 months (P recession increased from 0.86 ± 1.31 mm to 1.52 ± 1.62 after 9 months (P < .05). For the subset of 444 sites with initial PD greater than or equal to 5 mm, the PD decreased from 6.50 ± 2.07 mm to 3.92 ± 1.54 mm (P < .05) and CAL decreased from 7.42 ± 2.70 mm to 5.78 ± 2.06 mm (P < .05). As demonstrated by the clinical evaluation, the majority of treated sites demonstrated clinical improvement. LANAP therapy should be further investigated with long-term clinical trials to compare the stability of clinical results with conventional therapy. PMID:24396837

  20. Clinical and Statistical Study on Canine Impaction

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    Adina-Simona Coșarcă

    2013-08-01

    Full Text Available Aim: The aim of this study was to perform a clinical and statistical research on permanent impacted canine patients among those with dental impaction referred to and treated at the Oral and Maxillo-Facial Surgery Clinic of Tîrgu Mureș, over a four years period (2009-2012. Materials and methods: The study included 858 patients having dental impaction, and upon clinical records, different parameters, like frequency, gender, age, quadrant involvement, patient residence, associated complications, referring specialist and type of treatment, related to canine impaction, were assessed. Results: The study revealed: about 10% frequency of canine impaction among dental impactions; more frequent in women, in the first quadrant (tooth 13; most cases diagnosed between the age of 10-19 years; patients under 20 were referred by an orthodontist, those over 20 by a dentist; surgical exposure was more often performed than odontectomy. Conclusions: Canine impaction is the second-most frequent dental impaction in dental arch after third molars; it occurs especially in women. Due to its important role, canine recovery within dental arch is a goal to be achieved, whenever possible. Therefore, diagnose and treatment of canine impaction requires an interdisciplinary approach (surgical and orthodontic

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

    Directory of Open Access Journals (Sweden)

    Somers A

    2013-06-01

    very important (4.2%. A low interrater agreement concerning clinical relevance between the evaluators was found: kappa values ranged between 0.15 and 0.25. Summated MAI scores significantly improved after the pharmacist recommendations, with mean values decreasing from 9.3 to 6.2 (P < 0.001.Conclusion: In this study, the clinical pharmacist identified a high number of potential drug-related problems in older patients; however, the acceptance of the pharmacotherapy recommendations by the treating physician was lower than by a panel of evaluators. This panel, however, rated most recommendations as possibly important and as possibly having low relevance, with low interrater reliability. As the appropriateness of prescribing seemed to improve with decreased MAI scores, clinical pharmacy services may contribute to the optimization of drug therapy in older inpatients.Keywords: clinical pharmacist, drug-related problems, geriatric inpatients

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

    International Nuclear Information System (INIS)

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

  3. Asthma and coagulation: A clinical and pathophysiological evaluation

    OpenAIRE

    Majoor, C.J.

    2016-01-01

    In clinical practice pulmonologists have suspected that pulmonary embolisms occur more often in patients with asthma. To confirm this suspicion, a study was initiated to investigate the incidence of venous thromboembolic events in patients with asthma compared to the general population. In addition, this study aimed to determine if any relationship between asthma and venous thromboembolic events could be attributed to asthma severity, viral infections or the use of asthma medication. The acti...

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

    OpenAIRE

    FARIBA HAGHANI; MOHAMMAD HATEF KHORAMI; MOHAMMAD FAKHARI

    2016-01-01

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

  5. Students’ perceptions regarding the objective, structured, clinical evaluation as an assessment approach

    Directory of Open Access Journals (Sweden)

    Louis Frederick Small

    2013-04-01

    Full Text Available The nursing profession is characterised by the fact that a significant amount of time is spent on competency-related activities. The assessment of clinical competence is therefore an important issue in nursing education and the utilisation of objective structured clinical evaluation for that purpose was considered to be very important in this study. The objective of this research was to explore and describe the perceptions of first- and third-year student nurses with regard to the objective structured clinical evaluation assessment approach. A quantitative, cross-sectional, analytical research design was used. The instrument was a questionnaire (ordinal. This questionnaire focused on the perceptions of student nurses with regard to the objective structured clinical evaluation approach in particular, and with regard to aspects such as reality, execution, time allocation and student and assessor variables. The findings indicated that, as an assessment tool, the objective structured clinical evaluation approach was perceived as not being totally realistic, especially by the more senior nursing students (third-year as compared with the first-year nursing students. Varying degrees of stress were experienced by the nursing students in their first and third years but, in general, the overall perception appeared to be that the approach was well organised and that the respective students would be able to perform equally well in the clinical field. It may be concluded that the majority of students appreciate the format of the objective structured clinical evaluation approach. However, the study further highlighted the fact that more extensive training of students on time management and the relief of emotional stress is necessary during the implementation of this approach.

  6. Study design and methods of the BoTULS trial: a randomised controlled trial to evaluate the clinical effect and cost effectiveness of treating upper limb spasticity due to stroke with botulinum toxin type A

    Directory of Open Access Journals (Sweden)

    Graham Laura

    2008-10-01

    Full Text Available Abstract Background Following a stroke, 55–75% of patients experience upper limb problems in the longer term. Upper limb spasticity may cause pain, deformity and reduced function, affecting mood and independence. Botulinum toxin is used increasingly to treat focal spasticity, but its impact on upper limb function after stroke is unclear. The aim of this study is to evaluate the clinical and cost effectiveness of botulinum toxin type A plus an upper limb therapy programme in the treatment of post stroke upper limb spasticity. Methods Trial design : A multi-centre open label parallel group randomised controlled trial and economic evaluation. Participants : Adults with upper limb spasticity at the shoulder, elbow, wrist or hand and reduced upper limb function due to stroke more than 1 month previously. Interventions : Botulinum toxin type A plus upper limb therapy (intervention group or upper limb therapy alone (control group. Outcomes : Outcome assessments are undertaken at 1, 3 and 12 months. The primary outcome is upper limb function one month after study entry measured by the Action Research Arm Test (ARAT. Secondary outcomes include: spasticity (Modified Ashworth Scale; grip strength; dexterity (Nine Hole Peg Test; disability (Barthel Activities of Daily Living Index; quality of life (Stroke Impact Scale, Euroqol EQ-5D and attainment of patient-selected goals (Canadian Occupational Performance Measure. Health and social services resource use, adverse events, use of other antispasticity treatments and patient views on the treatment will be compared. Participants are clinically reassessed at 3, 6 and 9 months to determine the need for repeat botulinum toxin type A and/or therapy. Randomisation : A web based central independent randomisation service. Blinding : Outcome assessments are undertaken by an assessor who is blinded to the randomisation group. Sample size : 332 participants provide 80% power to detect a 15% difference in treatment

  7. Clinical study on osteoradionecrosis of the jaws

    Energy Technology Data Exchange (ETDEWEB)

    Okano, Atsuo; Kato, Joji

    1988-07-01

    In the present study osteoradionecrosis which had developed after radiotherapy for malignant tumor was studied clinically and therapeutically and the following results were obtained. 1. The subjects were 28 patients with squamous cell carcinoma and 2 patients with adenoid cystic carcinoma aged 38 to 72. The ratio of male: female was 3.3 : 1. The time of manifestation was 1 month-14 years after irradiation. The main symptoms were pain and exposed bone mainly in the region of mandibular molar tooth. 2. Osteoradionecrosis was observed in 10 cases supposed to be induced by tooth extraction but also in 5 edentulous cases. 3. When the osteoradionecrosis cases were classified into limited area type and wide range type on the basis of clinical findings. X-ray of the jaws showed the presence of bone resorption and induration together in many wide range type cases. 4. Scintigram of bone showed widespread accumulation of radiation even in clinically limited area type, and the picture of some loss of bone and the intensity of the accumulation were considered to be extremely useful as an index in making therapeutical plans and decisions on the prognosis of tumor of the jaws. 5. As the method of treatment, sequestrectomy was performed in 14 of 19 cases of the limited area type and 4 of 11 cases of the wide range type and excision of the jaws in 4 cases. 6. Hyperbaric oxygen therapy was carried out in 3 cases and had good effect. (J.P.N.).

  8. Clinical study on osteoradionecrosis of the jaws

    International Nuclear Information System (INIS)

    In the present study osteoradionecrosis which had developed after radiotherapy for malignant tumor was studied clinically and therapeutically and the following results were obtained. 1. The subjects were 28 patients with squamous cell carcinoma and 2 patients with adenoid cystic carcinoma aged 38 to 72. The ratio of male: female was 3.3 : 1. The time of manifestation was 1 month-14 years after irradiation. The main symptoms were pain and exposed bone mainly in the region of mandibular molar tooth. 2. Osteoradionecrosis was observed in 10 cases supposed to be induced by tooth extraction but also in 5 edentulous cases. 3. When the osteoradionecrosis cases were classified into limited area type and wide range type on the basis of clinical findings. X-ray of the jaws showed the presence of bone resorption and induration together in many wide range type cases. 4. Scintigram of bone showed widespread accumulation of radiation even in clinically limited area type, and the picture of some loss of bone and the intensity of the accumulation were considered to be extremely useful as an index in making therapeutical plans and decisions on the prognosis of tumor of the jaws. 5. As the method of treatment, sequestrectomy was performed in 14 of 19 cases of the limited area type and 4 of 11 cases of the wide range type and excision of the jaws in 4 cases. 6. Hyperbaric oxygen therapy was carried out in 3 cases and had good effect. (J.P.N.)

  9. Robust diffusion imaging framework for clinical studies

    CERN Document Server

    Maximov, Ivan I; Neuner, Irene; Shah, N Jon

    2015-01-01

    Clinical diffusion imaging requires short acquisition times and good image quality to permit its use in various medical applications. In turn, these demands require the development of a robust and efficient post-processing framework in order to guarantee useful and reliable results. However, multiple artefacts abound in in vivo measurements; from either subject such as cardiac pulsation, bulk head motion, respiratory motion and involuntary tics and tremor, or imaging hardware related problems, such as table vibrations, etc. These artefacts can severely degrade the resulting images and render diffusion analysis difficult or impossible. In order to overcome these problems, we developed a robust and efficient framework enabling the use of initially corrupted images from a clinical study. At the heart of this framework is an improved least trimmed squares diffusion tensor estimation algorithm that works well with severely degraded datasets with low signal-to-noise ratio. This approach has been compared with other...

  10. Clinical Study on Ocular Trauma in Children

    Institute of Scientific and Technical Information of China (English)

    Zicai Huang; Hongni Li; Yixia Huang; Zhongxia Zhou

    2002-01-01

    Purpose: To investigate the clinical characteristics of ocular trauma in children and put forward the major treatment and prevention of ocular trauma in children.Methods: To analyze the clinical data by 77 eyes in 77 cases of ocular trauma in children from April 1999 to February 2002. Results: The male and female were in the ratio of 2.21: 1. Right eye ocular traumas were more than left ones. Ocular penetrating trauma was 83.12% and blunt trauma 12.99%. 41 cases (53.25%) were injured by themselves while 33 cases by others. 90.91% patients came from the countryside.Conclusion: The rate of blindness of children with ocular trauma could be reduced by prompt treatment. The study indicated that ocular trauma preventive publicity should be faced in the countryside in order to improve the understanding of the severity of ocular trauma and treat it as a social problem.

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

    Directory of Open Access Journals (Sweden)

    Lamis Al-Qora’n

    2014-11-01

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

  12. Functional outcomes for clinical evaluation of implant restorations.

    Science.gov (United States)

    Bassi, Francesco; Carr, Alan B; Chang, Ting-Ling; Estafanous, Emad W; Garrett, Neal R; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J; Stanford, Clark M; Wolfaardt, Johan

    2013-01-01

    The functional outcomes related to treating patients afflicted with tooth loss are an important hallmark in substantiating prosthodontic intervention. The Oral Rehabilitation Outcomes Network (ORONet) conducted two international workshops to develop a core set of outcome measures, including a functional domain. The process followed the general format used in the Outcome Measures in Rheumatology (OMERACT) workshops to develop consensus for clinical outcome measures in arthritis research, which included: developing a comprehensive list of potential outcomes in the literature; submitting them to a filter for validity, clinical discrimination, and feasibility; and ranking those measures meeting all the filter criteria for relative value. The search was conducted to include functional assessments of speech, swallowing, mastication, nutrition, sensation, and motor function as they relate to dental implant therapies. This literature review surveyed 173 papers that produced some result of these descriptors in the functional domain. Of these, 67 papers reported on functional assessments and further defined objective and subjective outcomes. Many of these results were patient-perceived improvements in function, while others were objective assessments based on established methodologies and instruments. Objective evaluations of masticatory function and speech may meet criteria for validity and discriminability for selected interventions, but are generally not feasible for routine use in clinical care settings. The current recommendation is to employ a well-validated survey instrument that covers mastication and speech, such as the Oral Health Impact Profile (OHIP-14, short form), recognizing that patient perceptions of function may differ from objective ability. PMID:23998137

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  15. Organizational evaluation of an interprofessional study unit

    DEFF Research Database (Denmark)

    Odgaard, Eva; Jensen, Didde Cramer; Nørgaard, Birgitte;

    2012-01-01

    This article presents results from an organizational evaluation of an interprofessional clinical study unit (ICS) in Denmark. The aim of this study was to test whether the ICS was based on a durable organizational concept and to identify the prerequisites for the unit to be successful. The...... for the study unit to function organizationally. Further analysis examined whether these conditions had been present during the project period and whether all elements had been correctly implemented. The results suggested that although the ICS had taken into account stakeholders' requests, it was not...

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

    NARCIS (Netherlands)

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

    2004-01-01

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

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

    NARCIS (Netherlands)

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

    2004-01-01

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

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

    OpenAIRE

    Guilherme dos Santos Trento; Felipe Bueno Rosettti Bernabé; Delson João da Costa; Nelson Luis Barbosa Rebellato; Leandro Eduardo Klüppel; Rafaela Scariot

    2015-01-01

    Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure...

  19. Actual issues of clinical radiobiology and their experimental study

    International Nuclear Information System (INIS)

    Information being collector for some tens years in frame of clinical study of radiation effects in man in broad range of dose and exposure variant has been summarised and systematized. It has been formulated the questions which could be answered under only clinical observation with many difficulties: diagnostical and prognostical criteria for evaluation of therapy efficiency in non-bonemarrow syndrome of acute radiation disease choice and confirmaty of methods of bonemarrow syndrome therapy in overlethal range of dose; improving of preclinical examination of means and methods of acute radiation syndrome prophylaxis and treatment; comparative analysis of the role of various radiation factory in development of oncological and severe somatic disease and possibility of these effects modification. Some limitations in extrapolation of experimental data onto clinical practice has been discussed and optimal forms of cooperation are shown

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

    Directory of Open Access Journals (Sweden)

    Ahmet İrdem

    2004-01-01

    Full Text Available A total of 65 children with Subacute Sclerosing Panencephalitis (SSPE who admittedto our clinic between September 1998 and December 2002 were retrospectively evaluated interms of clinical and radiological findings.The most common symptoms and findings at admission were myoklonia (31 patients, 47%, behaveral changes (18 patients, 27.7 % and convulsion (8 patients, 12 %. There was atrauma history initiating symptoms in 14 patients (21.5 %. Neurological symptoms presentedsignificantly earlier in patients who had measles before 2 years of age compared to others(p0.05. The clinical stage of the patients at admission was determined based on Risk veHaddad classification. The most frequent stage was IIA (21 patients, 32.2%, IIC (17patients, 26.2% and IIB (16 patients, 24.6%. At the follow-up period, 46 (71% patients wasdepended to bed. The mean time interval between SSPE initiation age and bed dependencywas 4.68 ± 4.05 months (1-17 months.Of the 31 patients who underwent cranial magnetic rezonans imaging (MRI, 15patients (48.38% had pathological findings, the most frequent findings were cortical vesubcortical lesions. Of the 24 patients who underwent cranial tomographi, 22 (91.6% werenormal. Of the remaining two, one had atrophy and the other had increase in contrast. All ofthe patients underwent rutine EEG test. Fifty-four (83.1% of these had periodic complexhigh slow wave activity.The clinical findings and Electro Encephalographi results are important parameters inthe diagnosis of SSPE. Cranial tomographi is not useful in the diagnosis of SSPE. However,cranial MRI findings is pathologic only in the half of the patients.

  1. A clinical study of papular urticaria

    International Nuclear Information System (INIS)

    To determine the clinical features and demographic profile of the patients having papular urticaria. Individuals of all age groups and either gender either suspected of or having definite history of insect bite were included in the study. A specially-designed proforma was filled for each patient separately. The proforma included demographic features, information regarding clothing and sleeping habits, personal or family history of atopy and clinical patterns of the lesions. Computer programme SPSS 10 was used to manage and analyze the data. Out of 280 patients, 201 (71.8%) were children upto 12 years of age, 178 (63.6%) were males, 91 (32.5%) had atopy, 194 (69.3%) were non-locals, 212 (75.7%) came from urban/peri-urban areas and 173 (61.8%) presented during May-August. Lesions were present over exposed parts of the body in 36 (12.9%), arranged in groups in 152 (54.3%) and were papular urticaria in 185 (66.1%) patients. Children, adult males, non-locals and those belonging to urban/peri-urban areas are more vulnerable to papular urticaria in a particular region. Papular and urticarial lesions arranged in groups over both exposed as well as covered body parts of a single patient is the most common clinical pattern. (author)

  2. [Agreement between Clinical Evaluation and Structured Clinical Interviews in Psychosomatic Inpatients].

    Science.gov (United States)

    Reichert, Cornelia; Henniger, Stephan; Jäger, Burkard; de Zwaan, Martina

    2015-05-01

    The goal of this study was to determine the agreement between axis I mental disorders assessed with a structured clinical interview (SCID) and independently obtained non-structured clinical diagnoses in 185 psychosomatic in-patients. Additionally, the study focuses on the detection of potential predictors for the level of agreement. Diagnostic agreement was poor to moderate for the mood, anxiety and somatoform disorder cluster (κ = 0.293-0.444). Only for eating disorders an almost complete concordance could be found (κ = 0.812). The predictor analysis indicated a significant positive association between the comorbidity rate and the agreement in mood disorders. Furthermore, the diagnostic agreement of anxiety disorders was significantly higher for female than for male patients. These results reveal that even a team-based clinical diagnosis, assessed over the period of a hospital stay, shows little agreement with SCID-diagnoses. The predictor analysis as well as the poor correlation in 3 of 4 diagnostic clusters suggest that conceptual differences of the disorder criteria as well as their clinical interpretation might influence the concordance between diagnoses. Further studies focusing on methodical factors might reveal further insights to the cause of the diagnostic discrepancies. PMID:25941987

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  5. Evaluation of Clinical Features of Female Patients with Macroprolactinemia

    OpenAIRE

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

    2011-01-01

    Aim: Macroprolactin is a high-molecular-weight form of prolactin. It has been suggested that macroprolactin has no clinical importance because of its decreased or limited bioactivity. Although screening for macroprolactinemia is recommended especially in patients with idiopathic hyperprolactinemia; recent studies reported that patients with macroprolactinemia may have some hyperprolactinemia symptoms. Currently, the causes of the symptoms as well as the treatment and follow-up of this group o...

  6. Stroke and Pregnancy: Clinical Presentation, Evaluation, Treatment and Epidemiology

    OpenAIRE

    Grear, Karrie E; Bushnell, Cheryl D.

    2013-01-01

    Stroke is a neurological emergency that carries a risk of morbidity and mortality. Recent studies have shown that the incidence of stroke, while rare, is increasing in pregnant females. In this review, stroke and other vasculopathies in the pregnant and post-partum female are examined. A discussion of the symptoms and clinical presentation of stroke is provided, as well as the current guideline for treatment of stroke in pregnancy. Finally, the data illustrating the recent increases in stroke...

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

    OpenAIRE

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

    2015-01-01

    ABSTRACT Objective Facial diplegia (FD) is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS) (11), Bickerstaff’s brainstem encephalitis (1), neurosarcoidosis (1), non-Hodgkin’s Lymphoma (1), tuberculous meningitis (1) her...

  8. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression.

    OpenAIRE

    Morrell, C.J.; Sutcliffe, P.; BOOTH, A.; Stevens, J.; Scope, A; Stevenson, M.; Harvey, R.; Bessey, A.; Cantrell, A.; Dennis, C L; Ren, S.; Ragonesi, M.; Barkham, M; Churchill, D; Henshaw, C.

    2016-01-01

    BACKGROUND: Postnatal depression (PND) is a major depressive disorder in the year following childbirth, which impacts on women, their infants and their families. A range of interventions has been developed to prevent PND. OBJECTIVES: To (1) evaluate the clinical effectiveness, cost-effectiveness, acceptability and safety of antenatal and postnatal interventions for pregnant and postnatal women to prevent PND; (2) apply rigorous methods of systematic reviewing of quantitative and qualitative s...

  9. A STUDY OF OVARIAN TUMOURS : CLINICAL AND PATHOLOGICAL CORRELATION

    Directory of Open Access Journals (Sweden)

    Uma Devi

    2015-10-01

    Full Text Available OBJECTIVE: To study incidence age distribution of benign and malignant ovarian tu mours in general population. METHODS AND MATERIAL : To study 120 patients with ovarian tumours in Govt . general hospital during June 2003 and June 2005. RESULTS: Clinical and pathological evaluation of all ovarian tumours was done and incidence, age distrib ution of various benign and malignant ovarian neoplasms were tabulated and compared with other studies. CONCLUSIONS: Most common ovarian tumours are benign tumours and serous cystadenoma is the commonest benign tumour and S erous cystadeno carcinoma is the most common malignant tumour.

  10. Clinical laboratory studies in Barth Syndrome.

    Science.gov (United States)

    Vernon, Hilary J; Sandlers, Yana; McClellan, Rebecca; Kelley, Richard I

    2014-06-01

    Barth Syndrome is a rare X-linked disorder characterized principally by dilated cardiomyopathy, skeletal myopathy and neutropenia and caused by defects in tafazzin, an enzyme responsible for modifying the acyl chain moieties of cardiolipin. While several comprehensive clinical studies of Barth Syndrome have been published detailing cardiac and hematologic features, descriptions of its biochemical characteristics are limited. To gain a better understanding of the clinical biochemistry of this rare disease, we measured hematologic and biochemical values in a cohort of Barth Syndrome patients. We characterized multiple biochemical parameters, including plasma amino acids, plasma 3-methylglutaconic acid, cholesterol, cholesterol synthetic intermediates, and red blood cell membrane fatty acid profiles in 28 individuals with Barth Syndrome from ages 10 months to 30 years. We describe a unique biochemical profile for these patients, including decreased plasma arginine levels. We further studied the plasma amino acid profiles, cholesterol, cholesterol synthetic intermediates, and plasma 3-methylglutaconic acid levels in 8 female carriers and showed that they do not share any of the distinct, Barth Syndrome-specific biochemical laboratory abnormalities. Our studies augment and expand the biochemical profiles of individuals with Barth Syndrome, describe a unique biochemical profile for these patients, and provide insight into the possible underlying biochemical pathology in this disorder. PMID:24751896

  11. CLINICAL PROFILE AND MANAGEMENT OF LIVER ABSCESS BY USG GUIDED ASPIRATION IN COMBINATION WITH ANTIBIOTICS AND SURGERY: A CLINICAL STUDY

    OpenAIRE

    Amit; Shaleen

    2014-01-01

    Liver abscess could be amoebic, pyogenic, infected hydated, traumatic or ascaridal. Amoebic liver abscess follows 1-2months after amoebic dysentery due to invasion of liver by Entamoeba Histolytica via portal circulation. The study was taken by considering the following aims and objectives: Evaluation of clinical symptoms and signs of liver abscess. To evaluate the best modality of management of liver abscess. To evaluate the common microbiological organism responsible for...

  12. ND: YAG Laser in the therapy of hypersensitivity teeth clinical evaluation

    OpenAIRE

    Kovacevska, Ivona; Dimova, Cena; Georgiev, Zlatko

    2013-01-01

    Introduction: Various methods and materials are used in the treatment of dentin hypersensitivity. Sealing of open dentinal tubules is one of the methods to reach insensibility. Laser as a source of coherent radiation is used to melt layers of dentine surface. Objective: The purpose of this study was to evaluate the clinical effectiveness of Nd: YAG laser in the therapy of hypersensitive teeth. Study design: 43 patients of both sex at the age 26 - 54 were included in the study for cli...

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

    Directory of Open Access Journals (Sweden)

    Ayşe Serap Karadağ

    2013-03-01

    Full Text Available Objective: This study was aimed to define the clinical and demographic findings of psoriasis in childhood. Methods: In this retrospective study, the data from 64 children with psoriasis admitted at the our dermatology clinic between January 2007 and January 2011 were included whose data were fully. Results: Of the patients, 37 (57.8% were boys and 27 (42.2% were girls. Mean age of the children was 10.08 ±3.98 years (3-16. In 10 (15% cases, a positive family history was detected. The most frequent localizations at onset were trunk (46.9%, scalp (28.1%, knee-elbow (10.9% and extremities (7.9%, respectively. The most commonly seen clinical types were plaque (68.8%, guttate (20.3%, palmoplantar (9.4%, pustular (1.6%, respectively. Nine children had nail involvement. Out of all patients, 21.9% had upper respiratory tract infections and 9.4% had emotional stres. Four cases were diagnosed with depression. Of the cases, two cases were on non-steroid anti-inflammatory medication, and 4 of them were on antibiotics. Systemic treatments were given to 21.9% of the cases besides topical treatments. Conclusion: The epidemiological studies of psoriasis during childhood period for different countries have been reported. In this study, the ratio shows differences when compared to those previous studies. There are few epidemiologic studies for Turkey. We believe that further epidemiological studies including large number of patients' groups will contribute the diagnosis and treatment of the disease.

  14. Clinic-Radiological Study of facial paralysis

    International Nuclear Information System (INIS)

    We have gathered 159 cases of facial paralysis from recent records in our hospital, including paralyses of central as well as peripheral origin, and presenting as the only symptom or as one of several major symptoms of the discomfort of each patient. Sixty-four percent of them were studied by CT scan and/or MR, confirming the existence of alterations in the pathway of nerve pair VII in 50% of the patients who underwent radiological study. Idiopathic facial paralysis was the most common type (42% of the total); while tumors and post-traumatic findings were the most constant radiological findings. From the analysis of the data, the importance of the clinical criteria for selection of the patients in the study and the protocol for radiological diagnosis employed can be deduced. (author)

  15. Clinical studies of neuroinflammatory mechanisms in schizophrenia.

    Science.gov (United States)

    Watkins, Crystal C; Andrews, Sarah Ramsay

    2016-09-01

    Schizophrenia is a pervasive neurodevelopmental disorder that appears to result from genetic and environmental factors. Although the dopamine hypothesis is the driving theory behind the majority of translation research in schizophrenia, emerging evidence suggests that aberrant immune mechanisms in the peripheral and central nervous system influence the etiology of schizophrenia and the pathophysiology of psychotic symptoms that define the illness. The initial interest in inflammatory processes comes from epidemiological data and historical observations, dating back several decades. A growing body of research on developmental exposure to infection, stress-induced inflammatory response, glial cell signaling, structural and functional brain changes and therapeutic trials demonstrates the impact that inflammation has on the onset and progression of schizophrenia. Research in animal models of psychosis has helped to advance clinical and basic science investigations of the immune mechanisms disrupted in schizophrenia. However, they are limited by the inability to recapitulate the human experience of hallucinations, delusions and thought disorder that define psychosis. To date, translational studies of inflammatory mechanisms in human subjects have not been reviewed in great detail. Here, we critically review clinical studies that focus on inflammatory mechanisms in schizophrenia. Understanding the neuroinflammatory mechanisms involved in schizophrenia may be essential in identifying potential therapeutic targets to minimize the morbidity and mortality of schizophrenia by interrupting disease development. PMID:26235751

  16. Clinical and neuroradiological studies on internuclear ophthalmoplegia

    International Nuclear Information System (INIS)

    In this study 14 cases of internuclear ophthalmoplegia (INO) were analysed. The correlation of clinical symptoms with localization of the responsible lesions was studied in these patients. The subjects included 9 patients with CVD, 2 with MS, 1 with Fisher's syndrome, 1 with cranial polyneuritis and one with unknown etiology. Nine patients with unilateral INO are all associated with brainstem infarction. The other 5 patients including 2 MS had bilateral INO. CT showed abnormal findings in brain stem in 7 out of 14 patients. As for MRI an abnormality was found in 5 out of the 8 patients examined. Two of the 7 patients without any abnormality on CT had abnormal signals on MRI. We divided INO into 3 groups based on the clinical symptoms: 1) anterior type in which convergence was involved concomitantly with adduction paralysis, 2) typical type in which dissociated nystagmus was more marked in the abducting eye, and convergence was preserved, 3) posterior type in which abduction is impaired without adduction disturbance. There were 5 cases of anterior type, 9 of typical type, and none of posterior type. On MRI two patients of anterior type had abnormalities in the dorsal midbrain, and one patient had an abnormality in the pons, and two patients of typical type had abnormalities in the upper or middle dorsal pons to the dorsal midbrain. CT failed to demontrate any responsible lesions in 2 patients in whom the responsible legions were clearly identified on MRI. (J.P.N.)

  17. DNA Damage in Chronic Kidney Disease: Evaluation of Clinical Biomarkers

    Science.gov (United States)

    Schupp, Nicole; Stopper, Helga; Heidland, August

    2016-01-01

    Patients with chronic kidney disease (CKD) exhibit an increased cancer risk compared to a healthy control population. To be able to estimate the cancer risk of the patients and to assess the impact of interventional therapies thereon, it is of particular interest to measure the patients' burden of genomic damage. Chromosomal abnormalities, reduced DNA repair, and DNA lesions were found indeed in cells of patients with CKD. Biomarkers for DNA damage measurable in easily accessible cells like peripheral blood lymphocytes are chromosomal aberrations, structural DNA lesions, and oxidatively modified DNA bases. In this review the most common methods quantifying the three parameters mentioned above, the cytokinesis-block micronucleus assay, the comet assay, and the quantification of 8-oxo-7,8-dihydro-2′-deoxyguanosine, are evaluated concerning the feasibility of the analysis and regarding the marker's potential to predict clinical outcomes. PMID:27313827

  18. Clinical evaluation of gadodiamide injection in paediatric MR imaging

    International Nuclear Information System (INIS)

    The safety and efficacy of intravenous gadodiamide injection, 0.1 mmol/kg body weight, have been evaluated in an open label, non-comparative as to drug, phase III clinical trial in 50 children from 6 months to 13 years of age, referred for MRI requiring the injection of a contrast medium. The central nervous system and other body areas were examined with T1 sequences before and after intravenous injection of the contrast medium. Overall safety was very good and no clinically relevant changes were evident as regards heart rate and venous blood oxygen saturation after injection. No adverse event or discomfort was experienced by conscious patients that could with certainty be related to the contrast medium, but slight movements were observed in two sedated patients that could be related to the injection. Comparing pre- and post-injection images, additional diagnostic information could be obtained from the latter in 41 patients (82 %). In these images, the number of lesions detected increased and they were generally better delineated and their size more easily estimated. The results of this trial indicate that gadodiamide injection is safe and effective for MRI examinations in children. (orig.). With 3 figs., 1 tab

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

    DEFF Research Database (Denmark)

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

    ABSTRACT OARSI Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review Larsen CM1, Juul-Kristensen B1,2 Lund H1,2, Søgaard K11University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics2Institute of...... studies.MethodsA systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. The overall method used in this review can be divided into four steps: 1) Compile an...... evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was ‘fair’ (57%) to ‘poor’ (43%), with...

  20. Korean Clinic Based Outcome Measure Studies

    Directory of Open Access Journals (Sweden)

    Jongbae Park

    2003-02-01

    Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures

  1. EVALUATION OF THYROID NODULES: AN ULTRASONOGRAPHIC STUDY

    Directory of Open Access Journals (Sweden)

    Vijai

    2013-10-01

    Full Text Available ABSTRACT : Thyroid nodules are common in adults, with a reported prevalence of up to 50%. (1 – 5. Furthermore, 9% to 15% of nodules identified during clinical examinations are diagnosed as malignant (6 – 8. It is gen erally accepted that sonography and sonographically guided fine - needle aspiration cytologic examination are the modalities of choice for differentiating benign and malignant thyroid nodules (1 , 9 . Thyroid ultrasonography (USG is the major diagnostic moda lity for evaluating thyroid nodules. Using USG, a thyroid nodule appears as a nodular lesion within the thyroid gland that is distinguishable from the adjacent parenchyma. Several USG features, such as marked hypoechogenicity, irregular margin, micro calci fications, and a taller - than - wide shape have been introduced as potential predictors for the presence of thyroid malignancies. AIMS & OBJECTIVE : The aim of this study was to assess the accuracy of USG diagnosis for thyroid nodules. MATERIALS & METHODS: Th e present study was conducted in the Department of Radiodiagnosis, TMMC & RC, TMU, Moradabad. Patients under the study were referred from department of Surgery, Paediatrics, Medicine, ENT, Gynaecology and Obstetrics. Patients for the study were evaluated b y Clinical & Radiological examination. The total number of patients were 120. RESULT: On clinical examination, multiple nodules were found only in 17% of cases, whereas on USG, multiple nodules were found in 58%. 50% of clinically solitary nodules were d emonstrated to be multiple on USG. CONCLUSION: In conclusion, similar to the recent literature reviewed so far, for a large majority of patients, diagnosis changed after ultrasonography, so the results necessitate the use of ultrasonography, which is a non invasive method, as a complementary method to physical examination in the diagnosis of thyroid diseases, especially thyroid nodules.

  2. Industrial laser welding evaluation study

    Science.gov (United States)

    Hella, R.; Locke, E.; Ream, S.

    1974-01-01

    High power laser welding was evaluated for fabricating space vehicle boosters. This evaluation was made for 1/4 in. and 1/2 in. aluminum (2219) and 1/4 in. and 1/2 in. D6AC steel. The Avco HPL 10 kW industrial laser was used to perform the evaluation. The objective has been achieved through the completion of the following technical tasks: (1) parameter study to optimize welding and material parameters; (2) preparation of welded panels for MSFC evaluation; and (3) demonstration of the repeatability of laser welding equipment. In addition, the design concept for a laser welding system capable of welding large space vehicle boosters has been developed.

  3. Clinical studies on mercury poisoning in cattle

    Energy Technology Data Exchange (ETDEWEB)

    Sonoda, M.; Nakamura, R.; Too, K.; Matsuhashi, A.; Ishimoto, H.; Sasaki, R.; Ishida, K.; Takahashi, M.

    1956-01-01

    A sporadic outbreak of an unknown disease occurred among dairy cattle, from early February to late May 1955, in Japan. The characteristic symptoms of this disease were dyspnea and depilation; out of 29 cases, 8 died while 2 were slaughtered. Clinical studies have disclosed that the symptoms were similar to those found in cases of mercury poisoning as described by others. So the animals' feed was suspected of being the cause of the sickness. It was confirmed that the incident was due to poisoning resulting from ingestion of linseed meal treated with a mercurial fungicide. From the results of the testing anamnesis, it was found that 171 cattle were fed with the meal and 29 cases were affected. In veiw of the wide use of mercurial preparations for treating seed grains against fungi infection, a further experimental study was made on the effects of the feed and fungicide upon calves.

  4. Erythema infectiosumin children: A clinical study

    Directory of Open Access Journals (Sweden)

    Prćić Šonja

    2006-01-01

    Full Text Available Erythema infectiositm is a childhood illness characterized by mild constitutional symptoms and a blotchy or maculo-papular lacy rash on the cheeks (slapped - cheek spreading primarily to the extremities and trunk. The disease- is-caused by human parvovirus B19. Erythema infectiosum epidemics occur in a cyclic fashion, mostly during winter and spring months. The diagnosis of erythema infectiosum is usually based on the appearance and pattern of the rash. The aim of our study was to establish the frequency and clinical characteristics of erythema infectiosum in children, in the period between 2000 and 2004 at the Institute of Child and Youth Health Care, Department of Dermatology, Novi Sad. There were 0.23% of children with a clinical picture of infectious erythema. There was an outbreak of erythema infectiosum from December 2001 to September 2002. The highest number of cases was detected in April and May of 2002. from 2003 to 2004, no cases with infekctious erythema were diagnosed. The average age of infected children was 7.38. Female children were affected slightly more often than male (56.41%:43.58%. Pruritus was detected in 10.26% of children. The most constant clinical sign was reticular exanthema on the limbs, present in 100% of cases, followed by 89.74% of cheek exanthema, while limb and trunk exanthema was present in 7.68% of children. Adenopathies and mild constitutional symptoms were present in 5.12% of children. No complications were recorded in any of the cases. .

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

    Directory of Open Access Journals (Sweden)

    Ângela Brandão

    2014-10-01

    Full Text Available This research addresses the personality as a complex and dynamic structure and it relates the self-discrepancy theory with Millon's theory of personality. Self-discrepancy theory predicts that Ideal and Ought discrepancies originate different negative emotions. Millon's bipsychosocial theoty emphasizes the interaction between organism, environment and social learning, making salient the circularity of the interaction. The present study refers to the Real-Self (RS, Ideal-Self (IS and Ought-Self (OS discrepancies, evaluated using the MCMI-II in two different samples (clinical and non-clinical. The RSs results are different in the two samples and they were analized scale by scale. The RS-IS and RS-OS discrepancies results for each trait scale analyzes were mixed. It was given greater emphasis to RS-RI discrepancies and implications for personality theories and case conceptualization are taken into consideration.

  6. Evaluating the efficacy of memantine on improving cognitive functions in epileptic patients receiving anti-epileptic drugs: A double-blind placebo-controlled clinical trial (Phase IIIb pilot study

    Directory of Open Access Journals (Sweden)

    Priya Marimuthu

    2016-01-01

    Full Text Available Objectives: People with epilepsy have greater cognitive and behavioral dysfunction than the general population. There is no specific treatment available for cognitive impairment of these patients. We aimed to evaluate the effects of memantine, an N-methyl-D-aspartate-type glutamate receptor noncompetitive antagonist, on improving cognition and memory functions in epileptic patients with cognitive and memory impairment, who received anti-epileptic drugs (AEDs. Methods: We did a randomized, double-blind, placebo-controlled parallel group trial, in SRM Medical College Hospital and Research Centre, Kattankulathur, Kancheepuram, Tamil Nadu, India between April 2013 and September 2013. Fifty-nine epileptic patients taking AEDs with subjective memory complaints were recruited and randomized to either Group 1 to receive 16 weeks of once-daily memantine, (5 mg for first 8 weeks, followed by memantine 10 mg for next 8 weeks or Group 2 to receive once daily placebo. This trial is registered with Clinical Trial Registry of India CTRI/2013/04/003573. Results: Of 59 randomized patients, 55 patients completed the study (26 memantine and 29 placebo. Memantine group showed statistically significant improvement in total mini mental state examination score from baseline (P = 0.765 to 16 th week (P < 0.001 in comparison with the placebo. The Weshler′s Memory Scale total score in memantine group improved significantly after 8 weeks (P = 0.002 compared with baseline (P = 0.873 and highly significant at the end of 16 th week (P < 0.001. The self-rated quality of life and memory in memantine group also significantly improved at the study end. Conclusion: We conclude that once-daily memantine (10 mg treatment significantly improved cognition, memory and quality of life in epileptic patients with mild to moderate cognitive impairment and was found to have a favorable safety profile.

  7. Obesity and periodontitis: A clinical study

    OpenAIRE

    Mathur, Lalit Kumar; Manohar, Balaji; Shankarapillai, Rajesh; Pandya, Dhara

    2011-01-01

    Background: The aim of the study was to evaluate the relationship between obesity and periodontitis. Materials and Methods: A total of 300 subjects aged 20 years and above suffering from generalized periodontitis were recruited from Department of Periodontics, Pacific Dental College and Hospital, Udaipur. Periodontal status of the subjects was recorded. Body mass index and waist circumference were used as measure to assess obesity. Other variables like age, gender, oral hygiene index were als...

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

    OpenAIRE

    Patki, Pralhad

    2010-01-01

    Sunita Amrutesh1, J Malini2, Prakash S Tandur3, Pralhad S Patki41Department of Oral Medicine and Radiology, 2Department of Microbiology, 3Department of Oral and Maxillofacial Surgery, K.L.E. College of Dental Sciences and Hospital, Bangalore, India; 4Medical Services and Clinical Trials, R&D Center, The Himalaya Drug Company, Bangalore, IndiaBackground: The aim of this study was to evaluate the efficacy and safety of herbal dental cream in comparison to fluoride dental cream.Objective...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Boujan, Fazel [Hopital Hautepierre, Service d' Imagerie 2 - Neuroradiologie, Strasbourg (France); University Hospitals of Strasbourg, Division of Neurointerventional Radiology, Imaging Department, Strasbourg (France); Clauss, Nicolas; Mertz, Luc [University Hospitals of Strasbourg, Division of Radiation Physics and Radiation Safety, Imaging Department, Strasbourg (France); Santos, Emilie; Boon, Sjirk; Schouten, Gerard [Philips Healthcare, Best (Netherlands); Dietemann, Jean-Louis [University Hospitals of Strasbourg, Division of Neuroradiology and Neurointerventional, Imaging Department, Strasbourg (France)

    2014-11-15

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

  11. [Cardiac myxoma in the elderly. Clinical study].

    Science.gov (United States)

    Pentimone, F; Del Corso, L; Siuti, E; Verunelli, F; Bortolotti, U; Salvatore, L

    1997-01-01

    Cardiac mixoma in the elderly. A clinical study. The clinical features of 13 cardiac myxomas surgically resected are presented. The mean age at presentation was 68 years. Ten were in the left atrium, 5 near the fossa ovalis, 3 at the base of the atrial septum, 1 at the inferior wall and 1 on the anterior leaflet of mitral valve, 3 were in the right atrium, 1 of these was accompanied with a myxoma at the apex of left ventricle. The ECG and the chest X-ray were normal in 9 and in 8 patients, respectively. In 3 patients, the diagnosis was occasionally made by routine 2-dimensional echocardiography. 5 patients presented with fever of unknown origin, arthralgias, weakness, weight loss. None had intracardiac or extracardiac recurrence in the 73 months follow-up. The presentation with constitutional symptoms only like fever of UO, may mimic collagen and neoplastic diseases, vasculitis, lymphomas: the 2-dimensional echocardiography is mandatory to esclude a cardiac myxoma in the elderly. PMID:9213810

  12. Controlled outcome studies of child clinical hypnosis.

    Science.gov (United States)

    Adinolfi, Barbara; Gava, Nicoletta

    2013-08-01

    Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem. PMID:24165457

  13. Non-Clinical Safety Evaluation of Intranasal Iota-Carrageenan

    Science.gov (United States)

    Hebar, Alexandra; Koller, Christiane; Seifert, Jan-Marcus; Chabicovsky, Monika; Bodenteich, Angelika; Bernkop-Schnürch, Andreas; Grassauer, Andreas; Prieschl-Grassauer, Eva

    2015-01-01

    Carrageenan has been widely used as food additive for decades and therefore, an extended oral data set is available in the public domain. Less data are available for other routes of administration, especially intranasal administration. The current publication describes the non-clinical safety and toxicity of native (non-degraded) iota-carrageenan when applied intranasally or via inhalation. Intranasally applied iota-carrageenan is a topically applied, locally acting compound with no need of systemic bioavailability for the drug’s action. Animal experiments included repeated dose local tolerance and toxicity studies with intranasally applied 0.12% iota-carrageenan for 7 or 28 days in New Zealand White rabbits and nebulized 0.12% iota-carrageenan administered to F344 rats for 7 days. Permeation studies revealed no penetration of iota-carrageenan across nasal mucosa, demonstrating that iota-carrageenan does not reach the blood stream. Consistent with this, no relevant toxic or secondary pharmacological effects due to systemic exposure were observed in the rabbit or rat repeated dose toxicity studies. Data do not provide any evidence for local intolerance or toxicity, when carrageenan is applied intranasally or by inhalation. No signs for immunogenicity or immunotoxicity have been observed in the in vivo studies. This is substantiated by in vitro assays showing no stimulation of a panel of pro-inflammatory cytokines by iota-carrageenan. In conclusion, 0.12% iota-carrageenan is safe for clinical use via intranasal application. PMID:25875737

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

    Science.gov (United States)

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

    2016-02-01

    In the present study, we evaluate the impact of participation in a mental health recovery camp on the clinical confidence of undergraduate nursing students in dealing with individuals with mental illness. Twenty undergraduate nursing students who participated in the recovery camp completed the Mental Health Nursing Clinical Confidence Scale both before and directly after attending the camp. Data were analysed using descriptive and inferential statistics. Participation in the recovery camp was associated with a statistically-significant increase in students' level of overall confidence between the pretest and post-test data (P level of confidence in both the pre- and post-results. The clinical confidence of undergraduate nursing students improved through participation in an immersive clinical experience within the recovery camp. PMID:26767715

  15. Evaluation of patients with a recent clinical fracture and osteoporosis, a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Udrea Gabriela

    2008-08-01

    Full Text Available Abstract The aetiology of osteoporotic fractures is multifactorial, but little is known about the way to evaluate patients with a recent clinical fracture for the presence of secondary osteoporosis. The purpose of this study was to determine the prevalence of contributors to secondary osteoporosis in patients presenting with a clinical vertebral or non-vertebral fracture. Identifying and correcting these contributors will enhance treatment effect aimed at reducing the risk of subsequent fractures. In a multidisciplinary approach, including evaluation of bone and fall-related risk factors, 100 consecutive women (n = 73 and men (n = 27 older than 50 years presenting with a clinical vertebral or non-vertebral fracture and having osteoporosis (T-score ≤-2.5 were further evaluated clinically and by laboratory testing for the presence of contributors to secondary osteoporosis. In 27 patients, 34 contributors were previously known, in 50 patients 52 new contributors were diagnosed (mainly vitamin D deficiency in 42 and 14 needed further exploration because of laboratory abnormalities (mainly abnormal thyroid stimulating hormone in 9. The 57 patients with contributors were older (71 vs. 64 yrs, p We conclude that more than one in two patients presenting with a clinical vertebral or non-vertebral fracture and BMD-osteoporosis have secondary contributors to osteoporosis, most of which were correctable. Identifying and correcting these associated disorders will enhance treatment effect aimed at reducing the risk of subsequent fractures in patients older than 50 years.

  16. To evaluate the efficacy and clinical study of Morinda officinalis in treatment of osteoporosis%探讨巴戟天治疗骨质疏松症的疗效及临床研究

    Institute of Scientific and Technical Information of China (English)

    宋娟

    2013-01-01

    Objective to evaluate the efficacy and clinical study of Morinda officinalis in treatment of osteoporosis. Methods 41 patients with osteoporosis were randomly divided into treatment group and control group, 21 cases in the control group with conventional therapy, the treatment group of 20 cases on the basis of conventional therapy plus chinese medicine Morinda officinalis Decoction oral treatment, detection of bone density (BMD) and biochemical indexes of Serum Osteocalcin (BGP), urine pyridine phenol (PYd). Results the end of the two groups of patients after treatment, the observation group the total clinical effective rate was 85%, significantly better than the control group 57.1%, there are significant differences P <0.05. the observation group after treatment (BMd) on bone density and biochemical indexes of serum osteocalcin (BGP), urinary pyridinoline (PYD) and other parameters change significantly better than the control group, there was statistically significant difference in P <0.05. Conclusion Radix Morindae Officinalis can effectively prevent bone loss, promote calcium deposition, improve osteoporosis.%目的:探讨巴戟天治疗骨质疏松症的疗效及临床研究。方法对41例骨质疏松症患者随机分为治疗组与对照组,对照组21例采用常规治疗,治疗组20例在常规治疗基础上加用单味中药巴戟天煎液口服治疗,检测骨密度(BMd)及生化指标血清骨钙素(BGP)、尿吡啶酚(PYd)。结果两组患者疗程结束后,观察组临床总有效率为85%明显好于对照组57.1%,P <0.05差异有统计学意义。治疗后观察组骨密度(BMd)及生化指标血清骨钙素(BGP)、尿吡啶酚(PYd)等参数变化明显好于对照组,P <0.05差异有统计学意义。结论巴戟天可有效阻止骨质丢失,促进钙盐沉积,改善骨质疏松的功效。

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

    Energy Technology Data Exchange (ETDEWEB)

    Hibbert, Kathryn M.; Van Deven, Teresa [The Univ. of Western Ontario, London, ON (Canada). Dept. of Medical Imaging; Chhem, Rethy K. [Medical Univ. of Vienna (Austria). Dept. of Radiology; Nagasaki Univ. (Japan). Atomic Bomb Disease Inst.; Wang, Shih-chang (eds.) [Univ. of Sydney Westmead Hospital (Australia). Dept. of Radiology; Royal Australian and New Zealand College of Radiologists, Sydney (Australia). Faculty of Radiodiagnosis

    2012-11-01

    Third volume of a trilogy devoted to radiology education and improvement of medical imaging students' learning, teaching, and scholarship. Reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education. Includes a series of rich case studies. Written by an international group of experienced educators and medical professionals. This book reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education, highlighting emerging practices and work done in the field. The sometimes conflicting assessment and evaluation needs of accreditation bodies, academic programs, trainees, and patients are carefully considered. The final section of the book examines assessment and evaluation in practice, through the development of rich case studies reflecting the implementation of a variety of approaches. This is the third book in a trilogy devoted to the scholarship of radiology education and is the culmination of an important initiative to improve medical imaging students' learning, teaching, and scholarship by bringing together experienced educators and medical professionals. The previous two books focused on the culture and the learning organizations in which our future radiologists are educated and on the application of educational principles in the education of radiologists. Here, the trilogy comes full circle: attending to the assessment and evaluation of the education of its members has much to offer back to the learning of the organization.

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

    International Nuclear Information System (INIS)

    Third volume of a trilogy devoted to radiology education and improvement of medical imaging students' learning, teaching, and scholarship. Reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education. Includes a series of rich case studies. Written by an international group of experienced educators and medical professionals. This book reviews the philosophies, theories, and principles that underpin assessment and evaluation in radiology education, highlighting emerging practices and work done in the field. The sometimes conflicting assessment and evaluation needs of accreditation bodies, academic programs, trainees, and patients are carefully considered. The final section of the book examines assessment and evaluation in practice, through the development of rich case studies reflecting the implementation of a variety of approaches. This is the third book in a trilogy devoted to the scholarship of radiology education and is the culmination of an important initiative to improve medical imaging students' learning, teaching, and scholarship by bringing together experienced educators and medical professionals. The previous two books focused on the culture and the learning organizations in which our future radiologists are educated and on the application of educational principles in the education of radiologists. Here, the trilogy comes full circle: attending to the assessment and evaluation of the education of its members has much to offer back to the learning of the organization.

  19. Clinical evaluation of dynamic CT scan of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Tokuda, Masamichi

    1984-09-01

    The clinical usefulness of dynamic CT scans (DCT) of the pancreas was evaluated in 62 normal cases, 9 cases of acute pancreatitis, 24 cases of chronic pancreatitis and 43 cases of carcinoma of the pancreas. The normal pancreas was intensely and homogeneously enhanced on DCT, and peripancreatic vessels were clearly demonstrated, especially the gastroduodenal artery (98.4%). DCT was useful to demonstrate vascular lesions, associated with pancreatitis such as pseudoaneurysm. Although the carcinoma of the pancreas showed poor contrast enhancement on conventional enhanced CT (CCT), 37.2% showed intense contrast enhancement on DCT. Visualization of the gastroduodenal artery by DCT is helpful to decide the extent of tumor. DCT is superior to CCT in demonstrating collateral veins caused by tumor invasion to the portal system in carcinoma. DCT was approximately as accurate as angiography (92.6%) in evaluating tumor invasion to the portal system. DCT is a useful and minimally invasive modality in assessing the resectability of pancreatic carcinoma. DCT may eliminate angiography and surgery in unresectable cases. (author).

  20. Clinical evaluation of a novel respiratory rate monitor.

    Science.gov (United States)

    Lee, Peter J

    2016-04-01

    Respiratory rate has been shown to be an important predictor of cardiac arrest, respiratory adverse events and intensive care unit admission and has been designated a vital sign. However it is often inadequately monitored in hospitals. We test the hypothesis that RespiraSense, a piezoelectric-based novel respiratory rate (RR) monitor which measures the differential motion of the chest and abdomen during respiratory effort, is not inferior to commonly used methods of respiratory rate measurement. Respiratory rate was compared between the developed RespiraSense device and both electrocardiogram and direct observation by nursing staff. Data was collected from 48 patients admitted to the post-anaesthesia care unit in a tertiary level hospital. The primary outcome measure was difference in average RR calculated over a 15 min interval between (1) RespiraSense and ECG and (2) RespiraSense and nurses' evaluation. The secondary outcome measure was the correlation between the respiratory rates measured using these three methods. The 95 % confidence interval for the difference in average RR between RespiraSense and ECG was calculated to be [-3.9, 3.1]. The 95 % confidence interval for the difference in average RR between RespiraSense and nurses' evaluation was [-5.5, 4.3]. We demonstrate a clinically relevant agreement between RR monitored by the RespiraSense device with both ECG-derived and manually observed RR in 48 post-surgical patients in a PACU environment. PMID:25900144

  1. SPECT-PET in Epilepsy and Clinical Approach in Evaluation.

    Science.gov (United States)

    Ergün, Eser Lay; Saygi, Serap; Yalnizoglu, Dilek; Oguz, Kader Karli; Erbas, Belkis

    2016-07-01

    In epilepsy, a detailed history, blood chemistry, routine electroencephalography, and brain MRI are important for the diagnosis of seizure type or epilepsy syndrome for the decision of appropriate drug treatment. Although antiepileptic drugs are mostly successful for controlling epileptic seizures, 20%-30% patients are resistant to medical treatment and continue to have seizures. In this intractable patient group, surgical resection is the primarily preferred treatment option. This particular group of patients should be referred to the epilepsy center for detailed investigation and further treatment. When the results of electroencephalography, MRI, and clinical status are discordant or there is no structural lesion on MRI, ictal-periictal SPECT, and interictal PET play key roles for lateralization or localization of epileptic region and guidance for the subsequent subdural electrode placement in intractable epilepsy. SPECT and PET show the functional status of the brain. SPECT and PET play important roles in the evaluation of epilepsy sydromes in childhood by showing abnormal brain regions. Most of the experience has been gained with (18)FDG-PET, in this respect. (11)C-flumazenil-PET usually deliniates the seizure focus more smaller than (18)FDG-PET and is sensitive in identifying medial temporal sclerosis. (11)C-alpha-methyl-l-tryptophan is helpful in the differentiation of epileptogenic and nonepileptogenic regions in children especially in tuberous sclerosis and multifocal cortical dysplasia for the evaluation of surgery. Finally, when there is concordance among these detailed investigations, resective surgery or palliative procedures can be discussed individually. PMID:27237440

  2. Seizures after stroke : a prospective clinical study.

    Directory of Open Access Journals (Sweden)

    Dhanuka A

    2001-01-01

    Full Text Available Stroke is one of the most common causes of epilepsy in elderly. However, there have been very few prospective studies to define the incidence, pattern and outcome of seizures in stroke. Most studies are based on retrospective analysis of hospital records. Hence, we planned this prospective study to see the clinical, radiological and electroencephalographic characteristics of seizures in stroke and their outcome, from a north Indian tertiary care centre. Over a span of approximately 6 years, 269 consecutive patients with stroke were studied and followed up. Thirty-five (13% of these developed seizures, primarily related to stroke, during mean follow up period of 15.9 months. Twenty of these had infarctions while 15 had haemorrhages. Involvement of the cortical region was seen in most of the patients with seizures. In these patients, 86% of the lesions involved cortical areas exclusively or in addition to subcortical areas on CT scan of the brain. Twenty-seven (77% developed early seizures, two third of them had immediate post-stroke seizures. None of the patients with early onset seizures developed recurrent seizures or epilepsy, while 50% of late onset seizures developed epilepsy. No specific EEG pattern was found in those who later developed epilepsy. In the present study, early onset seizures after stroke were rather common and did not affect outcome and did not recur even when not treated with anti-epileptics. Late onset seizures were less common but were associated with recurrent seizures.

  3. A clinical evaluation on adhesive posts in extensive composite restorations

    Directory of Open Access Journals (Sweden)

    Ghavamnasiri M. Associate Professor

    2003-06-01

    Full Text Available Problem: A few studies have been conducted about bioglass posts."nAim: The aim of this study was to compare bioglass posts with prefabricated metallic posts in clinical performance of extensive composite restorations for anterior endodontically treated teeth. Materials and Methods: Sixty endodontocally maxillary anterior teeth, with horizontally or vertically destruction, were selected. Teeth were divided into two groups based on the kind of post: Metallic prefabricated parapost and bioglass post. Each group was divided into three subgroups based on anterior bite: normal, deep bite and edge to edge. Gutta-percha was removed from 2/3 of canal length for parapost and 1/3 for bioglass post. After etching with phosphoric-acid (37% and applying dentine bonding syntac, Duo cement was used for the adhesion of bioglass post and a self cured composite (Degufil for parapost. Restoration was done with a hybrid composite (Heliomolar. Follow up studies, radio-graphically and clinically, were done every three months for a 1.5-year period. Exact Fisher and Pearson tests were used for data analysis."nResults: Apical lesion was not observed in any of the radiographs. Post seal was increased by resin cement and dentin bonding agent. Post type did not significantly affect on the clinical success rate of the restorations. The retention of restoration, for both posts, was the same. Crown destruction had no significant effect on success rate. The type of anterior bite had a significant effect on success rate, as the total 6.6% failure rate was related to the patients with anterior deep bite."nConclusion: It is suggested to use metallic paraposts and bioglass posts, in extensive composite restorations for patients with deep-bite, more conservatively.

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

    OpenAIRE

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

    2011-01-01

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

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

    OpenAIRE

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

    1982-01-01

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

  6. A CLINICAL STUDY ON SCROTAL SWELLINGS

    Directory of Open Access Journals (Sweden)

    Sobha Rani

    2015-09-01

    Full Text Available INTRODUCTION: The scrotum is a cutaneous bag containing the right and left testis, the epididymis and the lower parts of the spermatic cords. 1 Scrotal swellings are the commonest swellings affecting both children and adults. Though these swellings are frequently encountered, many times correct dia gnosis is not made and testis has been sacrificed . It also affects the physical wellbeing of the patient, is rather a mental agony for him. Most of the times, patients hesitate to come early and may come with late complications. AIMS AND OBJECTIVES OF THE STUDY: 1. To determine and confirm various etiological aspects of different swellings of scrotum. 2. To study various modes of presentations, relative incidence and diagnostic procedures for swellings of scrotum. 3. To study the various techniques and proc edures done . MATERIALS AND METHODS: STUDY DESIGN: Prospective Clinical Study . STUDY AREA: Sri Venkateswara Medical College , Tirupathi . SOURCE OF DATA: The material for the present study is collected from the patients who present to the Out Patient Department of Surgery, Sri Venkateswara Medical College with swelling in the scrotal region fulfilling the inclusion criteria. SAMPLE SIZE: 100 patients fulfil ling the inclusion criteria . METHOD OF COLLECTION OF DATA: Detailed history taking , Complete clinical examination , Appropriate Investigations Blood & Urine Examination, USG , Performing surgery for the indicated cases & Operative findings were recorded. INC LUSION CRITERIA: Patients aged between 13 to 60yrs. Cystic swellings from the testes & its coverings, epididymis, spermatic cord & from scrotal skin. EXCLUSION CRITERIA : Cystic inguino - scrotal swellings. Patients aged above 60. RESULTS & CONCLUSIONS: Major ity of the patients with swelling of the scrotum belonged to the 31 - 40 years of age group (50% followed by 41 - 50 years (18% and 21 - 30 years (12%. Scrotal swelling was the common mode of presentation (60%. Right side was

  7. Clinical evaluation of digital subtraction angiography in Takayasu's arteritis

    International Nuclear Information System (INIS)

    Twenty-eight patients with Takayasu's arteritis were evaluated by either intra-venous DSA (28 patients) and/or intra-arterial DSA (9 patients). IV-DSA provided information comparable to those obtained by conventional angiography, although evaluation of collateral vessels with IV-DSA was not sufficient. With IA-DSA, images of definitive quality and completeness were obtained with small amount of contrast media in nearly all cases. IV-DSA is a choice of examination in screening and follow-up study for Takayasu's arteritis. Its usefulness and limitations are discussed, and interesting cases are presented. (author)

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

    Directory of Open Access Journals (Sweden)

    Sefer Varol

    2015-12-01

    Full Text Available ABSTRACT Objective Facial diplegia (FD is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS (11, Bickerstaff’s brainstem encephalitis (1, neurosarcoidosis (1, non-Hodgkin’s Lymphoma (1, tuberculous meningitis (1 herpes simplex reactivation (1 and idiopathic (1. In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

  9. The fitness for the Ageing Brain Study II (FABS II): protocol for a randomized controlled clinical trial evaluating the effect of physical activity on cognitive function in patients with Alzheimer's disease

    OpenAIRE

    Ames David; Flicker Leon; Almeida Osvaldo P; Cox Kay L; Cyarto Elizabeth V; Byrne Gerard; Hill Keith D; Beer Christopher D; LoGiudice Dina; Appadurai Kana; Irish Muireann; Renehan Emma; Lautenschlager Nicola T

    2010-01-01

    Abstract Background Observational studies have documented a potential protective effect of physical exercise in older adults who are at risk for developing Alzheimer's disease. The Fitness for the Ageing Brain II (FABS II) study is a multicentre randomized controlled clinical trial (RCT) aiming to determine whether physical activity reduces the rate of cognitive decline among individuals with Alzheimer's disease. This paper describes the background, objectives of the study, and an overview of...

  10. Evaluating dose response from flexible dose clinical trials

    Directory of Open Access Journals (Sweden)

    Baron David

    2008-01-01

    Full Text Available Abstract Background The true dose effect in flexible-dose clinical trials may be obscured and even reversed because dose and outcome are related. Methods To evaluate dose effect in response on primary efficacy scales from 2 randomized, double-blind, flexible-dose trials of patients with bipolar mania who received olanzapine (N = 234, 5–20 mg/day, or patients with schizophrenia who received olanzapine (N = 172, 10–20 mg/day, we used marginal structural models, inverse probability of treatment weighting (MSM, IPTW methodology. Dose profiles for mean changes from baseline were evaluated using weighted MSM with a repeated measures model. To adjust for selection bias due to non-random dose assignment and dropouts, patient-specific time-dependent weights were determined as products of (i stable weights based on inverse probability of receiving the sequence of dose assignments that was actually received by a patient up to given time multiplied by (ii stable weights based on inverse probability of patient remaining on treatment by that time. Results were compared with those by unweighted analyses. Results While the observed difference in efficacy scores for dose groups for the unweighted analysis strongly favored lower doses, the weighted analyses showed no strong dose effects and, in some cases, reversed the apparent "negative dose effect." Conclusion While naïve comparison of groups by last or modal dose in a flexible-dose trial may result in severely biased efficacy analyses, the MSM with IPTW estimators approach may be a valuable method of removing these biases and evaluating potential dose effect, which may prove useful for planning confirmatory trials.

  11. Gender effect on clinical features of achalasia: a prospective study

    Directory of Open Access Journals (Sweden)

    Mahdavinia Mahboobeh

    2006-04-01

    Full Text Available Abstract Background Achalasia is a well-characterized esophageal motor disorder but the rarity of the disease limits performing large studies on its demographic and clinical features. Methods Prospectively, 213 achalasia patients (110 men and 103 women were enrolled in the study. The diagnosis established by clinical, radiographic, and endoscopic as well as manometry criteria. All patients underwent a pre-designed clinical evaluation before and within 6 months after the treatment. Results Solid dysphagia was the most common clinical symptom in men and women. Chest pain was the only symptom which was significantly different between two groups and was more complained by women than men (70.9% vs. 54.5% P value= 0.03. Although the occurrence of chest pain significantly reduced after treatment in both groups (P Conclusion It seems that chest pain is the distinct symptom of achalasia which is affected by sex as well as age and does not relate to the duration of illness, LESP and the type of treatment achalasia patients receive.

  12. Experimental and clinical studies with intraoperative radiotherapy

    International Nuclear Information System (INIS)

    Studies of normal tissue tolerance to intraoperative radiotherapy were done upon 65 dogs subjected to laparotomy and 11 million electron volt electron irradiation in doses ranging from zero to 5,000 rads. Results of studies indicated that intact aorta and vena cava tolerate up to 5,000 rads without loss of structural integrity. Ureteral fibrosis and stenosis develop at doses of 3,000 rads or more. Arterial anastomoses heal after doses of 4,500 rads, but fibrosis can lead to occlusion. Intestinal suture lines heal after doses of 4,500 rads. Bile duct fibrosis and stenosis develop at doses of 2,000 rads or more. Biliary-enteric anastomoses fail to heal at any dose level. A clinical trial of intraoperative radiotherapy combined with radical surgery was performed upon 20 patients with advanced malignant tumors which were considered unlikely to be cured by conventional therapies and which included carcinomas of the stomach, carcinomas of the pancreas, carcinomas involving the hilus of the liver, retroperitoneal sarcomas and osteosarcomas of the pelvis. All patients underwent resection of gross tumor, followed by intraoperative irradiation of the tumor bed and regional nodal basins. Some patients received additional postoperative external beam radiotherapy. Treatment mortality for combined operation and radiotherapy occurred in four of 20 patients. Postoperative complications occurred in four of the 16 surviving patients. Local tumor control was achieved in 11 of the 16 surviving patients, with an over-all median follow-up period of 18 months. The clinical trial suggested that intraoperative radiotherapy is a feasible adjunct to resection in locally advanced tumors, that the resulting mortality and morbidity is similar to that expected from operation alone and that local tumor control may be improved

  13. The wish to hasten death: a review of clinical studies.

    Science.gov (United States)

    Monforte-Royo, Cristina; Villavicencio-Chávez, Christian; Tomás-Sábado, Joaquín; Balaguer, Albert

    2011-08-01

    It is common for patients who are faced with physical or psychological suffering, particularly those in the advanced stages of a disease, to have some kind of wish to hasten death (WTHD). This paper reviews and summarises the current state of knowledge about the WTHD among people with end-stage disease, doing so from a clinical perspective and on the basis of published clinical research. Studies were identified through a search strategy applied to the main scientific databases. Clinical studies show that the WTHD has a multi-factor aetiology. The literature review suggests-perhaps in line with better management of physical pain-that psychological and spiritual aspects, including social factors, are the most important cause of such a wish. One of the difficulties facing clinical research is the lack of terminological and conceptual precision in defining the construct. Indeed, studies frequently blur the distinction between a generic wish to die, a WTDH (whether sporadic or persistent over time), the explicit expression of a wish to die, and a request for euthanasia or physician-assisted suicide. A notable contribution to knowledge in this field has been made by scales designed to evaluate the WTHD, although the problems of conceptual definition may once again limit the conclusions, which can be drawn from the results. Studies using qualitative methodology have also provided new information that can help in understanding such wishes. Further clinical research is needed to provide a complete understanding of this phenomenon and to foster the development of suitable care plans. PMID:20821377

  14. Phase I/II clinical and pharmacokinetic study evaluating a fully human monoclonal antibody against EGFr (HuMax-EGFr) in patients with advanced squamous cell carcinoma of the head and neck

    DEFF Research Database (Denmark)

    Bastholt, Lars; Specht, Lena; Jensen, Kenneth;

    2007-01-01

    PURPOSE: To assess safety, tolerability, pharmacokinetics and clinical activity of HuMax-EGFr in patients with SCCHN. PATIENTS AND METHODS: Twenty-eight patients with SCCHN were enrolled. The study comprised a single-dose escalation part for assessment of safety issues followed by a repeat dose...

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

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H;

    2014-01-01

    Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review Larsen CM1, Juul-Kristensen B1,2 Lund H1,2, Søgaard K1 1University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics 2Institute of Occupational....... Methods A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. The overall method used in this review can be divided into four steps: 1) Compile an...... evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was ‘fair’ (57%) to ‘poor’ (43%), with...

  16. Pulse oximetry: instrumental alternative in the clinical evaluation by the bed for the dysphagia

    Directory of Open Access Journals (Sweden)

    Cardoso, Maria Cristina de Almeida Freitas

    2010-06-01

    Full Text Available Introduction: The clinical evaluation by the bed is the clinical procedure utilized by the speech therapy as a screening test for established if the individual presents or not a clinical picture of dysphagia. Its achievement count with the use of the pulse oximetry that is the not-invasive measure of the peripheral saturation of O2. When it related to the dysphagia, the saturation can decline in the moment of the swallowing, suggesting a compromise of the respiratory system. Such decline is observed in individuals that aspire with sustenances of liquid and solid consistency, before during and after food, when compared to the individuals that do not aspire. Objective: To verify the possibility of the utilization of the pulse oximetry as an instrumental alternative in the clinical evaluation for the dysphagia. Method: Revision of literature, based in articles indexed in the bases Lilacs and Medline having as a reference the descriptors: saturation of oxygen, pulse oximetry and swallowing disorders. Results: The association of the clinical evaluation to the pulse oximetry shows up with high sensibility in the detection of the penetration and aspiration laringotraqueal and with bass false-positive index, considering it desaturation, the indices that pierced with bigger values than 2%. Some data found are divergent as the aspiration detection possibility. Final Comments: The studies analyzed confer to oximetria of wrist the character of practically and possibility of use in the actions by the bed, being utilized ally to the clinical evaluation for dysphagia, although certain disagreement between the same is found as regards the utilization of its results as indicator of aspiration laringotraqueal, suggesting need of subsequent researches.

  17. Clinical application of cerebral dynamic perfusion studies

    International Nuclear Information System (INIS)

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

  18. A CLINICAL STUDY ON ILEAL PERFORATION

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    Kishore Babu

    2016-03-01

    Full Text Available INTRODUCTION Ileal perforation is a common problem seen in tropical countries, the commonest cause being typhoid fever. In western countries the causes are malignancy, trauma and mechanical aetiology, in the order of frequency.1,2,3 Over the years a definite changing trend has been observed in ileal perforations both in terms of causes, treatment and prognosis. Better antibiotics, aggressive surgery and the elimination of conservative treatment, better preoperative and postoperative care have all significantly contributed to the improvement in patient outcome.4,5 But still cases of ileal perforation cause a significant morbidity and mortality that persists despite the significant changes in health care over the years. AIMS AND OBJECTIVES To study the aetiology, presentation, management outcome and the factors influencing prognosis and outcome in ileal perforations. MATERIAL & METHODS Study Setting S. V. Medical College, Department of General Surgery, Tirupati. Study Period Patients attending S. V. Medical College, Department of General Surgery with perforation during the period from November 2012 to October 2015. Inclusion Criteria Patients between age group of more than 14 years presenting with pain abdomen and who are diagnosed to have ileal perforation in the intra operative period are selected. Exclusion Criteria Patients with peritonitis due to other causes like gastric, duodenum or large bowel perforation are excluded. Study Method The present study is a prospective study done on 28 patients of ileal perforation due to typhoid complication, nonspecific and traumatic perforations. History, clinical examination, investigations, operative findings, post-operative complications were recorded. In patients with non-traumatic perforations Widal test was done. CONCLUSION Typhoid fever and traumatic aetiology are the most common cause of Ileal perforation, followed by TB. Patients are more of male gender and are in reproductive age group. Widal

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

    Directory of Open Access Journals (Sweden)

    Carme Sansalvador-Comas

    2014-07-01

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

  20. Clinical impact of anatomo-functional evaluation of brain function during brain tumor surgery

    International Nuclear Information System (INIS)

    To attempt to improve surgical outcome of brain surgery, clinical significance of anatomo-functional evaluation of brain function during resection of brain tumors was assessed. Seventy four patients with glioma located near eloquent areas underwent surgery while awake. Intraoperative tractography-integrated functional neuronavigation and cortical/subcortical electrical stimulation were correlated with clinical symptoms during and after resection of tumors. Cortical functional areas were safely removed with negative electric stimulation and eloquent cortices could be removed in some circumstances. Subcortical functional mapping was difficult except for motor function. Studying cortical functional compensation allows more extensive removal of brain tumors located in the eloquent areas. (author)

  1. Compliance with mandatory reporting of clinical trial results on ClinicalTrials.gov: cross sectional study

    OpenAIRE

    Prayle, A.P.; Hurley, M.N.; Smyth, Alan R

    2012-01-01

    Objective To examine compliance with mandatory reporting of summary clinical trial results (within one year of completion of trial) on ClinicalTrials.gov for studies that fall under the recent Food and Drug Administration Amendments Act (FDAAA) legislation. Design Registry based study of clinical trial summaries. Data sources ClinicalTrials.gov, searched on 19 January 2011, with cross referencing with Drugs@FDA to determine for which trials mandatory reporting was required within one...

  2. [Clinical manifestations, complications and treatment of brucellosis: 45-patient study].

    Science.gov (United States)

    Zribi, M; Ammari, L; Masmoudi, A; Tiouiri, H; Fendri, C

    2009-07-01

    The aim of this study was to evaluate the clinical, laboratory findings and therapeutic features of patients with brucellosis. The diagnosis was made by clinical findings, automated blood culture, serology (Rose Bengal plate agglutination test, standard tube agglutination (Wright) and immunofluorerescence). The susceptibility of 13 strains was tested in vitro. The base sequence was determined for four strains. Forty-five cases were collected (31 acute and 14 sub-acute). Contamination was digestive in 62%. Symptoms of patients were fever (93%), sweating (82%), arthralgia (78%) and splenomegaly (51%). Elevated erythrocyte sedimentation rate was determined in 80%, leukopenia in 49% and anaemia in 37% of cases. Blood cultures were positives in 39% of cases. The four sequenced strains were identified as Brucella melitensis biovar abortus. Six strains were resistant to sufomethoxazol-trimetoprim (54%). In 93% of cases, the treatment was associated rifampicin and doxycyclin. One patient died. No relapse was reported. PMID:18387752

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

    Directory of Open Access Journals (Sweden)

    Zarrati S

    2011-02-01

    Full Text Available "nBackground and Aims: Nowadays, removable partial dentures are applied to patients who are not able to use dental implants or fixed prosthesis. Although based on the studies the users of removable partial dentures are in the risk of plaque accumulation and unacceptable changes such as gingivitis, periodontitis and mobility in abutment tooth. It is not clear whether the negative effects of removable partial dentures are more on the isolated teeth which are a kind of abutment adjacent to endentulous area in both sides. The purpose of this study was to investigate the clinical condition of isolated abutment teeth without splinting in comparison to control abutment from the aspects of B.O.P (bleeding on probing, mobility, pocket depth and gingivitis."nMaterials and Methods: In this cross-sectional study, the prepared questionnaires were filled out by 50 patients who received removable partial dentures in department of removable prosthodontics of dental school of Tehran University of Medical Sciences. The patients had isolated abutment tooth and did not have any systemic disease. The obtained data were analyzed. Using Wilcoxon, exact Fisher and Kruskal-Wallis test."nResults: B.O.P (P=0.004, pocket depth (P=0.035, and mobility (P<0.001 in isolated abutments were more than those in control abutments, but there were not significant differences in the degree of caries (P=0.083 and gingivitis (P=0.07."nConclusion: This study showed that clinical condition of isolated abutments is worse than that of control abutments. More attention should be paid to healthiness of isolated teeth without splinting and periodic follow ups should be done in these cases.

  4. Evaluation of Sialic Acid and Acute Phase Proteins (Haptoglobin and Serum Amyloid A) in Clinical and Subclinical Bovine Mastitis

    OpenAIRE

    S. Nazifi*, M. Haghkhah1, Z. Asadi, M. Ansari-Lari2, M. R. Tabandeh3, Z. Esmailnezhad and M. Aghamiri

    2011-01-01

    The present study was conducted to evaluate the concentrations of sialic acids (total, lipid bound and protein bound) and their correlation with acute phase proteins (haptoglobin and serum amyloid A) in clinical and subclinical mastitis of cattle. Thirty subclinical mastitic cows with positive California mastitis test (CMT) test and no clinical signs of mastitis, 10 clinical mastitic cows and 10 healthy cows with negative CMT test and normal somatic cell count were selected. Milk and blood sa...

  5. Clinical evaluation of children testing positive in screening tests for attention-deficit/hyperactivity disorder: A preliminary report

    OpenAIRE

    Maria Skounti; Katerina Mpitzaraki; Anastas Philalithis; Emmanouil Galanakis

    2009-01-01

    Background and Objectives: Screening tests are of great diagnostic value in attention-deficit/hyperactivity disorder (ADHD), however final diagnosis relies on a clinical examination by an expert. The objective of the present study was to clinically evaluate children who had been screened positive for ADHD through both a parent and a teacher questionnaire. Methods: Parent interview and child behavior checklist and clinical assessment were used to confirm the preliminary diagnosis in 42 childre...

  6. Clinical evaluation of multiplanar reformation CT images in disk hernias

    International Nuclear Information System (INIS)

    Computed tomography (CT) is a non-invasive procedure as compared with myelography in the diagnosis of diseases of the spine and spinal cord. In recent years, the performance of the CT-scan equipment has been markedly improved, resulting in an advancement of its diagnostic value, and it is said that CT is now superior to myelography in diagnosing some types of diseases of spine and spinal cord. We performed a multiplanar reformation in patients with disk hernia for the purpose of evaluating the method's clinical diagnostic value, and the reformatted images were compared with the axial images in the same patient. We used four types of reformation: coronal, sagittal, para-axial, and oblique reformations. The reformatted images were obtained from multiple continuous images with a slice thickness of 3 mm and with no declination of the gantry of the scanner. The axial images were obtained by making the gantry parallel to the disk and perpendicular to the vertebral body. The thickness of the axial images is 3 mm at the disk and 5 mm at the vertebral body level. We compared these reformatted and axial images with the extension of the disk hernia in the spinal canal and neural foramen and the degree of visualization of nerve roots. The sagittal reformatted images were useful in evaluating the extension of the disk hernia in the spinal canal and neural foramen. The coronal and oblique reformatted images were useful in visualizing the nerve roots. The axial images were excellent in ability to diagnose the disk hernia, while the reformatted images were significant in understanding the anatomical relation of the disease preoperatively. (author)

  7. Chronic actinic dermatitis - A study of clinical features

    Directory of Open Access Journals (Sweden)

    Somani Vijay

    2005-01-01

    Full Text Available Background: Chronic actinic dermatitis (CAD, one of the immune mediated photo-dermatoses, comprises a spectrum of conditions including persistent light reactivity, photosensitive eczema and actinic reticuloid. Diagnostic criteria were laid down about 20 years back, but clinical features are the mainstay in diagnosis. In addition to extreme sensitivity to UVB, UVA and/or visible light, about three quarters of patients exhibit contact sensitivity to several allergens, which may contribute to the etiopathogenesis of CAD. This study was undertaken to examine the clinical features of CAD in India and to evaluate the relevance of patch testing and photo-aggravation testing in the diagnosis of CAD. Methods: The clinical data of nine patients with CAD were analyzed. Histopathology, patch testing and photo-aggravation testing were also performed. Results: All the patients were males. The average age of onset was 57 years. The first episode was usually noticed in the beginning of summer. Later the disease gradually tended to be perennial, without any seasonal variations. The areas affected were mainly the photo-exposed areas in all patients, and the back in three patients. Erythroderma was the presenting feature in two patients. The palms and soles were involved in five patients. Patch testing was positive in seven of nine patients. Conclusions: The diagnosis of CAD mainly depended upon the history and clinical features. The incidence of erythroderma and palmoplantar eczema was high in our series. Occupation seems to play a role in the etiopathogenesis of CAD.

  8. Digital breast tomosynthesis versus digital mammography: a clinical performance study

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Baldan, Enrica; Bezzon, Elisabetta; Polico, Ilaria; Proietti, Alessandro; Toffoli, Aida [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Toledano, Alicia [Statistics Collaborative Inc., Washington, DC (United States); Di Maggio, Cosimo [Padua University, Department of Oncological and Surgical Sciences, Padua (Italy); La Grassa, Manuela [Aviano Oncological Reference Center (CRO), IRCCS, Department of Radiology, Aviano (Pordenone) (Italy); Pescarini, Luigi [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Padua University, Department of Oncological and Surgical Sciences, Padua (Italy); Muzzio, Pier Carlo [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Padua University, Department of Medical Diagnostic Sciences, Padua (Italy)

    2010-07-15

    To compare the clinical performance of digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) in a diagnostic population. The study enrolled 200 consenting women who had at least one breast lesion discovered by mammography and/or ultrasound classified as doubtful or suspicious or probably malignant. They underwent tomosynthesis in one view [mediolateral oblique (MLO)] of both breasts at a dose comparable to that of standard screen-film mammography in two views [craniocaudal (CC) and MLO]. Images were rated by six breast radiologists using the BIRADS score. Ratings were compared with the truth established according to the standard of care and a multiple-reader multiple-case (MRMC) receiver-operating characteristic (ROC) analysis was performed. Clinical performance of DBT compared with that of FFDM was evaluated in terms of the difference between areas under ROC curves (AUCs) for BIRADS scores. Overall clinical performance with DBT and FFDM for malignant versus all other cases was not significantly different (AUCs 0.851 vs 0.836, p = 0.645). The lower limit of the 95% CI or the difference between DBT and FFDM AUCs was -4.9%. Clinical performance of tomosynthesis in one view at the same total dose as standard screen-film mammography is not inferior to digital mammography in two views. (orig.)

  9. CLINICAL AND HISTOPATHOLOGICAL STUDY OF CUTANEOUS TUBERCULOSIS

    Directory of Open Access Journals (Sweden)

    Ashok S

    2014-09-01

    Full Text Available Extrapulmonary tuberculosis constitutes about 10% of all cases of tuberculosis, and cutaneous tuberculosis makes up only a small proportion of these cases. Despite prevention programs, tuberculosis is still progressing endemically in developing countries. Commonest clinical variant of cutaneous tuberculosis in our study was tuberculous verrucosa cutis (TBVC seen in 46.66% patients followed by Lupus vulgaris seen in 33.33% patients followed by scrofuloderma (13.33%, papulonecrotic tuberculide (6.66%. The commonest site of involvement was upper limbs seen in 46.66% patients followed by lower limb seen in 20% patients, face, neck, inguinal region, axilla, chest in 6.66% and generalized pappilary eruptions in 6.66% patients. Maximum percentage of patients (53.3% had duration of cutaneous tuberculosis between 1-3 years followed by 33.33% between 1-6 months, 6.66% had duration of cutaneous tuberculosis between 7-12 months, and rest 6.66% had duration between 4-6 years. The commonest histopathological feature in our study was tuberculoid granuloma with epithelioid and Langhans giant cells seen in 70% patients, hyperkeratosis was seen in 13.33% patients and AFB bacilli were seen in 6.66% patients.

  10. Bioplastique at 6 years: clinical outcome studies.

    Science.gov (United States)

    Ersek, R A; Gregory, S R; Salisbury, A V

    1997-11-01

    Bioplastique is a biphasic polymer for the permanent augmentation of some soft tissues. It was developed in 1987, and clinical studies at this institution were begun in 1990. The combination of low molecular weight polyvinylpyrrolidone and solid polymer particles allows the implantation of permanent polymer spheres through a small needle under local anesthesia. In this study 127 cases are reviewed of consecutive patients who have received Bioplastique for scar revision, wrinkles, and augmentation for soft-tissue defects at 6 years after application. All patients who had not been in for follow-up recently were contacted by mail and questioned on the permanence of augmentation and migration of particles. About 30 percent of the patients were unreachable and had their charts reviewed for permanence and migration of particles. In eight of these cases, Bioplastique was removed because of overcorrection, two of them may have had infection. Bioplastique has gained wide use throughout the world and although some complications have been reported, in general, it functions quite well when used in selected cases. PMID:9385974

  11. An evaluation of the regional cerebral blood flow (rCBF) measurement by xenon-enhanced dynamic CT with helical scanning technique and the functional imaging by multiplanar reconstruction (MPR). Fundamental study and clinical application

    International Nuclear Information System (INIS)

    We evaluated the quantitative rCBF by xenon-enhanced dynamic CT with helical scanning technique on all brain regions, and also examined clinical usefulness of coronal and sagittal section images which are similar to SPECT images obtained by the functional multiplanar reconstitution (MPR) imaging of many successive flow maps. We used 14 clinical cases. The conventional xenon-enhanced CT was simple and ideal method to measure rCBF, however, it had disadvantages; it gives a few laminagraphical images or only the axial directional images, compared to SPECT or PET. There is a risk to overlook lesions out of the image or not to obtain the whole images of the lesion. Although the helical scanning technique has a methodological characteristics to use adjacent data for the image reconstitution, it is by no means inferior to the conventional method in the contrast resolution or the image resolution when the co-helical function and an appropriate reconstituted function were used. It has an advantage to scan all brain regions by only one cycle of scanning. Furthermore on making good use of the property that the helical scanning technique can give the successive data, we can observe rCBF by coronal and sagittal images when many flow maps were made up by reconstituted images of the narrow steps. This shows the clinical usefulness of this technique. One of the future problem to be solved is to decrease the exposure dose. (K.H.)

  12. Clinical evaluation of stress fractures using bone scintigraphy

    International Nuclear Information System (INIS)

    Clinical evaluation of stress fractures were performed in 58 athletes using bone scintigraphy with sup(99m)Tc-MDP. Stress fractures of the tibia were most often seen in the males with running type sports. They occurred more often in the proximal tibia and on the right side. Stress fractures of the fibula were most often seen in females with jumping type sports, such as volley ball. They occurred more often in the distal fibula and on the right side. Tarsal bone fractures were seen most often rugby players. Metatarsal fractures occurred in the third fourth and fifth metatarsals. No lesion was seen in the first and second metatarsals. We feel that stress fractures of the femur can be differentiated from osteosarcoma by small loculated radionuclide accumulation as well as symptome, course and tomographic and CT finding. Bilateral involvement was seen in two cases in patellae and calcanei. Most of the other fractures were seen on the right side. Negative radiographs were seen in 36% of the patients and occurred most commonly in the tarsal bones excluding calcaneus. Bone scintigrams were positive in all cases and were most useful in fractures of the tarsal bones excluding calcaneus. (author)

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

    Science.gov (United States)

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

    2000-01-01

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

  14. Clinical Evaluation of Reasons for Replacement of Amalgam Restorations in Patients Referring to a Dental School in Iran

    OpenAIRE

    Pouralibaba, Firoz; Joulaei, Mohammad; Kashefimehr, Atabak; Pakdel, Farzaneh; Jamali, Zahra; Esmaeili, Ali

    2010-01-01

    Background and aims The present study evaluated the most common reasons for replacing amalgam restorations in a university clinic. Materials and methods A total of 217 restorations which needed to be replaced were clinically and radiographically evaluated in a period of 4 months. The frequencies of reasons for replacing amalgam restorations were calculated: The assessed items included recurrent caries, tooth structure fracture (functional or non-functional cusps), amalgam bulk fracture, amalg...

  15. Design Characteristics Influence Performance of Clinical Prediction Rules in Validation: A Meta-Epidemiological Study

    OpenAIRE

    Ban, J-W.; Emparanza, J I; Urreta, I.; Burls, A

    2016-01-01

    BACKGROUND: Many new clinical prediction rules are derived and validated. But the design and reporting quality of clinical prediction research has been less than optimal. We aimed to assess whether design characteristics of validation studies were associated with the overestimation of clinical prediction rules' performance. We also aimed to evaluate whether validation studies clearly reported important methodological characteristics. METHODS: Electronic databases were searched for system...

  16. Comparative clinical evaluation of two professional tooth-whitening products.

    Science.gov (United States)

    Kowitz, G M; Nathoo, S A; Wong, R

    1994-01-01

    A 2-week study was conducted to compare the tooth-whitening efficacy of two 10% carbamide peroxide products: Colgate Platinum Professional Toothwhitening System and Rembrandt Lighten Bleaching Gel. Fifty subjects were divided into two groups and assigned a product to use for 2 weeks. Change in tooth color was measured by reflectance spectroscopy at the initiation of study, at 1 week, and at 2 weeks into the study. Color change was calculated using the color-difference equation established by the Commission International de L'Eclairage. Results showed that Colgate Platinum was 62% more effective at tooth whitening after 1 week and 83% more effective after 2 weeks of treatment vs Rembrandt. At the termination of the study, the mean color difference (deltaE) for Colgate Platinum was 4.29 and 2.34 for Rembrandt. Statistical analysis demonstrated that the Colgate product is significantly superior at increasing tooth whiteness, increasing tooth lightness, reducing redness, and reducing yellowness. In this study, no adverse reactions were noted on clinical examination and none were reported by panelists with normal healthy dentition. PMID:8205580

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

    Directory of Open Access Journals (Sweden)

    Desiree A. Díaz

    2016-03-01

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

  18. Accuracy and Robustness Improvements of Echocardiographic Particle Image Velocimetry for Routine Clinical Cardiac Evaluation

    Science.gov (United States)

    Meyers, Brett; Vlachos, Pavlos; Charonko, John; Giarra, Matthew; Goergen, Craig

    2015-11-01

    Echo Particle Image Velocimetry (echoPIV) is a recent development in flow visualization that provides improved spatial resolution with high temporal resolution in cardiac flow measurement. Despite increased interest a limited number of published echoPIV studies are clinical, demonstrating that the method is not broadly accepted within the medical community. This is due to the fact that use of contrast agents are typically reserved for subjects whose initial evaluation produced very low quality recordings. Thus high background noise and low contrast levels characterize most scans, which hinders echoPIV from producing accurate measurements. To achieve clinical acceptance it is necessary to develop processing strategies that improve accuracy and robustness. We hypothesize that using a short-time moving window ensemble (MWE) correlation can improve echoPIV flow measurements on low image quality clinical scans. To explore the potential of the short-time MWE correlation, evaluation of artificial ultrasound images was performed. Subsequently, a clinical cohort of patients with diastolic dysfunction was evaluated. Qualitative and quantitative comparisons between echoPIV measurements and Color M-mode scans were carried out to assess the improvements delivered by the proposed methodology.

  19. Patients with the tako-tsubo cardiomyopathy-clinical evaluation and outcome

    Institute of Scientific and Technical Information of China (English)

    Agata Salska; Izabela Plesiewicz; Marzenna Zielinska; Krzysztof Chiżynski

    2014-01-01

    Objective:Tako-tsubo cardiomyopathy(TTC) or is a rare, acute, reversible cardiac dysfunction mimicking an acute coronary syndrome(ACS) and usually connected with a preceding intense physical or emotional stress trigger.This case series-observational study is to evaluate the clinical findings(including the depression and anxiety disorders) and outcome in patients with the tako-tsubo cardiomyopathy treated in ourCentre, during18 month period.Methods:From the group of730 patients, who were admitted with the suspected acute myocardial infarct, ten patients, who fulfilled diagnostic criteria forTTC, were evaluated.For each patient we assessed: clinical characteristic, previous medical history including coronary disease risk factors and preceding stress trigger,12-leads electrocardiography and laboratory tests.All patients underwent coronary-artery angiography, trans-thoracic echocardiography and completed the questionnaire evaluating the depression and anxiety disorders.Results:The estimated prevalence and clinical features of patients with the tako-tsubo cardiomyopathy in ourCentre were similar to those in the literature, with the wide range of stress triggers.There was a statistically significant improvement in the ejection fraction during the hospitalization.Psychological tests revealed the0.7 occurrence of depression or anxiety disorders among our patients.Conclusions:The exact pathogenesis of the tako-tsubo cardiomyopathy remains uncertain, but it is important to take it into account as a differential diagnosis in patients with the clinical features of myocardial infarct in the absenceof coronary artery stenosis.

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

    OpenAIRE

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

    2016-01-01

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