AIDS--Challenges to Basic and Clinical Biomedical Research.

Science.gov (United States)

Fauci, Anthony S.

1989-01-01

Clinical trials and access to therapeutic drugs pose dilemmas for researchers, physicians, and AIDS patients. The National Institute of Allergy and Infectious Diseases, recognizing the need for greater access to drugs by a broader spectrum of the infected population, is establishing the Community Programs for Clinical Research on AIDS. (Author/MLW)

Clinical Profile and HIV/AIDS Prevalence of Patients with ...

African Journals Online (AJOL)

Background: Clinical features of HIV/AIDS and various malignancies are similar. Clinical profiles and HIV/AIDS prevalence in Nigerian cancer patients have been poorly documented. Aim: To identify the patterns of clinical presentations in patients with malignancies and to determine the prevalence of HIV infection in cancer ...

European clinical guidelines for hyperkinetic disorder -- first upgrade

NARCIS (Netherlands)

Taylor, E.; Dopfner, M.; Sergeant, J.A.; Asherson, P.; Banaschewski, T.; Coghill, D.; Danckaerts, M.; Rothenberger, A.; Sonuga-Barke, E.; Steinhausen, H.C.; Zuddas, A.

2004-01-01

BACKGROUND: The validity of clinical guidelines changes over time, because new evidence-based knowledge and experience develop. OBJECTIVE: Hence, the European clinical guidelines on hyperkinetic disorder from 1998 had to be evaluated and modified. METHOD: Discussions at the European Network for

European clinical guidelines for hyperkinetic disorder-first upgrade

NARCIS (Netherlands)

Taylor, E.; Döpfner, M.; Sergeant, J.A.; Asherson, P.; Banaschewski, T.; Buitelaar, J.; Coghill, D.; Danckaerts, M.; Rothenberger, A.; Sonuga-Barke, E.; Steinhausen, H.C.; Zuddas, A.

2004-01-01

Background: The validity of clinical guidelines changes over time, because new evidence-based knowledge and experience develop. Objective: Hence, the European clinical guidelines on hyperkinetic disorder from 1998 had to be evaluated and modified. Method Discussions at the European Network for

[Clinical skills and outcomes of chair-side computer aided design and computer aided manufacture system].

Science.gov (United States)

Yu, Q

2018-04-09

Computer aided design and computer aided manufacture (CAD/CAM) technology is a kind of oral digital system which is applied to clinical diagnosis and treatment. It overturns the traditional pattern, and provides a solution to restore defect tooth quickly and efficiently. In this paper we mainly discuss the clinical skills of chair-side CAD/CAM system, including tooth preparation, digital impression, the three-dimensional design of prosthesis, numerical control machining, clinical bonding and so on, and review the outcomes of several common kinds of materials at the same time.

The epidemiology of HIV and AIDS reports in migrants in the 27 European Union countries, Norway and Iceland: 1999-2006.

Science.gov (United States)

Del Amo, Julia; Likatavičius, Giedrius; Pérez-Cachafeiro, Santiago; Hernando, Victoria; González, Cristina; Jarrín, Inma; Noori, Teymur; Hamers, Françoise F; Bolúmar, Francisco

2011-10-01

To describe the epidemiology of HIV and AIDS by geographical origin in the EU, 1999-2006. AIDS and HIV cases from the EU 27, Norway and Iceland reported to European Centre for Epidemiological Monitoring of AIDS were analysed. Of 75,021 AIDS reports over 1999-2006, 35% were migrants. Of 2988 heterosexual AIDS reports in 2006, 50% were migrants, largely from Sub-Saharan Africa (SSA), 20% of 1404 AIDS cases in men who have sex with men (MSM) were migrants from Latin-America and Western Europe. Of 57 mother-to-child transmission (MTCT) AIDS cases, 23% were from SSA. AIDS cases decreased from 1999 to 2006 in natives (42%), Western Europeans (40%) and North Africa and Middle East (34%), but increased in people from SSA (by 89%), Eastern Europe (by 200%) and Latin-America (50%). Of 17,646 HIV infections in men and 9066 in females in 2006, 49 and 76% were migrants, largely from SSA. Of 169 MTCT infections, 41% were from SSA. Migrants, largely from SSA, represent a considerable proportion of AIDS and HIV reports in EU, especially among heterosexual and MTCT infections. Their contribution is higher among female reports. A substantial percentage of diagnoses in MSM are migrants, largely from Western Europe and Latin-America.

Essentials from the 2015 European AIDS Clinical Society (EACS) guidelines for the treatment of adult HIV-positive persons.

Science.gov (United States)

Ryom, L; Boesecke, C; Gisler, V; Manzardo, C; Rockstroh, J K; Puoti, M; Furrer, H; Miro, J M; Gatell, J M; Pozniak, A; Behrens, G; Battegay, M; Lundgren, J D

2016-02-01

The European AIDS Clinical Society (EACS) guidelines are intended for all clinicians involved in the care of HIV-positive persons, and are available in print, online, and as a free App for download for iPhone and Android. The 2015 version of the EACS guidelines contains major revisions in all sections; antiretroviral treatment (ART), comorbidities, coinfections and opportunistic diseases. Among the key revisions is the recommendation of ART for all HIV-positive persons, irrespectively of CD4 count, based on the Strategic Timing of AntiRetroviral Treatment (START) study results. The recommendations for the preferred and the alternative ART options have also been revised, and a new section on the use of pre-exposure prophylaxis (PrEP) has been added. A number of new antiretroviral drugs/drug combinations have been added to the updated tables on drug-drug interactions, adverse drug effects, dose adjustment for renal/liver insufficiency and for ART administration in persons with swallowing difficulties. The revisions of the coinfection section reflect the major advances in anti-hepatitis C virus (HCV) treatment with direct-acting antivirals with earlier start of treatment in individuals at increased risk of liver disease progression, and a phasing out of interferon-containing treatment regimens. The section on opportunistic diseases has been restructured according to individual pathogens/diseases and a new overview table has been added on CD4 count thresholds for different primary prophylaxes. The diagnosis and management of HIV infection and related coinfections, opportunistic diseases and comorbidities continue to require a multidisciplinary effort for which the 2015 version of the EACS guidelines provides an easily accessable and updated overview. © 2015 British HIV Association.

The effect of treatment with zidovudine with or without acyclovir on HIV p24 antigenaemia in patients with AIDS or AIDS-related complex

DEFF Research Database (Denmark)

Pedersen, C; Cooper, D A; Brun-Vézinet, F

1992-01-01

with AIDS, AIDS-related complex (ARC) or Kaposi's sarcoma (KS). DESIGN: Double-blind, placebo-controlled randomized clinical trial of less than or equal to 6 months' therapy. SETTING: Samples were obtained from patients attending teaching hospital outpatient clinics in seven European countries and Australia....... SUBJECTS: One hundred and ninety-seven HIV-infected patients (60 with AIDS and 137 with ARC or KS). MAIN OUTCOME MEASURES: Serum HIV p24-antigen levels measured using the Abbott HIV solid-phase enzyme immunoassay. RESULTS: Of 76 ARC/KS patients who were initially HIV p24-antigen-positive, one out of 25...

Clinical and epidemiological features of AIDS/tuberculosis comorbidity

Directory of Open Access Journals (Sweden)

Song Alice Tung Wan

2003-01-01

Full Text Available Considering the relevance of AIDS/tuberculosis comorbidity worldwide, especially in Brazil, this study was developed to describe the clinical and epidemiological features of the comorbid cases identified from 1989 to 1997 by the epidemiology service of the Hospital das Clínicas of the Universidade de São Paulo. METHODS: Databases containing information on all identified AIDS/tuberculosis cases cared for at the hospital were used to gather information on comorbid cases. RESULTS: During the period, 559 patients were identified as presenting with AIDS/tuberculosis comorbidity. Risk behavior for AIDS was primarily heterosexual contact (38.9%, followed by intravenous drug use (29.3% and homosexual/bisexual contact (23.2%. Regarding clinical features, there were higher rates of extrapulmonary tuberculosis when compared to tuberculosis without comorbidity. There was an increase in reporting of AIDS by ambulatory units during the period. Epidemiologically, there was a decrease in the male/female ratio, a predominance in the 20 to 39 year-old age group, and a majority of individuals who had less than 8 years of schooling and had low professional qualifications. CONCLUSIONS: High rates of AIDS/tuberculosis cases at our hospital indicate the need for better attention towards early detection of tuberculosis, especially in its extrapulmonary form. Since the population that attends this hospital tends to be of a lower socioeconomic status, better management of AIDS and tuberculosis is required to increase the rates of treatment adherence and thus lower the social costs.

European and Developing Countries Clinical Trials Partnership (EDCTP): the path towards a true partnership.

Science.gov (United States)

Matee, Mecky I; Manyando, Christine; Ndumbe, Peter M; Corrah, Tumani; Jaoko, Walter G; Kitua, Andrew Y; Ambene, Herman Pa; Ndounga, Mathieu; Zijenah, Lynn; Ofori-Adjei, David; Agwale, Simon; Shongwe, Steven; Nyirenda, Thomas; Makanga, Michael

2009-07-20

European and Developing Countries Clinical Trials Partnership (EDCTP) was founded in 2003 by the European Parliament and Council. It is a partnership of 14 European Union (EU) member states, Norway, Switzerland, and Developing Countries, formed to fund acceleration of new clinical trial interventions to fight the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS), malaria and tuberculosis (TB) in the sub-Saharan African region. EDCTP seeks to be synergistic with other funding bodies supporting research on these diseases. EDCTP promotes collaborative research supported by multiple funding agencies and harnesses networking expertise across different African and European countries. EDCTP is different from other similar initiatives. The organisation of EDCTP blends important aspects of partnership that includes ownership, sustainability and responds to demand-driven research. The Developing Countries Coordinating Committee (DCCC); a team of independent scientists and representatives of regional health bodies from sub-Saharan Africa provides advice to the partnership. Thus EDCTP reflects a true partnership and the active involvement and contribution of these African scientists ensures joint ownership of the EDCTP programme with European counterparts. The following have been the major achievements of the EDCTP initiative since its formation in 2003; i) increase in the number of participating African countries from two to 26 in 2008 ii) the cumulative amount of funds spent on EDCTP projects has reached 150 m euros, iii) the cumulative number of clinical trials approved has reached 40 and iv) there has been a significant increase number and diversity in capacity building activities. While we recognise that EDCTP faced enormous challenges in its first few years of existence, the strong involvement of African scientists and its new initiatives such as unconditional funding to regional networks of excellence in sub-Saharan Africa is envisaged to

Aid Donor Meets Strategic Partner? The European Union’s and China’s Relations with Ethiopia

Directory of Open Access Journals (Sweden)

Christine Hackenesch

2013-01-01

Full Text Available The motives, instruments and effects of China’s Africa policy have spurred a lively debate in European development policy circles. This paper assesses the “competitive pressure” that China’s growing presence in Africa exerts on the European development policy regime. Drawing on a large number of interviews conducted in China, Ethiopia and Europe between 2008 and 2011, the paper analyses Ethiopia as a case study. Ethiopia has emerged as one of the most important countries in Chinese as well as European cooperation with Africa. Yet, Chinese and European policies toward Ethiopia differ greatly. The EU mainly engages Ethiopia as an aid recipient, whereas China has developed a comprehensive political and economic partnership with the East African state. China has thereby become an alternative partner to the Ethiopian government, a development that both sheds light on the gap between European rhetoric and policy practice and puts pressure on the EU to make more efforts to reform its development policy system.

Decision aids for people considering taking part in clinical trials.

Science.gov (United States)

Gillies, Katie; Cotton, Seonaidh C; Brehaut, Jamie C; Politi, Mary C; Skea, Zoe

2015-11-27

Several interventions have been developed to promote informed consent for participants in clinical trials. However, many of these interventions focus on the content and structure of information (e.g. enhanced information or changes to the presentation format) rather than the process of decision making. Patient decision aids support a decision making process about medical options. Decision aids support the decision process by providing information about available options and their associated outcomes, alongside information that enables patients to consider what value they place on particular outcomes, and provide structured guidance on steps of decision making. They have been shown to be effective for treatment and screening decisions but evidence on their effectiveness in the context of informed consent for clinical trials has not been synthesised. To assess the effectiveness of decision aids for clinical trial informed consent compared to no intervention, standard information (i.e. usual practice) or an alternative intervention on the decision making process. We searched the following databases and to March 2015: Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library; MEDLINE (OvidSP) (from 1950); EMBASE (OvidSP) (from 1980); PsycINFO (OvidSP) (from 1806); ASSIA (ProQuest) (from 1987); WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/); ClinicalTrials.gov; ISRCTN Register (http://www.controlled-trials.com/isrctn/). We also searched reference lists of included studies and relevant reviews. We contacted study authors and other experts. There were no language restrictions. We included randomised and quasi-randomised controlled trials comparing decision aids in the informed consent process for clinical trials alone, or in conjunction with standard information (such as written or verbal) or alongside alternative interventions (e.g. paper-based versus web-based decision aids). Included trials involved

State aid in the European Union

OpenAIRE

Bech, Laura Hundevadt; Santos Rodriguez, Raquel; Sumborg, Amalie Munkholm; Bertelsen, Benedicte Veller; Gundertofte, Cille Melin

2017-01-01

This project investigates illegal state aid through the case of Ireland granting an illegal tax deal to Apple. Moreover, it uses James A. Caporaso and David P. Levine’s theory of Neoclassical Political Economy in order to investigate externalities resulting from the state aid, both on the state, corporation and individual level. In addition, it relates these externalities to the effects on group welfare. The project emphasizes enforcement of state aid law through; the conduct of the Competiti...

correlation of who clinical staging with cd4 counts in adult hiv/aids

African Journals Online (AJOL)

2011-02-02

Feb 2, 2011 ... AIDS and HIV/AIDS case definitions for surveillance. (African region) (12). Laboratory and radiological methods were carried out if they were required to make a clinical diagnosis. In the majority of the cases, the HIV clinical events were presumptive diagnosis and based on the WHO clinical staging for ...

The Clinical Features of Paediatric HIV/AIDS at Presentation at the ...

African Journals Online (AJOL)

AIDS in African setting was found to be sensitive with low specificity and positive predictive value (PPV). Conclusion: Clinical presentation of paediatric HIV/AIDS appears similar with reports from other centers in spite of the wide variation in ...

Experimentation with e-cigarettes as a smoking cessation aid: a cross-sectional study in 28 European Union member states.

Science.gov (United States)

Filippidis, Filippos T; Laverty, Anthony A; Vardavas, Constantine I

2016-10-06

To describe patterns of experimentation with electronic cigarettes as a smoking cessation aid, their self-reported impact on smoking cessation and to identify factors associated with self-reported successful quit attempts within the European Union (EU). A cross-sectional study. 28 European Union member states. We analysed data from wave 82.4 of the Special Eurobarometer survey, collected in December 2014 from all 28 EU member states. The total sample size was n=27 801 individuals aged ≥15 years; however, our analyses were conducted in different subgroups with sample sizes ranging from n=470 to n=9363. Data on e-cigarette experimentation and its self-reported impact on smoking cessation were collected. Logistic regression models were used to assess factors associated with experimentation of e-cigarettes as cessation aids and with successful quitting. Logistic regression was also used to assess changes in the use of e-cigarettes as cessation aids between 2012 (using data from wave 77.1 of the Eurobarometer) and 2014 in each member state. E-cigarettes were often experimented with as a cessation aid, especially among younger smokers (OR=5.29) and those who reported financial difficulties (OR=1.33). In total, 10.6% of those who had ever attempted to quit smoking and 27.4% of those who did so using a cessation aid had experimented with e-cigarettes as a cessation aid. Among those who had used e-cigarettes as a cessation aid, those with higher education were more likely to have been successful in quitting (OR=2.23). There was great variation in trends of use of e-cigarette as a cessation aid between member states. Experimentation with e-cigarettes as a potential cessation aid at a population level has increased throughout the EU in recent years, and certain population groups are more likely to experiment with them as cessation aids. Research on the potential population impact of these trends is imperatively needed. Published by the BMJ Publishing Group Limited. For

A strategy of clinical tolerance for the prevention of HIV and AIDS in China.

Science.gov (United States)

Wang, Y

2000-02-01

HIV infection and AIDS create many dilemmas in Chinese AIDS/HIV prevention policy. A strategy of clinical tolerance is proposed to address these dilemmas. The immediate purpose of the strategy of clinical tolerance is to win the cooperation of members of stigmatized groups at high risk for contracting HIV infection and AIDS, which occurs as a result of acts done in private and thus beyond the reach of regulation. The strategy of clinical tolerance differs from both tolerance as liberal tolerance and tolerance as a moral ideal of tolerance. A strategy of clinical tolerance does not ask the government, health worker, health official or the public to change either laws or the disapproval of prostitution, homosexuality and drug use. A strategy of clinical tolerance asks, instead, that we weigh what we may regard as the wrong involved in prostitution, homosexuality, and drug use against the greater evil of an HIV/AIDS epidemic. A strategy of clinical tolerance offers the most effective and practical way to confront a growing and significant public health problem in China.

Clinical audits: who does control what? European guide lines

International Nuclear Information System (INIS)

Jarvinen, H.

2009-01-01

The E.C. directive 97/43/EURATOM (M.E.D.-directive) introduced the concept of Clinical Audit for the assessment of medical radiological practices (diagnostic radiology, nuclear medicine and radiotherapy). The European Commission started in June 2007 a special project to review in detail the status of implementation of Clinical audits in Member States and to prepare European Guidance on Clinical Audits for diagnostic radiology, nuclear medicine and radiotherapy. The purpose of this E.C. project is to provide clear and comprehensive information and guidance on the procedures and criteria for clinical audits in all radiological practices, in order to improve the implementation of Article 6.4 of the M.E.D.-directive. The guidance should be flexible and enable the member States to adopt the model of clinical audit with respect to their national legislation and administrative provisions. By definition, clinical audit is a systematic examination or review of medical radiological procedures. It seeks to improve the quality and the outcome of patient care through structured review whereby radiological practices, procedures and results are examined against agreed standards for good medical radiological procedures. Modifications of the practices are implemented where indicated and new standards applied if necessary. The general objectives of clinical audit should be: to improve the quality of patient care, to promote the effective use of resources, to enhance the provision and organization of clinical services, to further professional education and training. Clinical audits must be at the same time internal (set by the management of the department) and external (set by external auditors at the department). It must not be confused with other evaluation activities such inspections, accreditation or quality system certifications. Clinical audits should address structure, process and outcome such the unit mission, quality assurance, dosimetry and treatments follow-up. The recent

Clinical PET activities in European and Asia-Oceanian Countries

International Nuclear Information System (INIS)

Tashiro, Manabu; Ito, Masatoshi; Yamaguchi, Keiichiro; Kubota, Kazuo; Fujimoto, Toshihiko; Sasaki, Hidetada; Moser, E.

2001-01-01

Clinical diagnosis using positron emission tomography (PET) requires high costs. Therefore, sociomedical evaluation is very important for spread of clinical PET. In this report, sociomedical situation in European and Asia-Oceanian countries, especially concerning transportation of 18 F-FDG and reimbursement of medical costs for clinical PET indications, is reported. It seems that UK, Germany and Belgium are the most advanced in clinical PET in Europe. In these countries, many PET investigations are reimbursed though systems are different among the countries. In UK, both public and private insurance gives authorization for clinical PET to some extent. In Germany, private health insurance companies give authorization but public insurance has not. In Belgium, private health insurance does not exist and public insurance gives authorization for clinical PET. Other European countries seem to be in transitional stages. Transportation of 18 F-FDG has been already started in almost every country in Europe and Asia-Oceania. In Japan, neither transportation of FDG nor full reimbursement of clinical PET has not started yet and this situation seems to be exceptional. To promote clinical PET in Japan, there is the need of at least establishing a list of clinical indications for PET investigations and establishing commercial-based 18 F-FDG supplying system. They could be regarded as a kind of infrastructure for spread of clinical PET. (author)

Clinical and Epidemiological Characteristics of HIV Infection/AIDS in Hospitalized Patients.

Science.gov (United States)

Ahmetagic, Sead; Porobić-Jahic, Humera; Piljic, Dilista; Custovic, Amer; Sabitovic, Damir; Zepic, Denis

2015-02-01

More than three decades after recognition of acquired immunodeficiency syndrome (AIDS) in the United States, the pandemic of human immunodeficiency virus (HIV) infection has dramatically changed the global burden of disease. The main goal of this research is retrospective analysis of epidemiological and clinical characteristics of 28 HIV infected patients, who were diagnosed and treated at the Clinic for Infectious Diseases in University Clinical Center Tuzla in the period from 1996 until the end of 2013. Retrospective analysis was performed using the medical records of 28 HIV-infected persons. Two rapid tests were used for HIV testing: OraQuick Advance test, Vikia HIV1/2, Elisa combo test, HIV RNA test. AIDS disease was determined by using the criteria from WHO. Among a total of 28 HIV-infected persons, 23 (82.14%) were males and 5 (17.86%) were females, with the male: female ratio of 4,6:1. In terms of the transmission route, a large proportion of cases were infected through heterosexual contact 19 (67.86%). At the time of the first visit, 16 (57.15%) patients showed asymptomatic HIV infection, 4 (14.28%) HIV infection with symptoms other than the AIDS defining diseases, and 8 (28.57) had AIDS. At the time of first hospital visit, the CD4 + cells count ranged from 40 to 1795/µl (conducted in 19 patients), and mean value of CD4 + cells was 365,31/µl, and mean HIV RNA titer was 287 118 copies/ml³. Of 28 HIV-infected persons 39 cases of opportunistic diseases developed in 12 patients (42.9%). In terms of the frequency of opportunistic diseases, tuberculosis (12 cases, 42.9%). Among a total of 28 HIV-infected patients, 6 (21.4%) of them died. This study characterizes the epidemiological and clinical patterns of HIV-infected patients in Tuzla region of Bosnia and Herzegovina to accurately understand HIV infection/AIDS in our region, in the hope to contribute in the establishment of effective HIV guidelines in the Tuzla region of B&H in the future.

Genome-wide Association Study Implicates PARD3B-based AIDS Restriction

Science.gov (United States)

Nelson, George W.; Lautenberger, James A.; Chinn, Leslie; McIntosh, Carl; Johnson, Randall C.; Sezgin, Efe; Kessing, Bailey; Malasky, Michael; Hendrickson, Sher L.; Pontius, Joan; Tang, Minzhong; An, Ping; Winkler, Cheryl A.; Limou, Sophie; Le Clerc, Sigrid; Delaneau, Olivier; Zagury, Jean-François; Schuitemaker, Hanneke; van Manen, Daniëlle; Bream, Jay H.; Gomperts, Edward D.; Buchbinder, Susan; Goedert, James J.; Kirk, Gregory D.; O'Brien, Stephen J.

2011-01-01

Background. Host genetic variation influences human immunodeficiency virus (HIV) infection and progression to AIDS. Here we used clinically well-characterized subjects from 5 pretreatment HIV/AIDS cohorts for a genome-wide association study to identify gene associations with rate of AIDS progression. Methods.  European American HIV seroconverters (n = 755) were interrogated for single-nucleotide polymorphisms (SNPs) (n = 700,022) associated with progression to AIDS 1987 (Cox proportional hazards regression analysis, co-dominant model). Results.  Association with slower progression was observed for SNPs in the gene PARD3B. One of these, rs11884476, reached genome-wide significance (relative hazard = 0.3; P =3. 370 × 10−9) after statistical correction for 700,022 SNPs and contributes 4.52% of the overall variance in AIDS progression in this study. Nine of the top-ranked SNPs define a PARD3B haplotype that also displays significant association with progression to AIDS (hazard ratio, 0.3; P = 3.220 × 10−8). One of these SNPs, rs10185378, is a predicted exonic splicing enhancer; significant alteration in the expression profile of PARD3B splicing transcripts was observed in B cell lines with alternate rs10185378 genotypes. This SNP was typed in European cohorts of rapid progressors and was found to be protective for AIDS 1993 definition (odds ratio, 0.43, P = .025). Conclusions. These observations suggest a potential unsuspected pathway of host genetic influence on the dynamics of AIDS progression. PMID:21502085

The Scope of State Aid and Public Service Obligation for Airports and Air Carriers in the Light of European Law

Directory of Open Access Journals (Sweden)

Grzegorz Zajac

2015-10-01

Full Text Available Public aid is the kind of advantage granted directly or indirectly for private companies from State resources. The European Commission prerogative to control the transfer of public resources by the public authorities (national or local for the benefit of private undertakings, as a general rule, there is an obligation of notification, as provided for in article 108 (3 of the Treaty on the Functioning of the European Union (TFEU. It should be noted in the beginning that State aid given to undertakings conducting economic activity is, in principle, incompatible with the European Union’ law, as provided for in article. 107 (1 of the TFEU. There are certain situations that the granting of public funds will not constitute “public aid” within the meaning of article 107 of the TFEU and, therefore, will not violate European rules in this field. One of them are activities related to the exercise of the prerogatives of the public authority (security, safety, customs, air traffic control. The other is related to the exercise of services in general economic interest. This could be an example of public service obligation (PSO. This service can be applied in the light of the provisions of European law on two types of action on air routes, and on airport managing body. The imposition of a PSO to the specified route is the support given by the State to the outermost regions that due to their unfavourable geographical position cannot fully develop economically, and no carrier had not been interested in performing air services to that region due to the lack of cost effectiveness. Some activities at the airport may be considered as activities of general economic interest.

Compassionate use of interventions: results of a European Clinical Research Infrastructures Network (ECRIN) survey of ten European countries

LENUS (Irish Health Repository)

Whitfield, Kate

2010-11-12

Abstract Background \\'Compassionate use\\' programmes allow medicinal products that are not authorised, but are in the development process, to be made available to patients with a severe disease who have no other satisfactory treatment available to them. We sought to understand how such programmes are regulated in ten European Union countries. Methods The European Clinical Research Infrastructures Network (ECRIN) conducted a comprehensive survey on clinical research regulatory requirements, including questions on regulations of \\'compassionate use\\' programmes. Ten European countries, covering approximately 70% of the EU population, were included in the survey (Austria, Denmark, France, Germany, Hungary, Ireland, Italy, Spain, Sweden, and the UK). Results European Regulation 726\\/2004\\/EC is clear on the intentions of \\'compassionate use\\' programmes and aimed to harmonise them in the European Union. The survey reveals that different countries have adopted different requirements and that \\'compassionate use\\' is not interpreted in the same way across Europe. Four of the ten countries surveyed have no formal regulatory system for the programmes. We discuss the need for \\'compassionate use\\' programmes and their regulation where protection of patients is paramount. Conclusions \\'Compassionate use\\' is a misleading term and should be replaced with \\'expanded access\\'. There is a need for expanded access programmes in order to serve the interests of seriously ill patients who have no other treatment options. To protect these patients, European legislation needs to be more explicit and informative with regard to the regulatory requirements, restrictions, and responsibilities in expanded access programmes.

Compassionate use of interventions: results of a European Clinical Research Infrastructures Network (ECRIN) survey of ten European countries

Science.gov (United States)

2010-01-01

Background 'Compassionate use' programmes allow medicinal products that are not authorised, but are in the development process, to be made available to patients with a severe disease who have no other satisfactory treatment available to them. We sought to understand how such programmes are regulated in ten European Union countries. Methods The European Clinical Research Infrastructures Network (ECRIN) conducted a comprehensive survey on clinical research regulatory requirements, including questions on regulations of 'compassionate use' programmes. Ten European countries, covering approximately 70% of the EU population, were included in the survey (Austria, Denmark, France, Germany, Hungary, Ireland, Italy, Spain, Sweden, and the UK). Results European Regulation 726/2004/EC is clear on the intentions of 'compassionate use' programmes and aimed to harmonise them in the European Union. The survey reveals that different countries have adopted different requirements and that 'compassionate use' is not interpreted in the same way across Europe. Four of the ten countries surveyed have no formal regulatory system for the programmes. We discuss the need for 'compassionate use' programmes and their regulation where protection of patients is paramount. Conclusions 'Compassionate use' is a misleading term and should be replaced with 'expanded access'. There is a need for expanded access programmes in order to serve the interests of seriously ill patients who have no other treatment options. To protect these patients, European legislation needs to be more explicit and informative with regard to the regulatory requirements, restrictions, and responsibilities in expanded access programmes. PMID:21073691

Esophageal stenting for benign and malignant disease : European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

NARCIS (Netherlands)

Spaander, Manon C W; Baron, Todd H; Siersema, Peter D; Fuccio, Lorenzo; Schumacher, Brigitte; Escorsell, Àngels; Garcia-Pagán, Juan-Carlos; Dumonceau, Jean-Marc; Conio, Massimo; de Ceglie, Antonella; Skowronek, Janusz; Nordsmark, Marianne; Seufferlein, Thomas; Van Gossum, André; Hassan, Cesare; Repici, Alessandro; Bruno, Marco J

2016-01-01

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN).

The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: guide to the Register, version 3-2010

DEFF Research Database (Denmark)

McMurray, Janet; Zérah, Simone; Hallworth, Michael

2010-01-01

In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 12 years, more...... than 2200 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Forum of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). Two previous...

Epidemiology of cryptosporidiosis among European AIDS patients

DEFF Research Database (Denmark)

Pedersen, C; Danner, S; Lazzarin, A

1996-01-01

for intravenous drug users than for homosexual men (relative risk 0.34, 95% confidence limits 0.22-0.54) and for women compared with men (RR 0.43 (0.21-0.87)). The risk was higher in North Europe than in South and Central Europe. In a multivariate analysis only transmission category remained a significant.......6%) patients, 216 at time of the AIDS diagnosis and 216 during follow-up. The probability of being diagnosed with cryptosporidiosis at AIDS diagnosis was significantly lower for intravenous drug users (1.3%) than for homosexual men (4.1%) and for patients belonging to other transmission categories (4.0%) (p...... Europe compared with patients from South Europe (4.1% versus 2.5%, p = 0.005). The rate of developing cryptosporidiosis after the diagnosis of AIDS was 3 per 100 patient years of follow-up. The rate was significantly lower...

Computer-aided navigation in dental implantology: 7 years of clinical experience.

Science.gov (United States)

Ewers, Rolf; Schicho, Kurt; Truppe, Michael; Seemann, Rudolf; Reichwein, Astrid; Figl, Michael; Wagner, Arne

2004-03-01

This long-term study gives a review over 7 years of research, development, and routine clinical application of computer-aided navigation technology in dental implantology. Benefits and disadvantages of up-to-date technologies are discussed. In the course of the current advancement, various hardware and software configurations are used. In the initial phase, universally applicable navigation software is adapted for implantology. Since 2001, a special software module for dental implantology is available. Preoperative planning is performed on the basis of prosthetic aspects and requirements. In clinical routine use, patient and drill positions are intraoperatively registered by means of optoelectronic tracking systems; during preclinical tests, electromagnetic trackers are also used. In 7 years (1995 to 2002), 55 patients with 327 dental implants were successfully positioned with computer-aided navigation technology. The mean number of implants per patient was 6 (minimum, 1; maximum, 11). No complications were observed; the preoperative planning could be exactly realized. The average expenditure of time for the preparation of a surgical intervention with navigation decreased from 2 to 3 days in the initial phase to one-half day in clinical routine use with software that is optimized for dental implantology. The use of computer-aided navigation technology can contribute to considerable quality improvement. Preoperative planning is exactly realized and intraoperative safety is increased, because damage to nerves or neighboring teeth can be avoided.

Oral candidiasis as clinical manifestation of HIV/AIDS infection in Airlangga University hospital patients

Science.gov (United States)

Putranti, A.; Asmarawati, T. P.; Rachman, B. E.; Hadi, U.; Nasronudin

2018-03-01

The purpose of this study was to determine the characteristics of HIV/AIDS patients with oral candidiasis as its clinical manifestation at Airlangga University Hospital Surabaya. This is a descriptive analytic research with cross-sectional design using Chi-Square statistic test. Samples of this study consist of 34 patients using total sampling methods. Those patients were all HIV/AIDS infected patients with oral candidiasis clinical manifestations, who were admitted to Airlangga University Hospital Surabaya from January 2016 to September 2017. Results showed that mostly HIV/AIDS patients with oral candidiasis are male (79.4%), old age (40-75years) total amounted to 58.8%, heterosexual as main risk factor (70%), clinical stadium mostly in stage IV (61.8%), 26% of patients with chronic diarrhea and 56% with pulmonary TB, clinical stages of patients have a significant relation to the incidence of oral candidiasis infection (p=0.024). The most common oral lesions found in people with HIV are Candidiasis. The best management is through routine dental examination and dental precautions to maintain health and achieve a better quality of life.

A harmonized and efficient clinical research environment would benefit patients and enhance European competitiveness. Commentary.

Science.gov (United States)

Amato, Antonino; Aringhieri, Eugenio; Boccia, Stefania; Buccella, Filippo; Gorini, Barbara; Gramaglia, Donatella; Masetti, Riccardo; Rossi, Paolo; Pelicci, Pier Giuseppe

2017-01-01

The forthcoming implementation of the European Clinical Trial Regulation (Regulation (EU) No. 536/2014), which is expected to facilitate the conduct of clinical trials across the European Union, will require National Authorities to create the best conditions for the implementation of the new Regulation through national guidelines, so that sponsors may reconsider Europe as a prime location for planning clinical trials. During a meeting titled "Innovation in Clinical Research", an expert panel discussed potential local advances fostering competitiveness of European clinical research with representatives of the pharmaceutical industry, patient organisations and Italian regulatory agency in view of the forthcoming implementation of (EU) No. 536/2014 on clinical trials of medicinal products. In this article we summarise the findings of the meeting, describe features characterising clinical research patterns and offer some suggestions on the possible involvement of all stakeholders in order to foster research innovation and allow the timely access to novel medicines for patients.

Establishment of the European College of Veterinary Clinical Pathology (ECVCP) and the current status of veterinary clinical pathology in Europe

DEFF Research Database (Denmark)

O'Brien, P.J.; Fournel-Fleury, C.; Bolliger, Adrian Marc

2007-01-01

congresses and a joint journal (with the American Society for Veterinary Clinical Pathology) for communication of scientific research and information; the College also maintains a website, a joint listserv, and a newsletter; 6) collaboration in training and continuing education with relevant colleges......After 5 years of development, the European College of Veterinary Clinical Pathology (ECVCP)was formally recognized and approved on July 4, 2007 by the European Board of Veterinary Specialisation (EBVS), the European regulatory body that oversees specialization in veterinary medicine and which has......; currently there are 18 resident trainingprograms inEurope; 3) administration of 3 annual board-certifying examinations thus far,with an overall pass rate of 70%; 4) European consensus criteria for assessing the continuing education of specialists every 5 ears; 5) organization of 8 annual scientific...

Identifying design considerations for a shared decision aid for use at the point of outpatient clinical care: An ethnographic study at an inner city clinic.

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Hajizadeh, Negin; Perez Figueroa, Rafael E; Uhler, Lauren M; Chiou, Erin; Perchonok, Jennifer E; Montague, Enid

2013-03-06

Computerized decision aids could facilitate shared decision-making at the point of outpatient clinical care. The objective of this study was to investigate whether a computerized shared decision aid would be feasible to implement in an inner-city clinic by evaluating the current practices in shared decision-making, clinicians' use of computers, patient and clinicians' attitudes and beliefs toward computerized decision aids, and the influence of time on shared decision-making. Qualitative data analysis of observations and semi-structured interviews with patients and clinicians at an inner-city outpatient clinic. The findings provided an exploratory look at the prevalence of shared decision-making and attitudes about health information technology and decision aids. A prominent barrier to clinicians engaging in shared decision-making was a lack of perceived patient understanding of medical information. Some patients preferred their clinicians make recommendations for them rather than engage in formal shared decision-making. Health information technology was an integral part of the clinic visit and welcomed by most clinicians and patients. Some patients expressed the desire to engage with health information technology such as viewing their medical information on the computer screen with their clinicians. All participants were receptive to the idea of a decision aid integrated within the clinic visit although some clinicians were concerned about the accuracy of prognostic estimates for complex medical problems. We identified several important considerations for the design and implementation of a computerized decision aid including opportunities to: bridge clinician-patient communication about medical information while taking into account individual patients' decision-making preferences, complement expert clinician judgment with prognostic estimates, take advantage of patient waiting times, and make tasks involved during the clinic visit more efficient. These findings

Common definition for categories of clinical research: a prerequisite for a survey on regulatory requirements by the European Clinical Research Infrastructures Network (ECRIN)

DEFF Research Database (Denmark)

Kubiak, Christine; de Andres-Trelles, Fernando; Kuchinke, Wolfgang

2009-01-01

in relation to the wide spectrum of clinical research, the European Clinical Research Infrastructures Network (ECRIN) developed a multinational survey in ten European countries. However a lack of common classification framework for major categories of clinical research was identified, and therefore reaching...... with cell therapy, etc.); diagnostic studies; clinical research on nutrition; other interventional clinical research (including trials in complementary and alternative medicine, trials with collection of blood or tissue samples, physiology studies, etc.); and epidemiology studies. Our classification...

A European multi-language initiative to make the general population aware of independent clinical research: the European Communication on Research Awareness Need project

OpenAIRE

Mosconi, Paola; Antes, Gerd; Barbareschi, Giorgio; Burls, Amanda; Demotes-Mainard, Jacques; Chalmers, Iain; Colombo, Cinzia; Garattini, Silvio; Gluud, Christian; Gyte, Gill; Mcllwain, Catherine; Penfold, Matt; Post, Nils; Satolli, Roberto; Valetto, Maria Rosa

2016-01-01

BACKGROUND: The ECRAN (European Communication on Research Awareness Needs) project was initiated in 2012, with support from the European Commission, to improve public knowledge about the importance of independent, multinational, clinical trials in Europe. \\ud \\ud METHODS: Participants in the ECRAN consortium included clinicians and methodologists directly involved in clinical trials; researchers working in partnership with the public and patients; representatives of patients; and experts in s...

Evaluation of the WHO clinical case definition of AIDS among children in India.

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Gurprit, Grover; Tripti, Pensi; Gadpayle, A K; Tanushree, Banerjee

2008-03-01

The need of a clinical case definition (CCD) for Acquired Immunodeficiency Syndrome (AIDS) was felt by public health agencies to monitor diseases resulting from human immunodeficiency virus (HIV) infection. To test the statistical significance of the existing World Health Organization (WHO) CCD for the diagnosis of AIDS in areas where diagnostic resources are limited in India, a prospective study was conducted in the Paediatrics department at Dr. Ram Manohar Lohia Hospital, New Delhi. 360 cases between 18 months-12 years of age satisfying WHO case definitions of AIDS were included in the study group. Informed consent was taken from the parents. The serum of patients was subjected to ELISA to conform the diagnosis of HIV infection. Our study detected 16.66% (60) of HIV prevalence in children visiting paediatrics outpatient clinic. 20% cases manifested 3 major and 2 minor signs. This definition had a sensitivity of 73.33%, specificity of 90.66%, positive predictive value (PPV) of 61.11% and negative predictive value (NPV) of 94.44%. On using stepwise logistic regression analysis weight loss, chronic fever > 1 month and total lymphocyte count of less than 1500 cells/mm3 emerged as important predictors. Cases showing 2 major and 2 minor signs were 86 (23.89%) with a sensitivity and specificity of 86.66% and 88.66% respectively. Based on these findings, we propose a clinical case definition based on 13 clinical signs and symptoms for paediatric AIDS in India with better sensitivity and PPV than the WHO case definition but with almost similar specificity. Thus multicentric studies are further required to modify these criteria in Indian set up.

The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs

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Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

2011-01-01

The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs. PMID:21816958

Shared Rights--Shared Responsibilities. European Consultation on Collaboration between Government Sectors, Nongovernmental Organizations and Ethnic Minority Organizations in AIDS Prevention, Support and Care (London, United Kingdom, October 5-9, 1995).

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Naz Foundation, London (England).

A consultation was sponsored by the European Commission, the World Health Organization's Global Programme on AIDS, and the United Kingdom Department of Health to explore the specific needs of ethnic minority communities in European countries for culturally and linguistically appropriate Human Immunodeficiency Virus (HIV) and Acquired Immune…

Relating working memory to compression parameters in clinically fit hearing AIDS.

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Souza, Pamela E; Sirow, Lynn

2014-12-01

Several laboratory studies have demonstrated that working memory may influence response to compression speed in controlled (i.e., laboratory) comparisons of compression. In this study, the authors explored whether the same relationship would occur under less controlled conditions, as might occur in a typical audiology clinic. Participants included 27 older adults who sought hearing care in a private practice audiology clinic. Working memory was measured for each participant using a reading span test. The authors examined the relationship between working memory and aided speech recognition in noise, using clinically fit hearing aids with a range of compression speeds. Working memory, amount of hearing loss, and age each contributed to speech recognition, but the contribution depended on the speed of the compression processor. For fast-acting compression, the best performance was obtained by patients with high working memory. For slow-acting compression, speech recognition was affected by age and amount of hearing loss but was not affected by working memory. Despite the expectation of greater variability from differences in compression implementation, number of compression channels, or attendant signal processing, the relationship between working memory and compression speed showed a similar pattern as results from more controlled, laboratory-based studies.

The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: Code of Conduct, Version 2--2008.

LENUS (Irish Health Repository)

McMurray, Janet

2009-01-01

In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 10 years, more than 2000 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Federation of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). A Code of Conduct was adopted in 2003 and a revised and updated version, taking account particularly of the guidelines of the Conseil Européen des Professions Libérales (CEPLIS) of which EFCC is a member, is presented in this article. The revised version was approved by the EC4 Register Commission and by the EFCC Executive Board in Paris on 6 November, 2008.

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life

NARCIS (Netherlands)

Bamford, A.; Turkova, A.; Lyall, H.; Foster, C.; Klein, N.; Bastiaans, D.; Burger, D.; Bernadi, S.; Butler, K.; Chiappini, E.; Clayden, P.; della Negra, M.; Giacomet, V.; Giaquinto, C.; Gibb, D.; Galli, L.; Hainaut, M.; Koros, M.; Marques, L.; Nastouli, E.; Niehues, T.; Noguera-Julian, A.; Rojo, P.; Rudin, C.; Scherpbier, H. J.; Tudor-Williams, G.; Welch, S. B.

2018-01-01

The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines provide practical recommendations on the management of HIV-1 infection in children in Europe and are an update to those published in 2009. Aims of treatment have progressed significantly over the last decade, moving far

IMPLEMENTATION OF STATE AID POLICY FROM THE EUROPEAN UNION IN ROMANIA

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Cristina BALDAN

2012-12-01

Full Text Available In 2009, the Competition Council's activity regarding the state aid field has considered Romania's obligations as a member state, and the fulfillment of some specific tasks by the competition authority acquired after January 1, 2007. In this regard, the Competition Council has encouraged the collaboration between institutions to develop projects of state aid schemes. In 2010 there were six major investment projects approved, four of them being in the photovoltaic sector in which three are in Germany, one is in Spain and the rest concern the mechanical industry in Germany and Italy. Also, there were approved five ad hoc aid measures in favor of individual enterprises, for investments in areas that are on the regional aid maps for the period 2007-2013, and ten aid schemes, of which five related to the outermost regions. In accordance with the guidelines on national regional aids for 2007-2013, the Commission developed a statistical evaluation of the situation of state aid and regional aid ceiling which received a transitional assisted area status under Article 107 paragraph 3 letters (a by the end of 2010. The Commission accepted the changes introduced by the three member states (France, Ireland and Italy in state aid maps for certain regions eligible for regional aid under Article 107 paragraph 3letter (c.

Fractures (Broken Bones): First Aid

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First aid Fractures (broken bones) Fractures (broken bones): First aid By Mayo Clinic Staff A fracture is a ... 10, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-fractures/basics/ART-20056641 . Mayo Clinic ...

Association of systemic lupus erythematosus clinical features with European population genetic substructure.

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Elisa Alonso-Perez

Full Text Available Systemic Lupus Erythematosus (SLE is an autoimmune disease with a very varied spectrum of clinical manifestations that could be partly determined by genetic factors. We aimed to determine the relationship between prevalence of 11 clinical features and age of disease onset with European population genetic substructure. Data from 1413 patients of European ancestry recruited in nine countries was tested for association with genotypes of top ancestry informative markers. This analysis was done with logistic regression between phenotypes and genotypes or principal components extracted from them. We used a genetic additive model and adjusted for gender and disease duration. Three clinical features showed association with ancestry informative markers: autoantibody production defined as immunologic disorder (P = 6.8×10(-4, oral ulcers (P = 6.9×10(-4 and photosensitivity (P = 0.002. Immunologic disorder was associated with genotypes more common in Southern European ancestries, whereas the opposite trend was observed for photosensitivity. Oral ulcers were specifically more common in patients of Spanish and Portuguese self-reported ancestry. These results should be taken into account in future research and suggest new hypotheses and possible underlying mechanisms to be investigated. A first hypothesis linking photosensitivity with variation in skin pigmentation is suggested.

Association of Systemic Lupus Erythematosus Clinical Features with European Population Genetic Substructure

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Calaza, Manuel; Witte, Torsten; Papasteriades, Chryssa; Marchini, Maurizio; Migliaresi, Sergio; Kovacs, Attila; Ordi-Ros, Josep; Bijl, Marc; Santos, Maria Jose; Ruzickova, Sarka; Pullmann, Rudolf; Carreira, Patricia; Skopouli, Fotini N.; D'Alfonso, Sandra; Sebastiani, Gian Domenico; Suarez, Ana; Blanco, Francisco J.; Gomez-Reino, Juan J.; Gonzalez, Antonio

2011-01-01

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with a very varied spectrum of clinical manifestations that could be partly determined by genetic factors. We aimed to determine the relationship between prevalence of 11 clinical features and age of disease onset with European population genetic substructure. Data from 1413 patients of European ancestry recruited in nine countries was tested for association with genotypes of top ancestry informative markers. This analysis was done with logistic regression between phenotypes and genotypes or principal components extracted from them. We used a genetic additive model and adjusted for gender and disease duration. Three clinical features showed association with ancestry informative markers: autoantibody production defined as immunologic disorder (P = 6.8×10−4), oral ulcers (P = 6.9×10−4) and photosensitivity (P = 0.002). Immunologic disorder was associated with genotypes more common in Southern European ancestries, whereas the opposite trend was observed for photosensitivity. Oral ulcers were specifically more common in patients of Spanish and Portuguese self-reported ancestry. These results should be taken into account in future research and suggest new hypotheses and possible underlying mechanisms to be investigated. A first hypothesis linking photosensitivity with variation in skin pigmentation is suggested. PMID:22194982

STD Clinic Patients' Awareness of Non-AIDS Complications of HIV Infection.

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Castro, José Guillermo; Granovsky, Inna; Jones, Deborah; Weiss, Stephen M

2015-01-01

Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered before and after a brief information session on non-AIDS conditions associated with HIV infection. Participants included men (n = 46) and women (n = 51). Prior to the information session, at baseline, only 34% of the participants were worried about HIV infection. Most participants (82%) agreed that HIV could be treated with antiretroviral therapy (ART), while only 38% were aware that HIV-associated conditions cannot be easily treated with ART. After the information session, almost all participants reported they were concerned regarding the risk of HIV infection. High-risk patients may have limited knowledge about the consequences of HIV infection beyond the traditional AIDS-associated conditions. Increased awareness of these less known consequences of HIV infection may decrease the potential for complacency regarding acquiring HIV infection. © The Author(s) 2014.

Clinical and demographic profile of HIV/AIDS patients diagnosed at a tertiary care centre in Kashmir

International Nuclear Information System (INIS)

Mir, M.A.; Ahmad, P.M.; Siddeque, M.A.; Sofi, F.A.; Ahmad, S.N.; Dar, M.R.

2010-01-01

Objectives: To study the clinical and demographic profile of HIV/AIDS patients diagnosed at a tertiary care centre. Methods: The study was conducted on a group of 1141 patients suspected of having HIV/AIDS on clinical grounds. Screening was done using different Elisa's as advised by NACO and those confirmed as HIV positive were studied for their clinical spectrum and different demographic parameters. Results: Out of 1141 patients tested, 26 proved to have HIV 1 infection with no case of HIV 2 detected. Mean age of presentation was 40.04 +- 7 years, main age group affected 31-40 years and a male: female ratio of 4.2:1 was observed. More than 42% were non Kashmiris with armed forces outnumbering all other occupational classes. Heterosexual transmission was the commonest with married out numbering unmarried. Fever, asthenia and weight loss were the predominant symptoms and pulmonary tuberculosis and oropharyngeal candidiasis commonest opportunistic infections. Conclusion: The clinical and demographic profile of HIV/AIDS patients in Kashmir is largely similar to the rest of India. Kashmir no longer stands immune to the menace of HIV/AIDS. With increasing globalization, frequent travel and change in social values the state is likely to witness an alarming rise in new cases unless a multi pronged approach is undertaken to control the spread. (author)

Financial Aid to Students in Europe: A Summary Analysis.

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Vorbeck, Michael

1983-01-01

An outline of policies and trends in 21 European countries concerning student financial aid as a form of support for higher education includes a tuition survey, policy purposes and considerations, forms of direct and indirect aid, tax benefits, financial aid systems, and study abroad. (MSE)

The European Register of Specialists in Clinical Chemistry and Laboratory Medicine: guide to the Register, version 3-2010.

LENUS (Irish Health Repository)

McMurray, Janet

2010-07-01

In 1997, the European Communities Confederation of Clinical Chemistry and Laboratory Medicine (EC4) set up a Register for European Specialists in Clinical Chemistry and Laboratory Medicine. The operation of the Register is undertaken by a Register Commission (EC4RC). During the last 12 years, more than 2200 specialists in Clinical Chemistry and Laboratory Medicine have joined the Register. In 2007, EC4 merged with the Forum of European Societies of Clinical Chemistry and Laboratory Medicine (FESCC) to form the European Federation of Clinical Chemistry and Laboratory Medicine (EFCC). Two previous Guides to the Register have been published, one in 1997 and another in 2003. The third version of the Guide is presented in this article and is based on the experience gained and development of the profession since the last revision. Registration is valid for 5 years and the procedure and criteria for re-registration are presented as an Appendix at the end of the article.

Definition of a core set of quality indicators for the assessment of HIV/AIDS clinical care: a systematic review

Science.gov (United States)

2013-01-01

Background Several organizations and individual authors have been proposing quality indicators for the assessment of clinical care in HIV/AIDS patients. Nevertheless, the definition of a consensual core set of indicators remains controversial and its practical use is largely limited. This study aims not only to identify and characterize these indicators through a systematic literature review but also to propose a parsimonious model based on those most used. Methods MEDLINE, SCOPUS, Cochrane databases and ISI Web of Knowledge, as well as official websites of organizations dealing with HIV/AIDS care, were searched for articles and information proposing HIV/AIDS clinical care quality indicators. The ones that are on patient’s perspective and based on services set were excluded. Data extraction, using a predefined data sheet based on Cochrane recommendations, was done by one of the authors while a second author rechecked the extracted data for any inconsistency. Results A total of 360 articles were identified in our search query but only 12 of them met the inclusion criteria. We also identified one relevant site. Overall, we identified 65 quality indicators for HIV/AIDS clinical care distributed as following: outcome (n=15) and process-related (n=50) indicators; generic (n=36) and HIV/AIDS disease-specific (n=29) indicators; baseline examinations (n=19), screening (n=9), immunization (n=4), prophylaxis (n=5), HIV monitoring (n=16), and therapy (=12) indicators. Conclusions There are several studies that set up HIV clinical care indicators, with only a part of them useful to assess the HIV clinical care. More importantly, HIV/AIDS clinical care indicators need to be valid, reliable and most of all feasible. PMID:23809537

The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC): experiences from a successful ERS Clinical Research Collaboration.

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Chalmers, James D; Crichton, Megan; Goeminne, Pieter C; Loebinger, Michael R; Haworth, Charles; Almagro, Marta; Vendrell, Montse; De Soyza, Anthony; Dhar, Raja; Morgan, Lucy; Blasi, Francesco; Aliberti, Stefano; Boyd, Jeanette; Polverino, Eva

2017-09-01

In contrast to airway diseases like chronic obstructive pulmonary disease or asthma, and rare diseases such as cystic fibrosis, there has been little research and few clinical trials in bronchiectasis. Guidelines are primarily based on expert opinion and treatment is challenging because of the heterogeneous nature of the disease. In an effort to address decades of underinvestment in bronchiectasis research, education and clinical care, the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) was established in 2012 as a collaborative pan-European network to bring together bronchiectasis researchers. The European Respiratory Society officially funded EMBARC in 2013 as a Clinical Research Collaboration, providing support and infrastructure to allow the project to grow. EMBARC has now established an international bronchiectasis registry that is active in more than 30 countries both within and outside Europe. Beyond the registry, the network participates in designing and facilitating clinical trials, has set international research priorities, promotes education and has participated in producing the first international bronchiectasis guidelines. This manuscript article the development, structure and achievements of EMBARC from 2012 to 2017. To understand the role of Clinical Research Collaborations as the major way in which the European Respiratory Society can stimulate clinical research in different disease areasTo understand some of the key features of successful disease registriesTo review key epidemiological, clinical and translational studies of bronchiectasis contributed by the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) project in the past 5 yearsTo understand the key research priorities identified by EMBARC for the next 5 years.

The knowledge and attitude about HIV/AIDS among Jordanian dental students: (Clinical versus pre clinical students at the University of Jordan

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Shayyab Mohammad H

2011-06-01

Full Text Available Abstract Background The present study aimed to address the suspected deficiency in the level of understanding of HIV/AIDS among clinical and pre clinical dental students at the University of Jordan. In this cross-sectional study, structured questionnaires were distributed to fifth year dental students (n = 121 and to third year dental students (n = 144 in the academic year 2008/2009. Findings Significantly higher percentage of fifth-year students compared to third-year students felt that the teaching they received on cross-infection precautions and barrier dentistry was adequate (P Significantly higher proportion of third-year students compared to fifth-year (39.2% vs. 26.3% thought that HIV patients should be referred to other centers or support groups for treatment (P = 0.04. Conclusions The level of knowledge of Jordanian dental students about HIV and AIDS was generally acceptable; there were inadequacies, however, in their understanding regarding some aspects of AIDS epidemic which demands that dental school curriculum needs some improvement.

Skew-t partially linear mixed-effects models for AIDS clinical studies.

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Lu, Tao

2016-01-01

We propose partially linear mixed-effects models with asymmetry and missingness to investigate the relationship between two biomarkers in clinical studies. The proposed models take into account irregular time effects commonly observed in clinical studies under a semiparametric model framework. In addition, commonly assumed symmetric distributions for model errors are substituted by asymmetric distribution to account for skewness. Further, informative missing data mechanism is accounted for. A Bayesian approach is developed to perform parameter estimation simultaneously. The proposed model and method are applied to an AIDS dataset and comparisons with alternative models are performed.

The ENDOCARE questionnaire guides European endometriosis clinics to improve the patient-centeredness of their care.

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Dancet, E A F; Apers, S; Kluivers, K B; Kremer, J A M; Sermeus, W; Devriendt, C; Nelen, W L D M; D'Hooghe, T M

2012-11-01

How patient-centered are two included specialized endometriosis clinics relative to each other and how can they improve the patient-centeredness of their care? The validated ENDOCARE questionnaire (ECQ) reliably concluded that the adjusted overall patient-centeredness did not differ between the clinics, that each clinic was significantly more patient-centered for 2 out of 10 dimensions of patient-centered endometriosis care and that clinics 1 and 2 had to improve 8 and 13 specific care aspects, respectively. Patient-centered endometriosis care is essential to high-quality care and is defined by 10 dimensions. The ECQ was developed, validated and proved to be reliable in a European setting of self-reported endometriosis patients but had not yet been used at a clinic level for quality management. A cross-sectional survey was disseminated in 2011 to all 514 women diagnosed with endometriosis during a laparoscopy indicated for pain and/or infertility during a retrospective 2-year period (2009-2010) in two university clinics from two different European countries. In total 337 patients completed the ECQ (216 and 121 per clinic). Respondents had a mean age of 34.3 years. Three in four reported a surgical diagnosis of moderate or severe endometriosis and the majority reported surgical treatment by a multidisciplinary team. The ECQ assessed the 10 dimensions of patient-centeredness, more specifically whether the health-care performance, as perceived by patients, measured up to what is important to patients in general. The ECQ was completed by 337 respondents (response rate = 65.6%). Reliability and validity of the ECQ for use on clinic level were confirmed. Clinics did not differ in overall mean importance scores; importance rankings of the ECQ dimensions were almost identical. The overall patient-centeredness scores (PCS), adjusted for education level, did not discriminate between the clinics. However, the adjusted PCS for the dimensions 'clinic staff' and 'technical

Gastroenteritis: First Aid

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First aid Gastroenteritis: First aid Gastroenteritis: First aid By Mayo Clinic Staff Gastroenteritis is an inflammation of your stomach and intestines. Common causes are: Viruses. Food or water contaminated by ...

Snakebites: First Aid

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First aid Snakebites: First aid Snakebites: First aid By Mayo Clinic Staff Most North American snakes aren't dangerous to humans. Some exceptions include the rattlesnake, coral snake, water moccasin ...

Computer-aided diagnosis system for bone scintigrams from Japanese patients: importance of training database

DEFF Research Database (Denmark)

Horikoshi, Hiroyuki; Kikuchi, Akihiro; Onoguchi, Masahisa

2012-01-01

higher performance than the corresponding CAD software trained with a European database for the analysis of bone scans from Japanese patients. These results could at least partly be caused by the physical differences between Japanese and European patients resulting in less influence of attenuation......Computer-aided diagnosis (CAD) software for bone scintigrams have recently been introduced as a clinical quality assurance tool. The purpose of this study was to compare the diagnostic accuracy of two CAD systems, one based on a European and one on a Japanese training database, in a group of bone...... scans from Japanese patients.The two CAD software are trained to interpret bone scans using training databases consisting of bone scans with the desired interpretation, metastatic disease or not. One software was trained using 795 bone scans from European patients and the other with 904 bone scans from...

Danish first aid books compliance with the new evidence-based non-resuscitative first aid guidelines

DEFF Research Database (Denmark)

Jensen, Theo Walther; Møller, Thea Palsgaard; Viereck, Søren

2018-01-01

BACKGROUND: The European Resuscitation Council (ERC) released new guidelines on resuscitation in 2015. For the first time, the guidelines included a separate chapter on first aid for laypersons. We analysed the current major Danish national first aid books to identify potential inconsistencies...... between the current books and the new evidence-based first aid guidelines. METHODS: We identified first aid books from all the first aid courses offered by major Danish suppliers. Based on the new ERC first aid guidelines, we developed a checklist of 26 items within 16 different categories to assess...... the content; this checklist was adapted following the principle of mutually exclusive and collectively exhaustive questioning. To assess the agreement between four raters, Fleiss' kappa test was used. Items that did not reach an acceptable kappa score were excluded. RESULTS: We evaluated 10 first aid books...

«Dallas Buyers Club (2013» clinical research with drugs for the AIDS epidemic 80

Directory of Open Access Journals (Sweden)

Marian de HAAN-BOSCH

2015-07-01

Full Text Available Dallas Buyers Club (2013, inspired by true events, tells the story of Ron Woodroof, a middle?aged elec? trician from Dallas (Texas, who is diagnosed with AIDS in 1985. With few treatment options, he estab? lishes the Dallas Buyers Club in order to provide unapproved drugs to the AIDS community. This results in constant business travels, disputes with the FDA and problems with the law and the IRS. The article analyzes the buyers’ clubs phenomenon in the US, the drugs cited in the film and the clinical trial with zidovudine shown in the movie. The film could be useful as a teaching tool providing an introduction to the AIDS epidemic, clinical research and drug development, bioethics of human research and the agen? cies that regulate drug approval and their availability. Finally, the article presents a possible guideline for the use of the film in a teaching environment.

Current Status of Legislation on Dietary Products for Sportspeople in a European Framework.

Science.gov (United States)

Martínez-Sanz, José Miguel; Sospedra, Isabel; Baladía, Eduard; Arranz, Laura; Ortiz-Moncada, Rocío; Gil-Izquierdo, Angel

2017-11-08

The consumption of nutritional ergogenic aids is conditioned by laws/regulations, but standards/regulations vary between countries. The aim of this review is to explore legislative documents that regulate the use of nutritional ergogenic aids intended for sportspeople in a Spanish/European framework. A narrative review has been developed from official websites of Spanish (Spanish Agency of the Consumer, Food Safety, and Nutrition) and European (European Commission and European Food Safety Authority) bodies. A descriptive analysis of documents was performed. Eighteen legislative documents have been compiled in three sections: (1) Advertising of any type of food and/or product; (2) Composition, labeling, and advertising of foods; (3) Nutritional ergogenic aids. In spite of the existence of these legal documents, the regulation lacks guidance on the use/application of nutritional ergogenic aids for sportspeople. It is essential to prevent the introduction or dissemination of false, ambiguous, or inexact information and contents that induce an error in the receivers of the information. In this field, it is worth highlighting the roles of the European Food Safety Authority and the World Anti-Doping Agency, which provide information about consumer guidelines, prescribing practices, and recommendations for the prudent use of nutritional ergogenic aids.

Chest Pain: First Aid

Science.gov (United States)

First aid Chest pain: First aid Chest pain: First aid By Mayo Clinic Staff Causes of chest pain can vary from minor problems, such as indigestion ... 26, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-chest-pain/basics/ART-20056705 . Mayo ...

Head Trauma: First Aid

Science.gov (United States)

First aid Head trauma: First aid Head trauma: First aid By Mayo Clinic Staff Most head trauma involves injuries that are minor and don't require ... 21, 2015 Original article: http://www.mayoclinic.org/first-aid/first-aid-head-trauma/basics/ART-20056626 . Mayo ...

Animal Bites: First Aid

Science.gov (United States)

First aid Animal bites: First aid Animal bites: First aid By Mayo Clinic Staff These guidelines can help you care for a minor animal bite, such ... 26, 2017 Original article: http://www.mayoclinic.org/first-aid/first-aid-animal-bites/basics/ART-20056591 . Mayo ...

Integrating resource efficiency and EU State aid. An evaluation of resource efficiency considerations in the current EU State aid framework

Energy Technology Data Exchange (ETDEWEB)

Bennink, D.; Faber, J.; Smit, M. [CE Delft, Delft (Netherlands); Goba, V. [SIA Estonian, Latvian and Lithuanian Environment ELLE, Tallinn (Estonia); Miller, K.; Williams, E. [AEA Technology plc, London (United Kingdom)

2012-10-15

This study, for the European Commission, analyses the issues that need to be addressed in the revision of the EU State aid framework to ensure that they do not hinder environmental, resource efficiency and sustainable development goals. In some cases, State aid can be considered an environmentally harmful subsidy (EHS). The study analyses (1) the extent to which the Environmental Aid Guidelines (EAG) need to be changed to take into account recent European environmental policy developments; (2) existing and potential resource efficiency considerations in a) the Regional Aid Guidelines; b) the Research, Development and Innovation (RDI) Guidelines and c) the Agriculture and Forestry Guidelines; assesses cases and schemes using these guidelines to identify whether resource efficiency considerations are taken into account. The study also considers the social, environmental and economic impacts of these cases and schemes. It develops recommendations for the review of the EAG and a number of horizontal guidelines. One of the conclusions of the analysis is that the way in which multiple objectives and impacts are balanced, when deciding to approve state aid, is unclear. Also, EU member states are not required to provide information on certain types of (estimated) impacts. To guarantee that multiple objectives and impacts are sufficiently balanced, it is recommended that the State aid framework prescribes that applicants identify social, economic and environmental objectives and impacts and describe how these are taken into account in the procedure of balancing multiple (conflicting) objectives. Objectives and impacts should be quantified as much as possible, for example by making use of the method of external cost calculation laid down in 'the Handbook on estimation of external costs in the transport Sector'. The results of the study are used by the European Commission as an input for evaluating and improving the EU State aid framework.

Integrating resource efficiency and EU State aid. An evaluation of resource efficiency considerations in the current EU State aid framework

Energy Technology Data Exchange (ETDEWEB)

Bennink, D.; Faber, J.; Smit, M. [CE Delft, Delft (Netherlands); Goba, V. [SIA Estonian, Latvian and Lithuanian Environment ELLE, Tallinn (Estonia); Miller, K.; Williams, E. [AEA Technology plc, London (United Kingdom)

2012-10-15

This study, for the European Commission, analyses the issues that need to be addressed in the revision of the EU State aid framework to ensure that they do not hinder environmental, resource efficiency and sustainable development goals. In some cases, State aid can be considered an environmentally harmful subsidy (EHS). The study analyses (1) the extent to which the Environmental Aid Guidelines (EAG) need to be changed to take into account recent European environmental policy developments; (2) existing and potential resource efficiency considerations in a) the Regional Aid Guidelines; b) the Research, Development and Innovation (RDI) Guidelines and c) the Agriculture and Forestry Guidelines; assesses cases and schemes using these guidelines to identify whether resource efficiency considerations are taken into account. The study also considers the social, environmental and economic impacts of these cases and schemes. It develops recommendations for the review of the EAG and a number of horizontal guidelines. One of the conclusions of the analysis is that the way in which multiple objectives and impacts are balanced, when deciding to approve state aid, is unclear. Also, EU member states are not required to provide information on certain types of (estimated) impacts. To guarantee that multiple objectives and impacts are sufficiently balanced, it is recommended that the State aid framework prescribes that applicants identify social, economic and environmental objectives and impacts and describe how these are taken into account in the procedure of balancing multiple (conflicting) objectives. Objectives and impacts should be quantified as much as possible, for example by making use of the method of external cost calculation laid down in 'the Handbook on estimation of external costs in the transport Sector'. The results of the study are used by the European Commission as an input for evaluating and improving the EU State aid framework.

The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC: experiences from a successful ERS Clinical Research Collaboration

Directory of Open Access Journals (Sweden)

James D. Chalmers

2017-09-01

To understand the role of Clinical Research Collaborations as the major way in which the European Respiratory Society can stimulate clinical research in different disease areas To understand some of the key features of successful disease registries To review key epidemiological, clinical and translational studies of bronchiectasis contributed by the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC project in the past 5 years To understand the key research priorities identified by EMBARC for the next 5 years

Clinical highlights from the 2016 European Respiratory Society International Congress

Directory of Open Access Journals (Sweden)

Nicolas Kahn

2017-04-01

Full Text Available This article contains highlights and a selection of the scientific advances from the European Respiratory Society (ERS Clinical Assembly (Assembly 1 and its six respective groups (Groups 1.1–1.6 that were presented at the 2016 ERS International Congress in London, UK. The most relevant topics for clinicians will be discussed, covering a wide range of areas including clinical problems, rehabilitation and chronic care, thoracic imaging, interventional pulmonology, diffuse and parenchymal lung diseases, and general practice and primary care. In this comprehensive review, the newest research and actual data will be discussed and put into perspective.

Exploring the use of Option Grid™ patient decision aids in a sample of clinics in Poland.

Science.gov (United States)

Scalia, Peter; Elwyn, Glyn; Barr, Paul; Song, Julia; Zisman-Ilani, Yaara; Lesniak, Monika; Mullin, Sarah; Kurek, Krzysztof; Bushell, Matt; Durand, Marie-Anne

2018-05-29

Research on the implementation of patient decision aids to facilitate shared decision making in clinical settings has steadily increased across Western countries. A study which implements decision aids and measures their impact on shared decision making has yet to be conducted in the Eastern part of Europe. To study the use of Option Grid TM patient decision aids in a sample of Grupa LUX MED clinics in Warsaw, Poland, and measure their impact on shared decision making. We conducted a pre-post interventional study. Following a three-month period of usual care, clinicians from three Grupa LUX MED clinics received a one-hour training session on how to use three Option Grid TM decision aids and were provided with copies for use for four months. Throughout the study, all eligible patients were asked to complete the three-item CollaboRATE patient-reported measure of shared decision making after their clinical encounter. CollaboRATE enables patients to assess the efforts clinicians make to: (i) inform them about their health issues; (ii) listen to 'what matters most'; (iii) integrate their treatment preference in future plans. A Hierarchical Logistic Regression model was performed to understand which variables had an effect on CollaboRATE. 2,048 patients participated in the baseline phase; 1,889 patients participated in the intervention phase. Five of the thirteen study clinicians had a statistically significant increase in their CollaboRATE scores (pOption Grid TM helped some clinicians practice shared decision making as reflected in CollaboRATE scores, but most clinicians did not have a significant increase in their scores. Our study indicates that the effect of these interventions may be dependent on clinic contexts and clinician engagement. Copyright © 2018. Published by Elsevier GmbH.

A European multi-language initiative to make the general population aware of independent clinical research

DEFF Research Database (Denmark)

Mosconi, Paola; Antes, Gerd; Barbareschi, Giorgio

2016-01-01

2. An animated film about clinical trials, dubbed in the 23 official languages of the European Community, and an interactive tutorial 3. An inventory of resources, available in 23 languages, searchable by topic, author, and media type 4. Two educational games for young people, developed in six......BACKGROUND: The ECRAN (European Communication on Research Awareness Needs) project was initiated in 2012, with support from the European Commission, to improve public knowledge about the importance of independent, multinational, clinical trials in Europe. METHODS: Participants in the ECRAN...... materials and tools, making them freely available under a Creative Commons licence. RESULTS: The principal communication materials developed were: 1. A website ( http://ecranproject.eu ) in six languages, including a Media centre section to help journalists to disseminate information about the ECRAN project...

Are patient decision aids the best way to improve clinical decision making? Report of the IPDAS Symposium.

Science.gov (United States)

Holmes-Rovner, Margaret; Nelson, Wendy L; Pignone, Michael; Elwyn, Glyn; Rovner, David R; O'Connor, Annette M; Coulter, Angela; Correa-de-Araujo, Rosaly

2007-01-01

This article reports on the International Patient Decision Aid Standards Symposium held in 2006 at the annual meeting of the Society for Medical Decision Making in Cambridge, Massachusetts. The symposium featured a debate regarding the proposition that "decision aids are the best way to improve clinical decision making.'' The formal debate addressed the theoretical problem of the appropriate gold standard for an improved decision, efficacy of decision aids, and prospects for implementation. Audience comments and questions focused on both theory and practice: the often unacknowledged roots of decision aids in expected utility theory and the practical problems of limited patient decision aid implementation in health care. The participants' vote on the proposition was approximately half for and half against.

Current Status of Legislation on Dietary Products for Sportspeople in a European Framework

Directory of Open Access Journals (Sweden)

José Miguel Martínez-Sanz

2017-11-01

Full Text Available The consumption of nutritional ergogenic aids is conditioned by laws/regulations, but standards/regulations vary between countries. The aim of this review is to explore legislative documents that regulate the use of nutritional ergogenic aids intended for sportspeople in a Spanish/European framework. A narrative review has been developed from official websites of Spanish (Spanish Agency of the Consumer, Food Safety, and Nutrition and European (European Commission and European Food Safety Authority bodies. A descriptive analysis of documents was performed. Eighteen legislative documents have been compiled in three sections: (1 Advertising of any type of food and/or product; (2 Composition, labeling, and advertising of foods; (3 Nutritional ergogenic aids. In spite of the existence of these legal documents, the regulation lacks guidance on the use/application of nutritional ergogenic aids for sportspeople. It is essential to prevent the introduction or dissemination of false, ambiguous, or inexact information and contents that induce an error in the receivers of the information. In this field, it is worth highlighting the roles of the European Food Safety Authority and the World Anti-Doping Agency, which provide information about consumer guidelines, prescribing practices, and recommendations for the prudent use of nutritional ergogenic aids.

Current Status of Legislation on Dietary Products for Sportspeople in a European Framework

Science.gov (United States)

Arranz, Laura; Ortiz-Moncada, Rocío

2017-01-01

The consumption of nutritional ergogenic aids is conditioned by laws/regulations, but standards/regulations vary between countries. The aim of this review is to explore legislative documents that regulate the use of nutritional ergogenic aids intended for sportspeople in a Spanish/European framework. A narrative review has been developed from official websites of Spanish (Spanish Agency of the Consumer, Food Safety, and Nutrition) and European (European Commission and European Food Safety Authority) bodies. A descriptive analysis of documents was performed. Eighteen legislative documents have been compiled in three sections: (1) Advertising of any type of food and/or product; (2) Composition, labeling, and advertising of foods; (3) Nutritional ergogenic aids. In spite of the existence of these legal documents, the regulation lacks guidance on the use/application of nutritional ergogenic aids for sportspeople. It is essential to prevent the introduction or dissemination of false, ambiguous, or inexact information and contents that induce an error in the receivers of the information. In this field, it is worth highlighting the roles of the European Food Safety Authority and the World Anti-Doping Agency, which provide information about consumer guidelines, prescribing practices, and recommendations for the prudent use of nutritional ergogenic aids. PMID:29117104

The management of clinical laboratories in Europe: a FESCC survey. Forum of the European Societies of Clinical Chemistry and Laboratory Medicine.

Science.gov (United States)

de Kieviet, Wim; Blaton, Victor; Kovacs, Gabor L; Palicka, Vladimir; Pulkki, Kari

2002-03-01

The professional duties of the specialists in clinical chemistry differ from country to country in Europe. One of the main goals of the Strategic Plan of the Forum of the European Societies of Clinical Chemistry and Laboratory Medicine (FESCC; IFCC-Europe) is to promote a high scientific and professional standard in the field of clinical chemistry and laboratory medicine in Europe. This can be stimulated by the knowledge of the local conditions in each country and by striving towards a strong and harmonised position in all the European countries. In order to enhance the knowledge of the managerial situation of the specialists in clinical chemistry in Europe, FESCC launched a survey in September 2000. This survey provides information about the position of the specialists in clinical chemistry in the various disciplines in the medical laboratories and in hospitals, and about the advisory tasks and the managerial education during the post-graduate training in clinical chemistry. Of the 35 FESCC member countries 33 have participated in the survey (94%). The results show a rather heterogeneous situation in Europe caused by the local historical developments, the differences in academic background and the relative numbers of private and physicians' office laboratories. Large differences exist between the European countries in the disciplines of laboratory medicine that are headed by a specialist in clinical chemistry. In the different countries the clinical chemistry laboratories are headed by specialists in clinical chemistry in between 20% and 100% of the laboratories. The haematology, immunology, microbiology, therapeutic drug monitoring, molecular biology and haemostasis laboratories and departments of blood banking are headed by specialists in clinical chemistry in between 0% and 100% of the laboratories. The responsibilities for the various managerial tasks of the specialists in clinical chemistry show no uniformity in Europe. In the majority of the countries the

A European Master's Programme in Public Health Nutrition.

Science.gov (United States)

Yngve, A; Warm, D; Landman, J; Sjöström, M

2001-12-01

Effective population-based strategies require people trained and competent in the discipline of Public Health Nutrition. Since 1997, a European Master's Programme in Public Health Nutrition has been undergoing planning and implementation, by establishing initial quality assurance systems with the aid of funding from the European Commission (DG SANCO/F3). Partners from 17 European countries have been involved in the process. A European Network of Public Health Nutrition has been developed and accredited by the European Commission.

Nuclear safety and the European Community: Broadening perspectives

International Nuclear Information System (INIS)

Brinkhorst, L.J.

1992-01-01

The European Community's activities in harmonizing of regulations and practices in the field of nuclear safety are described. The issues of aid to Central and Eastern European countries as well as of public information, within this context, are discussed

Survival differences in European patients with AIDS, 1979-89. The AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Pedersen, C; Clumeck, N

1994-01-01

. The regional differences in survival were less pronounced for patients diagnosed in 1989 compared with earlier years. Improved survival in recent years was observed for patients with a variety of manifestations used to define AIDS but was significant only for patients diagnosed with Pneumocystis carinii...... pneumonia. The three year survival, however, remains unchanged over time. CONCLUSIONS--Survival of AIDS patients seems to vary within Europe, being shorter in southern than central and northern Europe. The magnitude of these differences, however, has declined gradually over time. Short term survival has...

The Cardiology Audit and Registration Data Standards (CARDS), European data standards for clinical cardiology practice

NARCIS (Netherlands)

M.R. Flynn (Rachel); C. Barrett (Conor); F.G. Cosio (Francisco); A.K. Gitt (Anselm); L.C. Wallentin (Lars); P. Kearney (Peter); M. Lonergan (Moira); E. Shelley (Emer); M.L. Simoons (Maarten)

2005-01-01

textabstractAIMS: Systematic registration of data from clinical practice is important for clinical care, local, national and international registries, and audit. Data to be collected for these different purposes should be harmonized. Therefore, during Ireland's Presidency of the European Union (EU)

Plasma HIV-1 Tropism and the Risk of Short-Term Clinical Progression to AIDS or Death

DEFF Research Database (Denmark)

Casadellà, Maria; Cozzi-Lepri, Alessandro; Phillips, Andrew

2017-01-01

OBJECTIVE: To investigate if plasma HIV-1 tropism testing could identify subjects at higher risk for clinical progression and death in routine clinical management. DESIGN: Nested case-control study within the EuroSIDA cohort. METHODS: Cases were subjects with AIDS or who died from any cause...

Common definition for categories of clinical research: a prerequisite for a survey on regulatory requirements by the European Clinical Research Infrastructures Network (ECRIN)

LENUS (Irish Health Repository)

Kubiak, Christine

2009-10-16

Abstract Background Thorough knowledge of the regulatory requirements is a challenging prerequisite for conducting multinational clinical studies in Europe given their complexity and heterogeneity in regulation and perception across the EU member states. Methods In order to summarise the current situation in relation to the wide spectrum of clinical research, the European Clinical Research Infrastructures Network (ECRIN) developed a multinational survey in ten European countries. However a lack of common classification framework for major categories of clinical research was identified, and therefore reaching an agreement on a common classification was the initial step in the development of the survey. Results The ECRIN transnational working group on regulation, composed of experts in the field of clinical research from ten European countries, defined seven major categories of clinical research that seem relevant from both the regulatory and the scientific points of view, and correspond to congruent definitions in all countries: clinical trials on medicinal products; clinical trials on medical devices; other therapeutic trials (including surgery trials, transplantation trials, transfusion trials, trials with cell therapy, etc.); diagnostic studies; clinical research on nutrition; other interventional clinical research (including trials in complementary and alternative medicine, trials with collection of blood or tissue samples, physiology studies, etc.); and epidemiology studies. Our classification was essential to develop a survey focused on protocol submission to ethics committees and competent authorities, procedures for amendments, requirements for sponsor and insurance, and adverse event reporting following five main phases: drafting, consensus, data collection, validation, and finalising. Conclusion The list of clinical research categories as used for the survey could serve as a contribution to the, much needed, task of harmonisation and simplification of the

Common definition for categories of clinical research: a prerequisite for a survey on regulatory requirements by the European Clinical Research Infrastructures Network (ECRIN

Directory of Open Access Journals (Sweden)

Sanz Nuria

2009-10-01

Full Text Available Abstract Background Thorough knowledge of the regulatory requirements is a challenging prerequisite for conducting multinational clinical studies in Europe given their complexity and heterogeneity in regulation and perception across the EU member states. Methods In order to summarise the current situation in relation to the wide spectrum of clinical research, the European Clinical Research Infrastructures Network (ECRIN developed a multinational survey in ten European countries. However a lack of common classification framework for major categories of clinical research was identified, and therefore reaching an agreement on a common classification was the initial step in the development of the survey. Results The ECRIN transnational working group on regulation, composed of experts in the field of clinical research from ten European countries, defined seven major categories of clinical research that seem relevant from both the regulatory and the scientific points of view, and correspond to congruent definitions in all countries: clinical trials on medicinal products; clinical trials on medical devices; other therapeutic trials (including surgery trials, transplantation trials, transfusion trials, trials with cell therapy, etc.; diagnostic studies; clinical research on nutrition; other interventional clinical research (including trials in complementary and alternative medicine, trials with collection of blood or tissue samples, physiology studies, etc.; and epidemiology studies. Our classification was essential to develop a survey focused on protocol submission to ethics committees and competent authorities, procedures for amendments, requirements for sponsor and insurance, and adverse event reporting following five main phases: drafting, consensus, data collection, validation, and finalising. Conclusion The list of clinical research categories as used for the survey could serve as a contribution to the, much needed, task of harmonisation and

Validation of World Health Organisation HIV/AIDS clinical staging in predicting initiation of antiretroviral therapy and clinical predictors of low CD4 cell count in Uganda.

Directory of Open Access Journals (Sweden)

Steven Baveewo

Full Text Available INTRODUCTION: The WHO clinical guidelines for HIV/AIDS are widely used in resource limited settings to represent the gold standard of CD4 counts for antiviral therapy initiation. The utility of the WHO-defined stage 1 and 2 clinical factors used in WHO HIV/AIDS clinical staging in predicting low CD4 cell count has not been established in Uganda. Although the WHO staging has shown low sensitivity for predicting CD4<200 cells/mm(3, it has not been evaluated at for CD4 cut-offs of <250 cells/mm(3 or <350 cells/mm(3. OBJECTIVE: To validate the World Health Organisation HIV/AIDS clinical staging in predicting initiation of antiretroviral therapy in a low-resource setting and to determine the clinical predictors of low CD4 cell count in Uganda. RESULTS: Data was collected on 395 participants from the Joint Clinical Research Centre, of whom 242 (61.3% were classified as in stages 1 and 2 and 262 (68% were females. Participants had a mean age of 36.8 years (SD 8.5. We found a significant inverse correlation between the CD4 lymphocyte count and WHO clinical stages. The sensitivity the WHO clinical staging at CD4 cell count of 250 cells/mm(3 and 350 cells/mm(3 was 53.5% and 49.1% respectively. Angular cheilitis, papular pruritic eruptions and recurrent upper respiratory tract infections were found to be significant predictors of low CD4 cell count among participants in WHO stage 1 and 2. CONCLUSION: The WHO HIV/AIDS clinical staging guidelines have a low sensitivity and about half of the participants in stages 1 and 2 would be eligible for ART initiation if they had been tested for CD4 count. Angular cheilitis and papular pruritic eruptions and recurrent upper respiratory tract infections may be used, in addition to the WHO staging, to improve sensitivity in the interim, as access to CD4 machines increases in Uganda.

AWARENESS ABOUT HIV/AIDS IN CLIENTS ATTENDING STI CLINIC: A CROSS SECTIONAL STUDY FROM SOUTH-EAST RAJASTHAN, INDIA

Directory of Open Access Journals (Sweden)

Atul

2015-12-01

Full Text Available BACKGROUND India bears a large burden of HIV/AIDS on globe. Major weapons against HIV/AIDS are treatment which is not curative, vaccine which is far from reality and accurate & adequate information about the disease which is practically acceptable and cost effective way of prevention in form of social vaccine and is a good tool for HIV/AIDS in developing countries like India. In India there is inadequate & inaccurate knowledge about the disease in general population. AIM In present study we tried to analyze the knowledge & awareness about HIV/AIDS in clients attending the STI clinic at Jhalawar Hospital and Medical College at south east part of Rajasthan, India. MATERIAL & METHODS We assessed 500 clients at STI clinic by using a predesigned questionnaire which gathers their knowledge regarding HIV/AIDS. All the clients above the age of 18 years who attended the STI clinic were enrolled for the study voluntarily. Participants were finally assessed as good/poor or unaware according to their level of knowledge. STATISTICAL ANALYSIS SPSS version 20.0 (trial was used to analyze all the data. Chi square test was used to find association between knowledge and their literacy level & occupation. RESULTS 142(28.4% of the participants had never heard about HIV/AIDS among them females were significantly more than males. Both low level of literacy and unemployment or house wives were associated with unawareness about HIV/AIDS. For the 358(71.6% participants who had heard about HIV/AIDS, mass media was the main source of information (53.07% in which television contributes the major part, followed by friends and colleagues (24.02%. While the knowledge about HIV transmission and prevention was good but the extent of misconceptions was also high (64.8%. CONCLUSION Our study is highly suggestive of the strong need to increase the level of HIV awareness among Indian population via proper education and through various resources on information.

Evaluation of a clinical auditory profile in hearing-aid candidates

DEFF Research Database (Denmark)

Thorup, Nicoline; Santurette, Sébastien; Jørgensen, Søren

2015-01-01

by default. However, this does not necessary lead to the same HA benefit. This study aimed at identifying clinically relevant tests that may be informative in addition to the audiogram and relate more directly to HA benefit. Twenty-nine HI listeners performed fast tests of loudness perception, spectral...... and temporal resolution, binaural hearing, speech intelligibility in stationary and fluctuating noise, and a working-memory test. Six weeks after HA fitting they answered the International Outcome Inventory – Hearing Aid evaluation. The HI group was homogeneous based on the audiogram, but only one test...

Assessment of the knowledge and attitudes regarding HIV/AIDS among pre-clinical medical students in Israel

Science.gov (United States)

2014-01-01

Background Today’s medical students are the future physicians of people living with HIV/AIDS (PLWHA). It is therefore essential that medical students possess the appropriate knowledge and attitudes regarding PLWHA. This study aims to evaluate knowledge and attitudes of pre-clinical Israeli medical students and to assess whether their knowledge and attitudes change throughout their pre-clinical studies. Methods A cross-sectional study was conducted among all pre-clinical medical students from the four medical schools in Israel during the academic year of 2010/2011 (a total of 1,470 students). A self-administered questionnaire was distributed. The questionnaire sought student responses pertaining to knowledge of HIV transmission and non-transmission routes, basic knowledge of HIV/AIDS treatment and attitudes towards HIV/AIDS. Results The study’s response rate was 62.24 percent. Knowledge among pre-clinical medical students was generally high and showed a statistically significant improvement as students progressed through their pre-clinical studies. However, there were some misconceptions, mostly regarding HIV transmission via breastfeeding and knowledge of HIV prevention after exposure to the virus. Students’ attitudes were found to include stigmatizing notions. Furthermore, the majority of medical students correlated HIV with shame and fear. In addition, students’ attitudes toward HIV testing and providing confidential medical information were contradictory to health laws, protocols and guidelines. Overall, no positive changes in students’ attitudes were observed during the pre-clinical years of medical school. Conclusion The knowledge of pre-clinical medical students in Israel is generally high, although there are some knowledge inadequacies that require more emphasis in the curricula of the medical schools. Contrary to HIV-related knowledge, medical students’ attitudes are unaffected by their progression through medical school. Therefore, medical

Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis.

Science.gov (United States)

van Schoor, N M; Zambon, S; Castell, M V; Cooper, C; Denkinger, M; Dennison, E M; Edwards, M H; Herbolsheimer, F; Maggi, S; Sánchez-Martinez, M; Pedersen, N L; Peter, R; Schaap, L A; Rijnhart, J J M; van der Pas, S; Deeg, D J H

2016-06-01

Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH. Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index. The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function. Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.

[Evaluation of production and clinical working time of computer-aided design/computer-aided manufacturing (CAD/CAM) custom trays for complete denture].

Science.gov (United States)

Wei, L; Chen, H; Zhou, Y S; Sun, Y C; Pan, S X

2017-02-18

To compare the technician fabrication time and clinical working time of custom trays fabricated using two different methods, the three-dimensional printing custom trays and the conventional custom trays, and to prove the feasibility of the computer-aided design/computer-aided manufacturing (CAD/CAM) custom trays in clinical use from the perspective of clinical time cost. Twenty edentulous patients were recruited into this study, which was prospective, single blind, randomized self-control clinical trials. Two custom trays were fabricated for each participant. One of the custom trays was fabricated using functional suitable denture (FSD) system through CAD/CAM process, and the other was manually fabricated using conventional methods. Then the final impressions were taken using both the custom trays, followed by utilizing the final impression to fabricate complete dentures respectively. The technician production time of the custom trays and the clinical working time of taking the final impression was recorded. The average time spent on fabricating the three-dimensional printing custom trays using FSD system and fabricating the conventional custom trays manually were (28.6±2.9) min and (31.1±5.7) min, respectively. The average time spent on making the final impression with the three-dimensional printing custom trays using FSD system and the conventional custom trays fabricated manually were (23.4±11.5) min and (25.4±13.0) min, respectively. There was significant difference in the technician fabrication time and the clinical working time between the three-dimensional printing custom trays using FSD system and the conventional custom trays fabricated manually (Pmanufacture custom trays by three-dimensional printing method, there is no need to pour preliminary cast after taking the primary impression, therefore, it can save the impression material and model material. As to completing denture restoration, manufacturing custom trays using FSD system is worth being

US - European Union Relations: Economic Change and Political Transition

National Research Council Canada - National Science Library

Kramer, Steven

1999-01-01

.... ̂ The introduction of the euro as the currency of the EMU will aid participating European Union (EU) member states by eliminating transaction costs, exchange rate risks, and interest rate spreads across the 11 European currencies early in the coming century...

[HIV/AIDS masks in a therapist's practice].

Science.gov (United States)

Roshchina, A A; Ponomareva, E Yu; Rebrov, A P

2015-01-01

To investigate clinical manifestations and diagnostic difficulties in patients with HIV/AIDS in the practice of therapeutic units of a multidisciplinary hospital. The investigation included 65 HIV/AIDS patients admitted to the therapy units of a Saratov Regional clinical hospital in 2007 to 2011. The clinical features of HIV/AIDS, immunological status, and viral load were studied. The structure of the clinical manifestation of HIV/AIDS showed a preponderance of lung injury in 45 (69%) patients. There were hematological disorders in 38 (58%) patients and nephropathy in 33 (51 %); 11 (17%) patients were diagnosed with infective endocarditis. Rheumatic symptoms and syndromes mimicking HIV/AIDS were found in 10 (15.4%) patients. The degree of immune disorders was most severe in patients with pulmonary dissemination and rheumatic masks and mutually related to the rate of cutaneous manifestations. The specific features of lung injury, infective endocarditis, pulmonary hypertension, rheumatic symptoms, and kidney injury were discussed in HIV/AIDS patients having different causes for admission to specialized therapy units. In connection with the clinical polymorphism of HIV/AIDS, physicians of all specialties should be alert for the possible clinical manifestations of this disease to timely examine patients.

Epidemiological observations in the AIDS clinic at the Hadassah University Hospital in Jerusalem.

Science.gov (United States)

Maayan, S; Engelhard, D; Boger, S; Ganer, A; Morag, A; Shapiro, M; Sacks, T

1989-06-01

Of the first 395 attendees at the AIDS clinic in Jerusalem, 32% were homo/bisexuals, 4% i.v. drug abusers (IVDAs), 24% persons with minimal risk for AIDS and 38% were persons having no risk. Human immunodeficiency virus (HIV) antibody rates were 7% for homosexuals, 29% for IVDAs, 1% for persons with minimal risk and 0% for persons at no risk. Israeli homosexuals had a significantly greater risk for HIV infection (9 of 35) if they had sexual contact with non-Israelis as compared with homosexuals who had contact with local partners only (0/91, P less than 0.001). The mean number of attendees per month increased by 431% during the 4 months following the first prime-time television program on AIDS. The largest mean increases occurred among persons at no risk (1 to 27.2), those with minimal risk (2.5 to 16.5), and among women (1.25 to 20.0). This report indicates that HIV infection among Israeli homosexuals has not yet reached U.S. proportions. It also shows that the TV program raised anxiety concerning AIDS among the general public, and probably encouraged the public to use HIV testing as part of a general health screening program.

Comparison of Leishmania typing results obtained from 16 European clinical laboratories in 2014

NARCIS (Netherlands)

van der Auwera, Gert; Bart, Aldert; Chicharro, Carmen; Cortes, Sofia; Davidsson, Leigh; Di Muccio, Trentina; Dujardin, Jean-Claude; Felger, Ingrid; Paglia, Maria Grazia; Grimm, Felix; Harms, Gundel; Jaffe, Charles L.; Manser, Monika; Ravel, Christophe; Robert-Gangneux, Florence; Roelfsema, Jeroen; Töz, Seray; Verweij, Jaco J.; Chiodini, Peter L.

2016-01-01

Leishmaniasis is endemic in southern Europe, and in other European countries cases are diagnosed in travellers who have visited affected areas both within the continent and beyond. Prompt and accurate diagnosis poses a challenge in clinical practice in Europe. Different methods exist for

Clinical use of patient decision-making aids for stone patients.

Science.gov (United States)

Lim, Amy H; Streeper, Necole M; Best, Sara L; Penniston, Kristina L; Nakada, Stephen Y

2017-08-01

Patient decision-making aids (PDMAs) help patients make informed healthcare decisions and improve patient satisfaction. The utility of PDMAs for patients considering treatments for urolithiasis has not yet been published. We report our experience using PDMAs developed at our institution in the outpatient clinical setting in patients considering a variety of treatment options for stones. Patients with radiographically confirmed urolithiasis were given PDMAs regarding treatment options for their stone(s) based on their clinical profile. We assessed patients' satisfaction, involvedness, and feeling of making a more informed decision with utilization of the PDMAs using a Likert Scale Questionnaire. Information was also collected regarding previous stone passage, history and type of surgical intervention for urolithiasis, and level of education. Patients (n = 43; 18 males, 23 females and two unknown) 53 +/- 14years old were included. Patients reported that they understood the advantages and disadvantages outlined in the PDMAs (97%), that the PDMAs helped them make a more informed decision (83%) and felt more involved in the decision making process (88%). Patients reported that the aids were presented in a balanced manner and used up-to-date scientific information (100%, 84% respectively). Finally, a majority of the patients prefer an expert's opinion when making a treatment decision (98%) with 73% of patients preferring to form their own opinion based on available information. Previous stone surgery was associated with patients feeling more involved with the decision making process (p = 0.0465). PDMAs have a promising role in shared decision-making in the setting of treatment options for nephrolithiasis.

Malignancies in HIV/AIDS patients attending an outpatient clinic in Vitória, State of Espírito Santo, Brazil

Directory of Open Access Journals (Sweden)

Lauro Ferreira da Silva Pinto Neto

2012-12-01

Full Text Available INTRODUCTION: The present study investigated cancer prevalence and associated factors among HIV-infected individuals attending an AIDS outpatient clinic in Vitória, State of Espírito Santo, Brazil. METHODS: A sectional study was conducted among HIV infected adults attending an AIDS outpatient clinic in Vitória, State of Espírito Santo, Brazil. Demographic, epidemiological and clinical data were abstracted from medical records, including cancer diagnoses; nadir and current CD4 cell count, HIV viral load, time on antiretroviral treatment (ART, type of ART and smoking status. RESULTS: A total of 730 (91.3% patients were included in the study. Median age was 44.0 [interquartile range (IQR: 35-50.3] years; median time since HIV diagnosis was 5.5 years (IQR: 2-10; 60% were male; and 59% were white. Thirty (4.1% cases of cancer were identified of which 16 (53% were AIDS defining cancers and 14 (47% were non-AIDS defining malignancies. Patients diagnosed with cancer presented higher chance of being tobacco users [OR 2.2 (95% CI: 1.04-6.24]; having nadir CD4 ≤200 cells/mm³ [OR 3.0 (95% CI: 1.19-7.81] and higher lethality [OR 13,3 (95% CI: 4,57-38,72]. CONCLUSIONS: These results corroborate the importance of screening for and prevention of non-AIDS defining cancers focus in HIV-infected population, as these cancers presented with similar frequency as AIDS defining cancers.

Prosthetic rehabilitation with an implant-supported fixed prosthesis using computer-aided design and computer-aided manufacturing dental technology for a patient with a mandibulectomy: A clinical report.

Science.gov (United States)

Yoon, Hyung-In; Han, Jung-Suk

2016-02-01

The fabrication of dental prostheses with computer-aided design and computer-aided manufacturing shows acceptable marginal fits and favorable treatment outcomes. This clinical report describes the management of a patient who had undergone a mandibulectomy and received an implant-supported fixed prosthesis by using additive manufacturing for the framework and subtractive manufacturing for the monolithic zirconia restorations. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Clinical evaluation of cardiovascular devices: principles, problems, and proposals for European regulatory reform. Report of a policy conference of the European Society of Cardiology.

Science.gov (United States)

Fraser, Alan G; Daubert, Jean-Claude; Van de Werf, Frans; Estes, N A Mark; Smith, Sidney C; Krucoff, Mitchell W; Vardas, Panos E; Komajda, Michel

2011-07-01

The European Commission announced in 2008 that a fundamental revision of the medical device directives is being considered in order to clarify and strengthen the current legal framework. The system for testing and approving devices in Europe was established >20 years ago as a 'New Approach' to a previously little-regulated industry. It is recognized by many that the regulatory system has not kept pace with technological advances and changing patterns of medical practice. New legislation will be drafted during 2011, but medical experts have been little involved in this important process. This context makes it an opportune time for a professional association to advise from both clinical and academic perspectives about changes which should be made to improve the safety and efficacy of devices used in clinical practice and to develop more appropriate systems for their clinical evaluation and post-marketing surveillance. This report summarizes how medical devices are regulated and it reviews some serious clinical problems that have occurred with cardiovascular devices. Finally, it presents the main recommendations from a Policy Conference on the Clinical Evaluation of Cardiovascular Devices that was held at the European Heart House in January 2011.

A global, incremental development method for a web-based prostate cancer treatment decision aid and usability testing in a Dutch clinical setting

NARCIS (Netherlands)

Cuypers, M.; Lamers, R.E.D.; Kil, P.J.M.; The, R.; Karssen, K.; van de Poll-Franse, L.V.; de Vries, M.

2018-01-01

Many new decision aids are developed while aspects of existing decision aids could also be useful, leading to a sub-optimal use of resources. To support treatment decision-making in prostate cancer patients, a pre-existing evidence-based Canadian decision aid was adjusted to Dutch clinical setting.

State aid for the adequacy of production in EU competition law

OpenAIRE

Domazet, Siniša

2017-01-01

State aid is essentially inadmissible in EU competition law. The paper deals with state aid for the adequacy of production. Research has shown that if the conditions contained in the guidelines on state aid for environmental protection and energy for the period 2014-2020 are fulfilled, this form of state aid will be permitted. It has been established that there is no practice of the European Commission in connection with this form of state aid. Recommendation to the Member States is to carry ...

Bibliometric Assessment of European and Sub-Saharan African Research Output on Poverty-Related and Neglected Infectious Diseases from 2003 to 2011.

Science.gov (United States)

Breugelmans, J Gabrielle; Makanga, Michael M; Cardoso, Ana Lúcia V; Mathewson, Sophie B; Sheridan-Jones, Bethan R; Gurney, Karen A; Mgone, Charles S

2015-08-01

The European & Developing Countries Clinical Trials Partnership (EDCTP) is a partnership of European and sub-Saharan African countries that aims to accelerate the development of medical interventions against poverty-related diseases (PRDs). A bibliometric analysis was conducted to 1) measure research output from European and African researchers on PRDs, 2) describe collaboration patterns, and 3) assess the citation impact of clinical research funded by EDCTP. Disease-specific research publications were identified in Thomson Reuters Web of Science using search terms in titles, abstracts and keywords. Publication data, including citation counts, were extracted for 2003-2011. Analyses including output, share of global papers, normalised citation impact (NCI), and geographical distribution are presented. Data are presented as five-year moving averages. European EDCTP member countries accounted for ~33% of global research output in PRDs and sub-Saharan African countries for ~10% (2007-2011). Both regions contributed more to the global research output in malaria (43.4% and 22.2%, respectively). The overall number of PRD papers from sub-Saharan Africa increased markedly (>47%) since 2003, particularly for HIV/AIDS (102%) and tuberculosis (TB) (81%), and principally involving Southern and East Africa. For 2007-2011, European and sub-Saharan African research collaboration on PRDs was highly cited compared with the world average (NCI in brackets): HIV/AIDS 1.62 (NCI: 1.16), TB 2.11 (NCI: 1.06), malaria 1.81 (NCI: 1.22), and neglected infectious diseases 1.34 (NCI: 0.97). The NCI of EDCTP-funded papers for 2003-2011 was exceptionally high for HIV/AIDS (3.24), TB (4.08) and HIV/TB co-infection (5.10) compared with global research benchmarks (1.14, 1.05 and 1.35, respectively). The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and sub-Saharan Africa. >90% of publications from EDCTP

Bibliometric Assessment of European and Sub-Saharan African Research Output on Poverty-Related and Neglected Infectious Diseases from 2003 to 2011

Science.gov (United States)

Gurney, Karen A.; Mgone, Charles S.

2015-01-01

Background The European & Developing Countries Clinical Trials Partnership (EDCTP) is a partnership of European and sub-Saharan African countries that aims to accelerate the development of medical interventions against poverty-related diseases (PRDs). A bibliometric analysis was conducted to 1) measure research output from European and African researchers on PRDs, 2) describe collaboration patterns, and 3) assess the citation impact of clinical research funded by EDCTP. Methodology/Principal Findings Disease-specific research publications were identified in Thomson Reuters Web of Science using search terms in titles, abstracts and keywords. Publication data, including citation counts, were extracted for 2003–2011. Analyses including output, share of global papers, normalised citation impact (NCI), and geographical distribution are presented. Data are presented as five-year moving averages. European EDCTP member countries accounted for ~33% of global research output in PRDs and sub-Saharan African countries for ~10% (2007–2011). Both regions contributed more to the global research output in malaria (43.4% and 22.2%, respectively). The overall number of PRD papers from sub-Saharan Africa increased markedly (>47%) since 2003, particularly for HIV/AIDS (102%) and tuberculosis (TB) (81%), and principally involving Southern and East Africa. For 2007–2011, European and sub-Saharan African research collaboration on PRDs was highly cited compared with the world average (NCI in brackets): HIV/AIDS 1.62 (NCI: 1.16), TB 2.11 (NCI: 1.06), malaria 1.81 (NCI: 1.22), and neglected infectious diseases 1.34 (NCI: 0.97). The NCI of EDCTP-funded papers for 2003–2011 was exceptionally high for HIV/AIDS (3.24), TB (4.08) and HIV/TB co-infection (5.10) compared with global research benchmarks (1.14, 1.05 and 1.35, respectively). Conclusions The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and

Bibliometric Assessment of European and Sub-Saharan African Research Output on Poverty-Related and Neglected Infectious Diseases from 2003 to 2011.

Directory of Open Access Journals (Sweden)

J Gabrielle Breugelmans

2015-08-01

Full Text Available The European & Developing Countries Clinical Trials Partnership (EDCTP is a partnership of European and sub-Saharan African countries that aims to accelerate the development of medical interventions against poverty-related diseases (PRDs. A bibliometric analysis was conducted to 1 measure research output from European and African researchers on PRDs, 2 describe collaboration patterns, and 3 assess the citation impact of clinical research funded by EDCTP.Disease-specific research publications were identified in Thomson Reuters Web of Science using search terms in titles, abstracts and keywords. Publication data, including citation counts, were extracted for 2003-2011. Analyses including output, share of global papers, normalised citation impact (NCI, and geographical distribution are presented. Data are presented as five-year moving averages. European EDCTP member countries accounted for ~33% of global research output in PRDs and sub-Saharan African countries for ~10% (2007-2011. Both regions contributed more to the global research output in malaria (43.4% and 22.2%, respectively. The overall number of PRD papers from sub-Saharan Africa increased markedly (>47% since 2003, particularly for HIV/AIDS (102% and tuberculosis (TB (81%, and principally involving Southern and East Africa. For 2007-2011, European and sub-Saharan African research collaboration on PRDs was highly cited compared with the world average (NCI in brackets: HIV/AIDS 1.62 (NCI: 1.16, TB 2.11 (NCI: 1.06, malaria 1.81 (NCI: 1.22, and neglected infectious diseases 1.34 (NCI: 0.97. The NCI of EDCTP-funded papers for 2003-2011 was exceptionally high for HIV/AIDS (3.24, TB (4.08 and HIV/TB co-infection (5.10 compared with global research benchmarks (1.14, 1.05 and 1.35, respectively.The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and sub-Saharan Africa. >90% of publications from EDCTP

Comparison of long-term prognosis of patients with AIDS treated and not treated with zidovudine. AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Phillips, A N; Pedersen, C

1994-01-01

zidovudine, the death rate was approximately constant for the first 5 years after AIDS diagnosis. For patients treated with zidovudine, the death rate within the first year since starting zidovudine was markedly lower than for untreated patients who had developed AIDS at the same time (relative rate, 0......OBJECTIVE--To determine the association between elapsed time since starting zidovudine and survival in patients with acquired immunodeficiency syndrome (AIDS). DESIGN--Inception cohort and observational study of patients treated and not treated with zidovudine. SETTING--Fifty-one centers in 17...... European countries. PATIENTS--A total of 4484 patients diagnosed as having AIDS from 1979 to 1989 who survived their initial AIDS-defining event and who had not started zidovudine before AIDS diagnosis. MAIN OUTCOME MEASURES--Use of zidovudine and mortality. RESULTS--Among patients who did not receive...

mortality after clinical management of aids-associated cryptococcal

African Journals Online (AJOL)

2014-05-01

May 1, 2014 ... among HIV/AIDS patients and is becoming a leading cause of morbidity and mortality in Africa. The short-term .... of potassium chloride, therapeutic lumbar puncture. (LP), fundoscopy ..... Kenya AIDS Indicator. Survey 2012: ...

Complying with the European Clinical Trials directive while surviving the administrative pressure

DEFF Research Database (Denmark)

Frandsen, Thomas Leth; Heyman, Mats; Abrahamsson, Jonas

2014-01-01

The European Clinical Trials Directive of 2004 has increased the amount of paper work and reduced the number of initiated clinical trials. Particularly multinational trials have been delayed. To meet this challenge we developed a novel, simplified, fast and easy strategy for on-line toxicity......-known serious, but rarer events with focus on changes in therapy introduced in the treatment protocol. This toxicity registration strategy was approved by the relevant regulatory authorities in all seven countries involved, as compliant within the EU directive of 2004. The centre compliance to registration...

Evaluation of epidemiological, clinical, and laboratory features and mortality of 144 HIV/AIDS cases in Turkey.

Science.gov (United States)

Ozdemir, Burcu; Yetkin, Meltem A; Bastug, Aliye; But, Ayşe; Aslaner, Halide; Akinci, Esragul; Bodur, Hurrem

2018-03-22

Background The number of HIV/AIDS cases in Turkey is increasing rapidly, as is the number of cases worldwide. The aim of this study is to evaluate the characteristics of the clinical and laboratory findings and epidemiological features of HIV/AIDS patients to obtain useful data on the epidemic type and transmission routes associated with Turkey and to identify risk factors for mortality. Methods The patient records of 144 HIV-infected patients who were admitted to our clinic between 2000 and 2015 were analyzed retrospectively. Results Most of the cases (55%) were diagnosed due to the detection of anti-HIV-positive individuals without clinical symptoms. The mean CD4 + lymphocyte count on first admission was 108 cells/μL for those admitted before 2009 and 265 cells/μL for those admitted after 2009 (p = 0.003). When the pre- and post-2009 groups were compared for the status of the disease, 55.6 and 44.4% of patients were in the AIDS stage, respectively (p = 0.04). The most noted opportunistic infection was mycobacterial, and throughout the follow-up, 31.2% of the cases were fatal. Conclusions Early diagnosis of HIV infection can have a direct impact on prognosis and survival. Therefore, screening laboratory investigations should be extended, particularly in high-risk groups.

Attitudes toward Shock Advertising of Western-European and Serbian University Students With Regard To Public Health Context (Anti-Smoking and Anti-HIV/AIDS Campaigns)

OpenAIRE

Krstic, Tamara

2007-01-01

The main objective of this dissertation is to examine attitudes toward shock advertising of western-European and Serbian university students with regard to public health context (anti-smoking and anti-HIV/AIDS campaigns). Although the use of shock advertising is widely adopted in practice, there has not been extensive research with regard to this topic. Public health context is of special interest in this dissertation as there is an urge for social marketing on Serbian market. The results of ...

Validation of the "United Registries for Clinical Assessment and Research" (UR-CARE), a European online registry for clinical care and research in Inflammatory Bowel Disease

DEFF Research Database (Denmark)

Burisch, Johan; Gisbert, Javier P; Siegmund, Britta

2018-01-01

Background: The "United Registries for Clinical Assessment and Research" (UR-CARE) database is an initiative of the European Crohn's and Colitis Organisation (ECCO) to facilitate daily patient care and research studies in inflammatory bowel disease (IBD). Herein, we sought to validate the database......-99%); Case 5: 91% (87-93%)]. These numbers did not differ significantly from those found 6 weeks later (NcNemar's test p>0.05). Conclusion: The UR-CARE database appears to be feasible, valid and reliable as a tool and easy to use regardless of prior user experience and level of clinical IBD experience. UR......-CARE has the potential to enhance future European collaborations regarding clinical research in IBD....

Development and Pilot Testing of a Decision Aid for Genomic Research Participants Notified of Clinically Actionable Research Findings for Cancer Risk.

Science.gov (United States)

Willis, Amanda M; Smith, Sian K; Meiser, Bettina; Ballinger, Mandy L; Thomas, David M; Tattersall, Martin; Young, Mary-Anne

2018-02-17

Germline genomic testing is increasingly used in research to identify genetic causes of disease, including cancer. However, there is evidence that individuals who are notified of clinically actionable research findings have difficulty making informed decisions regarding uptake of genetic counseling for these findings. This study aimed to produce and pilot test a decision aid to assist participants in genomic research studies who are notified of clinically actionable research findings to make informed choices regarding uptake of genetic counseling. Development was guided by published literature, the International Patient Decision Aid Standards, and the expertise of a steering committee of clinicians, researchers, and consumers. Decision aid acceptability was assessed by self-report questionnaire. All 19 participants stated that the decision aid was easy to read, clearly presented, increased their understanding of the implications of taking up research findings, and would be helpful in decision-making. While low to moderate levels of distress/worry were reported after reading the booklet, a majority of participants also reported feeling reassured. All participants would recommend the booklet to others considering uptake of clinically actionable research findings. Results indicate the decision aid is acceptable to the target audience, with potential as a useful decision support tool for genomic research participants.

Clinical utility of dronabinol in the treatment of weight loss associated with HIV and AIDS

Directory of Open Access Journals (Sweden)

Badowski ME

2016-02-01

Full Text Available Melissa E Badowski,1 Sarah E Perez2 1Department of Pharmacy Practice, Section of Infectious Diseases Pharmacotherapy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA; 2Infectious Diseases Clinic, Tufts Medical Center, Boston, MA, USA Abstract: Since the beginning of the HIV/AIDS epidemic, weight loss has been a common complaint for patients. The use of various definitions defining HIV wasting syndrome has made it difficult to determine its actual prevalence. Despite the use of highly active antiretroviral therapy, it is estimated that the prevalence of HIV wasting syndrome is between 14% and 38%. HIV wasting syndrome may stem from conditions affecting chewing, swallowing, or gastrointestinal motility, neurologic disease affecting food intake or the perception of hunger or ability to eat, psychiatric illness, food insecurity generated from psychosocial or economic concerns, or anorexia due to medications, malabsorption, infections, or tumors. Treatment of HIV wasting syndrome may be managed with appetite stimulants (megestrol acetate or dronabinol, anabolic agents (testosterone, testosterone analogs, or recombinant human growth hormone, or, rarely, cytokine production modulators (thalidomide. The goal of this review is to provide an in-depth evaluation based on existing clinical trials on the clinical utility of dronabinol in the treatment of weight loss associated with HIV/AIDS. Although total body weight gain varies with dronabinol use (–2.0 to 3.2 kg, dronabinol is a well-tolerated option to promote appetite stimulation. Further studies are needed with standardized definitions of HIV-associated weight loss and clinical outcomes, robust sample sizes, safety and efficacy data on chronic use of dronabinol beyond 52 weeks, and associated virologic and immunologic outcomes. Keywords: dronabinol, weight loss, HIV/AIDS, HIV wasting syndrome, cachexia

Women and AIDS: introduction.

Science.gov (United States)

Krieger, N; Margo, G

1991-01-01

Around the world, more and more women--principally poor women of color--are being diagnosed with and are dying of AIDS, the acquired immune deficiency syndrome. Yet, effective and appropriate prevention programs for women are sorely missing from the global program to control AIDS. To help us understand why this gap exists, and what we must do to close it, the three articles in this issue focus on women and AIDS. Examining the situation in such countries as Zimbabwe and South Africa, as well as in other economically underdeveloped and developed regions, the authors argue that women with the least control over their bodies and their lives are at greatest risk of acquiring AIDS. For example, the high rate of infection among women in Africa cannot be understood apart from the legacy of colonialism (including land expropriation and the forced introduction of a migrant labor system) and the insidious combination of traditional and European patriarchal values. Only by recognizing the socioeconomic and cultural determinants of both disease and sexual behavior, and only by incorporating these insights into our AIDS prevention programs, will we be able to curb the spread of this lethal disease.

Correlation between HIV-1 genotype and clinical progression in HIV/AIDS patients in Surabaya, Indonesia

Science.gov (United States)

Rachman, B. E.; Khairunisa, S. Q.; Witaningrum, A. M.; Yunifiar, M. Q.; Nasronudin

2018-03-01

Several factors such as host and viral factors can affect the progression of HIV/AIDS. This study aims to identify the correlation viral factors, especially the HIV-1 subtype with HIV/AIDS progression. Inpatient HIV/AIDS during the period March to September 2017 and willing to participate are included in the study. Historical data of disease and treatment was taken by medical record. Blood samples were amplified, sequenced and undergone phylogenetic analysis. Linear regression analysis was used to estimate beta coefficient (β) and 95%CI of HIV/AIDS progression (measured by the CD4 change rate, ΔCD4 cell count/time span in months).This study has 17 samples. The HIV-1 subtype was dominated by CRF01_AE (81.8%) followed by subtype B (18.2%). There was significant correlation between subtype HIV-1 (p = 0.04) and body mass index (p = 0.038) with HIV/AIDS clinical stage. Many factors were assumed to be correlated with increased rate of CD4, but we only subtype HIV-1 had a significant correlation (p = 0.024) with it. From multivariate analysis, we also found that subtype HIV-1 had a significant correlation (β = 0.788, 95%CI: 17.5-38.6, p = 0.004).

Development of diagnostic criteria for serious non-AIDS events in HIV clinical trials

DEFF Research Database (Denmark)

Lifson, Alan R; Belloso, Waldo H; Davey, Richard T

2010-01-01

PURPOSE: Serious non-AIDS (SNA) diseases are important causes of morbidity and mortality in the HAART era. We describe development of standard criteria for 12 SNA events for Endpoint Review Committee (ERC) use in START, a multicenter international HIV clinical trial. METHODS: SNA definitions were...... was reached. CONCLUSION: HIV clinical trials that include SNA diseases as clinical outcomes should have standardized SNA definitions to optimize event reporting and validation and should have review by an experienced ERC with opportunities for adjudication......., peripheral arterial disease, pulmonary embolism, and stroke. Of 563 potential SNA events reported in ESPRIT and reviewed by an ERC, 72% met "confirmed" and 13% "probable" criteria. Twenty-eight percent of cases initially reviewed by the ERC required follow-up discussion (adjudication) before a final decision...

Clinical features of dysthyroid optic neuropathy: a European Group on Graves' Orbitopathy (EUGOGO) survey

NARCIS (Netherlands)

McKeag, David; Lane, Carol; Lazarus, John H.; Baldeschi, Lelio; Boboridis, Kostas; Dickinson, A. Jane; Hullo, A. Iain; Kahaly, George; Krassas, Gerry; Marcocci, Claudio; Marinò, Michele; Mourits, Maarten P.; Nardi, Marco; Neoh, Christopher; Orgiazzi, Jacques; Perros, Petros; Pinchera, Aldo; Pitz, Susanne; Prummel, Mark F.; Sartini, Maria S.; Wiersinga, Wilmar M.

2007-01-01

BACKGROUND: This study was performed to determine clinical features of dysthyroid optic neuropathy (DON) across Europe. METHODS: Forty seven patients with DON presented to seven European centres during one year. Local protocols for thyroid status, ophthalmic examination and further investigation

Science without meritocracy. Discrimination among European specialists in infectious diseases and clinical microbiology: a questionnaire survey.

Science.gov (United States)

Tacconelli, Evelina; Poljak, Mario; Cacace, Marina; Caiati, Giovanni; Benzonana, Nur; Nagy, Elisabeth; Kortbeek, Titia

2012-01-01

In 2009, in a European survey, around a quarter of Europeans reported witnessing discrimination or harassment at their workplace. The parity committee from the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) designed a questionnaire survey to investigate forms of discrimination with respect to country, gender and ethnicity among medical professionals in hospitals and universities carrying out activities in the clinical microbiology (CM) and infectious diseases (ID) fields. The survey consisted of 61 questions divided into five areas (sociodemographic, professional census and environment, leadership and generic) and ran anonymously for nearly 3 months on the ESCMID website. European specialists in CM/ID. Overall, we included 1274 professionals. The majority of respondents (68%) stated that discrimination is present in medical science. A quarter of them reported personal experience with discrimination, mainly associated with gender and geographic region. Specialists from South-Western Europe experienced events at a much higher rate (37%) than other European regions. The proportion of women among full professor was on average 46% in CM and 26% in ID. Participation in high-level decision-making committees was significantly (>10 percentage points) different by gender and geographic origin. Yearly gross salary among CM/ID professionals was significantly different among European countries and by gender, within the same country. More than one-third of respondents (38%) stated that international societies in CM/ID have an imbalance as for committee member distribution and speakers at international conferences. A quarter of CM/ID specialists experienced career and research discrimination in European hospitals and universities, mainly related to gender and geographic origin. Implementing proactive policies to tackle discrimination and improve representativeness and balance in career among CM/ID professionals in Europe is urgently needed.

Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline

Energy Technology Data Exchange (ETDEWEB)

Spada, Cristiano; Barbaro, Federico; Petruzziello, Lucio [Catholic University, Digestive Endoscopy Unit, Rome (Italy); Stoker, Jaap; Haan, Margriet C. de [University of Amsterdam, Department of Radiology, Academic Medical Center, Amsterdam (Netherlands); Alarcon, Onofre [Universidad de La Laguna, Department of Gastroenterology, Hospital Universitario de Canarias, Facultad de Medicina, La Laguna, Tenerife (Spain); Bellini, Davide; Laghi, Andrea [Sapienza University of Rome, I.C.O.T. Hospital, Department of Radiological Sciences, Oncology and Pathology, Latina (Italy); Bretthauer, Michael [Oslo University Hospital, Department of Health Economy and Health Management, University of Oslo, and Department of Transplantation Medicine, Gastroenterology Unit, Oslo (Norway); Dumonceau, Jean-Marc [Gedyt Endoscopy Center, Buenos Aires (Argentina); Ferlitsch, Monika [Medical University of Vienna, Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Vienna (Austria); Halligan, Steve; Helbren, Emma; Plumb, Andrew; Taylor, Stuart A. [University College London, Centre for Medical Imaging, London (United Kingdom); Hellstrom, Mikael [Sahlgrenska University Hospital and Sahlgrenska Academy at University of Gothenburg, Department of Radiology, Gothenburg (Sweden); Kuipers, Ernst J. [Erasmus MC University Medical Center, Department of Gastroenterology and Hepatology, Rotterdam (Netherlands); Lefere, Philippe [Virtual Colonoscopy Teaching Centre, Hooglede (Belgium); AZ Delta, Roeselare (Belgium); Mang, Thomas [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Neri, Emanuele [University of Pisa, Diagnostic and Interventional Radiology, Pisa (Italy); Regge, Daniele [Institute for Cancer Research and Treatment, Candiolo-Torino (Italy); Hassan, Cesare [Catholic University, Digestive Endoscopy Unit, Rome (Italy); Ospedale Nuovo Regina Margherita, Department of Gastroenterology, Rome (Italy)

2014-10-03

Colorectal cancer (CRC) is a major cause of morbidity and mortality [1, 2]. CRC screening by fecal occult blood testing (FOBT) has been shown to reduce CRC mortality [3, 4], and is currently used in several European countries. Colonoscopy is highly effective for detecting advanced neoplasia, and endoscopic polypectomy reduces subsequent CRCspecific incidence and mortality [5]. In Europe, colonoscopy is mainly used to investigate FOBT-positive or symptomatic patients, or as a preventive strategy in those with increased CRC risk [6]. Computed tomographic colonography (CTC) is a minimally invasive imaging technique that is highly accurate for detecting colorectal cancer (CRC) and adenomatous polyps. The technique is standardized [7], and CTC is more easily performed than barium enema. Evidence-based data suggest that CTC is the natural replacement for barium enema and a complementary rather than an alternative examination to colonoscopy. However, the clinical scenarios for which CTC is indicated remain unclear. To address this uncertainty - 20 years after the first presentation of CTC at a radiological meeting [8] - the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) decided to produce a common guideline regarding indications for CTC in clinical practice. Technical and quality issues of CTC have been deliberately excluded from this work as these have already been discussed separately [7].

Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline

International Nuclear Information System (INIS)

Spada, Cristiano; Barbaro, Federico; Petruzziello, Lucio; Stoker, Jaap; Haan, Margriet C. de; Alarcon, Onofre; Bellini, Davide; Laghi, Andrea; Bretthauer, Michael; Dumonceau, Jean-Marc; Ferlitsch, Monika; Halligan, Steve; Helbren, Emma; Plumb, Andrew; Taylor, Stuart A.; Hellstrom, Mikael; Kuipers, Ernst J.; Lefere, Philippe; Mang, Thomas; Neri, Emanuele; Regge, Daniele; Hassan, Cesare

2015-01-01

Colorectal cancer (CRC) is a major cause of morbidity and mortality [1, 2]. CRC screening by fecal occult blood testing (FOBT) has been shown to reduce CRC mortality [3, 4], and is currently used in several European countries. Colonoscopy is highly effective for detecting advanced neoplasia, and endoscopic polypectomy reduces subsequent CRCspecific incidence and mortality [5]. In Europe, colonoscopy is mainly used to investigate FOBT-positive or symptomatic patients, or as a preventive strategy in those with increased CRC risk [6]. Computed tomographic colonography (CTC) is a minimally invasive imaging technique that is highly accurate for detecting colorectal cancer (CRC) and adenomatous polyps. The technique is standardized [7], and CTC is more easily performed than barium enema. Evidence-based data suggest that CTC is the natural replacement for barium enema and a complementary rather than an alternative examination to colonoscopy. However, the clinical scenarios for which CTC is indicated remain unclear. To address this uncertainty - 20 years after the first presentation of CTC at a radiological meeting [8] - the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) decided to produce a common guideline regarding indications for CTC in clinical practice. Technical and quality issues of CTC have been deliberately excluded from this work as these have already been discussed separately [7].

Danish first aid books compliance with the new evidence-based non-resuscitative first aid guidelines.

Science.gov (United States)

Jensen, Theo Walther; Møller, Thea Palsgaard; Viereck, Søren; Roland, Jens; Pedersen, Thomas Egesborg; Lippert, Freddy K

2018-01-10

The European Resuscitation Council (ERC) released new guidelines on resuscitation in 2015. For the first time, the guidelines included a separate chapter on first aid for laypersons. We analysed the current major Danish national first aid books to identify potential inconsistencies between the current books and the new evidence-based first aid guidelines. We identified first aid books from all the first aid courses offered by major Danish suppliers. Based on the new ERC first aid guidelines, we developed a checklist of 26 items within 16 different categories to assess the content; this checklist was adapted following the principle of mutually exclusive and collectively exhaustive questioning. To assess the agreement between four raters, Fleiss' kappa test was used. Items that did not reach an acceptable kappa score were excluded. We evaluated 10 first aid books used for first aid courses and published between 2009 and 2015. The content of the books complied with the new in 38% of the answers. In 12 of the 26 items, there was less than 50% consistency. These items include proximal pressure points and elevation of extremities for the control of bleeding, use of cervical collars, treatment for an open chest wound, burn dressing, dental avulsion, passive leg raising, administration of bronchodilators, adrenaline, and aspirin. Danish course material showed significant inconsistencies with the new evidence-based first aid guidelines. The new knowledge from the evidence-based guidelines should be incorporated into revised and updated first aid course material.

The clinical practice of interventional radiology: a European perspective.

LENUS (Irish Health Repository)

Keeling, Aoife N

2009-05-01

The purpose of this study was to determine the current clinical environment in which interventional radiology (IR) is practiced throughout Europe. A survey, comprising 12 questions on IR clinical practice, was sent to 1800 CIRSE members. Members were asked to return one survey per department. Two hundred seventy-four departments returned completed questionnaires, 22% from the United Kingdom (n = 60), 11% from Germany (n = 30), 8% from Austria (n = 23), and the remainder spread over Europe. Experts, with more than 10 years of IR experience, comprised 74% of the survey group. Almost one-third of the radiologists dedicated more than 80% of their clinical sessions to IR alone (27%; n = 75), with two-thirds practicing in a university teaching hospital setting (66%; n = 179). Few institutions have dedicated IR inpatient hospital beds (17%; n = 46), however, to compensate, day case beds are available (31%), IR admitting rights are in place (64% overall, 86% for in-patients, and 89% for day cases), and elective IR admissions can be made through other clinicians (87%). IR outpatient clinics are run at 26% of departments, with an average of two sessions per week. Dedicated nurses staff the majority of IR suites (82%), but clinical junior doctors are lacking (46%). Hospital management\\'s refusing access to beds was the most commonly cited reason for not developing a clinical IR service (41%). In conclusion, there is marked variation across European centers in the current practice of IR. Half do not have dedicated junior doctors and only a small minority have inpatient hospital beds. If IR is to be maintained as a dedicated clinical specialty, these issues need to be addressed urgently.

The Clinical Practice of Interventional Radiology: A European Perspective

International Nuclear Information System (INIS)

Keeling, Aoife N.; Reekers, Jim A.; Lee, Michael J.

2009-01-01

The purpose of this study was to determine the current clinical environment in which interventional radiology (IR) is practiced throughout Europe. A survey, comprising 12 questions on IR clinical practice, was sent to 1800 CIRSE members. Members were asked to return one survey per department. Two hundred seventy-four departments returned completed questionnaires, 22% from the United Kingdom (n = 60), 11% from Germany (n = 30), 8% from Austria (n = 23), and the remainder spread over Europe. Experts, with more than 10 years of IR experience, comprised 74% of the survey group. Almost one-third of the radiologists dedicated more than 80% of their clinical sessions to IR alone (27%; n = 75), with two-thirds practicing in a university teaching hospital setting (66%; n = 179). Few institutions have dedicated IR inpatient hospital beds (17%; n = 46), however, to compensate, day case beds are available (31%), IR admitting rights are in place (64% overall, 86% for in-patients, and 89% for day cases), and elective IR admissions can be made through other clinicians (87%). IR outpatient clinics are run at 26% of departments, with an average of two sessions per week. Dedicated nurses staff the majority of IR suites (82%), but clinical junior doctors are lacking (46%). Hospital management's refusing access to beds was the most commonly cited reason for not developing a clinical IR service (41%). In conclusion, there is marked variation across European centers in the current practice of IR. Half do not have dedicated junior doctors and only a small minority have inpatient hospital beds. If IR is to be maintained as a dedicated clinical specialty, these issues need to be addressed urgently.

Europe?s Shifting Response to HIV/AIDS

OpenAIRE

Smith, Julia

2016-01-01

Abstract Despite a history of championing HIV/AIDS as a human rights issue, and a rhetorical commitment to health as a human right, European states and institutions have shifted from a rights-based response to a risk management approach to HIV/AIDS since the economic recession of 2008. An interdisciplinary perspective is applied to analyze health policy changes at the national, regional, and global levels by drawing on data from key informant interviews, and institutional and civil society do...

Clinical audits: who does control what? European guide lines;Audits cliniques: qui controle quoi? Lignes directrices europeennes

Energy Technology Data Exchange (ETDEWEB)

Jarvinen, H. [Ingenieur es Sciences, Expert en chef pour l' Utilisation des Rayonnements Ionisants A des fins medicales, Autorite de Surete Nucleaire et de Radioprotection (STUK), Helsinki (Finland)

2009-12-15

The E.C. directive 97/43/EURATOM (M.E.D.-directive) introduced the concept of Clinical Audit for the assessment of medical radiological practices (diagnostic radiology, nuclear medicine and radiotherapy). The European Commission started in June 2007 a special project to review in detail the status of implementation of Clinical audits in Member States and to prepare European Guidance on Clinical Audits for diagnostic radiology, nuclear medicine and radiotherapy. The purpose of this E.C. project is to provide clear and comprehensive information and guidance on the procedures and criteria for clinical audits in all radiological practices, in order to improve the implementation of Article 6.4 of the M.E.D.-directive. The guidance should be flexible and enable the member States to adopt the model of clinical audit with respect to their national legislation and administrative provisions. By definition, clinical audit is a systematic examination or review of medical radiological procedures. It seeks to improve the quality and the outcome of patient care through structured review whereby radiological practices, procedures and results are examined against agreed standards for good medical radiological procedures. Modifications of the practices are implemented where indicated and new standards applied if necessary. The general objectives of clinical audit should be: to improve the quality of patient care, to promote the effective use of resources, to enhance the provision and organization of clinical services, to further professional education and training. Clinical audits must be at the same time internal (set by the management of the department) and external (set by external auditors at the department). It must not be confused with other evaluation activities such inspections, accreditation or quality system certifications. Clinical audits should address structure, process and outcome such the unit mission, quality assurance, dosimetry and treatments follow-up. The recent

Hearing aid patients in private practice and public health (Veterans Affairs) clinics: are they different?

Science.gov (United States)

Cox, Robyn M; Alexander, Genevieve C; Gray, Ginger A

2005-12-01

In hearing aid research, it is commonplace to combine data across subjects whose hearing aids were provided in different service delivery models. There is reason to question whether these types of patients are always similar enough to justify this practice. To explore this matter, this investigation evaluated similarities and differences in self-report data obtained from hearing aid patients derived from public health (Veterans Affairs, VA) and private practice (PP) settings. The study was a multisite, cross-sectional survey in which 230 hearing aid patients from VA and PP audiology clinic settings provided self-report data on a collection of questionnaires both before and after the hearing aid fitting. Subjects were all older adults with mild to moderately severe hearing loss. About half of them had previous experience wearing hearing aids. All subjects were fitted with wide-dynamic-range-compression instruments and received similar treatment protocols. Numerous statistically significant differences were observed between the VA and PP subject groups. Before the fitting, VA patients reported higher expectations from the hearing aids and more severe unaided problems compared with PP patients with similar audiograms. Three wks after the fitting, VA patients reported more satisfaction with their hearing aids. On some measures VA patients reported more benefit, but different measures of benefit did not give completely consistent results. Both groups reported using the hearing aids an average of approximately 8 hrs per day. VA patients reported age-normal physical and mental health, but PP patients tended to report better than typical health for their age group. These data indicate that hearing aid patients seen in the VA public health hearing services are systematically different in self-report domains from those seen in private practice services. It is therefore risky to casually combine data from these two types of subjects or to generalize research results from one

The European experience.

Science.gov (United States)

Bisgaard, N

2001-06-01

This article presents an overview of past and current experiences with time division multiple assess-based (Global System for Mobil Communication) mobile telephones in Europe as seen by the European Hearing Instrument Manufacturers Association. Initial fear of widespread interference problems for hearing aid users in general owing to use of a new generation of mobile telephones seems unjustified. The background for the International Electrotechnical Commission 118-13 standard for measuring interference is described. No solution to complete elimination of interference problems resulting from direct contact between hearing aids and mobile telephones has yet been found. Several reports on the subjects are cited, and new work on measurement standards for near-field situations is mentioned.

Clinical Characteristic of the HIV/AIDS Patients with Cryptosporidiosis Referring to Behavioral Diseases Consultation Center, Imam Khomeini Hospital, Tehran in 2013.

Science.gov (United States)

Gholami, Rashid; Gholami, Shirzad; Emadi-Kouchak, Hamid; Abdollahi, Alireza; Shahriari, Mona

2016-01-01

Cryptosporidium is known as an opportunist disease-causing agent in man in recent decades. It causes diarrhea and intestinal disorders in the immune deficit and immune competent individuals. This study was aimed to investigate the clinical characteristics of HIV/AIDS patients with cryptosporidiosis infection. This cross-sectional descriptive study was performed on 53 HIV/AIDS patients referred to the Behavior Disease Consultation Center of Imam Khomeini Hospital in Tehran, Iran in 2013. First, the patients were studied clinically and the context data were recorded in a questionnaire for parasitological examination and referred to the laboratory for eosinophil count, and CD4 count per ml of blood. Cryptosporidiosis was observed in 4 (7.6%) of the total 53 HIV/AIDS patients. The highest prevalence of infection was observed in the age range of 30-39 yr. It was observed in different sexes as 5.7% of male and 1.9% of female, but statistically was insignificant (P=0.163).75% of patients had no intestinal symptom, 11.4% with acute diarrhea and 3.8% with chronic diarrhea. Cryptosporidiosis cases were observed in 5.7% of patients without intestinal symptom. Practitioners in the clinical examination for the detection of the opportunistic intestinal protozoan infection should use clinical and paraclinical characteristics of the HIV/AIDS patients for the diagnostic of Cryptosporidium and other opportunistic parasitic diseases.

Free software to analyse the clinical relevance of drug interactions with antiretroviral agents (SIMARV®) in patients with HIV/AIDS.

Science.gov (United States)

Giraldo, N A; Amariles, P; Monsalve, M; Faus, M J

Highly active antiretroviral therapy has extended the expected lifespan of patients with HIV/AIDS. However, the therapeutic benefits of some drugs used simultaneously with highly active antiretroviral therapy may be adversely affected by drug interactions. The goal was to design and develop a free software to facilitate analysis, assessment, and clinical decision making according to the clinical relevance of drug interactions in patients with HIV/AIDS. A comprehensive Medline/PubMed database search of drug interactions was performed. Articles that recognized any drug interactions in HIV disease were selected. The publications accessed were limited to human studies in English or Spanish, with full texts retrieved. Drug interactions were analyzed, assessed, and grouped into four levels of clinical relevance according to gravity and probability. Software to systematize the information regarding drug interactions and their clinical relevance was designed and developed. Overall, 952 different references were retrieved and 446 selected; in addition, 67 articles were selected from the citation lists of identified articles. A total of 2119 pairs of drug interactions were identified; of this group, 2006 (94.7%) were drug-drug interactions, 1982 (93.5%) had an identified pharmacokinetic mechanism, and 1409 (66.5%) were mediated by enzyme inhibition. In terms of clinical relevance, 1285 (60.6%) drug interactions were clinically significant in patients with HIV (levels 1 and 2). With this information, a software program that facilitates identification and assessment of the clinical relevance of antiretroviral drug interactions (SIMARV ® ) was developed. A free software package with information on 2119 pairs of antiretroviral drug interactions was designed and developed that could facilitate analysis, assessment, and clinical decision making according to the clinical relevance of drug interactions in patients with HIV/AIDS. Copyright © 2016 Elsevier Inc. All rights reserved.

A clinical decision aid for the selection of antithrombotic therapy for the prevention of stroke due to atrial fibrillation

DEFF Research Database (Denmark)

LaHaye, Stephen Andrew; Gibbens, Sabra Lynn; Ball, David Gerald Andrew

2012-01-01

The availability of new antithrombotic agents, each with a unique efficacy and bleeding profile, has introduced a considerable amount of clinical uncertainty with physicians. We have developed a clinical decision aid in order to assist clinicians in determining an optimal antithrombotic regime...

The european hematology association roadmap for european hematology research : A consensus document

NARCIS (Netherlands)

A. Engert (Andreas); C.L. Balduini (Carlo); A. Brand (Anneke); B. Coiffier (Bertrand); C. Cordonnier (Charlotte); H. Döhner (Hartmut); De Wit, T.D. (Thom Duyvené); Eichinger, S. (Sabine); W.E. Fibbe (Willem); Green, T. (Tony); De Haas, F. (Fleur); A. Iolascon (Achille); T. Jaffredo (Thierry); F. Rodeghiero (Francesco); G. Salles (Gilles); J.J. Schuringa (Jan Jacob)

2016-01-01

textabstractThe European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European

The European Hematology Association Roadmap for European Hematology Research : A consensus document

NARCIS (Netherlands)

Engert, Andreas; Balduini, Carlo; Brand, Anneke; Coiffier, Bertrand; Cordonnier, Catherine; Döhner, Hartmut; de Wit, Thom Duyvené; Eichinger, Sabine; Fibbe, Willem; Green, Tony; de Haas, Fleur; Iolascon, Achille; Jaffredo, Thierry; Rodeghiero, Francesco; Salles, Gilles; Schuringa, Jan Jacob

The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology

Fractography of clinically fractured, implant-supported dental computer-aided design and computer-aided manufacturing crowns

NARCIS (Netherlands)

Lohbauer, Ulrich; Belli, Renan; Cune, Marco S; Schepke, Ulf

2017-01-01

Today, a substantial part of the dental crown production uses computer-aided design and computer-aided manufacturing (CAD/CAM) technology. A recent step in restorative dentistry is the replacement of natural tooth structure with pre-polymerized and machined resin-based methacrylic polymers.

The clinical impact of continuing to prescribe antiretroviral therapy in patients with advanced AIDS who manifest no virologic or immunologic benefit.

Directory of Open Access Journals (Sweden)

David A Wohl

Full Text Available Despite the efficacy and tolerability of modern antiretroviral therapy (ART, many patients with advanced AIDS prescribed these regimens do not achieve viral suppression or immune reconstitution as a result of poor adherence, drug resistance, or both. The clinical outcomes of continued ART prescription for such patients have not been well characterized.We examined the causes and predictors of all-cause mortality, AIDS-defining conditions, and serious non-AIDS-defining events among a cohort of participants in a clinical trial of pre-emptive therapy for CMV disease. We focused on participants who, despite ART had failed to achieve virologic suppression and substantive immune reconstitution.233 ART-receiving participants entered with a median baseline CD4+ T cell count of 30/mm(3 and plasma HIV RNA of 5 log10 copies/mL. During a median 96 weeks of follow-up, 24.0% died (a mortality rate of 10.7/100 patient-years; 27.5% reported a new AIDS-defining condition, and 22.3% a new serious non-AIDS event. Of the deaths, 42.8% were due to an AIDS-defining condition, 44.6% were due to a non-AIDS-defining condition, and 12.5% were of unknown etiology. Decreased risk of mortality was associated with baseline CD4+ T cell count ≥25/mm(3 and lower baseline HIV RNA.Among patients with advanced AIDS prescribed modern ART who achieve neither virologic suppression nor immune reconstitution, crude mortality percentages appear to be lower than reported in cohorts of patients studied a decade earlier. Also, in contrast to the era before modern ART became available, nearly half of the deaths in our modern-era study were caused by serious non-AIDS-defining events. Even among the most advanced AIDS patients who were not obtaining apparent immunologic and virologic benefit from ART, continued prescription of these medications appears to alter the natural history of AIDS--improving survival and shifting the causes of death from AIDS- to non-AIDS-defining conditions.

Factors associated with the development of Pneumocystis carinii pneumonia in 5,025 European patients with AIDS. AIDS in Europe Study Group

DEFF Research Database (Denmark)

Lundgren, Jens Dilling; Barton, S E; Lazzarin, A

1995-01-01

This study examined the factors associated with the development of a first episode of Pneumocystis carinii pneumonia (PCP) in 5,025 patients with AIDS, including 1,976 patients with primary PCP at the time of AIDS diagnosis and 635 with primary PCP occurring subsequently. Compared with untreated...... patients, patients treated with zidovudine were at similar risk of developing PCP during the first year of therapy but were at greater risk after longer intervals of treatment. The following factors were associated with an increased risk of PCP (either at the time of AIDS diagnosis or thereafter): lack...... of primary PCP prophylaxis, male homosexuality/bisexuality, diagnosis of AIDS in northern Europe, and CD4 cell count below 200 x 10(6)/L at the time of AIDS diagnosis. Patients with severe weight loss had a 60% higher risk of developing PCP during follow-up than those without such weight loss. Thus...

Effect of European Clinical Trials Directive on academic drug trials in Denmark: retrospective study of applications to the Danish Medicines Agency 1993-2006

DEFF Research Database (Denmark)

Berendt, Louise; Hakansson, Cecilia; Bach, Karin Ursula Friis

2008-01-01

To determine the impact of the European Union's Clinical Trials Directive on the number of academic drug trials carried out in Denmark.......To determine the impact of the European Union's Clinical Trials Directive on the number of academic drug trials carried out in Denmark....

Genetic variants in nuclear-encoded mitochondrial genes influence AIDS progression.

Directory of Open Access Journals (Sweden)

Sher L Hendrickson

2010-09-01

Full Text Available The human mitochondrial genome includes only 13 coding genes while nuclear-encoded genes account for 99% of proteins responsible for mitochondrial morphology, redox regulation, and energetics. Mitochondrial pathogenesis occurs in HIV patients and genetically, mitochondrial DNA haplogroups with presumed functional differences have been associated with differential AIDS progression.Here we explore whether single nucleotide polymorphisms (SNPs within 904 of the estimated 1,500 genes that specify nuclear-encoded mitochondrial proteins (NEMPs influence AIDS progression among HIV-1 infected patients. We examined NEMPs for association with the rate of AIDS progression using genotypes generated by an Affymetrix 6.0 genotyping array of 1,455 European American patients from five US AIDS cohorts. Successfully genotyped SNPs gave 50% or better haplotype coverage for 679 of known NEMP genes. With a Bonferroni adjustment for the number of genes and tests examined, multiple SNPs within two NEMP genes showed significant association with AIDS progression: acyl-CoA synthetase medium-chain family member 4 (ACSM4 on chromosome 12 and peroxisomal D3,D2-enoyl-CoA isomerase (PECI on chromosome 6.Our previous studies on mitochondrial DNA showed that European haplogroups with presumed functional differences were associated with AIDS progression and HAART mediated adverse events. The modest influences of nuclear-encoded mitochondrial genes found in the current study add support to the idea that mitochondrial function plays a role in AIDS pathogenesis.

[Non-AIDS-associated cancer disorders. A novel scenario after over thirty years from HIV discovery? Clinical experience and literature appraisal].

Science.gov (United States)

Manfredi, Roberto; Cascavilla, Alessandra; Calza, Leonardo

2015-08-01

Both natural history and epidemiological trend of HIV infection have been deeply modified by the introduction of highly active antiretroviral therapy (HAART), around twenty years ago. However, despite a rapid drop of the incidence of the large majority of opportunistic infections, a slow, but continued increase of malignancies occurred, with particular evidence focused on cancers which are not strictly related to the definition of full blown AIDS (the so called non-AIDS-defining malignancies). The unique clinical occurrence of HIV infection complicated by even four non-AIDS-defining cancers prompted us to re-discuss the epidemiology and the possible pathogenesis, the clinical presentation, and the differential diagnosis of this pathologic presentation. On the ground of our experience in this field, and the available literature evidences, we discuss how this clinical occurrence is acting on HIV infection presentation during the HAART era of the third millennium. These changes need broad scale studies, and promise relevant consequences on etiopathogenetic, prevention, therapeutic, and management aspects of HIV disease in the next future.

The European standard series in 9 European countries, 2002/2003 - First results of the European Surveillance System on Contact Allergies

NARCIS (Netherlands)

Uter, W; Hegewald, J; Aberer, W; Ayala, F; Bircher, AJ; Brasch, J; Coenraads, PJ; Schuttelaar, Marielouise; Elsner, P; Fartasch, M; Mahler, V.; Fortina, AB; Frosch, PJ; Fuchs, T; Johansen, JD; Menne, T; Jolanki, R; Krecisz, B; Kiec-Swierczynska, M; Larese, F; Orton, D; Peserico, A; Rantanen, T; Schnuch, A

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series,

Clinical and virological effects of high-dose recombinant interferon-alpha in disseminated AIDS-related Kaposi's sarcoma

NARCIS (Netherlands)

de Wit, R.; Schattenkerk, J. K.; Boucher, C. A.; Bakker, P. J.; Veenhof, K. H.; Danner, S. A.

1988-01-01

The effectiveness and antiretroviral activities of interferon-alpha in AIDS-related Kaposi's sarcoma was assessed in a non-randomised, phase-II clinical trial. 28 patients were treated with high-dose (27-36 MU) human recombinant interferon-alpha 2a subcutaneously every day for 8 weeks. In patients

Clinical utility of the PCA3 urine assay in European men scheduled for repeat biopsy.

NARCIS (Netherlands)

Haese, A.; Taille, A. De La; Poppel, H. van; Marberger, M.; Stenzl, A.; Mulders, P.F.A.; Huland, H.; Abbou, C.C.; Remzi, M.; Tinzl, M.; Feyerabend, S.; Stillebroer, A.B.; Gils, M.P.M.Q.; Schalken, J.A.

2008-01-01

BACKGROUND: The Prostate CAncer gene 3 (PCA3) assay has shown promise as an aid in prostate cancer (pCA) diagnosis in identifying men with a high probability of a positive (repeat) biopsy. OBJECTIVE: This study evaluated the clinical utility of the PROGENSA PCA3 assay. DESIGN, SETTING, AND

The European Union: a strategic approach

Directory of Open Access Journals (Sweden)

Lieve Fransen

2007-01-01

Full Text Available The European Union has developed policies and instruments that address – both directly and indirectly – sexual violence in conflict and beyond. Policy areas that are important in this respect include human rights, gender equality, development cooperation, humanitarian aid and conflict prevention.

The impact of European Union law on the possibilities of European Union Member States to adapt international tax rules to the business models of multinational enterprises

NARCIS (Netherlands)

Douma, S.; Kardachaki, A.

2016-01-01

European Union (EU) law has played a key role in enforcing the EU BEPS agenda, while also introducing limits to the application thereof. The European Commission (EC) sees a clear link between aggressive tax planning and competition law. Against this background, EU State aid law has been employed to

European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection

NARCIS (Netherlands)

Debast, S.B.; Bauer, M.P.; Kuijper, E.J.; et al.,

2014-01-01

In 2009 the first European Society of Clinical Microbiology and Infection (ESCMID) treatment guidance document for Clostridium difficile infection (CDI) was published. The guideline has been applied widely in clinical practice. In this document an update and review on the comparative effectiveness

European radiographers' challenges from mammography education and clinical practice - an integrative review.

Science.gov (United States)

Metsälä, Eija; Richli Meystre, Nicole; Pires Jorge, José; Henner, Anja; Kukkes, Tiina; Sá Dos Reis, Cláudia

2017-06-01

This study aims to identify European radiographers' challenges in clinical performance in mammography and the main areas of mammography that require more and better training. An extensive search was performed to identify relevant studies focused on clinical practice, education and training in mammography published between January 2010 and December 2015 in the English language. The data were analysed by using deductive thematic analysis. A total of 27 full text articles were read, evaluating their quality. Sixteen articles out of 27 were finally selected for this integrative review. The main challenges of radiographers' mammography education/training can be divided into three groups: training needs, challenges related to radiographers, and challenges related to the organization of education. The most common challenges of clinical performance in mammography among European radiographers involved technical performance, the quality of practices, and patient-centeredness. The introduction of harmonized mammography guidelines across Europe may serve as an evidence-based tool to be implemented in practice and education. However, the variability in human and material resources as well as the different cultural contexts should be considered during this process. • Radiographers' awareness of their professional identity and enhancing multiprofessional cooperation in mammography. • Radiographers' responsibilities regarding image quality (IQ) and optimal breast imaging performance. • Patient-centred mammography services focusing on the psychosocial needs of the patient. • Challenges: positioning, QC-testing, IQ-assessment, optimization of breast compression, communication, teamwork, and patient-centred care. • Introduction of evidence-based guidelines in Europe to harmonize mammography practice and education.

Examination of skin lesions for cancer : Which clinical decision aids and tools are available in general practice?

NARCIS (Netherlands)

Koelink, Cecile J. L.; Jonkman, Marcel F.; Van der Meer, Klaas; Van der Heide, Wouter K.

2014-01-01

Background While skin cancer incidence is rising throughout Europe, general practitioners (GP) feel unsure about their ability to diagnose skin malignancies. Objectives To evaluate whether the GP has sufficient validated clinical decision aids and tools for the examination of potentially malignant

A global, incremental development method for a web-based prostate cancer treatment decision aid and usability testing in a Dutch clinical setting.

Science.gov (United States)

Cuypers, Maarten; Lamers, Romy Ed; Kil, Paul Jm; The, Regina; Karssen, Klemens; van de Poll-Franse, Lonneke V; de Vries, Marieke

2017-07-01

Many new decision aids are developed while aspects of existing decision aids could also be useful, leading to a sub-optimal use of resources. To support treatment decision-making in prostate cancer patients, a pre-existing evidence-based Canadian decision aid was adjusted to Dutch clinical setting. After analyses of the original decision aid and routines in Dutch prostate cancer care, adjustments to the decision aid structure and content were made. Subsequent usability testing (N = 11) resulted in 212 comments. Care providers mainly provided feedback on medical content, and patients commented most on usability and summary layout. All participants reported that the decision aid was comprehensible and well-structured and would recommend decision aid use. After usability testing, final adjustments to the decision aid were made. The presented methods could be useful for cultural adaptation of pre-existing tools into other languages and settings, ensuring optimal usage of previous scientific and practical efforts and allowing for a global, incremental decision aid development process.

European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection.

Science.gov (United States)

Debast, S B; Bauer, M P; Kuijper, E J

2014-03-01

In 2009 the first European Society of Clinical Microbiology and Infection (ESCMID) treatment guidance document for Clostridium difficile infection (CDI) was published. The guideline has been applied widely in clinical practice. In this document an update and review on the comparative effectiveness of the currently available treatment modalities of CDI is given, thereby providing evidence-based recommendations on this issue. A computerized literature search was carried out to investigate randomized and non-randomized trials investigating the effect of an intervention on the clinical outcome of CDI. The Grades of Recommendation Assessment, Development and Evaluation (GRADE) system was used to grade the strength of our recommendations and the quality of the evidence. The ESCMID and an international team of experts from 11 European countries supported the process. To improve clinical guidance in the treatment of CDI, recommendations are specified for various patient groups, e.g. initial non-severe disease, severe CDI, first recurrence or risk for recurrent disease, multiple recurrences and treatment of CDI when oral administration is not possible. Treatment options that are reviewed include: antibiotics, toxin-binding resins and polymers, immunotherapy, probiotics, and faecal or bacterial intestinal transplantation. Except for very mild CDI that is clearly induced by antibiotic usage antibiotic treatment is advised. The main antibiotics that are recommended are metronidazole, vancomycin and fidaxomicin. Faecal transplantation is strongly recommended for multiple recurrent CDI. In case of perforation of the colon and/or systemic inflammation and deteriorating clinical condition despite antibiotic therapy, total abdominal colectomy or diverting loop ileostomy combined with colonic lavage is recommended. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

'My kidneys, my choice, decision aid': supporting shared decision making.

Science.gov (United States)

Fortnum, Debbie; Smolonogov, Tatiana; Walker, Rachael; Kairaitis, Luke; Pugh, Debbie

2015-06-01

For patients with chronic kidney disease (CKD) who are progressing to end-stage kidney disease (ESKD) a decision of whether to undertake dialysis or conservative care is a critical component of the patient journey. Shared decision making for complex decisions such as this could be enhanced by a decision aid, a practice which is well utilised in other disciplines but limited for nephrology. A multidisciplinary team in Australia and New Zealand (ANZ) utilised current decision-making theory and best practice to develop the 'My Kidneys, My Choice', a decision aid for the treatment of kidney disease. A patient-centred, five-sectioned tool is now complete and freely available to all ANZ units to support the ESKD education and shared decision-making process. Distribution and education have occurred across ANZ and evaluation of the decision aid in practice is in the first phase. Development of a new tool such as an ESKD decision aid requires vision, multidisciplinary input and ongoing implementation resources. This tool is being integrated into ANZ, ESKD education practice and is promoting the philosophy of shared decision making. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Governance beyond the European Consensus on Development: What Drives EU Aid Selectivity?

NARCIS (Netherlands)

W. Hout (Wil)

2013-01-01

textabstractThis paper focuses on the ‘governance turn’ in the development policies of the European Union, represented in particular by the adoption of the ‘European Consensus on Development’ in 2005. The main assumption inherent in the EU approach to development is that the quality of governance in

The 'end of AIDS' project: Mobilising evidence, bureaucracy, and big data for a final biomedical triumph over AIDS.

Science.gov (United States)

Leclerc-Madlala, Suzanne; Broomhall, Lorie; Fieno, John

2017-12-04

Efforts are currently underway by major orchestrators and funders of the global AIDS response to realise the vision of achieving an end to AIDS by 2030. Unlike previous efforts to provide policy guidance or to encourage 'best practice' approaches for combatting AIDS, the end of AIDS project involves the promotion of a clear set of targets, tools, and interventions for a final biomedical solution to the epidemic. In this paper, we examine the bureaucratic procedures of one major AIDS funder that helped to foster a common vision and mission amongst a global AIDS community with widely divergent views on how best to address the epidemic. We focus on the methods, movements, and materials that are central to the project of ending AIDS, including those related to biomedical forms of evidence and big data science. We argue that these approaches have limitations and social scientists need to pay close attention to the end of AIDS project, particularly in contexts where clinical interventions might transform clinical outcomes, but where the social, economic, and cultural determinants of HIV and AIDS remain largely intact and increasingly obscured.

Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV‐1 infection 2015: optimizing health in preparation for adult life

Science.gov (United States)

Turkova, A; Lyall, H; Foster, C; Klein, N; Bastiaans, D; Burger, D; Bernadi, S; Butler, K; Chiappini, E; Clayden, P; Della Negra, M; Giacomet, V; Giaquinto, C; Gibb, D; Galli, L; Hainaut, M; Koros, M; Marques, L; Nastouli, E; Niehues, T; Noguera‐Julian, A; Rojo, P; Rudin, C; Scherpbier, HJ; Tudor‐Williams, G; Welch, SB

2015-01-01

The 2015 Paediatric European Network for Treatment of AIDS (PENTA) guidelines provide practical recommendations on the management of HIV‐1 infection in children in Europe and are an update to those published in 2009. Aims of treatment have progressed significantly over the last decade, moving far beyond limitation of short‐term morbidity and mortality to optimizing health status for adult life and minimizing the impact of chronic HIV infection on immune system development and health in general. Additionally, there is a greater need for increased awareness and minimization of long‐term drug toxicity. The main updates to the previous guidelines include: an increase in the number of indications for antiretroviral therapy (ART) at all ages (higher CD4 thresholds for consideration of ART initiation and additional clinical indications), revised guidance on first‐ and second‐line ART recommendations, including more recently available drug classes, expanded guidance on management of coinfections (including tuberculosis, hepatitis B and hepatitis C) and additional emphasis on the needs of adolescents as they approach transition to adult services. There is a new section on the current ART ‘pipeline’ of drug development, a comprehensive summary table of currently recommended ART with dosing recommendations. Differences between PENTA and current US and World Health Organization guidelines are highlighted and explained. PMID:25649230

The European Hematology Association Roadmap for European Hematology Research

DEFF Research Database (Denmark)

Engert, Andreas; Balduini, Carlo; Brand, Anneke

2016-01-01

The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology...... research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness...... of the burden of blood disorders on European society, which purely in economic terms is estimated at €23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology...

Clinical utility of dronabinol in the treatment of weight loss associated with HIV and AIDS.

Science.gov (United States)

Badowski, Melissa E; Perez, Sarah E

2016-01-01

Since the beginning of the HIV/AIDS epidemic, weight loss has been a common complaint for patients. The use of various definitions defining HIV wasting syndrome has made it difficult to determine its actual prevalence. Despite the use of highly active antiretroviral therapy, it is estimated that the prevalence of HIV wasting syndrome is between 14% and 38%. HIV wasting syndrome may stem from conditions affecting chewing, swallowing, or gastrointestinal motility, neurologic disease affecting food intake or the perception of hunger or ability to eat, psychiatric illness, food insecurity generated from psychosocial or economic concerns, or anorexia due to medications, malabsorption, infections, or tumors. Treatment of HIV wasting syndrome may be managed with appetite stimulants (megestrol acetate or dronabinol), anabolic agents (testosterone, testosterone analogs, or recombinant human growth hormone), or, rarely, cytokine production modulators (thalidomide). The goal of this review is to provide an in-depth evaluation based on existing clinical trials on the clinical utility of dronabinol in the treatment of weight loss associated with HIV/AIDS. Although total body weight gain varies with dronabinol use (-2.0 to 3.2 kg), dronabinol is a well-tolerated option to promote appetite stimulation. Further studies are needed with standardized definitions of HIV-associated weight loss and clinical outcomes, robust sample sizes, safety and efficacy data on chronic use of dronabinol beyond 52 weeks, and associated virologic and immunologic outcomes.

Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy.

Science.gov (United States)

Dreischulte, Tobias; Fernandez-Llimos, Fernando

2016-12-01

Background The definitions that are being used for the terms 'clinical pharmacy' and 'pharmaceutical care' seem to have a certain overlap. Responsibility for therapy outcomes seems to be especially linked to the latter term. Both terms need clarification before a proper definition of clinical pharmacy can be drafted. Objective To identify current disagreements regarding the term 'Clinical Pharmacy' and its relationship to 'Pharmaceutical Care' and to assess to which extent pharmacists with an interest in Clinical Pharmacy are willing to accept responsibility for drug therapy outcomes. Setting The membership of the European Society of Clinical Pharmacy. Methods A total of 1,285 individuals affiliated with the European Society of Clinical Pharmacy were invited by email to participate in an online survey asking participants to state whether certain professional activities, providers, settings, aims and general descriptors constituted (a) 'Clinical Pharmacy only', (b) 'Pharmaceutical Care only', (c) 'both' or (d) 'neither'. Further questions examined pharmacists' willingness to accept ethical or legal responsibility for drug therapy outcomes, under current and ideal working conditions. Main outcome measures Level of agreement with a number of statements. Results There was disagreement (responsibility under current/ideal working conditions were: safety (32.7%/64.3%), effectiveness (17.9%/49.2%), patient-centeredness (17.1%/46.2%), cost-effectiveness (20.3%/44.0%). Conclusions The survey identified key disagreements around the term 'Clinical Pharmacy' and its relationship to 'Pharmaceutical Care', which future discussions around a harmonised definition of 'Clinical Pharmacy' should aim to resolve. Further research is required to understand barriers and facilitators to pharmacists accepting responsibility for drug therapy outcomes.

Towards the automotive HMI of the future: Overview of the AIDE - Integrated project results

NARCIS (Netherlands)

Amditis, A.; Andreone, L.; Pagle, K.; Markkula, G.; Deregibus, E.; Romera Rue, M.; Bellotti, F.; Engelsberg, A.; Brouwer, R.; Peters, B.; Gloria, A. de

2010-01-01

The Adaptive Integrated Driver-vehicle interfacE (AIDE) is an integrated project funded by the European Commission in the Sixth Framework Programme. The project, which involves 31 partners from the European automotive industry and academia, deals with behavioral and technical issues related to

ANALYSIS OF HIV SUBTYPES AND CLINICAL STAGING OF HIV DISEASE/AIDS IN EAST JAVA

Directory of Open Access Journals (Sweden)

Yulia Ismail

2012-04-01

Full Text Available Human Immunodeficiency Virus type 1 (HIV-1 known to cause Acquired Immune Deficiency Syndrome (AIDS disease are divided into several subtypes (A, B, C, D, F, G, H, J, K and Circulating Recombinant Form (CRF. Different characteristics of subtype of the virus and its interaction with the host can affect the severity of the disease. This study was to analyze HIV-1 subtypes circulating in HIV/AIDS patients from the East Java region descriptively and to analyze its relationship with clinical stadiums of HIV/AIDS. Information from this research was expected to complement the data of mocular epidemiology of HIV in Indonesia. This study utilited blood plasma from patients who had been tested to be HIV positive who sected treatment to or were reffered to the Intermediate Care Unit of Infectious Disease (UPIPI Dr. Soetomo Hospital Surabaya from various area representing the East Java regions. Plasma was separated from blood samples by centrifugation for use in the the molecular biology examination including RNA extraction, nested PCR using specific primer for HIV gp120 env gene region, DNA purifying, DNA sequencing, and homology and phylogenetic analysis. Based on the nucleotide sequence of the HIV gp120 env gene, it was found that the most dominant subtypes in East Java were in one group of Circulating Recombinant Form (CRF that is CRF01_AE, CRF33_01B and CRF34_01B which was also found in Southeast Asia. In the phylogenetic tree, most of HIV samples (30 samples are in the same branch with CRF01_AE, CRF33_01B and CRF34_01B, except for one sample (HIV40 which is in the same branch with subtype B. HIV subtypes are associated with clinical stadiums (disease severity since samples from different stages of HIV disease have the same subtype.

Previously Unidentified Single Nucleotide Polymorphisms in HIV/AIDS Cases Associate with Clinical Parameters and Disease Progression

Directory of Open Access Journals (Sweden)

Vladimir V. Anokhin

2016-01-01

Full Text Available The genetic background of an individual plays an important role in the progression of HIV infection to AIDS. Identifying previously unknown or uncharacterized single nucleotide polymorphisms (SNPs that associate with disease progression may reveal important therapeutic targets and provide a greater understanding of disease pathogenesis. In the present study, we employed ultra-high multiplex PCR on an Ion Torrent next-generation sequencing platform to sequence 23 innate immune genes from 94 individuals with HIV/AIDS. This data was used to identify potential associations of SNPs with clinical parameters and disease progression. SNPs that associated with an increased viral load were identified in the genes for the interleukin 15 receptor (IL15RA, toll-like receptor 7 (TLR7, tripartite motif-containing protein 5 (TRIM5, and two killer-cell immunoglobulin-like receptors (KIR2DL1 and KIR2DL3. Additionally, SNPs that associated with progression from HIV infection to AIDS were identified in two 2′-5′-oligoadenylate synthetase genes (OAS2 and OAS3. In contrast, other SNPs identified in OAS2 and OAS3 genes, as well as in the TRIM5 and KIR2DS4 genes, were associated with a slower progression of disease. Taken together, our data demonstrates the utility of ultra-high multiplex PCR in identifying polymorphisms of potential clinical significance and further,identifies SNPs that may play a role in HIV pathogenesis.

EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry and Laboratory Medicine: version 3 - 2005.

Science.gov (United States)

Zerah, Simone; McMurray, Janet; Bousquet, Bernard; Baum, Hannsjorg; Beastall, Graham H; Blaton, Vic; Cals, Marie-Josèphe; Duchassaing, Danielle; Gaudeau-Toussaint, Marie-Françoise; Harmoinen, Aimo; Hoffmann, Hans; Jansen, Rob T; Kenny, Desmond; Kohse, Klaus P; Köller, Ursula; Gobert, Jean-Gérard; Linget, Christine; Lund, Erik; Nubile, Giuseppe; Opp, Matthias; Pazzagli, Mario; Pinon, Georges; Queralto, José M; Reguengo, Henrique; Rizos, Demetrios; Szekeres, Thomas; Vidaud, Michel; Wallinder, Hans

2006-01-01

The EC4 Syllabus for Postgraduate Training is the basis for the European Register of Specialists in Clinical Chemistry and Laboratory Medicine. The syllabus: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. The syllabus is not primarily meant to be a training guide, but on the basis of the overview given (common minimal programme), national societies should formulate programmes that indicate where knowledge and experience is needed. The main points of this programme are: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory management; and Quality insurance management. The aim of this version of the syllabus is to be in accordance with the Directive of Professional Qualifications published on 30 September 2005. To prepare the common platforms planned in this directive, the disciplines are divided into four categories: Indicates the level of requirements in postgraduate training to harmonise the postgraduate education in the European Union (EU); Indicates the level of content of national training programmes to obtain adequate knowledge and experience; Is approved by all EU societies for clinical chemistry and laboratory medicine. Knowledge in biochemistry, haematology, immunology, etc.; Pre-analytical conditions; Evaluation of results; Interpretations (post-analytical phase); Laboratory

HIV/AIDS in eastern Europe: more than a sexual health crisis.

Science.gov (United States)

Lazarus, Jeffrey V; Bollerup, Annemarie; Matić, Srdan

2006-06-01

HIV/AIDS is often described as a sexually transmitted disease. In the former USSR, however, the HIV/AIDS epidemic is being driven by injecting drug use among men. This article addresses several widely circulated assumptions about HIV in eastern Europe: that sexual contact is the primary mode of transmission, that women form a major increasing proportion of those infected, and that the disease threatens young people in particular. Because the rate of injecting drug use is extremely high in many eastern European countries, HIV control there cannot just target sexual transmission but must embrace other approaches, such as comprehensive harm reduction. In the area of treatment, scaling up access to highly active antiretroviral therapy has been a major global priority for the last two years. European efforts to broaden access have been generally quite successful, yet in the two European countries with the greatest need, the Russian Federation and Ukraine, the demand for treatment is growing much faster than its availability.

Comparison of Leishmania typing results obtained from 16 European clinical laboratories in 2014.

Science.gov (United States)

Van der Auwera, Gert; Bart, Aldert; Chicharro, Carmen; Cortes, Sofia; Davidsson, Leigh; Di Muccio, Trentina; Dujardin, Jean-Claude; Felger, Ingrid; Paglia, Maria Grazia; Grimm, Felix; Harms, Gundel; Jaffe, Charles L; Manser, Monika; Ravel, Christophe; Robert-Gangneux, Florence; Roelfsema, Jeroen; Töz, Seray; Verweij, Jaco J; Chiodini, Peter L

2016-12-08

Leishmaniasis is endemic in southern Europe, and in other European countries cases are diagnosed in travellers who have visited affected areas both within the continent and beyond. Prompt and accurate diagnosis poses a challenge in clinical practice in Europe. Different methods exist for identification of the infecting Leishmania species. Sixteen clinical laboratories in 10 European countries, plus Israel and Turkey, conducted a study to assess their genotyping performance. DNA from 21 promastigote cultures of 13 species was analysed blindly by the routinely used typing method. Five different molecular targets were used, which were analysed with PCR-based methods. Different levels of identification were achieved, and either the Leishmania subgenus, species complex, or actual species were reported. The overall error rate of strains placed in the wrong complex or species was 8.5%. Various reasons for incorrect typing were identified. The study shows there is considerable room for improvement and standardisation of Leishmania typing. The use of well validated standard operating procedures is recommended, covering testing, interpretation, and reporting guidelines. Application of the internal transcribed spacer 1 of the rDNA array should be restricted to Old World samples, while the heat-shock protein 70 gene and the mini-exon can be applied globally. This article is copyright of The Authors, 2016.

Moving the boundaries of international collaboration on clinical trials and QoL: experiences in oncology and legislation within the European Parliament.

Science.gov (United States)

Bottomley, Andrew; Kirby, Tony; Bean, John; Walker, Julie

2013-02-01

The European Organisation for Research and Treatment of Cancer undertook another successful event with their third annual conference addressing quality of life matters in cancer clinical trials. More than 40 presentations were made over a 3-day period hosted at the European Parliament on 17-20 October 2012, in Brussels. The conference managed to get speakers and policy makers together to debate all the key issues in cancer clinical trials, design and reporting, including future policy and regulatory concerns. This meeting set the stage for future research and policy meetings to give greater visibility to quality of life as an outcome in clinical trials within the world of EU legislators.

European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults.

Science.gov (United States)

Bollerslev, Jens; Rejnmark, Lars; Marcocci, Claudio; Shoback, Dolores M; Sitges-Serra, Antonio; van Biesen, Wim; Dekkers, Olaf M

2015-08-01

Hypoparathyroidism (HypoPT) is a rare (orphan) endocrine disease with low calcium and inappropriately low (insufficient) circulating parathyroid hormone levels, most often in adults secondary to thyroid surgery. Standard treatment is activated vitamin D analogues and calcium supplementation and not replacement of the lacking hormone, as in other hormonal deficiency states. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of chronic HypoPT in adults who do not have end-stage renal disease. We intend to draft a practical guideline, focusing on operationalized recommendations deemed to be useful in the daily management of patients. This guideline was developed and solely sponsored by The European Society of Endocrinology, supported by CBO (Dutch Institute for Health Care Improvement) and based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) principles as a methodological base. The clinical question on which the systematic literature search was based and for which available evidence was synthesized was: what is the best treatment for adult patients with chronic HypoPT? This systematic search found 1100 articles, which was reduced to 312 based on title and abstract. The working group assessed these for eligibility in more detail, and 32 full-text articles were assessed. For the final recommendations, other literature was also taken into account. Little evidence is available on how best to treat HypoPT. Data on quality of life and the risk of complications have just started to emerge, and clinical trials on how to optimize therapy are essentially non-existent. Most studies are of limited sample size, hampering firm conclusions. No studies are available relating target calcium levels with clinically relevant endpoints. Hence it is not possible to formulate recommendations based on strict evidence. This guideline is therefore mainly based on how patients are managed in clinical practice

Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey

International Nuclear Information System (INIS)

Haslam, Philip J.; Yap, Bernard; Mueller, Peter R.; Lee, Michael J.

2000-01-01

Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends.Methods: A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived from a similar survey of interventional practice in the United States.Results: Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds.Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are

Foreign Object in the Eye: First Aid

Science.gov (United States)

... eye: First aid Foreign object in the eye: First aid By Mayo Clinic Staff If you get a foreign object in your eye Wash your hands ... et al., eds. American Medical Association Handbook of First Aid and Emergency Care. New York, N.Y.: Random ...

Introduction to a Special Issue of the Journal of Immunological Methods: Building global resource programs to support HIV/AIDS clinical trial studies.

Science.gov (United States)

Sanchez, Ana M; Denny, Thomas N; O'Gorman, Maurice

2014-07-01

This Special Issue of the Journal of Immunological Methods includes 16 manuscripts describing quality assurance activities related to virologic and immunologic monitoring of six global laboratory resource programs that support international HIV/AIDS clinical trial studies: Collaboration for AIDS Vaccine Discovery (CAVD); Center for HIV/AIDS Vaccine Immunology (CHAVI); External Quality Assurance Program Oversight Laboratory (EQAPOL); HIV Vaccine Trial Network (HVTN); International AIDS Vaccine Initiative (IAVI); and Immunology Quality Assessment (IQA). The reports from these programs address the many components required to develop comprehensive quality control activities and subsequent quality assurance programs for immune monitoring in global clinical trials including: all aspects of processing, storing, and quality assessment of PBMC preparations used ubiquitously in HIV clinical trials, the development and optimization of assays for CD8 HIV responses and HIV neutralization, a comprehensive global HIV virus repository, and reports on the development and execution of novel external proficiency testing programs for immunophenotyping, intracellular cytokine staining, ELISPOT and luminex based cytokine measurements. In addition, there are articles describing the implementation of Good Clinical Laboratory Practices (GCLP) in a large quality assurance laboratory, the development of statistical methods specific for external proficiency testing assessment, a discussion on the ability to set objective thresholds for measuring rare events by flow cytometry, and finally, a manuscript which addresses a framework for the structured reporting of T cell immune function based assays. It is anticipated that this series of manuscripts covering a wide range of quality assurance activities associated with the conduct of global clinical trials will provide a resource for individuals and programs involved in improving the harmonization, standardization, accuracy, and sensitivity of

Survey of surveillance systems and select prevention activities for hepatitis B and C, European Union/European Economic Area, 2009.

Science.gov (United States)

Duffell, E F; van de Laar, M J

2015-04-02

Hepatitis B and C viral infections are leading causes of hepatic cirrhosis and cancer. The incidence and prevalence of both hepatitis B and C varies across European countries. European wide surveillance data help to understand the dynamic epidemiology of hepatitis B and C, which is important for the implementation and effectiveness of prevention and control activities.Comparison of surveillance data between countries in Europe is hampered by the differences in national healthcare and reporting systems. This report presents the results of a survey in 2009 which was undertaken to collect baseline information on surveillance systems and core prevention programmes for hepatitis B and C in individual European Union/ European Economic Area countries. The results provide key information to aid the interpretation of surveillance data, and while indicating heterogeneity in national surveillance systems and programmes, they highlight the potential of these systems. This resource has supported the implementation of a standardised European enhanced surveillance programme.

AIDS in contemporary Islamic ethical literature.

Science.gov (United States)

Francesca, Ersilia

2002-01-01

AIDS has been mentioned in Islamic ethical literature since about 1985 as an illness pertaining to European and American homosexuals. Only since about 1990 has the presence of HIV/AIDS in Islamic countries cast light on the fact that the actual sexual behaviour of the population does not always conform to religious norms. The increase in the numbers of people with HIV has compelled religious leaders to take a stand on sexual practices they consider "deviant", from prostitution to homosexuality and extramarital sex. The aim of this paper is to analyse the attitude of Muslim religious authorities towards individual sexual behaviour and AIDS. It is based mainly on contemporary legal responses that largely provide the necessary information on most of Islamic medical ethics. According to Muslim scholars, AIDS is a warning from God not to indulge in illicit conduct. As a remedy against the spread of AIDS, they encourage compliance with traditional family values and the enhancement of faith and devotion and strongly oppose sex education. They oppose promotion of condoms or any form of safe sex outside of marriage, which they perceive as promoting promiscuity and defiance of divine law. All the above-mentioned arguments are not exhaustive of the Islamic attitude towards AIDS. Some religious groups disagree with such a conservative way of conceiving the fight against AIDS as being antithetical to both men's and women's well-being. They support an alternative view of reproductive health and human rights within the Islamic framework and stress the great tolerance of Islam and why it must include people with HIV and AIDS.

Automatic detection of pulmonary nodules at spiral CT: clinical application of a computer-aided diagnosis system

International Nuclear Information System (INIS)

Wormanns, Dag; Fiebich, Martin; Saidi, Mustafa; Diederich, Stefan; Heindel, Walter

2002-01-01

The aim of this study was to evaluate a computer-aided diagnosis (CAD) workstation with automatic detection of pulmonary nodules at low-dose spiral CT in a clinical setting for early detection of lung cancer. Eighty-eight consecutive spiral-CT examinations were reported by two radiologists in consensus. All examinations were reviewed using a CAD workstation with a self-developed algorithm for automatic detection of pulmonary nodules. The algorithm is designed to detect nodules with diameters of at least 5 mm. A total of 153 nodules were detected with at least one modality (radiologists in consensus, CAD, 85 nodules with diameter <5 mm, 68 with diameter ≥5 mm). The results of automatic nodule detection were compared to nodules detected with any modality as gold standard. Computer-aided diagnosis correctly identified 26 of 59 (38%) nodules with diameters ≥5 mm detected by visual assessment by the radiologists; of these, CAD detected 44% (24 of 54) nodules without pleural contact. In addition, 12 nodules ≥5 mm were detected which were not mentioned in the radiologist's report but represented real nodules. Sensitivity for detection of nodules ≥5 mm was 85% (58 of 68) for radiologists and 38% (26 of 68) for CAD. There were 5.8±3.6 false-positive results of CAD per CT study. Computer-aided diagnosis improves detection of pulmonary nodules at spiral CT and is a valuable second opinion in a clinical setting for lung cancer screening despite of its still limited sensitivity. (orig.)

The need for European professional standards and the challenges facing clinical microbiology.

Science.gov (United States)

Humphreys, H; Nagy, E; Kahlmeter, G; Ruijs, G J H M

2010-06-01

Microorganisms spread across national boundaries and the professional activities of clinical (medical) microbiologists are critical in minimising their impact. Clinical microbiologists participate in many activities, e.g. diagnosis, antibiotic therapy, and there is a need for a set of professional standards for Europe with a common curriculum, to build upon the current strengths of the specialty and to facilitate the free movement of specialists within the European Union. Such standards will also better highlight the important contribution of clinical microbiologists to healthcare. There is a move to larger centralised microbiology laboratories often located off-site from an acute hospital, driven by the concentration of resources, amalgamation of services, outsourcing of diagnostics, automation, an explosion in the range of staff competencies and accreditation. Large off-site centralised microbiology laboratories are often distant to the patient and may not facilitate the early detection of microbial spread. Ultimately, the needs of patients and the public are paramount in deciding on the future direction of clinical microbiology. Potential conflicts between integration on an acute hospital site and centralisation can be resolved by a common set of professional standards and a team-based approach that puts patients first.

The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals.

NARCIS (Netherlands)

Shaw, C.D.; Groene, O.; Botje, D.; Suñol, R.; Kutryba, B.; Klazinga, N.; Bruneau, C.; Hammer, A.; Wang, A.; Arah, O.A.; Wagner, C.

2014-01-01

Objective: To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design: A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management

Aid policy for peat from the EU's standpoint

International Nuclear Information System (INIS)

Alanen, J.; Suvanto-Luomala, S.; Aeimae, K.

2002-10-01

The study analyses the restrictions that may be imposed by the European Union on our national taxation schemes supporting the energy use of peat. These restrictions would mainly relate to the EU and international climate policy, which may change the attitudes towards the energy use of peat. The taxation arrangements studied concern the refunds of the electricity tax granted to small peat-fired power plants and the tax on peat, which compared especially with coal, is light in heat production. The study aims to find out whether the arrangements included State aid prohibited by the European Community or whether they gave rise to prohibited tax discrimination of other Member States' energy products. It was concluded that the objectives of the Community, particularly the regional security of energy supply, promotion of combined electricity and heat production, and employment, favour the energy use of peat rather than oppose to it. As for the aid to small power plants, it can be considered that the grounds for obtaining an exemption from the EC State aid prohibition exist, because the benefits of the aid referred to are more important than the disadvantages brought by it for undistorted trade and competition. This situation cannot be expected to change in the near future, either, e.g. as a result of the climate policy. As regards heat production, peat taxation cannot be considered to include State aid or to lead to discrimination against exported fuels like coal. This is essentially based on the taxation sovereignty of Member States and the related right to enhance national goals by means of taxation. The current energy tax regulation by the Community or the Commission's Proposal for an Energy Tax Directive do not seem to pose any obstacles to continuing Finland's present energy taxation policy. (orig.)

Sleep aid toxicosis in dogs: 317 cases (2004-2010).

Science.gov (United States)

Lancaster, Adam R; Lee, Justine A; Hovda, Lynn R; Hardy, Brian T; Miyahara, Lee X; Martin, Elizabeth P; Whelan, Megan F

2011-12-01

To summarize the signalment, clinical signs observed, time to onset of clinical signs, duration of clinical signs, and the outcome in a large case series of nonbenzodiazepine sleep aid ingestions in dogs, including 2 sleep aids that have not been previously described in the veterinary literature. Retrospective study conducted between 2004 and 2010. An animal poison control center based out of Bloomington, MN. During this time frame, 453 cases were identified involving 467 dogs. Of these cases, 150 cases were excluded due to incomplete medical records, multipet households, or the inability to calculate a dose exposure. A total of 317 dogs with presumed sleep aid medication toxicosis were included. None. Records of dogs with sleep aid medication toxicosis identified by a review of an animal poison control center electronic database were evaluated. The most common sleep aid medications ingested were zolpidem (240/317 [75.7%]), eszopiclone (62/317 [19.5%]), and zaleplon (15/317 [4.7%]). Overall, clinical signs developed in 36% of patients (115/317), while 64% (202/317) remained asymptomatic. The most common organ systems affected and clinical signs seen involved the central nervous system (eg, agitation, sedation) and gastrointestinal tract (eg, anorexia, hypersalivation, vomiting). Overall, the prognosis for dogs with sleep aid medication toxicosis was excellent, and no fatalities were reported in this clinical population. As significant clinical signs can still be seen with ingestion, appropriate decontamination is warranted in asymptomatic patients via emesis or gastric lavage, followed by activated charcoal administration. Symptomatic patients should be hospitalized for monitoring and supportive care for a minimum of 12 hours or until clinical signs resolve. © Veterinary Emergency and Critical Care Society 2011.

Evaluating Protocol Lifecycle Time Intervals in HIV/AIDS Clinical Trials

Science.gov (United States)

Schouten, Jeffrey T.; Dixon, Dennis; Varghese, Suresh; Cope, Marie T.; Marci, Joe; Kagan, Jonathan M.

2014-01-01

Background Identifying efficacious interventions for the prevention and treatment of human diseases depends on the efficient development and implementation of controlled clinical trials. Essential to reducing the time and burden of completing the clinical trial lifecycle is determining which aspects take the longest, delay other stages, and may lead to better resource utilization without diminishing scientific quality, safety, or the protection of human subjects. Purpose In this study we modeled time-to-event data to explore relationships between clinical trial protocol development and implementation times, as well as identify potential correlates of prolonged development and implementation. Methods We obtained time interval and participant accrual data from 111 interventional clinical trials initiated between 2006 and 2011 by NIH’s HIV/AIDS Clinical Trials Networks. We determined the time (in days) required to complete defined phases of clinical trial protocol development and implementation. Kaplan-Meier estimates were used to assess the rates at which protocols reached specified terminal events, stratified by study purpose (therapeutic, prevention) and phase group (pilot/phase I, phase II, and phase III/ IV). We also examined several potential correlates to prolonged development and implementation intervals. Results Even though phase grouping did not determine development or implementation times of either therapeutic or prevention studies, overall we observed wide variation in protocol development times. Moreover, we detected a trend toward phase III/IV therapeutic protocols exhibiting longer developmental (median 2 ½ years) and implementation times (>3years). We also found that protocols exceeding the median number of days for completing the development interval had significantly longer implementation. Limitations The use of a relatively small set of protocols may have limited our ability to detect differences across phase groupings. Some timing effects

The clinical characteristics and prognostic significance of AID, miR-181b, and miR-155 expression in adult patients with de novo B-cell acute lymphoblastic leukemia.

Science.gov (United States)

Zhou, Guangquan; Cao, Yang; Dong, Weimin; Lin, Yan; Wang, Qi; Wu, Wei; Hua, Xiaoying; Ling, Yun; Xie, Xiaobao; Hu, Shaoyan; Cen, Jiannong; Gu, Weiying

2017-09-01

This study aimed to investigate clinical characteristics and prognostic significance of activation-induced cytidine deaminase (AID) gene, miR-181b and miR-155 expression in de novo adult B-cell acute lymphoblastic leukemia (B-ALL) patients. Results showed that AID and miR-155 expression were higher in B-ALL patients than healthy controls, while miR-181b expression was lower in B-ALL patients. In addition, Ph + B-ALLs had higher AID expression than Ph - B-ALLs, and its high expression was associated with BCR-ABL. Moreover, B-ALL patients with AID high or miR-181b low expression had a shorter overall survival (OS). AID high with miR-181b low , AID high with miR-155 low , miR-181b low , miR-155 low , AID high with miR-181b low and miR-155 low expression were associated with shorter OS. Combination of the three molecules are more accurate predictors for unfavorable OS compared with univariate group. Therefore, AID, miR-181b and miR-155 provide clinical prognosis of adult de novo B-ALL patients and may refine their molecular risk classification.

Myths about AIDS in Cambodia.

Science.gov (United States)

Nariddh, M C

1994-08-01

HIV has been reported in the capital city of Cambodia, Phnom Penh, as well as in the northwestern provinces of Banteay Meanchey, Battambang, Pursat, and Kompong Chhnang. Unofficial reports indicate the presence of HIV in three northeastern provinces. According to World Health Organization data, 382 people were infected with HIV in Cambodia as of March 1994, but the national AIDS program estimates that 2000-4000 Cambodians may be HIV-seropositive. Small surveys in 1992 identified HIV infection rates to be 4.5% among patients of sexually transmitted disease (STD) clinics and 9.2% among prostitutes. A seroprevalence rate of 4.3% was found in 1993 among clients of STD clinics and others requesting HIV testing. These rather marked levels of infection exist in Cambodia even though HIV was first identified in the country as recently as 1991 among screened blood from volunteer donors. By December 1993, the rate of positive results from blood donors had increased to 1.97%.; the rate of infection among blood donors is expected to double to approximately 4% in 1994. People in Cambodia variously believe that AIDS is nonexistent, AIDS is a problem of other countries, can be transmitted by mosquitoes, healthy people do not have AIDS, a cure exists for AIDS, AIDS can be contracted only from prostitutes, AIDS is the most severe state of syphilis, and AIDS is only a propaganda ploy of condom producers to market their products. It is therefore proving extremely difficult to convince people that AIDS is a truly threatening disease against which they should protect themselves, especially when symptoms are rarely present during the early stage of infection. Health education campaigns, videos, posters, and accurate reporting in the media will, however, help change minds and hopefully induce HIV-preventive behaviors. Of interest, the article notes that virtually every prostitute in Cambodia has at least two-three STDs.

Decision aid for women considering breast cancer screening

DEFF Research Database (Denmark)

Pasternack, Iris; Saalasti-Koskinen, Ulla; Mäkelä, Marjukka

2011-01-01

OBJECTIVES: The aim of this study was to describe the process and challenges of developing a decision aid for the national public breast cancer screening program in Finland. METHODS: An expert team with stakeholder representation used European guidelines and other literature as basis for selecting...... relevant content and format for the decision aid for breast cancer screening. Feedback from women was sought for the draft documents. RESULTS: A decision aid attached to the invitation letter for screening was considered the best way to ensure access to information. In addition, tailored letter templates...... information for women invited to breast cancer screening is demanding and requires careful planning. Professionals and service providers need to be engaged in the HTA process to ensure proper dissemination and implementation of the information. End user participation is essential in the formulation...

HIV/hepatitis coinfection in eastern Europe and new pan-European approaches to hepatitis prevention and management

DEFF Research Database (Denmark)

Lazarus, Jeff; Shete, Priya B; Eramova, Irina

2007-01-01

ISSUES: HIV/hepatitis coinfection in Europe; WHO European clinical protocols on the management of people coinfected with HIV/AIDS and hepatitis B or C (HBV or HCV); stakeholder recommendations for better HCV services. INTRODUCTION: The increasing availability of highly active antiretroviral therapy...... in countries where the HIV epidemic is driven by injecting drug use. Access to hepatitis treatment for PLWHA and IDUs is still very limited in Europe due to a lack of clear clinical management guidelines for HIV/hepatitis coinfections, high costs and a national failure to recognise hepatitis as a critical...... health issue. DESCRIPTION: In October 2006, the WHO Regional Office for Europe issued protocols for the clinical management of HIV/HCV and HIV/HBV coinfections. They include diagnostic algorithms adjusted for resource availability, and guidelines for the management of patients who do not yet need...

Staphylococcus aureus carriage among participants at the 13th European Congress of Clinical Microbiology and Infectious Diseases.

NARCIS (Netherlands)

Nulens, E.; Gould, I.; MacKenzie, F.; Deplano, A.; Cookson, B.; Alp, E.; Bouza, E.; Voss, A.

2005-01-01

The aim of this study was to measure the rate of Staphylococcus aureus nasal colonization among attendees of the 13th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), particularly with regard to methicillin-resistant (MRSA) strains. The 31.4% rate of Staphylococcus aureus

[Gdansk HIV-AIDS project, yesterday, today and future].

Science.gov (United States)

Zielińska, W

1995-09-01

Medical care project for HIV positive and AIDS patients in Gdańsk voivodship was established in 1988 in the Clinic for Infectious Diseases of Gdańsk Medical University. The aim of this modern and multidirectional program was to provide full medical care for HIV/AIDS patients and introduce effective prophylaxis against spread of HIV infection. According to the project-clinical ward, outpatient clinic for HIV positive and AIDS patients, diagnostic and laboratory units, were established. Close cooperation including specialistic and general medical care, was set with detoxication ward, rehabilitation centers for drug addicts, prison medical services and the Korczak Orphanage. Education of medical staff and some social groups was provided (teachers, teenagers of secondary schools, journalists, police employees). Clinical ward for HIV positive patients who are in need of inpatient medical care is localized in the Clinic for Infectious Diseases of Gdańsk Medical University. The ward has 16 double - bed Melcer's boxes which are used for other HIV/AIDS patients according to present needs. Free beds are used for HIV negative patients. HIV/AIDS Outpatient Clinic is localized in Venerologic Outpatient Unit. This was because of some psychological, social, professional and organization aspects. Outpatient Clinic staff is responsible for first patients' examination. Serological diagnostics of HIV infection is follow up for everyone (anonymous testing is possible); testing for STD is available also. Diagnostic laboratory base for clinical ward and other units are the laboratories of Gdańsk Voivodship Hospital for Infectious Diseases. Clinic for Infectious Diseases supervises all co-operating units. These are the following: 10-beds detoxication ward for drug addicts in Psychiatric - Neurological Hospital "Srebrzysko", 70-80 places in rehabilitation centers for drug addicts in Zapowiednik and Smazyno, remand prison ward for HIV positive patients (this is the first ward

Epidemiology of AIDS in Africa--part 2.

Science.gov (United States)

Cigielski, J P

1988-03-01

A recently completed study involving over 10,000 people from 6 Central African countries found seroprevalence rates generally under 1% for the acquired immunodeficiency syndrome (AIDS); however, rates were significantly higher for urban residents, prostitutes and their sexual contacts, and patients attending sexually transmitted disease clinics. The 4 major modes of transmission of AIDS in Africa are sexual contact, perinatal transmission, transfusion of infected blood or blood products, and the reuse of equipment such as needles and syringes. In 1985, a 2nd AIDS virus, human immunodeficiency virus (HIV)-2, was discovered in West Africa--a finding with important implications for epidemiologic surveillance, screening programs, and clinical diagnostic testing. Although 45 of the 50 African countries have developed concrete public health policies and strategies for the prevention and control of AIDS, most nations of sub-Saharan Africa lack the economic and social resources to implement these programs effectively. Thus, international cooperation and a commitment on the part of the US and Western Europe to provide assistance will be essential. Needs must be addressed on 2 fronts: treatment of those already infected or suffering from the disease and containment of the AIDS epidemic. Public health efforts should focus initially on high risk behaviors through health education. At the same time, it should be recognized that AIDS is not the largest health issue facing Africans, and there is a complex interaction between AIDS and other health problems such as malnutrition, genital ulcers, diarrhea, and tuberculosis. An approach to AIDS requires an expansion of public health initiatives in areas such as clean water supplies, maternal-child health programs, nutrition and immunization programs, and sexually transmitted disease clinics.

A mutually beneficial collaboration between the European Academy of Allergy and Clinical Immunology Junior Members and Clinical and Translational Allergy.

Science.gov (United States)

Tomazic, Peter Valentin; Graessel, Anke; Silva, Diana; Eguiluz-Gracia, Ibon; Guibas, George V; Grattan, Clive; Bousquet, Jean; Tsilochristou, Olympia

2016-01-01

The European Academy of Allergy and Clinical Immunology (EAACI) Junior Members (JM) comprise the largest EAACI section with around 4000 clinicians and scientists under 35 years of age working in the field of allergy and clinical immunology. The Junior Member collaboration with Clinical and Translational Allergy Journal is a mutually beneficial relationship providing Junior Members of EAACI with excellent opportunities to publish their work in the Journal, enhance their visibility in their respective field, and get involved with Journal-related activities and processes. In the future, this collaboration will grow, not only by the consolidation of these activities, but also by the implementation of new initiatives, such as a platform for discussing and/or publishing Junior Members' dissertations in the Journal. From the CTA perspective, the collaboration presents an opportunity to promote a new generation of allergists with experience of conducting and presenting research, with improved skills in critical review.

The debate on law propositions about energy by the European Commission

International Nuclear Information System (INIS)

Kerebel, C.

2008-01-01

After a presentation of the third Energy Package put forward by the European Commission on the 19 September 2007, and a presentation of the European Strategic Energy Technology Plan (SET-Plan) presented by the Commission on the 22 November 2007, the author more precisely presents the contents of the European Union Energy and Climate Package of January 2008. Several aspects are addressed: renewable energies, greenhouse gas emissions, carbon capture and storage, and public aids for these different themes. A graph gives a description of the co-decision procedure

Forum: Interaction of State Aid, Free Movement, Policy Competition and Abuse Control in Direct Tax Matters

NARCIS (Netherlands)

Wattel, P.J.

2013-01-01

The European Union has woken up to State aid possibly contained in national direct tax measures. As a result, the number of Commission actions against Member States on the basis of fiscal State aid has increased in recent years, with some amazing results. It has also revealed overlap and

Epidemiological composition, clinical and treatment characteristics of the patient cohort of the german competence network for HIV/AIDS

Directory of Open Access Journals (Sweden)

Jansen K

2009-09-01

Full Text Available Abstract Objective As its central basis for research, the Competence Network for HIV/AIDS (KompNet established a nationwide cohort study on HIV-positive patients being in medical care in Germany. In this paper, we describe the epidemiological composition, and clinical as well as treatment characteristics of the KompNet cohort over time. Methods The KompNet cohort is an open, retrospective and prospective, multi-center, disease-specific and nationwide cohort study that started gathering data in June 2004. Semiannually, follow up visits of the patients are documented, covering a wide range of clinical and sociodemographic data. At enrolment and three years afterwards, an EDTA-sample is taken; a serum-sample is taken at every follow up. Results As of 20.10.2008, a total of 15,541 patients were enrolled by 44 documenting sites. In September 2007, the cohort size was reduced to ten outpatient clinics and fifteen private practitioners, covering a total of 9,410 patients. The documentation of these patients comprised 24,117 years of follow up-time since enrolment (mean: 2.6 years, 62,862 person years inclusive data documented retrospectively on course of HIV-infection and antiretroviral therapy (ART, mean: 6.7 years. Due to the short period of recruitment till now, rates of death (0.3%-0.8% and losses to follow up (1.1%-5.5% were low. 84.9% of patients were men. Main risk of transmission was sex between men (MSM: 62.9%. Mean age was 45 years. About two third of patients were classified as CDC-stage B or C. Therapy regimens of currently treated patients complied with recent guidelines. Trends of mean CD4 cell count/μl regarding the initial therapy and concerning the population under treatment reflected the developments and the changing standards of antiretroviral therapy over time. Conclusion The KompNet cohort covers about a quarter of all patients estimated as being under treatment in Germany. Its composition can be accounted approximately

[Problem issues related to HIV/AIDS in Eastern European and Central Asian countries].

Science.gov (United States)

Onishchenko, G G

2007-01-01

HIV has been spreading over the territories of our countries for 18 years, and it is still possible to resist the epidemic in a unique and efficient way. In June 2001, the UNO General Assembly Special Session was devoted to the problem of HIV/AIDS in full. Its Declaration of Commitment on HIV/AIDS (Resolution S-26/2) defines main directions of this work both in world-wide, regional, and international scopes. It should be stressed that first of all the Declaration emphasizes the necessity to improve management and coordination of efforts at the global, regional, and national levels, which is of special importance to Eastern Europe and Central Asia, where a new phase of HIV infection epidemic has begun and the spread of the virus grows and very soon may gain uncontrollable character. As for the countries of our region, here the epidemic process has been developing mostly through sexual way of transmission for 8 years since 1987, when the first case of HIV infection was revealed. More than 350000 HIV-infected people, including more than 15,000 children, have been registered in Russian Federation. More than 9000 people have died. The proportion of childbearing age women constantly grows, and the number of children born to mothers with AIDS has now exceeded 15,000. To realize the component "Prevention of HIV infection, B and C hepatitis, and revealing and treatment of HIV patients" of the priority national health project, 3.1 billion rubles are allocated for the prophylaxis of and fight against HIV and AIDS. The measures that are planned to take will allow for principle changes in the present situation with medical aid providence of contemporary antiretroviral medicines. Russian Orthodox Church with its parishes, monasteries etc. carries out numerous projects of primary HIV prophylaxis among children and young people in different regions; these projects are directed towards forming moral values.

Aids and Surgery

African Journals Online (AJOL)

user

2004-12-02

Dec 2, 2004 ... The correlation between HIV infection and surgery began to be highlighted only two ... expect greater clinical exposure to patients with. HIV/AIDS. .... fractures in HIV patient, although too little is known about the relationship ...

Computer-aided diagnosis and artificial intelligence in clinical imaging.

Science.gov (United States)

Shiraishi, Junji; Li, Qiang; Appelbaum, Daniel; Doi, Kunio

2011-11-01

Computer-aided diagnosis (CAD) is rapidly entering the radiology mainstream. It has already become a part of the routine clinical work for the detection of breast cancer with mammograms. The computer output is used as a "second opinion" in assisting radiologists' image interpretations. The computer algorithm generally consists of several steps that may include image processing, image feature analysis, and data classification via the use of tools such as artificial neural networks (ANN). In this article, we will explore these and other current processes that have come to be referred to as "artificial intelligence." One element of CAD, temporal subtraction, has been applied for enhancing interval changes and for suppressing unchanged structures (eg, normal structures) between 2 successive radiologic images. To reduce misregistration artifacts on the temporal subtraction images, a nonlinear image warping technique for matching the previous image to the current one has been developed. Development of the temporal subtraction method originated with chest radiographs, with the method subsequently being applied to chest computed tomography (CT) and nuclear medicine bone scans. The usefulness of the temporal subtraction method for bone scans was demonstrated by an observer study in which reading times and diagnostic accuracy improved significantly. An additional prospective clinical study verified that the temporal subtraction image could be used as a "second opinion" by radiologists with negligible detrimental effects. ANN was first used in 1990 for computerized differential diagnosis of interstitial lung diseases in CAD. Since then, ANN has been widely used in CAD schemes for the detection and diagnosis of various diseases in different imaging modalities, including the differential diagnosis of lung nodules and interstitial lung diseases in chest radiography, CT, and position emission tomography/CT. It is likely that CAD will be integrated into picture archiving and

Improvement of a Clinical Score for Necrotizing Fasciitis: 'Pain Out of Proportion' and High CRP Levels Aid the Diagnosis.

Science.gov (United States)

Borschitz, Thomas; Schlicht, Svenja; Siegel, Ekkehard; Hanke, Eric; von Stebut, Esther

2015-01-01

Necrotizing fasciitis (NF) is a rare mono-/polymicrobial skin infection that spreads to underlying tissues. NF is quickly progressing and leads to life threatening situations. Immediate surgical debridement together with i.v. antibiotic administration is required to avoid fatal outcome. Early diagnosis is often delayed due to underestimation or confusion with cellulitis. We now compared the initial clinical and laboratory presentation of NF and cellulitis in detail to assess if a typical pattern can be identified that aids timely diagnosis of NF and avoidance of fatal outcome. 138 different clinical and laboratory features of 29 NF patients were compared to those of 59 age- and gender matched patients with severe erysipelas requiring a subsequent hospitalization time of ≥10 days. Differences in clinical presentation were not obvious; however, NF patients suffered significantly more often from strong pain. NF patients exhibited dramatically elevated CRP levels (5-fold, p>0.001). The overall laboratory risk indicator for necrotizing fasciitis (LRINEC) score was significantly higher in NF patients as compared to cellulitis. However, a modification of the score (alteration of laboratory parameters, addition of clinical parameters) led to a clear improvement of the score with a higher positive predictive value without losing specificity. In summary, clinical differentiation of NF from cellulitis appears to be hard. 'Pain out of proportion' may be an early sign for NF. An improvement of the LRINEC score emphasizing only relevant laboratory and clinical findings as suggested may aid the early diagnosis of NF in the future leading to improvement of disease outcome by enabling rapid adequate therapy.

Parkinsonism and AIDS: a clinical comparative study before and after HAART

Directory of Open Access Journals (Sweden)

Ana Lucia Zuma de Rosso

2009-09-01

Full Text Available In 2002, after analyzing 28 HIV-positive patients with movement disorders we emphasized the decreasing not only of Parkinsonism but also of other involuntary movements in HIV patients in the last few years. The objective of this study is to compare the clinical results between HIV-positive patients with Parkinsonism before and after HAART. In 14 years (1986-1999 2,460 HIV-positive patients were seen in our Hospital 14 (0.6% of which presented with Parkinsonism. Eight years after (2000-2007 970 HIV positive patients were seen and only two (0.2% had Parkinsonism. We conclude that after the introduction of HAART there was an evident decrease in AIDS-related Parkinsonism.No ano de 2002, após analisarmos 28 pacientes HIV-positivos que apresentavam distúrbios do movimento, enfatizamos o declínio, não só do parkinsonismo, como também de outros movimentos involuntários em pacientes infectados pelo HIV nos últimos anos. O objetivo deste estudo é comparar os resultados clínicos entre pacientes HIV-positivos com parkinsonismo antes e depois da introdução do esquema HAART. Em 14 anos (1986-1999, 2.460 pacientes HIV-positivos foram avaliados em nosso Hospital dos quais 14 (0,6% apresentaram parkinsonismo. Nos oito anos seguintes (2000-2007, 970 pacientes HIV-positivos foram avaliados e somente dois (0,2% tinham parkinsonismo. Concluímos que após a introdução do esquema HAART houve evidente declínio do parkinsonismo secundário à AIDS.

Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar city, North West Ethiopia.

Science.gov (United States)

Alemu, Abebe; Shiferaw, Yitayal; Getnet, Gebeyaw; Yalew, Aregaw; Addis, Zelalem

2011-08-01

To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among HIV/AIDS patients in Bahir Dar. Cross-sectional study was conducted among HIV/AIDS patients attending Gambi higher clinic from April1-May 30, 2009. Convenient sampling technique was employed to identify the study subjects and hence a total of 248 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration and modified Ziehl-Neelsen staining technique. Out of 248 enrolled in the study, 171(69.0%) (90 males and 81 females) were infected with one or more intestinal parasites. The highest rate of intestinal parasites were observed among HIV/AIDS patients (80.3%, 151/188), and the infection rate of HIV negative individuals was 33.3% (20/60). Cryptosporidum parvum (43.6%), Isospora belli (15.5%) and Blastocystis hominis (10.5%) were opportunistic parasites that were found only in HIV/AIDS patients. Opportunistic parasite infections are common health problem among HIV/AIDS patients in the study area. Therefore, early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients. Copyright © 2011 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

European Symposium on Precision Medicine in Allergy and Airways Diseases: Report of the European Union Parliament Symposium (October 14, 2015)

NARCIS (Netherlands)

Muraro, A.; Fokkens, W. J.; Pietikainen, S.; Borrelli, D.; Agache, I.; Bousquet, J.; Costigliola, V.; Joos, G.; Lund, V. J.; Poulsen, L. K.; Price, D.; Rolland, C.; Zuberbier, T.; Hellings, P. W.

2016-01-01

The European Academy of Allergy and Clinical Immunology (EAACI), the European Rhinologic Society (ERS), and the European Medical Association (EMA) organized, on October 14, 2015, a symposium in the European Parliament in Brussels on Precision Medicine in Allergy and Airways Diseases, hosted by MEP

PSA velocity does not aid the detection of prostate cancer in men with a prior negative biopsy: data from the European Randomized Study of Prostate Cancer Screening in Göteborg, Sweden and Rotterdam, Netherlands

Science.gov (United States)

Vickers, Andrew J.; Wolters, Tineke; Savage, Caroline J.; Cronin, Angel M.; O’Brien, M. Frank; Roobol, Monique J.; Aus, Gunnar; Scardino, Peter T.; Hugosson, Jonas; Schröder, Fritz H.; Lilja, Hans

2012-01-01

Purpose Prostate specific antigen (PSA) velocity has been proposed as a marker to aid detection of prostate cancer. We sought to determine whether PSA velocity could predict the results of repeat biopsy in men with persistently elevated PSA after initial negative biopsy. Materials and Methods We identified 1,837 men who participated in the Göteborg or Rotterdam section of the European Randomized Screening study of Prostate Cancer (ERSPC), and who had one or more subsequent prostate biopsies after an initial negative finding. We evaluated whether PSA velocity improved predictive accuracy beyond that of PSA alone. Results There were a total of 2579 repeat biopsies, of which 363 (14%) were positive for prostate cancer, and 44 (1.7%) were high grade (Gleason score ≥7). Although PSA velocity was statistically associated with cancer risk (p<0.001), it had very low predictive accuracy (area-under-the-curve [AUC] of 0.55). There was some evidence that PSA velocity improved AUC compared to PSA for high grade cancer. However, the small increase in risk associated with high PSA velocity – from 1.7 % to 2.8% as velocity increased from 0 to 1 ng / ml / year - is of questionable clinical relevance. Conclusions Men with a prior negative biopsy have a lower risk for prostate cancer at subsequent biopsies, with high grade disease particularly rare. We found little evidence to support the use of PSA velocity to aid decisions about repeat biopsy for prostate cancer. PMID:20643434

Scientific and regulatory challenges in evaluating clinical trial protocols for HIV-1/AIDS vaccines - A review from a regulatory perspective.

Science.gov (United States)

Sheets, Rebecca L; Zhou, TieQun; Knezevic, Ivana

2016-03-01

Clinical development of prophylactic HIV/AIDS vaccines presents many scientific challenges that result in challenges for regulators reviewing clinical trial applications (CTAs). The World Health Organization (WHO) has the responsibility to provide technical support to these regulators. The search for an HIV/AIDS vaccine will only succeed through well-designed, -conducted and -controlled human efficacy studies reviewed and approved by regulators in countries worldwide, particularly in countries where the epidemic has hit hardest, such as in sub-Saharan Africa and Asia. This review summarizes the current candidates in development and focuses on challenges regulators face when reviewing CTAs, such as the evolving landscape of "standard of prevention," trials in adolescents, adaptive trial designs, correlates of protection and their analysis, and access to successful vaccines. There are many unknowns in the field of HIV/AIDS vaccine development and often, there is not a clear right or wrong approach because of the scientific challenges described in this review. Consequently, regulators should not feel that decisions need be made in isolation, when there are many available international collaborative efforts and opportunities to seek expert advice. The WHO provides many such opportunities and support to regulators across the globe. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of Computer-Aided Manufacturing Technology on Precision of Clinical Metal-Free Restorations.

Science.gov (United States)

Lee, Ki-Hong; Yeo, In-Sung; Wu, Benjamin M; Yang, Jae-Ho; Han, Jung-Suk; Kim, Sung-Hun; Yi, Yang-Jin; Kwon, Taek-Ka

2015-01-01

The purpose of this study was to investigate the marginal fit of metal-free crowns made by three different computer-aided design/computer-aided manufacturing (CAD/CAM) systems. The maxillary left first premolar of a dentiform was prepared for all-ceramic crown restoration. Thirty all-ceramic premolar crowns were made, ten each manufactured by the Lava system, Cercon, and Cerec. Ten metal ceramic gold (MCG) crowns served as control. The marginal gap of each sample was measured under a stereoscopic microscope at 75x magnification after cementation. One-way ANOVA and the Duncan's post hoc test were used for data analysis at the significance level of 0.05. The mean (standard deviation) marginal gaps were 70.5 (34.4) μm for the MCG crowns, 87.2 (22.8) μm for Lava, 58.5 (17.6) μm for Cercon, and 72.3 (30.8) μm for Cerec. There were no significant differences in the marginal fit among the groups except that the Cercon crowns had significantly smaller marginal gaps than the Lava crowns (P < 0.001). Within the limitation of this study, all the metal-free restorations made by the digital CAD/CAM systems had clinically acceptable marginal accuracy.

Pulmonary manifestation of AIDS

International Nuclear Information System (INIS)

Blum, U.; Dinkel, E.; Laaff, H.; Wuertemberger, G.; Senn, H.; Vaith, P.; Kroepelin, T.; Freiburg Univ.; Freiburg Univ.; Freiburg Univ.; Freiburg Univ.

1989-01-01

We reviewed retrospectively the clinical records of 28 patients with AIDS staged group IV according to CDC-criteria. Among these, 19 had pulmonary disease: most of them (n=17) had pneumocystis carinii pneumonia (Pcp). 12/17 patients with proven Pcp displayed typical X-ray findings with diffuse perihilar interstitial infiltration sparing lung periphery. 3/17 had atypical features and 2 normal chest x-ray findings. These data are important to identify patients with pulmonary complications of AIDS. (orig.) [de

Working memory and hearing aid processing: Literature findings, future directions, and clinical applications

Directory of Open Access Journals (Sweden)

Pamela eSouza

2015-12-01

Full Text Available Working memory—the ability to process and store information—has been identified as an important aspect of speech perception in difficult listening environments. Working memory can be envisioned as a limited-capacity system which is engaged when an input signal cannot be readily matched to a stored representation or template. This mismatch is expected to occur more frequently when the signal is degraded. Because working memory capacity varies among individuals, those with smaller capacity are expected to demonstrate poorer speech understanding when speech is degraded, such as in background noise. However, it is less clear whether (and how working memory should influence practical decisions, such as hearing treatment. Here, we consider the relationship between working memory capacity and response to specific hearing aid processing strategies. Three types of signal processing are considered, each of which will alter the acoustic signal: fast-acting wide-dynamic range compression, which smooths the amplitude envelope of the input signal; digital noise reduction, which may inadvertently remove speech signal components as it suppresses noise; and frequency compression, which alters the relationship between spectral peaks. For fast-acting wide-dynamic range compression, a growing body of data suggests that individuals with smaller working memory capacity may be more susceptible to such signal alterations, and may receive greater amplification benefit with low alteration processing. While the evidence for a relationship between wide-dynamic range compression and working memory appears robust, the effects of working memory on perceptual response to other forms of hearing aid signal processing are less clear cut. We conclude our review with a discussion of the opportunities (and challenges in translating information on individual working memory into clinical treatment, including clinically-feasible measures of working memory.

Working Memory and Hearing Aid Processing: Literature Findings, Future Directions, and Clinical Applications.

Science.gov (United States)

Souza, Pamela; Arehart, Kathryn; Neher, Tobias

2015-01-01

Working memory-the ability to process and store information-has been identified as an important aspect of speech perception in difficult listening environments. Working memory can be envisioned as a limited-capacity system which is engaged when an input signal cannot be readily matched to a stored representation or template. This "mismatch" is expected to occur more frequently when the signal is degraded. Because working memory capacity varies among individuals, those with smaller capacity are expected to demonstrate poorer speech understanding when speech is degraded, such as in background noise. However, it is less clear whether (and how) working memory should influence practical decisions, such as hearing treatment. Here, we consider the relationship between working memory capacity and response to specific hearing aid processing strategies. Three types of signal processing are considered, each of which will alter the acoustic signal: fast-acting wide-dynamic range compression, which smooths the amplitude envelope of the input signal; digital noise reduction, which may inadvertently remove speech signal components as it suppresses noise; and frequency compression, which alters the relationship between spectral peaks. For fast-acting wide-dynamic range compression, a growing body of data suggests that individuals with smaller working memory capacity may be more susceptible to such signal alterations, and may receive greater amplification benefit with "low alteration" processing. While the evidence for a relationship between wide-dynamic range compression and working memory appears robust, the effects of working memory on perceptual response to other forms of hearing aid signal processing are less clear cut. We conclude our review with a discussion of the opportunities (and challenges) in translating information on individual working memory into clinical treatment, including clinically feasible measures of working memory.

The cost of antiretroviral treatment service for patients with HIV/AIDS in a central outpatient clinic in Vietnam

Directory of Open Access Journals (Sweden)

Nguyen LT

2014-02-01

Full Text Available Long Thanh Nguyen,1 Bach Xuan Tran,2 Cuong Tuan Tran,1 Huong Thi Le,1 Son Van Tran1 1Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam; 2Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam Introduction: Antiretroviral treatment (ART services are estimated to account for 30% of the total resources needed for human immunodeficiency virus (HIV/acquired immunodeficiency syndrome (AIDS control and prevention in Vietnam during the 2011–2020 timeframe. With international funding decreasing, determining the total cost of HIV/AIDS treatment is necessary in order to develop a master plan for the transition of ART services delivery and management. We analyzed the costs of HIV/AIDS treatment paid by both HIV programs and patients in a central outpatient clinic, and we explored factors associated with the capacity of patients to pay for this service. Methods: Patients (n=315 receiving ART in the Department of Infectious Diseases at Bach Mai Hospital, Hanoi, Vietnam, were interviewed. Patient records and expenses were reviewed. Results: The total cost of ART per patient was US$611 (75% from health care providers, 25% from patients or their families. The cost of a second-line regimen was found to be 2.7 times higher than the first-line regimen cost. Most outpatients (73.3% were able to completely pay for all of their ART expenses. Capacity to pay for ART was influenced by five factors, including marital status, distance from house to clinic, patient's monthly income, household economic condition, and health insurance status. Most of the patients (84.8% would have been willing to pay for health insurance if a copayment scheme for ART were to be introduced. Conclusion: This study provides evidence on payment capacity of HIV/AIDS patients in Vietnam and supplies information on ART costs from both provider and patient perspectives. In particular, results from this study suggest that earlier access to ART

The Bolton Treovance abdominal stent-graft: European clinical trial design.

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Chiesa, R; Riambau, V; Coppi, G; Zipfel, B; Llagostera, S; Marone, E M; Kahlberg, A

2012-10-01

Endovascular aortic repair (EVAR) has emerged as a promising, less invasive alternative to conventional open surgery for the treatment of infrarenal abdominal aortic aneurysms (AAAs). In the last 20 years, the application rate of EVAR and its clinical results have significantly improved thanks to the evolution of stent-grafts and endovascular delivery systems. However, further development is still needed to reduce the incidence of complications and secondary re-interventions. The Treovance abdominal aortic stent-graft (Bolton Medical, Barcelona, Spain) is a new-generation endovascular device, developed to increase flexibility, lower profile, improve deployment and sealing mechanisms. In particular, it is provided with some innovative features as a double layer of proximal barbs (suprarenal and infrarenal) for supplemental fixation, dull barbs between modules to avoid potential leg disconnections, detachable outer sheath provided with a new-design hemostatic valve, and a double improved mechanism (slow motion and "pin and pull") for precise stent-graft deployment. A European prospective, non-randomized, multi-institutional, "first-in-human" trial (the ADVANCE trial) was conducted from March to December 2011 to assess the safety and performance of the Treovance stent-graft system before commercialization. Thirty patients with anatomically suitable non-ruptured AAAs were enrolled at five clinical sites in Italy, Spain, and Germany. EVAR was completed successfully in all patients. The stent-graft was delivered and deployed safely even in heavily angulated or calcified anatomies. No 30-day device-related complications nor deaths were observed. Preliminary experience with the Treovance abdominal stent-graft within the ADVANCE trial was satisfactory with regard to technical success and perioperative clinical results. Follow-up data are needed to assess mid- and long-term clinical outcomes, along with durability of this new-generation endovascular device.

Hydration and chemical ingredients in sport drinks: food safety in the European context.

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Urdampilleta, Aritz; Gómez-Zorita, Saioa; Soriano, José M; Martínez-Sanz, José M; Medina, Sonia; Gil-Izquierdo, Angel

2015-05-01

Before, during and after physical activity, hydration is a limiting factor in athletic performance. Therefore, adequate hydration provides benefits for health and performance of athletes. Besides, hydration is associated to the intake of carbohydrates, protein, sodium, caffeine and other substances by different dietary aids, during the training and/or competition by athletes. These requirements have led to the development of different products by the food industry, to cover the nutritional needs of athletes. Currently in the European context, the legal framework for the development of products, substances and health claims concerning to sport products is incomplete and scarce. Under these conditions, there are many products with different ingredients out of European Food Safety Authority (EFSA) control where claims are wrong due to no robust scientific evidence and it can be dangerous for the health. Further scientific evidence should be constructed by new clinical trials in order to assist to the Experts Commitees at EFSA for obtaining robust scientific opinions concerning to the functional foods and the individual ingredients for sport population. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Knowledge and attitude of Indian clinical dental students towards the dental treatment of patients with human immunodeficiency virus (HIV)/acquired immune-deficiency syndrome (AIDS).

Science.gov (United States)

Oberoi, Sukhvinder Singh; Marya, Charu Mohan; Sharma, Nilima; Mohanty, Vikrant; Marwah, Mohita; Oberoi, Avneet

2014-12-01

Oral health care of patients with human immunodeficiency virus (HIV)/acquired immune-deficiency syndrome (AIDS) is a growing area of concern. Information on HIV- and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS. The purpose of this study was to assess the knowledge and attitude of Indian clinical dental students towards the treatment of patients with HIV/AIDS and perceived sources of information regarding HIV-related issues. Data were collected from clinical dental students (third year, fourth year and internship) from three dental institutions in Delhi National Capital Region (NCR). The questions assessed the knowledge and attitude towards treatment of patients with HIV and the perceived source of information related to HIV. The willingness to treat HIV-positive patients among dental students was 67.0%, and 74.20% were confident of treating a patient with HIV/AIDS. The potential problems in rendering treatment to these patients were effect on the attitude of other patients (49.90%) and staff fears (52.50%). The correct knowledge regarding the infection-control practice (barrier technique) was found among only 15.50% of respondents. The respondents had sufficient knowledge regarding the oral manifestations of HIV/AIDS. There was no correlation between the knowledge and attitude score, demonstrating a gap between knowledge and attitude among dental students regarding treatment of HIV-infected patients. Appropriate knowledge has to be delivered through the dental education curriculum, which can instil confidence in students about their ability to manage HIV-positive patients. © 2014 FDI World Dental Federation.

Pediatric Clinical Trials Conducted in South Korea from 2006 to 2015: An Analysis of the South Korean Clinical Research Information Service, US ClinicalTrials.gov and European Clinical Trials Registries.

Science.gov (United States)

Choi, Sheung-Nyoung; Lee, Ji-Hyun; Song, In-Kyung; Kim, Eun-Hee; Kim, Jin-Tae; Kim, Hee-Soo

2017-12-01

The status of pediatric clinical trials performed in South Korea in the last decade, including clinical trials of drugs with unapproved indications for children, has not been previously examined. The aim was to provide information regarding the current state of pediatric clinical trials and create a basis for future trials performed in South Korea by reviewing three databases of clinical trials registrations. We searched for pediatric clinical studies (participants South Korea between 2006 and 2015 registered on the Clinical Research Information Service (CRIS), ClinicalTrials.gov, and the European Clinical Trials Registry (EuCTR). Additionally, we reviewed whether unapproved indications were involved in each trial by comparing the trials with a list of authorized trials provided by the Ministry of Food and Drug Safety (MFDS). The primary and secondary outcomes were to determine the change in number of pediatric clinical trials with unapproved indications over time and to assess the status of unauthorized pediatric clinical trials from the MFDS and the publication of articles after these clinical trials, respectively. We identified 342 clinical studies registered in the CRIS (n = 81), ClinicalTrials.gov (n = 225), and EuCTR (n = 36), of which 306 were reviewed after excluding duplicate registrations. Among them, 181 studies were interventional trials dealing with drugs and biological agents, of which 129 (71.3%) involved unapproved drugs. Of these 129 trials, 107 (82.9%) were authorized by the MFDS. Pediatric clinical trials in South Korea aiming to establish the safety and efficacy of drugs in children are increasing; however, non-MFDS-authorized studies remain an issue.

The EC4 European syllabus for post-graduate training in clinical chemistry and laboratory medicine: version 4--2012.

Science.gov (United States)

Wieringa, Gijsbert; Zerah, Simone; Jansen, Rob; Simundic, Ana-Maria; Queralto, José; Solnica, Bogdan; Gruson, Damien; Tomberg, Karel; Riittinen, Leena; Baum, Hannsjörg; Brochet, Jean-Philippe; Buhagiar, Gerald; Charilaou, Charis; Grigore, Camelia; Johnsen, Anders H; Kappelmayer, Janos; Majkic-Singh, Nada; Nubile, Giuseppe; O'Mullane, John; Opp, Matthias; Pupure, Silvija; Racek, Jaroslav; Reguengo, Henrique; Rizos, Demetrios; Rogic, Dunja; Špaňár, Július; Štrakl, Greta; Szekeres, Thomas; Tzatchev, Kamen; Vitkus, Dalius; Wallemacq, Pierre; Wallinder, Hans

2012-08-01

Laboratory medicine's practitioners across the European community include medical, scientific and pharmacy trained specialists whose contributions to health and healthcare is in the application of diagnostic tests for screening and early detection of disease, differential diagnosis, monitoring, management and treatment of patients, and their prognostic assessment. In submitting a revised common syllabus for post-graduate education and training across the 27 member states an expectation is set for harmonised, high quality, safe practice. In this regard an extended 'Core knowledge, skills and competencies' division embracing all laboratory medicine disciplines is described. For the first time the syllabus identifies the competencies required to meet clinical leadership demands for defining, directing and assuring the efficiency and effectiveness of laboratory services as well as expectations in translating knowledge and skills into ability to practice. In a 'Specialist knowledge' division, the expectations from the individual disciplines of Clinical Chemistry/Immunology, Haematology/Blood Transfusion, Microbiology/ Virology, Genetics and In Vitro Fertilisation are described. Beyond providing a common platform of knowledge, skills and competency, the syllabus supports the aims of the European Commission in providing safeguards to increasing professional mobility across European borders at a time when demand for highly qualified professionals is increasing and the labour force is declining. It continues to act as a guide for the formulation of national programmes supplemented by the needs of individual country priorities.

An automated tuberculosis screening strategy combining X-ray-based computer-aided detection and clinical information

Science.gov (United States)

Melendez, Jaime; Sánchez, Clara I.; Philipsen, Rick H. H. M.; Maduskar, Pragnya; Dawson, Rodney; Theron, Grant; Dheda, Keertan; van Ginneken, Bram

2016-04-01

Lack of human resources and radiological interpretation expertise impair tuberculosis (TB) screening programmes in TB-endemic countries. Computer-aided detection (CAD) constitutes a viable alternative for chest radiograph (CXR) reading. However, no automated techniques that exploit the additional clinical information typically available during screening exist. To address this issue and optimally exploit this information, a machine learning-based combination framework is introduced. We have evaluated this framework on a database containing 392 patient records from suspected TB subjects prospectively recruited in Cape Town, South Africa. Each record comprised a CAD score, automatically computed from a CXR, and 12 clinical features. Comparisons with strategies relying on either CAD scores or clinical information alone were performed. Our results indicate that the combination framework outperforms the individual strategies in terms of the area under the receiving operating characteristic curve (0.84 versus 0.78 and 0.72), specificity at 95% sensitivity (49% versus 24% and 31%) and negative predictive value (98% versus 95% and 96%). Thus, it is believed that combining CAD and clinical information to estimate the risk of active disease is a promising tool for TB screening.

Exploring the Healthcare Environment and Associations with Clinical Outcomes of People Living with HIV/AIDS.

Science.gov (United States)

Hawk, Mary; Coulter, Robert W S; Egan, James E; Friedman, Mackey Reuel; Meanley, Steven; Fisk, Stuart; Watson, Courtney; Kinsky, Suzanne

2017-12-01

Despite three decades of dramatic treatment breakthroughs in antiretroviral regimens, clinical outcomes for people living with HIV vary greatly. The HIV treatment cascade models the stages of care that people living with HIV go through toward the goal of viral suppression and demonstrates that <30% of those living with HIV/AIDS in the United States have met this goal. Although some research has focused on the ways that patient characteristics and patient-provider relationships contribute to clinical adherence and treatment success, few studies to date have examined the ways that contextual factors of care and the healthcare environment contribute to patient outcomes. Here, we present qualitative findings from a mixed-methods study to describe contextual and healthcare environment factors in a Ryan White Part C clinic that are associated with patients' abilities to achieve viral suppression. We propose a modification of Andersen's Behavioral Model of Health Services Utilization, and its more recent adaptation developed by Ulett et al., to describe the ways that clinic, system, and provider factors merge to create a system of care in which more than 86% of the patient population is virally suppressed.

EDCTP regional networks of excellence: initial merits for planned clinical trials in Africa.

Science.gov (United States)

Miiro, George M; Oukem-Boyer, Odile Ouwe Missi; Sarr, Ousmane; Rahmani, Maerangis; Ntoumi, Francine; Dheda, Keertan; Pym, Alexander; Mboup, Souleymane; Kaleebu, Pontiano

2013-03-22

Achieving the Millennium Development Goals (MDGs) and combating hotspots with escalating but preventable communicable diseases remain major challenges in Africa. The European and Developing Countries Clinical Trials Partnership (EDCTP) intervened to combat poverty-related diseases including malaria, tuberculosis and HIV/AIDS, and to conduct multi-centre clinical trials and multi-disciplinary health research through an innovative model of regional Networks of Excellence (NoEs). We participated in a quasi-formative evaluation between October and December 2011 on the 4 regional-led research networks. These included the: Central Africa Network on Tuberculosis, HIV/AIDS and Malaria (CANTAM); East African Consortium for Clinical Research (EACCR); West African Network of Excellence for TB, AIDS and Malaria (WANETAM), and the Trials of Excellence for Southern Africa (TESA) launched between 2009 and 2010. We shared a participatory appraisal of field reports, progress reports and presentations from each network to jointly outline the initial experiences of the merits, outputs and lessons learnt. The self-regulating democratic networks, with 64 institutions in 21 African countries, have trained over 1, 000 African scientists, upgraded 36 sites for clinical trials, leveraged additional € 24 million and generated 38 peer-reviewed publications through networking and partnerships. The shared initial merits and lessons learnt portray in part the strengthened capacity of these networks for improved research coordination and conduct of planned multi-center clinical trials in Africa. Increased funding by African agencies, governments and international health partners will ensure sustainability of these networks for research capacity development and demonstrate their commitment to achieving the MDGs in Africa.

Executive summary of final evaluation: ActionAid women’s right to land

OpenAIRE

Forsythe, Lora; Wellard, Kate

2014-01-01

The Women’s Rights to Land (WRL) programme aimed to support women’s movements from marginalised communities, including indigenous women in Guatemala, Dalit women in India, and women living with HIV/AIDS in Sierra Leone, to improve their access and control over land. Theprogramme ran from November 2010 to October 2013 and was funded by the European Commission (EC). ActionAid commissioned the Natural Resources Institute to conduct a final evaluation of the programme, the results of which are pr...

China’s Foreign Aid and Its Role in the International Architecture

Directory of Open Access Journals (Sweden)

Meibo Huang

2012-03-01

Full Text Available Published by Palgrave MacmillanThough China has long been an aid provider, the recent and remarkable surge in China’s foreign aid has important implications for the global aid architecture. It relies on aid principles that diverge in many ways from those of traditional Development Assistance Committee (DAC donor countries, particularly in relation to non-interference, mutual benefit and non-conditionality. China’s foreign aid also relies on a mixing of economic cooperation, trade and investment deals. While several Western scholars have examined the Chinese development cooperation system, few voices from China have been heard in European and North American journals and media. This chapter aims to offer a Chinese perspective on the evolution of China’s foreign aid. It focuses on the aid principles that have thus far informed Chinese development assistance, highlighting the successful outcomes achieved so far in Africa and South-East Asia. The chapter also addresses the main shortcomings of the Chinese approach, by recommending the improvement of institutional transparency, and strengthening of dialogue with DAC donors, all with a view towards learning from past experiences and exchanging best practices.

Multicriteria methodology for decision aiding

CERN Document Server

Roy, Bernard

1996-01-01

This is the first comprehensive book to present, in English, the multicriteria methodology for decision aiding In the foreword the distinctive features and main ideas of the European School of MCDA are outlined The twelve chapters are essentially expository in nature, but scholarly in treatment Some questions, which are too often neglected in the literature on decision theory, such as how is a decision made, who are the actors, what is a decision aiding model, how to define the set of alternatives, are discussed Examples are used throughout the book to illustrate the various concepts Ways to model the consequences of each alternative and building criteria taking into account the inevitable imprecisions, uncertainties and indeterminations are described and illustrated The three classical operational approaches of MCDA synthesis in one criterion (including MAUT), synthesis by outranking relations, interactive local judgements, are studied This methodology tries to be a theoretical or intellectual framework dire...

Effects of Computer-Aided Manufacturing Technology on Precision of Clinical Metal-Free Restorations

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Ki-Hong Lee

2015-01-01

Full Text Available Purpose. The purpose of this study was to investigate the marginal fit of metal-free crowns made by three different computer-aided design/computer-aided manufacturing (CAD/CAM systems. Materials and Methods. The maxillary left first premolar of a dentiform was prepared for all-ceramic crown restoration. Thirty all-ceramic premolar crowns were made, ten each manufactured by the Lava system, Cercon, and Cerec. Ten metal ceramic gold (MCG crowns served as control. The marginal gap of each sample was measured under a stereoscopic microscope at 75x magnification after cementation. One-way ANOVA and the Duncan’s post hoc test were used for data analysis at the significance level of 0.05. Results. The mean (standard deviation marginal gaps were 70.5 (34.4 μm for the MCG crowns, 87.2 (22.8 μm for Lava, 58.5 (17.6 μm for Cercon, and 72.3 (30.8 μm for Cerec. There were no significant differences in the marginal fit among the groups except that the Cercon crowns had significantly smaller marginal gaps than the Lava crowns (P<0.001.  Conclusions. Within the limitation of this study, all the metal-free restorations made by the digital CAD/CAM systems had clinically acceptable marginal accuracy.

Green paper. Towards a European strategy for the security of energy supply

International Nuclear Information System (INIS)

2001-01-01

This Green Paper is the response to an observable fact: Europe growing future energy dependence. Its aim is to initiate a debate on the security of energy supply, an issue that is still very much alive. Three main points emerge from the Green Paper: the European Union will become increasingly dependent on external energy sources; enlargement will not change the situation; based on current forecasts, dependence will reach 70 % in 2030; the European Union has very limited scope to influence energy supply conditions (it is essentially on the demand side that the EU can intervene, mainly by promoting energy saving in buildings and the transport sector); at present, the European Union is not in a position to respond to the challenge of climate change and to meet its commitments, notably under the Kyoto Protocol. In these circumstances, the Commission would like the debate on the future strategy to be structured around the following principal questions: 1. Can the European Union accept an increase in its dependence on external energy sources without compromising its security of supply and European competitiveness? 2. Does not Europe increasingly integrated internal market, where decisions taken in one country have an impact on the others, call for a consistent and coordinated policy at Community level? What should such a policy consist of and where should competition rules fit in? 3. Are tax and State aid policies in the energy sector an obstacle to competitiveness in the European Union or not? 4. In the framework of an ongoing dialogue with producer countries, what should supply and investment promotion agreements contain? Given the importance of a partnership with Russia in particular, how can stable quantities, prices and investments be guaranteed? 5. Should more reserves be stockpiled, as already done for oils, and should other energy sources be included, such as gas or coal? Does the risk of physical disruption to energy supplies justify more onerous measures for

Green paper. Towards a European strategy for the security of energy supply

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

This Green Paper is the response to an observable fact: Europe growing future energy dependence. Its aim is to initiate a debate on the security of energy supply, an issue that is still very much alive. Three main points emerge from the Green Paper: the European Union will become increasingly dependent on external energy sources; enlargement will not change the situation; based on current forecasts, dependence will reach 70 % in 2030; the European Union has very limited scope to influence energy supply conditions (it is essentially on the demand side that the EU can intervene, mainly by promoting energy saving in buildings and the transport sector); at present, the European Union is not in a position to respond to the challenge of climate change and to meet its commitments, notably under the Kyoto Protocol. In these circumstances, the Commission would like the debate on the future strategy to be structured around the following principal questions: 1. Can the European Union accept an increase in its dependence on external energy sources without compromising its security of supply and European competitiveness? 2. Does not Europe increasingly integrated internal market, where decisions taken in one country have an impact on the others, call for a consistent and coordinated policy at Community level? What should such a policy consist of and where should competition rules fit in? 3. Are tax and State aid policies in the energy sector an obstacle to competitiveness in the European Union or not? 4. In the framework of an ongoing dialogue with producer countries, what should supply and investment promotion agreements contain? Given the importance of a partnership with Russia in particular, how can stable quantities, prices and investments be guaranteed? 5. Should more reserves be stockpiled, as already done for oils, and should other energy sources be included, such as gas or coal? Does the risk of physical disruption to energy supplies justify more onerous measures for

Translation, Cultural Adaptation and Validation of the Satisfaction with Amplification in Daily Life Scale for European Portuguese

Directory of Open Access Journals (Sweden)

Luis Roque dos Reis

2017-02-01

Conclusion: This adaptation of the Satisfaction with Amplification in Daily Life questionnaire for European Portuguese speakers should be considered a good tool for evaluation of the level of satisfaction of hearing aid users, and until now, is the only available scale for speakers of European Portuguese.

Patient-reported outcomes among patients using exenatide twice daily or insulin in clinical practice in six European countries

DEFF Research Database (Denmark)

Reaney, Matthew; Mathieu, Chantal; Ostenson, Claes-Göran

2013-01-01

who did not meet this endpoint) and Diabetes Health Profile-18 scores (versus the main cohorts). High levels of missing data were observed for all PRO measures in both cohorts compared with those for clinical outcomes. CONCLUSIONS: These data from a clinical practice study support those from clinical...... clinical practice are lacking. We examined PROs in patients initiating injectable treatment in the CHOICE (CHanges to treatment and Outcomes in patients with type 2 diabetes initiating InjeCtablE therapy) study. METHODS: CHOICE was a 24-month, prospective observational study conducted in six European......BACKGROUND: Improvements in the clinical condition of patients with type 2 diabetes are often accompanied by improvements in health-related quality of life and other patient-reported outcomes (PROs), but data assessing injectable treatment initiation from the patient's perspective in routine...

[The incidence, etiology and clinical significance of visceral mycoses in patients with AIDS].

Science.gov (United States)

Manfredi, R; Nanetti, A; Mazzoni, A; Mastroianni, A; Chiodo, F

1993-01-01

The incidence, aetiology and clinical significance of visceral mycoses in HIV-infected subjects were evaluated by a retrospective survey of the clinical and microbiological records of 237 consecutive AIDS patients followed-up since 1984. Seventy-four patients out of 237 (31.2%) (56 males, 18 females; 55 IV drug abusers, 7 heterosexuals, 6 homobisexuals, 3 blood recipients and 3 children with congenitally-acquired HIV infection) presented 77 different episodes of visceral fungal infection as a whole, represented by candidiasis in 56 cases (oesophageal 45, pulmonary 5, sepsis 2, eye involvement 2, endocarditis and invasive oropharyngeal infection in the remaining 2 patients), cryptococcosis in 17 cases (meningoencephalitis in all subjects, with disseminated infection in 11 of them), and aspergillosis in 4 cases (pulmonary 2, cerebral and cranio-facial in the remaining 2 patients). In 57 out of 74 patients (77%), visceral mycoses were diagnostic or concurrent with the diagnosis of AIDS. Fungal diseases, as a whole, showed a significantly higher incidence (p drug abusers, whereas homobisexual men presented a significantly lower frequency (p test) than AIDS patients with other risk factors for HIV infection. The onset of cryptococcosis was significantly associated with the male sex (p test). All subjects suffering from a visceral mycosis were severely immunosuppressed, with a higher rate of neutropenia in patients developing Candida and Aspergillus spp. infection (23 out of 56 patients with visceral candidiasis and 3 out of 4 cases of aspergillosis had an absolute neutrophil count lower than 1500 cells/mm3), while a severe reduction in CD4+ lymphocyte count was more evident among patients with cryptococcosis (13 out of 17 patients had a CD4+ cell count lower than 50/mm3). After remission of the primary episode of fungal infection (obtained in 80.5% of cases), the incidence of relapse observed in a long follow-up period (mean time 57.6 +/- 39.2 weeks) was elevated both

Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

Science.gov (United States)

Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

2014-07-01

Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and

State aid in the Austrian electricity industry law

International Nuclear Information System (INIS)

Rehulka, J.

2009-01-01

The present work deals with the existence of State aid in the Austrian electricity industry and focuses on three selected areas of the Austrian legal system, which are examined for their compatibility with Community law. Subject of the first part of this work is a representation of the article 87 ff Treaty of Rome and its impact on Austrian provisions on the promotion of electricity from renewable energies or on the promotion of cogeneration energy. In this context, the first principles of the European state aid law and in particular the European Court are presented regarding the existence of State aid. Here, the Rsp of the Court in connection with the use of State resources in the Rs PreussenElektra Stardust Marine and Pearle is paid in connection with para-fiscal levies special attention. The evaluation of the Austrian support model is based on PreussenElektra, Stardust Marine and Pearle. Then the system of green electricity production in Austria represented. In addition to the Community law principles (green power directive, frameworks and guidelines for environmental aid) is here in particular the 'Oekostromgesetz' and treated it's novellas. It is an intensive discussion with the Commission's decisions on the compatibility of the green power and CHP funding and the funding of the countries with state aid rules. As part of this analysis is to attempt a classification of the Commission's practice in the Community legal system. The second part of the work deals with the determination of absorbed. System utilization rates and their distribution to the network operator. After a presentation of the Community legislation (EC regulations, the internal electricity market directives) and Rsp of the European Court of Justice (Case ADBHu, Ferring, Altmark Trans) to services of general economic interest is first attempted to determine the presence of these services in the 216 Austrian legislation. Here, the question will be, entrusted with services of general economic

The European standard series in 9 European countries, 2002/2003 -- first results of the European Surveillance System on Contact Allergies

DEFF Research Database (Denmark)

Uter, W; Hegewald, J; Aberer, W

2005-01-01

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series...... observed. The prevalence of contact allergy to Myroxylon pereirae resin (balsam of Peru) (5.8%) is coming close to the frequency found with the fragrance mix (6.4%). Regarding contact allergy to chromium compounds, different frequencies were noted in the 2 centres focused on occupational dermatitis (2......-marketing surveillance in the field of contact allergy, ESSCA will meet its objective of increased consumer safety across Europe....

Dermatology and HIV/AIDS in Africa

Directory of Open Access Journals (Sweden)

Jenny Hu

2011-01-01

Full Text Available Human immunodeficiency virus and the acquired immunodeficiency syndrome (HIV/AIDS have greatly complicated dermatologic disease and the required care in most regions of Africa. Opportunistic infections, ectoparasites, Kaposi sarcoma, and skin manifestations of systemic infections are exceedingly common in patients with HIV/AIDS. Dermatologists have contributed significantly to our knowledge base about HIV/AIDS and have played an important educational role regarding the clinical manifestations historically. Because of the increased burden of skin disease in Africa due to the HIV/AIDS epidemic we must redouble our efforts to provide dermatology education to care providers in Africa. We review the burden of skin disease in Africa, how it relates to HIV/AIDS and global infectious disease, current educational strategies in Africa to address this need, and suggest potential solutions to move these efforts forward.

Variability of bio-clinical parameters in Chinese-origin Rhesus macaques infected with simian immunodeficiency virus: a nonhuman primate AIDS model.

Directory of Open Access Journals (Sweden)

Song Chen

Full Text Available BACKGROUND: Although Chinese-origin Rhesus macaques (Ch RhMs infected with simian immunodeficiency virus (SIV have been used for many years to evaluate the efficacy of AIDS vaccines and therapeutics, the bio-clinical variability of such a nonhuman primate AIDS model was so far not established. METHODOLOGY/PRINCIPAL FINDINGS: By randomizing 150 (78 male and 72 female Ch RhMs with diverse MHC class I alleles into 3 groups (50 animals per group challenged with intrarectal (i.r. SIVmac239, intravenous (i.v. SIVmac239, or i.v. SIVmac251, we evaluated variability in bio-clinical endpoints for 118 weeks. All SIV-challenged Ch RhMs became seropositive for SIV during 1-2 weeks. Plasma viral load (VL peaked at weeks 1-2 and then declined to set-point levels as from week 5. The set-point VL was 30 fold higher in SIVmac239 (i.r. or i.v.-infected than in SIVmac251 (i.v.-infected animals. This difference in plasma VL increased overtime (>100 fold as from week 68. The rates of progression to AIDS or death were more rapid in SIVmac239 (i.r. or i.v.-infected than in SIVmac251 (i.v.-infected animals. No significant difference in bio-clinical endpoints was observed in animals challenged with i.r. or i.v. SIVmac239. The variability (standard deviation in peak/set-point VL was nearly one-half lower in animals infected with SIVmac239 (i.r. or i.v. than in those infected with SIVmac251 (i.v., allowing that the same treatment-related difference can be detected with one-half fewer animals using SIVmac239 than using SIVmac251. CONCLUSION/SIGNIFICANCE: These results provide solid estimates of variability in bio-clinical endpoints needed when designing studies using the Ch RhM SIV model and contribute to the improving quality and standardization of preclinical studies.

Bourdieu, International Relations and European Security

DEFF Research Database (Denmark)

Berling, Trine Villumsen

2012-01-01

Despite promising attempts to apply the sociology of Pierre Bourdieu to International Relations (IR), the field could still profit from unexplored potential in his thinking for understanding pivotal theoretical and empirical puzzles. This article takes the failure to fully grasp the paradigmatic...... case of European security after the Cold War as an example of how IR would benefit from reformulating not only its empirical research questions but also several of its central conceptual building blocks with the aid of Bourdieusian sociology. The separation between theory and practice...... and the overemphasis on military power and state actors blind IR from seeing the power struggles that reshaped European security. Instead, a Bourdieusian reformulation adds new types of agency, focuses on the social production of forms of power, and stresses the processual rather than the substantive character...

Lung complications in AIDS

International Nuclear Information System (INIS)

Weiske, R.; Buck, J.; Schneider, R.; Hannemann, T.; Krauss, B.

1986-01-01

A short description of epidemiologic and clinical facts correlated with the acquired immunodeficiency syndrome (AIDS) is followed by a report on the manifestation of pulmonary infections mostly effected by pneumocystis carinii. Two examples out of four cases will demonstrate the radiographic appearance of the pneumocystis carinii pneumonia and clinical data. Only in rare cases does it seem possible to reduce the fatal outcome by early diagnosis. (orig.) [de

Farm level optimal water management : assistant for irrigation under deficit (FLOW-AID)

NARCIS (Netherlands)

Balendonck, J.; Stanghellini, C.; Hemming, J.; Kempkes, F.L.K.; Tuijl, van B.A.J.

2008-01-01

FLOW-AID is an on-going 6th Framework European project (2006-2009) with the objective to contribute to sustainable irrigated agriculture by developing an irrigation management system that can be used for crop production in cases with limited water supply and marginal water quality. The project

Farm level optimal water management: Assistant for irrigation under Defecit (FLOW-AID)

NARCIS (Netherlands)

Balendonck, J.; Stanghellini, C.; Hemming, J.; Kempkes, F.L.K.; Tuijl, van B.A.J.

2009-01-01

Flow-aid is an on-going 6th Framework European project (2006-2009) with the objective to contribute to sustainable irrigated agriculture by developing an irrigation management system that can be used for crop production in cases with limited water supply and marginal water quality. The project

[Clinical and bacteriological profiles of the urinary infections associated the VIH/AIDS in hospital area of Bamako, Mali].

Science.gov (United States)

Dao, S; Oumar, A A; Dembele, J P; Noutache, J L; Fongoro, S; Maiga, I; Bougoudogo, F

2007-01-01

The syndrome of immunodepression is the bed of multiple infections of which urinary infections. The goal of this study was to determine the aspects clinical and bacteriological urinary infections during the AIDS with the service of the infectious diseases of the hospital of the Point G of February 1, 2003 to June 30 2005. The diagnosis of the urinary infection was retained on the basis of bacteria number > or =10(4) bacteriury and or leucocytes count > or =10(5)/mm3. The prevalence of the urinary infection was estimated at 8.85%. The principal clinical aspects were a symptomatic pyelonephritis 73.5%, the leucocytiury 11.8%, the cystitis 8.8%, and acute prostatitis 5.9%. Escherichia coli was the most frequent bacterium (46.7%). The sensitivity of the germs was 91.7% with the aminosides, 90.9% with the fluoroquinolones, from 63.6 to 80% respectively with the cephalosporines of first and second generation. Resistance to ampicilline, chloramphenicol and sulfamides was about 72 and 80%. The systematic research of the urinary infection is necessary during the AIDS and the antibiotherapy of choice in first intention in absence of etiologic possibility of diagnosis should be the aminosides and or the fluoroquinolones.

Encounter Decision Aid vs. Clinical Decision Support or Usual Care to Support Patient-Centered Treatment Decisions in Osteoporosis: The Osteoporosis Choice Randomized Trial II.

Directory of Open Access Journals (Sweden)

Annie LeBlanc

Full Text Available Osteoporosis Choice, an encounter decision aid, can engage patients and clinicians in shared decision making about osteoporosis treatment. Its effectiveness compared to the routine provision to clinicians of the patient's estimated risk of fracture using the FRAX calculator is unknown.Patient-level, randomized, three-arm trial enrolling women over 50 with osteopenia or osteoporosis eligible for treatment with bisphosphonates, where the use of Osteoporosis Choice was compared to FRAX only and to usual care to determine impact on patient knowledge, decisional conflict, involvement in the decision-making process, decision to start and adherence to bisphosphonates.We enrolled 79 women in the three arms. Because FRAX estimation alone and usual care produced similar results, we grouped them for analysis. Compared to these, use of Osteoporosis Choice increased patient knowledge (median score 6 vs. 4, p = .01, improved understanding of fracture risk and risk reduction with bisphosphonates (p = .01 and p<.0001, respectively, had no effect on decision conflict, and increased patient engagement in the decision making process (OPTION scores 57% vs. 43%, p = .001. Encounters with the decision aid were 0.8 minutes longer (range: 33 minutes shorter to 3.0 minutes longer. There were twice as many patients receiving and filling prescriptions in the decision aid arm (83% vs. 40%, p = .07; medication adherence at 6 months was no different across arms.Supporting both patients and clinicians during the clinical encounter with the Osteoporosis Choice decision aid efficiently improves treatment decision making when compared to usual care with or without clinical decision support with FRAX results.clinical trials.gov NCT00949611.

Knowledge, Attitude and Practice in First Aid Management of ...

African Journals Online (AJOL)

Knowledge, Attitude and Practice in First Aid Management of Epistaxis by ... A vast majority of these patients settle with simple standard first aid measures. ... The principal researcher administered a questionnaire to the clinical staffs who were ...

Now that you want to take your HIV/AIDS vaccine/biological product research concept into the clinic: what are the "cGMP"?

Science.gov (United States)

Sheets, Rebecca L; Rangavajhula, Vijaya; Pullen, Jeffrey K; Butler, Chris; Mehra, Vijay; Shapiro, Stuart; Pensiero, Michael

2015-04-08

The Division of AIDS Vaccine Research Program funds the discovery and development of HIV/AIDS vaccine candidates. Basic researchers, having discovered a potential vaccine in the laboratory, next want to take that candidate into the clinic to test the concept in humans, to see if it translates. Many of them have heard of "cGMP" and know that they are supposed to make a "GMP product" to take into the clinic, but often they are not very familiar with what "cGMP" means and why these good practices are so important. As members of the Vaccine Translational Research Branch, we frequently get asked "can't we use the material we made in the lab in the clinic?" or "aren't Phase 1 studies exempt from cGMP?" Over the years, we have had many experiences where researchers or their selected contract manufacturing organizations have not applied an appropriate degree of compliance with cGMP suitable for the clinical phase of development. We share some of these experiences and the lessons learned, along with explaining the importance of cGMP, just what cGMP means, and what they can assure, in an effort to de-mystify this subject and facilitate the rapid and safe translational development of HIV vaccines. Published by Elsevier Ltd.

Recommendations for an update of the 2010 European regulatory guideline on clinical investigation of medicinal products used in the treatment of osteoarthritis and reflections about related clinically relevant outcomes: expert consensus statement.

Science.gov (United States)

Reginster, J-Y; Reiter-Niesert, S; Bruyère, O; Berenbaum, F; Brandi, M-L; Branco, J; Devogelaer, J-P; Herrero-Beaumont, G; Kanis, J; Maggi, S; Maheu, E; Richette, P; Rizzoli, R; Cooper, C

2015-12-01

The European Society on Clinical and Economic aspects of Osteoporosis and Osteoarthritis (ESCEO) organised a working group to evaluate the need for updating the current European guideline on clinical investigation of drugs used in the treatment of osteoarthritis (OA). Areas of potential attention were identified and the need for modifications, update or clarification was examined. Proposals were then developed based on literature reviews and through a consensus process. It was agreed that the current guideline overall still reflects the current knowledge in OA, although two possible modifications were identified. The first relates to the number and timing of measurements required as primary endpoints during clinical trials of symptom-relieving drugs, either drugs with rapid onset of action or slow acting drugs. The suggested modifications are intended to take into consideration the time related clinical need and expected time response to these drugs - i.e., a more early effect for the first category in addition to the maintenance of effect, a more continuous benefit over the long-term for the latter - in the timing of assessments. Secondly, values above which a benefit over placebo should be considered clinically relevant were considered. Based on literature reviews, the most consensual values were determined for primary endpoints of both symptom-relieving drugs (i.e., pain intensity on a visual analogue scale (VAS)) and disease-modifying drugs (i.e., radiographic joint-space narrowing). This working document might be considered by the European regulatory authorities in a future update of the guideline for the registration of drugs in OA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

A randomized, double-blind, phase I/II trial of tumor necrosis factor and interferon-gamma for treatment of AIDS-related complex (Protocol 025 from the AIDS Clinical Trials Group).

Science.gov (United States)

Agosti, J M; Coombs, R W; Collier, A C; Paradise, M A; Benedetti, J K; Jaffe, H S; Corey, L

1992-05-01

To determine safety and efficacy of tumor necrosis factor (TNF) and interferon-gamma (IFN gamma) in the treatment of patients with acquired immunodeficiency syndrome (AIDS)-related complex, a randomized, double-blind study was conducted. Twenty-five patients with AIDS-related complex and CD4 lymphocytes less than or equal to 500 x 10(6)/L attended an AIDS Clinical Trials Unit of a tertiary referral center. Patients were administered tumor necrosis factor (TNF) (10 micrograms/m2) or IFN gamma (10 micrograms/m2), or both intramuscularly three times weekly for 16 weeks. Side effects from all three preparations included fever, constitutional symptoms, and local reactions. No significant hematologic, hepatic, renal, or coagulation abnormalities were observed. CD4 lymphocyte counts, beta 2-microglobulin, p24 antigen levels, and anti-p24 antibody did not change significantly during therapy. Similarly, no significant change was noted in rates of HIV isolation from peripheral blood mononuclear cells or plasma. TNF and IFN gamma were tolerable after premedication with acetaminophen; however, no significant change in markers of human immunodeficiency virus infection was demonstrated. These cytokines alone do not appear to be of benefit, nor do they appear to hasten the progression of HIV infection.

How to perform first aid.

Science.gov (United States)

Gloster, Annabella Satu; Johnson, Phillip John

2016-01-13

RATIONALE AND KEY POINTS: This article aims to help nurses to perform first aid in a safe, effective and patient-centred manner. First aid comprises a series of simple, potentially life-saving steps that an individual can perform with minimal equipment. Although it is not a legal requirement to respond to an emergency situation outside of work, nurses have a professional duty to respond and provide care within the limits of their competency. First aid is the provision of immediate medical assistance to an ill or injured person until definitive medical treatment can be accessed. First aid can save lives and it is essential that nurses understand the basic principles. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. Your skill in performing first aid and any areas where you may need to extend your knowledge. 2. How reading this article will change your practice. Subscribers can upload their reflective accounts at: rcni.com/portfolio .

Stateless Income, State Aid and the (Which?) Arm’s Length Principle

NARCIS (Netherlands)

Wattel, P.J.

2016-01-01

The arm’s length principle has a new function. When used by the European Union (EU) Commission for State aid control purposes, it is aimed at protecting a level playing field for all economic operators in the internal market, i.e. at protecting free competition, rather than at tax base protection or

CT of AIDS-related musculoskeletal infections

International Nuclear Information System (INIS)

Magid, D.; Fishman, E.K.

1990-01-01

This paper characterizes musculoskeletal inflammatory diseases in human immunodeficiency virus-positive patients and with acquired immunodeficiency syndrome (AIDS). CT, radiographic, and clinical data were reviewed in 10 patients, and patterns and features were compared with those in musculoskeletal infections occurring in non-AIDS patients. Infection was confirmed by means of biopsy or aspiration in eight cases and strongly suggested in the other two by blood cultures, cell counts, and other data

Access to HIV/AIDS services for disabled persons in Uganda

DEFF Research Database (Denmark)

Andersen, Helle Elisabeth

2006-01-01

Abstract This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person with dis......Abstract This project is based on five weeks’ ethnographically inspired fieldwork in May 2006 in the Republic of Uganda. The study started out with the hypothesis that there was some kind of discrimination going on in the interaction between health workers at HIV/AIDS clinics, and person...... with disabilities (PWDs) coming for HIV/AIDS testing or treatment. However, problems with discriminatory attitudes towards PWDs could not be confirmed from my fieldwork observations at five different HIV/AIDS clinics in Uganda. That observation was confirmed in my interviews with PWDs and health workers. Health...... workers said that PWDs were entitled to the same care and treatment as everybody else. However, I observed that only few PWDs seem to attend those HIV/AIDS services, and the question arose why that is so. Problems with access and confidence (for example lack of sign language interpreters) are often...

Clinical study on the efficacy, acceptance, and safety of hearing aids in patients with mild to moderate presbyacusis.

Science.gov (United States)

Romanet, Phillipe; Guy, Martine; Allaert, Francois-André

2018-04-17

of the study: The primary objective of this trial was to demonstrate the effect of wearing a Hearing aid (HA) on improvement of hearing and comprehension in everyday life situations. This mono-centre phase IV open-label clinical trial was carried out on men or women 40 years old or more, presenting mild or moderate first-degree presbyacusis. Presbyacusis was diagnosed by performance of pure-tone audiometry in silence. The main criterion was the comparison of the Glasgow Hearing Aid Benefit Profile (GHABP) before wearing HA and after a month of use and the secondary one was audiometric parameters. 47 patients, 60.0 ± 6.9 years old were included in the study. After 4 weeks, when wearing HA, no significant difficulty remains in the patients when they watch television (GHABP situation 1) or when they have a conversation without background noise (GHABP situation 2). To have a conversation in a busy street or a shop GHABP (situation 3) 4.4% of patients still have great difficulty, as are 2.2% of them when participating in a group conversation (GHABP situation 4). The GHABP score of residual disability for the whole of the 4 situations of difficulty is 1.3 ± 0.5, translating into no or only slight residual disability, in very significant amelioration of 1.3 ± 0.7 points (p: <0.0001), or 46.4% compared to the initial value. Audiometric parameters were also significantly improved. This study has allowed us to highlight from a clinical as well as an audiometric perspective the safety, effectiveness, as well as the important benefit of Sonalto® pre-set hearing aids on the improvement of hearing in patients presenting incipient presbyacusis.

Clinical features of AIDS patients with Hodgkin's lymphoma with isolated bone marrow involvement: report of 12 cases at a single institution

International Nuclear Information System (INIS)

Corti, Marcelo; Villafañe, Maria; Minue, Gonzalo; Campitelli, Ana; Narbaitz, Marina; Gilardi, Leonardo

2015-01-01

To study the main clinical and histopathological features of 12 patients with Hodgkin’s lymphoma (HL) diagnosed primarily from bone marrow (BM) involvement. We included 12 acquired immunodeficiency syndrome (AIDS) patients with HL assisted in the F. J. Muñiz Infectious Diseases Hospital since January 2002 to December 2013. The diagnosis of HL with primary BM involvement in patients was confirmed by clinical, histopathological, and immunohistochemical findings. All patients presented “B” symptoms and pancytopenia. All of them had stage IV neoplasm disease because of BM infiltration. The median of CD4 + T-cell counts was 114 cells/μL, and mixed cellularity (MC) was the most frequent histopathological subtype of 92% cases. When other causes are excluded, BM biopsy should be performed in AIDS patients with “B” symptoms and pancytopenia to evaluate BM infiltration by atypical lymphocytes

Assessment of HIV molecular surveillance capacity in the European Union, 2016.

Science.gov (United States)

Keating, Patrick; Pharris, Anastasia; Leitmeyer, Katrin; De Angelis, Stefania; Wensing, Annemarie; Amato-Gauci, Andrew J; Broberg, Eeva

2017-12-01

IntroductionExpanding access to HIV antiretroviral treatment is expected to decrease HIV incidence and acquired immunodeficiency syndrome (AIDS) mortality. However, this may also result in increased HIV drug resistance (DR). Better monitoring and surveillance of HIV DR is required to inform treatment regimens and maintain the long term effectiveness of antiretroviral drugs. As there is currently no formal European Union (EU)-wide collection of HIV DR data, this study aimed to assess the current HIV molecular surveillance capacity in EU/European Economic Area (EEA) countries in order to inform the planning of HIV DR monitoring at EU level. Methods: Thirty EU/EEA countries were invited to participate in a survey on HIV molecular surveillance capacity, which also included laboratory aspects. Results: Among 21 responding countries, 13 reported using HIV sequence data (subtype and/or DR) for surveillance purposes at national level. Of those, nine stated that clinical, epidemiological and sequence data were routinely linked for analysis. Discussion/conclusion : We identified similarities between existing HIV molecular surveillance systems, but also found important challenges including human resources, data ownership and legal issues that would need to be addressed.Information on capacities should allow better planning of the phased introduction of HIV DR surveillance at EU/EEA level.

European aid control policy and environmental protection - an evaluation of the new Community guidelines; Die europaeische Beihilfenaufsicht im Umweltschutz - Darstellung und Kritik des neuen Gemeinschaftsrahmens

Energy Technology Data Exchange (ETDEWEB)

Ewringmann, D.; Thoene, M. [Koeln Univ. (Germany). Finanzwissenschaftliches Forschungsinstitut; Fischer, H.G.

2002-01-01

On 3 February 2001 the European Commission adopted the new Community guidelines on state aid for environmental protection. These guidelines outline the methods and criteria used by the Commission when controlling environmental state aid according to Art. 87 and 88 of the EC-Treaty. The study analyses the development of the new guidelines and their potential effects on environmental protection and environmental policy in the Member States of the European Union. In essence, the guidelines display three harmful tendencies: - they hamper progressive and innovative environmental policy that improves on 'least common denominator'-Community standards; - they do not respect the limits of the Commissions's authority, and interfere with the Member States' exclusive authority to decide on strategies and instruments of their respective environmental policies, and they especially affect Member States' choices between different energy sources and the general structure of its energy supply; - finally, they do not improve the protection of air competition on the common market. Based on these findings, the report delineates perspectives for an aid control policy that protects fair competition, and that gives incentives for voluntary national and regional environmental protection, allows for the equal treatment of clean techniques, and provides a consistent framework for exemptions from ecological taxes and environmental levies at the same time. (orig.) [German] Die Europaeische Kommission hat mit Wirkung vom 3. Februar 2001 einen neuen Gemeinschaftsrahmen fuer staatliche Umweltschutzbeihilfen erlassen. Dieser skizziert die Verfahren und Kriterien, welche die Kommission in ihrer Ueberpruefung staatlicher Umweltschutzbeihilfen auf Vereinbarkeit mit dem gemeinsamen Markt nach Art. 87 u. 88 EGV nutzen will. Die vorliegende Untersuchung schildert die Entstehung des Beihilferahmens und analysiert dessen potenzielle Wirkungen auf den Umweltschutz und die

The AIDS and Cancer Specimen Resource: Role in HIV/AIDS scientific discovery

Directory of Open Access Journals (Sweden)

McGrath Michael S

2007-03-01

Full Text Available Abstract The AIDS Cancer and Specimen Resource (ACSR supports scientific discovery in the area of HIV/AIDS-associated malignancies. The ACSR was established as a cooperative agreement between the NCI (Office of the Director, Division of Cancer Treatment and Diagnosis and regional consortia, University of California, San Francisco (West Coast, George Washington University (East Coast and Ohio State University (Mid-Region to collect, preserve and disperse HIV-related tissues and biologic fluids and controls along with clinical data to qualified investigators. The available biological samples with clinical data and the application process are described on the ACSR web site. The ACSR tissue bank has more than 100,000 human HIV positive specimens that represent different processing (43, specimen (15, and anatomical site (50 types. The ACSR provides special biospecimen collections and prepares speciality items, e.g., tissue microarrays (TMA, DNA libraries. Requests have been greatest for Kaposi's sarcoma (32% and non-Hodgkin's lymphoma (26%. Dispersed requests include 83% tissue (frozen and paraffin embedded, 18% plasma/serum and 9% other. ACSR also provides tissue microarrays of, e.g., Kaposi's sarcoma and non-Hodgkin's lymphoma, for biomarker assays and has developed collaborations with other groups that provide access to additional AIDS-related malignancy specimens. ACSR members and associates have completed 63 podium and poster presentations. Investigators have submitted 125 letters of intent requests. Discoveries using ACSR have been reported in 61 scientific publications in notable journals with an average impact factor of 7. The ACSR promotes the scientific exploration of the relationship between HIV/AIDS and malignancy by participation at national and international scientific meetings, contact with investigators who have productive research in this area and identifying, collecting, preserving, enhancing, and dispersing HIV/AIDS

Clinical information system based on the medical smart card.

Science.gov (United States)

Danon, Y L; Saiag, E

2000-07-01

Over the last 5 years Israel has implemented a nationwide health insurance plan covering the entire population of the country. We have developed a clinical information system based on electronic-chip health care medical smart cards. Health care cards are used in several European countries and chip smart cards have been successful in many sectors. Our project involves the community use of the MSC, thereby enabling health care professionals to skillfully employ card systems in the health care sector. This system can easily arrange electronic medical charts in clinics, facilitating the confidential sharing of personal health databases among health professionals. To develop an MSC applicable for daily use in the community and hospital system. The MSC project, currently underway in Israel and the USA, will aid in determining the costs, benefits and feasibility of the MSC. Successful implementation of the MSC in chosen clinics will promote a nationwide willingness to adopt this promising technology.

STATE AID AND COMPETITIVENESS COMPOSED INDICATORS FOR ROMANIA AND SLECTED EU MEMBER STATES. A COMPARATIVE ANALISYS

Directory of Open Access Journals (Sweden)

DODESCU D.B. ANCA

2015-07-01

Full Text Available Despite the proclaimed revival of the industrial policy, state aid granted by the EU still remain at a concerning low level. This may be explained by EU’s unique institutional achitecture, that allows the European Commission to monitor and restrict state aid related activities in the member states. Relying on 2007 –2013 statistical data published by Eurostat, AMECO and OCDE data bases, the main purpose of this paper refers to determining the corelation between state aid authorised by the European Comission for Romania and some selected member states and their competitiveness level, in the period 2007 – 2013. Even if the member states government would know which industry of company should br supported, the actual allocation of the public fund is strongly influenced by legitime interests. Therefor, state aid allocation is usualy dependent on political considerations and on the negotiation power of the involved parties, rather than on economic objectives. The main purose of this paper is the following: firstly to determine the relation State Ais – Competitiveness, analysing the cases of Romania, Germany, France, Austria and Poland between 2007 and 2013; and secondly t determine if there is a measurable impact at national level, and to identify new growth possibilities of state aid efficiency. Our main hypothesys is analysed with the help of an original system consisting in competitiveness agregated indicators and their corespondents from the state aid field, and the results obtained are graphicaly presented. This paper is based on the research for the PhD thesis entitled Competition versus competitineness. State aid impact in Romania in the context of EU integration context

S4HARA: System for HIV/AIDS resource allocation.

Science.gov (United States)

Lasry, Arielle; Carter, Michael W; Zaric, Gregory S

2008-03-26

HIV/AIDS resource allocation decisions are influenced by political, social, ethical and other factors that are difficult to quantify. Consequently, quantitative models of HIV/AIDS resource allocation have had limited impact on actual spending decisions. We propose a decision-support System for HIV/AIDS Resource Allocation (S4HARA) that takes into consideration both principles of efficient resource allocation and the role of non-quantifiable influences on the decision-making process for resource allocation. S4HARA is a four-step spreadsheet-based model. The first step serves to identify the factors currently influencing HIV/AIDS allocation decisions. The second step consists of prioritizing HIV/AIDS interventions. The third step involves allocating the budget to the HIV/AIDS interventions using a rational approach. Decision-makers can select from several rational models of resource allocation depending on availability of data and level of complexity. The last step combines the results of the first and third steps to highlight the influencing factors that act as barriers or facilitators to the results suggested by the rational resource allocation approach. Actionable recommendations are then made to improve the allocation. We illustrate S4HARA in the context of a primary healthcare clinic in South Africa. The clinic offers six types of HIV/AIDS interventions and spends US$750,000 annually on these programs. Current allocation decisions are influenced by donors, NGOs and the government as well as by ethical and religious factors. Without additional funding, an optimal allocation of the total budget suggests that the portion allotted to condom distribution be increased from 1% to 15% and the portion allotted to prevention and treatment of opportunistic infections be increased from 43% to 71%, while allocation to other interventions should decrease. Condom uptake at the clinic should be increased by changing the condom distribution policy from a pull system to a push

Hearing aid fine-tuning based on Dutch descriptions.

Science.gov (United States)

Thielemans, Thijs; Pans, Donné; Chenault, Michelene; Anteunis, Lucien

2017-07-01

The aim of this study was to derive an independent fitting assistant based on expert consensus. Two questions were asked: (1) what (Dutch) terms do hearing impaired listeners use nowadays to describe their specific hearing aid fitting problems? (2) What is the expert consensus on how to resolve these complaints by adjusting hearing aid parameters? Hearing aid dispensers provided descriptors that impaired listeners use to describe their reactions to specific hearing aid fitting problems. Hearing aid fitting experts were asked "How would you adjust the hearing aid if its user reports that the aid sounds…?" with the blank filled with each of the 40 most frequently mentioned descriptors. 112 hearing aid dispensers and 15 hearing aid experts. The expert solution with the highest weight value was considered the best solution for that descriptor. Principal component analysis (PCA) was performed to identify a factor structure in fitting problems. Nine fitting problems could be identified resulting in an expert-based, hearing aid manufacturer independent, fine-tuning fitting assistant for clinical use. The construction of an expert-based, hearing aid manufacturer independent, fine-tuning fitting assistant to be used as an additional tool in the iterative fitting process is feasible.

Prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients with pre-ART and on-ART attending dessie hospital ART clinic, Northeast Ethiopia.

Science.gov (United States)

Missaye, Assefa; Dagnew, Mulat; Alemu, Abebe; Alemu, Agersew

2013-02-25

Intestinal parasites are a major concern in most developing countries where HIV/AIDS case are concentrate and almost 80% of AIDS patients die of AIDS-related infections. In the absence of ART, HIV/AIDS patients in developing countries unfortunately continue to suffer from the consequences of opportunistic parasites. But this prevalence has dramatically decreased in countries where antiretroviral agents are widely available. Therefore, the aim of this study was to assess the prevalence of intestinal parasite and risk factor among pre- ART and on ART adult HIV/ AIDS patients attending ART clinic in Dessie hospital. A comparative cross-sectional study was conducted among pre-ART and on ART adult HIV/AIDS patients of Dessie Hospital. A total of 272 (136 from each group) study subjects were selected by using systematic random sampling. Stool sample was collected and processed using direct wet mount, formol-ether concentration technique and modified Ziehl-Neelson staining techniques. A structured questionnaire was used to collect data on Sociodemographic & associated risk factors. Data was entered and analyzed by using SPSS 16 software and logistic regressions were applied to assess any association between explanatory factors and outcome variables. The overall prevalence of IP in pre-ART and on-ART was 39% and 17.6%, respectively with significant decrease of intestinal parasite in the ART era (p intestinal parasite. The overall prevalence of IP was differ by ART status and opportunistic parasite like cryptosporidium spps were found in low CD4 counts in ART naive patients. This study identified some environmental and some clinical finding as determinant factor for IP infections. Therefore, public health measures and adherence to ART should be strengthened to improve the quality of life of these patients.

Normative Power vs. Political Interest: EU Aid Selectivity beyond the European Consensus on Development, 2008-13

NARCIS (Netherlands)

W. Hout (Wil)

2013-01-01

markdownabstract__Abstract__ This paper focuses on the ‘governance turn’ in the development policies of the European Union, represented in particular by the adoption of the ‘European Consensus on Development’ in 2005. The main assumption inherent in the EU approach to development is that the

Perfil clínico da Enterocolite por Citomegalovírus (CMV na síndrome da imunodeficiência adquirida (Aids Clinical profile of Cytomegalovirus Colitis in AIDS

Directory of Open Access Journals (Sweden)

D.B. de Lima

2000-03-01

Full Text Available Múltiplos agentes estão envolvidos na etiopatogenia da diarréia em Aids. O exame de fezes e a colonoscopia são elementos decisivos para o diagnóstico específico. A enterocolite por CMV pode cursar com febre, emagrecimento, diarréia intermitente e hematoquesia. Outros agentes causadores de diarréia podem ter o mesmo espectro de apresentação. OBJETIVO: Definir o perfil clínico da enterocolite por CMV em pacientes com Aids, comparando os parâmetros clínicos, endoscópicos e de tempo de sobrevida entre dois grupos com diarréia crônica, grupo A com CMV e grupo B sem CMV. MÉTODOS: Foram acompanhados 48 pacientes com Aids e diarréia de duração maior que 30 dias, sendo 27 do grupo A e 21 do grupo B. Os parâmetros analisados foram idade, situação de risco, duração da diarréia, hematoquesia, intervalo de tempo entre diagnóstico da infecção por HIV e início de diarréia, achados endoscópicos e sobrevida. Foram realizados exames parasitológicos, culturas e colonoscopia com biópsias. Foi utilizado o teste "t-student" para amostras não pareadas e o teste Qui-Quadrado com correção de Yates para variáveis não paramétricas. Foram construídas curvas de sobrevida pelo método descrito por Kaplan-Meier e aplicado o teste de Mantel - Haenszel. Foi assumido como nível de significância estatística o valor de P menor que 0.05. RESULTADOS: O padrão endoscópico da infecção por CMV correspondeu a ulcerações associadas a hemorragia de submucosa 14 (51.8% P P > 0.001. Os outros parâmetros estudados não mostraram significância estatística. CONCLUSÕES: A presença de enterocolite por CMV em Aids é marcador de mau prognóstico e menor sobrevida. Existe um padrão endoscópico sugestivo da infecção por CMV.OBJECTIVE: To determine the clinical profile of CMV colitis in AIDS patients, comparing clinical, endoscopic parameters and survival time between 2 groups of AIDS patients having chronic diarrhea. Group A being CMV

US refuses to issue entry visas to people with HIV / AIDS.

Science.gov (United States)

1991-07-01

The US government, ignoring the almost unanimous recommendation of medical and public health experts throughout the world, continues to ban both immigration and travel by people with HIV. Following recommendations from the US Centers for Disease Control and Prevention, the US Department of Health and Human Services indicated its intention to reduce the list of dangerous and contagious diseases for excluding entry to the US to include only active tuberculosis. That decision would have removed HIV/AIDS from the list. However, due to the subsequent 35,000 letters and postcards, mostly generated by conservative religious broadcasters and mailing houses opposed to lifting the ban, AIDS remained on the list. Opposition to lifting the ban came from the US Justice Department, as well as in the form of a signed statement to that end from 67 Republican members of the US Congress. US AIDS activists have organized their own letter campaign to support the removal of HIV/AIDS from the list. The June 1990 Sixth International Conference on AIDS was disrupted because of the travel ban. More than 70 AIDS, medical, and governmental organizations, including the International Red Cross, the British Medical Association, and the European Parliament boycotted the conferences. Planning for the 8th International Conference on AIDS, scheduled to be held in Boston in May 1992, is already being disputed and may not be held.

Now That You Want to Take Your HIV/AIDS Vaccine/Biological Product Research Concept into the Clinic: What are “cGMP”?

Science.gov (United States)

Sheets, Rebecca L.; Rangavajhula, Vijaya; Pullen, Jeffrey K.; Butler, Chris; Mehra, Vijay; Shapiro, Stuart

2015-01-01

The Division of AIDS Vaccine Research Program funds the discovery and development of HIV/AIDS vaccine candidates. Basic researchers, having discovered a potential vaccine in the laboratory, next want to take that candidate into the clinic to test the concept in humans, to see if it translates. Many of them have heard of “cGMP” and know that they are supposed to make a “GMP product” to take into the clinic, but often they are not very familiar with what “cGMP” means and why these good practices are so important. As members of the Vaccine Translational Research Branch, we frequently get asked “can’t we use the material we made in the lab in the clinic?” or “aren’t Phase 1 studies exempt from cGMP?” Over the years, we have had many experiences where researchers or their selected contract manufacturing organizations have not applied an appropriate degree of compliance with cGMP suitable for the clinical phase of development. We share some of these experiences and the lessons learned, along with explaining the importance of cGMP, just what cGMP means, and what they can assure, in an effort to de-mystify this subject and facilitate the rapid and safe translational development of HIV vaccines. PMID:25698494

Clinical outcomes and immune benefits of anti-epileptic drug therapy in HIV/AIDS

Directory of Open Access Journals (Sweden)

Krentz Hartmut B

2010-06-01

Full Text Available Abstract Background Anti-epileptic drugs (AEDs are frequently prescribed to persons with HIV/AIDS receiving combination antiretroviral therapy (cART although the extent of AED use and their interactions with cART are uncertain. Herein, AED usage, associated toxicities and immune consequences were investigated. Methods HIV replication was analysed in proliferating human T cells during AED exposure. Patients receiving AEDs in a geographically-based HIV care program were assessed using clinical and laboratory variables in addition to assessing AED indication, type, and cumulative exposures. Results Valproate suppressed proliferation in vitro of both HIV-infected and uninfected T cells (p 0.05 but AED exposures did not affect HIV production in vitro. Among 1345 HIV/AIDS persons in active care between 2001 and 2007, 169 individuals were exposed to AEDs for the following indications: peripheral neuropathy/neuropathic pain (60%, seizure/epilepsy (24%, mood disorder (13% and movement disorder (2%. The most frequently prescribed AEDs were calcium channel blockers (gabapentin/pregabalin, followed by sodium channel blockers (phenytoin, carbamazepine, lamotrigine and valproate. In a nested cohort of 55 AED-treated patients receiving cART and aviremic, chronic exposure to sodium and calcium channel blocking AEDs was associated with increased CD4+ T cell levels (p 0.05 with no change in CD8+ T cell levels over 12 months from the beginning of AED therapy. Conclusions AEDs were prescribed for multiple indications without major adverse effects in this population but immune status in patients receiving sodium or calcium channel blocking drugs was improved.

Pulmonary infection in AIDS

International Nuclear Information System (INIS)

Kim, Seog Joon; Im, Jung Gi; Seong, Chang Kyu; Yeon, Kyung Mo; Han, Man Chung; Song, Jae Woo

1998-01-01

To analyze the clinical and radiological manifestations of pulmonary infection in patients with AIDS. We reviewed the medical records and analyzed retrospectively analysed the chest radiographs(n=3D24) and CT scans(n=3D11) of 26 patients with AIDS who had been followed up at our institute from 1987 to June 1998. Pulmonary infections were confirmed by sputum smear and culture(n=3D18), pleural examination(n=3D3), bronchoalveolar lavage(n=3D3), autopsy(n=3D4), transbronchial lung biopsy(n=3D1) or clinical history(n=3D9). The study group included 23 men and three women aged 25-54(average 35.2) years. We correlated the radiologic findings with CD4 lymphocyte counts. Pulmonary infections included tuberculosis(n=3D22), pneumocystis carinii pneumonia(n=3D9), cytomegalovirus(n=3D3), and unidentified bacterial pneumonia(n=3D2). Radiologically pulmonary tuberculosis was classified as primary tuberculosis(n=3D11;mean CD4 counts:41.3 cells/mm 3 ) and post-primary tuberculosis(n=3D11;mean CD4 counts:251.3cells/mm 3 ). CT findings of tuberculosis included lymphadenitis(n=3D6), bronchogenic spread(n=3D5), large consolidation(n=3D4), esophago-mediastinal fistula(n=3D2), and cavity(n=3D1). Tuberculosis in AIDS responded rapidly to anti-TB medication with complete or marked resolution of lesions within three months. Radiologic findings of Pneumocystis carinii pneumonia included diffuse ground glass opacities, cysts, and reticular opacities. Tuberculosis was the most common infection in patients with AIDS in Korea, and this is attributed to the high prevalence of tuberculosis. Radiological findings varied with CD4+cell count, showing those of primary tuberculosis as a patient's CD4+ cell count decreased. Pulmonary tuberculosis in AIDS responded rapidly to anti-Tb medication. =20

HIV / AIDS is a challenge we have to face -- Colin Hollis.

Science.gov (United States)

2000-01-01

On July 21, 2000, the Asian Forum of Parliamentarians on Population and Development (AFPPD) Malaysia, in cooperation with the UN Population Fund and the UN Development Program (Malaysia), organized the National HIV/AIDS Seminar for Parliamentarians in Kuala Lumpur, Malaysia. During the seminar, Mr. Colin Hollis, secretary general of AFPPD, spoke about the challenge posed by HIV/AIDS on the government. He noted that the epidemic is a part of life and these figures should not only challenge the assumptions of legislators but for them to act as well. He further informed that AFPPD would organize the Asia-Africa Meeting of Parliamentarians and Asia European Dialogue.

European Marketing Authorizations Granted Based on a Single Pivotal Clinical Trial: The Rule or the Exception?

Science.gov (United States)

Morant, Anne Vinther; Vestergaard, Henrik Tang

2018-07-01

A minimum of two positive, adequate, and well-controlled clinical trials has historically been the gold standard for providing substantial evidence to support regulatory approval of a new medicine. Nevertheless, the present analysis of European Marketing Authorizations granted between 2012 and 2016 showed that 45% of new active substances were approved based on a single pivotal clinical trial. For therapeutic areas such as oncology and cardiovascular diseases, approvals based on a single pivotal trial are the rule rather than the exception, whereas new medicines within the nervous system area were generally supported by two or more pivotal trials. While overall similar trends have been observed in the US, the recent US Food and Drug Administration approvals of nervous system medicines based on a single pivotal trial suggest that a case-by-case scientific evaluation of the totality of evidence is increasingly applied to facilitate faster access of new medicines to patients suffering from serious diseases. © 2017 American Society for Clinical Pharmacology and Therapeutics.

Home-use cancer detecting band aid

Science.gov (United States)

Zalevsky, Zeev; Rudnitsky, Arkady; Sheinman, Victor; Tzoy, Andrey; Toktosunov, Aitmamat; Adashov, Arkady

2016-03-01

In this paper we present a novel concept in which special band aid is developed for early detection of cancer. The band aid contains an array of micro needles with small detection array connected to each needle which inspects the color of the surface of the skin versus time after being pinched with the needles. We were able to show in pre-clinical trials that the color varies differently if the skin is close to tumor tissue.

Validation of the 'United Registries for Clinical Assessment and Research' [UR-CARE], a European Online Registry for Clinical Care and Research in Inflammatory Bowel Disease.

Science.gov (United States)

Burisch, Johan; Gisbert, Javier P; Siegmund, Britta; Bettenworth, Dominik; Thomsen, Sandra Bohn; Cleynen, Isabelle; Cremer, Anneline; Ding, Nik John Sheng; Furfaro, Federica; Galanopoulos, Michail; Grunert, Philip Christian; Hanzel, Jurij; Ivanovski, Tamara Knezevic; Krustins, Eduards; Noor, Nurulamin; O'Morain, Neil; Rodríguez-Lago, Iago; Scharl, Michael; Tua, Julia; Uzzan, Mathieu; Ali Yassin, Nuha; Baert, Filip; Langholz, Ebbe

2018-04-27

The 'United Registries for Clinical Assessment and Research' [UR-CARE] database is an initiative of the European Crohn's and Colitis Organisation [ECCO] to facilitate daily patient care and research studies in inflammatory bowel disease [IBD]. Herein, we sought to validate the database by using fictional case histories of patients with IBD that were to be entered by observers of varying experience in IBD. Nineteen observers entered five patient case histories into the database. After 6 weeks, all observers entered the same case histories again. For each case history, 20 key variables were selected to calculate the accuracy for each observer. We assumed that the database was such that ≥ 90% of the entered data would be correct. The overall proportion of correctly entered data was calculated using a beta-binomial regression model to account for inter-observer variation and compared to the expected level of validity. Re-test reliability was assessed using McNemar's test. For all case histories, the overall proportion of correctly entered items and their confidence intervals included the target of 90% (Case 1: 92% [88-94%]; Case 2: 87% [83-91%]; Case 3: 93% [90-95%]; Case 4: 97% [94-99%]; Case 5: 91% [87-93%]). These numbers did not differ significantly from those found 6 weeks later [NcNemar's test p > 0.05]. The UR-CARE database appears to be feasible, valid and reliable as a tool and easy to use regardless of prior user experience and level of clinical IBD experience. UR-CARE has the potential to enhance future European collaborations regarding clinical research in IBD.

Validation of the walking index for spinal cord injury in a US and European clinical population

DEFF Research Database (Denmark)

Ditunno, J.F.; Scivoletto, G.; Patrick, M.

2008-01-01

OBJECTIVE: To demonstrate the prospective construct validity of the walking index for spinal cord injury (WISCI) in US/European clinical population. DESIGN: Prospective Cohort in Denmark, Germany, Italy and the USA. PARTICIPANTS/METHOD: Participants with acute complete/incomplete (ASIA Impairment...... Scale (AIS) A, B, C and D) traumatic spinal cord injuries were enrolled from four centers. Lower extremity motor scores (LEMS), WISCI level and Locomotor Functional Independence Measure (LFIM) levels were assessed with change in ambulatory status. WISCI progression was assessed for monotonic direction...

Notification of suspected and unexpected serious adverse reactions according to the Clinical Trials Directive - A descriptive analysis of the legislation and the requirements in a European context

DEFF Research Database (Denmark)

Larsen, Ellen Moseholm; Grarup, Jesper; Gey, Daniela Christine

2010-01-01

The European Clinical Trials Directive (CTD) came into force on May 1st 2004. The CTD provides the legal basis for monitoring the safety of clinical trials and covers the requirements for notification of SUSAR. Implementation of the CTD into national legislation in each Member State has resulted...... in various interpretations of CTD requirements. The objective of this paper is to investigate how the European Member States administer the safety reporting requirements of the CTD and to clarify the requirements for SUSAR notification in the different Member States. Data was collected through publicly...

The European Prader-Willi Syndrome Clinical Research Database: An Aid in the Investigation of a Rare Genetically Determined Neurodevelopmental Disorder

Science.gov (United States)

Holland, A.; Whittington, J.; Cohen, O.; Curfs, L.; Delahaye, F.; Dudley, O.; Horsthemke, B.; Lindgren, A. -C.; Nourissier, C.; Sharma, N.; Vogels, A.

2009-01-01

Background: Prader-Willi Syndrome (PWS) is a rare genetically determined neurodevelopmental disorder with a complex phenotype that changes with age. The rarity of the syndrome and the need to control for different variables such as genetic sub-type, age and gender limits clinical studies of sufficient size in any one country. A clinical research…

Renewable Energy Policy Fact sheet - European Union

International Nuclear Information System (INIS)

2017-09-01

The EurObserv'ER policy profiles give a snapshot of the renewable energy policy in the EU Member States. The European Union aims to achieve a 20% share (with legally binding national targets) of its final energy consumption from RES by 2020, and at least a 27% share (not broken down into nationally binding targets) by 2030. Key instruments at EU level to promote RES include directives, such as the 2009 Renewable Energy Directive. The EU Emission Trading Scheme (ETS) is also intended to support RES. The European Commission has also adopted state aid guidelines to ensure that support schemes to promote RES at national level are compatible with EU competition law and internal market rules. Further instruments are research, development and innovation funding programmes, such as Horizon2020, the Innovation Fund, and the NER300 programme. RES are also supported through regional development funds as well as through grants and loans for RES projects and related infrastructure from the European Investment Bank (EIB) and the European Fund for Strategic Investments (EFSI). A recast directive on the promotion of RES in the period 2020- 2030 is to be adopted along with governance rules to ensure that the EU-wide RES target for 2030 is met

AIDS: epidemiology and the international response.

Science.gov (United States)

Blake, D

1993-06-01

A presentation at the second Conference on AIDS and Ethics discussed the status of the AIDS pandemic, the success of the international response, and the need for continued commitment by the European Community (EC) and the Group of Seven to the worldwide AIDS prevention and control effort. As of mid 1992, the World Health Organization (WHO) estimated that about 10-12 million adults and 1 million children had been infected with HIV. Africa had over 7 million infected adults with 6.5 million of these located in Sub-Saharan Africa. However, in south and southeast Asia the pandemic is spreading as fast as it did a decade ago in Sub-Saharan Africa. Well over a million adults have been infected so far, most of them in Thailand, India, and Myanmar. WHO projections show that in the mid- to late 1990s more Asians will be newly infected each year than Africans. Starting in 1987 WHO was designated as the leader of the global response to AIDS and urged national leaders to commit themselves to taking decisive HIV preventive action. Preventing HIV infection calls for promoting safer sex and providing condoms, as well as encouraging people to seek care for other sexually transmitted diseases (STDs). The results of 5 prevention projects in Zaire, Zimbabwe, Rwanda, and Thailand have been highly effective. In Zaire a social marketing project widely promoted condoms in the mass media and sold them through every available retail outlet. Condom sales had increased from fewer than 0.5 million in 1987 to over 18 million in 1991. In Thailand a policy of 100% condom use was implemented simultaneously in all the sex entertainment establishments in a few pilot areas. Given the magnitude of the HIV/AIDS pandemic, the international response of the EC and the Group of Seven needs political commitment, respect for human rights, and resources.

76 FR 30951 - Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program

Science.gov (United States)

2011-05-27

... Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services... White HIV/AIDS Program, Part C Funds for the Tutwiler Clinic. SUMMARY: HRSA will award non-competitively Ryan White HIV/AIDS Program, Part C funds to the Tutwiler Clinic, Tutwiler, Mississippi, to support...

Poverty, Migration and the Incidence of HIV/AIDS among Rural ...

African Journals Online (AJOL)

It is based on data from a clinic-based HIV/AIDS prevalence study with 150 ... to the gender discrimination embedded in Basotho culture, the acute lack of access to ... Keywords: Lesotho, HIV/AIDS, rural women, gender-based discrimination, ...

Effect of patient decision aid was influenced by presurgical evaluation among patients with osteoarthritis of the knee.

Science.gov (United States)

Boland, Laura; Taljaard, Monica; Dervin, Geoffrey; Trenaman, Logan; Tugwell, Peter; Pomey, Marie-Pascale; Stacey, Dawn

2018-02-01

Decision aids help patients make total joint arthroplasty decisions, but presurgical evaluation might influence the effects of a decision aid. We compared the effects of a decision aid among patients considering total knee arthroplasty at 2 surgical screening clinics with different evaluation processes. We performed a subgroup analysis of a randomized controlled trial. Patients were recruited from 2 surgical screening clinics: an academic clinic providing 20-minute physician consultations and a community clinic providing 45-minute physiotherapist/nurse consultations with education. We compared the effects of decision quality, decisional conflict and surgery rate using Cochran-Mantel-Haenszel χ 2 tests and the Breslow-Day test. We evaluated 242 patients: 123 from the academic clinic (61 who used the decision aid and 62 controls) and 119 from the community clinic (59 who used the decision aid and 60 controls). Results suggested a between-site difference in the effect of the decision aid on the patients' decision quality ( p = 0.09): at the academic site, patients who used the decision aid were more likely to make better-quality decisions than controls (54% v. 35%, p = 0.044), but not at the community site (47% v. 51%, p = 0.71). Fewer patients who used decision aids at the academic site than at the community site experienced decisional conflict ( p = 0.007) (33% v. 52%, p = 0.05 at the academic site and 40% v. 24%, p = 0.08 at the community site). The effect of the decision aid on surgery rates did not differ between sites ( p = 0.65). The decision aid had a greater effect at the academic site than at the community site, which provided longer consultations with more verbal education. Hence, decision aids might be of greater value when more extensive total knee arthroplasty presurgical assessment and counselling are either impractical or unavailable.

Development of a new first-aid biochemical detector

Science.gov (United States)

Hu, Jingfei; Liao, Haiyang; Su, Shilin; Ding, Hao; Liu, Suquan

2016-10-01

The traditional biochemical detector exhibits poor adaptability, inconvenient carrying and slow detection, which can't meet the needs of first-aid under field condition like natural or man-made disasters etc. Therefore a scheme of first-aid biochemical detector based on MOMES Micro Spectrometer, UV LED and Photodiode was proposed. An optical detection structure combined continuous spectrum sweep with fixed wavelength measurement was designed, which adopted mobile detection optical path consisting of Micro Spectrometer and Halogen Lamp to detect Chloride (Cl-), Creatinine (Cre), Glucose (Glu), Hemoglobin (Hb). The UV LED and Photodiode were designed to detect Potassium (K-), Carbon dioxide (CO2), Sodium (Na+). According to the field diagnosis and treatment requirements, we designed the embedded control hardware circuit and software system, the prototype of first-aid biochemical detector was developed and the clinical trials were conducted. Experimental results show that the sample's absorbance repeatability is less than 2%, the max coefficient of variation (CV) in the batch repeatability test of all 7 biochemical parameters in blood samples is 4.68%, less than the clinical requirements 10%, the correlation coefficient (R2) in the clinical contrast test with AU5800 is almost greater than 0.97. To sum up, the prototype meets the requirements of clinical application.

[Translation, Cultural Adaptation and Validation of the Satisfaction with Amplification in Daily Life Scale for European Portuguese].

Science.gov (United States)

Roque Dos Reis, Luis; Donato, Mariana; Sousa, Rita; Escada, Pedro

2017-02-27

The scale Satisfaction with Amplification in Daily Life uses a simple and easily administered questionnaire to evaluate the adaptation of individuals to their hearing aids. The objective of this study is to validate the scale for European Portuguese speakers, by means of translation and cultural adaptation of the questionnaire. The study includes an evaluation of reproducibility and a description of the results of the administration of the questionnaire to patients fitted with hearing aids. We invited 147 individuals fitted with hearing aids (uni- or bilateral) to participate in the study. Participants had used a hearing aid for at least six weeks and were patients of the Department of Otolaryngology at the Egas Moniz Hospital (Lisbon). The consent as well the guidelines for translation from and into the English language were obtained from the author of the scale, and the translation from and into, and cultural adaptation were carried out, along with an evaluation of reproducibility and internal consistency. The participants were 54% male and 46% female, aged between 16 and 93 (66.09 ± 17.41 years). The results of the study showed an overall level of satisfaction of 5.4 among hearing aids users. The sub-scale satisfaction levels were: positive effects 5.88, service and cost 5.25, negative effects 4.24, and self-image 5.57. The Cronbach α score was 0.75 which indicates good internal consistency. Furthermore, the questionnaire's overall and sub-scale average scores did not differ significantly from the results obtained under the American scale. The inter-examiner reproducibility was also good. This study provides reliable results of the scale for the Portuguese of Portugal and adequate internal consistency, with significant age variability in the sample. This adaptation of the Satisfaction with Amplification in Daily Life questionnaire for European Portuguese speakers should be considered a good tool for evaluation of the level of satisfaction of hearing aid users

CD4 descriptions at various clinical HIV/AIDS stages with tuberculosis and non-tuberculosis opportunistic infections at dr. Zainoel Abidin hospital in Banda Aceh, Indonesia

Science.gov (United States)

Shaleh, A. S.; Fahrial; Siregar, M. L.; Jamil, K. F.

2018-03-01

Human Immunodeficiency Virus (HIV) / Acquired Immune Deficiency Syndrome (AIDS) is a retrovirus that infects the human immune system. Damaged immunity in HIV/AIDS patients is marked by a decline in CD4 cells. Opportunistic infections appear differently, depending on the levels of immunosuppressive degrees, and the frequency of opportunistic infections in the environment. This study aims to describe the CD4 at various clinical stages of HIV/AIDS with tuberculosis and non-tuberculosis opportunistic infections (OI). Descriptive study with a cross-sectional design. This study is secondary data obtained from the medical records of patients with HIV/AIDS in the period of January 2011 - December 2015 at dr. Zainoel Abidin Hospital in Banda Aceh. The samples that met the inclusion criteria were 135 people with 63 cases were tuberculosis OI, 33 cases were non-tuberculosis and 39 cases were without OI. The study showed CD4 tuberculosis OI and 93.9% for non-tuberculosis OI.

S4HARA: System for HIV/AIDS resource allocation

Directory of Open Access Journals (Sweden)

Carter Michael W

2008-03-01

Full Text Available Abstract Background HIV/AIDS resource allocation decisions are influenced by political, social, ethical and other factors that are difficult to quantify. Consequently, quantitative models of HIV/AIDS resource allocation have had limited impact on actual spending decisions. We propose a decision-support System for HIV/AIDS Resource Allocation (S4HARA that takes into consideration both principles of efficient resource allocation and the role of non-quantifiable influences on the decision-making process for resource allocation. Methods S4HARA is a four-step spreadsheet-based model. The first step serves to identify the factors currently influencing HIV/AIDS allocation decisions. The second step consists of prioritizing HIV/AIDS interventions. The third step involves allocating the budget to the HIV/AIDS interventions using a rational approach. Decision-makers can select from several rational models of resource allocation depending on availability of data and level of complexity. The last step combines the results of the first and third steps to highlight the influencing factors that act as barriers or facilitators to the results suggested by the rational resource allocation approach. Actionable recommendations are then made to improve the allocation. We illustrate S4HARA in the context of a primary healthcare clinic in South Africa. Results The clinic offers six types of HIV/AIDS interventions and spends US$750,000 annually on these programs. Current allocation decisions are influenced by donors, NGOs and the government as well as by ethical and religious factors. Without additional funding, an optimal allocation of the total budget suggests that the portion allotted to condom distribution be increased from 1% to 15% and the portion allotted to prevention and treatment of opportunistic infections be increased from 43% to 71%, while allocation to other interventions should decrease. Conclusion Condom uptake at the clinic should be increased by

Prevalence of clinical oral manifestations and symptoms of HIV/AIDS ...

African Journals Online (AJOL)

Type of study: Cross-sectional study. Population: HIV/AIDS individuals attended at Sikonge hospital. Setting: ... However, the distribution and relative frequency of the different lesions is variable from that from other studies. There is need for ...

Consensus document on European brain research

DEFF Research Database (Denmark)

Di Luca, Monica; Baker, Mary; Corradetti, Renato

2011-01-01

will increase exponentially in the years to come due to ageing of the European population, it is necessary to act now in order to curb this increase and possibly reverse the trend. Thus, establishing a strong European platform supporting basic and clinical research in neuroscience is needed to confront...... version. Multinational and multidisciplinary teams have once again come together to express their views, not only on the current strengths in European research, but also on what needs to be done in priority, hoping that this update will inspire policy makers and stakeholders in directing funding...

European Symposium on Precision Medicine in Allergy and Airways Diseases

DEFF Research Database (Denmark)

Muraro, A; Fokkens, W J; Pietikainen, S

2016-01-01

: personalized care based on molecular, immunologic and functional endotyping of the disease, with participation of the patient in the decision making process of therapeutic actions, and considering predictive and preventive aspects of the treatment. Implementation of Precision Medicine into clinical practice......The European Academy of Allergy and Clinical Immunology (EAACI), the European Rhinologic Society (ERS) and the European Medical Association (EMA) organized, on 14 October 2015, a symposium in the European Parliament in Brussels on Precision Medicine in Allergy and Airways Diseases, hosted by MEP...... the most frequently diagnosed chronic non-communicable diseases in the EU. 30% of the total European population is suffering from allergies and asthma, and more than half are deprived from adequate diagnosis and treatment. Precision Medicine represents a novel approach, embracing 4 key features...

The role of European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase in standardization and harmonization of the preanalytical phase in Europe

DEFF Research Database (Denmark)

Cornes, Michael P; Church, Stephen; van Dongen-Lases, Edmée

2016-01-01

Patient safety is a leading challenge in healthcare and from the laboratory perspective it is now well established that preanalytical errors are the major contributor to the overall rate of diagnostic and therapeutic errors. To address this, the European Federation of Clinical Chemistry and Labor......Patient safety is a leading challenge in healthcare and from the laboratory perspective it is now well established that preanalytical errors are the major contributor to the overall rate of diagnostic and therapeutic errors. To address this, the European Federation of Clinical Chemistry...... and Laboratory Medicine Working Group for Preanalytical Phase (EFLM WG-PRE) was established to lead in standardization and harmonization of preanalytical policies and practices at a European level. One of the key activities of the WG-PRE is the organization of the biennial EFLM-BD conference on the preanalytical...... summarises the work that has and will be done in these areas. The goal of this initiative is to ensure the EFLM WG-PRE produces work that meets the needs of the European laboratory medicine community. Progress made in the identified areas will be updated at the next preanalytical phase conference and show...

Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report.

Science.gov (United States)

Cingi, C; Gevaert, P; Mösges, R; Rondon, C; Hox, V; Rudenko, M; Muluk, N B; Scadding, G; Manole, F; Hupin, C; Fokkens, W J; Akdis, C; Bachert, C; Demoly, P; Mullol, J; Muraro, A; Papadopoulos, N; Pawankar, R; Rombaux, P; Toskala, E; Kalogjera, L; Prokopakis, E; Hellings, P W; Bousquet, J

2017-01-01

This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.

[AIDS in Chile: a problem with multiple facets].

Science.gov (United States)

Ormazabal, B

1991-03-01

Chile's 1st case of AIDS was diagnosed in 1984. Some 250 AIDS cases and 1600 HIV positive persons have since been reported, although the actual number by some estimates may reach 5000. Chile, although in the initial stages of the epidemic, already has a serious problem which at present can only be combatted through education. It will be necessary to convince the population that significant modifications of sexual behavior are needed to control the spread of the disease. Education for AIDS prevention is a priority of the National Commission on AIDS (CONASIDA), which is basing its program on the premise that stable monogamy is the most natural form of expression of a couple. Manuals for prevention are under development, and the 1st, for health workers and the general population, is in process of publication. A series of pamphlets and educational videos for workers in sexually transmitted disease clinics are under development. Educational materials are also being created for specific groups such as university students and agricultural workers and for groups at high risk. A social communications campaign has been prepared and approved by the authorities, and is awaiting funding for dissemination. Education of the population is also a concern for the Catholic Church, which views reinforcement of the family and its mission of providing sex education as a primary means of preventing AIDS. CONASIDA is also responsible for epidemiological study of AIDS in Chile through surveillance of sentinel groups and in quality control of the blood supply. Condoms are to be distributed in sexually transmitted disease clinics for the purpose of AIDS prevention.

Goals? What goals? Europeans to hear more about the world's millennium development goals

International Nuclear Information System (INIS)

Bianchi, S.

2005-01-01

The European Union (EU) is quickly becoming the front-runner of development aid to regions in Africa and other developing countries. However, over three-quarters of EU citizens are unaware of development efforts being made on the part of the Union to Third World countries, according to a public opinion poll released by Eurobarometer. In light of the low awareness of the EU's development agenda and the United Nations's Millennium Development Goals, the EU Humanitarian Aid and Development Commission has employed a campaign to raise the level of awareness among the EU's 460 million citizens

The educational and professional status of clinical embryology and clinical embryologists in Europe.

Science.gov (United States)

Kovačič, B; Plas, C; Woodward, B J; Verheyen, G; Prados, F J; Hreinsson, J; De los Santos, M J; Magli, M C; Lundin, K; Plancha, C E

2015-08-01

What is the recognition of clinical embryology and the current status of clinical embryologists in European countries, regarding educational levels, responsibilities and workload, and need for a formal education in assisted reproductive technology (ART)? It is striking that the profession of clinical embryology, almost 40 years after the introduction of IVF, is still not officially recognized in most European countries. Reproductive medicine has developed into a sophisticated multidisciplinary medical branch since the birth of Louise Brown 37 years ago. The European Board & College of Obstetrics and Gynaecology (EBCOG) has recognized reproductive medicine as a subspeciality and has developed a subspeciality training for gynaecologists in collaboration with the European Society for Human Reproduction and Embryology (ESHRE). However, nothing similar exists for the field of clinical embryology or for clinical embryologists. A questionnaire about the situation in clinical embryology in the period of 2012-2013 in the respective European country was sent to ESHRE National representatives (basic scientists only) in December 2013. At this time, 28 European countries had at least one basic scientist in the ESHRE Committee of National Representatives. The survey consisted of 46 numeric, dichotomous (yes/no) or descriptive questions. Answers were obtained from 27 out of 28 countries and the data were tabulated. Data about the numbers of 'ESHRE Certified Embryologists' were taken from the ESHRE Steering Committee for Embryologist Certification. In 2012, more than 7000 laboratory staff from 1349 IVF clinics in 27 European countries performed over 700 000 fresh and frozen ART cycles. Despite this, clinical embryology is only recognized as an official profession in 3 out of 27 national health systems. In most countries clinical embryologists need to be registered under another profession, and have limited possibilities for organized education in clinical embryology. Mostly they

Dermatological manifestations in patients with HIV/AIDS

OpenAIRE

Sahily De la Paz Peña; Leonides Rojas Barly; Reynaldo Hugo Remond Vázquez; Maira Lozano Lavernia

2015-01-01

In view of the frequency of the dermatological manifestations in patients who suffer from AIDS/HIV, and with the objective of describing their behaviour, a descriptive,observational, and cross sectional investigation was carried out in the cases of the AIDS provincial consultation at Ernesto Guevara General Teaching Hospital of Las Tunas from January, 2007 to June, 2008. The information was obtained from the survey, the dermatological examination, and the clinical charts. The sample was made ...

Europe's Shifting Response to HIV/AIDS: From Human Rights to Risk Management.

Science.gov (United States)

Smith, Julia

2016-12-01

Despite a history of championing HIV/AIDS as a human rights issue, and a rhetorical commitment to health as a human right, European states and institutions have shifted from a rights-based response to a risk management approach to HIV/AIDS since the economic recession of 2008. An interdisciplinary perspective is applied to analyze health policy changes at the national, regional, and global levels by drawing on data from key informant interviews, and institutional and civil society documents. It is demonstrated that, in the context of austerity measures, member states such as the UK and Greece reduced commitments to rights associated with HIV/AIDS; at the regional level, the EU failed to develop rights-based approaches to address the vulnerabilities and health care needs of key populations affected by HIV/AIDS, particularly migrants and sex workers; and at the global level, the EU backtracked on commitments to global health and is prioritizing the intellectual property rights of pharmaceutical companies over the human rights of people living with HIV/AIDS. The focus within and from the EU is on containment, efficiency, and cost reduction. The rights of those most affected are no longer prioritized.

Audiovisual spoken word recognition as a clinical criterion for sensory aids efficiency in Persian-language children with hearing loss.

Science.gov (United States)

Oryadi-Zanjani, Mohammad Majid; Vahab, Maryam; Bazrafkan, Mozhdeh; Haghjoo, Asghar

2015-12-01

The aim of this study was to examine the role of audiovisual speech recognition as a clinical criterion of cochlear implant or hearing aid efficiency in Persian-language children with severe-to-profound hearing loss. This research was administered as a cross-sectional study. The sample size was 60 Persian 5-7 year old children. The assessment tool was one of subtests of Persian version of the Test of Language Development-Primary 3. The study included two experiments: auditory-only and audiovisual presentation conditions. The test was a closed-set including 30 words which were orally presented by a speech-language pathologist. The scores of audiovisual word perception were significantly higher than auditory-only condition in the children with normal hearing (Paudiovisual presentation conditions (P>0.05). The audiovisual spoken word recognition can be applied as a clinical criterion to assess the children with severe to profound hearing loss in order to find whether cochlear implant or hearing aid has been efficient for them or not; i.e. if a child with hearing impairment who using CI or HA can obtain higher scores in audiovisual spoken word recognition than auditory-only condition, his/her auditory skills have appropriately developed due to effective CI or HA as one of the main factors of auditory habilitation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

ALARA in European nuclear installations

International Nuclear Information System (INIS)

Lefaure, C.; Croft, J.; Pfeffer, W.; Zeevaert, T.

1995-01-01

For over a decade the Commission of the European Community has sponsored research projects on the development and practical implementation of the Optimization principle, or as it is often referred to, ALARA. These projects have given rise to a series of successful international Optimization training courses and have provided a significant input to the periodic European Seminars on Optimization, the last one of which took place in April 1993. This paper reviews the approaches to Optimization that have development within Europe and describes the areas of work in the current project. The on-going CEC research project addresses the problem of ALARA and internal exposures, and tries to define procedures for ALARA implementation, taking account of the perception of the hazard as well as the levels of probability of exposure. The relationships between ALARA and work management, and ALARA and decommissioning of installations appear to be other fruitful research areas. Finally, this paper introduces some software for using ALARA decision aiding techniques and databases containing feed back experience developed in Europe

ALARA in European nuclear installations

Energy Technology Data Exchange (ETDEWEB)

Lefaure, C. [CEPN, Fontenay-Aux-Roses (France); Croft, J. [NRPB, Chilton, Didcot (United Kingdom); Pfeffer, W. [GRS, Koeln (Germany); Zeevaert, T. [SCK/CEN, Mol (Belgium)

1995-03-01

For over a decade the Commission of the European Community has sponsored research projects on the development and practical implementation of the Optimization principle, or as it is often referred to, ALARA. These projects have given rise to a series of successful international Optimization training courses and have provided a significant input to the periodic European Seminars on Optimization, the last one of which took place in April 1993. This paper reviews the approaches to Optimization that have development within Europe and describes the areas of work in the current project. The on-going CEC research project addresses the problem of ALARA and internal exposures, and tries to define procedures for ALARA implementation, taking account of the perception of the hazard as well as the levels of probability of exposure. The relationships between ALARA and work management, and ALARA and decommissioning of installations appear to be other fruitful research areas. Finally, this paper introduces some software for using ALARA decision aiding techniques and databases containing feed back experience developed in Europe.

To Pee, or Not to Pee: A Review on Envenomation and Treatment in European Jellyfish Species

Directory of Open Access Journals (Sweden)

Louise Montgomery

2016-07-01

Full Text Available There is a growing cause for concern on envenoming European species because of jellyfish blooms, climate change and globalization displacing species. Treatment of envenomation involves the prevention of further nematocyst release and relieving local and systemic symptoms. Many anecdotal treatments are available but species-specific first aid response is essential for effective treatment. However, species identification is difficult in most cases. There is evidence that oral analgesics, seawater, baking soda slurry and 42–45 °C hot water are effective against nematocyst inhibition and giving pain relief. The application of topical vinegar for 30 s is effective on stings of specific species. Treatments, which produce osmotic or pressure changes can exacerbate the initial sting and aggravate symptoms, common among many anecdotal treatments. Most available therapies are based on weak evidence and thus it is strongly recommended that randomized clinical trials are undertaken. We recommend a vital increase in directed research on the effect of environmental factors on envenoming mechanisms and to establish a species-specific treatment. Adequate signage on jellyfish stings and standardized first aid protocols with emphasis on protective equipment and avoidance of jellyfish to minimize cases should be implemented in areas at risk.

European Option Pricing with Transaction Costs in Lévy Jump Environment

Directory of Open Access Journals (Sweden)

Jiayin Li

2014-01-01

Full Text Available The European option pricing problem with transaction costs is investigated for a risky asset price model with Lévy jump. By the aid of arbitrage pricing theory and the generalized Itô formula (which includes Poisson jump, the explicit solution to the risk asset price model is given. According to arbitrage-free principle, we first discretize the continuous-time model. Then, in each small time interval, the transaction costs are introduced. By using the Δ-hedging strategy, the explicit solutions of the European options pricing formula with transaction costs are given for the risky asset price model with Lévy jump.

Intelligent hearing aids: the next revolution.

Science.gov (United States)

Tao Zhang; Mustiere, Fred; Micheyl, Christophe

2016-08-01

The first revolution in hearing aids came from nonlinear amplification, which allows better compensation for both soft and loud sounds. The second revolution stemmed from the introduction of digital signal processing, which allows better programmability and more sophisticated algorithms. The third revolution in hearing aids is wireless, which allows seamless connectivity between a pair of hearing aids and with more and more external devices. Each revolution has fundamentally transformed hearing aids and pushed the entire industry forward significantly. Machine learning has received significant attention in recent years and has been applied in many other industries, e.g., robotics, speech recognition, genetics, and crowdsourcing. We argue that the next revolution in hearing aids is machine intelligence. In fact, this revolution is already quietly happening. We will review the development in at least three major areas: applications of machine learning in speech enhancement; applications of machine learning in individualization and customization of signal processing algorithms; applications of machine learning in improving the efficiency and effectiveness of clinical tests. With the advent of the internet of things, the above developments will accelerate. This revolution will bring patient satisfactions to a new level that has never been seen before.

Association between biological properties of human immunodeficiency virus variants and risk for AIDS and AIDS mortality

NARCIS (Netherlands)

Tersmette, M.; Lange, J. M.; de Goede, R. E.; de Wolf, F.; Eeftink-Schattenkerk, J. K.; Schellekens, P. T.; Coutinho, R. A.; Huisman, J. G.; Goudsmit, J.; Miedema, F.

1989-01-01

49 individuals seropositive for human immunodeficiency virus (HIV) antibody were studied longitudinally for the relation between in-vitro properties of their sequential HIV isolates and clinical course before and after the development of AIDS. They were classified into three groups according to the

European Symposium on Precision Medicine in Allergy and Airways Diseases: Report of the European Union Parliament Symposium (October 14, 2015).

Science.gov (United States)

Muraro, A; Fokkens, W J; Pietikainen, S; Borrelli, D; Agache, I; Bousquet, J; Costigliola, V; Joos, G; Lund, V J; Poulsen, L K; Price, D; Rolland, C; Zuberbier, T; Hellings, P W

2016-05-01

The European Academy of Allergy and Clinical Immunology (EAACI), the European Rhinologic Society (ERS), and the European Medical Association (EMA) organized, on October 14, 2015, a symposium in the European Parliament in Brussels on Precision Medicine in Allergy and Airways Diseases, hosted by MEP David Borrelli, and with active participation of the EU Commissioner for Health and Food Safety Vytenis Andriukaitis, MEP Sirpa Pietikainen, Chair of the European Parliament Interest Group on Allergy and Asthma, the European Respiratory Society (ERS), the European Federations of Allergy and Airways Diseases Patients Associations (EFA), the Global Allergy and Asthma European Network (Ga2len), Allergic Rhinitis and Its Impact on Asthma (ARIA), and the Respiratory Effectiveness Group (REG). The socioeconomic impact of allergies and chronic airways diseases cannot be underestimated, as they represent the most frequently diagnosed chronic noncommunicable diseases in the EU; 30% of the total European population is suffering from allergies and asthma, and more than half are deprived from adequate diagnosis and treatment. Precision medicine represents a novel approach, embracing four key features: personalized care based on molecular, immunologic, and functional endotyping of the disease, with participation of the patient in the decision-making process of therapeutic actions, and considering predictive and preventive aspects of the treatment. Implementation of precision medicine into clinical practice may help to achieve the arrest of the epidemic of allergies and chronic airways diseases. Participants underscored the need for optimal patient care in Europe, supporting joint action plans for disease prevention, patient empowerment, and cost-effective treatment strategies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Computer-aided proximal caries diagnosis: correlation with clinical examination and histology

International Nuclear Information System (INIS)

Kang, Byung Cheol; Scheetz, James P.; Aarman, Allan G.

2002-01-01

To evaluate the performance of the LOGICON Caries Detector using RVG-4 and RVG-ui sensors, by comparing results of each detector to the results of clinical and histological examinations. Pairs of extracted teeth were radiographed, and a total of 57 proximal surfaces, which included both carious and non-carious situations, were analyzed. The RVG-4 produced 8-bit images, while the RVG-ui unit produced 12-bit images, which were taken in the high sensitivity mode. The images produced by the LOGICON were evaluated by a trained observer using both automated and manual caries detection software modes. Ground sections of the teeth established the actual absence or existence of caries. LOGICON-aided caries detection and depth discrimination of the RVG-4 and RVG-ui sensors were equally inconsistent irrespective of whether the LOGICON software was set to the automated or manual mode. Sensitivity ranged from 50% to 57% for caries penetration of the enamel-dentin junction. Care needs to be taken when using LOGICON in conjunction with RVG images as an adjunct for treatment planning dental caries. Even when applied by a trained observer, substantial discrepancies exist between the results of the LOGICON software-guided evalutation using RVG images and histologic examination.

The AFFORD clinical decision aid to identify emergency department patients with atrial fibrillation at low risk for 30-day adverse events.

Science.gov (United States)

Barrett, Tyler W; Storrow, Alan B; Jenkins, Cathy A; Abraham, Robert L; Liu, Dandan; Miller, Karen F; Moser, Kelly M; Russ, Stephan; Roden, Dan M; Harrell, Frank E; Darbar, Dawood

2015-03-15

There is wide variation in the management of patients with atrial fibrillation (AF) in the emergency department (ED). We aimed to derive and internally validate the first prospective, ED-based clinical decision aid to identify patients with AF at low risk for 30-day adverse events. We performed a prospective cohort study at a university-affiliated tertiary-care ED. Patients were enrolled from June 9, 2010, to February 28, 2013, and followed for 30 days. We enrolled a convenience sample of patients in ED presenting with symptomatic AF. Candidate predictors were based on ED data available in the first 2 hours. The decision aid was derived using model approximation (preconditioning) followed by strong bootstrap internal validation. We used an ordinal outcome hierarchy defined as the incidence of the most severe adverse event within 30 days of the ED evaluation. Of 497 patients enrolled, stroke and AF-related death occurred in 13 (3%) and 4 (aid included the following: age, triage vitals (systolic blood pressure, temperature, respiratory rate, oxygen saturation, supplemental oxygen requirement), medical history (heart failure, home sotalol use, previous percutaneous coronary intervention, electrical cardioversion, cardiac ablation, frequency of AF symptoms), and ED data (2 hours heart rate, chest radiograph results, hemoglobin, creatinine, and brain natriuretic peptide). The decision aid's c-statistic in predicting any 30-day adverse event was 0.7 (95% confidence interval 0.65, 0.76). In conclusion, in patients with AF in the ED, Atrial Fibrillation and Flutter Outcome Risk Determination provides the first evidence-based decision aid for identifying patients who are at low risk for 30-day adverse events and candidates for safe discharge. Copyright © 2015 Elsevier Inc. All rights reserved.

Paediatric HIV/AIDS in Abakaliki | Ojukwu | Nigerian Journal of ...

African Journals Online (AJOL)

Objectives: The study was aimed at determining the mode of transmission, clinical presentation, and outcome of HIV infection in children admitted with clinical manifestations suspicious of HIV infection. It was also to examine whether the WHO clinical case definition for paediatric AIDS in Africa could help predict the infection ...

International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: Guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT).

Science.gov (United States)

Torres, Antoni; Niederman, Michael S; Chastre, Jean; Ewig, Santiago; Fernandez-Vandellos, Patricia; Hanberger, Hakan; Kollef, Marin; Li Bassi, Gianluigi; Luna, Carlos M; Martin-Loeches, Ignacio; Paiva, J Artur; Read, Robert C; Rigau, David; Timsit, Jean François; Welte, Tobias; Wunderink, Richard

2017-09-01

The most recent European guidelines and task force reports on hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) were published almost 10 years ago. Since then, further randomised clinical trials of HAP and VAP have been conducted and new information has become available. Studies of epidemiology, diagnosis, empiric treatment, response to treatment, new antibiotics or new forms of antibiotic administration and disease prevention have changed old paradigms. In addition, important differences between approaches in Europe and the USA have become apparent.The European Respiratory Society launched a project to develop new international guidelines for HAP and VAP. Other European societies, including the European Society of Intensive Care Medicine and the European Society of Clinical Microbiology and Infectious Diseases, were invited to participate and appointed their representatives. The Latin American Thoracic Association was also invited.A total of 15 experts and two methodologists made up the panel. Three experts from the USA were also invited (Michael S. Niederman, Marin Kollef and Richard Wunderink).Applying the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology, the panel selected seven PICO (population-intervention-comparison-outcome) questions that generated a series of recommendations for HAP/VAP diagnosis, treatment and prevention. Copyright ©ERS 2017.

Vida/SIDA: A Grassroots Response to AIDS in Chicago's Puerto Rican Community

Science.gov (United States)

Sanabria, Roberto

2004-01-01

Chicago's Puerto Rican community in West Town had a unique reaction to the spread of AIDS within its limits. They created their own institutions and tackled the epidemic themselves. In its infancy, Vida/SIDA, which translates as Life/AIDS, was solely an alternative health clinic for people with AIDS. Free of charge, it provided services such as…

A deadly combination of AIDS, TB and cardiac tumour.

Science.gov (United States)

Sahasrabudhe, Tushar Ramesh

2013-05-22

Immunocompromised status in AIDS makes differential diagnosis of any symptom very difficult for a clinician. Sharp clinical judgement and plenty of investigations may be needed to reach the diagnosis, as in this case. We hereby present a case of AIDS and active tuberculosis (TB) under treatment. The patient developed acute onset multifocal neurological symptoms following an episode of fever and diarrhoea. The MRI scan revealed numerous large cerebral infarcts. On investigations to evaluate brain infarcts, we made a diagnosis of left atrial cardiac tumour. Association of cardiac tumours with AIDS has only been rarely reported. It is uncertain if these can be opportunistic tumours in AIDS. The patient successfully came out of this deadly combination of diseases, viz AIDS, TB and large brain infarcts due to atrial tumour; with almost complete recovery.

European specialist porphyria laboratories: diagnostic strategies, analytical quality, clinical interpretation, and reporting as assessed by an external quality assurance program.

Science.gov (United States)

Aarsand, Aasne K; Villanger, Jørild H; Støle, Egil; Deybach, Jean-Charles; Marsden, Joanne; To-Figueras, Jordi; Badminton, Mike; Elder, George H; Sandberg, Sverre

2011-11-01

The porphyrias are a group of rare metabolic disorders whose diagnosis depends on identification of specific patterns of porphyrin precursor and porphyrin accumulation in urine, blood, and feces. Diagnostic tests for porphyria are performed by specialized laboratories in many countries. Data regarding the analytical and diagnostic performance of these laboratories are scarce. We distributed 5 sets of multispecimen samples from different porphyria patients accompanied by clinical case histories to 18-21 European specialist porphyria laboratories/centers as part of a European Porphyria Network organized external analytical and postanalytical quality assessment (EQA) program. The laboratories stated which analyses they would normally have performed given the case histories and reported results of all porphyria-related analyses available, interpretative comments, and diagnoses. Reported diagnostic strategies initially showed considerable diversity, but the number of laboratories applying adequate diagnostic strategies increased during the study period. We found an average interlaboratory CV of 50% (range 12%-152%) for analytes in absolute concentrations. Result normalization by forming ratios to the upper reference limits did not reduce this variation. Sixty-five percent of reported results were within biological variation-based analytical quality specifications. Clinical interpretation of the obtained analytical results was accurate, and most laboratories established the correct diagnosis in all distributions. Based on a case-based EQA scheme, variations were apparent in analytical and diagnostic performance between European specialist porphyria laboratories. Our findings reinforce the use of EQA schemes as an essential tool to assess both analytical and diagnostic processes and thereby to improve patient care in rare diseases.

Economic costs of chemotherapy-induced febrile neutropenia among patients with non-Hodgkin’s lymphoma in European and Australian clinical practice

Directory of Open Access Journals (Sweden)

Weycker Derek

2012-08-01

Full Text Available Abstract Background Economic implications of chemotherapy-induced febrile neutropenia (FN in European and Australian clinical practice are largely unknown. Methods Data were obtained from a European (97% and Australian (3% observational study of patients with non-Hodgkin’s lymphoma (NHL receiving CHOP (±rituximab chemotherapy. For each patient, each cycle of chemotherapy within the course, and each occurrence of FN within cycles, was identified. Patients developing FN in a given cycle (“FN patients”, starting with the first, were matched to those who did not develop FN in that cycle (“comparison patients”, irrespective of subsequent FN events. FN-related healthcare costs (£2010 were tallied for the initial FN event as well as follow-on care and FN events in subsequent cycles. Results Mean total cost was £5776 (95%CI £4928-£6713 higher for FN patients (n = 295 versus comparison patients, comprising £4051 (£3633-£4485 for the initial event and a difference of £1725 (£978-£2498 in subsequent cycles. Among FN patients requiring inpatient care (76% of all FN patients, mean total cost was higher by £7259 (£6327-£8205, comprising £5281 (£4810-£5774 for the initial hospitalization and a difference of £1978 (£1262-£2801 in subsequent cycles. Conclusions Cost of chemotherapy-induced FN among NHL patients in European and Australian clinical practice is substantial; a sizable percentage is attributable to follow-on care and subsequent FN events.

Aid and AIDS: a delicate cocktail

NARCIS (Netherlands)

van Dalen, H.P.; Reuser, M.

2008-01-01

Development assistance targeting health overwhelmingly concentrates on HIV/AIDS. This column argues that that focus neglects critical demographic issues and degrades health infrastructure, particularly in Sub-Saharan Africa. The prime rule for AIDS aid should be “First, do no harm”.

The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer.

Science.gov (United States)

Brunelli, Alessandro; Charloux, Anne; Bolliger, Chris T; Rocco, Gaetano; Sculier, Jean-Paul; Varela, Gonzalo; Licker, Marc; Ferguson, Mark K; Faivre-Finn, Corinne; Huber, Rudolf Maria; Clini, Enrico M; Win, Thida; De Ruysscher, Dirk; Goldman, Lee

2009-07-01

The European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS) established a joint task force with the purpose to develop clinical evidence-based guidelines on evaluation of fitness for radical therapy in patients with lung cancer. The following topics were discussed, and are summarized in the final report along with graded recommendations: Cardiologic evaluation before lung resection; lung function tests and exercise tests (limitations of ppoFEV1; DLCO: systematic or selective?; split function studies; exercise tests: systematic; low-tech exercise tests; cardiopulmonary (high tech) exercise tests); future trends in preoperative work-up; physiotherapy/rehabilitation and smoking cessation; scoring systems; advanced care management (ICU/HDU); quality of life in patients submitted to radical treatment; combined cancer surgery and lung volume reduction surgery; compromised parenchymal sparing resections and minimally invasive techniques: the balance between oncological radicality and functional reserve; neoadjuvant chemotherapy and complications; definitive chemo and radiotherapy: functional selection criteria and definition of risk; should surgical criteria be re-calibrated for radiotherapy?; the patient at prohibitive surgical risk: alternatives to surgery; who should treat thoracic patients and where these patients should be treated?

Maine belowground marsh destruction from the European green crab documented by computer-aided tomography

Science.gov (United States)

Invasive European green crab (Carcinus maenus) populations have exploded with devastating losses to Maine’s intertidal resources including soft-shell clams, eelgrass beds, and salt marshes. This project quantified the green crab abundance in three different marsh locations ...

Development of a computer-aided clinical patient education system to provide appropriate individual nursing care for psychiatric patients.

Science.gov (United States)

Tseng, Kuan-Jui; Liou, Tsan-Hon; Chiu, Hung-Wen

2012-06-01

A lot of researches have proven that health education can help patients to maintain and improve their health. And it also shortens the time staying in hospital to save medication resource. Because the patients are willing to get healthcare knowledge to enhance the ability of self-care, they pay more attention to the health education. In Taiwan, the clinical nurses play an important role in patient education, and the health education take most time in their daily work. Such work includes the collection, production and delivery of education materials. To generate the correct and customized health education material is the key of success of patient education. In this study, we established a computer-aided health education contents generating system for psychiatric patients by integrating the databases for disease, medicine and nursing knowledge to assist nurse generating the customized health education document suitable for different patients. This system was evaluated by clinical nurses in usability and feasibility. This system is helpful for nurse to carry out the clinical health education to patients and further to encourage patient to pay attention to self-health.

The value of haematological screening for AIDS in an at risk population

OpenAIRE

1986-01-01

The haematological variables measured by automated full blood count in matched homosexual and heterosexual men attending a clinic for sexually transmitted diseases (STD) were compared with those of normal controls and patients infected with the human T lymphotropic virus type III (HTLV-III). Homosexual and heterosexual men were statistically identical for all variables, but both differed noticeably from patients with clinical diagnoses of the acquired immune deficiency syndrome (AIDS) or AIDS...

[First-aid in France. Current situation and future perspectives].

Science.gov (United States)

Larcan, Alain; Julien, Henri

2010-06-01

the training period in order to make volunteer first- aiding more accessible, notably by employing the latest teaching methods. Authorize professional first-aiders to use monitoring equipment, airway clearance techniques, and certain emergency medications. Finally, give first-aid a European dimension, underline the need for prevention, and reinforce and develop the ethical side of first-aiding. First-aid provides access to citizenship and altruism, is the first link in the chain of emergency medical assistance capable of saving lives, and is crucial for civil security As such, it is a national cause and must be strongly supported by the political and administrative authorities.

Industry Perspective of Pediatric Drug Development in the United States: Involvement of the European Union Countries.

Science.gov (United States)

Onishi, Taku; Tsukamoto, Katsura; Matsumaru, Naoki; Waki, Takashi

2018-01-01

Efforts to promote the development of pediatric pharmacotherapy include regulatory frameworks and close collaboration between the US Food and Drug Administration and the European Medicines Agency. We characterized the current status of pediatric clinical trials conducted in the United States by the pharmaceutical industry, focusing on the involvement of the European Union member countries, to clarify the industry perspective. Data on US pediatric clinical trials were obtained from ClinicalTrials.gov . Binary regression analysis was performed to identify what factors influence the likelihood of involvement of European Union countries. A total of 633 US pediatric clinical trials that met inclusion criteria were extracted and surveyed. Of these, 206 (32.5%) involved a European Union country site(s). The results of binary regression analysis indicated that attribution of industry, phase, disease area, and age of pediatric participants influenced the likelihood of the involvement of European Union countries in US pediatric clinical trials. Relatively complicated or large pediatric clinical trials, such as phase II and III trials and those that included a broad age range of participants, had a significantly greater likelihood of the involvement of European Union countries ( P European Union countries, and (3) feasibility of clinical trials is mainly concerned by pharmaceutical industry for pediatric drug development. Additional incentives for high marketability may further motivate pharmaceutical industry to develop pediatric drugs.

Spectrum Of Opportunistic Infections In Aids Cases In A Tertiary Care Hospital In Nepal

Directory of Open Access Journals (Sweden)

Hari Shanker Joshi

2006-12-01

Full Text Available A retrospective study was carried out, 404 clinically suspected cases attending AIDS clinic at Manipal Teaching Hospital, Pokhara, Nepal to assess an occurance of opportunistic infections in AIDS cases. Study reveals that Tuberculosis (60%, Cryptospridiosis (13.33% and candidasis (11.11% are the predominant opportunistic infection in HIV/AIDS patients in the Pokharo village. Next common pathogen was found an ubiquitous yeast. Candida obtained from skin, oral cavity, oesophagus, sputum and stool. The least common documented documented infection was pneumocystis carini pneumonia (2.22%.

Interview: Nanomedicine and the fight against HIV/AIDS.

Science.gov (United States)

Nel, André; Swindells, Susan; Bronich, Tatiana; Gendelman, Howard E

2014-02-01

Ahead of the 4th Annual Meeting of the American Society of Nanomedicine, this collection of interviews brings together experts from the fields of nanomedicine and HIV/AIDS treatment. Professor André Nel gives us a general introduction and update on the nanomedicine field and how he hopes it will progress. Professor Susan Swindells describes the current challenges faced in the clinic for HIV/AIDS treatment. Professor Tatiana Bronich explains the research efforts being undertaken by the nanomedicine community for the treatment of microbial infections and HIV/AIDS specifically. Finally, Professor Howard Gendelman looks to the future and assesses the potential and challenges of nanomedicine approaches for HIV eradication.

Health Services: Clinical. Pharmacy Aide. Instructor's Manual. Competency-Based Education.

Science.gov (United States)

Cave, Julie; And Others

This instructor's manual consists of materials for use in presenting a course in the occupational area of pharmacy aide. Included in the first part of the guide are a program master sequence; a master listing of instructional materials, equipment, and supplies; an overview of the competency-based vocational education (CBVE) system; and guidelines…

Transformações da "aids aguda" para a "aids crônica": percepção corporal e intervenções cirúrgicas entre pessoas vivendo com HIV e aids From "acute AIDS" to "chronic AIDS": body perception and surgical interventions in people living with HIV and AIDS

Directory of Open Access Journals (Sweden)

Tatianna Meireles Dantas de Alencar

2008-12-01

the availability and use of new technologies that allowed for AIDS to transform into a chronic, clinically treatable disease, there are still important aspects lived by patients that reedit fears and difficulties similar to those of the initial periods of the epidemic, among others appearance-impairing physical stigma.

A review of the organization, regulation, and financing practices of postgraduate education in clinical nursing in 12 European countries.

Science.gov (United States)

Rautiainen, Elina; Vallimies-Patomäki, Marjukka

2016-01-01

The aim of this study was to generate information of postgraduate education in clinical nursing in the EU member states. Data were collected via a structured electronic questionnaire and the questionnaire was sent to the government chief nurses in 26 EU countries in May 2013. Response rate was 46% (n=12). In total, 42 domains of specialization were identified. The most common domains were intensive care, mental health, operating room, emergency care, and pediatrics. Specialization programs were organized by university in two of the respondent countries, as residency program in one country, and as a mix of them in four countries. Regulation practices varied remarkably between the countries: scope of practice, subjects, entry requirements, length of education, description of the minimum competence requirements, and education standards related to the specialization programs were most often regulated by act, decree or other regulation. In some of the countries, no registration was required beyond the initial registration, whereas in some others, registration practices varied depending on the specialization program. New information was gathered on the regulation practices of postgraduate education in clinical nursing in the European Region concerning title provision, entry requirements, and financing practices. The awarded title on specialization programs depended on the level of postgraduate education, and the title might vary between the domains. General clinical experience was included in the entry requirements in seven countries. The government was mainly responsible for financing the postgraduate education in four countries, employer in three countries, and in the rest of the countries, there was a combination of different financiers. The importance of knowledge exchange on postgraduate education across the European countries needs to be acknowledged. Information provided by this study on international regulation practices provides useful information for the policy

Interventions to improve hearing aid use in adult auditory rehabilitation.

Science.gov (United States)

Barker, Fiona; Mackenzie, Emma; Elliott, Lynette; Jones, Simon; de Lusignan, Simon

2016-08-18

Acquired adult-onset hearing loss is a common long-term condition for which the most common intervention is hearing aid fitting. However, up to 40% of people fitted with a hearing aid either fail to use it or may not gain optimal benefit from it. This is an update of a review first published in The Cochrane Library in 2014. To assess the long-term effectiveness of interventions to promote the use of hearing aids in adults with acquired hearing loss fitted with at least one hearing aid. The Cochrane ENT Information Specialist searched the Cochrane ENT Trials Register; Central Register of Controlled Trials (CENTRAL 2016, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 13 June 2016. We included randomised controlled trials (RCTs) of interventions designed to improve or promote hearing aid use in adults with acquired hearing loss compared with usual care or another intervention. We excluded interventions that compared hearing aid technology. We classified interventions according to the 'chronic care model' (CCM). The primary outcomes were hearing aid use (measured as adherence or daily hours of use) and adverse effects (inappropriate advice or clinical practice, or patient complaints). Secondary patient-reported outcomes included quality of life, hearing handicap, hearing aid benefit and communication. Outcomes were measured over the short ( 12 to quality of evidence to be very low or low for the primary outcomes where data were available.The majority of participants were over 65 years of age with mild to moderate adult-onset hearing loss. There was a mix of new and experienced hearing aid users. Six of the studies (287 participants) assessed long-term outcomes.All 37 studies tested interventions that could be classified using the CCM as self-management support (ways to help someone to manage their hearing loss and hearing aid(s) better by giving

European symposium on precision medicine in allergy and airways diseases

DEFF Research Database (Denmark)

Muraro, A; Fokkens, W J; Pietikainen, S

2015-01-01

suffering from allergies and asthma, more than half of these patients are deprived from adequate diagnosis and treatment. Precision Medicine represents a novel approach in medicine, embracing 4 key features: personalized care based on molecular, immunologic and functional endotyping of the disease......On 14 October 2015, the European Academy of Allergy and Clinical Immunology (EAACI), the European Rhinologic Society (ERS) and the European Medical Association (EMA) organized a symposium in the European Parliament in Brussels on Precision Medicine in Allergy and Airways Diseases, hosted by MEP......, with participation of the patient in the decision making process of therapeutic actions, and taking into account predictive and preventive aspects of the treatment. Implementation of Precision Medicine into clinical practice may help to achieve the arrest of the Epidemic of Allergies and Chronic Airways Diseases...

Provider training and experience for people living with HIV/AIDS.

Science.gov (United States)

Rackal, Julia M; Tynan, Anne-Marie; Handford, Curtis D; Rzeznikiewiz, Damian; Agha, Ayda; Glazier, Richard

2011-06-15

The complexity of HIV/AIDS raises challenges for the effective delivery of care. It is important to ensure that the expertise and experience of care providers is of high quality. Training and experience of HIV/AIDS providers may impact not only individual patient outcomes but increasingly on health care costs as well. The objective of this review is to assess the effects of provider training and experience on people living with HIV/AIDS on the following outcomes: immunological (ie. viral load, CD4 count), medical (ie. mortality, proportion on antiretrovirals), psychosocial (ie. quality of life measures) and economic outcomes (ie health care costs). We searched MEDLINE, EMBASE, Dissertation Abstracts International (DAI), CINAHL, HealthStar, PsycInfo, PsycLit, Social Sciences Abstracts, and Sociological Abstracts from January 1, 1980 through May 29, 2009.  Electronic searches were performed for abstracts from major international AIDS conferences. Reference lists from pertinent articles, books and review articles were retrieved and reviewed. Randomized controlled trials (RCTs), controlled clinical trials, cohort, case control, cross-sectional studies and controlled before and after designs that examined the qualifications/training and patient volume of HIV/AIDS care of providers caring for persons known to be infected with HIV/AIDS were included. At least two authors independently assessed trial quality and extracted data. Study authors were contacted for further information as required. Assessment of confounding factors was undertaken independently by two reviewers. A total of four studies (one randomized controlled trial, three non- randomized studies) involving 8488 people living with HIV/AIDS were included. The main findings of this review demonstrated a trend to improved outcomes when treated by a provider with more training/expertise in HIV/AIDS care in the outpatient (clinic) setting. Due to the heterogeneity of the included studies, we could not perform a

Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy. European Society of Human Genetics and European Society of Human Reproduction and Embryology.

Science.gov (United States)

Harper, Joyce C; Geraedts, Joep; Borry, Pascal; Cornel, Martina C; Dondorp, Wybo; Gianaroli, Luca; Harton, Gary; Milachich, Tanya; Kääriäinen, Helena; Liebaers, Inge; Morris, Michael; Sequeiros, Jorge; Sermon, Karen; Shenfield, Françoise; Skirton, Heather; Soini, Sirpa; Spits, Claudia; Veiga, Anna; Vermeesch, Joris Robert; Viville, Stéphane; de Wert, Guido; Macek, Milan

2013-11-01

In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation - ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and provide

Chemokine Receptor CCR5 Antagonist Maraviroc: Medicinal Chemistry and Clinical Applications

Science.gov (United States)

Xu, Guoyan G.; Guo, Jia; Wu, Yuntao

2015-01-01

The human immunodeficiency virus (HIV) causes acquired immumodeficiency syndrome (AIDS), one of the worst global pandemic. The virus infects human CD4 T cells and macrophages, and causes CD4 depletion. HIV enters target cells through the binding of the viral envelope glycoprotein to CD4 and the chemokine coreceptor, CXCR4 or CCR5. In particular, the CCR5-utilizing viruses predominate in the blood during the disease course. CCR5 is expressed on the surface of various immune cells including macrophages, monocytes, microglia, dendric cells, and active memory CD4 T cells. In the human population, the CCR5 genomic mutation, CCR5Δ32, is associated with relative resistance to HIV. These findings paved the way for the discovery and development of CCR5 inhibitors to block HIV transmission and replication. Maraviroc, discovered as a CCR5 antagonist, is the only CCR5 inhibitor that has been approved by both US FDA and the European Medicines Agency (EMA) for treating HIV/AIDS patients. In this review, we summarize the medicinal chemistry and clinical studies of Maraviroc. PMID:25159165

[Key points for esthetic rehabilitation of anterior teeth using chair-side computer aided design and computer aided manufacture technique].

Science.gov (United States)

Yang, J; Feng, H L

2018-04-09

With the rapid development of the chair-side computer aided design and computer aided manufacture (CAD/CAM) technology, its accuracy and operability of have been greatly improved in recent years. Chair-side CAD/CAM system may produce all kinds of indirect restorations, and has the advantages of rapid, accurate and stable production. It has become the future development direction of Stomatology. This paper describes the clinical application of the chair-side CAD/CAM technology for anterior aesthetic restorations from the aspects of shade and shape.

European clinical guidelines for Tourette Syndrome and other tic disorders. Part I : assessment

NARCIS (Netherlands)

Cath, Danielle C.; Hedderly, Tammy; Ludolph, Andrea G.; Stern, Jeremy S.; Murphy, Tara; Hartmann, Andreas; Czernecki, Virginie; Robertson, Mary May; Martino, Davide; Munchau, A.; Rizzo, R.

A working group of the European Society for the Study of Tourette Syndrome (ESSTS) has developed the first European assessment guidelines of Tourette Syndrome (TS). The available literature including national guidelines was thoroughly screened and extensively discussed in the expert group of ESSTS

Piloting the European Unified Patient Identity Management (EUPID) Concept to Facilitate Secondary Use of Neuroblastoma Data from Clinical Trials and Biobanking.

Science.gov (United States)

Ebner, Hubert; Hayn, Dieter; Falgenhauer, Markus; Nitzlnader, Michael; Schleiermacher, Gudrun; Haupt, Riccardo; Erminio, Giovanni; Defferrari, Raffaella; Mazzocco, Katia; Kohler, Jan; Tonini, Gian Paolo; Ladenstein, Ruth; Schreier, Guenter

2016-01-01

Data from two contexts, i.e. the European Unresectable Neuroblastoma (EUNB) clinical trial and results from comparative genomic hybridisation (CGH) analyses from corresponding tumour samples shall be provided to existing repositories for secondary use. Utilizing the European Unified Patient IDentity Management (EUPID) as developed in the course of the ENCCA project, the following processes were applied to the data: standardization (providing interoperability), pseudonymization (generating distinct but linkable pseudonyms for both contexts), and linking both data sources. The applied procedures resulted in a joined dataset that did not contain any identifiers that would allow to backtrack the records to either data sources. This provided a high degree of privacy to the involved patients as required by data protection regulations, without preventing proper analysis.

The Rate of Low Vision Aids Usage after Prescription at the Saba and Khazaneh Clinics in Low Vision Clients

Directory of Open Access Journals (Sweden)

Nasser Sadegh-Pour

2008-04-01

Full Text Available Objective: This research was aimed to determine the rate of low vision aids uses by low vision clients in their daily living. Materials & Methods: In this descriptive study that was done at the Saba and Khazaneh clinics, 50 people from low vision clients were selected by convenient sampling during 2005 & 2006. One questionnaire was completed by therapist at the first time of optometric examination and useful low vision aid (LVA has been prescript and given to clients. After three months (at least they should came back to center and fill the second form. The first form was about functional vision without LVA and second too, but by using of LVA. They have been compared to fulfill the result of research. Data were analyzed by Spearman correlation coefficient, Chi – square and Wilcoxon tests. Results: Spearman correlation coefficient between use of LVAs for near with duration and frequency of study were 0/491 and 0/520 with probability values such as P=0/003 and P=0/002 that shown significant relation. There was significant difference in traffic measure and environment knowing between before and after of far LVAs using (P=0/002 and their SCC was 0/499. There was significant relation between use of low vision aid and education after prescription (P=0/011. Conclusion: However the LVAs improve vision of low vision person, but many of them don’t use by different reasons.

Gingival Anaplastic Large-Cell Lymphoma Mimicking Hyperplastic Benignancy as the First Clinical Manifestation of AIDS: A Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Rafaela Elvira Rozza-de-Menezes

2013-01-01

Full Text Available This paper presents an unusual case of gingival ALCL, which mimicked a benign hyperplastic lesion that occurred in a 57-year-old white man representing the first clinical manifestation of acquired immunodeficiency syndrome (AIDS. The patient was referred to the Dental Clinic of PUCPR complaining of a lobulated nodule on the gingiva of his upper central incisors. The presence of advanced chronic periodontitis and dental plaque raised suspicion for a benignancy. An excisional biopsy was performed, and large pleomorphic cells with an abundant cytoplasm, sometimes containing prominent nucleoli and “Hallmark” cells, were observed through hematoxylin and eosin staining. The tumor cells showed strong CD30 expression, EMA, Ki-67, and LCA, and negative stain for p80NPM/ALK, CKAE1/AE3, CD20, CD3, CD56, and CD15. The final diagnosis was ALCL (ALK-negative. Further laboratory tests revealed positivity for human immunodeficiency virus (HIV. The patient was submitted to chemotherapy, but four months after diagnosis, the patient died due to pneumonia and respiratory failure. Oral anaplastic large-cell lymphoma (ALCL is a rare disorder. Only 5 cases involving the gingiva have been reported, and to our knowledge, this is the first case reported of the ALCL, which mimicked a hyperplastic benignancy as the first clinical manifestation of AIDS.

The European Hematology Association Roadmap for European Hematology Research: a consensus document.

Science.gov (United States)

Engert, Andreas; Balduini, Carlo; Brand, Anneke; Coiffier, Bertrand; Cordonnier, Catherine; Döhner, Hartmut; de Wit, Thom Duyvené; Eichinger, Sabine; Fibbe, Willem; Green, Tony; de Haas, Fleur; Iolascon, Achille; Jaffredo, Thierry; Rodeghiero, Francesco; Salles, Gilles; Schuringa, Jan Jacob

2016-02-01

The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness of the burden of blood disorders on European society, which purely in economic terms is estimated at €23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology of blood disorders, and has improved diagnostics and treatments, sometimes in revolutionary ways. This progress highlights the potential of focused basic research programs such as this EHA Roadmap.The EHA Roadmap identifies nine 'sections' in hematology: normal hematopoiesis, malignant lymphoid and myeloid diseases, anemias and related diseases, platelet disorders, blood coagulation and hemostatic disorders, transfusion medicine, infections in hematology, and hematopoietic stem cell transplantation. These sections span 60 smaller groups of diseases or disorders.The EHA Roadmap identifies priorities and needs across the field of hematology, including those to develop targeted therapies based on genomic profiling and chemical biology, to eradicate minimal residual malignant disease, and to develop cellular immunotherapies, combination treatments, gene therapies, hematopoietic stem cell treatments, and treatments that are better tolerated by elderly patients. Copyright© Ferrata Storti Foundation.

European consensus statement on diagnosis and treatment of adult ADHD: the European Network adult ADHD

LENUS (Irish Health Repository)

Kooij, Sandra JJ

2010-09-03

Abstract Background Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe. Methods The European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated. Results Besides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated? Conclusions ADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group.

Lymphocyte transformation response to pokeweed mitogen as a predictive marker for development of AIDS and AIDS related symptoms in homosexual men with HIV antibodies

DEFF Research Database (Denmark)

Hofmann, B; Lindhardt, B O; Gerstoft, J

1987-01-01

To identify factors that may predict the development of the acquired immune deficiency syndrome (AIDS) or AIDS related symptoms various immunological measurements were studied in a group of homosexual men attending screening clinics for AIDS in Copenhagen. Fifty seven men whose ratio of T helper...... lymphocytes to T suppressor lymphocytes (CD4:CD8 ratio) was less than 1.0 before the study began were included. Forty two were positive for antibody to the human immunodeficiency virus (HIV), of whom 38 were reinvestigated after a median observation period of 10 months. Among the seropositive men...

European Network of Bipolar Research Expert Centre (ENBREC)

DEFF Research Database (Denmark)

Henry, Chantal; Andreassen, Ole A; Barbato, Angelo

2013-01-01

Bipolar disorders rank as one of the most disabling illnesses in working age adults worldwide. Despite this, the quality of care offered to patients with this disorder is suboptimal, largely due to limitations in our understanding of the pathology. Improving this scenario requires the development...... centres across Europe can collaborate on a wide range of basic science and clinical programmes using shared protocols. This paper is to describe the network and how it aims to improve the quality and effectiveness of research in a neglected priority area....... of a critical mass of expertise and multicentre collaborative projects. Within the framework of the European FP7 programme, we developed a European Network of Bipolar Research Expert Centres (ENBREC) designed specifically to facilitate EU-wide studies. ENBREC provides an integrated support structure...... facilitating research on disease mechanisms and clinical outcomes across six European countries (France, Germany, Italy, Norway, Spain and the UK). The centres are adopting a standardised clinical assessment that explores multiple aspects of bipolar disorder through a structured evaluation designed to inform...

'Mind the gap' between the development of therapeutic innovations and the clinical practice in oncology: A proposal of the European Organisation for Research and Treatment of Cancer (EORTC) to optimise cancer clinical research.

Science.gov (United States)

Kempf, Emmanuelle; Bogaerts, Jan; Lacombe, Denis; Liu, Lifang

2017-11-01

In Europe, most of the cancer clinical research dedicated to therapeutic innovations aims primarily at regulatory approval. Once an anticancer drug enters the common market, each member state determines its real-world use based on its own criteria: pricing, reimbursement and clinical indications. Such an innovation-centred clinical research landscape might neglect patient-relevant issues in real-world setting, such as comparative effectiveness of distinct treatment options or long-term safety monitoring. The European Organisation for Research and Treatment of Cancer (EORTC) advocates reforming the current 'innovation-centred' system to a truly 'patient-centred' paradigm with systematically coordinated applied clinical research in conjunction with drug development, featuring the following strategy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is Gender Mainstreamed? : A study of the European Commission's use of gender mainstreaming in development policies

OpenAIRE

Karlsson, Sophie

2016-01-01

The EU has long expressed a will to be a normative power and to externally promote the values it views as important. Seeing as the EU collectively is the largest donor of foreign aid in the world, development policies are a perfect platform for doing this. One value that has gained ground in recent years is the notion of gender equality. Bearing this in mind, this thesis explores how the EU’s largest institutional donor of foreign aid, the European Commission, has chosen to promote the value ...

A NEW CHALLENGE FOR THE ROMANIAN COAL INDUSTRY: ELIMINATION OF THE STATE AID

Directory of Open Access Journals (Sweden)

Gruian Claudiu-Marian

2010-12-01

Full Text Available According to the European Commission decision N 239/2007 the Romanian coal industry will receive state aid by the end of 2010. After this period public companies in this sector will finance the costs of current production and investment entirely by their revenue. This article presents a short literature review regarding the subsidization of coal industry, shows the evolution of the mining industry in Romania so far, and identifies opportunities for continuing coal production after December 31, 2010 without state aid. The paper concludes that the abolition of subsides in is a positive measure but it must be taken gradually and responsibly, in order to ameliorate the negative effects on social end natural environment.

MR imaging of white matter lesions in AIDS

International Nuclear Information System (INIS)

Olsen, W.L.; Longo, F.; Norman, D.

1987-01-01

Autopsy reports have shown white-matter abnormalities from infection of the brain by the human immunodeficiency virus (HIV), the agent that causes acquired immunodeficiency syndrome (AIDS). The authors observed abnormal signal on T2-weighted images in the white matter of approximately one third of all AIDS patients. Of 50 patients with white-matter lesions, approximately two thirds had no clinical or biopsy evidence of cytomegalovirus, toxoplasmosis, PML, or lymphoma. Several patients were shown at autopsy to have isolated evidence of HIV encephalitis. The authors conclude that white-matter lesions are common in AIDS and are frequently caused by infection with HIV. Some MR findings may be helpful in characterizing these lesions, but the various etiologies are often indistinguishable

EPIDEMIOLOGY OF HIV/AIDS IN SOUTH AFRICA

African Journals Online (AJOL)

women attending antenatal clinics in 1998 and 1999. ... The Joint United ations Programme on HIV/ AIDS (UNAIDS) and the World Health Organisation (WHO) ... S of every 10 women, and 9 of every 10 children) live in sub-Saharan Africa.

AID SELECTIVITY PRACTICE AND AID EFFECTIVENESS IN SUB-SAHARAN AFRICA

Directory of Open Access Journals (Sweden)

Adeniyi Jimmy Adedokun

2017-09-01

Full Text Available Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship in Sub-Saharan Africa (SSA and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to aid selectivity practice.

THE MODERNISATION OF STATE AID CONTROL AND ITS OBJECTIVES: CLARITY, RELEVANCE, EFFECTIVENESS

Directory of Open Access Journals (Sweden)

Vittorio Di Bucci

2014-12-01

Full Text Available On 8 May 2012, the Commission adopted its Communication on State aid modernisation. Two years later, most elements of the reform have come into force. This was the most comprehensive overhaul in the history of State aid control. First, the Council quickly agreed to amendments of the Enabling Regulation, enlarging the scope of measures that can be exempted from notification, and of the Procedural Regulation, enhancing the investigative powers of the Commission and introducing the possibility for the Commission to intervene in national litigation. Second, the Commission issued new versions, based on a common structure, of its horizontal guidelines and frameworks: regional aid, risk finance, environmental protection with the addition of energy, research and development and innovation, rescuing and restructuring of undertakings in difficulty, a new document concerning important projects of common European interest, and some important sectorial instruments (broadband, aviation. Third, the Commission adopted a new de minimis regulation and a new, comprehensive block exemption regulation, intended to cover the majority of national aid measures. Fourth, a new notice on the notion of aid, yet to be finally adopted, should provide interpretative guidance. The result of the exercise is a considerable clarification of the rules, an improvement of the procedural tools and a limitation of the obligation to notify State aid projects. In turn, this should allow the Commission to work more efficiently, to reduce the duration of its procedures and to focus on the most distortive measures.

Report of the 1st meeting of the "Vienna Initiative to Save European Academic Research (VISAER)".

Science.gov (United States)

Druml, Christiane; Singer, Ernst A; Wolzt, Michael

2006-04-01

The European Directive 2001/20/EC ("Clinical Trials Directive") was aimed at simplifying and harmonising European clinical research. The directive's attempt represents an important step because many European Member States lack national laws that specifically address details of research, but the goal has been only partly achieved. For academic investigators doing national or multi-national research the new European law and the requirements following its implementation are likely to have the opposite effect. Some areas seem to be of particular concern: trial sponsorship, the ethical review process, the participation of patients who are temporarily not able to consent in clinical trials, in particular the informed consent process, an accepted European registry for all clinical trials, insurance and pharmacovigilance. Furthermore there are fundamental problems of the conduct of clinical trials that could have been foreseen at the time of implementation of the new law, which are impeding academic basic clinical research. The bureaucratic burden for academic investigators has tremendously increased without representing any contribution to patients' safety or to the scientific value of research. Furthermore some large European academic trials cannot be conducted anymore due to the new regulations. This result in a reduction in the number of trials and additionally in a reduction in the number of patients enrolled in a study. European research and thus European patients will suffer from the loss of potential benefits of research. The Vienna Initiative to Save European Academic Research (VISEAR) brings together leading stakeholders from academic research groups and interested parties from industry, international organisations and regulatory authorities to focus on the issues of concern regarding the organisational and funding of academic clinical research in order to improve the development and use of medicines in Europe. The first step of the initiative was a meeting held

Precision medicine in allergic disease-food allergy, drug allergy, and anaphylaxis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology

DEFF Research Database (Denmark)

Muraro, A; Lemanske, Robert F; Castells, M

2017-01-01

This consensus document summarizes the current knowledge on the potential for precision medicine in food allergy, drug allergy, and anaphylaxis under the auspices of the PRACTALL collaboration platform. PRACTALL is a joint effort of the European Academy of Allergy and Clinical Immunology and the ......This consensus document summarizes the current knowledge on the potential for precision medicine in food allergy, drug allergy, and anaphylaxis under the auspices of the PRACTALL collaboration platform. PRACTALL is a joint effort of the European Academy of Allergy and Clinical Immunology...... and the American Academy of Allergy, Asthma and Immunology, which aims to synchronize the European and American approaches to allergy care. Precision medicine is an emerging approach for disease treatment based on disease endotypes, which are phenotypic subclasses associated with specific mechanisms underlying...

Foreign aid

DEFF Research Database (Denmark)

Tarp, Finn

2008-01-01

Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles and instituti......Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles...... and institutions of the aid system; and (c) discusses whether aid has been effective. While much of the original optimism about the impact of foreign aid needed modification, there is solid evidence that aid has indeed helped further growth and poverty reduction...

Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions

OpenAIRE

Kotseva, Kornelia; De Bacquer, Dirk; De Backer, Guy; Ryden, Lars; Jennings, Catriona; Gyberg, Viveca; Abreu, Ana; Aguiar, Carlos; Conde, Almudena C.; Davletov, Kairat; Dilic, Mirza; Dolzhenko, Maryna; Gaita, Dan; Georgiev, Borislav; Gotcheva, Nina

2016-01-01

BACKGROUND: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV in primary care was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2014-2015 in 71 centres from 14 European countries. The main objective was to determine whether the 2012 Joint European Societies' guidelines on cardiovascular disease (CVD) prevention in people at high CVD risk have been followed in clinical practi...

European research priorities for intracerebral haemorrhage

DEFF Research Database (Denmark)

Steiner, Thorsten; Petersson, Jesper; Al-Shahi Salman, Rustam

2011-01-01

and disability. The European Research Network on Intracerebral Haemorrhage EURONICH is a multidisciplinary academic research collaboration that has been established to define current research priorities and to conduct large clinical studies on all aspects of ICH........ No standardised diagnostic workup for the detection of the various underlying causes of ICH currently exists, and the evidence for medical or surgical therapeutic interventions remains limited. A dedicated European research programme for ICH is needed to identify ways to reduce the burden of ICH-related death...

The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial.

Science.gov (United States)

Humes, Larry E; Rogers, Sara E; Quigley, Tera M; Main, Anna K; Kinney, Dana L; Herring, Christine

2017-03-01

The objectives of this study were to determine efficacy of hearing aids in older adults using audiology best practices, to evaluate the efficacy of an alternative over-the-counter (OTC) intervention, and to examine the influence of purchase price on outcomes for both service-delivery models. The design of this study was a single-site, prospective, double-blind placebo-controlled randomized trial with three parallel branches: (a) audiology best practices (AB), (b) consumer decides OTC model (CD), and (c) placebo devices (P). Outcome measures were obtained after a typical 6-week trial period with follow-up 4-week AB-based trial for those initially assigned to CD and P groups. Older adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic. Participants were adults, ages 55-79 years, with mild-to-moderate hearing loss. There were 188 eligible participants: 163 enrolled as a volunteer sample, and 154 completed the intervention. All participants received the same high-end digital mini-behind-the-ear hearing aids fitted bilaterally. AB and P groups received best-practice services from audiologists; differing mainly in use of appropriate (AB) or placebo (P) hearing aid settings. CD participants self-selected their own pre-programmed hearing aids via an OTC model. Primary outcome measure was a 66-item self-report, Profile of Hearing Aid Benefit (Cox & Gilmore, 1990). Secondary outcome measure was the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing-aid benefit, satisfaction, and usage were also obtained. Per-protocol analyses were performed. AB service-delivery model was found to be efficacious for most of the outcome measures, with moderate or large effect sizes (Cohen's d). CD service-delivery model was efficacious, with similar effect sizes. However, CD group had a significantly (p purchase hearing aids after the trial. Hearing aids are efficacious in

Educational aids

International Nuclear Information System (INIS)

Lenkeit, S.

1989-01-01

Educational aids include printed matter, aural media, visual media, audiovisual media and objects. A distinction is made between learning aids, which include blackboards, overhead projectors, flipcharts, wallcharts and pinboards, and learning aids, which include textbooks, worksheets, documentation and experimental equipment. The various aids are described and their use explained. The aids available at the School for Nuclear Technology of the Karlsruhe Nuclear Research Centre are described

Pulmonary lobar volumetry using novel volumetric computer-aided diagnosis and computed tomography

Science.gov (United States)

Iwano, Shingo; Kitano, Mariko; Matsuo, Keiji; Kawakami, Kenichi; Koike, Wataru; Kishimoto, Mariko; Inoue, Tsutomu; Li, Yuanzhong; Naganawa, Shinji

2013-01-01

OBJECTIVES To compare the accuracy of pulmonary lobar volumetry using the conventional number of segments method and novel volumetric computer-aided diagnosis using 3D computed tomography images. METHODS We acquired 50 consecutive preoperative 3D computed tomography examinations for lung tumours reconstructed at 1-mm slice thicknesses. We calculated the lobar volume and the emphysematous lobar volume volumetry computer-aided diagnosis system could more precisely measure lobar volumes than the conventional number of segments method. Because semi-automatic computer-aided diagnosis and automatic computer-aided diagnosis were complementary, in clinical use, it would be more practical to first measure volumes by automatic computer-aided diagnosis, and then use semi-automatic measurements if automatic computer-aided diagnosis failed. PMID:23526418

The EuroMPs defend aid to coal mining; Los eurodiputados defienden las ayudas a la mineria del carbon

Energy Technology Data Exchange (ETDEWEB)

NONE

1992-04-01

The maintenance of public aid to the coal industry and the creation of a communitarian politics of energy are the two principal requests which the European Parliament made to the Commission and the Council after the discussion of two reports from the Commission of Energy.

The European Community programmes in the sector of wind energy

International Nuclear Information System (INIS)

Diamantaras, K.; Ferrero, G.L.

1992-01-01

The wind technology market has known a considerable evolution over the last decade. From the early eighties - when there were only a few kilowatts of the research prototype wind turbines installed - the total installed capacity within the European Community has reached nowadays more than 765 MW in commercial machines. This expansion has been brought about with the aid of important R and D energy technology programmes run by national governments, and by the Commission of European Communities with its research, development, demonstration and market development programmes, such as the JOULE, demonstration and THERMIE programmes. This paper presents the activities of the Community demonstration and THERMIE programmes in the wind energy sector from 1983 to 1992. Reference is also made to the Community programmes JOULE II and ALTENER. (au)

Magnetic resonance imaging findings of the brain in adult HIV and AIDS patients; Magnetresonanztomografische Befunde des Gehirns bei adulten Patienten mit HIV und AIDS

Energy Technology Data Exchange (ETDEWEB)

Kloska, S.P.; Schlegel, P.M.; Fischbach, R.; Heindel, W. [Inst. fuer Klinische Radiologie, Universitaetsklinikum Muenster (Germany); Husstedt, I.W.; Anneken, K.; Evers, S. [Klinik und Poliklinik fuer Neurologie, Universitaetsklinikum Muenster (Germany)

2008-01-15

The spectrum of pathology affecting the central nervous system (CNS) in patients suffering from acquired immunodeficiency syndrome (AIDS) includes not only the human immunodeficiency virus (HIV) infection itself but also opportunistic infections and tumors secondary to AIDS. Despite progress in antiretroviral therapy and the subsequent decrease in the incidence of associated diseases, opportunistic infections and tumors secondary to the HIV infection continue to be the limiting factor in terms of survival with AIDS. Therefore, the therapeutic aim is permanent antiretroviral therapy as well as early diagnosis and treatment of opportunistic infections. Magnetic resonance imaging is often the diagnostic method of choice in suspected CNS pathology of HIV patients. In the following, the typical clinical and radiological features of several AIDS-related pathologies are presented and discussed. (orig.)

Cerebral computerized tomography findings in AIDS patients; Cerebrale CT-funn ved AIDS

Energy Technology Data Exchange (ETDEWEB)

Hol, P.K.; Dunlop, O. [Ullevaal Sykehus, Oslo (Norway)

1997-09-01

A cerebral CT was performed in 82 of 525 AIDS patients, with positive findings in 46 cases. These findings included cerebral atrophy in 28 cases, pathological demyelinisation in two, progressive multifocal leukoencephalopathy in one, toxoplasmoses in 11, lymphomas in seven, infarction in one and one subdural haematoma. The radiological findings are correlated to pathology and clinical symptoms. The authors point out the importance of these findings for correct interpretation of the CT scans. 11 refs., 7 figs., 2 tabs.

AID SELECTIVITY PRACTICE AND AID EFFECTIVENESS IN SUB-SAHARAN AFRICA

OpenAIRE

Adedokun, Adeniyi Jimmy; Abiodun O. Folawewo, Abiodun O.

2017-01-01

Foreign aid strategies have undergone restructuring as donors adopt aid selectivity practice to improve aid effectiveness. This study investigates the impact of aid selectivity practice on aid effectiveness (aid-growth relationship) in Sub-Saharan Africa (SSA) and several groups of countries within SSA from 1980 to 2012. Employing system generalized methods of moments (system GMM) technique; the study produces strong evidence that there is significant improvement in aid effectiveness due to a...

Tuberculosis among migrant populations in the European Union and the European Economic Area.

Science.gov (United States)

Odone, Anna; Tillmann, Taavi; Sandgren, Andreas; Williams, Gemma; Rechel, Bernd; Ingleby, David; Noori, Teymur; Mladovsky, Philipa; McKee, Martin

2015-06-01

Although tuberculosis (TB) incidence has been decreasing in the European Union/European Economic Area (EU/EEA) in the last decades, specific subgroups of the population, such as migrants, remain at high risk of TB. This study is based on the report 'Key Infectious Diseases in Migrant Populations in the EU/EEA' commissioned by The European Centre for Disease Prevention and Control. We collected, critically appraised and summarized the available evidence on the TB burden in migrants in the EU/EEA. Data were collected through: (i) a comprehensive literature review; (ii) analysis of data from The European Surveillance System (TESSy) and (iii) evidence provided by TB experts during an infectious disease workshop in 2012. In 2010, of the 73,996 TB cases notified in the EU/EEA, 25% were of foreign origin. The overall decrease of TB cases observed in recent years has not been reflected in migrant populations. Foreign-born people with TB exhibit different socioeconomic and clinical characteristics than native sufferers. This is one of the first studies to use multiple data sources, including the largest available European database on infectious disease notifications, to assess the burden and provide a comprehensive description and analysis of specific TB features in migrants in the EU/EEA. Strengthened information about health determinants and factors for migrants' vulnerability is needed to plan, implement and evaluate targeted TB care and control interventions for migrants in the EU/EEA. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association.

The European Network of Coloproctology: a strategy towards the European research and healthcare system.

Science.gov (United States)

Rubbini, Michele

2016-12-01

Many documents from the International Institutions point out that Health represents an engine of economic and social development. Based on these documents and concepts, the European Parliament decided to create a system of European Reference Networks as a synthesis of clinical and research activities, particularly in the field of rare diseases. This initiative, properly implemented, could be first step towards a new European health system. This article instead, wanting to deepen this perspective, postulates that the ERNs may also be related to widespread diseases, such as those of coloproctological interest, with the aim of setting up a European Network of Coloproctology (ENCP). Here are analyzed: (a) the documents related to ERNs and others related to research and training, the characteristics of the coloproctological diseases, and proposal of the ENCP; (b) a survey that involves 14 out of 25 of the National and Regional Representative of the European Society of Coloproctology. Hundred percent of the people interviewed agree to the ENCP project. The percentage of the approved proposed fields of activity of the ENCP are: Healthcare 71%, Research 100%, Training 86%, Support to legislation 78%, Professional Mobility 64%, Patient Database 71%, and Expenditure control 64%. From the analysis of the documents and the result of the survey, ERNs are appropriate not only in relation to rare diseases but also in those fields with higher diffusion and the creation of a European Network of Coloproctology is then postulated.

Estudo comparativo do LCR de pacientes com neurocriptococose sem AIDS e com AIDS Comparison between CSF samples from AIDS and non-AIDS patients with neurocryptococcosis

Directory of Open Access Journals (Sweden)

João Baptista dos Reis-Filho

1994-06-01

Full Text Available Até a década de 80, antes do surgimento da AIDS, a criptococose era relativamente rara. Verificou-se que esta doença afeta muito frequentemente os pacientes com AIDS e pode ser a primeira manifestação desta síndrome. O objetivo deste trabalho é o de comparar o resultado dos exames das amostras do LCR inicial na meningencefalite por criptococo entre pacientes com e sem AIDS. Este trabalho é baseado no estudo de 41 pacientes com neurocriptococose sem AIDS e de 23 pacientes com neurocriptococose e AIDS. Este estudo permitiu verificar que a reação inflamatória, no sistema nervoso, quando presente, foi de menor intensidade nos pacientes com AIDS; a reação inflamatória esteve presente em todos os pacientes sem AIDS e ausente em 21,7% dos pacientes com AIDS; o quadro inflamatório crônico, semelhante ao da meningencefalite tuberculosa, clássico nas meningencefalites por criptococo, ocorreu raramente nos pacientes com AIDS; em média, o número de criptococos no LCR foi maior nos pacientes com AIDS; pode ser feito diagnóstico presuntivo da AIDS quando o criptococo estiver presente no LCR que não apresenta alterações citológicas e bioquímicas.Neurocryptococcosis was a rare nervous system infection. With the rising number of patients with AIDS it became a very frequent disease. This infection is supposed to infect patients with some kind of immunodeficiency and the CSF alterations often simulate tuberculous meningitis. The purpose of this research was to compare the CSF changes in AIDS and non-AIDS patients with meningoencephalitis caused by Cr. neoformans. There were analysed 41 CSF samples from non-AIDS patients with neurocryptococcosis and 23 CSF samples from AIDS patients with neurocryptococcosis. The results of this research allowed to conclude that the inflammatory changes in the CSF from AIDS patients showed a lower intensity compared to those non-AIDS patients. These results showed as well, that the CSF samples from non-AIDS

A deadly combination of AIDS, TB and cardiac tumour

OpenAIRE

Sahasrabudhe, Tushar Ramesh

2013-01-01

Immunocompromised status in AIDS makes differential diagnosis of any symptom very difficult for a clinician. Sharp clinical judgement and plenty of investigations may be needed to reach the diagnosis, as in this case. We hereby present a case of AIDS and active tuberculosis (TB) under treatment. The patient developed acute onset multifocal neurological symptoms following an episode of fever and diarrhoea. The MRI scan revealed numerous large cerebral infarcts. On investigations to evaluate br...

Aid Effectiveness

DEFF Research Database (Denmark)

Arndt, Channing; Jones, Edward Samuel; Tarp, Finn

of the main relationships; (ii) estimating the impact of aid on a range of final and intermediate outcomes; and (iii) quantifying a simplied representation of the full structural form, where aid impacts on growth through key intermediate outcomes. A coherent picture emerges: aid stimulates growth and reduces......Controversy over the aggregate impact of foreign aid has focused on reduced form estimates of the aid-growth link. The causal chain, through which aid affects developmental outcomes including growth, has received much less attention. We address this gap by: (i) specifying a structural model...... poverty through physical capital investment and improvements in health....

Measuring clinical management by physicians and nurses in European hospitals: development and validation of two scales.

Science.gov (United States)

Plochg, Thomas; Arah, Onyebuchi A; Botje, Daan; Thompson, Caroline A; Klazinga, Niek S; Wagner, Cordula; Mannion, Russell; Lombarts, Kiki

2014-04-01

Clinical management is hypothesized to be critical for hospital management and hospital performance. The aims of this study were to develop and validate professional involvement scales for measuring the level of clinical management by physicians and nurses in European hospitals. Testing of validity and reliability of scales derived from a questionnaire of 21 items was developed on the basis of a previous study and expert opinion and administered in a cross-sectional seven-country research project 'Deepening our Understanding of Quality improvement in Europe' (DUQuE). A sample of 3386 leading physicians and nurses working in 188 hospitals located in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey. Validity and reliability of professional involvement scales and subscales. Psychometric analysis yielded four subscales for leading physicians: (i) Administration and budgeting, (ii) Managing medical practice, (iii) Strategic management and (iv) Managing nursing practice. Only the first three factors applied well to the nurses. Cronbach's alpha for internal consistency ranged from 0.74 to 0.86 for the physicians, and from 0.61 to 0.81 for the nurses. Except for the 0.74 correlation between 'Administration and budgeting' and 'Managing medical practice' among physicians, all inter-scale correlations were measurement instrument can be used for international research on clinical management.

Improving clinical trials for cardiovascular diseases: a position paper from the Cardiovascular Round Table of the European Society of Cardiology.

Science.gov (United States)

Jackson, Neville; Atar, Dan; Borentain, Maria; Breithardt, Günter; van Eickels, Martin; Endres, Matthias; Fraass, Uwe; Friede, Tim; Hannachi, Hakima; Janmohamed, Salim; Kreuzer, Jörg; Landray, Martin; Lautsch, Dominik; Le Floch, Chantal; Mol, Peter; Naci, Huseyin; Samani, Nilesh J; Svensson, Anders; Thorstensen, Cathrine; Tijssen, Jan; Vandzhura, Victoria; Zalewski, Andrew; Kirchhof, Paulus

2016-03-01

Cardiovascular disease is the most common cause of mortality and morbidity in the world, but the pharmaceutical industry's willingness to invest in this field has declined because of the many challenges involved with bringing new cardiovascular drugs to market, including late-stage failures, escalating regulatory requirements, bureaucracy of the clinical trial business enterprise, and limited patient access after approval. This contrasts with the remaining burden of cardiovascular disease in Europe and in the world. Thus, clinical cardiovascular research needs to adapt to address the impact of these challenges in order to ensure development of new cardiovascular medicines. The present paper is the outcome of a two-day workshop held by the Cardiovascular Round Table of the European Society of Cardiology. We propose strategies to improve development of effective new cardiovascular therapies. These can include (i) the use of biomarkers to describe patients who will benefit from new therapies more precisely, achieving better human target validation; (ii) targeted, mechanism-based approaches to drug development for defined populations; (iii) the use of information technology to simplify data collection and follow-up in clinical trials; (iv) streamlining adverse event collection and reducing monitoring; (v) extended patent protection or limited rapid approval of new agents to motivate investment in early phase development; and (vi) collecting data needed for health technology assessment continuously throughout the drug development process (before and after approval) to minimize delays in patient access. Collaboration across industry, academia, regulators, and payers will be necessary to enact change and to unlock the existing potential for cardiovascular clinical drug development. A coordinated effort involving academia, regulators, industry, and payors will help to foster better and more effective conduct of clinical cardiovascular trials, supporting earlier

The Oral HIV/AIDS Research Alliance: updated case definitions of oral disease endpoints.

Science.gov (United States)

Shiboski, C H; Patton, L L; Webster-Cyriaque, J Y; Greenspan, D; Traboulsi, R S; Ghannoum, M; Jurevic, R; Phelan, J A; Reznik, D; Greenspan, J S

2009-07-01

The Oral HIV/AIDS Research Alliance (OHARA) is part of the AIDS Clinical Trials Group (ACTG), the largest HIV clinical trials organization in the world. Its main objective is to investigate oral complications associated with HIV/AIDS as the epidemic is evolving, in particular, the effects of antiretrovirals on oral mucosal lesion development and associated fungal and viral pathogens. The OHARA infrastructure comprises: the Epidemiologic Research Unit (at the University of California San Francisco), the Medical Mycology Unit (at Case Western Reserve University) and the Virology/Specimen Banking Unit (at the University of North Carolina). The team includes dentists, physicians, virologists, mycologists, immunologists, epidemiologists and statisticians. Observational studies and clinical trials are being implemented at ACTG-affiliated sites in the US and resource-poor countries. Many studies have shared end-points, which include oral diseases known to be associated with HIV/AIDS measured by trained and calibrated ACTG study nurses. In preparation for future protocols, we have updated existing diagnostic criteria of the oral manifestations of HIV published in 1992 and 1993. The proposed case definitions are designed to be used in large-scale epidemiologic studies and clinical trials, in both US and resource-poor settings, where diagnoses may be made by non-dental healthcare providers. The objective of this article is to present updated case definitions for HIV-related oral diseases that will be used to measure standardized clinical end-points in OHARA studies, and that can be used by any investigator outside of OHARA/ACTG conducting clinical research that pertains to these end-points.

Kazakh Initiatives on Cooperation with European Union

Directory of Open Access Journals (Sweden)

Rustem S. Kurmanguzhin

2015-01-01

Full Text Available The author of this article presents initiatives of the Republic of Kazakhstan to develop cooperation with the European Union that was initiated through 2000 - 2009. In 2000 the Republic of Kazakhstan proposed to EU Comment cooperation doctrine in Central Asia. The purpose of the doctrine lied in expanding cooperation in the areas of trade, economy and investment; in granting access to commodities and services from European markets; in developing collaboration in the areas of energy, transport, communication, finance and banking. In 2006 Kazakhstan introduced a new set of prepossess to the new European Union Strategy for Central Asian 2007-2013 that was developed under the chairmanship of Germany of the EU in the first half of 2007. The Strategy covered areas of cooperation such as regional integration, economic development, democratization, energy and security. In 2008 under the instructions of the President of Kazakhstan Ministry of Foreign Affairs in cooperation with other ministries developed a state programme "Path to Europe" for 2009 - 2011, which aided the priorities of cooperation between Kazakhstan and the European Union. "Path to Europe" has become a key initiative of the Kazakh foreign policy that was successfully implemented, as well as the most important document aimed at modernization of the national economy and the Kazakh society. In the beginning of2009 using the accumulated positive experience of cooperation with the EU and experience of a number of countries in Europe and Asia, Kazakhstan devised and submitted a concept of a new treaty which was supposed to replace the Partnership and Cooperation Agreement of 1995. The Republic of Kazakhstan's influence eventually persuaded the European Union to agree on the necessity of devising the Enhanced Partnership and Cooperation Agreement.

Medical emergency and first aid for radiation accident

International Nuclear Information System (INIS)

Suzuki-Yasumoto, Masashi

1980-01-01

The thinkings concerning the injuries to human beings in nuclear accidents differ somewhat between Japan and the U.S.A. and other European countries. In accordance with the historical evolution of nuclear power and the characteristics of medical system in respective countries, there are more or less modified measures in the scheme of three phases; i.e. first aid stations on the sites of nuclear facilities, support hospitals, and radiation injury centers, in order. So far, easy reliance on such as the National Institute of Radiological Sciences was large, but with the Three Mile Island nuclear plant accident as the turning point, the emergency and first aid systems are being studied intensively both in the Government and private nuclear power enterprises. The following matters are described: the differences in thinkings between Japan and other countries; fundamentals in the medical emergency scheme in radiation accidents; the systems in U.S.A., U.K., France and West Germany; and the problems and measures in the scheme of Japan. (J.P.N.)

Present and future of clinical cardiovascular PET imaging in Europe - a position statement by the European Council of Nuclear Cardiology (ECNC)

International Nuclear Information System (INIS)

Le Guludec, D.; Lautamaeki, R.; Bengel, F.M.; Knuuti, J.; Bax, J.J.

2008-01-01

This position statement was prepared by the European Council of Nuclear Cardiology and summarises the current and future potential of PET as a clinical cardiovascular diagnostic imaging tool. The first section describes how methodological developments have positively influenced the transition of PET from a research tool towards a clinical diagnostic test. In the second section, evidence in support of its superior diagnostic accuracy, its value to guide decision making and to predict outcome and its cost effectiveness is summarised. The third section finally outlines new PET-based approaches and concepts, which will likely influence clinical cardiovascular medicine in the future. The notion that integration of cardiac PET into healthcare systems and disease management algorithms will advance quality of care is increasingly supported by the literature highlighted in this statement. (orig.)

The Frequency of Occurrence of Air Masses Over Twelve European Cities.

Science.gov (United States)

1983-01-01

cluster analysis technique to investigate the possibility of simplifying the European "",Oskar Essermanger, 1954, Neue Methode der Zerleang von...Masses, Streamlines, and the Boreal Forest," Geographical Bulletin, Vol 8 11 J. M. Davis, 1981, The Use of Cluster Analysis in the Identification and...Atmosphere and a Proposed Model for Frontal Analysis," Tellus, Vol 5 ’’N. S. McDonald, 1975, "Etgenvectur Analisis as an Aid to Air Mass Recognition

A mathematical model of the spread of the AIDS virus

Energy Technology Data Exchange (ETDEWEB)

Hyman, J.M.; Stanley, E.A.

1987-01-01

A mathematical computer model of the spread of the AIDS epidemic in the US is being developed at Los Alamos National Laboratory. This model predicts the spreading of the HIV infection, and subsequent development of clinical AIDS in various population groups. These groups are chosen according to age, frequency and type of sexual contact, population density, and region of the country. Type of sexual contact includes not only the heterosexual, homosexual differentiation but also repeated contacts with such primary partners as spouses. In conjunction with the computer model, we are developing a database containing relevant information on the natural history of the viral infection, the prevalence of the infection and of clinical AIDS in the population, the distribution of people into sexual behavior groups as a function of age and information on interregional contacts. The effects of variable infectiousness and sexual activity during the long period from infection to disease are found to have a major impact on the predictions of the model. 24 refs., 5 figs.

PUBLIC SUBSIDIES FOR ENVIRONMENTAL PROTECTION AND ENERGY SAVING IN RESPECT OF THE COMPETITION POLICY OF THE EUROPEAN UNION IN THE YEARS 2004–2012

Directory of Open Access Journals (Sweden)

Krzysztof Rutkiewicz

2016-09-01

Full Text Available The aim of this paper is to discuss the legal and economic aspects of granting state aid for environmental protection in the Member States in respect of the competition policy of the European Union in the years 2004–2012. For the purpose of this study, deductive, descriptive and criticalcognitive methods were applied in order to analyze the theoretical knowledge contained in the literature of the subject as well as in legal and normative acts. Empirical data were derived from studies, documents and reports of the DirectorateGeneral for Competition of the European Commission and the Offi ce of Competition and Consumer Protection. Based on the study, in the years 2004–2012 in the EU horizontal objectives mostly involved aid granted for the purposes of environmental protection (123 bln EUR, 24.3%. The total expenditure for environmental protection in the EU was strongly determined by decisions taken by Germany and Sweden. The most signifi - cant benefi ciaries who were granted such aid were entrepreneurs from Great Britain, the Netherlands, Austria and Spain. More than half of the decisions (54% issued by the European Commission were taken by fi ve countries: Italy, Great Britain, the Netherlands, Germany and Spain. Investments in renewable sources of energy were most often subsidized. Moreover, companies were granted aid in order to adjust to requirements stricter than the EU standards in the fi eld of environment. A smaller percentage of aid was allocated to fi nance environmental research and to improve energy effi ciency (cogeneration, including heating and cooling systems. Analysis of the structure of the preferred instruments indicates that 77% of aid was granted as tax reductions and exemptions and the other 23% in the form of direct subsidies. In the years 2004–2012 state fi nancial aid in Poland was mainly granted by the fi scal and customs authorities (77% as well as in the form of subsidies and loans granted by the President of the

Performance factors of mobile rich media job aids for community health workers.

Science.gov (United States)

Florez-Arango, Jose F; Iyengar, M Sriram; Dunn, Kim; Zhang, Jiajie

2011-01-01

To study and analyze the possible benefits on performance of community health workers using point-of-care clinical guidelines implemented as interactive rich media job aids on small-format mobile platforms. A crossover study with one intervention (rich media job aids) and one control (traditional job aids), two periods, with 50 community health workers, each subject solving a total 15 standardized cases per period per period (30 cases in total per subject). Error rate per case and task, protocol compliance. A total of 1394 cases were evaluated. Intervention reduces errors by an average of 33.15% (p = 0.001) and increases protocol compliance 30.18% (p technologies in general, and the use of rich media clinical guidelines on cell phones in particular, for the improvement of community health worker performance in developing countries.

AIDS Myths and Myths about AIDS Myths : A Study about AIDS-related Perceptions in South Africa

OpenAIRE

Sivelä, Jonas

2016-01-01

This doctoral thesis, consisting of four separate articles and a summarizing report, discusses so-called South African AIDS myths also called AIDS beliefs, rumours, misconceptions and legends. AIDS myths have been put forth as an outcome of and a major reason behind the severe HIV/AIDS situation in South Africa. They are proposed to flourish among black South Africans living in impoverished townships and villages. In previous studies, the reasons and mechanisms behind AIDS myths have be...

Clinical algorithms to aid osteoarthritis guideline dissemination

DEFF Research Database (Denmark)

Meneses, S. R. F.; Goode, A. P.; Nelson, A. E

2016-01-01

Background: Numerous scientific organisations have developed evidence-based recommendations aiming to optimise the management of osteoarthritis (OA). Uptake, however, has been suboptimal. The purpose of this exercise was to harmonize the recent recommendations and develop a user-friendly treatment...... algorithm to facilitate translation of evidence into practice. Methods: We updated a previous systematic review on clinical practice guidelines (CPGs) for OA management. The guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation for quality and the standards for developing...... to facilitate the implementation of guidelines in clinical practice are necessary. The algorithms proposed are examples of how to apply recommendations in the clinical context, helping the clinician to visualise the patient flow and timing of different treatment modalities. (C) 2016 Osteoarthritis Research...

European symposium on the awareness of allergy: report of the promotional campaign in the European Parliament (26-28 April 2016).

Science.gov (United States)

Muraro, A; Steelant, B; Pietikainen, S; Borrelli, D; Childers, N; Callebaut, I; Kortekaas Krohn, I; Martens, K; Pugin, B; Popescu, F-D; Vieru, M; Jutel, M; Agache, I; Hellings, P W

2017-02-01

From 26 to 28 of April 2016, an allergy awareness campaign was organized by the European Academy of Allergy and Clinical Immunology and the European Federation of Allergy and Airway Diseases Patients Associations in the European Parliament in Brussels, with support of the European Parliament's Interest group on Allergy and Asthma and was co-hosted by the Members of the European Parliament David Borrelli, Sirpa Pietikainen and Nessa Childers. Skin prick tests (SPTs) were performed to gain attention for the increasing prevalence of allergic airway diseases in Europe. Since more than 30% of the total European population suffers from airway allergies and asthma, reaching a higher level of awareness and elaboration of an active prevention plan is mandatory. Of the 406 individuals undergoing SPT in the European Parliament, 211 participants (52%) reported to have suffered from an allergy in the past, with allergic symptoms being present in the nose and eyes (40% and 36%, respectively), the skin (27%), lower airways (14%) and the gut (8%). Of the 381 SPT with reliable results, cutaneous hypersensitivity was found in 201 (53%) participants. Of those with positive SPT (n = 201), 70 participants (35%) were monosensitized while 131 participants (65%) were polysensitized. The positive skin reactions were found mostly for grass pollen (n = 108), followed by Dermatophagoides pteronyssinus (n = 105), Dermatophagoides farina (n = 96) and birch pollen (n = 85). Of note, 54 individuals (14% of the total tested population) without reported allergy or allergic symptoms showed a positive SPT without clinical relevance. This report summarizes the main idea and goals of the symposium: chronic airway diseases are a major and growing health problem in Europe. Therefore, a joint preventive action plan needs to be developed for a better health status of European citizens. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

AIDS and population "control".

Science.gov (United States)

Piel, G

1994-02-01

Many people believe that the AIDS pandemic will end the population explosion, especially in Africa, where population growth is very high and poverty reigns. Africans make up 10 million of all 15 million HIV- infected persons worldwide. Yet, the proposition that AIDS will sole population explosion does not stand up to reason. About 200 million people in Africa will be HIV infected by 2010, but the loss of 200 million people would not slow population growth. The 14th century's Black Death killed more than 50% of the European population, but by 1750 Europe had reached the population size it would have reached without the Black Death. The 200 million people who died violent deaths between the start and end of the two World Wars did not stop world population growth from peaking in 1970 at about 2%. When Malthus made his prediction that human population would crash, the industrial revolution had already helped production outrun population growth. Today all industrial countries are either at or near zero population growth and have completed the demographic transition (from near zero growth in 1600 with high births and death rates and a 25-year life expectancy, to near zero growth in 1990s at low death and birth rates with a 75-year life expectancy). Mass education, sanitation, primary medicine, and the green revolution have already reduced death rates and increased life expectancy in developing countries. Thus, they have entered the first phase of the demographic transition. Some developing countries are in the second phase; birth rate decline For example, in India and China, fertility has fallen from 6 to 4 in India and is at 2.3 in China. The AIDS pandemic is a diversion of physical and human resources from helping developing countries pass through the demographic transition more quickly to achieve sustainable development. This delay is likely to effect a larger maximum population. The industrial revolution has shifted the key to stopping population growth the people

HIV/AIDS - resources

Science.gov (United States)

Resources - HIV/AIDS ... information on AIDS : AIDS.gov -- www.aids.gov AIDS Info -- aidsinfo.nih.gov The Henry J. Kaiser Family Foundation -- www.kff.org/hivaids US Centers for Disease Control and Prevention -- www.cdc.gov/hiv

Recruiting long-term survivors of European Organisation for Research and Treatment of Cancer phase III clinical trials into quality of life studies : Challenges and opportunities

NARCIS (Netherlands)

van Leeuwen, M.L.; Efficace, F.; Fosså, S.D.; Bolla, M.; de Giorgi, U.; De Wit, R.; Holzner, B.; van de Poll-Franse, L.; White, J.; Collette, L.; Osanto, S.; Aaronson, N.K.; European Organisation for Research and Treatment of Cancer Quality of Life Group; Genito-Urinary Cancers Group, The

2014-01-01

Objectives In this pilot study we evaluated the feasibility of and methods for assessing the quality of life of long term survivors of European Organisation for Research and Treatment of Cancer (EORTC) phase III clinical trials. Here we report the results pertaining to the feasibility of conducting

Recruiting long-term survivors of European Organisation for Research and Treatment of Cancer phase III clinical trials into quality of life studies: Challenges and opportunities

NARCIS (Netherlands)

van Leeuwen, M.; Efficace, F.; Fosså, S.D.; Bolla, M.; De Giorgi, U.; de Wit, R; Holzner, B.; van de Poll-Franse, L.V.; van Poppel, H.; White, J.; Collette, L.; Osanto, S.; Aaronson, N.K.

2014-01-01

Objectives: In this pilot study we evaluated the feasibility of and methods for assessing the quality of life of long term survivors of European Organisation for Research and Treatment of Cancer (EORTC) phase III clinical trials. Here we report the results pertaining to the feasibility of conducting

Advance Pricing Agreements and the Selectivity Criterion in EU State Aid Rules

OpenAIRE

Härö, O

2017-01-01

The Commission of the EU has recently decided that Advance Pricing Agreement rulings (the APA rulings) that Ireland, Luxembourg and the Netherlands have granted for Apple, Fiat and Starbucks (respectively) constitute illegal State aid according to Article 107 of the Treaty on the Functioning of the European Union (TFEU). The Commission claims that the APA rulings deviate from the arm´s length principle and that they grant economic benefit for the beneficiary undertakings in a selective manner...

Physicians' intentions and use of three patient decision aids

Directory of Open Access Journals (Sweden)

Mitchell Susan L

2007-07-01

Full Text Available Abstract Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270 returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80% also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians ( Conclusion Despite strong support for the format, content, and quality of patient decision aids, and physicians' stated intentions to adopt them into clinical practice, most did not use them within three months of completing the survey. There is a wide gap between intention and behaviour. Further research is required to study the determinants of this intention-behaviour gap and to develop interventions aimed at barriers to physicians' use of decision aids.

Attitudes of pediatric intensive care unit physicians towards the use of cognitive aids: a qualitative study.

Science.gov (United States)

Weiss, Matthew J; Kramer, Chelsea; Tremblay, Sébastien; Côté, Luc

2016-05-21

Cognitive aids are increasingly recommended in clinical practice, yet little is known about the attitudes of physicians towards these tools. We employed a qualitative, descriptive design to explore physician attitudes towards cognitive aids in pediatric intensive care units (PICUs). Semi-structured interviews elicited the opinions of a convenience sample of practicing PICU physicians towards the use of cognitive aids. We analyzed interview data for thematic content to examine the three factors of intention to use cognitive aids as defined by the Theory of Planned Behavior (TPB), attitudes, social norms, and perceived control. Analysis of 14 interviews suggested that in the PICU setting, cognitive aids are widely used. Discovered themes related to their use touched on all three TPB factors of intention and included: aids are perceived to improve team communication; aids may improve patient safety; aids may hinder clinician judgment; physicians may resist implementation if it occurs prior to demonstration of benefit; effective adoption requires cognitive aids to be integrated into local workplace culture; and implementation should take physician concerns into account. Our sample of PICU physicians were open to cognitive aids in their practice, as long as such aids preserve the primacy of clinical judgment, focus on team communication, demonstrate effectiveness through preliminary testing, and are designed and implemented with the local culture and work environment in mind. Future knowledge translation efforts to implement cognitive aids would benefit from consideration of these issues.

Evaluating Adaptation of a Cancer Clinical Trial Decision Aid for Rural Cancer Patients: A Mixed-Methods Approach.

Science.gov (United States)

Pathak, Swati; George, Nerissa; Monti, Denise; Robinson, Kathy; Politi, Mary C

2018-06-03

Rural-residing cancer patients often do not participate in clinical trials. Many patients misunderstand cancer clinical trials and their rights as participant. The purpose of this study is to modify a previously developed cancer clinical trials decision aid (DA), incorporating the unique needs of rural populations, and test its impact on knowledge and decision outcomes. The study was conducted in two phases. Phase I recruited 15 rural-residing cancer survivors in a qualitative usability study. Participants navigated the original DA and provided feedback regarding usability and implementation in rural settings. Phase II recruited 31 newly diagnosed rural-residing cancer patients. Patients completed a survey before and after using the revised DA, R-CHOICES. Primary outcomes included decisional conflict, decision self-efficacy, knowledge, communication self-efficacy, and attitudes towards and willingness to consider joining a trial. In phase I, the DA was viewed positively by rural-residing cancer survivors. Participants provided important feedback about factors rural-residing patients consider when thinking about trial participation. In phase II, after using R-CHOICES, participants had higher certainty about their choice (mean post-test = 3.10 vs. pre-test = 2.67; P = 0.025) and higher trial knowledge (mean percentage correct at post-test = 73.58 vs. pre-test = 57.77; P decision self-efficacy, communication self-efficacy, and attitudes towards or willingness to join trials. The R-CHOICES improved rural-residing patients' knowledge of cancer clinical trials and reduced conflict about making a trial decision. More research is needed on ways to further support decisions about trial participation among this population.

European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases: report of the European Union Parliament Summit (29 March 2017).

Science.gov (United States)

Hellings, Peter W; Borrelli, David; Pietikainen, Sirpa; Agache, Ioana; Akdis, Cezmi; Bachert, Claus; Bewick, Michael; Botjes, Erna; Constantinidis, Jannis; Fokkens, Wytske; Haahtela, Tari; Hopkins, Claire; Illario, Maddalena; Joos, Guy; Lund, Valerie; Muraro, Antonella; Pugin, Benoit; Seys, Sven; Somekh, David; Stjärne, Pär; Valiulis, Arunas; Valovirta, Erkka; Bousquet, Jean

2017-01-01

On March 29, 2017, a European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases (CRD) was organized by the European Forum for Research and Education in Allergy and Airway Diseases. The event took place in the European Parliament of Brussels and was hosted by MEP David Borrelli and MEP Sirpa Pietikainen. The aim of the Summit was to correspond to the needs of the European Commission and of patients suffering from CRD to join forces in Europe for the prevention and self-management. Delegates of the European Rhinologic Society, European Respiratory Society, European Academy of Allergy and Clinical Immunology, European Academy of Paediatrics, and European Patients Organization EFA all lectured on their vision and action plan to join forces in achieving adequate prevention and self-management of CRD in the context of Precision Medicine. Recent data highlight the preventive capacity of education on optimal care pathways for CRD. Self-management and patient empowerment can be achieved by novel educational on-line materials and by novel mobile health tools enabling patients and doctors to monitor and optimally treat CRDs based on the level of control. This report summarizes the contributions of the representatives of different European academic stakeholders in the field of CRD.

Self-reported disability and handicap after hearing-aid fitting and benefit of hearing aids: comparison of fitting procedures, degree of hearing loss, experience with hearing aids and uni- and bilateral fittings

NARCIS (Netherlands)

Metselaar, Mick; Maat, Bert; Krijnen, Pieta; Verschuure, Hans; Dreschler, Wouter A.; Feenstra, Louw

2009-01-01

Self-reported outcome on hearing disability and handicap as well as overall health-related quality of life were measured after hearing-aid fitting in a large-scale clinical population. Fitting was performed according to two different procedures in a double-blind study design. We used a comparative

Self-reported disability and handicap after hearing-aid fitting and benefit of hearing aids : comparison of fitting procedures, degree of hearing loss, experience with hearing aids and uni- and bilateral fittings

NARCIS (Netherlands)

Metselaar, Mick; Maat, Bert; Krijnen, Pieta; Verschuure, Hans; Dreschler, Wouter A; Feenstra, Louw

Self-reported outcome on hearing disability and handicap as well as overall health-related quality of life were measured after hearing-aid fitting in a large-scale clinical population. Fitting was performed according to two different procedures in a double-blind study design. We used a comparative

Evaluation of computer-aided detection and diagnosis systems.

Science.gov (United States)

Petrick, Nicholas; Sahiner, Berkman; Armato, Samuel G; Bert, Alberto; Correale, Loredana; Delsanto, Silvia; Freedman, Matthew T; Fryd, David; Gur, David; Hadjiiski, Lubomir; Huo, Zhimin; Jiang, Yulei; Morra, Lia; Paquerault, Sophie; Raykar, Vikas; Samuelson, Frank; Summers, Ronald M; Tourassi, Georgia; Yoshida, Hiroyuki; Zheng, Bin; Zhou, Chuan; Chan, Heang-Ping

2013-08-01

Computer-aided detection and diagnosis (CAD) systems are increasingly being used as an aid by clinicians for detection and interpretation of diseases. Computer-aided detection systems mark regions of an image that may reveal specific abnormalities and are used to alert clinicians to these regions during image interpretation. Computer-aided diagnosis systems provide an assessment of a disease using image-based information alone or in combination with other relevant diagnostic data and are used by clinicians as a decision support in developing their diagnoses. While CAD systems are commercially available, standardized approaches for evaluating and reporting their performance have not yet been fully formalized in the literature or in a standardization effort. This deficiency has led to difficulty in the comparison of CAD devices and in understanding how the reported performance might translate into clinical practice. To address these important issues, the American Association of Physicists in Medicine (AAPM) formed the Computer Aided Detection in Diagnostic Imaging Subcommittee (CADSC), in part, to develop recommendations on approaches for assessing CAD system performance. The purpose of this paper is to convey the opinions of the AAPM CADSC members and to stimulate the development of consensus approaches and "best practices" for evaluating CAD systems. Both the assessment of a standalone CAD system and the evaluation of the impact of CAD on end-users are discussed. It is hoped that awareness of these important evaluation elements and the CADSC recommendations will lead to further development of structured guidelines for CAD performance assessment. Proper assessment of CAD system performance is expected to increase the understanding of a CAD system's effectiveness and limitations, which is expected to stimulate further research and development efforts on CAD technologies, reduce problems due to improper use, and eventually improve the utility and efficacy of CAD in

Two Different Percutaneous Bone-Anchored Hearing Aid Abutment Systems: Comparative Clinical Study.

Science.gov (United States)

Polat, Beldan; İşeri, Mete; Orhan, Kadir Serkan; Yılmazer, Ayça Başkadem; Enver, Necati; Ceylan, Didem; Kara, Ahmet; Güldiken, Yahya; Çomoğlu, Şenol

2016-04-01

To compare two different percutaneous bone-anchored hearing aid (BAHA) abutment systems regarding operation time, scar healing, quality of life, implant stability, audiologic results, and complications. The study involves a prospective multi-center clinical evaluation. Thirty-two consecutive patients who had undergone BAHA surgery from January 2011 to January 2013 in two tertiary centers were included in the study. The Glasgow Inventory Benefit Score was used to assess the patients at least 6 months after surgery. The operation time and complications were recorded. Implant stability quotient (ISQ) values were recorded using resonance frequency analysis. Holger's classification was used to evaluate skin reactions. The mean length of the operation was 39.2±4 min for standard abutment and 18.3±5.7 min for hydroxyapatite-coated abutment. ISQ scores were significantly better for standard abutment in all tests. The mean total Glasgow Inventory Benefit Score was 39.3±19 for the standard abutment and 46.3±24.5 for the hydroxyapatite-coated abutment groups, but there was no statistical significance between the two groups. There was no difference in audiological improvement between the two groups after surgery. Hydroxyapatite-coated abutment provided a shorter operation time that was significantly different from standard abutment. There were no significant differences between standard abutment and hydroxyapatite-coated abutment regarding audiologic improvement, quality of life, loading time, and complications.

Site Characteristics Influencing the Translation of Clinical Research Into Clinical Practice

DEFF Research Database (Denmark)

Smed, Marie; Getz, Kenneth A.

2014-01-01

Investigative sites participating in clinical trials play an instrumental role in aiding market adoption. Site experiences in clinical research help physician investigators and research professionals gain familiarity with and exposure to investigational treatments. This knowledge may be passed...

[The role of supply-side characteristics of services in AIDS mortality in Mexico].

Science.gov (United States)

Bautista-Arredondo, Sergio; Serván-Mori, Edson; Silverman-Retana, Omar; Contreras-Loya, David; Romero-Martínez, Martín; Magis-Rodríguez, Carlos; Uribe-Zúñiga, Patricia; Lozano, Rafael

2015-01-01

To document the association between supply-side determinants and AIDS mortality in Mexico between 2008 and 2013. We analyzed the SALVAR database (system for antiretroviral management, logistics and surveillance) as well as data collected through a nationally representative survey in health facilities. We used multivariate logit regression models to estimate the association between supply-side characteristics, namely management, training and experience of health care providers, and AIDS mortality, distinguishing early and non-early mortality and controlling for clinical indicators of the patients. Clinic status of the patients (initial CD4 and viral load) explain 44.4% of the variability of early mortality across clinics and 13.8% of the variability in non-early mortality. Supply-side characteristics increase explanatory power of the models by 16% in the case of early mortality, and 96% in the case of non-early mortality. Aspects of management and implementation of services contribute significantly to explain AIDS mortality in Mexico. Improving these aspects of the national program, can similarly improve its results.

Outcome measures in European patients with haemophilia: Survey of implementation in routine clinical practice, perception of relevance and recommendations by European treaters in the EHTSB.

Science.gov (United States)

Hermans, C; Klamroth, R; Richards, M; de Moerloose, P; Garrido, R P

2017-03-01

This study was conducted to evaluate the current implementation of outcome measures in routine clinical haemophilia practice and to explore and appreciate the perception of the relevance of such measures by treaters. A survey was completed by 19 of the 26 physicians involved in the European Haemophilia Therapy Strategy Board (EHTSB). Employing an extensive inventory of outcome measures used in patients with haemophilia, information was collected about the frequency of data collection and the subjective appreciation of their importance during clinic review. The survey revealed that most treaters currently collect data that are mainly related to the haemostatic treatment (consumption of concentrates) and the bleeding symptoms (number and location of bleeds) in a non-uniform and non-standardized way. By contrast, functional, physical and quality of life scorings are rarely used and show considerable heterogeneity between treaters. Also, many disparities emerged between practice and perception, in particular quality of life data that are perceived as being important but for most of the time are not collected. This survey represents, in our view, the first attempt to evaluate the actual utilization of outcome measures in haemophilia care. While the value of outcome measures is appreciated, they are not assessed regularly. Therefore, there is a need to include appropriate performance indicators (outcome measures) of haemophilia care in routine clinical practice. Consensus recommendations to provide a framework for achieving this aim are provided. © 2016 John Wiley & Sons Ltd.

Fear of AIDS and suicide in Finland: a review

DEFF Research Database (Denmark)

Aro, A R; Henriksson, M; Leinikki, P

1995-01-01

health care contacts than the others. Suicidal fear and underlying depression were not being properly identified and treated. Despite recent improvement in media reporting, health education and identification of depression, clinical experience, help line calls and population surveys indicate that AIDS......This review presents data on HIV epidemiology and suicide mortality, and summarizes studies on fear of AIDS in completed suicides in Finland. Finland has a low prevalence of HIV and a high suicide mortality. A 12-month nationwide suicide population, 1987-88 (n = 1397, all HIV negative) at the time...... of a sensational media campaign against HIV included 28 (2%) cases with fear of AIDS as a contributing factor. Triggers of fear could be classified in 20 cases: persistent symptoms in 10, casual sex contacts in eight, and a TV programme in two. The AIDS fear cases were younger, had more major depression and more...

Better together: reduced compliance after sequential versus simultaneous bilateral hearing aids fitting.

Science.gov (United States)

Lavie, Limor; Banai, Karen; Attias, Joseph; Karni, Avi

2014-03-01

The purpose of this study was to determine the effects of sequential versus simultaneous bilateral hearing aids fitting on patient compliance. Thirty-six older adults with hearing impairment participated in this study. Twelve were fitted with bilateral hearing aids simultaneously. The remaining participants were fitted sequentially: One hearing aid (to the left or to the right ear) was used initially; 1 month later, the other ear was also fitted with a hearing aid for bilateral use. Self-reports on usefulness and compliance were elicited after the first and second months of hearing aid use. In addition, the number of hours the hearing aids were used was extracted from the data loggings of each device. Simultaneous fitting resulted in high levels of compliance and consistent usage throughout the study period. Sequential fitting resulted in abrupt reduction in compliance and hours of use once the second hearing aid was added, both in the clinical scoring and in the data loggings. Simultaneous fitting of bilateral hearing aids results in better compliance compared with sequential fitting. The addition of a second hearing aid after a relatively short period of monaural use may lead to inconsistent use of both hearing aids.

European Utility Requirements: European nuclear energy

International Nuclear Information System (INIS)

Komsi, M.; Patrakka, E.

1997-01-01

The work procedure and the content of the European Utility Requirements (EUR) concerning the future LWRs is described in the article. European Utility Requirements, produced by utilities in a number of European countries, is a document specifying the details relating to engineered safety, operating performance, reliability and economics of the reactors to be built by manufacturers for the European market

Tobacco industry strategies for influencing European Community tobacco advertising legislation.

Science.gov (United States)

Neuman, Mark; Bitton, Asaf; Glantz, Stanton

2002-04-13

Restrictions on tobacco company advertising and sponsorship are effective parts of tobacco control programmes worldwide. Through Council Directive 98/43/EC, the European Community (EC) sought to end all tobacco advertising and sponsorship in EC member states by 2006. Initially proposed in 1989, the directive was adopted in 1998, and was annulled by the European Court of Justice in 2000 following a protracted lobbying campaign against the directive by a number of interested organisations including European tobacco companies. A new advertising directive was proposed in May, 2001. We reviewed online collections of tobacco industry documents from US tobacco companies made public under the US Master Settlement Agreement of 1998. Documents reviewed dated from 1978 to 1994 and came from Philip Morris, R J Reynolds, and Brown and Williamson (British American Tobacco) collections. We also obtained approximately 15,000 pages of paper records related to British American Tobacco from its documents' depository in Guildford, UK. This information was supplemented with information in the published literature and consultations with European tobacco control experts. The tobacco industry lobbied against Directive 98/43/EC at the level of EC member state governments as well as on a pan-European level. The industry sought to prevent passage of the directive within the EC legislature, to substitute industry-authored proposals in place of the original directive, and if necessary to use litigation to prevent implementation of the directive after its passage. The tobacco industry sought to delay, and eventually defeat, the EC directive on tobacco advertising and sponsorship by seeking to enlist the aid of figures at the highest levels of European politics while at times attempting to conceal the industry's role. An understanding of these proposed strategies can help European health advocates to pass and implement effective future tobacco control legislation.

Competition Policy in the European Film Industry Focused on Consumers’ Interests – a Romanian Perspective

Directory of Open Access Journals (Sweden)

Puiu Nistoreanu

2017-05-01

Full Text Available European cinema was and still is often assimilated by film consumers as art cinema which is more difficult to understand and ultimately to reach a big number of consumers. The objectives of this paper were to examine the pathway of European cinema market and the relationship with its consumers along with their interests and attitudes towards European films and to research the most important measures taken by European Union institutions under their competition policy to support European films through state aid schemes. In order to give shape to these objectives, in-depth interviews with five elite specialists from the Romanian film industry were used, specialists who possess international expertise and recognition. The problems of the qualitative research are: the modification of consumer behaviour face to European cinema and support measures. The findings suggest that regarding its relationship with consumers and their interests in the seventh art, European cinema faces many different difficulties ranging from the competition with American films and insufficient funds, to the increased comfortableness or coziness of the movie consumers of our times. The paper concludes with examples of measures suggested by the respondents, to help European cinema become more attractive to consumers, measures which are already being implemented by the industry, making the results of our study useful for policy and decision makers within this cultural area.

Aids em área rural de Minas Gerais: abordagem cultural AIDS in rural Minas Gerais state (Southeastern Brazil: a cultural approach

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Patricia Neves Guimarães

2007-06-01

Full Text Available OBJETIVO: Descrever comportamentos facilitadores à exposição ao HIV/Aids em população rural. MÉTODOS: Pesquisa qualitativa realizada com 52 pacientes atendidos em ambulatório de DST/Aids, em 2002-2003. Foram feitas entrevistas abertas e semi-estruturadas em profundidade com os participantes (30 homens e 22 mulheres, conduzidas no ambulatório ou em suas residências, em municípios rurais da região norte de Minas Gerais. As entrevistas foram transcritas, analisadas em categorias: concepções da doença, trabalho, sociabilidade, informações prévias sobre a doença, modo de vida. A interpretação dos resultados baseou-se na análise de conteúdo. RESULTADOS: Na percepção dos entrevistados, a Aids era "doença de cidade grande" e de "forasteiro", desvinculada da cultura local. Todos os entrevistados se infectaram através de atividades heterossexuais ou homossexuais. A migração rural-urbana é aspecto relevante da infecção do HIV na região devido ao deslocamento em busca de trabalho. CONCLUSÕES: As noções populares de doença contribuem para vulnerabilidade à infecção pelo HIV. É necessário apreender noções culturais locais para melhor entender as categorias de pensamento dessa população, enfocando essas noções ao divulgar informações sobre a doença.OBJECTIVE: To describe behaviors facilitating HIV/AIDS exposure in rural population. METHODS: A qualitative study was conducted comprising 52 patients who attended a STD/AIDS outpatient clinic in 2002 and 2003. In-depth open and semi-structured interviews were carried out with subjects (30 males, 22 females at the clinic or at home in rural municipalities in the northern area of Minas Gerais state, Southeastern Brazil. Interviews were transcribed and analyzed considering categories such as disease, work, social life, prior HIV/AIDS knowledge, and lifestyle. Content analysis was used for result interpretation. RESULTS: Interviewees perceived AIDS as a "big city

mHealth and memory aids: levels of smartphone ownership in patients.

Science.gov (United States)

Migo, Ellen M; Haynes, Becky I; Harris, Lara; Friedner, Kim; Humphreys, Kate; Kopelman, Michael D

2015-01-01

The use of mobile devices to deliver healthcare has not yet been exploited in neuropsychological rehabilitation. Smartphones have the potential to serve as multi-functional memory aids. To investigate whether patients attending a clinic for mixed memory problems own smartphones, to determine whether this could be a widely applicable medium to use as a memory aids device. A questionnaire on smartphone ownership was given to an opportunity sample of consecutive patients attending a neuropsychiatry and memory disorders outpatient clinic. Data were collected in 2012 and repeated 12 months later in 2013 to assess changes over time. Ownership of mobile phones was stable between 2012 (81%) and 2013 (85%), but ownership of smartphones showed a significant increase (from 26% to 40%). Age negatively predicted smartphone ownership. Despite cognitive or psychiatric problems, our patient group are as likely to own a mobile phone as a member of the general population. Ownership levels are at 40% and likely to increase in the future. Exploring how smartphones and their apps could function as memory aids is likely to be useful for a large enough number of patients to be clinically worthwhile.

European Society of Gynaecological Oncology (ESGO) Guidelines for Ovarian Cancer Surgery

NARCIS (Netherlands)

Querleu, Denis; Planchamp, Francois; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Christiana; van der Zee, Ate; Vergote, Ignace; duBois, Andreas

Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecological cancers across Europe. Methods The European Society of Gynaecological Oncology

Aid Policy and the Macroeconomic Management of Aid

DEFF Research Database (Denmark)

Addison, Tony; Tarp, Finn

2015-01-01

This is an introduction to the UNU-WIDER special issue of World Development on aid policy and the macroeconomic management of aid. We provide an overview of the 10 studies, grouping them under three sub-themes: the aid–growth relationship; the supply-side of aid (including its level, volatility......, and coordination of donors); and the macroeconomic framework around aid. The studies in the special issue demonstrate the centrality of research methodology, the importance of disaggregation, and the need to account for country-specific situations and problems. This introduction concludes that the sometimes “over...

Comparative decline in funding of European Commission malaria vaccine projects: what next for the European scientists working in this field?

Directory of Open Access Journals (Sweden)

Imoukhuede Egeruan B

2011-09-01

Full Text Available Abstract Since 2000, under the Fifth and subsequent Framework Programmes, the European Commission has funded research to spur the development of a malaria vaccine. This funding has contributed to the promotion of an integrated infrastructure consisting of European basic, applied and clinical scientists in academia and small and medium enterprises, together with partners in Africa. Research has added basic understanding of what is required of a malaria vaccine, allowing selected candidates to be prioritized and some to be moved forward into clinical trials. To end the health burden of malaria, and its economic and social impact on development, the international community has now essentially committed itself to the eventual eradication of malaria. Given the current tentative advances towards elimination or eradication of malaria in many endemic areas, malaria vaccines constitute an additional and almost certainly essential component of any strategic plan to interrupt transmission of malaria. However, funding for malaria vaccines has been substantially reduced in the Seventh Framework Programme compared with earlier Framework Programmes, and without further support the gains made by earlier European investment will be lost.

Pulmonary complications of AIDS: radiologic features

International Nuclear Information System (INIS)

Cohen, B.A.; Pomeranz, S.; Rabinowitz, J.G.; Rosen, M.J.; Train, J.S.; Norton, K.I.; Mendelson, D.S.

1984-01-01

Fifty-two patients with pulmonary complications of acquired immunodeficiency syndrome (AIDS) were studied over a 3-year period. The vast majority of the patients were homosexual; however, a significant number were intravenous drug abusers. Thirteen different organisms were noted, of which Pneumocystis carinii was by far the most common. Five patients had neoplasia. Most patients had initial abnormal chest films; however, eight patients subsequently shown to have Pneumocystis carinii pneumonia had normal chest films. A significant overlap in chest radiographic findings was noted among patients with different or multiple organisms. Lung biopsy should be an early consideration for all patients with a clinical history consistent with the pulmonary complications of AIDS. Of the 52 patients, 41 had died by the time this report was completed

The role of European Federation of Clinical Chemistry and Laboratory Medicine Working Group for Preanalytical Phase in standardization and harmonization of the preanalytical phase in Europe

NARCIS (Netherlands)

Cornes, Michael P.; Church, Stephen; van Dongen-Lases, Edmée; Grankvist, Kjell; Guimarães, João T.; Ibarz, Mercedes; Kovalevskaya, Svetlana; Kristensen, Gunn Bb; Lippi, Giuseppe; Nybo, Mads; Sprongl, Ludek; Sumarac, Zorica; Simundic, Ana-Maria

2016-01-01

Patient safety is a leading challenge in healthcare and from the laboratory perspective it is now well established that preanalytical errors are the major contributor to the overall rate of diagnostic and therapeutic errors. To address this, the European Federation of Clinical Chemistry and

Development of a multimedia educational programme for first-time hearing aid users: a participatory design.

Science.gov (United States)

Ferguson, Melanie; Leighton, Paul; Brandreth, Marian; Wharrad, Heather

2018-05-02

To develop content for a series of interactive video tutorials (or reusable learning objects, RLOs) for first-time adult hearing aid users, to enhance knowledge of hearing aids and communication. RLO content was based on an electronically-delivered Delphi review, workshops, and iterative peer-review and feedback using a mixed-methods participatory approach. An expert panel of 33 hearing healthcare professionals, and workshops involving 32 hearing aid users and 11 audiologists. This ensured that social, emotional and practical experiences of the end-user alongside clinical validity were captured. Content for evidence-based, self-contained RLOs based on pedagogical principles was developed for delivery via DVD for television, PC or internet. Content was developed based on Delphi review statements about essential information that reached consensus (≥90%), visual representations of relevant concepts relating to hearing aids and communication, and iterative peer-review and feedback of content. This participatory approach recognises and involves key stakeholders in the design process to create content for a user-friendly multimedia educational intervention, to supplement the clinical management of first-time hearing aid users. We propose participatory methodologies are used in the development of content for e-learning interventions in hearing-related research and clinical practice.

Qualitative Research Methods in Visual Communication. Case Study: Visual Networks in the Promotional Videos of the European Year of Volunteering

Directory of Open Access Journals (Sweden)

Camelia Cmeciu

2013-05-01

Full Text Available European Years are a means of promoting European issues at a macro and micro-level. The objective of this paper is to provide the visual differences in the framing of the issue of volunteering at a European and national level. The approach focuses on a blending of two qualitative research methods in visual communication: ATLAS.ti (computer assisted/ aided qualitative data analysis software and social semiotics. The results of our analysis highlight two network views on volunteering promoted through videos, a salience of transactional processes in the implementation of volunteering at a European and national level, and a classification of various types of social practices specific to Romania. This study provides an insight into the way in which two different qualitative methods may be combined in order to provide a visual representation and interpretation to a European issue.

Removable partial dentures: clinical concepts.

Science.gov (United States)

Bohnenkamp, David M

2014-01-01

This article provides a review of the traditional clinical concepts for the design and fabrication of removable partial dentures (RPDs). Although classic theories and rules for RPD designs have been presented and should be followed, excellent clinical care for partially edentulous patients may also be achieved with computer-aided design/computer-aided manufacturing technology and unique blended designs. These nontraditional RPD designs and fabrication methods provide for improved fit, function, and esthetics by using computer-aided design software, composite resin for contours and morphology of abutment teeth, metal support structures for long edentulous spans and collapsed occlusal vertical dimensions, and flexible, nylon thermoplastic material for metal-supported clasp assemblies. Copyright © 2014 Elsevier Inc. All rights reserved.

Aid is dead. Long live aid!

Directory of Open Access Journals (Sweden)

Jean-Michel Severino

2012-06-01

Full Text Available The concepts, targets, tools, institutions and modes of operation of official development assistance have been overtaken by the pace of change in a world marked by the combined momentum of demography, technology and economic growth.Aid can however recover, as social consequences of the globalization call for new forms of regulation. It will then be necessary to modify and diversify our target-setting processes, to update operating procedures, and to find better ways of measuring policy implementation. Aid volumes will certainly continue to grow, and we must transform the way aid is financed. Public and private aid stakeholders must recognize the importance of these transformations and be ready to support them, by questioning the methods as well as the objectives of the policies they are implementing. Otherwise, they will severely impede the emergence of the policies we need if we are to build a better world.

Clinical characteristics and causes of visual impairment in a low vision clinic in northern Jordan.

Science.gov (United States)

Bakkar, May M; Alzghoul, Eman A; Haddad, Mera F

2018-01-01

The aim of the study was to identify causes of visual impairment among patients attending a low vision clinic in the north of Jordan and to study the relevant demographic characteristics of these patients. The retrospective study was conducted through a review of clinical records of 135 patients who attended a low vision clinic in Irbid. Clinical characteristics of the patients were collected, including age, gender, primary cause of low vision, best corrected visual acuity, and current prescribed low vision aids. Descriptive statistics analysis using numbers and percentages were calculated to summarize categorical and nominal data. A total of 135 patients (61 [45.2%] females and 74 [54.8%] males) were recruited in the study. Mean age ± standard deviation for the study population was 24.53 ± 16.245 years; age range was 5-90 years. Of the study population, 26 patients (19.3%) had mild visual impairment, 61 patients (45.2%) had moderate visual impairment, 27 patients (20.0%) had severe visual impairment, and 21 patients (15.6%) were blind. The leading causes of visual impairment across all age groups were albinism (31.9%) and retinitis pigmentosa (RP) (18.5%). Albinism also accounted for the leading cause of visual impairment among the pediatric age group (0-15 years) while albinism, RP, and keratoconus were the primary causes of visual impairment for older patients. A total of 59 patients (43.7%) were given low vision aids either for near or distance. The only prescribed low vision aids for distances were telescopes. For near, spectacle-type low vision aid was the most commonly prescribed low vision aids. Low vision services in Jordan are still very limited. A national strategy programme to increase awareness of low vision services should be implemented, and health care policies should be enforced to cover low vision aids through the national medical insurance.

Oral combination chemotherapy in the treatment of AIDS ...

African Journals Online (AJOL)

Objectives: To determine the effectiveness of an oral combination chemotherapy regimen administered to patients with AIDS-associated Hodgkin's disease. Design: Prospective, pilot phase II clinical trial. Setting: Consecutive patient recruitment occurred at two medical centers in the United States: Albany Medical Center, ...

Hearing aid fitting in older persons with hearing impairment: the influence of cognitive function, age, and hearing loss on hearing aid benefit.

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Meister, Hartmut; Rählmann, Sebastian; Walger, Martin; Margolf-Hackl, Sabine; Kießling, Jürgen

2015-01-01

To examine the association of cognitive function, age, and hearing loss with clinically assessed hearing aid benefit in older hearing-impaired persons. Hearing aid benefit was assessed using objective measures regarding speech recognition in quiet and noisy environments as well as a subjective measure reflecting everyday situations captured using a standardized questionnaire. A broad range of general cognitive functions such as attention, memory, and intelligence were determined using different neuropsychological tests. Linear regression analyses were conducted with the outcome of the neuropsychological tests as well as age and hearing loss as independent variables and the benefit measures as dependent variables. Thirty experienced older hearing aid users with typical age-related hearing impairment participated. Most of the benefit measures revealed that the participants obtained significant improvement with their hearing aids. Regression models showed a significant relationship between a fluid intelligence measure and objective hearing aid benefit. When individual hearing thresholds were considered as an additional independent variable, hearing loss was the only significant contributor to the benefit models. Lower cognitive capacity - as determined by the fluid intelligence measure - was significantly associated with greater hearing loss. Subjective benefit could not be predicted by any of the variables considered. The present study does not give evidence that hearing aid benefit is critically associated with cognitive function in experienced hearing aid users. However, it was found that lower fluid intelligence scores were related to higher hearing thresholds. Since greater hearing loss was associated with a greater objective benefit, these results strongly support the advice of using hearing aids regardless of age and cognitive function to counter hearing loss and the adverse effects of age-related hearing impairment. Still, individual cognitive capacity might

Compliance of blood sampling procedures with the CLSI H3-A6 guidelines: An observational study by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PRE)

NARCIS (Netherlands)

Simundic, Ana-Maria; Church, Stephen; Cornes, Michael P.; Grankvist, Kjell; Lippi, Giuseppe; Nybo, Mads; Nikolac, Nora; van Dongen-Lases, Edmee; Eker, Pinar; Kovalevskaya, Svjetlana; Kristensen, Gunn B. B.; Sprongl, Ludek; Sumarac, Zorica

2015-01-01

Abstract Background: An observational study was conducted in 12 European countries by the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for the Preanalytical Phase (EFLM WG-PRE) to assess the level of compliance with the CLSI H3-A6 guidelines. Methods: A structured

Specialized home care for patients with AIDS: an experiment in Rotterdam, The Netherlands.

NARCIS (Netherlands)

Moons, M.; Kerkstra, A.; Biewenga, T.

1994-01-01

Patients with AIDs are permanently dependent on medical and technical nursing care. During a certain phase of the disease some of the patients have to visit the out-patient clinic of the hospital for regular treatment. It was noticed that AIDS patients find these visits a severe burden. Therefore in

Comparison of the distribution of non-AIDS Kaposi's sarcoma and non-Hodgkin's lymphoma in Europe

Science.gov (United States)

Maso, L Dal; Franceschi, S; Re, A Lo; Vecchia, C La

1999-01-01

To evaluate whether some form of mild immunosuppression may influence the geographical distribution of non-AIDS Kaposi's sarcoma (KS), we correlated incidence rates of KS and non-Hodgkin's lymphoma in individuals aged 60 or more in 18 European countries and Israel. Significant positive correlations emerged but, within highest risk countries (i.e.Italy and Israel), internal correlations were inconsistent. © 1999 Cancer Research Campaign PMID:10408708

AIDS

Science.gov (United States)

... page: //medlineplus.gov/ency/article/000594.htm HIV/AIDS To use the sharing features on this page, ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ...

Diagnosis and Management of AIDS-related Diarrhea

Directory of Open Access Journals (Sweden)

John F Johanson

1996-01-01

Full Text Available The spectrum of illness associated with the acquired immunodeficiency syndrome (AIDS has been increasing since the initial description in 1981. While virtually all organ systems may be affected, the gastrointestinal tract appears to be a major target. Diarrhea is the most common symptom, affecting up to half of all AIDS patients during the course of their disease. Although diarrhea occurs frequently, its optimal management remains controversial. An extensive evaluation including stool studies and endoscopic biopsies of both the colon and small intestine has been widely recommended to identify all potential pathogenic organisms. An alternative approach is a more limited evaluation consisting of stool and blood cultures followed by symptomatic treatment with antidiarrheal agents if no specific organisms are identified. The clinical presentation of the most common opportunistic pathogens are reviewed, including several recently discovered organisms. Recommendations for treatment are followed by a brief discussion of management strategies used to care for patients with AIDS-related diarrhea.

Pseudoaneurysms of large arteries associated with AIDS

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Carlos Eli Piccinato

Full Text Available BACKGROUND: Several vascular complications are known to occur in association with the acquired immunodeficiency syndrome (AIDS and recent publications have called attention to the development of pseudoaneurysms of large arteries in patients with AIDS. CASE REPORT: We report on 2 patients with AIDS aged 23 and 31 years with pseudoaneurysms of the abdominal aorta and common iliac arteries. After clinical and radiological evaluation by arteriography and computed tomography, the patients were submitted to aneurysmectomy, with the placement of a patch of dacron in the first case and the interposition of a right aorto-iliac and left femoral prosthesis in the second. The second patient developed new aneurysms of the right subclavian and left popliteal arteries 2 months after surgery. Proximal ligation of the right subclavian artery was performed to treat the first aneurysm and resection and interposition of a reversed saphenous vein was carried out to treat the pseudoaneurysm of the popliteal artery. Histopathological examination of the popliteal artery revealed necrotizing arteritis.

Dermatological manifestations in patients with HIV/AIDS

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Sahily De la Paz Peña

2015-11-01

Full Text Available In view of the frequency of the dermatological manifestations in patients who suffer from AIDS/HIV, and with the objective of describing their behaviour, a descriptive,observational, and cross sectional investigation was carried out in the cases of the AIDS provincial consultation at Ernesto Guevara General Teaching Hospital of Las Tunas from January, 2007 to June, 2008. The information was obtained from the survey, the dermatological examination, and the clinical charts. The sample was made up of 43 patients, in which males and 31 to 40 age groups prevailed. There were no important quantity differences between the seropositive number and AIDS cases. The 27, 9% had dermatosis that made suspect the presence of the chronic retrovirus. The viral and the mycotic diseases were the most frequent ones, being the neoplastic type and drugreactions the least frequent ones. Other sexually transmitted diseases (STD appeared associated to the primary disease, mainly herpes simplex type II, and verruca acuminata.

Evaluation of the Fracture Resistance of Computer‑aided Design ...

African Journals Online (AJOL)

2018-04-04

Apr 4, 2018 ... were milled using a CEREC 4 CAD/CAM system (Software Version, 4.2.0.57192). CAD/CAM crowns ... Computer‑aided Manufacturing Monolithic Crowns Prepared in. Different ..... Engineering long term clinical success of ...

Religious and spiritual coping in people living with HIV/Aids

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Clarissa Mourão Pinho

Full Text Available ABSTRACT Objective: evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. Method: descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL, and the Religious/Spiritual Coping Scale (RCOPE. Results: the sample presented high indices of organizational religiosity (4.23±1.66, non-organizational religiosity (4.63±1.50, and intrinsic religiosity (13.13±2.84. Positive RCOPE was used in high mean scores (3.66±0.88, and negative RCOPE had low use (2.12 ± 0.74. In total, use of RCOPE was high (3.77±0.74, having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46. Conclusion: it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.

European clinical guidelines for Tourette syndrome and other tic disorders. Part III: behavioural and psychosocial interventions

DEFF Research Database (Denmark)

Verdellen, Cara; van de Griendt, Jolande; Hartmann, Andreas

2011-01-01

This clinical guideline provides recommendations for the behavioural and psychosocial interventions (BPI) of children and adolescents with tic disorders prepared by a working group of the European Society for the Study of Tourette Syndrome (ESSTS). A systematic literature search was conducted...... to obtain an update on the efficacy of BPI for tics. Relevant studies were identified using computerised searches of the Medline and PsycINFO databases and the Cochrane Library for the years 1950-2010. The search identified no meta-analyses, yet twelve (systematic) reviews and eight randomised controlled...... trials provided evidence for the current review. Most evidence was found for habit reversal training (HRT) and the available but smaller evidence also supports the efficacy of exposure with response prevention (ERP). Both interventions are considered first line behavioural treatments for tics for both...

European perspective on the management of rheumatoid arthritis: clinical utility of tofacitinib.

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Kawalec, Paweł; Śladowska, Katarzyna; Malinowska-Lipień, Iwona; Brzostek, Tomasz; Kózka, Maria

2018-01-01

Xeljanz ® (tofacitinib) is an oral small-molecule inhibitor that reversibly inhibits Janus-activated kinase (JAK)-dependent cytokine signaling, thus reducing inflammation. As a result of these mechanisms, effects on the immune system such as a moderate decrease in the total lymphocyte count, a dose-dependent decrease in natural killer (NK) cell count, and an increase in B-cell count have been observed. Therefore, tofacitinib provides an innovative approach to modulating the immune and inflammatory responses in patients with rheumatoid arthritis (RA), which is especially important in individuals who do not respond to tumor necrosis factor inhibitors or show a loss of response over time. The aim of this article was to review studies on the pharmacology, mode of action, pharmacokinetics, efficacy, and safety of tofacitinib in patients with RA. Tofacitinib has been shown to reduce symptoms of RA and improve the quality of life in the analyzed groups of patients. Moreover, it showed high efficacy and an acceptable safety profile in Phase III randomized clinical trials on RA and was the first JAK inhibitor approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) in the RA therapy, thus providing a useful alternative treatment strategy. Randomized controlled studies revealed a significant benefit over placebo in efficacy outcomes (American College of Rheumatology [ACR] 20 and ACR50 response rates); accordingly, clinically meaningful improvements in patient-related outcomes compared with placebo have been reported. The safety profile seems acceptable, although some severe adverse effects have been observed, including serious infections, opportunistic infections (including tuberculosis and herpes zoster), malignancies, and cardiovascular events, which require strict monitoring irrespective of the duration of tofacitinib administration. As an oral drug, tofacitinib offers an alternative to subcutaneous or intravenous biologic drugs and

Cutaneous manifestations in patients with mastocytosis: Consensus report of the European Competence Network on Mastocytosis; the American Academy of Allergy, Asthma & Immunology; and the European Academy of Allergology and Clinical Immunology.

Science.gov (United States)

Hartmann, Karin; Escribano, Luis; Grattan, Clive; Brockow, Knut; Carter, Melody C; Alvarez-Twose, Ivan; Matito, Almudena; Broesby-Olsen, Sigurd; Siebenhaar, Frank; Lange, Magdalena; Niedoszytko, Marek; Castells, Mariana; Oude Elberink, Joanna N G; Bonadonna, Patrizia; Zanotti, Roberta; Hornick, Jason L; Torrelo, Antonio; Grabbe, Jürgen; Rabenhorst, Anja; Nedoszytko, Boguslaw; Butterfield, Joseph H; Gotlib, Jason; Reiter, Andreas; Radia, Deepti; Hermine, Olivier; Sotlar, Karl; George, Tracy I; Kristensen, Thomas K; Kluin-Nelemans, Hanneke C; Yavuz, Selim; Hägglund, Hans; Sperr, Wolfgang R; Schwartz, Lawrence B; Triggiani, Massimo; Maurer, Marcus; Nilsson, Gunnar; Horny, Hans-Peter; Arock, Michel; Orfao, Alberto; Metcalfe, Dean D; Akin, Cem; Valent, Peter

2016-01-01

Cutaneous lesions in patients with mastocytosis are highly heterogeneous and encompass localized and disseminated forms. Although a classification and criteria for cutaneous mastocytosis (CM) have been proposed, there remains a need to better define subforms of cutaneous manifestations in patients with mastocytosis. To address this unmet need, an international task force involving experts from different organizations (including the European Competence Network on Mastocytosis; the American Academy of Allergy, Asthma & Immunology; and the European Academy of Allergology and Clinical Immunology) met several times between 2010 and 2014 to discuss the classification and criteria for diagnosis of cutaneous manifestations in patients with mastocytosis. This article provides the major outcomes of these meetings and a proposal for a revised definition and criteria. In particular, we recommend that the typical maculopapular cutaneous lesions (urticaria pigmentosa) should be subdivided into 2 variants, namely a monomorphic variant with small maculopapular lesions, which is typically seen in adult patients, and a polymorphic variant with larger lesions of variable size and shape, which is typically seen in pediatric patients. Clinical observations suggest that the monomorphic variant, if it develops in children, often persists into adulthood, whereas the polymorphic variant may resolve around puberty. This delineation might have important prognostic implications, and its implementation in diagnostic algorithms and future mastocytosis classifications is recommended. Refinements are also suggested for the diagnostic criteria of CM, removal of telangiectasia macularis eruptiva perstans from the current classification of CM, and removal of the adjunct solitary from the term solitary mastocytoma. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Parotid enlargement in children with AIDS

International Nuclear Information System (INIS)

Soberman, N.; Leonidas, J.C.; Berdon, W.E.; Haller, J.O.; Posner, M.; Bonagura, V.

1990-01-01

PURPOSE: Painless parotid enlargement has been recently reported as a sign of AIDS, but little is known of the imaging characteristics of parotid involvement in affected children. The aim of this paper is to use US, CT and MR imaging to determine the anatomic changes of the parotid; study their possible association with pulmonary lymphoid hyperplasia (PLH); and define the immunologic parameters and clinical course. Eighteen children were evaluated clinically, radiologically, and immunologically. All patients underwent US of the parotids and chest radiography; some children had CT of the chest and MR imaging of the parotids

Aid and good governance: Examining aggregate unintended effects of aid.

Science.gov (United States)

Dijkstra, Geske

2018-06-01

Although donors generally aim to improve governance in recipient countries by various means, critics claim that the aggregate effect of large aid flows is the deterioration of governance. Aid is said to weaken domestic accountability, sustain authoritarian regimes, increase political instability, weaken government capacities, and increase corruption. Conducting a systematic search in Web of Science, this paper reviews the empirical evidence for these unintended aggregate effects of aid on the political, administrative, and judicial dimensions of good governance. It finds that the negative effects of aid on governance are much exaggerated. The aggregate effect of aid on democracy has become more positive after the Cold War, and the effect of aid on government capacity and on reducing corruption has also improved over time. Furthermore, most studies show a positive effect of aid on political stability. These findings imply that donor intentions matter: donors that are serious about their intended effects on governance are able to mitigate the possible negative unintended effects of their aid. Copyright © 2017 Elsevier Ltd. All rights reserved.

TurbinAID

International Nuclear Information System (INIS)

Moradian, M.A.; Chow, M.P.; Osborne, R.L.; Jenkins, M.A.

1991-01-01

The Westinghouse Turbine Artificial Intelligence Diagnostics system or TurbinAID, can diagnose both thermodynamic and mechanical component anomalies within the turbine, and around the turbine cycle. any monitoring system can detect that a variable is in an abnormal state, but TurbinAID can also indicate the cause, and provide recommended corrective action(s). The TurbinAID Expert Systems utilize multiple sensor and variable inputs, and their interdependencies in the generation of a diagnosis. The system performs sensor validation as part of the data acquisition scheme. The TurbinAID system has been in operation for several years. This paper describes the monitoring and diagnostic functions provided by TurbinAID, and how the utility industry both nuclear and fossil, can utilize the system to enhance unit operation

Assessment of Workplace Stigma and Discrimination among People Living with HIV/AIDS Attending Antiretroviral Clinics in Health Institutions in Enugu, Southeast Nigeria.

Science.gov (United States)

Aguwa, E N; Arinze-Onyia, S U; Okwaraji, F; Modebe, I

2015-05-06

The onset of HIV/AIDS has increased stigma and discrimination at workplaces, making those with these ailments worried about going to work to avoid being victimized. Most previous works focussed on stigma and discrimination in the communities with little emphasis on what occurs in the workplaces. This study assessed the prevalence of workplace stigma and discrimination among people living with HIV/AIDS (PLWHA) attending antiretroviral (ARV) clinics in health institutions in Enugu, southeast Nigeria. A cross-sectional descriptive study was done between February and May of 2014 using a selfadministered questionnaire to assess 489 PLWHA attending ARV clinics. Out of 489 studied, 255 (52.1%) were females. About 23.7% said being HIV positive had affected their relationship with other workers and 20.7% were blamed for their condition. Some were not given time off to go to hospital (72.5%). The commonest fears of PLWHA were stigmatization/discrimination from other workers (78.1%) and dying from the disease (62.8%). Gender did not significantly affect the way PLWHA were stigmatized or discriminated against in their workplaces. However, those who were employed in private establishments were more likely to have their schedule changed due to their status compared to government employees ( p discriminating practices were not significantly different between government and private employees. The prevalence of stigma and discrimination in workplaces is high. Efforts should be made by agencies to reduce such social problems in the workplace since they can affect overall management and productivity.

[Industrial first aid equipment: a historical analysis (1840-1914) ].

Science.gov (United States)

Porro, Alessandro; Franchini, Antonia Francesca; Lorusso, Lorenzo; Falconi, Bruno

2015-01-09

Even if references to the tools required to intervene after an accident can be found in the works of Bernardino Ramazzini (1633-1714) or Johann Peter Frank (1745-1821), it was only with the development of industrial manufacturing that the need to study means to prevent and intervene in cases of accident became evident. In October 1894 the III Congrés International des Accidents du Travail et des Assurances Sociales was held in Milan. The following year, the Milanese trade union movement acknowledged the necessity to address the problem of industrial accidents. In 1896 the Association for Medical Assistance in  Industrial Accidents was founded in Milan. A specific medical institute was set up, appropriate first aid tools were collected and first aid rooms in the main Milanese factories were inaugurated. Nevertheless, few data seem to be available regarding the manufacture and use of this equipment in industry. We analyzed more than fifty catalogs of European industrial products, between 1843 and 1914, to study the evolution of first aid equipment for industrial use. They reflect and attest to the evolution of medicine and surgery, although some models seem to be related to certain industrial categories (railways, electrical appliances), some were similar to ordinary first aid boxes, others were strictly related to surgery; some could only be used by physicians, and others only by workers. Identification, conservation, and reappraisal of these tools is essential for historians of occupational health because these objects were normally not preserved. The catalogues of industrial production are also precious sources, since they are rarely preserved in public libraries and deserve to be used for historical studies.

Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort

DEFF Research Database (Denmark)

Shaw, Dominick E; Sousa, Ana R; Fowler, Stephen J

2015-01-01

U-BIOPRED is a European Union consortium of 20 academic institutions, 11 pharmaceutical companies and six patient organisations with the objective of improving the understanding of asthma disease mechanisms using a systems biology approach.This cross-sectional assessment of adults with severe...... asthma, mild/moderate asthma and healthy controls from 11 European countries consisted of analyses of patient-reported outcomes, lung function, blood and airway inflammatory measurements.Patients with severe asthma (nonsmokers, n=311; smokers/ex-smokers, n=110) had more symptoms and exacerbations...

[A survey on AIDS knowledge rate and sexual behavior among men who have sex with men population at sexually transmitted disease clinic].

Science.gov (United States)

Jian, Dan; Xie, Hongfu; Yi, Mei; Li, Ji; Chen, Mingliang; Feng, Hao; Cheng, Xiaoming; Zhang, Guiying

2010-07-01

To survey on men who have sex with men (MSM) population's sexual behaviors, condom-service condition, HIV related knowledge and other issues among MSM population at sexually transmitted disease (STD) clinics to understand the characteristics of behaviors and offer suggestions for effective health education and behavior intervention. From January to December, 2009, we used anonymous questionnaires which involved in their mastery of demographic characteristics, sexual behavior, condom-service condition, HIV related knowledge, and so one, to investigate 200 MSM at 3 STD clinics of comprehensive hospital. The average age of informant was (26.7+/- 8.9) years and 121 individuals (62.6%) had confirmed with STD in recent one year. In the recent 6 months, the average number of homosexual partners was 9.2+/- 4.8 and 102 (52.8%) had heterosexual partners. In the sexual intercourse with homosexual, 123 individuals had anal intercourse (63.7 %) and 117 had oral intercourse (60.6%). In the sexual intercourse with heterosexual, 92 (90.2%) individuals had vaginal intercourse, 37 (36.2%) had anal intercourse, and 59 (57.8%) had oral sex behavior.There were a statistical difference between heterosexual and homosexual sex behaviors (Pcondom-using frequency had statistic difference in different sexual behaviors(χ²=188.396, Pcondom-using condition in sexual behaviors except the heterosexual anal intercourse. High AIDS knowledge mastery rate is found in our survey. The respondents get HIV/AIDS knowledge through various ways actively. There is no obvious relation between the mastery of HIV related knowledge and condom-using frequency. The ratio of non-protected sexual behaviors is high in heterosexuals. How to adopt effective methods for behavior intervention to MSM at STD clinic needs to be further studied.

Physicians' intentions and use of three patient decision aids

Science.gov (United States)

Graham, Ian D; Logan, Jo; Bennett, Carol L; Presseau, Justin; O'Connor, Annette M; Mitchell, Susan L; Tetroe, Jacqueline M; Cranney, Ann; Hebert, Paul; Aaron, Shawn D

2007-01-01

intention. Conclusion Despite strong support for the format, content, and quality of patient decision aids, and physicians' stated intentions to adopt them into clinical practice, most did not use them within three months of completing the survey. There is a wide gap between intention and behaviour. Further research is required to study the determinants of this intention-behaviour gap and to develop interventions aimed at barriers to physicians' use of decision aids. PMID:17617908

Improving quality in the preanalytical phase through innovation, on behalf of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE)

DEFF Research Database (Denmark)

Lippi, Giuseppe; Baird, Geoffrey S.; Banfi, Giuseppe

2017-01-01

process remain, especially in the preanalytical phase ranging from test ordering to obtaining and managing the biological specimens. The Working Group for the Preanalytical Phase (WG-PRE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has planned many activities aimed...... at mitigating the vulnerability of the preanalytical phase, including the organization of three European meetings in the past 7 years. Hence, this collective article follows the previous three opinion papers that were published by the EFLM WGPRE on the same topic, and brings together the summaries...

AIDS care: why and how should industry respond?

Science.gov (United States)

Smart, R

2000-01-01

This article reports the AIDS care response of industries to the rising AIDS epidemic in South Africa. It has been reported that during 1993-99 the rate of hospital bed occupancy doubled to over 8/1000 and that 50% of ill-health retirements in 1998 were due to AIDS. Important issues to be considered by industries are the medical separation due to ill health, poor health care services. The focus of HIV/AIDS care should be on the patient, family, care giver, community, and health services, and must be based on the principles of decentralization and integration of sustainable and cost-effective HIV/AIDS services. The development of a care package must be based on six dimensions; namely, appropriateness, acceptability, accessibility, effectiveness, efficiency, and equity. On the other hand, identification of indicators in relation to the components of the care package must include support groups and networks of people living with HIV; the provision of home-based care; responsiveness of the health system; the existence and application of clinical guidelines; and the effectiveness of referrals. Any organization with a commitment in providing care should establish a Care Task Team to develop a care strategy. It should focus on who can have access to the care, what the care consists of, and who will cover the cost. In addition, a review of the existing HIV/AIDS services must be done to identify shortfalls and highlight priority gaps.

Student′s preference of various audiovisual aids used in teaching pre- and para-clinical areas of medicine

Directory of Open Access Journals (Sweden)

Navatha Vangala

2015-01-01

Full Text Available Introduction: The formal lecture is among the oldest teaching methods that have been widely used in medical education. Delivering a lecture is made easy and better by use of audiovisual aids (AV aids such as blackboard or whiteboard, an overhead projector, and PowerPoint presentation (PPT. Objective: To know the students preference of various AV aids and their use in medical education with an aim to improve their use in didactic lectures. Materials and Methods: The study was carried out among 230 undergraduate medical students of first and second M.B.B.S studying at Malla Reddy Medical College for Women, Hyderabad, Telangana, India during the month of November 2014. Students were asked to answer a questionnaire on the use of AV aids for various aspects of learning. Results: This study indicates that students preferred PPT, the most for a didactic lecture, for better perception of diagrams and flowcharts. Ninety-five percent of the students (first and second M.B.B.S were stimulated for further reading if they attended a lecture augmented by the use of visual aids. Teacher with good teaching skills and AV aids (58% was preferred most than a teacher with only good teaching skills (42%. Conclusion: Our study demonstrates that lecture delivered using PPT was more appreciated and preferred by the students. Furthermore, teachers with a proper lesson plan, good interactive and communicating skills are needed for an effective presentation of lecture.

Abdominal ultrasound in AIDS patients

International Nuclear Information System (INIS)

Escribano, J.; Gonzalez, J.; Alvarez, M.; Rivero, S.; Raya, J.L.; Ruza, M.

1998-01-01

To analyze the ultrasonography findings in abdomen in the AIDS patients in our hospital, as well as the indications for this exploration, assessing the role of abdominal ultrasound (AU). The ultrasonographic and clinical findings in 527 patients who underwent a total of 715 explorations between 1992 and 1996 were studied. Hepatomegaly and/or splenomegaly, usually homogeneous, were observed in nearly half of the studies (45%); one third of the patients with marked splenomegaly presented visceral leishmaniasis. Focal lesions in liver and/or spleen, corresponding to angiomas, abscesses, lymphomatous lesions and metastasis, were detected in 5.7% of the explorations. Thirty-five percent of the AU revealed the presence of lymphadenopathy; nodes measuring over 2.5 cm were usually related to potential treatable infection or neoplasm. Thickening of the gallbladder wall did not usually indicate the presence of acute cholecystitis unless Murphy''s sign was also detected. Bile duct dilation and wall thickening was related to opportunistic cholangitis, and the increase in the echogenicity of the renal parenchyma was linked to AIDS-related nephropathy. Despite the fact that many of findings with AU are nonspecific, we consider that this approach should be the principal diagnostic technique in AIDS patients with suspected abdominal pathology or fever of unknown origin. (Author) 43 refs,

Costs incurred by applying computer-aided design/computer-aided manufacturing techniques for the reconstruction of maxillofacial defects.

Science.gov (United States)

Rustemeyer, Jan; Melenberg, Alex; Sari-Rieger, Aynur

2014-12-01

This study aims to evaluate the additional costs incurred by using a computer-aided design/computer-aided manufacturing (CAD/CAM) technique for reconstructing maxillofacial defects by analyzing typical cases. The medical charts of 11 consecutive patients who were subjected to the CAD/CAM technique were considered, and invoices from the companies providing the CAD/CAM devices were reviewed for every case. The number of devices used was significantly correlated with cost (r = 0.880; p costs were found between cases in which prebent reconstruction plates were used (€3346.00 ± €29.00) and cases in which they were not (€2534.22 ± €264.48; p costs of two, three and four devices, even when ignoring the cost of reconstruction plates. Additional fees provided by statutory health insurance covered a mean of 171.5% ± 25.6% of the cost of the CAD/CAM devices. Since the additional fees provide financial compensation, we believe that the CAD/CAM technique is suited for wide application and not restricted to complex cases. Where additional fees/funds are not available, the CAD/CAM technique might be unprofitable, so the decision whether or not to use it remains a case-to-case decision with respect to cost versus benefit. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

E-cigarettes as smoking cessation aids: a survey among practitioners in Italy.