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  1. Optimizing the patient transport function at Mayo Clinic.

    Science.gov (United States)

    Kuchera, Dustin; Rohleder, Thomas R

    2011-01-01

    In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to consider the trade-offs between patient waiting time and staffing levels. While improved staffing efficiency was a desire of the project, it was important that patient service quality was also maintained. The results show that staffing could be reduced while maintaining historical patient service levels.

  2. Case Study: Review of Operating Room Utilization at Mayo Clinic Arizona (MCA)

    Science.gov (United States)

    2008-05-01

    offers. The premier programs of the hospital are cancer treatment and solid organ /bone marrow transplant . (Mayo Clinic, 2007) Problem Statement In...improve revenue streams (Overdyl, Harvey, Fishman , & Shippey, 1998). Organizations have seen reduced revenues from operating room care because of lower...TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) RESIDENCY SITE ADDRESS Mayo Clinic Arizona 5777 East Mayo

  3. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

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    Scott Okuno

    2011-08-01

    Full Text Available Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.

  4. Postradiation sarcoma of bone: review of 78 Mayo Clinic cases

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    Weatherby, R.P.; Dahlin, D.C.; Ivins, J.C.

    1981-05-01

    Postradiation sarcoma of bone is an uncommon but serious sequela of radiation therapy. Seventy-eight Mayo Clinic patients have been treated for sarcomas arising in irradiated bones. They received their initial radiotherapy for a wide variety of nonneoplastic and neoplastic conditions, both benign and malignant. Thirty-five sarcomas arose in bone that was normal at the time of radiotherapy, and 43 arose in irradiated preexisting osseous lesions. The latent period between radiotherapy and diagnosis of sarcoma averaged 14.3 years. Ninety percent of the postradiation sarcomas were either osteosarcomas or fibrosarcomas; chondrosarcoma, malignant (fibrous) histiocytoma, malignant lymphoma, Ewing's tumor, and metastasizing chondroblastoma also occurred. Prompt radical surgery, when feasible, is usually the treatment of choice for the sarcoma. About 30% of patients with sarcomas of the extremities or craniofacial bones survived 5 years without recurrence; there were no disease-free survivors among patients with tumors of the vertebral column, pelvis, or shoulder girdle. The low risk of sarcoma following radiotherapy for the treatment of cancer should not be a contraindication to its use in these patients; however, radiation therapy for benign bone tumors should be reserved for lesions that are not amenable to surgical treatment. An unusual case is also reported herein in which a fibrosarcoma was discovered in the humerus of a patient who had received radiotherapy 55 years previously for a verified osteosarcoma in the same site.

  5. Autoimmune Hemolytic Anemia in Children: Mayo Clinic Experience.

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    Sankaran, Janani; Rodriguez, Vilmarie; Jacob, Eapen K; Kreuter, Justin D; Go, Ronald S

    2016-04-01

    We studied 35 pediatric patients with autoimmune hemolytic anemia seen at Mayo Clinic from 1994 to 2014. The median age was 10.0 years and 65.7% were males. Most had warm antibodies (80.0%) and some secondary to viral (14.3%) or autoimmune disorders (31.4%). Seven (20.0%) patients presented with Evans syndrome, 3 of whom also had common variable immunodeficiency. The median hemoglobin at diagnosis was 6.1 g/dL and 62.8% patients required red cell transfusions. The severity of anemia was worse among children below 10 years (median 5.5 vs. 7.0 g/dL, P=0.01). Steroid was the initial treatment for 88.5% patients, with overall response rate of 82.7% (68.5% complete, 14.2% partial) and median response duration of 10.7 months (range, 0.2 to 129.7+ mo). After median follow-up of 26.6 months, 8 (22.8%) patients relapsed. Salvage treatments included splenectomy, intravenous immunoglobulin, rituximab, and mycophenolate mofetil. Infectious complications occurred in 9 (25.7%) patients and 1 patient died of cytomegalovirus infection. Four patients had cold agglutinin disease and 3 (75.0%) responded to steroids. Autoimmune hemolytic anemia is a rare disorder in pediatric population and most respond well to steroids regardless of the type of antibody. Infectious complications are common and screening for immunodeficiency is recommended among those with Evans syndrome.

  6. Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach

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    Joglekar, Siddharth B. [Musculoskeletal Oncology, Mayo Clinic, Rochester, MN55905 (United States); Rose, Peter S.; Sim, Franklin, E-mail: sim.franklin@mayo.edu [Department of Orthopedics, Mayo Clinic, 200 1st ST SW, Rochester, MN 55905 (United States); Okuno, Scott [Department of Oncology, Mayo Clinic, Rochester, MN55905 (United States); Petersen, Ivy [Department of Radiation Oncology, Mayo Clinic, Rochester, MN55905 (United States)

    2011-08-08

    Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.

  7. Twenty years of human immunodeficiency virus care at the Mayo Clinic: Past, present and future

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    Cummins, Nathan W; Badley, Andrew D; Kasten, Mary J; Sampath, Rahul; Temesgen, Zelalem; Whitaker, Jennifer A; Wilson, John W; Yao, Joseph D; Zeuli, John; Rizza, Stacey A

    2016-01-01

    The Mayo human immunodeficiency virus (HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a “Mayo Model” of HIV care that exceeds national outcomes and may be applicable in other settings. PMID:27175350

  8. Final Environmental Assessment for Jacksonville Aviation Authority Launch Site Operator License at Cecil Field, Florida

    Science.gov (United States)

    2009-07-01

    provide an environment compatible with surrounding land use; to adapt the zoning process to changes in construction and development technology ; to...Health System Hospital 5,600 Citibank (Citi-Cards) Credit Card Company - Division Headquarters 5,000 Mayo Clinic Multi-Specialty Health Center 5,000...Control Problem. MSNBC, Technology and Science. http://www.msnbc.msn.com/id/5261571/ (accessed on January 20, 2009). City of Jacksonville (City of

  9. The Enterprise Data Trust at Mayo Clinic: a semantically integrated warehouse of biomedical data.

    Science.gov (United States)

    Chute, Christopher G; Beck, Scott A; Fisk, Thomas B; Mohr, David N

    2010-01-01

    Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research data. While facile access for cohort definition or aggregate retrieval is supported, a high level of security, retrieval audit, and user authentication ensures privacy, confidentiality, and respect for the trust imparted by our patients for the respectful use of information about their conditions.

  10. The Enterprise Data Trust at Mayo Clinic: a semantically integrated warehouse of biomedical data

    Science.gov (United States)

    Beck, Scott A; Fisk, Thomas B; Mohr, David N

    2010-01-01

    Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research data. While facile access for cohort definition or aggregate retrieval is supported, a high level of security, retrieval audit, and user authentication ensures privacy, confidentiality, and respect for the trust imparted by our patients for the respectful use of information about their conditions. PMID:20190054

  11. Management of Endometrial Cancer at Mayo Clinic: Intensive Surgical Staging and Disease-based Postoperative Treatment

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    Mariani, A.

    2006-01-01

    Chapter 1 is a general introduction, while chapter 8 is the final discussion and conclusions. The remaining chapters (from 2 to 7) are composed by a brief introduction, followed by the published article(s) that form(s) the structure of the chapter. Management of Endometrial Cancer at Mayo Clinic: I

  12. Management of Endometrial Cancer at Mayo Clinic: Intensive Surgical Staging and Disease-based Postoperative Treatment

    NARCIS (Netherlands)

    Mariani, A.

    2006-01-01

    Chapter 1 is a general introduction, while chapter 8 is the final discussion and conclusions. The remaining chapters (from 2 to 7) are composed by a brief introduction, followed by the published article(s) that form(s) the structure of the chapter. Management of Endometrial Cancer at Mayo Clinic: I

  13. Fecal microbiota transplant for recurrent Clostridium difficile infection: Mayo Clinic in Arizona experience.

    Science.gov (United States)

    Patel, Neal C; Griesbach, Cheryl L; DiBaise, John K; Orenstein, Robert

    2013-08-01

    To report the initial experience of treating recurrent Clostridium difficile infection (CDI) with fecal microbiota transplant (FMT) at Mayo Clinic in Arizona. The study retrospectively reviewed FMTs performed at Mayo Clinic in Arizona between January 1, 2011, and January 31, 2013. All the recipients had multiple recurrent CDIs unresponsive to traditional antibiotic drug therapy. A standardized protocol was developed to identify patients, screen donors, perform FMT, and determine outcomes via telephone surveys. Thirty-one patients (mean ± SD age, 61.26±19.34 years) underwent FMT. Median time from index infection to FMT was 340 days. Ninety-seven percent (29 of 30) of patients reported substantial improvement or resolution of diarrhea (median time to improvement, 3 days), 74% (17 of 23) reported improvement or resolution of abdominal pain (median time to improvement, 3 days), and 55% (16 of 29) had improvement or resolution of fatigue (median time to improvement, 6 days). Three patients underwent repeated FMT owing to persistent symptoms; 2 reported improvement in diarrhea with the second therapy. No serious adverse events directly related to FMT were reported. A standardized regimen of FMT for recurrent CDI is safe, is highly effective, and can be provided using a relatively simple protocol. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  14. Patient quality of life in the Mayo Clinic Care Transitions program: a survey study

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    Faucher J

    2016-08-01

    Full Text Available Joshua Faucher,1 Jordan Rosedahl,2 Dawn Finnie,3 Amy Glasgow,3 Paul Takahashi4 1Mayo Medical School, Mayo Clinic College of Medicine, 2Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, 3Center for the Science of Health Care Delivery, 4Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA Background: Transitional care programs are common interventions aimed at reducing medical complications and associated readmissions for patients recently discharged from the hospital. While organizations strive to reduce readmissions, another important related metric is patient quality of life (QoL. Aims: To compare the relationship between QoL in patients enrolled in the Mayo Clinic Care Transitions (MCCT program versus usual care, and to determine if QoL changed in MCCT participants between baseline and 1-year follow-up. Methods: A baseline survey was mailed to MCCT enrollees in March 2013. Those who completed a baseline survey were sent a follow-up survey 1 year later. A cross-sectional survey of usual care participants was mailed in November 2013. We included in our analysis 199 participants (83 in the MCCT and 116 in usual care aged over 60 years with multiple comorbidities and receiving primary care. Primary outcomes were self-rated QoL; secondary outcomes included self-reported general, physical, and mental health. Intra- and intergroup comparisons of patients were evaluated using Pearson’s chi-squared analysis. Results: MCCT participants had more comorbidities and higher elder risk assessment scores than those receiving usual care. At baseline, 74% of MCCT participants reported responses of good-to-excellent QoL compared to 64% after 1 year (P=0.16. Between MCCT and usual care, there was no significant difference in self-reported QoL (P=0.21. Between baseline and follow-up in MCCT patients, and compared to usual care, there were no significant

  15. Clinical diagnostic testing for the cytogenetic and molecular causes of male infertility: the Mayo Clinic experience.

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    Hofherr, Sean E; Wiktor, Anne E; Kipp, Benjamin R; Dawson, D Brian; Van Dyke, Daniel L

    2011-11-01

    Approximately 8% of couples attempting to conceive are infertile and male infertility accounts for approximately 50% of infertility among couples. Up to 25% of males with non-obstructive infertility have chromosomal abnormalities and/or microdeletions of the long arm of the Y-chromosome. These are detected by conventional chromosome and Y-microdeletion analysis. In this study, we reviewed the results of testing performed in the Mayo Clinic Cytogenetics and Molecular Genetics Laboratories and compared our findings with previously published reports. This study includes 2,242 chromosome studies from males ≥18 years of age referred for infertility between 1989 and 2000 and 2,749 Y-deletion molecular studies performed between 2002 and 2009. 14.3% of infertile males tested by karyotyping had abnormalities identified. These include: (258) 47,XXY and variants consistent with Klinefelter syndrome, (3) combined 47,XXY and balanced autosomal rearrangements, (9) 47,XYY, (9) Y-deletions, (7) 46,XX males, (32) balanced rearrangements, and (1) unbalanced rearrangement. 3.6% of males tested for Y-microdeletion analysis had abnormalities identified, 90% of which included a deletion of the AZFc region. This study highlights the need of males suffering from non-obstructive infertility to have laboratory genetic testing performed. An abnormal finding can have significant consequences to assisted reproductive techniques and fertility treatment, and provide a firm diagnosis to couples with longstanding infertility.

  16. Building a protocol expressway: the case of Mayo Clinic Cancer Center.

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    McJoynt, Terre A; Hirzallah, Muhanad A; Satele, Daniel V; Pitzen, Jason H; Alberts, Steven R; Rajkumar, S Vincent

    2009-08-10

    Inconsistencies and errors resulting from nonstandard processes, together with redundancies, rework, and excess workload, lead to extended time frames for clinical trial protocol development. This results in dissatisfaction among sponsors, investigators, and staff and restricts the availability of novel treatment options for patients. A team of experts from Mayo Clinic formed, including Protocol Development Unit staff and management from the three Mayo Clinic campuses (Florida, Minnesota, and Arizona), a systems and procedures analyst, a quality office analyst, and two physician members to address the identified deficiencies. The current-state process was intensively reviewed, and improvement steps were taken to accelerate the development and approval of cancer-related clinical trials. The primary goal was to decrease the time from receipt of a new protocol through submission to an approving authority, such as the National Cancer Institute or institutional review board. Using the Define, Measure, Analyze, Improve, Control (DMAIC) framework infused with Lean waste-reduction methodologies, areas were identified for improvement, including enhancing first-time quality and processing new studies on a first-in/first-out basis. The project was successful in improving the mean turnaround time for internally authored protocols (P Lean methodologies is an effective tool to structure the definition, planning, analysis, and implementation of significant process changes.

  17. Bringing human resources to the table: utilization of an HR balanced scorecard at Mayo Clinic.

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    Fottler, Myron D; Erickson, Eric; Rivers, Patrick A

    2006-01-01

    Rather than viewing HR as a critical driver of organizational strategy and outcomes, most health care organizations see HR as a drain on the organization's bottom line. Only by aligning HR with the organizational strategy will HR leaders truly get a seat at the leadership table. HR professionals can overcome impediments and gain a seat at the table by learning the language of business and the ways in which organizational leaders use data to drive their decisions. This article shows how Mayo Clinic uses the popular Balanced Scorecard approach to align its measures of HR performance to the organization's strategic plan.

  18. Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience.

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    Swensen, Stephen; Kabcenell, Andrea; Shanafelt, Tait

    2016-01-01

    The process of creating healthy organization-physician relationships is critical to organizational success. Partnerships in process improvement can nurture these relationships and mitigate burnout by meeting physicians' psychological needs. To flourish, physicians need some degree of choice (control over their lives), camaraderie (social connectedness), and an opportunity for excellence (being part of something meaningful). Organizations can provide these opportunities by establishing constructive organization-physician relationships and developing physician leaders. We present a case study from the Mayo Clinic that supports the foundational principles of a physician-engagement model. We developed the Listen-Act-Develop model as an integrated strategy to reduce burnout and engage physicians in the mission of the organization. The intent of the model is to maximize physician wellness by fostering engagement and mitigating the drivers of burnout. This model provides a path to increase physician satisfaction and meaning in work and to improve organizational effectiveness.

  19. Children Thyroid Cancer treatment in Saint-Petersburg Endocrine SurgeryCenter and Mayo Clinic

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    Aleksandr Filippovich Romanchishen

    2015-02-01

    Full Text Available IntroductionThyroid cancer (TC is the most often malignant tumor in childhood and made 1.5 – 3.0% of all children population or 45.3% of pediatric endocrine epithelial cancers. A lot of questions concerning to volume of thyroid surgery, postoperative radio iodine therapy (RIT needs to be discussed.AimEstimation of childhood sporadic thyroid cancer specificity and comparison of children and adolescents treatment in Saint-Petersburg Endocrine Surgery Center (Russia and Mayo Clinic (USA.Material and methodsDuring 1970 –2011 in the Saint-Petersburg Center (1 group were operated 105 TC children and adolescent (up to 20 yeas and in Mayo Clinic – 188 (2 group in  1940 – 2000 period. Since of 80-s in those clinics were used the same perioperative examinations, like TSH, T4, T3 blood levels, USG, fine needles aspiration biopsy, CT and morphological examinations.Results and discussionAverage age of the Saint-Petersburg Center and Rochester patients was the same and achieve 16.3±0.3 and 16.0±0.5, accordingly. In both groups has prevailed girls: in the 1 group they made 73.3% (M:F 1:2.7 and in the 2 – 70.7% (M:F 1:2.4. Childhood differentiated TC were associated with aggressive behavior: regional metastases were found in 53.0% and 81.4%, extrathyroid TC spreading – in 9.6 and 19.7%, distant metastases - in 9.6 and 4.8%, accordingly. In our Center (1 group we have performed hemithyroidectomies and subtotal Thyroidectomies in 58.1% with ipsilateral central neck dissection (CND. In Mayo Clinic in all TC cases were performed thyroidectomy (TE since 1950. TC relapses we have no   observed in 1 group and they have place in 6.9% 2 group patients, recurring lymphatic metastases – in 8.4% and 20.7%, accordingly. Radioiodine therapy (RIT has performed in 21.1% and 25.5% operated children.In 1 group 95 (96.0 % of 99 operated were alive during 5 – 36 years, in the 2– only in two cases reason of death was TC, but in 14 – other malignant tumor

  20. Long-term outcome of patients with POEMS syndrome: An update of the Mayo Clinic experience.

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    Kourelis, Taxiarchis V; Buadi, Francis K; Kumar, Shaji K; Gertz, Morie A; Lacy, Martha Q; Dingli, David; Go, Ronald S; Kapoor, Prashant; Lust, John A; Hayman, Suzanne R; Hwa, Yi; Rajkumar, S Vincent; Zeldenrust, Steven R; Russell, Stephen J; Lin, Yi; Leung, Nelson; Kyle, Robert A; Gonsalves, Wilson I; Dispenzieri, Angela

    2016-06-01

    Over the past decade, a number of changes have occurred in the diagnostic evaluation, management, and long-term follow-up of patients with POEMS syndrome at our institution. This study included 291 patients with POEMS syndrome diagnosed at the Mayo Clinic between 1974 and 2014. Patients diagnosed after 2003 had more features of the syndrome identified at diagnosis and were more likely to receive an autologous transplant (49% versus 8%, P complete response (CR) to treatment (41% vs 25%, P C.I., 56%, 67%). On multivariate analysis, the three factors associated with superior OS were younger age (RR 0.98 [0.96-1.00]), albumin greater-than 3.2 g/dL (RR 0.5 [0.32-0.89]) and attainment of complete hematologic response (RR 0.4 [0.2, 0.9]). This study confirms the very good long-term outcomes of patients with POEMS syndrome and identifies two new prognostic risk factors: albumin at diagnosis and attainment of complete hematologic response. Am. J. Hematol. 91:585-589, 2016. © 2016 Wiley Periodicals, Inc.

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

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    Zhou Jessica

    2011-09-01

    Full Text Available Abstract Background The role of adjuvant chemoradiation therapy for ampullary carcinoma is unknown. Previous literature suggests that certain populations with high risk factors for recurrence may benefit from adjuvant chemoradiation. We combined the experience of two institutions to better delineate which patients may benefit from adjuvant chemoradiation. Methods Patients who underwent curative surgery for ampullary carcinoma at the Johns Hopkins Hospital (n = 290; 1992-2007 and at the Mayo Clinic (n = 130; 1977-2005 were reviewed. Patients with Results Median overall-survival was 39.9 months with 2- and 5-year survival rates of 62.4% and 39.1%. On univariate analysis, adverse prognostic factors for overall survival included T3/T4 stage disease (RR = 1.86, p = 0.002, node positive status (RR = 3.18, p Conclusions Node-positive patients with resected ampullary adenocarcinoma may benefit from 5-FU based adjuvant chemoradiation. Since a significant proportion of patients develop metastatic disease, there is a need for more effective systemic treatment.

  2. Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic.

    Science.gov (United States)

    Hylwa, Sara A; Foster, Ashley A; Bury, Jessica E; Davis, Mark D P; Pittelkow, Mark R; Bostwick, J Michael

    2012-01-01

    Delusional infestation, which encompasses both delusions of parasitosis and delusions of infestation with inanimate objects (sometimes called Morgellons disease), has been said to represent a distinct and encapsulated delusion, that is, a stand-alone diagnosis. Anecdotally, we have observed that patients with delusional infestation often have one or more psychiatric comorbid conditions and that delusional infestation should not be regarded as a stand-alone diagnosis. The purpose of this study was to identify whether patients with delusional infestation have psychiatric comorbid conditions. We therefore identified patients who had been formally evaluated in the Department of Psychiatry during their visit to Mayo Clinic. We retrospectively searched for and reviewed the cases of all patients with delusional infestation seen from 2001 through 2007 at Mayo Clinic, Rochester, Minnesota, and who underwent psychiatric evaluation. The diagnoses resulting from psychiatric evaluation were analyzed. During the 7-year study period, 109 patients seen for delusional infestation at Mayo Clinic were referred to the Department of Psychiatry, 54 (50%) of whom actually followed through with psychiatric consultation. Of these 54 patients, 40 (74%) received additional active psychiatric diagnoses; 14 patients (26%) had delusional infestation alone. Abnormal personality traits were rarely documented. Most patients with delusional infestation have multiple coexisting or underlying psychiatric disorders. Therefore, evaluation by a psychiatrist, when possible, is advised for all patients with delusional infestation. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  3. Complex fibroadenoma and breast cancer risk: a Mayo Clinic Benign Breast Disease Cohort Study.

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    Nassar, Aziza; Visscher, Daniel W; Degnim, Amy C; Frank, Ryan D; Vierkant, Robert A; Frost, Marlene; Radisky, Derek C; Vachon, Celine M; Kraft, Ruth A; Hartmann, Lynn C; Ghosh, Karthik

    2015-09-01

    The purpose of this study is to examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. The study included women aged 18-85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed versus expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression [nonproliferative disease, proliferative disease without atypia (PDWA), or atypical hyperplasia]. Fibroadenoma was identified in 2136 women [noncomplex, 1835 (85.9%); complex, 301 (14.1%)]. SIR for noncomplex fibroadenoma was 1.49 (95% CI 1.26-1.74); for complex fibroadenoma, it was 2.27 (95% CI 1.63-3.10) (test for heterogeneity in SIR, P = .02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (e.g., incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics.

  4. Syndrome of rapid onset end stage renal disease in incident Mayo Clinic chronic hemodialysis patient

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    M. A. C. Onuigbo

    2014-01-01

    Full Text Available Despite decades of research, a full understanding of chronic kidney disease (CKD-end stage renal disease (ESRD progression remains elusive. The common consensus is a predictable, linear, progressive and time-dependent decline of CKD to ESRD. Acute kidney injury (AKI on CKD is usually assumed to be transient, with recovery as the expected outcome. AKI-ESRD association in current nephrology literature is blamed on the so-called "residual confounding." We had previously described a relationship between AKI events and rapid onset yet irreversible ESRD happening in a continuum in a high-risk CKD cohort. However, the contribution of the syndrome of rapid onset-ESRD (SORO-ESRD to incident United States ESRD population remained conjectural. In this retrospective analysis, we analyzed serum creatinine trajectories of the last 100 consecutive ESRD patients in 4 Mayo Clinic chronic hemodialysis units to determine the incidence of SORO-ESRD. Excluding 9 patients, 31 (34% patients, including two renal transplant recipients, had SORO-ESRD: 18 males and 13 females age 72 (range 50-92 years. Precipitating AKI followed pneumonia (8, acutely decompensated heart failure (7, pyelonephritis (4, post-operative (5, sepsis (3, contrast-induced nephropathy (2, and others (2. Time to dialysis was shortest following surgical procedures. Concurrent renin angiotensin aldosterone system blockade was higher with SORO-ESRD - 23% versus 5%, P = 0.0113. In conclusion, SORO-ESRD is not uncommon among the incident general US ESRD population. The implications for ESRD care planning, AV-fistula-first programs, general CKD care and any associations with renal ageing/senescence warrant further study.

  5. Long-term outcomes of radiotherapy for stage II testicular seminoma--the Mayo Clinic experience.

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    Hallemeier, Christopher L; Pisansky, Thomas M; Davis, Brian J; Choo, Richard

    2013-11-01

    To report long-term outcomes of patients with stage II testicular seminoma treated with radiotherapy (RT). A retrospective review was performed of 52 patients who received megavoltage RT for stage II testicular seminoma at Mayo Clinic between 1974 and 2007. Forty-eight patients (92%) had computed tomography staging. Overall survival (OS), relapse-free survival (RFS), and cause-specific survival (CSS) were determined using the Kaplan-Meier method. Major cardiac event (MCE) was defined as myocardial infarction, coronary artery bypass grafting or stenting, or valve replacement. Second malignancy (SM) was defined as biopsy-confirmed malignancy occurring in the RT field. The median patient age at diagnosis was 36 years. Stage was IIA (n = 24), IIB (n = 7), IIC (n = 17), and II not otherwise specified (NOS, n = 4). The median infradiaphragmatic RT dose was 30.7 Gy. Twenty-six patients (50%) received prophylactic mediastinal/supraclavicular (MSCV) RT. The median follow-up was 19 years. Estimates of OS, RFS, and CSS were 94%, 80%, and 96% at 10 years, and 83%, 72%, and 96% at 20 years, respectively. RFS at 10 years for stage IIA, IIB, IIC, and II NOS were 83%, 54%, 81%, and 100%, respectively (log-rank P = 0.21). Ten patients (19%) experienced disease relapse in the MSCV region (n = 7), para-aortic lymph nodes (n = 1), lung (n = 1), or peritoneal cavity (n = 1). Eight patients were successfully salvaged with chemotherapy and/or surgery, while 2 died of seminoma. Risk of MSCV relapse was significantly lower in patients who received MSCV RT vs. those who did not (10-year estimates: 4% vs. 21%, respectively, log-rank P = 0.01). MCE occurred in 10 patients (19%) at a median of 18 years (range 7-30) after RT. SM occurred in 5 patients (10%) at a median of 27 years (range 20-34) after RT. In patients with stage II testicular seminoma treated with RT, relapse in the irradiated site was uncommon. Infradiaphragmatic RT alone was associated with a significant risk of MSCV failure

  6. Patient quality of life in the Mayo Clinic Care Transitions program: a survey study

    Science.gov (United States)

    Faucher, Joshua; Rosedahl, Jordan; Finnie, Dawn; Glasgow, Amy; Takahashi, Paul

    2016-01-01

    Background Transitional care programs are common interventions aimed at reducing medical complications and associated readmissions for patients recently discharged from the hospital. While organizations strive to reduce readmissions, another important related metric is patient quality of life (QoL). Aims To compare the relationship between QoL in patients enrolled in the Mayo Clinic Care Transitions (MCCT) program versus usual care, and to determine if QoL changed in MCCT participants between baseline and 1-year follow-up. Methods A baseline survey was mailed to MCCT enrollees in March 2013. Those who completed a baseline survey were sent a follow-up survey 1 year later. A cross-sectional survey of usual care participants was mailed in November 2013. We included in our analysis 199 participants (83 in the MCCT and 116 in usual care) aged over 60 years with multiple comorbidities and receiving primary care. Primary outcomes were self-rated QoL; secondary outcomes included self-reported general, physical, and mental health. Intra- and intergroup comparisons of patients were evaluated using Pearson’s chi-squared analysis. Results MCCT participants had more comorbidities and higher elder risk assessment scores than those receiving usual care. At baseline, 74% of MCCT participants reported responses of good-to-excellent QoL compared to 64% after 1 year (P=0.16). Between MCCT and usual care, there was no significant difference in self-reported QoL (P=0.21). Between baseline and follow-up in MCCT patients, and compared to usual care, there were no significant differences in self-reported general, physical, or mental health. Conclusion We detected no difference over time in QoL between MCCT patients and those receiving usual care, and a nonsignificant QoL decline in MCCT participants after 1 year. Progression of chronic disease may overwhelm any QoL improvement attributable to the MCCT intervention. The MCCT interventions may blunt expected declines in QoL, producing

  7. Long term outcomes of cardiac transplant for immunoglobulin light chain amyloidosis: The Mayo Clinic experience

    Science.gov (United States)

    Grogan, Martha; Gertz, Morie; McCurdy, Arleigh; Roeker, Lindsey; Kyle, Robert; Kushwaha, Sudhir; Daly, Richard; Dearani, Joseph; Rodeheffer, Richard; Frantz, Robert; Lacy, Martha; Hayman, Suzanne; McGregor, Christopher; Edwards, Brooks; Dispenzieri, Angela

    2016-01-01

    AIM: To determine the outcome of orthotopic heart transplantation (OHT) in immunoglobulin light chain (AL) amyloidosis. METHODS: The medical records of patients with AL who underwent orthotopic heart transplantation at the Mayo Clinic in Rochester Minnesota from 1992 to 2011 were reviewed. Patients met at least one of the following at: New York Heart Association class IV heart failure, ventricular thickness > 15 mm, ejection fraction < 40%. Selection guidelines for heart transplant included age < 60 years, absence of multiple myeloma and significant extra-cardiac organ involvement. Baseline characteristics including age, gender, organ involvement, and New York Heart Association functional class were recorded. Laboratory data, waiting time until heart transplant, and type of treatment of the underlying plasma cell disorder were recorded. Survival from the time of OHT was calculated using Kaplan-Meier survival curves. Survival of patients undergoing OHT for AL was compared to that of non-amyloid patients undergoing OHT during the same time period. RESULTS: Twenty-three patients (median age 53 years) with AL received OHT. There were no deaths in the immediate perioperative period. Twenty patients have died post OHT. For the entire cohort, the median overall survival was 3.5 years (95%CI: 1.2, 8.2 years). The 1-year survival post OHT was 77%, the 2-year survival 65%, and the 5-year survival 43%. The 5-year survival for non-amyloid patients undergoing OHT during the same era was 85%. Progressive amyloidosis contributed to death in twelve patients. Of those without evidence of progressive amyloidosis, the cause of death included complications of autologous hematopoietic stem cell transplantation for 3 patients, post-transplant lymphoproliferative disorder for 2 patients; and for the remaining one death was related to each of the following causes: acute rejection; cardiac vasculopathy; metastatic melanoma; myelodysplastic syndrome; and unknown. Eight patients had

  8. What makes a Catholic hospital "Catholic" in an age of religious-secular collaboration? The case of the Saint Marys hospital and the Mayo Clinic.

    Science.gov (United States)

    Swetz, Keith M; Crowley, Mary E; Maines, T Dean

    2013-06-01

    Mayo Clinic is recognized as a worldwide leader in innovative, high-quality health care. However, the Catholic mission and ideals from which this organization was formed are not widely recognized or known. From partnership with the Sisters of St. Francis in 1883, through restructuring of the Sponsorship Agreement in 1986 and current advancements, this Catholic mission remains vital today at Saint Marys Hospital. This manuscript explores the evolution and growth of sponsorship at Mayo Clinic, defined as "a collaboration between the Sisters of St. Francis and Mayo Clinic to preserve and promote key values that the founding Franciscan sisters and Mayo physicians embrace as basic to their mission, and to assure the Catholic identity of Saint Marys Hospital." Historical context will be used to frame the evolution and preservation of Catholic identity at Saint Marys Hospital; and the shift from a "sponsorship-by-governance" to a "sponsorship-by-influence" model will be highlighted. Lastly, using the externally-developed Catholic Identity Matrix (developed by Ascension Health and the University of St. Thomas, Minnesota), specific examples of Catholic identity will be explored in this joint venture of Catholic health care institution and a secular, nonprofit corporation (Mayo Clinic).

  9. Harmonizing and consolidating the measurement of patient-reported information at health care institutions: a position statement of the Mayo Clinic

    Directory of Open Access Journals (Sweden)

    Eton DT

    2014-02-01

    Full Text Available David T Eton,1,2 Timothy J Beebe,1,2 Philip T Hagen,3 Michele Y Halyard,4 Victor M Montori,1,5 James M Naessens,1,2 Jeff A Sloan,6 Carrie A Thompson,7 Douglas L Wood1,81Division of Heath Care Policy and Research, Department of Health Sciences Research, 2Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, 3Department of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, MN, 4Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, 5Knowledge and Evaluation Research Unit, 6Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, 7Division of Hematology, Department of Medicine, 8Center for Innovation, Mayo Clinic, Rochester, MN, USAAbstract: Patient-reported outcomes (PROs capture how patients perceive their health and their health care; their use in clinical research is longstanding. Today, however, PROs increasingly are being used to inform the care of individual patients, and document the performance of health care entities. We recently wrote and internally distributed an institutional position statement titled "Harmonizing and Consolidating the Measurement of Patient-Reported Outcomes at Mayo Clinic: A Position Statement for the Center for the Science of Health Care Delivery". The statement is meant to educate clinicians, clinical teams, and institutional administrators about the merits of using PROs in a systematic manner for clinical care and quality measurement throughout the institution. The present article summarizes the most important messages from the statement, describing PROs and their use, identifying practical considerations for implementing them in routine practice, elucidating potential barriers to their use, and formulating strategies to overcome these barriers. The lessons learned from our experience – including pitfalls, challenges, and successes – may inform other health care institutions that are interested in

  10. 78 FR 57063 - Special Local Regulations; Jacksonville Dragon Boat Festival; St. Johns River; Jacksonville, FL

    Science.gov (United States)

    2013-09-17

    ... SECURITY Coast Guard 33 CFR Part 100 RIN 1625-AA08 Special Local Regulations; Jacksonville Dragon Boat... Jacksonville, Florida during the Jacksonville Dragon Boat Festival, a series of paddle boat races. The event is... is to ensure safety of life on navigable waters of the United States during the Jacksonville...

  11. How well do whole exome sequencing results correlate with medical findings? A study of 89 Mayo Clinic Biobank samples

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    Sumit eMiddha

    2015-07-01

    Full Text Available Whole Exome Sequencing (WES is increasingly being used for diagnosis without adequate information on predictive characteristics of reportable variants typically found on any given individual and correlation with clinical phenotype. In this study, we performed WES on 89 deceased individuals (mean age at death 74 years, range 28-93 from the Mayo Clinic Biobank. Significant clinical diagnoses were abstracted from electronic-medical-record via chart review. Variants (Single Nucleotide Variant and insertion/deletion were filtered based on quality (accuracy >99%, read-depth >20, alternate-allele read-depth >5, minor-allele-frequency 0.19. Evaluating genotype-phenotype correlations across the exome, 202 (3% of 7046 filtered variants had some evidence for phenotypic correlation in medical-records, while 3710 (53% variants had no phenotypic correlation. The phenotype associated with the remaining 44% could not be assessed from a typical medical record review. These data highlight significant continued challenges in the ability to extract medically meaningful predictive results from WES.

  12. Early experience of a fall and fracture prevention clinic at Mayo General Hospital.

    LENUS (Irish Health Repository)

    Hanley, A

    2010-06-01

    Falls in the elderly are a significant public health problem. Previous studies have shown that most falls are multifactorial and an efficacious way of reducing the risk of falling is provided by a falls clinic.

  13. Thrombotic Microangiopathy Care Pathway: A Consensus Statement for the Mayo Clinic Complement Alternative Pathway-Thrombotic Microangiopathy (CAP-TMA) Disease-Oriented Group.

    Science.gov (United States)

    Go, Ronald S; Winters, Jeffrey L; Leung, Nelson; Murray, David L; Willrich, Maria A; Abraham, Roshini S; Amer, Hatem; Hogan, William J; Marshall, Ariela L; Sethi, Sanjeev; Tran, Cheryl L; Chen, Dong; Pruthi, Rajiv K; Ashrani, Aneel A; Fervenza, Fernando C; Cramer, Carl H; Rodriguez, Vilmarie; Wolanskyj, Alexandra P; Thomé, Stephan D; Hook, C Christopher

    2016-09-01

    Thrombotic microangiopathies (TMAs) comprise a heterogeneous set of conditions linked by a common histopathologic finding of endothelial damage resulting in microvascular thromboses and potentially serious complications. The typical clinical presentation is microangiopathic hemolytic anemia accompanied by thrombocytopenia with varying degrees of organ ischemia. The differential diagnoses are generally broad, while the workup is frequently complex and can be confusing. This statement represents the joint recommendations from a multidisciplinary team of Mayo Clinic physicians specializing in the management of TMA. It comprises a series of evidence- and consensus-based clinical pathways developed to allow a uniform approach to the spectrum of care including when to suspect TMA, what differential diagnoses to consider, which diagnostic tests to order, and how to provide initial empiric therapy, as well as some guidance on subsequent management. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  14. Comparison of MMPI Scores of Drug Abusers and Mayo Clinic Normative Groups.

    Science.gov (United States)

    Patalano, Frank

    1980-01-01

    Compared MMPIs of 80 male and 80 female drug abusers with MMPIs of 550 male and 695 female medical patients. Male drug abusers obtained significantly higher scores than male medical patients on all clinical scales. Female drug abusers obtained significantly higher scores than female medical patients on seven scales. (Author)

  15. Patterns in deer-related traffic injuries over a decade: the Mayo clinic experience

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    Smoot Dustin L

    2010-08-01

    Full Text Available Abstract Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC. We characterized injury patterns between motorcycle/all-terrain vehicles (MCC and automobile (MVC crashes related to dMVC (deer motor vehicle crash with the hypotheses that MCC will present with higher Injury Severity Score (ISS and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS. Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5 and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained.

  16. Subacute Cutaneous Lupus Erythematosus: Clinical Characteristics, Disease Associations, Treatments, and Outcomes in a Series of 90 Patients at Mayo Clinic, 1996-2011.

    Science.gov (United States)

    Alniemi, Dema T; Gutierrez, Albert; Drage, Lisa A; Wetter, David A

    2017-03-01

    To characterize the clinical presentation, laboratory studies, disease associations, and treatments of subacute cutaneous lupus erythematosus (SCLE). A retrospective review of 90 patients with SCLE at Mayo Clinic from January 1, 1996, through October 28, 2011, was performed. The mean patient age at diagnosis was 61 years; 64 patients (71%) were women, and 11 cases (12%) were drug induced (1996-2000, no drug-induced cases; 2001-2005, 2 cases; 2006-2011, 9 cases). Seventeen of 59 patients (29%) with available data were smokers at the time of diagnosis. The SCLE lesions were photodistributed in 75 patients (83%), and 52 (58%) had papulosquamous morphologic findings. Anti-Ro/SS-A positivity was present in 84 of 85 patients tested (99%), whereas 32 of the 85 patients (38%) tested positive for anti-La/SS-B. Associated autoimmune connective tissue diseases included Sjögren syndrome (n=13, 14%) and systemic lupus erythematosus (SLE) (n=8, 9%). Eighteen patients (20%) had at least 4 American College of Rheumatology criteria for SLE; 1 had lupus nephritis, and none had neurologic or notable hematologic sequelae. The most common therapy was hydroxychloroquine, with a complete response noted in 34 of 46 patients (74%) with available follow-up data. Twenty-eight percent of patients with SCLE (n=25) had an associated autoimmune connective tissue disease, although the severe sequelae of SLE, such as nephritis, were rare. The frequency of drug-induced SCLE increased during the study. Most patients responded to treatment with hydroxychloroquine. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  17. Jacksonville History Curriculum Guide. Grade 3.

    Science.gov (United States)

    Davis, Elisabeth Fern; And Others

    A part of the Social Studies program for third graders in Duval County Public Schools (Jacksonville, Florida) is represented in this curriculum guide. The guide focuses on Jacksonville's history and emphasizes the relationship between people and their environment at various times in history and changes occurring in those relationships. The central…

  18. The beginnings of Orthopedic Surgery at the Mayo Clinic: A Review of the First Orthopedic Patients who Presented Over 100 Years Ago.

    Science.gov (United States)

    Camp, Christopher L; Morrey, Bernard F; Trousdale, Robert T

    2016-01-01

    Formalized training in the specialty of orthopedic surgery began at the Mayo Clinic nearly 100 years ago, and treatment of patients with musculoskeletal injuries and disease began even earlier. A robust historical patient database provides the opportunity for review of the first recorded orthopedic cases at our institution, which date back to 1907. The first 400 sequential medical charts of the Mayo Clinic's patient record database were comprehensively reviewed in order to identify the first documented orthopedic cases. Of the first 400 patients reviewed, 15 (4%) received specific orthopedic diagnoses. All presented during a three week period in 1907, and they traveled from all over the region for evaluation. The diagnoses included skeletal tuberculosis (n=6), traumatic fracture (n=3), osteomyelitis (n=2), syphilitic pathologic fracture (n=1), syphilitic ostitis of the tibia and radius (n=1), painful flat foot (n=1), and Morton's toe (n=1). Included with the records are patient demographics, diagnoses, symptoms, physical examination findings, radiograph reports, operative reports, and detailed drawings of symptomatology. Although the technology and science has advanced since the early practice of orthopedic surgery that took place over a century ago, we consider ourselves to be merely an extension of those who established the field before us. Just as the past relies on the future for the continuation of what it began so many years ago, we rely on our founders for the groundwork that they laid in creating this field of surgical medicine.

  19. Phase I/II study of first-line irinotecan combined with 5-fluorouracil and folinic acid Mayo Clinic schedule in patients with advanced colorectal cancer

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    Davidson Neville

    2004-07-01

    Full Text Available Abstract Background This multicentre phase I/II study was designed to determine the maximum tolerated dose of irinotecan when combined with 5-fluorouracil and folinic acid according to the Mayo Clinic schedule and to evaluate the activity of this combination as first-line therapy in patients with advanced colorectal cancer. Methods Sixty-three patients received irinotecan (250 or 300 mg/m2, 30- to 90-minute intravenous infusion on day 1, immediately followed by folinic acid (20 mg/m2/day and 5-fluorouracil (425 mg/m2, 15-minute bolus infusion days 1 to 5, every four weeks. Results Diarrhoea was dose limiting at 300 mg/m2 irinotecan in combination with 5-fluorouracil and folinic acid, and this was determined to be the maximum tolerated dose. Grade 3–4 neutropenia was the most frequently reported toxicity. The recommended dose of irinotecan for the phase II part of the study was 250 mg/m2. The response rate for the evaluable patient population was 36% (13/36, and 44% (16 patients had stable disease (including 19% of minor response. For the intention-to-treat population, the response rate was 29% (14/49 and 35% (17 patients stable disease (including 14% of minor response. The median time to progression was 7.0 months and the median survival was 12.0 months. Grade 3–4 non-haematological drug-related toxicities included delayed diarrhoea, stomatitis, fatigue, and nausea/vomiting. There were three deaths due to septic shock that were possibly or probably treatment-related. Conclusions This regimen of irinotecan in combination with the Mayo Clinic schedule of bolus 5-fluorouracil/folinic acid every four weeks showed activity as first-line therapy in patients with advanced colorectal cancer. In keeping with other published results of studies using bolus 5-fluorouracil combined with irinotecan, the use of this regimen is limited by a relatively high rate of grade 3–4 neutropenia, and the combination of irinotecan and infusional 5-fluorouracil

  20. Effects of different hormone therapies on breast pain in recently postmenopausal women: findings from the Mayo Clinic KEEPS breast pain ancillary study.

    Science.gov (United States)

    Files, Julia A; Miller, Virginia M; Cha, Stephen S; Pruthi, Sandhya

    2014-10-01

    Abstract Background: It is estimated that 70% of women in Western societies experience breast pain at least once during their lifetime. In the Women's Health Initiative (WHI), women treated with oral conjugated equine estrogen (0.625 mg) with or without continuous oral medroxyprogesterone acetate (2.5 mg) had a higher incidence of breast pain than those who received placebo. The effect of other hormone therapy regimens on breast pain is unknown. We compared breast pain among healthy, recently menopausal women enrolled in the Kronos Early Estrogen Prevention Study (KEEPS) at Mayo Clinic. Women were randomized to: 0.45 mg/day oral conjugated equine estrogen (o-CEE) plus 200 mg/day micronized progesterone (m-P) for the first 12 days of the month, 50 μg/day transdermal 17β estradiol (t-E2) plus m-P for 12 days, or placebo pills and patch. Participants completed the Mayo Clinic breast pain questionnaire at baseline and yearly for the duration of the study. Participants (116) averaged 53.0 years of age and 1.6 years past their last menses at baseline. At baseline, 12 women (10%) reported breast pain with an average worst pain score [from 0 (no pain) to 10 (worst pain)] of 0.39±1.28. With treatment, the number of women reporting pain did not increase, and with either intention-to-treat or per-protocol analyses, breast pain scores did not differ significantly (p=0.39) among groups: t-E2 (0.53±1.21), o-CEE (0.32±0.78), placebo (0.23±0.87). Four years of treatment with o-CEE at a lower dose than that studied in the WHI with cyclic m-P or transdermal E2 with cyclic m-P did not increase breast pain in healthy, recently menopausal women.

  1. In newly diagnosed breast cancer, screening MRI of the contralateral breast detects mammographically occult cancer, even in elderly women: the mayo clinic in Florida experience.

    Science.gov (United States)

    Bernard, Johnny Ray; Vallow, Laura A; DePeri, Elizabeth R; McNeil, Rebecca B; Feigel, Deborah G; Amar, Surabhi; Buskirk, Steven J; Perez, Edith A

    2010-01-01

    The role of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer is somewhat controversial. The purpose of this study was to evaluate the prevalence of synchronous, occult contralateral breast cancer detected by MRI but not by mammography or clinical breast examination in women with newly diagnosed breast cancer, including those aged 70 years or older at our institution. MRI results for women with newly diagnosed breast cancer who underwent bilateral breast MRI after negative mammography and clinical examination between February 2003 and November 2007 at Mayo Clinic in Florida were reviewed. The prevalence of pathologically confirmed contralateral carcinoma diagnosed solely by MRI was determined and analyzed in the context of age, family history, menopausal status, breast density, and primary-tumor characteristics. Logistic regression was used to explore the association between contralateral carcinoma and potential patient risk factors. A total of 425 women were evaluated, of whom 129 (30%) were aged 70 years or older. A contralateral biopsy was recommended and performed solely on the basis of MRI in 72 of the 425 women (17%). Sixteen of these 72 women (22%) had pathologically confirmed carcinoma, including seven in the older subgroup. The prevalence of clinically and mammographically occult contralateral carcinoma detected by MRI was 3.8% (16/425) overall and 5.4% (7/129) in the group of older women. When potential risk factors for contralateral breast cancer were evaluated, postmenopausal status was the only significant predictor of contralateral cancer detected by MRI (p = 0.016). We concluded that contralateral breast screening with MRI should be considered in postmenopausal women with newly diagnosed breast cancer, even those aged 70 years or older at diagnosis.

  2. Mayo Registry for Telemetry Efficacy in Arrest Study: An Assessment of the Utility of Telemetry in Predicting Clinical Decompensation.

    Science.gov (United States)

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Harris, Dana; Bosworth, Veronica; Dumitrascu, Adrian; Clark, Brooke; Vadeboncoeur, Tyler; Kusumoto, Fred; Bowman, Cammi; Burton, M Caroline

    2016-02-17

    Our study assesses the utility of telemetry in identifying decompensation in patients with documented cardiopulmonary arrest. A retrospective review of inpatients who experienced a cardiopulmonary arrest from May 1, 2008, until June 30, 2014, was performed. Telemetry records 24 hours prior to and immediately preceding cardiopulmonary arrest were reviewed. Patient subanalyses based on clinical demographics were made as well as analyses of survival comparing patients with identifiable rhythm changes in telemetry to those without. Of 242 patients included in the study, 75 (31.0%) and 110 (45.5%) experienced telemetry changes at the 24-hour and immediately preceding time periods, respectively. Of the telemetry changes, the majority were classified as nonmalignant (n = 50, 66.7% and n = 66, 55.5% at 24 hours prior and immediately preceding, respectively). There was no difference in telemetry changes between intensive care unit (ICU) and non-ICU patients and among patients stratified according to the American Heart Association telemetry indications. There was no difference in survival when comparing patients with telemetry changes immediately preceding and at 24 hours prior to an event (n = 30, 27.3% and n = 15, 20.0%) to those without telemetry changes during the same periods (n = 27, 20.5% and n = 42, 25.2%; P = .22 and .39). Telemetry has limited utility in predicting clinical decompensation in the inpatient setting. © The Author(s) 2016.

  3. Editorial REDVET Mayo/2009

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    veterinaria.org

    2009-05-01

    Full Text Available ResumenUn mes más y de manera puntual presentamos el número deREDVET correspondiente a Mayo.El brote de influenza H1N1 ha inundado los medios, tantos losespecializados como la prensa general y sensacionalista conabundante información. En REDVET a ello le dedicamos la otraeditorial (“Sobre la Gripe porcina A (H1N1 notificados en personas”y un par de artículos cortos de tipo divulgativo (“La Gripe Mexicana”y “Algunos aspectos ligados a la Influenza porcina”, que se unen a“Siglo XXI: ¿Era de las Zoonosis?” y “Foca arpa, un mundoinsostenible, sordo y ciego”, en el mismo apartado de divulgación.

  4. African American Women's Perceptions and Attitudes Regarding Participation in Medical Research: The Mayo Clinic/The Links, Incorporated Partnership

    Science.gov (United States)

    Brewer, LaPrincess C.; Parker, Monica W.; Balls-Berry, Joyce E.; Halyard, Michele Y.; Pinn, Vivian W.; Radecki Breitkopf, Carmen

    2014-01-01

    Abstract Objective: To examine perceptions and attitudes toward health-related research participation among professional African American women. Methods: Participants were members of an African American women's service organization, The Links, Incorporated. Data were collected via self-administered questionnaires at The Links, Incorporated 2012 National Assembly. Sociodemographics, prior research experience, intention to participate (ITP), willingness to participate (WTP) in a variety of research studies and attitudes about research participation were measured. Results: A total of 381 surveys were analyzed. A majority of respondents were married (66%), employed (69%), and college educated (96%). Median age was 59; 38% reported prior research participation. Overall, 78% agreed with the statement, “Participation in research will mean better care,” 24% agreed “Participation in research is risky” and 3% agreed “Scientists cannot be trusted.” Fifty-two percent agreed with the statement, “Research conducted in the U.S. is ethical.” Mean ITP in research was 4.9±1.7 on a rating scale of 1 (“definitely no”) to 7 (“definitely yes”). WTP was highest for an interview study and providing a blood sample, and lowest for clinical trial and medical record review. Conclusion: Attitudes toward research participation were generally favorable among professional African American women; many expressed WTP in a variety of research study types. PMID:25046058

  5. William and Charles Mayo: their influence on American medicine.

    Science.gov (United States)

    Anaya-Prado, Roberto; Rubí, Marisol Godínez

    2007-01-01

    In a little-known Midwest town named Rochester, Minnesota, a talented physician grew in fame and respect: Dr. William Worrall Mayo, who was influential in the evolution of medicine. He was a steadfast learner and raised two sons, William and Charles, to follow in his footsteps and further medical knowledge. They were leaders in surgery and in the creation of advanced and sophisticated medical facilities. Their talents, the issues surrounding medical practice, and unexpected opportunity all came into play for the Mayos. Two hospitals, St. Mary's Hospital and later the Methodist Hospital, witnessed and influenced the advancement of medicine through the Mayo Clinic heritage and dynasty in Minnesota and the rest of the world. In this article, we focus on the role of the Mayo brothers and their influence over the increasing acceptance of hospital care in America and abroad.

  6. Mayo de Los Capomos, Sinaloa (Mayo of Los Capomos, Sinaloa).

    Science.gov (United States)

    Freeze, Ray A.

    This document is one of 17 volumes on indigenous Mexican languages and is the result of a project undertaken by the Archivo de Lenguas Indigenas de Mexico. This volume contains information on Mayo, an indigenous language of Mexico spoken in Los Capomos, in the state of Sinaloa. The objective of collecting such a representative sampling of the…

  7. Carlos Mayo and Argentine historiography

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    Sara E. Mata

    2012-11-01

    Full Text Available The work of Carlos Mayo is distinguished by its originality and academic excellence. Our goal has been to briefly address their valuable contributions to the Argentine historiography, particularly that relating to the agricultural history of the Río de la Plata

  8. Clinical utilities of aromatase inhibitors in breast cancer

    Directory of Open Access Journals (Sweden)

    Chumsri S

    2015-05-01

    Full Text Available Saranya Chumsri Department of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USA Abstract: Aromatase is an enzyme that converts testosterones to estrogens. Inhibition of this enzyme has been shown to have several clinical utilities in breast cancer. Currently, there are three aromatase inhibitors (AIs in clinical use, namely anastrozole, letrozole, and exemestane. AIs have been used in various clinical settings for breast cancer, ranging from chemoprevention in breast cancer to treating breast cancer in both early stage in the adjuvant setting and metastatic disease. This article reviews mechanism of action, AI classification, and clinical utilities of AIs in various clinical settings in the context of breast cancer. Keywords: aromatase inhibitor, endocrine therapy, breast cancer

  9. The Mayo Innovation Scholars Program: Undergraduates Explore the Science and Economics of Medical Innovations

    Science.gov (United States)

    Pellegrini, John J.; Jansen, Elizabeth

    2013-01-01

    The Mayo Innovation Scholars Program introduces undergraduates to technology transfer in biomedical sciences by having teams of students from multiple disciplines (e.g., biology, chemistry, economics, and business) analyze inventions in development at the Mayo Clinic. Over 6 months, teams consult with inventors, intellectual property experts, and…

  10. AAFCS Accreditation: From Dream to Reality at Jacksonville State University

    Science.gov (United States)

    Goodwin, Debra K.; Roberts, W. Tim; Boggs, Robbie; Townsel, Kim; Frazier, Jeannie; Marsh, Jill

    2014-01-01

    Accreditation by the American Association of Family and Consumer Sciences (AAFCS) was a long-held dream of the Family and Consumer Sciences (FCS) Unit at Jacksonville State University in Alabama. After more than 6 decades of preparing FCS students for life and the workplace, the FCS Unit resolutely began the journey to the coveted and honored…

  11. Mayo v. Prometheus: A Year Later.

    Science.gov (United States)

    Dorn, Brian R

    2013-07-11

    Last year's U.S. Supreme Court decision in Mayo v. Prometheus regarding the patent eligibility of diagnostic method claims will probably have the most profound lasting effect of any recent court decision on the biopharmaceutical industry. The Mayo decision changed the evaluation of patent eligibility of a method claim under 35 U.S.C. § 101. The new evaluation is a more difficult standard to clear and needs to be considered prior to filing a patent application.

  12. Transforming Research Management Systems at Mayo Clinic

    Science.gov (United States)

    Smith, Steven C.; Gronseth, Darren L.

    2011-01-01

    In order for research programs at academic medical centers and universities to survive and thrive in the increasingly challenging economic, political and regulatory environment, successful transformation is extremely important. Transformation and quality management techniques are increasingly well established in medical practice organizations. In…

  13. Elton Mayo and Carl Rogers: A Tale of Two Techniques.

    Science.gov (United States)

    Mahoney, Kevin T.; Baker, David B.

    2002-01-01

    Compares the simultaneous emergence of Mayo's nonauthoritarian interviewing approach and Rogers' nondirective counseling approach. Examines the influence of Piaget on Mayo and reviews the Hawthorne studies. Concludes that differences in the approaches outweigh similarities. (Contains 21 references.) (SK)

  14. Brookvale Manor, Hazelhill, Ballyhaunis, Mayo

    LENUS (Irish Health Repository)

    Hawkes, C P

    2010-01-01

    Egg allergy is incorrectly considered to constitute a contraindication to MMR in the community, despite a long history of its safe administration to egg allergic children. The product insert perpetuates this misinformation but the Irish guidelines from the RCPI are unequivocal. We reviewed all paediatric cases vaccinated in our hospital in 2007-2008. Forty seven of 91 children receiving vaccinations in hospital, had been referred for MMR due to concerns regarding egg allergy. In 32% (n=15), GP referral for vaccination was made despite correspondence from the clinic advising routine vaccination in the community. Nineteen were second MMR immunisations, which should all have occurred in the community. Unnecessary hospital referral for MMR vaccination is an extra burden on hospital resources, and causes unwarranted anxiety amongst parents of children with egg allergy. A change in practice seems difficult to achieve, as many referrals happen despite individualised correspondence to GPs and other referring clinicians outlining the current guidelines.

  15. Young adults with spina bifida transitioned to a medical home: a survey of medical care in Jacksonville, Florida.

    Science.gov (United States)

    Aguilera, Antonio M; Wood, David L; Keeley, Cortney; James, Hector E; Aldana, Philipp R

    2015-10-23

    OBJECT The transition of the young adult with spina bifida (YASB) from pediatric to adult health care is considered a priority by organized pediatrics. There is a paucity of transition programs and related studies. Jacksonville Health and Transition Services (JaxHATS) is one such transition program in Jacksonville, Florida. This study's purpose was to evaluate the health care access, utilization, and quality of life (QOL) of a group of YASBs who have transitioned from pediatric care. METHODS A survey tool addressing access to health care and quality of health and life was developed based on an established survey. Records of the Spinal Defects Clinic held at Wolfson Children's Hospital and JaxHATS Clinic were reviewed and YASBs (> 18 and spina bifida (SB) specialists; none reported difficulty or delays in obtaining health care. Only 2 patients required emergent care in the last year for an SB-related medical problem. Seven respondents reported very good to excellent QOL. Family, lifestyle, and environmental factors were also examined. CONCLUSIONS In this small group of YASBs with a medical home, easy access to care for medical conditions was the norm, with few individuals having recent emergency visits and almost all reporting at least a good overall QOL. Larger studies of YASBs are needed to evaluate the positive effects of medical homes on health and QOL in this population.

  16. Time-trend analysis on the Framingham risk score and prevalence of cardiovascular risk factors in patients undergoing percutaneous coronary intervention without prior history of coronary vascular disease over the last 17 years: a study from the Mayo Clinic PCI registry.

    Science.gov (United States)

    Lee, Moo-Sik; Flammer, Andreas J; Li, Jing; Lennon, Ryan J; Singh, Mandeep; Holmes, David R; Rihal, Charanjit S; Lerman, Amir

    2014-07-01

    There is a paucity of data on the temporal trends of cardiovascular risk factors in patients undergoing percutaneous coronary intervention (PCI). We investigated the secular trends of risk profiles of patients undergoing PCI without prior history of cardiovascular disease (CVD). CVD risk factors are changed over time. This time-trend analysis from 1994 to 2010 was performed within the Mayo Clinic PCI Registry. Outcome measures were prevalence of CVD risk factors, including the Framingham risk score (FRS), at the time of admission for PCI. During this period, 12,055 patients without a history of CVD (mean age, 65.0 ± 12.4 years, 67% male) underwent PCI at the Mayo Clinic. Age distribution slightly shifted toward older age (P for trend trend trend trend trend <0.001), whereas smoking prevalence did not change. The current study demonstrates that although traditional FRS and its associated predicted 10-year cardiovascular risk declined over time, the prevalence of risk factors increased in patients undergoing PCI. The study suggests the need for a new risk-factor assessment in this patient population. © 2014 Wiley Periodicals, Inc.

  17. Le nonne di Plaza de Mayo

    Directory of Open Access Journals (Sweden)

    Benedetta Calandra

    2006-11-01

    Full Text Available The article is focused on a specific case study of ‘motherist movement’ in Argentina during the last military rule (1976-1983: the Grandmothers of Plaza de Mayo. Blurring the boundaries between public and private realm, these old women, without a previous, soundly-based political conscience, were able to set up a transnational human rights movement, well known all over the world, while looking for their abducted grandchildren. A crucial issue, still, is: how far did this group go in terms of advocating womens’ rights? Could we really find a correspondence, as Jelin puts it, between ‘women for human rights’ and ‘women for women’s rights’? The answer, as the Argentinean case shows, seems to be not so straightforward.

  18. Against the Corporate Culture Ideology: An Interview with Peter Mayo

    Science.gov (United States)

    Suoranta, Juha

    2010-01-01

    This article presents an interview with Peter Mayo, author and expert in the field of sociology of adult education, on his major influences in this area, his books, and his views on the role of radical adult education and radical scholarship in the future. In the interview, Peter Mayo states that his initial view of adult education was quite a…

  19. Against the Corporate Culture Ideology: An Interview with Peter Mayo

    Science.gov (United States)

    Suoranta, Juha

    2010-01-01

    This article presents an interview with Peter Mayo, author and expert in the field of sociology of adult education, on his major influences in this area, his books, and his views on the role of radical adult education and radical scholarship in the future. In the interview, Peter Mayo states that his initial view of adult education was quite a…

  20. El paro estudiantil de mayo de 1938

    Directory of Open Access Journals (Sweden)

    Orlando Moreno Martínez

    2010-10-01

    Full Text Available El presente artículo tiene como propósito analizar los sucesos ocurridos en la ciudad de Bogotá durante el paro estudiantil de mayo de 1938, programado para oponerse a algunas medidas de modernización y secularización educativa impuestas por el gobierno liberal del presidente Alfonso López Pumarejo. Específicamente, los estudiantes se levantaron contra el examen de revisión que se aplicaba al terminar la secundaria y el curso preparatorio que era un requisito para poder ingresar a la universidad. El escrito aborda la problemática suscitada por la reforma educativa, el desencadenamiento de la protesta estudiantil, las acciones desarrolladas por los estudiantes en la capital de la República, el impacto del movimiento en otras partes del país y las tendencias ideológicas que apoyaron el paro de estudiantes. A propósito de este último punto, si bien fue evidente el respaldo de la oposición conservadora, muchos estudiantes universitarios y de secundaria lucharon con convicción por lo que consideraron en su momento una arbitrariedad por parte del gobierno liberal.

  1. Estadísticas culturales de Colombia: mayo de 1969

    Directory of Open Access Journals (Sweden)

    Fernán Torres León

    1969-05-01

    Full Text Available El documento presenta un cuadro comparativo de las actividades culturales del pais, así como las exposiciones de artes plasticas y otras inauguradas en el pais en el mes de mayo de 1969

  2. Las actividades de la Comisión Europea en materia de Derecho internacional privado en el periodo mayo 2015– mayo 2016

    OpenAIRE

    Lafuente Sánchez, Raúl

    2016-01-01

    El presente trabajo tiene por objeto informar sobre las actividades desarrolladas por la Comisión Europea en materias relacionadas con el Derecho internacional privado durante el periodo comprendido entre mayo 2015 y mayo 2016.

  3. Specialized consultant in radiological safety to the Reforma peripheral clinic, PEMEX. - I. - May-June of 2003; Asesoria especializada en seguridad radiologica a la clinica periferica Reforma, PEMEX.- I.- Mayo-Junio de 2003

    Energy Technology Data Exchange (ETDEWEB)

    Torres P, A.; Garcia A, J.; Rodriguez A, F

    2003-07-15

    The Reforma peripheral clinic, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the clinic can conserve its respective sanitary license.(Author)

  4. Manatee Use of Two Power Plant Effluents on the St. Johns River in Jacksonville. Florida

    OpenAIRE

    Kinnaird, Margaret F.

    1983-01-01

    The purpose of this study is to provide a better basis for understanding manatee winter abundance and habitat use patterns along the northern limit of the species' range, the purposes of this study were to: a) document the degree and nature of manatee use at two Jacksonville power plants, b) determine the influence of air and water temperature on manatee use of the plants, c) identify and photograph individual manatees observed in the outfalls, d) document site fidelity, and ...

  5. Estadísticas culturales de Colombia: mayo de 1966

    Directory of Open Access Journals (Sweden)

    Fernán Torres León

    1966-05-01

    Full Text Available El documento presenta un cuadro comparativo de las actividades culturales del pais, así como las exposiciones de artes plasticas y otras inauguradas, recitales poéticos, conciertos y recitales de música, libros de autores colombianos publicados y representaciones teatrales realizadas en el pais en el mes de mayo de 1966.

  6. Estadísticas culturales de Colombia: mayo de 1967

    Directory of Open Access Journals (Sweden)

    Fernán Torres León

    1967-05-01

    Full Text Available El documento presenta un cuadro comparativo de las actividades culturales del pais, así como las exposiciones de artes plasticas y otras inauguradas, recitales poéticos, conciertos y recitales de música, libros de autores colombianos publicados y representaciones teatrales realizadas en el pais en el mes de mayo de 1967

  7. Estadísticas culturales de Colombia: Mayo de 1968

    Directory of Open Access Journals (Sweden)

    Fernán Torres León

    1968-05-01

    Full Text Available El documento presenta un cuadro comparativo de las actividades culturales del país. Además, se presenta información sobre las exposiciones de artes plasticas y otras inauguradas en el país durante el mes de mayo de 1968.

  8. "Quadruple whammy"- a preventable newly described syndrome of post-operative AKI in CKD II and CKD III patients on combination "Triple whammy" medications: a Mayo Clinic Health System, Eau Claire, Wisconsin experience.

    Science.gov (United States)

    Onuigbo, M A; Agbasi, N

    2014-01-01

    The potential combination of diuretics- angiotensin-converting enzyme inhibitors- Non-steroidal anti-inflammatory drugs (diuretics-ACEIs-NSAIDs), the so-called 'triple whammy', to produce clinically significant nephrotoxicity in chronic kidney disease (CKD) is often unrecognized. In 2013, in the British Medical Journal, we described accelerated post-operative acute kidney injury (AKI) in CKD patients concurrently on 'triple whammy' medications, a new syndrome that we aptly named 'quadruple whammy'. Two case reports. I. A 59-year-old Caucasian male, hypertensive CKD III, serum creatinine (SCr) 1.42 mg/dL, developed accelerated oliguric AKI after elective right nephrectomy. Outpatient medications included Lisinopril-Hydrochlorothiazide and Nabumetone (NSAID). SCr rapidly more than doubled with metabolic acidosis and hyperkalemia within 24 hours, peaking at 4.02 mg/dL. 'Triple whammy' medications were promptly stopped and the hypotension was corrected. SCr was 1.64 mg/dL and stable, after three months. II. A 46-year-old Caucasian male, hypertensive CKD II, SCr 1.21 mg/dL, developed accelerated AKI after elective right hip arthroplasty. Outpatient medications included Lisinopril and Hydrochlorothiazide. Celecoxib (200 mg) was given pre-operatively. Within 36 hours, SCr rapidly more than doubled to 2.58 mg/dL, with metabolic acidosis. 'Triple whammy' medications were promptly stopped and the hypotension was corrected. SCr was 0.99 mg/dL, and stable, after one month. We have described two cases of preventable accelerated AKI following post-operative hypotension in CKD patients concurrently on 'triple whammy' medications. We dubbed this new syndrome "Quadruple Whammy". It is not uncommon. 'Renoprevention', the pre-emptive withholding of (potentially nephrotoxic) medications, including 'triple whammy' medications, pre-operatively, in CKD patients, together with the simultaneous avoidance of peri-operative hypotension would help reduce, if not eliminate such AKI - a call

  9. Pilgrim's Rest, Barley Hill, Westport, Mayo.

    LENUS (Irish Health Repository)

    Stack, Austin G

    2014-01-01

    Chronic Kidney Disease (CKD) is a major non-communicable chronic disease that is associated with adverse clinical and economic outcomes. Passive surveillance systems are likely to improve efforts for prevention of chronic kidney disease (CKD) and inform national service planning. This study was conducted to determine the overall prevalence of CKD in the Irish health system, assess period trends and explore patterns of variation as part of a novel surveillance initiative.

  10. An Academic Healthcare Twitter Account: The Mayo Clinic Experience.

    Science.gov (United States)

    Widmer, R Jay; Engler, Nicole B; Geske, Jeffrey B; Klarich, Kyle W; Timimi, Farris K

    2016-06-01

    With more than 300 million monthly active users, Twitter is a powerful social media tool in healthcare, yet the characterization of an academic healthcare Twitter account remains poor to date. We assessed basic gender and geographic data on the account's "followers," as well as categorization of each tweet based on content type. We analyzed the impressions, engagements, retweets, favorites, replies, hashtag clicks, and detail expansions using both Sprinklr and Twitter Analytics. Over a period of 12 months, the account amassed 1,235 followers, with 54 percent being male and 68 percent residing in the United States. Of the 1,635 tweets sent out over the life of the account, we report more than 382,464 impressions, 6,023 engagements, 1,255 retweets, 776 favorites, and 1,654 embedded media clicks in this period. When broken down by tweet category, publication tweets garnered the highest engagement with an estimated mean number of clicks per tweet of 8.2 ± 81.9. Original content had higher total engagement per tweet than retweeted material (2.8 ± 9.2 vs. 0.2 ± 0.9 engagements per tweet; p importance of combining physician-led knowledge with intermittent marketing messages.

  11. Australian influences on Elton Mayo: the construct of Revery in industrial society.

    Science.gov (United States)

    Griffin, Mark A; Landy, Frank J; Mayocchi, Lisa

    2002-11-01

    Elton Mayo was born in Australia and spent most of his first 42 years living in that country. This article explores the Australian context in which he developed his views views of Australia compared with that of the United States during the time that Mayo developed his approach to psychology and the role of workers in industry. In addition, the social context in which Mayo established his career was shaped by significant political events in Australia. The construct of revery, which describes a specific state of consciousness, is central to Mayo's early theorizing and was developed by Mayo partly in reaction to political and industrial conflict occurring in Australia.

  12. Remembering Joseph Mayo and His Contributions to Animal Science | Poster

    Science.gov (United States)

    By Carolynne Keenan, Guest Writer In the 1990s, when Joseph Mayo, D.V.M, ran out of gas leading coworkers home from a meeting in Bethesda, he pulled over to the side of the road on I-270 and waited for help. He didn’t have to wait long; within a few minutes a passing motorist took pity on the group of scientists and offered them a lift back to Fort Detrick.

  13. Estadísticas culturales de Colombia: mayo de 1964

    Directory of Open Access Journals (Sweden)

    Fernán Torres León

    1964-05-01

    Full Text Available El documento presenta un cuadro comparativo de las actividades culturales del país, así como las exposiciones de artes plásticas y otras inauguradas, recitales poéticos, conciertos y recitales de música, libros de autores colombianos publicados y representaciones teatrales realizadas en el país en el mes de mayo de 1964

  14. Estadísticas culturales de Colombia: mayo de 1965

    Directory of Open Access Journals (Sweden)

    Fernán Torres León

    1965-05-01

    Full Text Available El documento presenta un cuadro comparativo de las actividades culturales del país, así como las exposiciones de artes plásticas y otras inauguradas, recitales poéticos, conciertos y recitales de música, libros de autores colombianos publicados y representaciones teatrales realizadas en el país en el mes de mayo de 1965.

  15. Mayo's Older African Americans Normative Studies: WMS-R norms for African American elders.

    Science.gov (United States)

    Lucas, John A; Ivnik, Robert J; Smith, Glenn E; Ferman, Tanis J; Willis, Floyd B; Petersen, Ronald C; Graff-Radford, Neill R

    2005-06-01

    Norms for African American elders on the Wechsler Memory Scale-Revised (WMS-R) were derived from a sample of 309 community-dwelling individuals participating in Mayo's Older African Americans Normative Studies (MOAANS). Normative estimates are provided for traditional WMS-R subtest scores and for supplemental procedures to evaluate forgetting rates and recognition memory. Tables are provided to convert raw WMS-R subtest and supplemental scores to age-corrected scaled scores. These may be further adjusted for years of education, if desired, by applying regression-based corrections. We anticipate that these data will enhance the diagnostic utility and clinical interpretation of WMS-R performance in older African Americans.

  16. Potential geothermal energy use at the Naval Air Rework Facilities, Norfolk, Virginia and Jacksonville, Florida, and at the naval shipyard, Charleston, South Carolina

    Energy Technology Data Exchange (ETDEWEB)

    Costain, J.K.; Glover, L. III; Newman, R.W.

    1984-05-01

    The feasibility of geothermal energy use at naval installations in Norfolk, VA, Jacksonville, FL, and Charleston, SC was assessed. Geophysical and geological studies of the above areas were performed. Engineering and economic factors, affecting potential energy use, were evaluated. The Norfolk and Jacksonville facilities are identified as candidates for geothermal systems. System costs are predicted. Economic benefits of the proposed geothermal systems are forecast, using the net present value method of predicting future income.

  17. Comparison of BG-Sentinel Trap and Oviposition Cups for Aedes aegypti and Aedes albopictus Surveillance in Jacksonville, Florida, USA

    Science.gov (United States)

    2015-03-01

    COMPARISON OF BG-SENTINELH TRAP AND OVIPOSITION CUPS FOR AEDES AEGYPTI AND AEDES ALBOPICTUS SURVEILLANCE IN JACKSONVILLE, FLORIDA, USA JENNIFER A...tropical and subtropical areas around the world (WHO 2009, Bhatt et al. 2013). In the USA , the principal mosquito vector, Aedes aegypti (L.), has been...virus is well known, the importance of Ae. albopictus in the transmission of arboviruses in the USA , including dengue, is not clear. Specifically, Cache

  18. Immunotherapeutic Strategies in Breast Cancer: Preclinical and Clinical Trials

    Science.gov (United States)

    2008-09-01

    Study Co-chairs: James N. Ingle , M.D (Mayo Clinic, Rochester) Pinku Mukherjee, Ph. D (Mayo Clinic, Scottsdale) √ Tom Fitch, M.D (Mayo Clinic...Not reported: Patient refused or not available ___ Unknown: Patient unsure Ethnicity (check one) ___ Not Hispanic or Latino ___ Hispanic or... Latino ___ Not reported: Refused or data not available ___ Unknown: Unsure of their ethnicity 55 MCCC Pre-Registration (Step 1) Eligibility Checklist

  19. Study on Mobile Augmented Reality Adoption for Mayo Language Learning

    Directory of Open Access Journals (Sweden)

    Erasmo Miranda Bojórquez

    2016-01-01

    Full Text Available This paper presents the results of a study applied to undergraduates in order to know how the cultural dimensions affect their perceptions of the acceptance and use of new technologies in a student-centered learning environment. A total of 85 undergraduate students from the Autonomous Indigenous University of Mexico (UAIM participated in the study. Each student was asked to use a mobile augmented reality (MAR application designed to learn Mayo language (language spoken in Northwestern Mexico. Afterwards, the students responded to a survey with items concerning the use and technology acceptance and about cultural dimensions of individualism and uncertainty avoidance. Structural equation modeling (SEM was used to analyze the data collected from students. Results provide evidence that the individualism contributes positively to perceived ease of use of the MAR app, and uncertainty avoidance has no impact. The findings showed that the MAR system could be easily used if it includes a natural way to promote collaborative work. In addition, to gain the trust of students, the uncertainty avoidance needs to be reduced by enriching the help information offered for app use.

  20. Drilling optimization methodology - 25 de Mayo El Medanito - Neuquen - Argentina

    Energy Technology Data Exchange (ETDEWEB)

    Aguero, Guillermo [Smith International, Inc., Houston, TX (United States); Lugones, Juan M. [PETROBRAS Argentina S.A. (Argentina); Marzialetti, Humberto [Pride San Antonio (Argentina)

    2004-07-01

    This paper was prepared based on the optimization of the performance and wear pattern of Polycrystalline Diamond Cutter (PDC) bits used in 25 de Mayo S.E. El Medanito Field, Neuquen/Argentina out of a joint effort done by the operator and the service company. The main objective was to reach the casing point in a single bit run at a reasonable penetration rate of the 8 1/2'' section (Choiyoi Formation - Igneous Rock), in order to avoid the use of an extra tungsten carbide insert roller cone bit to reach (4400 ft) which increases the drilling costs as well as allows to a higher exposure to accidents during trips in and out of the hole. A methodology was introduced to the field operations enabling a close follow-up to optimize the drill bit cutting structures, operating conditions, as well as the incorporation of state-of-the-art technology regarding cutters and its geometry. This proved less wear on cutting structures of PDC bits, leading to the achievement of the established casing set depth with reduction of drilling hours and being cost effective to the Operator. (author)

  1. Psychometric properties of the Mayo Elbow Performance Score.

    Science.gov (United States)

    Celik, Derya

    2015-06-01

    To translate and culturally adapt the Mayo Elbow Performance Score (MEPS), a widely used instrument for evaluating disability associated with elbow injuries, into Turkish (MEPS-T) and to determine psychometric properties of the translated version. The MEPS was translated into Turkish using published methodological guidelines. The measurement properties of the MEPS-T (construct validity and floor and ceiling effects) were tested in 91 patients with elbow pathology. The reproducibility of the MEPS-T was tested in 59 patients over 7-14 days. The responsiveness of the MEPS-T was tested in a subgroup of 46 patients diagnosed with lateral epicondylitis and who received conservative treatment for 6 weeks. The interclass correlation coefficient (ICC) was used to estimate the test-retest reliability. The construct validity was analyzed with the disabilities of the arm, shoulder and hand (DASH), Visual Analog Scale (VAS) and the Short Form 36 (SF-36). Effect size (ES) was used to assess the responsiveness. The distribution of floor and ceiling effects was determined. The MEPS-T showed very good test-retest reliability (ICC 0.89). The correlation coefficients between the MEPS-T and DASH and VAS were -0.61 and -0.53, respectively (p elbow disease.

  2. Solar hot water system installed at Days Inn Motel, Jacksonville, Florida

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-09-01

    The solar energy hot water system installed in the Days Inns of America, Inc., Days Inn Motel (120 rooms) I-95 and Cagle Road, Jacksonville, Florida, is described. The solar system was designed by ILI, Incorporated to provide 65 percent of the hot water demand. The system is one of eleven systems planned under this grant. Water (in the Solar Energy Products, Model CU-30ww liquid flat plate collector (900 square feet) system) automatically drains into the 1000 gallon lined and vented steel storage tank when the pump is not running. Heat is transferred from storage to Domestic Hot Water (DHW) tanks through a tube and shell heat exchanger. A circulating pump between the DHW tanks and heat exchanger enables solar heated water to help make up DHW standby losses. All pumps are controlled by differential temperature. This system was turned on June 19, 1979. The solar components were partly funded ($15,823 of $31,823 cost) by the Department of Energy.

  3. Mida mõtleb professor Andrew Mayo? / Anne-Mari Ernesaks

    Index Scriptorium Estoniae

    Ernesaks, Anne-Mari

    2005-01-01

    PARE koordinaator tutvustab tuntud inimkapitali ideoloogi Andrew Mayo raamatut "Ettevõtte inimväärtus". Raamatu autori hinnangul on tänapäeva organisatsioonides juhtimise olulisim ülesanne inimese juhtimine varana. Lisa: Konverents

  4. Mida mõtleb professor Andrew Mayo? / Anne-Mari Ernesaks

    Index Scriptorium Estoniae

    Ernesaks, Anne-Mari

    2005-01-01

    PARE koordinaator tutvustab tuntud inimkapitali ideoloogi Andrew Mayo raamatut "Ettevõtte inimväärtus". Raamatu autori hinnangul on tänapäeva organisatsioonides juhtimise olulisim ülesanne inimese juhtimine varana. Lisa: Konverents

  5. Therapy for Relapsed Multiple Myeloma: Guidelines From the Mayo Stratification for Myeloma and Risk-Adapted Therapy.

    Science.gov (United States)

    Dingli, David; Ailawadhi, Sikander; Bergsagel, P Leif; Buadi, Francis K; Dispenzieri, Angela; Fonseca, Rafael; Gertz, Morie A; Gonsalves, Wilson I; Hayman, Susan R; Kapoor, Prashant; Kourelis, Taxiarchis; Kumar, Shaji K; Kyle, Robert A; Lacy, Martha Q; Leung, Nelson; Lin, Yi; Lust, John A; Mikhael, Joseph R; Reeder, Craig B; Roy, Vivek; Russell, Stephen J; Sher, Taimur; Stewart, A Keith; Warsame, Rahma; Zeldenrust, Stephen R; Rajkumar, S Vincent; Chanan Khan, Asher A

    2017-04-01

    Life expectancy in patients with multiple myeloma is increasing because of the availability of an increasing number of novel agents with various mechanisms of action against the disease. However, the disease remains incurable in most patients because of the emergence of resistant clones, leading to repeated relapses of the disease. In 2015, 5 novel agents were approved for therapy for relapsed multiple myeloma. This surfeit of novel agents renders management of relapsed multiple myeloma more complex because of the occurrence of multiple relapses, the risk of cumulative and emergent toxicity from previous therapies, as well as evolution of the disease during therapy. A group of physicians at Mayo Clinic with expertise in the care of patients with multiple myeloma regularly evaluates the evolving literature on the biology and therapy for multiple myeloma and issues guidelines on the optimal care of patients with this disease. In this article, the latest recommendations on the diagnostic evaluation of relapsed multiple myeloma and decision trees on how to treat patients at various stages of their relapse (off study) are provided together with the evidence to support them. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  6. New Inhibitors of the Peripheral Site in Acetylcholinesterase that Specifically Block Organophosphorylation

    Science.gov (United States)

    2000-09-01

    Research, Mayo Clinic Jacksonville, Jacksonville, Florida, 32224 and the 2 Centro de Regulaci6n Celular y Patologia , Departamento de Biologia Celular y...between peptides and nonpeptides in the perpetual search for potent, orally active, and selective pharmaceuticals. Natural products have served as a...relatively rare example of a fairly large peptide that retains significant oral activity in humans. One possible explanation for this is that the lack of free

  7. Exploring the uncertainties of early detection results: model-based interpretation of mayo lung project

    Directory of Open Access Journals (Sweden)

    Berman Barbara

    2011-03-01

    Full Text Available Abstract Background The Mayo Lung Project (MLP, a randomized controlled clinical trial of lung cancer screening conducted between 1971 and 1986 among male smokers aged 45 or above, demonstrated an increase in lung cancer survival since the time of diagnosis, but no reduction in lung cancer mortality. Whether this result necessarily indicates a lack of mortality benefit for screening remains controversial. A number of hypotheses have been proposed to explain the observed outcome, including over-diagnosis, screening sensitivity, and population heterogeneity (initial difference in lung cancer risks between the two trial arms. This study is intended to provide model-based testing for some of these important arguments. Method Using a micro-simulation model, the MISCAN-lung model, we explore the possible influence of screening sensitivity, systematic error, over-diagnosis and population heterogeneity. Results Calibrating screening sensitivity, systematic error, or over-diagnosis does not noticeably improve the fit of the model, whereas calibrating population heterogeneity helps the model predict lung cancer incidence better. Conclusions Our conclusion is that the hypothesized imperfection in screening sensitivity, systematic error, and over-diagnosis do not in themselves explain the observed trial results. Model fit improvement achieved by accounting for population heterogeneity suggests a higher risk of cancer incidence in the intervention group as compared with the control group.

  8. Annual Proceedings of Selected Research and Development Papers Presented at the Annual Convention of the Association for Educational Communications and Technology (37th, Jacksonville, Florida, 2014). Volume 1

    Science.gov (United States)

    Simonson, Michael, Ed.

    2014-01-01

    For the thirty-seventh year, the Research and Theory Division and the Division of Instructional Design of the Association for Educational Communications and Technology (AECT) sponsored the publication of these Proceedings. Papers published in this volume were presented at the annual AECT Convention in Jacksonville, Florida. This year's Proceedings…

  9. Age-dependent vitreous separation from the macula in a clinic population

    Directory of Open Access Journals (Sweden)

    Syed Z

    2016-07-01

    Full Text Available Zahid Syed,1 Michael W Stewart2 1Georgetown University, Washington, DC, 2Department of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USA Background: Vitreous degeneration begins soon after birth and accelerates throughout life. Vitreous liquefaction with a slowly progressive separation of the posterior hyaloid from the peripheral macula usually leads to complete posterior vitreous detachment. The purpose of this study is to measure the age-related prevalence of partial vitreous separation and the length of residual vitreous adhesion in an ophthalmology clinic population. Methods: Patients examined by the senior author (MWS during a 6-month period were included in a retrospective chart review. Demographic data and spectral domain optical coherence tomography scan results were gathered. Data analysis with descriptive statistics focused on the prevalence and extent of partial vitreous separation. Results: The mean age of the study patients was 69.9 years, and 62% were phakic. The highest prevalence of partial posterior hyaloid separation from the internal limiting membrane (71.2% was seen in the 50- to 54-year age group. This prevalence rate steadily decreased to 5.6% in the 95- to 99-year age group. The prevalence of complete vitreous detachment as determined by slit-lamp biomicroscopy increased from 1.7% in the <50-year age group to a maximum of 29.2% in the 75- to 79-year group. The length of vitreomacular adhesion averaged 4.6 mm in the 50- to 54-year age group and steadily decreased to 2.1 mm in the 90- to 95-year group. Conclusion: Vitreomacular separation affects the majority of eyes in the sixth decade of life. The prevalence of partial vitreous separation decreases with advancing age, probably because an increasing number of these patients progress to complete posterior vitreous detachment. Keywords: optical coherence tomography, posterior hyaloid, posterior vitreous detachment, syneresis, vitreomacular adhesion, vitreous

  10. Memorabilia: del grito de Córdoba al mayo francés

    OpenAIRE

    Biagini, Hugo Edgardo

    2009-01-01

    Al mayo francés puede asignársele una trascendencia semejante al de una verdadera revolución. No por ello cabe desconocer el carácter anticipador que tuvieron distintas proposiciones y efectividades de la juventud universitaria latinoamericana en los inicios del siglo XX, la cual, entre sus tantos aportes generacionales, ha defendido la ciudadanía supranacional y ha armado una legión de redes intelectuales y sindicales. Como el mismo Mayo francés, la Reforma Universitaria de 1918 cabe ser res...

  11. 78 FR 14528 - Mayo Hydropower, LLC, Avalon Hydropower, LLC; Notice of Application for Transfer of License, and...

    Science.gov (United States)

    2013-03-06

    ... Energy Regulatory Commission Mayo Hydropower, LLC, Avalon Hydropower, LLC; Notice of Application for Transfer of License, and Soliciting Comments and Motions To Intervene On November 20, 2012, Mayo Hydropower, LLC (transferor) and Avalon Hydropower, LLC (transferee) filed an application for transfer of license...

  12. Clinical and differential utility of VEGF inhibitors in wet age-related macular degeneration: focus on aflibercept

    Directory of Open Access Journals (Sweden)

    Stewart MW

    2012-07-01

    Full Text Available Michael W StewartCollege of Medicine, Mayo Clinic, Jacksonville, FL, USAAbstract: Age-related macular degeneration (AMD has become a major public health problem and a leading cause of blindness in industrialized nations. AMD results from the ageing eye's inability to metabolize and dispose completely of photoreceptor outer segments and other waste products. As a result, lipids, particularly apolipoproteins, accumulate within Bruch's membrane, leading to chronic ischemia and inflammation. The subsequent upregulation of inflammatory cytokines and growth factors, including vascular endothelial growth factor (VEGF, induces the growth of neovascular membranes from the choriocapillaris into the subretinal or subretinal pigment epithelium spaces. To counter this, intravitreally administered drugs (pegaptanib, bevacizumab, ranibizumab that specifically target VEGF have become the standard treatment for exudative AMD. Aflibercept, a recently approved fusion protein, binds to all isoforms of both VEGF-A and placental growth factor with high affinity. Phase III trials showed that monthly or every other month injections of aflibercept prevent vision loss (fewer than 15 letters in 95% of patients. Additionally, aflibercept injections every 4 or 8 weeks produce average vision gains of 6.9 letters to 10.9 letters, comparable with those achieved with monthly ranibizumab. After one year of regularly administered aflibercept injections, patients required an average of only 4.2 injections during the second year. Aflibercept promises to decrease the injection frequency required for many patients and appears to serve as an effective “salvage” therapy for patients who respond poorly to other anti-VEGF drugs.Keywords: age-related macular degeneration, choroidal neovascularization, vascular endothelial growth factor, aflibercept, ranibizumab, bevacizumab, VEGF trap

  13. Prácticas de crianza y educación inicial en la etnia Mayo

    Directory of Open Access Journals (Sweden)

    Ángel Vera Noriega

    2010-01-01

    Full Text Available En el artículo se describen las características de las prácticas de crianza en una comunidad mayo y se realiza un análisis documental del Modelo de Educación Inicial no Escolarizada del CONAFE. Ello con la finalidad de contrastar los resultados de la práctica de crianza con las competencias esperadas de los padres y niños que asisten al programa y con base en ello, identificar la eficacia de la implementación del programa para la reproducción social en la etnia mayo. Participaron cincuenta madres y niños de la comunidad indígena mayo "El Júpare" ubicada en el municipio de Huatabampo, al sur de Sonora. Los instrumentos utilizados fueron Índice de Estrés Parental (Abidin, 1990, Interacción Padre-Hijo-Madre (Peña, 2004, Estimulación del Niño en el Hogar (Caldwell y Bradley, 1967 y Escala del Desarrollo Integral del niño (Atkin, 1987. En la evaluación del desarrollo, 54% de los niños presentan un desarrollo normal, 26% rrollo en riesgo y en 20% se detectan problemas. El programa de Educación Inicial no Escolarizado requiere de modificaciones sustantivas para responder a las prácticas de crianza que se desarrollan en la etnia mayo.

  14. Primary biliary cirrhosis : Dutch application of the Mayo model before and after orthotopic liver transplantation

    NARCIS (Netherlands)

    vanDam, GM; Verbaan, BW; Therneau, TM; Dickson, ER; Malinchoc, M; Murtaugh, PA; Huizenga, [No Value; Gips, CH

    1997-01-01

    Background/Aims: A retrospective study of primary biliary cirrhosis (PBC) was performed to study the Original Mayo Model for predicting survival by a Dutch data-set of patients, presentation of disease progression; assessment of liver transplantation, prediction of post-transplantation survival; and

  15. Matters of Priority: Herbert Mayo, Charles Bell and Discoveries in the Nervous System

    Science.gov (United States)

    Bradley, James

    2014-01-01

    Between 1822 and the late 1830s a highly personal priority dispute was fought between the celebrated surgeon and anatomist Sir Charles Bell and his ex-student Herbert Mayo. The dispute was over the motor and sensory functions of the Vth and VIIth cranial nerves. Over the course of the 1820s and the 1830s, the competing claims of Bell and Mayo were presented in newspapers, journals, and textbooks. But by the time of Bell’s death in 1842, Mayo had been discredited, a seemingly tragic footnote in the history of nervous discovery. And yet, with the benefit of hindsight, Bell’s case was at best disingenuous. His success was not due to any intrinsic scientific merit in his argument, but rather his ability to create a narrative that undermined the credibility of Mayo. However, only when Mayo’s public performances elided with Bell’s descriptions did this ploy succeed. As a result, the dispute illuminates the importance of credibility to the creation of an idealised scientific medical practitioner. PMID:25284895

  16. Hollymount Private Nursing and Retirement Home, Kilrush, Hollymount, Mayo.

    LENUS (Irish Health Repository)

    Naasan, M

    2012-05-01

    Information on the outcomes of ART treatments in Ireland is not readily available to Irish practitioners. The data for hospital affiliated clinics has been made available for many years and is included in the hospital reports. We present a 10-year analysis of the Irish ART results voluntarily reported by six out of seven IVF clinics. The data was collected from published ESHRE reports and from results (2007-8) not yet published. Data collected included: number of clinics and ART cycles, female age, clinical and multiple pregnancy rates and treatment complications. The clinical pregnancy rate per embryo transfer was 31.7% for IVF and 29.8% for ICSI. The proportion of singleton, twin and triplet deliveries for IVF and ICSI combined was 75%, 23.35% and 1.64%. The rate of ovarian hyperstimulation was 0.8%. ART practice in Ireland is safe, effective and responsible. Financial and societal savings could result from the introduction of state funded IVF with compulsory eSET where recommended.

  17. D'Alton Community Nursing Unit, Claremorris, Mayo.

    LENUS (Irish Health Repository)

    Cahir, Caitriona

    2012-01-01

    There are concerns that proton pump inhibitors (PPI) are being over prescribed in both primary and secondary care. This study aims to establish potential cost savings in a community drug scheme for a one year period according to published clinical and cost-effective guidelines for PPI prescribing.

  18. Queen of Peace Nursing Home, Churchfield, Knock, Mayo.

    LENUS (Irish Health Repository)

    Holland, Deirdre M

    2015-04-01

    Medication reconciliation is a basic principle of good medicines management. With the establishment of the National Acute Medicines Programme in Ireland, medication reconciliation has been mandated for all patients at all transitions of care. The clinical pharmacist is widely credited as the healthcare professional that plays the most critical role in the provision of medication reconciliation services.

  19. Mac Bride Community Nursing Unit, St. Mary's Crescent, Westport, Mayo.

    LENUS (Irish Health Repository)

    Holland, Deirdre M

    2015-04-01

    Medication reconciliation is a basic principle of good medicines management. With the establishment of the National Acute Medicines Programme in Ireland, medication reconciliation has been mandated for all patients at all transitions of care. The clinical pharmacist is widely credited as the healthcare professional that plays the most critical role in the provision of medication reconciliation services.

  20. Flor de Mayo Eugenia, nueva variedad de frijol para riego y temporal en el centro de México Flor de Mayo Eugenia, new bean cultivar for irrigated and rainfall conditions in Central Mexico

    OpenAIRE

    Jorge Alberto Acosta Gallegos; Yanet Jiménez Hernández; Bertha María Sánchez García; Francisco M. Mendoza Hernández; María Guadalupe Herrera Hernández; Rafael A. Salinas Pérez; Mario González Chavira

    2010-01-01

    Dentro del frijol tipo Flor de Mayo, el subtipo 'media oreja' esta cobrando importancia en el norte-centro de México, éste es de tamaño mediano, forma alargada y color rosa atractivo. Se describe una nueva variedad de este tipo de frijol, Flor de Mayo Eugenia (FME). FME se derivó de una cruza interracial entre Flor de Mayo Anita (FMA) (raza Jalisco) y Rayado Rojo (raza Nueva Granada). El rendimiento promedio de FME en temporal varia de 0.8 a 2.0 t ha-1 y bajo riego el máximo rendimiento ha si...

  1. Evaluación positiva de medicamentos: marzo/abril/mayo 2016

    Directory of Open Access Journals (Sweden)

    R. Aparicio Hernández

    Full Text Available Se reseñan los medicamentos evaluados y con dictamen positivo por la comisión de expertos de la Agencia Española de Medicamentos y Productos Sanitarios o de la Agencia Europea del Medicamento hechos públicos en marzo, abril y mayo de 2016. Se trata de opiniones técnicas positivas previas a la autorización y puesta en el mercado del medicamento.

  2. Mayo Older Americans Normative Studies: Factor Analysis of an Expanded Neuropsychological Battery

    OpenAIRE

    Greenaway, Melanie C.; Smith, Glenn E.; Tangalos, Eric G.; Geda, Yonas E.; Ivnik, Robert J.

    2008-01-01

    The Mayo Cognitive Factor Scores were derived from a “core battery” consisting of the WAIS-R, WMS-R, and Auditory Verbal Learning Test. The present study sought to clarify the factor structure of an expanded neuropsychological battery in normal elderly controls. Confirmatory factor analysis was performed on the WAIS-III, WRAT-3 Reading, Boston Naming Test, Controlled Oral Word Association Test, Category Fluency, Rey-Osterrieth Complex Figure, Visual Form Discrimination, and Trail Making Test ...

  3. Evaluación positiva de medicamentos: marzo/abril/mayo 2015

    Directory of Open Access Journals (Sweden)

    R. Aparicio Hernández

    2015-09-01

    Full Text Available Se reseñan los medicamentos evaluados y con dictamen positivo por comisión de expertos de la Agencia Española de Medicamentos y Productos Sanitarios o de la Agencia Europea del Medicamento hechos públicos en marzo, abril y mayo de 2015. Se trata de opiniones técnicas positivas previas a la autorización y puesta en el mercado del medicamento.

  4. Investidura de doctor Honoris Causa de Gonzalo Torrente Ballester. Universidad de Salamanca, 23 de mayo de 1987

    OpenAIRE

    1987-01-01

    Cincuenta y cinco fotografías de la ceremonia de investidura de doctor Honoris Causa de Gonzalo Torrente Ballester. Acto celebrado en el Paraninfo de la Universidad de Salamanca el 23 de mayo de 1987.

  5. Resumen de sismos reportados por los meses de mayo, junio, julio, agosto setiembre 2003

    OpenAIRE

    Costa Rica. Comisión Nacional de Prevención de Riesgos y Atención de Emergencias

    2003-01-01

    Se presenta un resumen de datos recolectados sobre los sismos reportados en Costa Rica, durante el periodo comprendido entre mayo y setiembre del 2003. Comprende el mes, la fecha, la hora, la magnitud, la ubicación, la profundidad, los sitios donde fue sentido y su origen. Incluye un mapa con la ubicación de los sismos reportados It presents a summary of the data collected about the earthquakes reported in Costa Rica between May and September 2003. It includes month, date, time, magnitude...

  6. Relaciones hídricas y temperaturas altas en frijol del tipo "flor de mayo"

    OpenAIRE

    2010-01-01

    Se estudió el efecto del déficit hídrico del suelo y temperatura alta del aire en las relaciones hídricas y temperatura del dosel del cultivo (Tc), rendimiento de semilla (RS) y sus componentes en 8 variedades de frijol del tipo ?Flor de Mayo? (FM) y una variedad criolla. Se realizaron 3 experimentos de campo; Montecillo en riego (MR) con la aplicación de agua de la siembra a la madurez, Montecillo en secano (MS) con la lluvia como fuente única de humedad y Celaya en secano (CS) con lluvia y ...

  7. Resumen de sismos reportados por los meses de mayo, junio, julio, agosto setiembre 2003

    Directory of Open Access Journals (Sweden)

    Costa Rica. Comisión Nacional de Prevención de Riesgos y Atención de Emergencias

    2003-09-01

    Full Text Available Se presenta un resumen de datos recolectados sobre los sismos reportados en Costa Rica, durante el periodo comprendido entre mayo y setiembre del 2003. Comprende el mes, la fecha, la hora, la magnitud, la ubicación, la profundidad, los sitios donde fue sentido y su origen. Incluye un mapa con la ubicación de los sismos reportados It presents a summary of the data collected about the earthquakes reported in Costa Rica between May and September 2003. It includes month, date, time, magnitude, location, depth, places where it was felt and origin. It includes a map with the location of the earthquakes reported

  8. Salida de campo a Fuensaldaña (Valladolid) el 29 de mayo de 1953

    OpenAIRE

    Valverde Gómez, José Antonio, 1926-2003

    2008-01-01

    Salida de campo a Fuensaldaña (Valladolid) el 29 de mayo de 1953, de la que se anotaron observaciones sobre una Malpolon monspessulanus (Culebra bastarda, llamada Coleopeltis mouspessulanus por el autor) hallada muerta, los siguientes mamíferos: Apodemus sp. (Ratón), Crocidura sp. (Musaraña), Eliomys quercinus (Lirón careto, también llamado Ratón ojalbo por el autor) y "Pytimis" (llamado así por el autor, siendo posiblemente el actual género Microtus), hallados dentro de egagrópilas de Lechu...

  9. Del testimonio al Best-seller en la Plaza de Mayo

    OpenAIRE

    Araujo, Helena; Pontificia Universidad Javeriana, Bogotá

    2014-01-01

    Con vida los trajimos, con vida los queremos, gritaban las mujeres en la Plaza de Mayo durante la dictadura militar argentina, "haciendo de la maternidad un derecho político y utilizando el cuerpo maternal como una táctica contra el poder fascista" (Guerra, 1989: 158). Desde los años setenta, su terca, desesperada, heroica denuncia, constituiría un referente en la producción textual, no sólo con respecto a obras documentales, sino a novelas como la recientemente publicada por Elsa Osorio. A v...

  10. Three-dimensional Physical Modeling: Applications and Experience at Mayo Clinic.

    Science.gov (United States)

    Matsumoto, Jane S; Morris, Jonathan M; Foley, Thomas A; Williamson, Eric E; Leng, Shuai; McGee, Kiaran P; Kuhlmann, Joel L; Nesberg, Linda E; Vrtiska, Terri J

    2015-01-01

    Radiologists will be at the center of the rapid technologic expansion of three-dimensional (3D) printing of medical models, as accurate models depend on well-planned, high-quality imaging studies. This article outlines the available technology and the processes necessary to create 3D models from the radiologist's perspective. We review the published medical literature regarding the use of 3D models in various surgical practices and share our experience in creating a hospital-based three-dimensional printing laboratory to aid in the planning of complex surgeries.

  11. Falls prevention at Mayo Clinic Rochester: a path to quality care.

    Science.gov (United States)

    Sulla, Stephanie J; McMyler, Eileen

    2007-01-01

    Falls prevention is a complex problem. Following in the footsteps of an earlier fall prevention team, the Safe Landings Fall Prevention Team used many strategies for implementing a fall prevention/reduction program. The tactics we used to prevent falls combined with the adoption of a fall assessment risk model are shared.

  12. Animal-assisted therapy at Mayo Clinic: The time is now.

    Science.gov (United States)

    Creagan, Edward T; Bauer, Brent A; Thomley, Barbara S; Borg, Jessica M

    2015-05-01

    The animal-human bond refers to an emotional, almost existential, relationship between animals and people. From the time of antiquity, domestic animals were an important source of economic vitality, but with the changing cultural landscape, the companion animal has become a faithful friend. Overwhelming anecdotal evidence supports the healing power of this relationship. We summarize the emerging literature on the neurobiochemical and cardiovascular benefits of companion pet ownership. We address the peer-reviewed data from myriad journal articles assessing the impact of the companion animal on the quality and often the length of life of select patients.

  13. Culture-Proven Thorn-Associated Infections in Arizona: 10-Year Experience at Mayo Clinic.

    Science.gov (United States)

    Simmons, Sierra C; Budavari, Adriane I; Kusne, Shimon; Zhang, Nan; Vikram, Holenarasipur R; Blair, Janis E

    2017-01-01

    Thorn injuries are common in the desert Southwest; however, the frequency and microbiology of thorn-associated infections have not been systematically described. Most information comes from case reports describing infections from atypical or environmental microorganisms. Our aim was to summarize the spectrum of thorn-associated infections. We conducted a retrospective review of electronic health records for patients presenting to our institution from January 1, 2005 to December 31, 2014 for treatment of thorn-associated injuries and then focused on the patients with cultures. Of 2758 records reviewed, 1327 patients had thorn-associated injuries; however, only 58 (4.4%) had cultures. Of these patients, 37 (64%) had positive findings; 5 had polymicrobial infection. The most commonly identified organisms were Staphylococcus aureus (n = 22, 59.0%) and coagulase-negative Staphylococcus species (n = 8, 21.6%). Other pathogens included Nocardia species (n = 3, 8.1%), Streptococcus species (n = 2, 5.4%), Gram-negative bacteria (n = 2, 5.4%), Aspergillus species (n = 2, 5.4%), Paecilomyces lilacinus (n = 1, 2.7%), and Candida species (n = 1, 2.7%). There were no infections caused by Pantoea agglomerans, Sporothrix schenckii, or Coccidioides spp. In contrast to most published case reports, we found that typical cutaneous microorganisms, such as Staphylococcus species, caused the majority of culture-positive, thorn-related infections.

  14. Mayo Clinic/Renal Pathology Society Consensus Report on Pathologic Classification, Diagnosis, and Reporting of GN.

    Science.gov (United States)

    Sethi, Sanjeev; Haas, Mark; Markowitz, Glen S; D'Agati, Vivette D; Rennke, Helmut G; Jennette, J Charles; Bajema, Ingeborg M; Alpers, Charles E; Chang, Anthony; Cornell, Lynn D; Cosio, Fernando G; Fogo, Agnes B; Glassock, Richard J; Hariharan, Sundaram; Kambham, Neeraja; Lager, Donna J; Leung, Nelson; Mengel, Michael; Nath, Karl A; Roberts, Ian S; Rovin, Brad H; Seshan, Surya V; Smith, Richard J H; Walker, Patrick D; Winearls, Christopher G; Appel, Gerald B; Alexander, Mariam P; Cattran, Daniel C; Casado, Carmen Avila; Cook, H Terence; De Vriese, An S; Radhakrishnan, Jai; Racusen, Lorraine C; Ronco, Pierre; Fervenza, Fernando C

    2016-05-01

    Renal pathologists and nephrologists met on February 20, 2015 to establish an etiology/pathogenesis-based system for classification and diagnosis of GN, with a major aim of standardizing the kidney biopsy report of GN. On the basis of etiology/pathogenesis, GN is classified into the following five pathogenic types, each with specific disease entities: immune-complex GN, pauci-immune GN, antiglomerular basement membrane GN, monoclonal Ig GN, and C3 glomerulopathy. The pathogenesis-based classification forms the basis of the kidney biopsy report. To standardize the report, the diagnosis consists of a primary diagnosis and a secondary diagnosis. The primary diagnosis should include the disease entity/pathogenic type (if disease entity is not known) followed in order by pattern of injury (mixed patterns may be present); score/grade/class for disease entities, such as IgA nephropathy, lupus nephritis, and ANCA GN; and additional features as detailed herein. A pattern diagnosis as the sole primary diagnosis is not recommended. Secondary diagnoses should be reported separately and include coexisting lesions that do not form the primary diagnosis. Guidelines for the report format, light microscopy, immunofluorescence microscopy, electron microscopy, and ancillary studies are also provided. In summary, this consensus report emphasizes a pathogenesis-based classification of GN and provides guidelines for the standardized reporting of GN.

  15. Potential effects of deepening the St. Johns River navigation channel on saltwater intrusion in the surficial aquifer system, Jacksonville, Florida

    Science.gov (United States)

    Bellino, Jason C.; Spechler, Rick M.

    2013-01-01

    The U.S. Army Corps of Engineers (USACE) has proposed dredging a 13-mile reach of the St. Johns River navigation channel in Jacksonville, Florida, deepening it to depths between 50 and 54 feet below North American Vertical Datum of 1988. The dredging operation will remove about 10 feet of sediments from the surficial aquifer system, including limestone in some locations. The limestone unit, which is in the lowermost part of the surficial aquifer system, supplies water to domestic wells in the Jacksonville area. Because of density-driven hydrodynamics of the St. Johns River, saline water from the Atlantic Ocean travels upstream as a saltwater “wedge” along the bottom of the channel, where the limestone is most likely to be exposed by the proposed dredging. A study was conducted to determine the potential effects of navigation channel deepening in the St. Johns River on salinity in the adjacent surficial aquifer system. Simulations were performed with each of four cross-sectional, variable-density groundwater-flow models, developed using SEAWAT, to simulate hypothetical changes in salinity in the surficial aquifer system as a result of dredging. The cross-sectional models were designed to incorporate a range of hydrogeologic conceptualizations to estimate the effect of uncertainty in hydrogeologic properties. The cross-sectional models developed in this study do not necessarily simulate actual projected conditions; instead, the models were used to examine the potential effects of deepening the navigation channel on saltwater intrusion in the surficial aquifer system under a range of plausible hypothetical conditions. Simulated results for modeled conditions indicate that dredging will have little to no effect on salinity variations in areas upstream of currently proposed dredging activities. Results also indicate little to no effect in any part of the surficial aquifer system along the cross section near River Mile 11 or in the water-table unit along the cross

  16. Concept Design of Trailor Ferry Service to Carry 150 Trailers Between Jacksonville, FL and Bridgeport, CT of USA

    Science.gov (United States)

    Sindagi, S. C.; Sandhu, B. S.

    2015-04-01

    With the increased load on highways, today there is a need to develop alternate ways to transport goods within the sovereignty. The use of ships to transport goods has always been the primary method of transporting goods across the seas but it can also be used to transport goods within the country. This way we can reduce the load on highways which at this point of time serve as the primary method of transportation. Worldwide very few ferries are in operation which transports 100-150 Trailers between two ports. Catching on this opportunity for design, construction and operation of vessels, a survey for possible routes in United States of America which will transport 150 Trailers has been conducted by various authorities and organizations. The challenge here is to determine the parameters of the vessel and design a fleet of vessels that could carry trailers along with their tractors within the least possible time and in with least possible freight between Jacksonville, FL and Bridgeport, CT of United States of America. The primary aim of the work presented here is to propose a design with fleet in such a way that each day 150 trailers could be loaded and unloaded at each of the two mentioned ports. An analysis of the route between the ports brought out various primary parameters like the distance, weather, different load lines to be encountered and also several size constraints that the vessel needs to adhere to, in order to ply smoothly on this route. The vessel is designed as per the Guidelines for ships operating in international waters. The economic analysis of the project was performed spanning over 20 years and the best freight was found out which would be most profitable for the company as well as be a good value for money for the customers.

  17. «Mayo Teatral 2008»: o teatro contemporâneo em Havana – Cuba

    Directory of Open Access Journals (Sweden)

    Marcos Antônio Alexandre

    2011-10-01

    Full Text Available Resumo: Este artigo traz para discussão o panorama artístico cubano a partir da análise crítica de alguns textos espetaculares que foram apresentados no evento 8ª Temporada de Teatro Latinoamericano y Caribeño Mayo Teatral 2008. Para esta reflexão, são utilizadas as contribuições da semiótica teatral e são discutidas temáticas relacionadas, entre outras questões, à memória, à cultura cubana e afrocubana e às identidades.  Palavras-chave: Teatro; semiótica teatral; Cuba; memória; cultura; identidade.Resumen: Este artículo se propone a discutir el panorama artístico cubano a través del análisis de algunos textos espectaculares que fueron presentados en el evento 8ª Temporada de Teatro Latinoamericano y Caribeño – Mayo Teatral 2008. Para esta reflexión son utilizados los aportes de la semiótica teatral y son discutidas temáticas relacionadas, entre otras cuestiones, a la memoria, a la cultura cubana y afro-cubana y a las identidades.Palabras-clave: Teatro; semiótica teatral; Cuba; memoria; cultura; identidad.Keywords: Theater; theater semiotics; Cuba; memory; culture; identity.

  18. Fracturas del tercio medio facial: experiencia en el Hospital Nacional Dos de Mayo, 1999 - 2009

    Directory of Open Access Journals (Sweden)

    Francisco Avello Canisto

    2013-04-01

    Full Text Available Introducción: Correspondiendo a una patología frecuente en la especialidad de cabeza, cuello y máxilo-facial, consecuencia de traumatismos severos, es importante determinar las características de las fracturas del tercio medio facial, para su manejo. Objetivo: Determinar la presentación de las fracturas del tercio medio facial por edad, sexo, agente causal. Diseño: Estudio observacional descriptivo. Lugar: Servicio de Cirugía de Cabeza, Cuello y Máxilo-Facial del Hospital Nacional Dos de Mayo, Lima, Perú. Participantes: Pacientes con fractura del tercio medio facial. Intervenciones: Recolección de datos registrados en las historias clínicas, entre junio 1999 y mayo 2009. Principales medidas de resultados: Edad, sexo, agente causal y clasificación. Resultados: De 471 pacientes, 83% fue de sexo masculino, 72,5% tenía entre 21 y 40 años de edad, 48% fue por accidentes de tránsito y 25% por robos; 83% correspondió solamente a fracturas del tercio medio y 88% a trazo unilateral. Conclusiones: Las fracturas del tercio medio facial son las más frecuentes de la región facial; el diagnóstico clínico depende de la estructura afectada. Se debe actuar oportunamente para evitar secuelas y complicaciones.

  19. Deluges of Grandeur: Water, Territory, and Power on Northwest Mexico’s Río Mayo, 1880-1910

    OpenAIRE

    Jeffrey M. Banister

    2011-01-01

    Northwest Mexico’s irrigation landscape, known today as El Distrito de Riego 038, or El Valle del Mayo, issues from historical struggles to build an official order out of a diverse world of signs, symbols, processes, places, and peoples. It is the ancestral home of the Yoreme (Mayo), an indigenous group for whom colonisation and agricultural development have meant the loss of autonomy and of the seasonal mobility required to subsist in an arid land. It is also the birthplace of President Álva...

  20. Comparison of BG-Sentinel® Trap and Oviposition Cups for Aedes aegypti and Aedes albopictus Surveillance in Jacksonville, Florida, USA.

    Science.gov (United States)

    Wright, Jennifer A; Larson, Ryan T; Richardson, Alec G; Cote, Noel M; Stoops, Craig A; Clark, Marah; Obenauer, Peter J

    2015-03-01

    The BG-Sentinel® (BGS) trap and oviposition cups (OCs) have both proven effective in the surveillance of Aedes species. This study aimed to determine which of the 2 traps could best characterize the relative population sizes of Aedes albopictus and Aedes aegypti in an urban section of Jacksonville, FL. Until 1986, Ae. aegypti was considered the dominant container-breeding species in urban northeastern Florida. Since the introduction of Ae. albopictus, Ae. aegypti has become almost completely extirpated. In 2011, a resurgence of Ae. aegypti was detected in the urban areas of Jacksonville; thus this study initially set out to determine the extent of Ae. aegypti reintroduction to the area. We determined that the BGS captured a greater number of adult Ae. aegypti than Ae. albopictus, while OCs did not monitor significantly different numbers of either species, even in areas where the BGS traps suggested a predominance of one species over the other. Both traps were effective at detecting Aedes spp.; however, the BGS proved more diverse by detecting over 20 other species as well. Our results show that in order to accurately determine vectorborne disease threats and the impact of control operations on these 2 species, multiple trapping techniques should be utilized when studying Ae. aegypti and Ae. albopictus population dynamics.

  1. Mayo Adhesive Probability Score Is an Independent Computed Tomography Scan Predictor of Adherent Perinephric Fat in Open Partial Nephrectomy.

    Science.gov (United States)

    Martin, Logan; Rouviere, Olivier; Bezza, Riadh; Bailleux, Jérôme; Abbas, Fatima; Schott-Pethelaz, Anne-Marie; Ruffion, Alain; Paparel, Philippe

    2017-05-01

    To evaluate predictive radiological elements for adherent perinephric fat (APF) and the Mayo adhesive probability (MAP) score in the setting of open partial nephrectomy, and to assess their reproducibility. We performed a retrospective case-control study involving 86 patients who had open partial nephrectomies performed by a single surgeon between January 1, 2009 and April 1, 2015. Radiological elements were assessed by 4 readers blinded to patient APF status. Univariate and multivariate analyses were performed for all radiological and clinical factors. Reproducibility was analyzed using agreement coefficients. On univariate analysis for radiological findings, lateral and posterior fat thickness (odds ratio [OR]: 1.084 [1.033, 1.138], P < .001), stranding (OR: 2.179 [1.431, 3.318], P < .001), -80 HU fat area, and the MAP score (OR: 1.797 [1.332, 2.424], P < .001) were predictive of APF. On multivariate analysis, only age and the MAP score remained statistically significant (OR: 1.060 [1.005, 1.118], P = .03; and OR: 1.560 [1.137, 2.139], P = .0058, respectively). The reproducibility of the MAP score was fair (AC1 = 0.367 and kappa F = 0.353), as was that of stranding (AC1 = 0.499, kappa F = 0.376). The agreement was important if we defined a "low" (0 to 3) or "high" (4 or 5) score (AC1 = 0.706 and kappa F = 0.681). The MAP score was the element that best predicted APF in our study, although its reproducibility among our readers was only fair. The agreement becomes important if we defined "low or high" score. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. El poder de la palabra: o la "mirada inversa" de Michel de Certeau sobre el mayo francés

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    Luis Ignacio Sierra Gutiérrez

    2008-01-01

    Full Text Available Este comentario pretende reflexionar sobre la "mirada inversa" de Michel de Certeau, a partir de la "toma de la palabra" como eje central de las acciones simbólicas de mayo del 68 y su resonancia en la realidad sociopolítica de la nación colombiana.

  3. Incisional hernia recurrence following 'vest-over-pants' or vertical mayo repair of primary hernias of the midline

    NARCIS (Netherlands)

    R.W. Luijendijk; M.H.M. Lemmen (M. H M); W.C.J. Hop (Wim); J.C.J. Wereldsma

    1997-01-01

    textabstractA series of 68 primary midline incisional hernias with a vertical Mayo repair was evaluated retrospectively. Patients without documented hernia recurrence following this repair were invited for physical examination. Life- table methods were used for statistical analysis. The 1-, 3-, 5-,

  4. Detection and quality of previously undetermined Floridan aquifer system discharge to the St. Johns River, Jacksonville, to Green Cove Springs, northeastern Florida

    Science.gov (United States)

    Spechler, R.M.

    1996-01-01

    Potentiometric surface maps of the Upper Floridan aquifer show two depressions around the St. Johns River frm the city of Jacksonville south toward Green Cove Springs. These depressions, depending on their locations, are the result of withdrawals from agricultural, industrial, domestic and public-supply wells, diffuse upward leakage, and discharge from springs. Submerged springs that discharge into the St. Johns River between Jacksonville and Green Cove Springs have been thought to exist, but locating and evaluating these springs had not been attempted before this investigation. Thermal infrared imagery, seismic reflection, and numerous interviews with local residents were used to locate springs. An airborne thermal infrared survey was conducted along a section of the St. Johns River in northeastern Florida during February 1992 to detect possible sources of ground-water discharge to the river. An infrared image displayed one thermal anomaly in the St. Johns River which is associated with a previously unknown spring discharge from the Floridan aquifer system. Thermal anomalies also were observed at six locations where municipal facilities discharge treated wastewater to the river. Results of seismic reflection surveys indicate the presence of collapse and other karst features underlying the St. Johns River. These features indicate that the surficial deposits and the Hawthorn Formation that underlie the river probably do not consist of continuous beds. The collapse or deformation of the Hawthorn Formation or the presence of permeable sediment of localized extent could create zones of relatively high vertical leakance. This could provide a more direct hydraulic connection between the Upper Floridan aquifer and the river. Water samples collected from the only submerged spring in the St. Johns River within the Jacksonville-Green Cove Springs reach indicate that the source of the water is the Floridan aquifer system. Chloride and sulfate concentrations were 12 and 340

  5. Major clinical events, signs and severity assessment scores related to actual survival in patients who died from primary biliary cirrhosis. A long-term historical cohort study

    NARCIS (Netherlands)

    van Dam, GM; Gips, CH; Reisman, Y; Maas, KW; Purmer, IM; Huizenga, [No Value; Verbaan, BW

    1999-01-01

    BACKGROUND/AIMS: One of the prognostic methods for survival in primary biliary cirrhosis (PBC) is the Mayo model, with a time-scale limited to 7 years. The aim of our study was to assess how major clinical events, signs, several severity assessment methods and Mayo survival probabilities fit in with

  6. Petrology of suprasubductive mantle xenoliths from Estancia Sol De Mayo (Central Patagonia, Argentina)

    Science.gov (United States)

    Melchiorre, M.; Coltorti, M.; Gregoire, M.; Benoit, M.

    2012-04-01

    A new suite of mantle xenoliths from Estancia Sol de Mayo (Patagonia) has been investigated. They were entrained in alkaline lavas from the south western sector of Meseta Lago Buenos Aires. Trace element abundances of these lavas are well comparable with those of the main and post-plateau lavas from the Triple Junction Province and resemble those of OIB. Xenoliths are spinel-bearing harzburgites and dunites, with minor lherzolites and one wehrlite. They are characterized by a coarse grained protogranular texture and devoid of modal metasomatic features and hydrated minerals. They show two texturally different clinopyroxenes. One is protogranular (cpx1), while the second surrounds, and is genetically related to, spinel (cpx2). Three different types of orthopyroxenes are also recognized: the first one is represented by large protogranular crystals with exsolution lamellae (opx1), the second one by small clean and undeformed grains without exsolution lamellae (opx2) and the last one occurs as small grains filling veins (opx3). Major element compositions of both clinopyroxenes and orthopyroxenes highlight two different trends. The first one is characterized by high Al2O3 (high-Al trend) content at almost constant mg# [MgO/(MgO+FeO) mol %], while the second shows a slight increase in Al2O3 (low-Al trend) content with decreasing mg#. Trace element contents of cpx are enriched in LREE and characterized by prominent to slightly negative Nb, Zr and Ti anomalies. No differences are observed between cpx1 and cpx2. The three groups of orthopyroxenes are variably depleted in LREE, with opx1 and opx2 always showing prominent to slightly negative Ti and Zr anomalies, while opx3 is characterized by a prominent positive Zr anomaly. Al2O3 in cpx is inversely correlated with LREE and LILE suggesting that a refertilization event occur within the upper mantle beneath Estancia Sol de Mayo. The most likely melt which can account for this event has a tholeiitic affinity, as supported by i

  7. El movimiento estudiantil reformista frente al primer episodio de la 'laica o libre' [mayo de 1956

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    Juan Sebastián Califa

    2009-11-01

    Full Text Available En mayo de 1956 se libró en la Argentina el primer episodio del conflicto "laica o libre". Así se llamó al enfrentamiento entre reformistas, contrarios al artículo 28 del decreto-ley 6.403 que permitía a las universidades privadas otorgar títulos habilitantes, y católicos favorables al mismo. En este contexto, se registró un ascendente proceso de tomas estudiantiles de secundarios y universidades. El conflicto le costó el cargo al católico ministro de Educación nacional Atilio Dell'Oro Maini y a los rectores de las universidades de Buenos Aires [UBA] y de Córdoba [UNC]. No obstante las tensas implicancias que el mismo deparó dentro del gobierno de la autoproclamada "Revolución Libertadora", poco se conoce sobre él. En este artículo iniciaré su estudio. Para ello reconstruiré los hechos a través de los diarios La Nación y La Prensa, entre otras fuentes y bibliografía. Particularmente concentraré mi atención en el estudiantado reformista de la UBA

  8. Polyphenolic substrates and dyes degradation by yeasts from 25 de Mayo/King George Island (Antarctica).

    Science.gov (United States)

    Rovati, José I; Pajot, Hipólito F; Ruberto, Lucas; Mac Cormack, Walter; Figueroa, Lucía I C

    2013-11-01

    Antarctica offers a range of extreme climatic conditions, such as low temperatures, high solar radiation and low nutrient availability, and constitutes one of the harshest environments on Earth. Despite that, it has been successfully colonized by ’cold-loving’ fungi, which play a key role in decomposition cycles in cold ecosystems. However, knowledge about the ecological role of yeasts in nutrient or organic matter recycling/mineralization remains highly fragmentary. The aim of this work was to study the yeast microbiota in samples collected on 25 de Mayo/King George Island regarding the scope of their ability to degrade polyphenolic substrates such as lignin and azo dyes. Sixty-one yeast isolates were obtained from 37 samples, including soil, rocks, wood and bones. Molecular analyses based on rDNA sequences revealed that 35 yeasts could be identified at the species level and could be classified in the genera Leucosporidiella, Rhodotorula, Cryptococcus, Bullera and Candida. Cryptococcus victoriae was by far the most ubiquitous species. In total, 33% of the yeast isolates examined showed significant activity for dye decolorization, 25% for laccase activity and 38% for ligninolytic activity. Eleven yeasts did not show positive activity in any of the assays performed and no isolates showed positive activity across all tested substrates. A high diversity of yeasts were isolated in this work, possibly including undescribed species and conspicuous Antarctic yeasts, most of them belonging to oligotrophic, slow-growing and metabolically diverse basidiomycetous genera.

  9. Meta-analysis comparing same-day versus delayedvitrectomy clinical outcomes for intravitreal retained lens fragments after age-relatedcataract surgery

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    Vanner EA

    2014-11-01

    Full Text Available Elizabeth A Vanner,1 Michael W Stewart21Department of Preventive Medicine, Pathology and Bioinformatics, Stony Brook University, Stony Brook, NY, USA; 2Department of Ophthalmology, Mayo Clinic College of Medicine, Jacksonville, FL, USAPurpose/design: We aimed to perform a systematic review and meta-analysis comparing the risk difference of clinical outcomes for same-day (SD vs delayed (DEL pars plana vitrectomy (PPV.Methods: We searched MEDLINE (English; January 1, 1985 to July 16, 2013 and article reference lists, for patients with crystalline retained lens fragments and discussion of SD-PPV vs DEL-PPV. For the meta-analysis, articles needed the number of patients receiving SD-PPV and DEL-PPV, and the number, in each group, who experienced one or more of the outcomes: not good visual acuity (VA (<20/40, bad VA (≤20/200, retinal detachment, increased intraocular pressure/glaucoma, intraocular infection/inflammation, cystoid macular edema, and corneal edema.Results: Of 304 articles identified, 23 provided data for the meta-analysis. Results were mixed, indicating 1 neither vitrectomy time produced better outcomes in all studies (not good VA risk difference =10.3% [positive numbers favored SD-PPV; negative numbers favored DEL-PPV], 95% confidence interval [CI] = [-0.4% to 21.0%], P=0.059; and bad VA risk difference =-0.3%, 95% CI = [-10.7% to 10.1%], P=0.953; 2 better outcomes with immediate SD-PPV compared with all DEL-PPV (not good VA risk difference =16.2%, 95% CI = [0.8% to 31.5%], P=0.039; and bad VA risk difference =8.5%; 95% CI = [0.8% to 16.2%], P=0.030; and 3 immediate SD-PPV and prompt DEL-PPV (3 to 14 days after cataract surgery had no significant differences and so may produce similar outcomes (not good VA risk differences range = [-19.9% to 6.5%], 95% CI = [-59.9% to 36.4%]; and bad VA risk differences range = [-6.9% to 7.4%], 95% CI = [-33.1% to 31.8%].Conclusion: Perhaps SD-PPV should be limited to facilities at which a

  10. The December 2012 Mayo River debris flow triggered by Super Typhoon Bopha in Mindanao, Philippines: lessons learned and questions raised

    Science.gov (United States)

    Rodolfo, Kelvin S.; Lagmay, A. Mahar F.; Eco, Rodrigo C.; Herrero, Tatum Miko L.; Mendoza, Jerico E.; Minimo, Likha G.; Santiago, Joy T.

    2016-12-01

    Category 5 Super Typhoon Bopha, the world's worst storm of 2012, formed abnormally close to the Equator, and its landfall on Mindanao set the record proximity to the Equator for its category. Its torrential rains generated an enormous debris flow in the Mayo River watershed that swept away much of the village Andap in the New Bataan municipality, burying areas under rubble as thick as 9 m and killing 566 people. Established in 1968, New Bataan had never experienced super typhoons and debris flows. This unfamiliarity compounded the death and damage. We describe Bopha's history, debris flows and the Mayo River disaster, and then we discuss how population growth contributed to the catastrophe, as well as the possibility that climate change may render other near-Equatorial areas vulnerable to hazards brought on by similar typhoons. Finally, we recommend measures to minimize the loss of life and damage to property from similar future events.

  11. Seroprevalence and correlates of Toxoplasma gondii infection in Yoremes (Mayos) in Mexico: a cross-sectional study

    Science.gov (United States)

    Alvarado-Esquivel, Cosme; Rascón-Careaga, Antonio; Hernández-Tinoco, Jesús; Corella-Madueño, María Alba Guadalupe; Sánchez-Anguiano, Luis Francisco; Aldana-Madrid, María Lourdes; Almada-Balderrama, Gerardo Javier; Nuñez-Aguirre, Alan Daniel; Liesenfeld, Oliver

    2016-01-01

    Objectives We sought to determine the prevalence of anti-Toxoplasma gondii antibodies in Yoremes and to identify associations of T. gondii exposure with sociodemographic, clinical and behavioural characteristics of Yoremes. Design A cross-sectional survey. Setting Yoremes were enrolled in the locality of Tierra Blanca in the municipality of Navojoa in Sonora State, Mexico. Participants We studied 200 Yoremes (Mayos); they are an indigenous ethnic group living in a coastal region in northwestern Mexico. Primary and secondary outcome measures We assessed the prevalence of anti-Toxoplasma IgG and IgM antibodies in participants using enzyme-linked immunoassays. We used a standardised questionnaire to obtain the characteristics of Yoremes. The association of T. gondii exposure and Yoremes’ characteristics was assessed by bivariate and multivariate analyses. Results Of the 200 Yoremes studied (mean age: 31.50±18.43 years), 26 (13.0%) were positive for anti-T. gondii IgG antibodies and 19 (73.1%) of them were also positive for anti-T. gondii IgM antibodies. Seroprevalence of T. gondii infection did not vary with sex, educational level, occupation or socioeconomic status. In contrast, multivariate analysis of sociodemographic and behavioural characteristics showed that T. gondii exposure was associated with increasing age (OR=1.02; 95% CI 1.00 to 1.04; p=0.03) and consumption of squirrel meat (OR=4.99; 95% CI 1.07 to 23.31; p=0.04). Furthermore, seroprevalence of T. gondii infection was significantly higher in Yoremes with a history of lymphadenopathy (p=0.03) and those suffering from frequent abdominal pain (p=0.03). In women, T. gondii exposure was associated with a history of caesarean sections (p=0.03) and miscarriages (p=0.02). Conclusions We demonstrate, for the first time, serological evidence of T. gondii exposure among Yoremes in Mexico. Results suggest that infection with T. gondii might be affecting the health of Yoremes. Results may be useful for an

  12. Recursos florísticos de la cuenca baja del río mayo, Sonora

    Directory of Open Access Journals (Sweden)

    Julio César Duarte Ruiz

    2014-06-01

    Full Text Available En México se presentan prácticamente todos los grandes tipos de vegetación que existen en el mundo y su distribución a menudo es compleja. El objetivo del trabajo consistió en realizar un listado de la flora silvestre ribereña del Río Mayo, localizado en el sur del estado de Sonora, para conocer su composición. La recolección de especímenes se realizó mediante la técnica de intercepción o línea de Canfield (1941, en 15 sitios con dos repeticiones sumando 30 transectos. Se encontraron un total de 40 familias, 79 géneros y 99 especies. Las familias mejor representadas fueron: Leguminoseae, Cactaceae, Gramineae, Compositae, Chenopodiaceae, Salicaceae, Solanaceae, Euphorbiaceae, Amaranthaceae y Asteraceae. La dominante fue Leguminoseae con vegetación de bosque espinoso compuesta por Acacia cymbispina, Acacia farnesiana, Parkinsonia aculeata y Prosopis juliflora. Resulta perceptible la pérdida de flora debido al cambio de uso de suelo. Especies representativas de la zona riparia como Populus fremontii y Salix bonplandiana están desapareciendo por alteración del ecosistema. Poblaciones de mangle como Rhizophora mangle y Conocarpus erectus están disminuidas. El área estudiada es rica en especies a pesar de la perturbación. La diversidad varía de acuerdo al gradiente altitudinal y el número de especies guarda relación con los géneros y familias recolectadas. La agricultura, acuicultura, ganadería, la industria pesquera y la urbanización, son los giros que causan mayor afectación en los ecosistemas

  13. Los acontecimientos de mayo del 68 y la lucha antipsiquiátrica

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    Valentín Galván García

    2009-12-01

    Full Text Available Los movimientos de detracción a la psiquiatría clásica no nacieron hasta la década de los años 60. Las reflexiones comunes de sociólogos, filósofos, políticos, psiquiatras y enfermos mentales coincidieron en un severo replanteamiento del saber psiquiátrico y de las prácticas propugnadas. El término propuesto en 1967 por David Cooper fue el estandarte de estos nuevos planteamientos. Con anterioridad al movimiento psiquiátrico, en 1961, se publicaron dos textos fundamentales: Internados de Erving Goffman y la Historia de la locura de Michel Foucault. Ambas obras, hasta entonces, conocidas exclusivamente en el ámbito académico, por lo que sus enfoques y problemáticas tuvieron escasa repercusión hasta los acontecimientos de Mayo del 68, los cuales propiciaron unas condiciones más favorables para su discurso.________________________ABSTRACT:The movements back to the classical psychiatry weren’t born until the 60 ths decade. The common thoughts of sociologists, philosophers, politicians, psychiatrists and mentally sick people joined together a strict reconsideration of the phychiatric knowledge and the proposed training. The word “antipsychiatry” proposed in 1967 by David Cooper was the flagship of these new thoughts. Before the psychiatric movement, in 1961, two main books were published: Asylums by Erving Goffman and History of mandess by Michel Foucault. Both books, until then, were known exclusively in the academic field, for its focus and problems had little repercussion until the May 68 events, which encouraged more favourable conditions for its speech.  

  14. Flor de Mayo Eugenia, nueva variedad de frijol para riego y temporal en el centro de México Flor de Mayo Eugenia, new bean cultivar for irrigated and rainfall conditions in Central Mexico

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    Jorge Alberto Acosta Gallegos

    2010-12-01

    Full Text Available Dentro del frijol tipo Flor de Mayo, el subtipo 'media oreja' esta cobrando importancia en el norte-centro de México, éste es de tamaño mediano, forma alargada y color rosa atractivo. Se describe una nueva variedad de este tipo de frijol, Flor de Mayo Eugenia (FME. FME se derivó de una cruza interracial entre Flor de Mayo Anita (FMA (raza Jalisco y Rayado Rojo (raza Nueva Granada. El rendimiento promedio de FME en temporal varia de 0.8 a 2.0 t ha-1 y bajo riego el máximo rendimiento ha sido de 3.8 t ha-1. El peso de 100 semillas promedio de diferentes localidades de FME es significativamente superior al de FMA en condiciones de temporal, 32 vs 26 g 100 semillas, y riego 35 vs 31 g 100 semillas. En cuanto la calidad del grano, el tiempo promedio de cocción de FME en cocedor tipo Mattson es 97 min, mientras que el de FMA es de 109 min; el contenido promedio de proteína del grano de FME es 19% en base a peso seco, similar al de FMA, mientras que el contenido de hierro de FME resultó superior al de FMA con 6.1 vs 5 mg 100 g. FME es tolerante a las razas de roya presentes en el Altiplano de México, a la raza 292 de antracnosis y tolerante a los tizones común y de halo.Within 'Flor de Mayo' bean type, the 'media oreja' subtype is becoming important in North-Central México; this last type has a mid-size elongated seed with showy pink color. A new bean cv. of 'media oreja' subtype is described: Flor de Mayo Eugenia (FME. FME was derived from an interracial cross between Flor de Mayo Anita (FMA (Jalisco breed and Rayado Rojo (Nueva Granada breed. The seed yield of FME under rainfall conditions varied from 0.8 to 2.0 t ha-1 and under irrigation the highest yield recorded was 3.8 t ha-1. The 100-seed weight of FME across different locations was significantly superior to the weight of FMA, 32 vs 26 g per 100 seeds under rainfall conditions and 35 vs 31 g per 100 seeds under irrigation conditions. In regard to seed quality, cooking time average of

  15. La jornada de reconciliación nacional del 5 de mayo de 1958

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    Félix Hernández

    2008-01-01

    Full Text Available En la segunda mitad de la década de los cincuenta la dictadura franquista atravesaba un período de crisis, ante la gravedad de la situación socio-económica que atravesaba el país, es en este contexto en el que el Partido Comunista de España decidió convocar una jornada de movilización contra la dictadura, a la que denominó Jornada de Reconciliación Nacional, para el 5 de mayo de 1958, pese a estar precedida de un período de fuertes protestas sociales los resultados de la misma fueron muy modestos, en este hecho influyeron el propio aislamiento en que se encontraban los comunistas dentro de la oposición antifranquista, como el miedo a la represión, mientras el franquismo continuaría recibiendo el apoyo de las instituciones políticas y grupos sociales sobre las que se asentaba asi como sus apoyos exteriores, lo que le permitiría imponer sus propias soluciones y sobrevivir hasta la muerte del dictador.In the second half of the fifties, the Franco dictatorship was going through a period of crisis given the gravity of the socioeconomic situation that the country was facing. It is in this context that the Spanish Communist Party decided to call mobilization day against dictatorship, which he called National Reconciliation Day, for the 5th of May 1958. Although it was preceded by a period of strong social protest, the results of it were very modest.In this event influenced the isolation itself in which the Communists were inside the anti-Franco opposition, as the fear of repression. While the Franco´s regime would continue receiving the support of political institutions and social groups on which was laid down as well as their external supports, which would enable it to impose its own solutions and survive until the dictator’s death.

  16. Refertilization process in the Patagonian subcontinental lithospheric mantle of Estancia Sol de Mayo (Argentina)

    Science.gov (United States)

    Melchiorre, Massimiliano; Coltorti, Massimo; Gregoire, Michel; Benoit, Mathieu

    2015-05-01

    Anhydrous mantle xenoliths equilibrated at 1003-1040 °C from Estancia Sol de Mayo (ESM, Central Patagonia, Argentina) and entrained in post-plateau alkaline lavas belonging to Meseta Lago Buenos Aires have been investigated aiming at reconstructing the depletion and enrichment processes that affected this portion of the Patagonia lithospheric mantle. Xenoliths are characterized by a coarse-grained protogranular texture and are devoid of evident modal metasomatism. They show two texturally different clinopyroxenes: protogranular (cpx1) and texturally related to spinel (cpx2). Three different types of orthopyroxenes are also recognized: large protogranular crystals with exsolution lamellae (opx1); small clean and undeformed grains without exsolution lamellae (opx2) and small grains arranged in a vein (opx3). Major element composition of clinopyroxenes and orthopyroxenes highlights two different trends characterized by i) a high Al2O3 content at almost constant mg# and ii) a slight increase in Al2O3 content with decreasing mg#. Clinopyroxenes are enriched in LREE and are characterized by prominent to slightly negative Nb, Zr and Ti anomalies. No geochemical differences are observed between cpx1 and cpx2, while a discrimination can be observed between opx1 and opx2 (LREE-depleted; prominent to slightly negative Ti and Zr anomalies) and opx3 (prominent positive Zr anomaly). Partial melting modeling using both major and trace elements indicates a melting degree between ~ 5% and ~ 13% (up to ~ 23% according to major element modeling) for lherzolites and between ~ 20% and ~ 30% for harzburgites (down to ~ 5% according to trace element modeling). La/Yb and Al2O3, as well as Sr and Al2O3 negative correlations in clinopyroxenes point to a refertilization event affecting this lithospheric mantle. The agent was most probably a transitional alkaline/subalkaline melt, as indicated by the presence of orthopyroxene in the vein and the similar geochemical features of ESM

  17. Deluges of Grandeur: Water, Territory, and Power on Northwest Mexico’s Río Mayo, 1880-1910

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    Jeffrey M. Banister

    2011-02-01

    Full Text Available Northwest Mexico’s irrigation landscape, known today as El Distrito de Riego 038, or El Valle del Mayo, issues from historical struggles to build an official order out of a diverse world of signs, symbols, processes, places, and peoples. It is the ancestral home of the Yoreme (Mayo, an indigenous group for whom colonisation and agricultural development have meant the loss of autonomy and of the seasonal mobility required to subsist in an arid land. It is also the birthplace of President Álvaro Obregón, a one-time chickpea farmer who transformed late-19th century irrigation praxis into the laws and institutions of 20th century water management. Reshaping territory for the ends of centralising ('federalising' water resources has always proved exceedingly difficult in the Mayo. But this was particularly so in the beginning of the federalisation process, a time of aggressive modernisation under the direction of President Porfirio Díaz (1876-1910. Research on Mexican hydraulic politics and policy, with some important exceptions, has tended to focus on the scale and scope of centralisation. Scholars have paid less attention to the moments and places where water escapes officials’ otherwise ironclad grasp. This paper explores water governance (and state formation more broadly in the late 19th century, on the eve of Mexico’s 1910 Revolution, as an ongoing, ever-inchoate series of territorial claims and projects. Understanding the weaknesses and incompleteness of such projects offers critical insight into post-revolutionary and/or contemporary hydraulic politics.

  18. Current strategies for the prevention of breast cancer

    OpenAIRE

    Advani P; Moreno-Aspitia A

    2014-01-01

    Pooja Advani, Alvaro Moreno-AspitiaDepartment of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USAAbstract: Due to the high incidence of breast cancer in the United States, optimal strategies for its prevention are imperative. This entails identification of women who are at an increased risk for breast cancer and an integrative approach that includes effective screening methods as well as nutritional, pharmacologic, and surgical management. Several breast cancer risk-assessment tool...

  19. Los programas de desarrollo Micro-Regional: Caso de la Micro-Región Dos de Mayo

    OpenAIRE

    Rosales Albornoz, Edmundo

    1990-01-01

    Los Programas de Desarrollo Micro-Regional están siendo ejecutados por el actual Gobierno Constitucional con la finalidad de impulsar el desarrollo socio-económico de las zonas deprimidas y coordinar las acciones del sector público. El objetivo central de este trabajo es conocer cómo se están ejecutándose dichos Programas, en especial el Programa de Desarrollo Micro-Regional Dos de Mayo en el Departamento de Huánuco, con la finalidad de formular las recomendaciones del caso.

  20. Recursos naturales y género : el caso de la comunidad Once de Mayo (Campeche, México)

    OpenAIRE

    Flecha Legaz, Carla

    2013-01-01

    Este estudio pretende realizar una aproximación al papel de la cooperación en el empoderamiento femenino sobre los recursos naturales en la comunidad rural mexicana Once de Mayo. Para ello se analizan las experiencias de doce participantes en proyectos destinados a mujeres utilizando como medios la historia de vida, la observación participativa y los talleres. De todo ello se desprende la importancia de que los programas y/o proyectos aborden las necesidades prácticas de las mujeres, vinculad...

  1. Actitud del gobierno ante el 1º de mayo, desde 1890 hasta la Segunda República

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    Lucía Rivas Lara

    1988-01-01

    Full Text Available El 1° de Mayo, cuyo origen estuvo en la aspiración obrera a la jornada de ocho horas, se celebró por primera vez en Estados Unidos en 1886, después de muchos años de lucha de los trabajadores en los diversos países por el acortamiento de las jornadas, dado que hasta entonces habían sido de 12 a 16 horas según los lugares. Pero este 1° de mayo de 1886 tuvo un nacimiento espontáneo entre los trabajadores anarquistas norteamericanos, merced a la decisión de un congreso de la Federación Americana del Trabajo (AFL, sin perspectiva de continuidad ni trascendencia más allá de sus fronteras. No obstante, en el marco de su país tuvo un notable éxito consiguiendo con él muchos trabajadores la jornada de ocho horas, y sirviendo de precedente.

  2. CONTRA LA DESPOLITIZACIÓN DE LA MEMORIA. ENTREVISTA CON CARLOS ANTONIO AGUIRRE ROJAS, A PROPÓSITO DE LOS 40 AÑOS DE MAYO DEL 68

    Directory of Open Access Journals (Sweden)

    John Jaime Correa Ramírez

    2008-01-01

    Full Text Available Con motivo de la celebración de los 40 años de mayo del 68, se realizaron algunas conferencias con invitados internacionales en la Universidad Tecnológica de Pereira. Se aprovecho la visita del historiador mexicano Carlos Antonio Aguirre Rojas, para realizar una entrevista en la que ampliara sus conceptos respecto al significado histórico de Mayo del 68, su pervivencia en los imaginarios de muchos movimientos estudiantiles del presente, y al mismo tiempo, sus diferentes percepciones respecto a la historiografía tradicional y al movimiento zapatista.

  3. Salinity monitoring using remote sensing in the 038 Rio Mayo Irrigation District. Sonora, Mexico, by remote sensing; Monitoreo de la salinidad en el Distrito de Riego 038 Rio Mayo Sonora, Mexico, mediante sensores remotos

    Energy Technology Data Exchange (ETDEWEB)

    Pulido Madrigal, L.; Gonzalez Meraz, J.

    2009-07-01

    a soil salinity survey was carried out in the Rio Mayo irrigation district (ID) in 1996, using satellite imagery along with and EM-38 electromagnetic (EM) device. Data from Landsat TM imagery were calibrated with field data, according to the Plant Indicator methodology. This methodology yielded a partial salinity map of the ID, but including only those areas where indicator crops were cultivated. The remaining non-mapped areas were surveyed with an EM-38 electromagnetic device, generating a second partial salinity map. Both partial maps were integrated to get a complete soil salinity map of the ID. In 2001, another soil salinity survey was carried out using solely the EM device. The results of both methodologies were analyzed, resulting in less affected areas in 2001 compared too those obtained in 1996. (Author) 4 refs.

  4. Making Canada a destination for medical tourists: why Canadian provinces should not try to become "Mayo Clinics of the North".

    Science.gov (United States)

    Turner, Leigh

    2012-05-01

    When Canadian researchers examine the subject of medical tourism, they typically focus on ethical, social, public health and health policy issues related to Canadians seeking health services in other countries. They emphasize study of Canada as a departure point for medical tourists rather than as a potential destination for international patients. Several influential voices have recently argued that provincial healthcare systems in Canada should market health services to international patients. Proponents of marketing Canada as a destination for medical tourists argue that attracting international patients will generate revenue for provincial healthcare systems. Responding to such proposals, I argue that there are at least seven reasons why provincial health systems in Canada should not dedicate institutional, financial and health human resources to promoting themselves as destinations for medical tourists.

  5. Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

    Science.gov (United States)

    Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

    2010-03-01

    Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes.

  6. Validation of the revised International Prognostic Score of Thrombosis for Essential Thrombocythemia (IPSET-thrombosis) in 585 Mayo Clinic patients.

    Science.gov (United States)

    Haider, Mahnur; Gangat, Naseema; Lasho, Terra; Abou Hussein, Ahmed K; Elala, Yoseph C; Hanson, Curtis; Tefferi, Ayalew

    2016-06-01

    The primary objective of treatment in essential thrombocythemia (ET) is to prevent thromboembolic complications. In this regard, advanced age and thrombosis history have long distinguished "low" from "high" risk patients. More recently, JAK2V617F and cardiovascular (CV) risk factors were identified as additional modifiers, leading to the development of a 3-tiered International Prognostic Score of Thrombosis for ET (IPSET-thrombosis): "low," "intermediate," and "high". The international data set used to develop IPSET-thrombosis was recently re-analyzed in order to quantify the additional pro-thrombotic effect of JAK2V617F and CV risk factors in specific risk subcategories. The revised IPSET-thrombosis identified four risk categories based on three adverse variables (thrombosis history, age >60 years and JAK2V617F): very low (no adverse features), low (presence of JAK2V617F), intermediate (age >60 years) and high (presence of thrombosis history or presence of both advanced age and JAK2V617F). In this study of 585 patients with ET (median age 68 years; 61% female), we validated the revised IPSET-thrombosis by confirming significant differences in thrombosis risk between "very low" and "low" (HR 2.4, 95% CI 1.1 - 5.3) and between "intermediate" and "high" (HR 2.3, 95% CI 1.1 - 5.2) risk patients. Furthermore, in multivariable analysis, only JAK2V617F (HR=1.8, CI= 1.07 - 2.94) and history of thrombosis (HR=2.1, CI= 1.20 - 3.58) were independently predictive of future thrombotic events. The revised IPSET-thrombosis needs confirmation in prospective studies, especially in terms of risk-adapted therapy that includes the need for aspirin therapy in very low risk, twice-daily aspirin therapy for low risk and cytoreductive therapy for low or intermediate risk patients.

  7. Sex and ethnic differences in 47 candidate proteomic markers of cardiovascular disease: the Mayo Clinic proteomic markers of arteriosclerosis study.

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    Charles X Kim

    Full Text Available BACKGROUND: Cardiovascular disease (CVD susceptibility differs between men and women and varies with ethnicity. This variability is not entirely explained by conventional CVD risk factors. We examined differences in circulating levels of 47 novel protein markers of CVD in 2561 men and women of African-American (AA and non-Hispanic White (NHW ethnicity, enrolled at geographically distinct sites. METHODOLOGY/PRINCIPAL FINDINGS: Participants (1,324 AAs, mean age 63.5 y, 71% women; 1,237 NHWs, mean age 58.9 y, 57% women belonged to sibships ascertained on the basis of hypertension. Solid-phase immunoassays and immunoturbidometric, clot-based, chromogenic, and electrophoretic assays were used to measure the 47 protein markers in plasma or serum. Marker levels were log transformed and outliers were adjusted to within 4 SD. To identify markers independently associated with sex or ethnicity, we employed multivariable regression analyses that adjusted for conventional risk factors, prior history of CVD, medication use and lifestyle factors (physical activity, alcohol consumption and education. Generalized estimating equations were used to correct for intrafamilial correlations. After adjustment for the above covariates, female sex was associated with higher levels of 29 markers and lower levels of 6 markers. Female sex was independently associated with higher levels of several inflammatory markers as well as lipoproteins, adipokines, natriuretic peptides, vasoconstrictor peptides and markers of calcification and thrombosis. AA ethnicity was associated with higher levels of 19 markers and lower levels of 6 markers, including higher levels of several inflammatory makers, higher leptin and lower adiponectin levels, lower levels of vasodilator-natriuretic peptides, higher levels of vasoconstrictor-antidiuretic peptides and markers of calcification and thrombosis. CONCLUSIONS/SIGNIFICANCE: Plasma levels of several novel protein markers of CVD differ significantly in the context of sex and ethnicity. These results have implications for individualized CVD risk assessment.

  8. A brief report on WAIS-R normative data collection in Mayo's Older African Americans Normative Studies.

    Science.gov (United States)

    Lucas, John A; Ivnik, Robert J; Smith, Glenn E; Ferman, Tanis J; Willis, Floyd B; Petersen, Ronald C; Graff-Radford, Neill R

    2005-06-01

    Historically, neuropsychological measures such as the Wechsler Adult Intelligence Scale-Revised (WAIS-R) have yielded unacceptably high rates of misdiagnosis of impairment among cognitively normal African Americans, primarily due to poor test specificity and inadequate representation of ethnic minorities in the normative sample. In this report, we briefly review these issues and describe efforts by investigators in Mayo's Older African Americans Normative Studies (MOAANS) to develop more appropriate norms for African American elders on the WAIS-R. During MOAANS data collection, the third edition of the WAIS (WAIS-III) was introduced with updated representation of ethnic minorities in the normative database. More recently, specific demographic corrections for African Americans have been derived for WAIS-III subtest scores and indices. As such, WAIS-R normative estimates are not presented here. Interested readers who wish to obtain a full set of MOAANS WAIS-R norms, however, are invited to contact the authors for these data.

  9. Gastrointestinal helminths of Gentoo penguins (Pygoscelis papua) from Stranger Point, 25 de Mayo/King George Island, Antarctica.

    Science.gov (United States)

    Diaz, Julia Inés; Fusaro, Bruno; Longarzo, Lucrecia; Coria, Néstor Rubén; Vidal, Virginia; Jerez, Silvia; Ortiz, Juana; Barbosa, Andrés

    2013-05-01

    The aim of this work is to contribute to the knowledge of gastrointestinal parasites of the Gentoo penguin (Pygoscelis papua) from 25 de Mayo/King George Island (South Shetlands, Antarctica). Gastrointestinal tracts of 37 fresh dead individuals (21 chicks, 10 juveniles, and 6 adults) were collected from December 2006 to February 2012 and examined for macroparasites. Four adult parasite species were found: one Cestoda species (Parorchites zederi), two Nematoda species (Stegophorus macronectes and Tetrameres wetzeli), and one Acanthocephalan (Corynosoma shackletoni). Two species of immature acanthocephalans, Corynosoma hamanni and Corynosoma bullosum, were found in a single host. This is the first record of Tetrameres wetzeli in Gentoo penguins. The low parasite richness observed could be related to the stenophagic and pelagic diet of this host species which feeds almost exclusively on krill.

  10. A look into the 21st century as viewed by a Mayo Health System patient care executive.

    Science.gov (United States)

    McBeth, A

    2000-01-01

    The 21st century needs to be dedicated to the broader vision of building healthy communities. The challenge for us as leaders in the communities in which we live and work will be to develop a nondisparate shared vision of health that serves all populations from birth to death. Disparity benchmarks and indicators will be key in order to achieve the U.S. Surgeon General's commitment to eliminate the disparities in health in this new century. Florence Nightingale's 19th century vision of creating an environment of healing--together with the Mayo brothers' primary value that the needs of the patient come first, which were set forth during the same time period--needs to guide us as we embark upon our 21st century journey.

  11. The US Supreme Court in Mayo v. Prometheus - Taking the fire from or to biotechnology and personalized medicine?

    DEFF Research Database (Denmark)

    Minssen, Timo; Nilsson, David

    2012-01-01

    On 20 March 2012, the US Supreme Court handed down its much awaited patent eligibility- ruling in the dispute between Prometheus Laboratories Inc (“Prometheus”), acting as plaintiffs, and Mayo Medical Laboratories (“Mayo”), as alleged infringers of Prometheus’ licensed patents. This case review w...... including some comparative European views (4). The paper concludes with general remarks (5)....

  12. Annual Proceedings of Selected Research and Development Papers Presented at the Annual Convention of the Association for Educational Communications and Technology - Volume 1 and Selected Papers on the Practice of Educational Communications and Technology - Volume 2 (34th, Jacksonville, Florida, 2011)

    Science.gov (United States)

    Simonson, Michael, Ed.

    2011-01-01

    For the thirty-fourth year, the Association for Educational Communications and Technology (AECT) is sponsoring the publication of these Proceedings. Papers published in this volume were presented at the annual AECT Convention in Jacksonville, FL. A limited quantity of these Proceedings were printed and sold in both hardcopy and electronic…

  13. Rendimiento y reacción a enfermedades en frijol tipo Flor de Mayo en riego y temporal Seed yield and disease reaction in Flor de Mayo bean type grown under irrigation and rainfed conditions

    Directory of Open Access Journals (Sweden)

    Jorge Alberto Acosta Gallegos

    Full Text Available El frijol tipo Flor de Mayo es de alta demanda entre los consumidores del centro de México, su producción se realiza en las regiones de la Mesa Central, El Bajío y Semiárida. El objetivo fue determinar el rendimiento, peso de la semilla y reacción a enfermedades de un grupo de 14 líneas y dos testigos a través de 14 ambientes, 10 de temporal y cuatro de riego. Los ensayos se condujeron durante los ciclos primavera-verano 2008 y otoño-invierno 2008-2009. Se realizaron análisis de conjunto y por ensayos de temporal y de riego en forma independiente. Diferentes enfermedades atacaron al cultivo a través de los sitios de prueba; bajo temporal, las de mayor distribución fueron la bacteriosis común (Xanthomonas campestris pv phaseoli y la mancha angular (Phaeoisariopsis griseola; mientras que la antracnosis (Colletotrichum lindemuthianum y el mildiú velloso (Phythohpthora phaseoli mostraron un fuerte ataque en Calera, Zacatecas y Celaya, Guanajuato, respectivamente. El ambiente de mayor rendimiento promedio fue Celaya bajo riego (4.15 t ha-1 y el menor se obtuvo en Texcoco bajo temporal (0.90 t ha-1. El análisis conjunto detecto diferencias significativas (pThe 'Flor de Mayo' bean type is highly demanded by consumers in Central Mexico, its production takes place at the semiarid, El Bajio and the central plateau regions. The aim was to test a set of 14 bred lines plus two checks across 10 rainfed locations and four irrigated sites on the basis of seed yield, 100-seeds weight and disease reaction. Trials were conducted in the spring-summer season 2008 and fall-winter season 2008-2009. Data analyses were conducted including all test sites, and independently rainfed and irrigated sites. Different diseases attacked the crop across test sites; those widely distributed were common bacterial blight (Xanthomonas campestris pv phaseoli and angular leaf spot (Phaeoisariopsis griseola; whereas anthracnose (Colletotrichum lindemuthianum and downy

  14. A designated centre for people with disabilities operated by Western Care Association, Mayo

    LENUS (Irish Health Repository)

    Fitzgerald, C

    2016-04-27

    In an era when clinical microbiology laboratories are under increasing financial pressure, there is a need for inexpensive, yet effective, rapid microbiology tests. The aim of this study was to evaluate a novel modification of standard methodology for the identification and antimicrobial susceptibility testing (AST) of pathogens in positive blood cultures, reducing the turnaround time of laboratory results by 24 h.

  15. A designated centre for people with disabilities operated by The Cheshire Foundation in Ireland, Mayo

    LENUS (Irish Health Repository)

    Hogan, A E

    2011-11-01

    The innate immune cells, invariant natural killer T cells (iNKT cells), are implicated in the pathogenesis of psoriasis, an inflammatory condition associated with obesity and other metabolic diseases, such as diabetes and dyslipidaemia. We observed an improvement in psoriasis severity in a patient within days of starting treatment with an incretin-mimetic, glucagon-like peptide-1 (GLP-1) receptor agonist. This was independent of change in glycaemic control. We proposed that this unexpected clinical outcome resulted from a direct effect of GLP-1 on iNKT cells.

  16. Holoceno marino en la península Potter, Isla 25 de Mayo, Antártida

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    R.A. del Valle

    2007-03-01

    Full Text Available La sucesión sedimentaria del Holoceno temprano expuesta en la terraza marina de 3,77 m s.n.m. en la costa sur de la caleta Potter (Isla 25 de Mayo/King George Island, islas Shetland del Sur, Antártida contiene invertebrados marinos, algas y huesos de foca y pingüino. Dataciones por radiocarbono de huesos de pingüino obtenidos en esta sucesión dieron edades de 7.562 a cal AP (años calibrados antes del Presente y 7.414 a cal AP. Las dataciones indican que los huesos están entre los restos de vertebrados más antiguos del Holoceno hallados en las Islas Shetland del Sur, y pueden ser consideradas como edades mínimas de ocupación por estas aves de las costas de las islas en el Holoceno temprano. Esto indica condiciones interglaciales en esa época, con situación clima/hielo marino similar a la presente y condiciones marinas estacionalmente abiertas.

  17. El primero de mayo en la ciudad de México en los tiempos de la revolución.

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    Anna Ribera Carb\\u00F3

    2006-01-01

    Full Text Available De entre las tradiciones inventadas por los trabajadores del mundo, la más exitosa es, sin duda, la del Primero de Mayo que sirvió para cohesionar a grupos obreros de distinta denominación ideológica y a crear entre ellos conciencia de clase como ninguna otra. En México la conmemoración empezó a realizarse de manera tardía. Fue en 1913 cuando se organizó en la ciudad de México la primera manifestación masiva a partir de la iniciativa de la Casa del Obrero Mundial fundada un año antes y vinculada al pensamiento anarcosindicalista. Fue justamente con esta manifestación que la clase obrera empezó a construir su propio espacio en la capital del país y convirtió a la Casa del Obrero Mundial en un elemento fundamental del entramado político de la Revolución Mexicana.

  18. Outcome prediction in home- and community-based brain injury rehabilitation using the Mayo-Portland Adaptability Inventory.

    Science.gov (United States)

    Malec, James F; Parrot, Devan; Altman, Irwin M; Swick, Shannon

    2015-01-01

    The objective of the study was to develop statistical formulas to predict levels of community participation on discharge from post-hospital brain injury rehabilitation using retrospective data analysis. Data were collected from seven geographically distinct programmes in a home- and community-based brain injury rehabilitation provider network. Participants were 642 individuals with post-traumatic brain injury. Interventions consisted of home- and community-based brain injury rehabilitation. The main outcome measure was the Mayo-Portland Adaptability Inventory (MPAI-4) Participation Index. Linear discriminant models using admission MPAI-4 Participation Index score and log chronicity correctly predicted excellent (no to minimal participation limitations), very good (very mild participation limitations), good (mild participation limitations), and limited (significant participation limitations) outcome levels at discharge. Predicting broad outcome categories for post-hospital rehabilitation programmes based on admission assessment data appears feasible and valid. Equations to provide patients and families with probability statements on admission about expected levels of outcome are provided. It is unknown to what degree these prediction equations can be reliably applied and valid in other settings.

  19. The cosmic background: evolution of infrared galaxies and dust properties. A lecture dedicated to the memory of Mayo Greenberg

    CERN Document Server

    Puget, J L; Dole, H; Puget, Jean-Loup; Lagache, Guilaine; Dole, Herve

    2004-01-01

    In recent years it became clear that a population of galaxies radiating most of their power in the far-infrared contribute an important part of the whole star formation activity in the universe. These galaxies emit up to 99% of their energy output in the infrared by dust. The optical properties of dust in galaxies are thus very important to understand this population. Mayo Greenberg who has brought many of the ideas underlying our understanding of the physics of interstellar dust has been a pioneer in predicting the important role of organic solid material formed on dust grains in molecular clouds and of potential importance of transient heating of very small particles. It appeared with the ISO data on galaxies and even more today with the first Spitzer data that these mechanisms are important globally for the observations of infrared galaxies at significant redshifts. The understanding of their evolution is one of the keys to the understanding of galaxy built up and evolution.

  20. Los movimientos sociales en la transición democrática. El caso de las Madres de Plaza de Mayo: sentimiento y discurso

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    Martín D'ALESSANDRO

    2009-11-01

    Full Text Available RESUMEN: El presente artículo hace un repaso por el surgimiento y consolidación de Madres de Plaza de Mayo como movimiento social que inició sus actividades cuestionando la lucha antisubversiva emprendida por la dictadura militar argentina. Plantea además como este movimiento ha sufrido una radicalización de su discurso en la época de la transición a la democracia, cuando se desarrolla el enjuiciamiento de las Juntas Militares, y a partir de ese momento deciden enfrentarse al "sistema burgués". El discurso de Madres de Plaza de Mayo es inicialmente ético y moral para posteriormente adquirir matices de izquierda.ABSTRACT: This article analyzes the emergence and consolidation of the "Madres de Plaza de Mayo" as a social movement which initiated its action questioning the repressive policies led by the Argentine military dictatorship. It shows how the "Madres" undertook a radicalization of its discourse during the democratic transition, as the military "Juntas" were tried by Argentine courts. At this moment, the "Madres" dcided to struggle against the "bourgeois system." The discourse of the Madres was initially ethical and moral, and it became later left wing oriented.

  1. A designated centre for people with disabilities operated by Western Care Association, Mayo

    LENUS (Irish Health Repository)

    Brennan, Gráinne I

    2012-03-01

    Sequence type 22 (ST22) methicillin-resistant Staphylococcus aureus (MRSA) harboring staphylococcal cassette chromosome mec (SCCmec) IV (ST22-MRSA-IV) has predominated in Irish hospitals since the late 1990s. Six distinct clones of community-associated MRSA (CA-MRSA) have also been identified in Ireland. A new strain of CA-MRSA, ST772-MRSA-V, has recently emerged and become widespread in India and has spread into hospitals. In the present study, highly similar MRSA isolates were recovered from seven colonized neonates in a neonatal intensive care unit (NICU) in a maternity hospital in Ireland during 2010 and 2011, two colonized NICU staff, one of their colonized children, and a NICU environmental site. The isolates exhibited multiantibiotic resistance, spa type t657, and were assigned to ST772-MRSA-V by DNA microarray profiling. All isolates encoded resistance to macrolides [msr(A) and mpb(BM)] and aminoglycosides (aacA-aphD and aphA3) and harbored the Panton-Valentine leukocidin toxin genes (lukF-PV and lukS-PV), enterotoxin genes (sea, sec, sel, and egc), and one of the immune evasion complex genes (scn). One of the NICU staff colonized by ST772-MRSA-V was identified as the probable index case, based on recent travel to India. Seven additional hospital and CA-ST772-MRSA-V isolates recovered from skin and soft tissue infections in Ireland between 2009 and 2011 exhibiting highly similar phenotypic and genotypic characteristics to the NICU isolates were also identified. The clinical details of four of these patients revealed connections with India through ethnic background or travel. Our study indicates that hospital-acquired and CA-ST772-MRSA-V is currently emerging in Ireland and may have been imported from India on several occasions.

  2. Reglamento del Instituto para el Desarrollo Empresarial (INDEM), aprobado por el Consejo de Gobierno en sesión de 3 de diciembre de 2004 y modificado en sesión de 16 de mayo de 2013

    OpenAIRE

    2013-01-01

    El "Instituto universitario Carmen Vidal Ballester sobre desarrollo empresarial" pasó a denominarse "Instituto para el desarrollo empresarial (INDEM)" tras la sesión del Consejo de Gobierno de 16 de mayo de 2013.

  3. Utility of the Mayo End-Stage Liver Disease (MELD score in assessing prognosis of patients with alcoholic hepatitis

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    Patel Tushar

    2002-01-01

    Full Text Available Abstract Background Alcoholic hepatitis is characterized by acute, or acute-on-chronic hepatic failure and associated with a high mortality. Specific therapies should be considered for those at high risk of mortality. The Mayo End-Stage Liver Disease (MELD score is a marker of disease severity and mortality in persons with chronic alcoholic liver disease. Our aims were to assess the utility of the MELD score as a predictor of short-term mortality in persons with alcoholic hepatitis. Methods We assessed the utility of the MELD score and compared it with the Discriminant Function (DF as a predictor of mortality in 34 patients hospitalized with alcoholic hepatitis. Results The area under the curve of a receiver operating characteristic curve for the MELD score was 0.82 (confidence intervals 0.65–0.98, and for the DF was 0.86 (confidence intervals 0.70–1.00. However, the sensitivity and specificity in predicting 30-day mortality for a MELD score of greater than 11 was 86% and 81%, but for a DF greater than 32 was 86% and 48% respectively. The presence of ascites and bilirubin greater than 8 mg/dL were also highly predictive of mortality with a sensitivity of 71% and a specificity of 96%. Conclusions Alcoholic hepatitis remains associated with a high mortality in hospitalized patients. The MELD score performs as well as the DF in predicting mortality at 30 days. A MELD score of greater than 11, or the presence of both ascites and an elevated bilirubin greater than 8 mg/dL should prompt consideration of specific therapeutic interventions to reduce mortality.

  4. Cephalopoda as prey of juvenile Southern elephant seals at Isla 25 de Mayo/King George, South Shetland Islands

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    Luciana Burdman

    2015-03-01

    Full Text Available The aim of the present study was to enhance the knowledge of the feeding habits of the juvenile component of the population of Southern elephant seals [Mirounga leonina (Linnaeus, 1758] from Isla 25 de Mayo, South Shetland Islands, age class whose diet information is scarce. A total of 60 individuals were stomach lavaged in the spring - summer seasons of three consecutive years (2003, 2004 and 2005 of which 53.3 % (n = 32 presented food remnants. The Antarctic glacial squid Psychroteuthis glacialis Thiele, 1921 was the dominant prey taxon in terms of frequency of occurrence (68.7%, numerical abundance (60.1% and biomass (51.5%, contributing 84.1% to the total relative importance index. Other squid prey species of importance were Slosarczykovia circumantartica Lipinski, 2001 in terms of occurrence (37.5% and numerical abundance (14% and Moroteuthis knipovitchi Filippova, 1972 in terms of biomass (16%. All identified cephalopod prey taxa are distributed south of the Antarctic Polar Front, except for the squid Martialia hyadesi Rochebrune & Mabille, 1889 which has a circumpolar distribution associated to the Polar Frontal Zone. No significant differences in the sizes of P. glacialis preyed upon by elephant seals were found between sexes and years. However, significant interannual differences were found in the taxonomical composition of their diet. This would be associated with temporal changes in food availability at the foraging areas of seals, which in turn may have been influenced by changes in oceanographic conditions as a result of the El Niño Southern Oscillation (ENSO phenomenon that occurred during part of the study period. Furthermore, a differential response of males and females to this temporal variation was observed, with the former being also associated to a predation on octopods. This would suggest a sexual segregation in foraging habits of this species from the early stages of its life cycle.

  5. Salida de campo a La Tour du Valat y La Capeliére (La Camarga, Francia) el 21 de mayo de 1954

    OpenAIRE

    Valverde Gómez, José Antonio, 1926-2003

    2008-01-01

    Salida de campo a La Tour du Valat y La Capeliére (La Camarga, Francia) el 21 de mayo de 1954, de la que se anotaron observaciones sobre ranas, los siguientes peces: Anguilla anguilla (Anguila), "Carp. sol", Cyprinus carpio (Carpa) y Gambusia holbrooki (Gambusia), el reptil Natrix natrix (Culebra de collar, llamada Tropidonotus natrix por el autor), los siguientes mamíferos: Mus spicilegus (Ratón), Mustela nivalis (Comadreja) y Rattus norvegicus (Rata parda, llamada E.norvegicus por el autor)...

  6. Una aproximación a la demanda de los principales agregados monetarios en el Perú : Junio 1991-mayo 1997

    OpenAIRE

    Quispe Misaico, Zenón

    1998-01-01

    El presente informe resume los resultados de la estimación de la demanda por los principales agregados monetarios en el Perú en el período comprendido entre junio de 1991 y mayo de 1997. Luego de un examen exhaustivo de especificaciones alternativas para agregados monetarios de distintos grados de liquidez y para varios períodos muestrales se ha podido identificar al menos una relación de equilibrio de largo plazo para cada agregado monetario con relación al producto bruto interno (PBI), a la...

  7. Tratamiento de la escuela de las relaciones humanas (trabajos paralelos y posteriores a Elton Mayo) desde algunas perspectivas contemporáneas

    OpenAIRE

    Caicedo Botero, Natalia

    2010-01-01

    Se realizó una investigación de tipo exploratoria-descriptiva, con el objetivo primordial de analizar comparativamente desde un enfoque cualitativo el tratamiento que se le ha dado a la escuela de las relaciones humanas (trabajos paralelos y posteriores a Elton Mayo), desde algunas perspectivas contemporáneas y rescatar su papel protagónico en el surgimiento, desarrollo y evolución de la teoría organizacional, al igual que sus limitaciones y distorsiones; lo cual, implica un recorrido hist...

  8. ¿Quién ganó las elecciones autonómicas y municipales celebradas el 27 de mayo de 2007 en España?

    Directory of Open Access Journals (Sweden)

    Gema Sánchez Medero

    2008-01-01

    Full Text Available A lo largo de este artículo se analizan las elecciones municipales y autonómicas celebradas en España el 27 de mayo de 2007 para conocer cuál partido realmente salió reforzado para las próximas elecciones legislativas a celebrarse el 9 de marzo de 2008. Aunque en un principio pareciera que el gran ganador ha sido el Partido Popular, otros partidos, sin alcanzar las cifras de los dos grandes partidos nacionales, han obtenido resultados que les han convertido en piezas claves dentro del sistema político español.

  9. Prevalencia de fluorosis en niños de 10 a 14 años en el municipio de Cajibio de marzo a mayo de 2011

    OpenAIRE

    González Varona, María Andrea; Pazos Vivas, Gloria Alexandra

    2011-01-01

    Generar un informe dirigido a las entidades pertinentes (Secretaria de Salud) acerca de la prevalencia del estado de fluorosis de los niños de 10 - 14 años en el Municipio de Cajibio, que asisten a la consulta odontológica entre Marzo 1 a Mayo 30 de 2011, para con los hallazgos encontrados, iniciar el diseño de ideas que por medio de un trabajo conjunto, a largo plazo, permitan marcar las directrices en la prevención de la fluorosis y sus consecuencias.

  10. The impact of Myriad and Mayo: will advancements in the biological sciences be spurred or disincentivized? (Or was biotech patenting not complicated enough?).

    Science.gov (United States)

    Gordon, Jennifer

    2014-12-11

    For years, purified and isolated naturally occurring biological substances of great medical importance--including genes--have been the subject of U.S. patents. Similarly, methods in which the detection of a biological substance (e.g., in a blood sample) dictates subsequent actions, as in disease diagnostics and treatment, have long enjoyed patent protection. However, two recent Supreme Court cases, Association for Molecular Pathology v. Myriad Genetics, Inc. (133 S. Ct. 2107) (2013) and Mayo Collaborative Services v. Prometheus Laboratories, Inc. (132 S. Ct. 1289) (2012), have shaken up the status quo of biotech patenting. The highest court in our land unanimously agreed with patent challengers that much of what we took for granted as patentable subject matter is not, as a matter of law, eligible for patenting after all. This review discusses the Myriad and Mayo cases, their impact on which biology-based innovations we may or may not continue to patent, and whether the altered status quo is benignly corrective or gravely disruptive. Is what happened here a good thing or not?

  11. Stemcell Information: SKIP000919 [SKIP Stemcell Database[Archive

    Lifescience Database Archive (English)

    Full Text Available a Thatava Tayaramma Thatava Department of Molecular Medicine, Mayo Clinic Department... of Molecular Medicine, Mayo Clinic ... Information Only Department of Molecular Medicine, Mayo Clinic Department

  12. Stemcell Information: SKIP000918 [SKIP Stemcell Database[Archive

    Lifescience Database Archive (English)

    Full Text Available a Thatava Tayaramma Thatava Department of Molecular Medicine, Mayo Clinic Department... of Molecular Medicine, Mayo Clinic ... Information Only Department of Molecular Medicine, Mayo Clinic Department

  13. Diluvios de grandeza: agua, territorio y poder en el río Mayo en el noroeste de México, 1880-1910

    Directory of Open Access Journals (Sweden)

    Jeffrey M. Banister

    2012-01-01

    Full Text Available El actual distrito de riego 038 o valle del Mayo, que forma parte del espacio de riego del noroeste de México, surge de luchas históricas por construir un orden oficial en un mundo diverso de signos, símbolos, procesos, lugares y personas. Es el hogar ancestral de los yoremes (mayos, un grupo indígena para el que la colonización y el desarrollo agrícola han significado la pérdida de autonomía y de la movilidad estacional que requieren para subsistir en un terreno árido. Es el lugar donde nació el presidente Álvaro Obregón, otrora productor de garbanzo, que transformó las prácticas de riego de fines del siglo xix en las leyes e instituciones para la administración del agua del siglo xx. Reconfigurar el territorio con el fin de centralizar ("federalizar" los recursos hídricos ha probado ser excesivamente difícil en la zona del Mayo, pero esto fue así en particular al inicio del proceso de federalización, una época de modernización dinámica bajo la dirección del presidente Porfirio Díaz (1876-1910. La investigación sobre la política hidráulica de México, con algunas importantes excepciones, ha tendido a enfocarse en la centraliza- ción. Los estudiosos le han prestado menor atención a los momentos y lugares en los que el agua escapa al control de las autoridades. Este trabajo explora la importancia de la administración del agua (y más ampliamente la formación del Estado a finales del siglo xix, en vísperas de la Revolución Mexicana de 1910, como una serie continua, siempre incipiente de derechos y proyectos relativos a las tierras. Entender las debilidades e incompetencias de dichos proyectos ofrece un discernimiento crucial acerca de la política hidráulica posrevolucionaria o contemporánea.

  14. SU-E-J-171: Evaluation of Cervical Spine and Mandible Reproducibility of the CDR Mayo Mold and Civco Type-S Head and Neck Immobilization Systems.

    Science.gov (United States)

    Chungbin, S

    2012-06-01

    To evaluate the cervical spine (c-spine) and mandible reproducibility of the CDR Mayo Mold and Civco Type-S head and neck immobilization system using Mosaiq Setup Intelligence Curve Image Registration Methods: Patients were immobilized with either the Mayo Mold or Civco Type-S head and neck immobilization systems. Using curve image registration tools in Mosaiq, the c-spine and mandible were outlined. For each lateral image, two separate image registrations were performed using an initial kV image as reference - 1) c-spine only 2) mandible only. To evaluate the relative difference between the c-spine and mandible position, the mandible image registration results were subtracted from the c-spine image registration results. To evaluate whether the initial difference between the planning CT and the first kV setup image is larger than subsequent daily imaging variations, the difference in the image registration of the DRR was compared to the variation in subsequent image registrations. The degree of neck flexion was determined by observing the amount of mismatch between the upper and lower cervical spine after the pitch correction. During the first weeks of treatment, there was minimal difference in the image registration results for both the c-spine and mandible individually, and in the relative difference between them. For neck flexion, the Mayo Mold system demonstrated 82.6% minimal difference and 3.8% significant difference between the alignment of upper and lower c spine, vs. 84% and 5.2% for the S frame. For some patients, there is a greater difference between the DRR and the initial kV image registration than the variation in registrations for subsequent daily imaging. Preliminary results indicate minimal difference in the c-spine and mandible reproducibility between the two immobilization systems during the first weeks of treatment. Further analysis of whether this minimal difference remains consistent throughout the entire course and treatment and with greater

  15. La violencia de género y el principio de igualdad ante la Ley (Comentario a la STC 59/2008, de 14 de mayo)

    OpenAIRE

    2010-01-01

    En este artículo se examina la sentencia del Tribunal Constitucional español 59/2008, de 14 de mayo, que desestima la cuestión de inconstitucionalidad por vulneración del mandato de igualdad en relación a la discriminación por razón de sexo que contempla el artículo 153.1 del Código Penal, en su redacción dada por el artículo 37 de la Ley Orgánica 1/2004, de 28 de diciembre, de Medidas de Protección Integral contra la Violencia de Género. Para llevar a cabo este análisis, se realizará una bre...

  16. Chemistry and origin of the Mayo Kila sapphires, NW region Cameroon (Central Africa): Their possible relationship with the Cameroon volcanic line

    Science.gov (United States)

    Paul Mbih, Kemeng; Meffre, Sebastien; Yongue, Rose Fouateu; Kanouo, Nguo Sylvestre; Jay, Thomson

    2016-06-01

    Mineralogical, chemical and geochronological studies constrained the origin of sapphires from Mayo Kila, Northwest Cameroon. The sapphires are mostly blue, with sizes ranging from 2 to 5 mm. The pale blue grains are transparent, whereas, other corundums are transparent to translucent and/or opaque. The sapphires are dominantly euhedral to sub-hedral with few polished lustrous grains, acquired features during moderate to short distance transport from a proximal source rock. Solid inclusions are limited to rutile and zircon. Trace element analysis of sapphires shows significant concentration (in ppm) in some elements: Fe (2208-14,473), Ti (82-1783), Ga (77-512), Mg (0.9-264.9), Cr (b.d.l -168) and V (1.3-82). The other elements (e.g. Sn, Nb, Ta, Th, Zr, Ni, Ce) are generally below 10 ppm. The calculated ratios for some of the selected elements show an extreme variation: Fe/Mg (43-3043), Fe/Ti (2-76), Ti/Mg (1-328), and Ga/Mg (0.4-363). They are dominantly corundum crystallized in alkaline magma (s) with few from metamorphic source (s). Trace elemental features with Hf (13,354-26,238 ppm), Th (4018-45,584 ppm) and U (7825-17,175 ppm), and Th/U (0.39-2.65) found in zircon inclusions are compatible with quantified values in magmatic crystallized zircons. The Cenozoic age (mean of 30.78 ± 0.28 Ma) obtained for zircon inclusions is close to the age of some igneous rocks found within the Cameroon Volcanic Line (e.g. rocks of the Mount Oku: 31-22 Ma), showing the same period of formation. The most probable source of the zircon host sapphires is the Oku Mountain located SW of Mayo Kila.

  17. De la resistencia a la integración. Las transformaciones de la Asociación Madres de Plaza de Mayo en la "era Kirchner" From the Resistance to the Integration. The Transformations of the Mothers of Plaza de Mayo in the "Age Kirchner"

    Directory of Open Access Journals (Sweden)

    Enrique Andriotti Romanin

    2012-12-01

    Full Text Available A partir de la presidencia de Néstor Kirchner algunos organismos del movimiento de derechos humanos de Argentina decidieron progresivamente acompañar las políticas de Estado y, en algunos casos, incorporarse a las estructuras gubernamentales. Entre estos se destaca la Asociación Madres de Plaza de Mayo de Argentina, que históricamente ha confrontado con el Estado y los distintos gobiernos, tras el retorno de la democracia en 1983. En este trabajo se analizan algunos aspectos de los cambios en las estrategias, marcos de acción colectiva y claves interpretativas acerca del Estado y la política que elabora esta asociación durante el periodo 2003-2010, con el objetivo de comprender los factores que explican el pasaje de una estrategia dominante de confrontación a una de integración al Estado por parte de esta organización, tal vez la más emblemática del movimiento de derechos humanos de Argentina. Para su realización se utilizan fuentes de información primaria, especialmente discursos y documentos de la organización seleccionados entre la enorme cantidad de material que ha producido la Asociación Madres de Plaza de Mayo, y fuentes secundarias como diarios y revistas argentinas de circulación nacional.From the presidency of Nestor Kirchner some agencies of the human rights movement in Argentina decided to progressively follow state politics and, in some cases, be incorporated into government structures. These highlighted the Mothers of Plaza de Mayo, which had historically confronted with the state and the various governments since the return of democracy in 1983.This paper discusses some aspects of the changes in strategies, collective action frames and key interpretations about state and politics that produced this association during the period 2003-2010 with the aim of: Understanding the factors behind the passage of a dominant strategy of confrontation to one of integration to the state by the organization, perhaps, the most

  18. Descriptive Analysis of Medication Administration During Inpatient Cardiopulmonary Arrest Resuscitation (from the Mayo Registry for Telemetry Efficacy in Arrest Study).

    Science.gov (United States)

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Dumitrascu, Adrian; Harris, Dana; Bosworth, Veronica; Clark, Brooke; Thomas, Colleen S; Heckman, Michael G; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline

    2016-05-15

    Advanced cardiovascular life support guidelines exist, yet there are variations in clinical practice. Our study aims to describe the utilization of medications during resuscitation from in-hospital cardiopulmonary arrest. A retrospective review of patients who suffered a cardiopulmonary arrest from May 2008 to June 2014 was performed. Clinical and resuscitation data, including timing and dose of medications used, were extracted from the electronic medical record and comparisons made. A total of 94 patients were included in the study. Patients were divided into different groups based on the medication combination used during resuscitation: (1) epinephrine; (2) epinephrine and bicarbonate; (3) epinephrine, bicarbonate, and calcium; (4) epinephrine, bicarbonate, and epinephrine drip; and (5) epinephrine, bicarbonate, calcium, and epinephrine drip. No difference in baseline demographics or clinical data was present, apart from history of dementia and the use of calcium channel blockers. The number of medications given was correlated with resuscitation duration (Spearman's rank correlation = 0.50, p <0.001). The proportion of patients who died during the arrest was 12.5% in those who received epinephrine alone, 30.0% in those who received only epinephrine and bicarbonate, and 46.7% to 57.9% in the remaining groups. Patients receiving only epinephrine had shorter resuscitation durations compared to that of the other groups (p <0.001) and improved survival (p = 0.003). In conclusion, providers frequently use nonguideline medications in resuscitation efforts for in-hospital cardiopulmonary arrests. Increased duration and mortality rates were found in those resuscitations compared with epinephrine alone, likely due to the longer resuscitation duration in the former groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Cold Sore

    Science.gov (United States)

    ... fluid-filled blisters typically break out along the border where the outside edge of the lips meets ... MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo ...

  20. Postherpetic Neuralgia

    Science.gov (United States)

    ... possibly touching it in places to determine the borders of the affected area. In most cases, no ... MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo ...

  1. Breast Lumps

    Science.gov (United States)

    ... You might notice: A distinct lump with definite borders A firm, hard area within your breast A ... MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo ...

  2. Livedo Reticularis: When Is It a Concern?

    Science.gov (United States)

    ... in sort of a netlike pattern with distinct borders. Sometimes livedo reticularis is simply the result of ... MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo ...

  3. Mayo Registry for Telemetry Efficacy in Arrest (MR TEA) study: An analysis of code status change following cardiopulmonary arrest.

    Science.gov (United States)

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Chirila, Razvan; Maniaci, Michael; Bosworth, Veronica; Whitman, Anastasia; Lewis, Patricia; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline

    2015-07-01

    Code status discussions are important during a hospitalization, yet variation in its practice exists. No data have assessed the likelihood of patients to change code status following a cardiopulmonary arrest. A retrospective review of all patients that experienced a cardiopulmonary arrest between May 1, 2008 and June 30, 2014 at an academic medical center was performed. The proportion of code status modifications to do not resuscitate (DNR) from full code was assessed. Baseline clinical characteristics, resuscitation factors, and 24-h post-resuscitation, hospital, and overall survival rates were compared between the two subsets. A total of 157 patients survived the index event and were included. One hundred and fifteen (73.2%) patients did not have a change in code status following the index event, while 42 (26.8%) changed code status to DNR. Clinical characteristics were similar between subsets, although patients in the change to DNR subset were older (average age 67.7 years) compared to the full code subset (average age 59.2 years; p = 0.005). Patients in the DNR subset had longer overall resuscitation efforts with less attempts at defibrillation. Compared to the DNR subset, patients that remained full code demonstrated higher 24-h post-resuscitation (n = 108, 93.9% versus n = 32, 76.2%; p = 0.001) and hospital (n = 50, 43.5% versus n = 6, 14.3%; p = 0.001) survival rates. Patients in the DNR subset were more likely to have neurologic deficits on discharge and shorter overall survival. Patient code status wishes do tend to change during critical periods within a hospitalization, adding emphasis for continued code status evaluation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Hoy hace: la erupción del Rincón de la Vieja el 8 de mayo de 1991

    Directory of Open Access Journals (Sweden)

    Soto Bonilla, Gerardo

    2005-08-01

    Full Text Available Uno de los eventos volcánicos importantes del siglo XX en Costa Rica fue el ocurrido el 8 de mayo del año 1991 en el Volcán Rincón de la Vieja. A continuación, se muestra la información recopilada en la serie Hoy hace. concerniente a la emergencia suscitada en esa ocasión. Se incluye una relación de las principales observaciones reportadas con respecto al Volcán desde el año 1765 hasta el año 1998. El documento explica el mecanismo de la erupción principal y enlista las actividades posteriores que se dieron One of the important volcanic events of the 20th Century in Costa Rica was the one of May 8, 1991 at the Rincón de la Vieja Volcano. Following, it shows the information collected in the series Today in History (Hoy hace related to the emergency generated at that moment. It includes a relation to the main observations reported in regards to the Volcano from the year 1765 to the year 1998. The document explains the mechanism of the main eruption and lists the posterior activities

  5. El asedio de Manila (mayo-agosto 1898. «Diario de los sucesos ocurridos durante la guerra de España con Estados Unidos, 1898»

    Directory of Open Access Journals (Sweden)

    Togores Sánchez, Luis E.

    1998-08-01

    Full Text Available There are two landmarks in the loss of Philippines in 1898: the Cavite naval battle and the subsequent siege of Manila. Between May and August 1898 the Tagalo independentist forces under Aguinaldo, and the Northamerican soldiers under Commodore Dewey and General Merrit, laid siege to and took over the capital city of the Colony after a long and hard siege, full of struggles. A Jesuit's personal diary found in the Rome archives provides a day-by-day chronicle of the siege. By contrasting this Information with other existing documentation it has been possible to reconstruct one of the historical keys to the understanding of Spain's defeat in the Pacific.

    La pérdida de Filipinas en 1898 tiene dos hitos, la batalla naval de Cavite y el subsiguiente asedio de Manila. Entre mayo y agosto de 1898 las fuerzas independentistas tagalas de Aguinaldo y los soldados norteamericanos del comodoro Dewey y el general Merrit sitiaron la capital de la colonia para finalmente rendirla el 13 de agosto tras un duro y largo asedio repleto de combates. El diario de un jesuita encontrado en los archivos de Roma, el cual narra día a día aquellos sucesos, nos permite reconstruir —contrastándolo con otra documentación existente— una de las claves históricas para comprender la derrota de España ante los Estados Unidos en el Pacífico.

  6. Las primeras declaraciones de los profesionales de la salud del Hospital de Campo de Mayo. Una aproximación a las actitudes sociales en la última Dictadura

    Directory of Open Access Journals (Sweden)

    Clara Sarsale

    2016-08-01

    Full Text Available En los primeros meses del gobierno de Raúl Alfonsín, en 1984, la Comisión Nacional sobre la Desaparición de Personas comenzó a recibir testimonios de todo aquel que tuviera información sobre lo acontecido en los años de dictadura. Entre los declarantes se encontraron familiares de desaparecidos, sobrevivientes, entre otros testigos menos usuales. Allí residirá el foco de este trabajo: en el testimonio de algunos de los profesionales de la salud del Hospital Militar de Campo de Mayo frente a la CONADEP. Estos profesionales, asistieron los partos de mujeres que se encontraban secuestradas por la dictadura. Como se verá en el artículo, ubicados en el corazón del sistema represivo, estos profesionales tuvieron diversas respuestas frente a lo que estaba ocurriendo. Su estudio, permite abrir nuevas preguntas sobre las actitudes sociales en dictadura.

  7. La identidad en la encrucijada: la comunidad galesa del Chubut y las conmemoraciones del Centenario y Bicentenario de la Revolución de Mayo

    Directory of Open Access Journals (Sweden)

    Geraldine Lublin

    2013-12-01

    Full Text Available El presente artículo se propone rastrear a grandes rasgos la relación ―especial‖ entre el estado nacional argentino y, a partir de 1958, la provincia de Chubut por una parte y los colonos galeses que se establecieron en Chubut desde 1865 y sus descendientes por otra, a través del análisis de la posición de la colectividad galesa del Chubut en dos momentos históricos destacados: el Centenario y el Bicentenario de la Revolución de Mayo (1810. Al corresponderse el perfil de los galeses con la idea de poblaciones "civilizadas" que las autoridades pretendían impulsar en desmedro de los legítimos pobladores originales, estas políticas dieron lugar a una fuerte identificación histórica de la Provincia de Chubut con la llamada "gesta galesa". Se generó asimismo una peculiar dinámica triangular de las relaciones estatales, cuya evolución a través del tiempo ha desembocado en la actual promoción de la identidad chubutense como el resultado de la fusión de las culturas de los tehuelches originarios y los colonos galeses.

  8. Hydatidiform mole clinical and pathological characteristics

    OpenAIRE

    Pacheco D., José; Instituto de Patología, UNMSM; Instituto de Medicina Legal; Alegre, Jaime; Hospital Nacional Dos de Mayo, Lima, Perú; Paniagua, Gissela; Instituto de Patología de la UNMSM

    2013-01-01

    Objective: To determine clinical and pathological findings in hydatidiform mole. Design: Descriptive retrospective study. Material and methods: All cases de molar pregnancy attended at Dos de Mayo National Hospital (HNDM) between 1998 and 2001 were reviewed. Results: Twenty-four cases of hydatidiform mole were attended; mean age was 26,4 years ± 6,4 and gestational age 13,1 weeks ± 3,3. Past history only showed 1 and 3 cases of hyperemesis gravidarum and previous abortions, respectively; 18 p...

  9. Lesão do bíceps distal: avaliação funcional e dinamometria digital da sua reconstrução pela técnica da minidupla via de mayo Isokinetic and functional: evaluation of the distal biceps reconstruction by using the mayo technique

    Directory of Open Access Journals (Sweden)

    José Carlos Garcia Júnior

    2012-10-01

    Full Text Available OBJETIVO: Avaliar o resultado funcional de pacientes com lesão do bíceps distal, operados pela técnica da minidupla via de Mayo, com seguimento mínimo de seis meses pós-cirurgia através de dinamometria digital isocinética, goniometria e escores subjetivos a fim de estabelecer padrões objetivos e subjetivos de melhora e discutir a efetividade do procedimento. MÉTODOS: Foram avaliados nove pacientes submetidos à cirurgia para tratamento de lesão do bíceps distal através de dinamometria digital com Cybex® utilizando velocidade angular de 30°/s, cinco repetições e 120°/s, 15 repetições, comparando com o lado não lesado. Foram utilizados também DASH (Disabilities of the Arm, Shoulder and Hand, MayoElbow Score e goniometria convencional. RESULTADOS: A dinamometria digital mostrou que à velocidade angular de 30°/s com cinco repetições a flexão apresentou déficit médio de 9,6% e a supinação déficit médio de -28,97%. Com velocidade angular de 120°/s com 15 repetições, a flexão teve déficit médio de 4,43%; a supinação de -24,1%. CONCLUSÕES: A Perda de flexão segue o padrão já demonstrado na literatura; entretanto, em nossa série houve ganho de força para supinação, possivelmente devido ao protocolo rígido de reabilitação. A técnica empregada neste estudo mostrou-se segura, de baixo custo e com poucas complicações, apresentando bons resultados funcionais.OBJECTIVE: To evaluate the functional outcome among patients with distal biceps injuries who were operated using the Mayo mini-double route technique, with a minimum follow-up of six months after surgery, through digital isokinetic dynamometry, goniometry and subjective scores in order to establish objective and subjective improvement patterns and discuss the effectiveness of the procedure. METHODS: Nine patients who underwent surgery to treat distal biceps injury were evaluated by means of Cybex digital dynamometry using an angular velocity of 30

  10. Agresión infantil como problema social en Costa Rica, desde enero de 2005 hasta mayo de 2006 Child Abuse as a Social Problem in Costa Rica, from January 2005 to May 2006

    Directory of Open Access Journals (Sweden)

    Carlos Abarca Campos

    2006-09-01

    Full Text Available La agresión infantil es un problema social que ha persistido a lo largo de la historia. La problemática abarca lesiones tanto a nivel físico como psicológico. La clínica, en la mayor parte de las veces, es el eje principal en el diagnóstico acertado y el posterior manejo. En este trabajo se analizaron 192 casos de agresión infantil durante el periodo comprendido entre enero de 2005 y mayo de 2006 y se presentan sus resultados donde la mayoría de los maltratos infantiles incluye abuso sexual, no es común la atención médica luego de la agresión, las víctimas consultan mucho tiempo después y se presentan más casos de maltrato infantil en el mes de Diciembre lo cual podemos asociar con las conductas del mes que suelen ser más irresponsables (fiestas, alcohol, etc.. Es importante que el médico tenga claro los signos de abuso sexual y sus repercusiones tanto físicas como psicológicas ya que es el tipo de agresión más frecuente y muchas veces puede pasar desapercibida.Child abuse is an issue which has persisted through history. This problem includes not only physical, but psychological damage. Clinical report, most of the times, is the principal axis in the correct diagnosis and the posterior treatment. In this study, 192 cases of child abuse were analyzed between January 2005 and May 2006, and the results presented most of the cases include child molesting, occasional medical attention after the assault, the victims receive medical attention long time after the assault, and most of the cases occur during December, which can be associated with irresponsible behavior (alcohol, parties, etc.. It is very important that the physician is very clear about the signs of sexual abuse and its physical and psychological consequences, since it is the most common type of aggression and in many cases can be unnoticed.

  11. Invocación de motivos religiosos en propaganda política Análisis de la resolución n° 3281-E1-2010 del 3 de mayo de 2010

    Directory of Open Access Journals (Sweden)

    Gustavo Román Jacobo

    2011-01-01

    Full Text Available Describe los aspectos esenciales de la resolución del Tribunal Supremo de Elecciones de Costa Rica, número 3281-E1-2010 del 3 de mayo de 2010, en la cual se resuelve el tema sobre la invocación de motivos religiosos en la propagranda política. A la vez explica la lógica básica que lo sustenta conceptualmente.

  12. Microbial synthesis of gold nanoparticles using the fungus Penicillium brevicompactum and their cytotoxic effects against mouse mayo blast cancer C 2 C 12 cells.

    Science.gov (United States)

    Mishra, Amrita; Tripathy, Suraj Kumar; Wahab, Rizwan; Jeong, Song-Hoon; Hwang, Inho; Yang, You-Bing; Kim, Young-Soon; Shin, Hyung-Shik; Yun, Soon-Il

    2011-11-01

    Microorganisms, their cell filtrates, and live biomass have been utilized for synthesizing various gold nanoparticles. The shape, size, stability as well as the purity of the bio synthesized nanoparticles become very essential for application purpose. In the present study, gold nanoparticles have been synthesized from the supernatant, live cell filtrate, and biomass of the fungus Penicillium brevicompactum. The fungus has been grown in potato dextrose broth which is also found to synthesize gold nanoparticles. The size of the particles has been investigated by Bio-TEM before purification, following purification and after storing the particles for 3 months under refrigerated condition. Different characterization techniques like X-ray diffraction, Fourier transform infrared spectroscopy, and UV-visible spectroscopy have been used for analysis of the particles. The effect of reaction parameters such as pH and concentration of gold salt have also been monitored to optimize the morphology and dispersity of the synthesized gold nanoparticles. A pH range of 5 to 8 has favored the synthesis process whereas increasing concentration of gold salt (beyond 2 mM) has resulted in the formation of bigger sized and aggregated nanoparticles. Additionally, the cytotoxic nature of prepared nanoparticles has been analyzed using mouse mayo blast cancer C(2)C(12) cells at different time intervals (24, 48, and 72 h) of incubation period. The cells are cultivated in Dulbecco's modified Eagle's medium supplemented with fetal bovine serum with antibiotics (streptopenicillin) at 37°C in a 5% humidified environment of CO(2). The medium has been replenished every other day, and the cells are subcultured after reaching the confluence. The viability of the cells is analyzed with 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide method.

  13. Development of an Educational Game to Set Up Surgical Instruments on the Mayo Stand or Back Table: Applied Research in Production Technology.

    Science.gov (United States)

    Paim, Crislaine Pires Padilha; Goldmeier, Silvia

    2017-01-10

    Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom's taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. The development of the game called "Playing with Tweezers" was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. The "digital" nursing student needs engagement, stimulation, reality, and entertainment, not just readings. "Playing with Tweezers" is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we cannot forget that skill training in an educational game does not

  14. Development of an Educational Game to Set Up Surgical Instruments on the Mayo Stand or Back Table: Applied Research in Production Technology

    Science.gov (United States)

    2017-01-01

    Background Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. Objective To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. Methods The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom’s taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. Results The development of the game called “Playing with Tweezers” was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. Conclusions The “digital” nursing student needs engagement, stimulation, reality, and entertainment, not just readings. “Playing with Tweezers” is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we

  15. Patient satisfaction and acceptability: a journey through an ambulatory gynaecology clinic in the West of Ireland

    LENUS (Irish Health Repository)

    Uzochukwu, I

    2016-06-01

    Ambulatory Gynaecology allows a “see-and-treat” approach to managing gynaecological conditions, providing a more streamlined, integrated care pathway than the traditional gynaecology clinic and inpatient care model. This study was designed to assess patient satisfaction and acceptability of Ambulatory Gynaecology services in Mayo University Hospital, Castlebar, Ireland. It also provided for feedback from patients as to how the service might be improved. \\r\

  16. Microvesicle Production After Trauma and its Clinical Impact on Veno-thrombolism

    Science.gov (United States)

    2012-10-01

    Department of Medicine, Mayo Clinic, Rochester Introduction: Trauma is an independent risk factor for venous thromboembolism (VTE; odds ratio ~12...all major trauma patients receive VTE chemoprophylaxis. This practice exposes those not at risk for thrombosis to potentially serious bleeding and...our military personnel. The patients who have polytrauma are at increased risk of developing either bleeding and/or a clot in their veins which

  17. A pilot study assessing social support among cancer patients enrolled on clinical trials: a comparison of younger versus older adults

    Directory of Open Access Journals (Sweden)

    Paul J Novotny

    2010-05-01

    Full Text Available Paul J Novotny1, Denise J Smith1, Lorna Guse2, Teresa A Rummans3, Lynn Hartmann4, Steven Alberts4, Richard Goldberg5, David Gregory6, Mary Johnson7, Jeff A Sloan11Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 2Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada; 3Psychiatry, Mayo Clinic, Rochester, MN, USA; 4Medical Oncology, Mayo Clinic, Rochester, MN, USA; 5Oncology Services, University of North Carolina, Chapel Hill, NC, USA; 6Faculty of Health Sciences Nursing, University of Lethbridge, Lethbridge, Alberta, Canada; 7Chaplain Services, Mayo Clinic, Rochester, MN, USAPurpose: This study tested the logistical feasibility of obtaining data on social support systems from cancer patients enrolled on clinical trials and compared the social support of older adults (age ≥65 and younger adults (<50 years of age with cancer.Methods: Patients had to be eligible for a phase II or phase III oncology clinical trial and enter the study prior to treatment. Patients filled out the Lubben Social Network Scale (LSNS at baseline. The Symptom Distress Scale (SDS and single-item overall quality of life (QOL Uniscale were assessed at baseline and weekly for 4 weeks.Results: There was no significant difference in overall mean Lubben social support levels by age. Older patients had more relatives they felt close to (85% versus 53% with 5 or more relatives, P = 0.02, heard from more friends monthly (84% versus 53% with 3 or more friends, P = 0.02, less overall symptom distress (P = 0.03, less insomnia (P = 0.003, better concentration (P = 0.005, better outlook (P = 0.01, and less depression (P = 0.005 than younger patients.Conclusions: Younger subjects reported worse symptoms, a smaller social support network, and fewer close friends and relatives than older subjects. Having someone to discuss decisions and seeing friends or relatives often was associated with longer survival. Keywords: social support, Lubben scale, QOL, elderly

  18. Eventos de Mayo (May Events).

    Science.gov (United States)

    Toro, Leonor; Pla, Myrna

    Designed as a resource for teachers, this booklet, written in Spanish, contains brief information on seven May events: La Semana de la Educacion (first Friday in May), Harry S. Truman (May 8), Dia de las Madres (second Sunday in May), Luis Llorens Torres (May 14), La Cruz Roja (May 21), John F. Kennedy (May 29), and El Dia De Conmemoracion (May…

  19. Blackrocks Nursing Home, Foxford, Mayo.

    LENUS (Irish Health Repository)

    Joyce, C W

    2014-01-01

    We compared the tensile strength of a novel knotless barbed suture method with a traditional four-strand Adelaide technique for flexor tendon repairs. Forty fresh porcine flexor tendons were transected and randomly assigned to one of the repair groups before repair. Biomechanical testing demonstrated that the tensile strengths between both tendon groups were very similar. However, less force was required to create a 2 mm gap in the four-strand repair method compared with the knotless barbed technique. There was a significant reduction in the cross-sectional area in the barbed suture group after repair compared with the Adelaide group. This would create better gliding within the pulley system in vivo and could decrease gapping and tendon rupture.

  20. Eventos de Mayo (May Events).

    Science.gov (United States)

    Toro, Leonor; Pla, Myrna

    Designed as a resource for teachers, this booklet, written in Spanish, contains brief information on seven May events: La Semana de la Educacion (first Friday in May), Harry S. Truman (May 8), Dia de las Madres (second Sunday in May), Luis Llorens Torres (May 14), La Cruz Roja (May 21), John F. Kennedy (May 29), and El Dia De Conmemoracion (May…

  1. Coliseo de Jacksonville, (U.S.A.

    Directory of Open Access Journals (Sweden)

    Ryad Fisher, G.

    1966-04-01

    Full Text Available This hall has room for 1,200 spectators, sitting down, and is suitable for holding wrestling, boxing and other similar sporting activities, also conventions, lectures, industrial exhibitions, festivals, circus, skating spectacles and other performances. The roof of this hall is its most significant feature, and also the manner of arrangement of the seats, which makes it possible to distribute them in a variety of ways.Este edificio, capaz de albergar a 1.200 espectadores sentados, ha sido construido para celebrar: combates de lucha libre y de boxeo, convenciones, conferencias, exposiciones industriales, festivales, partidos de hockey sobre hielo, baloncesto, sesiones de circo, campeonatos de tenis, espectáculos sobre hielo, etc. Lo más notable del Coliseo es la solución estructural adoptada para la cubierta, así como la disposición dada a los asientos para permitir una gran flexibilidad de usos.

  2. Virus influenza y el diagnóstico diferencial de sintomáticos febriles en la costa norte del Perú (Mayo, 2001

    Directory of Open Access Journals (Sweden)

    Yvonne Torres de Yon

    2004-01-01

    Full Text Available Objetivo: Identificar el virus influenza y otros agentes etiológicos relacionados con la presentación de síndrome febril en los departamentos de Piura, Tumbes, Lambayeque y La Libertad, en mayo de 2001. Material y Métodos: Estudio descriptivo, transversal. Incluye pacientes febriles que acudieron a los puestos de salud centinelas y que presentaban fiebre mayor de 38°C y gota gruesa negativa. Se obtuvieron dos muestras de sangre con un intervalo de 15-45 días. Se registró la sintomatología asociada a fiebre, y se determinó la presencia de anticuerpos mediante pruebas serológicas para dengue, influenza, sarampión y rubéola, además de pruebas para aislamiento y tipificación viral. Resultados: Se registraron 174 pacientes, 58,6% de ellos mujeres, siendo el grupo etáreo más frecuente de menores de 16 años (32,2%. Además de la fiebre se informaron como síntomas más frecuentes el dolor de cabeza (90,1% y dolor de huesos (81,9%. En 89 pacientes (51,1% se pudo obtener muestras de sueros pareados, los cuales fueron incluidos en el estudio serológico; 62 pacientes (69,6% presentaron serología positiva para dengue, 53 (59,5% para influenza y sólo uno (1,1% para rubéola. Conclusiones: El diagnóstico diferencial de pacientes sintomáticos febriles en los departamentos de la costa norte del Perú, luego de descartarse malaria, debe incluir además entre otras etiologías al virus influenza. Un diagnóstico diferencial adecuado permitirá un tratamiento precoz y efectivo. Se hace necesario implementar la vigilancia epidemiológica para mejorar el diagnóstico diferencial en sintomáticos febriles, que incluya a influenza.

  3. Pygoscelis antarcticus feathers as bioindicator of trace element risk in marine environments from Barton Peninsula, 25 de Mayo (King George) Island, Antarctica.

    Science.gov (United States)

    Catán, Soledad Perez; Bubach, Debora; Di Fonzo, Carla; Dopchiz, Laura; Arribére, Maria; Ansaldo, Martin

    2017-04-01

    We report the contents of elements in feathers of Chinstrap penguin (Pygoscelis antarcticus), which had not been informed up to now, such as silver and bromine and others listed as hazardous by the United States Environmental Protection Agency as arsenic, cobalt, chromium, and mercury. Analyses of the element concentrations in feathers, adult and chicken, from Barton Peninsulas at 25 de Mayo (King George) Island, South Shetlands, were made by Instrumental Neutron Activation Analysis. Samarium, lanthanum a, thorium, and uranium concentrations in Chinstrap penguin feathers were below 0.1 mg/kg. This suggests that the elements in feather do not come from atmospheric particles surface deposition. Arsenic (0.120 ± 0.050 mg/kg) and cobalt (0.030 ± 0.020 mg/kg) concentrations were lower than the reports for other colony of Chinstrap penguins, and essential elements as iron (26 ± 12 mg/kg), zinc (78.0 ± 5.3 mg/kg), and chromium (0.51 ± 0.27 mg/kg) were in the same range while Se (2.90 ± 0.65 mg/kg) content were the lowest reported. Mercury (0.43 ± 0.21 mg/kg), chromium (0.210 ± 0.060 mg/kg), and silver (0.083 ± 0.003 mg/kg) in chicks tended to be lower than in adults. Iron, cobalt, and arsenic concentrations in feathers found in this study were the lowest compared to measurements were in several penguin species in Antarctica. These results confirm to feathers like effective indicators for the trace elements incorporated in the penguins and it provide a data set which can adds to the baseline for bioindication studies using feathers.

  4. Cambios morfológicos recientes en lagos de la península Potter, isla 25 de Mayo, islas Shetland del Sur, Antártida

    Directory of Open Access Journals (Sweden)

    R.A. del Valle

    2004-09-01

    Full Text Available Aunque la historia ambiental del Holoceno-Reciente de los lagos antárticos informada en este trabajo es menos espectacular que la historia de los grandes paleolagos patagónicos formados al este de los Andes durante el Pleistoceno tardío-Holoceno temprano, la evidencia paleoambiental sugiere que recurrentes cambios de las vías de drenaje acompañados por descensos escalonados del nivel de lagos proglaciales antárticos también fueron probablemente disparados por episodios de desglaciación. Este trabajo está enfocado en los lagos mayores de la península Potter (62°15´S, 58°40´O, isla 25 de Mayo (Islas Shetland del Sur, Antártida, los cuales se formaron entre morenas neoglaciales depositadas por el frente retrocedente del campo de hielo de la península, durante el Holoceno tardío-Reciente. Después de alcanzar su altura máxima, el nivel de estos lagos descendió en forma escalonada por la apertura de canales de drenaje ubicados progresivamente a menor altitud. Estos drenajes ocuparon antiguos valles sucesivamente abandonados por glaciares de descarga del campo de hielo de la península. Testigos sedimentarios obtenidos en las cuencas lacustres estudiadas indican que allí la depositación glaciaria alternó con la formación de varves clásticos, lo cual probablemente refleja las rápidas fluctuaciones del frente de los glaciares que caracterizan a la parte más reciente del Holoceno en la región. Sólo se pudo acotar imprecisamente en <5500 años antes del presente, la edad máxima de uno de los cambios de drenaje del lago más antiguo estudiado en este trabajo. El cambio de drenaje del lago más joven ocurrió en el verano austral de 1999-2000, lo cual sugiere que el proceso de desglaciación y la consecuente desestabilización del permafrost y los diques morénicos de los lagos en la península Potter probablemente continúan activos.

  5. ¿Retirarse a tiempo? La visión del Mayo del 68 francés en la España Contemporánea

    Directory of Open Access Journals (Sweden)

    Álvaro Fleites Marcos

    2009-12-01

    Full Text Available El presente artículo tiene por objeto examinar la imagen de los acontecimientos franceses conocidos en su conjunto como la “crisis de mayo de 1968” en la España franquista contemporánea. En primer lugar, las autoridades franquistas mostraron un gran temor ante la posible extensión de las revueltas a España e intentaron establecer un cordón sanitario sobre las noticias procedentes de Francia, que la prensa española no tardó en romper aprovechando la nueva libertad consecuencia de la ley Fraga de 1966. Sin embargo, si los diferentes diarios adoptaron posturas inicialmente divergentes ante los acontecimientos, con la significativa excepción de Calvo Serer y Madrid terminaron por apoyar la restauración del orden llevada a cabo por el régimen gaullista. Por último, los informes de los diplomáticos galos en misión en España, conservados en los Archives du Ministère français des Affaires Étrangères muestran a una opinión pública española mayoritariamente favorable al gobierno francés y comprensiva con su situación, lo que se contradice con la postura del Partido Comunista Español, favorable a las revueltas._____________________ABSTRACT:This article examines the image of the French events known as the May 1968 crisis in contemporary Spain. The Franco government was frightened by the possibility of the revolts spreading to Spain so that it tried to establish a cordon sanitaire to prevent the news of the gravity of the French events from reaching the Spanish people. However, the Spanish press profited from the theoretical freedom brought by the new Fraga press law of 1966 and initially continued to inform about the seriousness of the revolts. Anyway, all the journals but Calvo Serer´s Madrid supported in the end the French government and its policy of restoring order. Finally, the reports from the French diplomats in Madrid, conserved in the Archives du Ministère français des Affaires Étrangères, show a Spanish public

  6. Abbreviation and acronym disambiguation in clinical discourse.

    Science.gov (United States)

    Pakhomov, Sergeui; Pedersen, Ted; Chute, Christopher G

    2005-01-01

    Use of abbreviations and acronyms is pervasive in clinical reports despite many efforts to limit the use of ambiguous and unsanctioned abbreviations and acronyms. Due to the fact that many abbreviations and acronyms are ambiguous with respect to their sense, complete and accurate text analysis is impossible without identification of the sense that was intended for a given abbreviation or acronym. We present the results of an experiment where we used the contexts harvested from the Internet through Google API to collect contextual data for a set of 8 acronyms found in clinical notes at the Mayo Clinic. We then used the contexts to disambiguate the sense of abbreviations in a manually annotated corpus.

  7. Acción colectiva, visibilidad y espacio público en la construcción de la ciudadanía. Los cortes de puentes de mayo del 97 en San Salvador de Jujuy

    Directory of Open Access Journals (Sweden)

    Lic. Alejandra García Vargas

    2000-01-01

    Full Text Available Salvador de Jujuy es la ciudad capital de la provincia de Jujuy, Argentina. En mayo de 1997, y paralelamente a cortes de rutas en todo el territorio provincial, parte de sus habitantes interrumpieron el tránsito sobre los puentes del río Chico o Xibi Xibi, que atraviesa la ciudad. Este trabajo propone analizar, a partir de entrevistas a participantes de los cortes y artículos de la prensa gráfica local, las características de esta acción colectiva y su vinculación con la construcción de la ciudadanía.

  8. Aplicabilidad de los aportes de Elton Mayo en la gestión de las pequeñas y medianas organizaciones de la ciudad de Bahía Blanca

    OpenAIRE

    Cabrera, Cecilia; Schwerdt, Fabio Adrián

    2014-01-01

    La presente ponencia se orienta a identificar los aportes más significativos de la Escuela de Relaciones Humanas iniciada por el psicólogo austríaco Elton Mayo, y compararlos con su actual aplicabilidad en la gestión de Pequeñas y Medianas organizaciones de la localidad de Bahía Blanca. Se intenta averiguar cuáles de los aportes de este autor se emplean en el contexto actual, signado por cambiantes circunstancias políticas, económicas, sociales y culturales, que generan un ambiente externo...

  9. Cambios morfológicos recientes en lagos de la península Potter, isla 25 de Mayo, islas Shetland del Sur, Antártida Recent morphological changes in the Peninsula Potter lakes, 25 de Mayo Island, Southern Shetland Islands, Antarctica

    Directory of Open Access Journals (Sweden)

    R.A. del Valle

    2004-09-01

    Full Text Available Aunque la historia ambiental del Holoceno-Reciente de los lagos antárticos informada en este trabajo es menos espectacular que la historia de los grandes paleolagos patagónicos formados al este de los Andes durante el Pleistoceno tardío-Holoceno temprano, la evidencia paleoambiental sugiere que recurrentes cambios de las vías de drenaje acompañados por descensos escalonados del nivel de lagos proglaciales antárticos también fueron probablemente disparados por episodios de desglaciación. Este trabajo está enfocado en los lagos mayores de la península Potter (62°15´S, 58°40´O, isla 25 de Mayo (Islas Shetland del Sur, Antártida, los cuales se formaron entre morenas neoglaciales depositadas por el frente retrocedente del campo de hielo de la península, durante el Holoceno tardío-Reciente. Después de alcanzar su altura máxima, el nivel de estos lagos descendió en forma escalonada por la apertura de canales de drenaje ubicados progresivamente a menor altitud. Estos drenajes ocuparon antiguos valles sucesivamente abandonados por glaciares de descarga del campo de hielo de la península. Testigos sedimentarios obtenidos en las cuencas lacustres estudiadas indican que allí la depositación glaciaria alternó con la formación de varves clásticos, lo cual probablemente refleja las rápidas fluctuaciones del frente de los glaciares que caracterizan a la parte más reciente del Holoceno en la región. Sólo se pudo acotar imprecisamente en Although the Holocene-Recent environmental history of the Antarctic lakes reported in this paper is less spectacular than that of the big proglacial palaeolakes formed on the eastern flank of the Andes of southern Patagonia during the late Pleistocene-early Holocene, palaeoenvironmental evidence suggests that recurrent changes in drainage accompanied by the stepped descent of Antarctic proglacial lakes were also probably triggered by the deglaciation event, which may have shifted southward in high

  10. Visual outcomes of age-related macular degeneration patients undergoing intravitreal ranibizumab monotherapy in an urban population: letter to the editor

    Directory of Open Access Journals (Sweden)

    Stewart MW

    2015-09-01

    Full Text Available Michael W Stewart Department of Ophthalmology, Mayo Clinic Florida, Jacksonville, FL, USA In their recently published manuscript entitled “Visual outcomes of age-related macular degeneration patients undergoing intravitreal ranibizumab monotherapy in an urban population” Basheer et al1 reported on the prospectively acquired results of 123 eyes (106 patients treated for 2 years with ranibizumab as needed. Visual acuity (VA outcomes from this series were summarized by the following statement: “Although our results, and those from other clinical settings, do not quite match the degree of vision preservation and gain as the large clinical trials, they are not dramatically dissimilar”.1 Unfortunately, the authors provide no statistical analysis to support this statement.View original paper by Basheer and colleagues.

  11. Prácticas de estimulación y promoción del desarrollo infantil en la etnia Mayo Stimulation practices and promotion of child development in Maya ethnicity

    Directory of Open Access Journals (Sweden)

    José Ángel Vera Noriega

    2010-12-01

    Full Text Available En este estudio se identificaron las características de las prácticas de estimulación y promoción del desarrollo en una comunidad indígena Mayo del estado de Sonora y Sinaloa en el noroeste de México. Se evaluaron dos grupos de 50 madres cada uno: un primer grupo que llamaremos de resistencia étnica, hablaba la lengua mayo a sus hijos y participaba en un programa educativo no escolarizado cuyo objeto es estimular el desarrollo. Un segundo grupo de madres que llamaremos de asimilación étnica, no hablaba la lengua mayo y no pertenecía al programa educativo. Se realizó mediante la aplicación de entrevistas a las madres y con escalas de desarrollo psicológico para niños de 0 y 5 años de edad. Los resultados indican que la población no hablante y sin educación inicial (asimilación étnica presenta baja frecuencia en el rango de problemas en el desarrollo y estimulación del niño en el hogar, comparado con la población hablante y con educación inicial (resistencia étnica. Se concluye en términos de un modelo intercultural de educación inicial para población indígena.In this study the characteristics of stimulation practices and developmental practices in an indigenous Maya community from the state of Sonora and Sinaloa in the northwestern part of Mexico have been evaluated. Two groups of 50 mothers each: the first group, which we will call ethnic resistance, spoke the Mayan language to their children and participated in a non-schooled educational program of development stimulation. A second group of mothers which we will call ethnic assimilation did not speak the Mayan language and didn't belong to the initial educational program. It was accomplished by the application of interviews to mothers with the scales of psychological development for children ranging from 0 to 5 years of age. The results indicate that the non-speaking population and without the initial education (ethnic assimilation present low frequency in the range

  12. Holoceno marino en la península Potter, Isla 25 de Mayo, Antártida Marine sediments of the early Holocene in the Potter Península, King George Island, Southern Shetland, Antarctica

    Directory of Open Access Journals (Sweden)

    R.A. del Valle

    2007-11-01

    Full Text Available La sucesión sedimentaria del Holoceno temprano expuesta en la terraza marina de 3,77 m s.n.m. en la costa sur de la caleta Potter (Isla 25 de Mayo/King George Island, islas Shetland del Sur, Antártida contiene invertebrados marinos, algas y huesos de foca y pingüino. Dataciones por radiocarbono de huesos de pingüino obtenidos en esta sucesión dieron edades de 7.562 a cal AP (años calibrados antes del Presente y 7.414 a cal AP. Las dataciones indican que los huesos están entre los restos de vertebrados más antiguos del Holoceno hallados en las Islas Shetland del Sur, y pueden ser consideradas como edades mínimas de ocupación por estas aves de las costas de las islas en el Holoceno temprano. Esto indica condiciones interglaciales en esa época, con situación clima/hielo marino similar a la presente y condiciones marinas estacionalmente abiertas.The early Holocene sedimentary succession exposed at the 3.77 m-high marine terrace on the south coast of Potter Cove (King George Island/Isla 25 de Mayo, South Shetland Islands, Antarctica contains marine invertebrates, seaweed and bones of seals and penguins. Radiocarbon dating on penguin bones from this succession yielded 7,562 cal yr BP and 7,414 cal yr BP. These dates suggest that the bones are among the oldest remains of Holocene vertebrates found in South Shetland Islands, and may be considered as minimum ages of penguin occupation of coastal areas on the islands during the early Holocene. This indicates interglacial conditions in this time, with climate/sea ice situation similar to the present and seasonally open marine conditions.

  13. Mayo肺脏计划关于肺癌发生率的进一步随访及过度诊断结果的评价%Evaluation of Extended Lung Cancer Incidence Follow-up in the Mayo Lung Project and Overdiagnosis

    Institute of Scientific and Technical Information of China (English)

    徐向英; 徐崇锐

    2007-01-01

    @@ 1 文献类型 诊断. 2证据水平 2b. 3文献来源 Marcus PM,Bergstralh EJ,Zweig MH,et al.Extended lung cancer incidence follow-up in the Mayo Lung Project and overdiagnosis[J].J Natl Cancer Inst,2006,98(11):748-756.

  14. Review of Immanuel Kant, Primera Introducción a la Crítica del Juicio, Edición bilingüe. Introducción, edición crítica y traducción de Nuria Sánchez Madrid (Ed. Escolar y mayo: Madrid, 2011).

    OpenAIRE

    Clara Benito Ortiz

    2015-01-01

    Review of   Immanuel Kant, Primera Introducción a la Crítica del Juicio, Edición bilingüe. Introducción, edición crítica y traducción de Nuria Sánchez Madrid (Ed. Escolar y mayo: Madrid, 2011).

  15. Evaluation of the content coverage of SNOMED CT: ability of SNOMED clinical terms to represent clinical problem lists.

    Science.gov (United States)

    Elkin, Peter L; Brown, Steven H; Husser, Casey S; Bauer, Brent A; Wahner-Roedler, Dietlind; Rosenbloom, S Trent; Speroff, Ted

    2006-06-01

    To evaluate the ability of SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms) version 1.0 to represent the most common problems seen at the Mayo Clinic in Rochester, Minn. We selected the 4996 most common nonduplicated text strings from the Mayo Master Sheet Index that describe patient problems associated with inpatient and outpatient episodes of care. From July 2003 through January 2004, 2 physician reviewers compared the Master Sheet Index text with the SNOMED CT terms that were automatically mapped by a vocabulary server or that they identified using a vocabulary browser and rated the "correctness" of the match. If the 2 reviewers disagreed, a third reviewer adjudicated. We evaluated the specificity, sensitivity, and positive predictive value of SNOMED CT. Of the 4996 problems in the test set, SNOMED CT correctly identified 4568 terms (true-positive results); 36 terms were true negatives, 9 terms were false positives, and 383 terms were false negatives. SNOMED CT had a sensitivity of 92.3%, a specificity of 80.0%, and a positive predictive value of 99.8%. SNOMED CT, when used as a compositional terminology, can exactly represent most (92.3%) of the terms used commonly in medical problem lists. Improvements to synonymy and adding missing modifiers would lead to greater coverage of common problem statements. Health care organizations should be encouraged and provided incentives to begin adopting SNOMED CT to drive their decision-support applications.

  16. Mineralogía y termo-barometría de los Complejos máficos Sol de Mayo y Suya Taco, Norte de las Sierras de Comechingones, Córdoba Mineralogy and thermo-barometry of the Sol de Mayo and Suya Taco mafic complexes from northern Sierra de Comechingones, Córdoba

    Directory of Open Access Journals (Sweden)

    Alina M. Tibaldi

    2008-03-01

    the latter method may be not applicable to rocks crystallized from Fe-rich magmas. Amphibole-plagioclase thermometry estimates, which use typical core compositions, yield equilibrium temperature in the range of 750-850ºC. Whereas using rim compositions, Amph-pl thermometry estimates significantly give lower temperatures (< 600ºC, suggesting that amphiboles mostly crystallized at post-magmatic stages. Orthopyroxene-biotite Fe-Mg exchange thermometry shows that these minerals tend to equilibrate within two distinct thermal ranges (430-650ºC and 740-1030ºC. This indicates that biotites might have crystallized at both late-magmatic and post-magmatic stages. Barometric estimates have some variability in function of the type of calibration used, however they show a systematic pattern in which the equilibrium pressure determined in the Suya Taco complex are lower (5.5 ± 1 kbar than those obtained in the Sol de Mayo complex (8 ± 1 kbar. Overall, this result is consistent with barometry already performed in granulitic xenoliths. The P-T conditions deduced from igneous rocks indicate that the hosting regional metasedimentary sequence were experiencing amphibolite-facies temperatures and residing at middle crustal levels.

  17. Selective reversal of muscle relaxation in general anesthesia: focus on sugammadex

    Directory of Open Access Journals (Sweden)

    Sorin J Brull

    2009-04-01

    Full Text Available Sorin J Brull1, Mohamed Naguib21Department of Anesthesiology, Mayo Clinic College of Medicine, Mayo Clinic Hospital, Jacksonville, FL, USA; 2Department of Anesthesiology and Pain Medicine, The University of Texas M D Anderson Cancer Center,  Houston, TX, USAAbstract: Despite the significant improvements in the pharmacology of muscle relaxants in the past six decades, the search for the ideal muscle relaxant continues, mainly because of the incomplete efficacy and persistent side effects associated with their antagonism. Clinical concerns remain about the residual paralysis and hemodynamic side effects associated with the classic pharmacologic reversal agents, the acetylcholinesterase inhibitors. Although the development of the “ideal muscle relaxant” remains illusory, pharmacologic advancements hold promise for improved clinical care and patient safety. Recent clinical advances include the development of short-acting nondepolarizing muscle relaxant agents that have fast onset and a very rapid metabolism that allows reliable and complete recovery; and the development of selective, “designer” reversal agents that are specific for a single drug or class of drugs. This article reviews recent developments in the pharmacology of these selective reversal agents: plasma cholinesterases, cysteine, and sugammadex. Although each of the selective reversal agents is specific in its substrate, the clinical use of the combination of muscle relaxant with its specific reversal agent will allow much greater intraoperative titrating ability, decreased side effect profile, and may result in a decreased incidence of postoperative residual paralysis and improved patient safety.Keywords: selective reversal agents, cysteine, plasma cholinesterases, sugammadex

  18. "SUMAR Y NO SER SUMADOS": CULTURAS JUVENILES REVOLUCIONARIAS. MAYO DE 1968 Y DIVERSIFICACIÓNIDENTITARIA EN CHILE "To add but not to be added": Youth cultures Revolutionaries. May 1968 and identitary diversification in Chile

    Directory of Open Access Journals (Sweden)

    Yanko González

    2010-07-01

    Full Text Available El trabajo analiza y discute la génesis y diversificación identitaria de las y los jóvenes en Chile a partir de su articulación y secularización con los movimientos estudiantiles. Para ello se centra en algunos referentes que posibilitaron la emergencia de la juventud como sujeto y actor social, para llegar a la expansión y diversificación de las culturas juveniles en sincronía tanto con los procesos de reforma universitaria en el país (1967 como con el imaginario emancipatorio y juvenilizante emanado de la revolución de mayo de 1968 en Francia.This paper analyzes and discusses the genesis and the identity diversification of Chilean youth, starting from their articulation and secularization with regard to the student movements. In order to do so, it is centered in some referents that made possible the emergency of youth as subject and social actor, so as to arrive to the expansion and diversification of youth cultures in synchrony with the Chilean university reform (1967, and with the emancipationist and juvenilized imaginary that came along with the French revolution of May 68'.

  19. Semantic characteristics of NLP-extracted concepts in clinical notes vs. biomedical literature.

    Science.gov (United States)

    Wu, Stephen; Liu, Hongfang

    2011-01-01

    Natural language processing (NLP) has become crucial in unlocking information stored in free text, from both clinical notes and biomedical literature. Clinical notes convey clinical information related to individual patient health care, while biomedical literature communicates scientific findings. This work focuses on semantic characterization of texts at an enterprise scale, comparing and contrasting the two domains and their NLP approaches. We analyzed the empirical distributional characteristics of NLP-discovered named entities in Mayo Clinic clinical notes from 2001-2010, and in the 2011 MetaMapped Medline Baseline. We give qualitative and quantitative measures of domain similarity and point to the feasibility of transferring resources and techniques. An important by-product for this study is the development of a weighted ontology for each domain, which gives distributional semantic information that may be used to improve NLP applications.

  20. Effect of Platelet-Rich Plasma (PRP versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial

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    Seyed Ahmad Raeissadat

    2014-01-01

    Full Text Available Background. Autologous whole blood and platelet-rich plasma (PRP have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS, modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P>0.05. At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P<0.05. Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion.

  1. Clinical utility of varenicline for smokers with medical and psychiatric comorbidity

    Directory of Open Access Journals (Sweden)

    Jon O Ebbert

    2009-11-01

    Full Text Available Jon O Ebbert, Kirk D Wyatt, Ali Zirakzadeh, Michael V Burke, JT HaysMayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USAAbstract: Chronic obstructive pulmonary disease (COPD is a costly and deadly disease afflicting an estimated 210 million people and accounting for 5% of all global deaths. Exposure to cigarette smoke is the greatest risk factor for COPD in the developed world. Smoking cessation improves respiratory symptoms and lung function and reduces mortality among patients with COPD. Cigarette smokers with COPD and other co-morbid conditions such as cardiovascular disease and psychiatric illnesses should receive comprehensive tobacco treatment interventions incorporating efficacious pharmacotherapies. Varenicline, an α4β2 nicotinic acetylcholine receptor partial agonist, is the newest and most effective drug currently available to promote smoking cessation. In conjunction with behavioral interventions and clinical monitoring for potential side effects, varenicline offers great hope for reducing smoking-attributable death and disability.Keywords: smoking cessation, chronic obstructive pulmonary disease, varenicline

  2. Whole-exome sequencing as a diagnostic tool in a family with episodic ataxia type 1.

    Science.gov (United States)

    Tacik, Pawel; Guthrie, Kimberly J; Strongosky, Audrey J; Broderick, Daniel F; Riegert-Johnson, Douglas L; Tang, Sha; El-Khechen, Dima; Parker, Alexander S; Ross, Owen A; Wszolek, Zbigniew K

    2015-03-01

    Complex neurologic phenotypes are inherently difficult to diagnose. Whole-exome sequencing (WES) is a new tool in the neurologist's diagnostic armamentarium. Whole-exome sequencing can be applied to investigate the "diagnostic odyssey" cases. These cases involve patients with rare diseases that likely have a genetic etiology but have failed to be diagnosed by clinical evaluation and targeted gene testing. We describe such a case, a 22-year-old man who had mild intellectual developmental disability and episodes of jerking ataxic movements that affected his whole body. He underwent numerous multidisciplinary and multicentric evaluations throughout his life that failed to establish a clear diagnosis. Following his visit to Mayo Clinic in Jacksonville, Florida, WES was applied for genetic determination of the unknown disorder in the proband and his biological parents and sister. Additional clinical evaluation, magnetic resonance neuroimaging, electromyography, and electroencephalography of the proband were performed to verify the phenotype after the WES results were available. To our knowledge, this is the first report of the application of WES to facilitate the diagnosis of episodic ataxia type 1. This case illustrates that WES supported by clinical data is a useful and time-saving tool in the evaluation of patients with rare and complex hereditary disorders. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  3. Evaluation of DNA Repair Function as a Predictor of Response in a Clinical Trial of PARP Inhibitor Monotherapy for Recurrent Ovarian Carcinoma

    Science.gov (United States)

    2015-10-01

    Award Number: W81XWH-­‐13-­‐1-­‐0485 TITLE: Evaluation of DNA Repair Function as a Predictor of Response in a Clinical Trial of PARP Inhibitor...UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Mayo Clinic and Foundation AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT...Biomarkers That Predict Response to PARP Inhibitors and Platinum.” Over the past 12 months we have i) completed validation of the immunohistochemical

  4. Azilsartan alone and in combination for the treatment of hypertension – clinical utility and patient considerations

    Directory of Open Access Journals (Sweden)

    Jones JD

    2013-08-01

    Full Text Available Jocelyn D Jones,1 Sylvia H Jackson,1 Charlie Colquitt21College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Jacksonville, FL, USA; 2College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tampa, FL, USAAbstract: Hypertension is a common disease that leads to significant cardiovascular morbidity and mortality. Adequate blood pressure control is essential in preventing end organ complications. One of the most popular antihypertensive strategies for the treatment of elevated blood pressure is to attenuate the actions of the renin-angiotensin-aldosterone system. The agents include the angiotensin converting enzyme inhibitors, angiotensin II receptor blockers (ARBs, direct renin inhibitors, and aldosterone antagonists. The ARBs inhibit the action of angiotensin II by binding to the angiotensin II type 1 receptor. The inhibition of angiotensin II results in a dose dependent decrease in peripheral resistance, reduction in vascular smooth muscle contraction, and reduced synthesis of aldosterone in the kidneys. Azilsartan medoxomil is a highly selective ARB. It was approved by the US Food and Drug Administration in February 2011 for the treatment of hypertension in adults. It is the eighth ARB to be added to the market. This article will discuss the pharmacologic and clinical characteristics of azilsartan medoxomil to help differentiate it from other ARBs that are used for the management of hypertension.Keywords: hypertension, azilsartan medoxomil, angiotensin II receptor blocker, ARB

  5. «God save us from more revolutions»: the Aranjuez Mutiny and the Dos de Mayo uprising in the light of Count Fernán Núñez’s widow | «Dios nos libre de más revoluciones»: el Motín de Aranjuez y el Dos de Mayo vistos por la condesa viuda de Fernán Núñez

    Directory of Open Access Journals (Sweden)

    Antonio Calvo Maturana

    2011-12-01

    Full Text Available This essay’s objective is to analyse a direct and unpublished testimony of the two biggest Spanish historical events of 1808: the Mutiny of Aranjuez and Dos de Mayo Uprising. With this purpose we present to the public a collection of letters written by Maria Esclavitud Sarmiento, Countess of Fernan Nuñez, and found in the French National Archives of Paris. In this lady’s correspondence we can appreciate the fears, the hopes and the speculations lived and suffered by the people from Madrid during this period. Thanks to this source we have access to the impressions of an eyewitness (a woman, something even more interesting and unusual who was in constant relation with the current situation, gathering news and rumours, sometimes already obsolete in the next letter because of the frenetic political situation. By her contacts with well-informed people (such as her son, the count of Fernan Nuñez, or members of government like Pedro Cevallos or Eusebio Bardaji, the widow countess offers interesting information about the most important figures and events of this year: Ferdinand VII (his rise to the throne and the preparation for his trip to Bayonne, Napoleon (his arrival to Spain and his recognition, or not, of the new king, Manuel Godoy (his imprisonment and his delivery to French authorities, Charles IV (the renounce of his claim and his posterior regret and Marie Louise of Parme (many rumours related to her dark legend. | El objetivo de este trabajo es ofrecer al lector un testimonio directo e inédito de lo acontecido en Madrid durante los dos grandes hitos históricos españoles de 1808: el Motín de Aranjuez y el Dos de Mayo. Para ello utilizaremos principalmente unas cartas de María Esclavitud Sarmiento, condesa viuda de Fernán Núñez, encontradas en los Archivos Nacionales de París. Esta dama de la alta nobleza reflejó en su correspondencia los miedos, esperanzas y especulaciones que asaltaron a la sociedad madrileña del momento. De

  6. External Compression Headaches

    Science.gov (United States)

    ... If protective headwear, such as a sports or construction helmet, is necessary, make sure it fits properly ... shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2017 Mayo ...

  7. Interstitial Lung Disease

    Science.gov (United States)

    ... toxins. If you work in mining, farming or construction or for any reason are exposed to environmental ... shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2017 Mayo ...

  8. El mundo del libro : mayo de 1969

    Directory of Open Access Journals (Sweden)

    Agustín Rodríguez Garavito

    1969-05-01

    Full Text Available Se presentan las reseñas de los siguientes títulos: SITIOS, SUCESOS, PERSONAJES CARAQUEÑOS-Por Héctor Parra Márquez-Caracas. Venezuela. THESAURUS-Boletín del Instituto Caro y Cuervo-Bogotá-Colombia. HISTORIA DE LA ETERNIDAD-Por Jorge Luis Borges-Buenos Aires-Argentina. MINERVA EN LA RUECA-Por Jorge Zalamea.

  9. El mundo del libro: Mayo de 1959

    Directory of Open Access Journals (Sweden)

    Agustín Rodríguez Garavito

    1959-05-01

    Full Text Available Se presentan las reseñas de las siguientes obras y autores: Un campesino sin regreso / Euclides Jaramillo Arango. La estación violenta / Octavio Paz La casimba / Isaac López Freyre Sonetos del amor y de la muerte / Carlos Castro Saavedra El Girasol / Eduardo Santa Los Estados Unidos mito y realidad. Obra inducida / Ricardo Alvarado La vida literaria en la edad media / Gustavo Cohen Se llamaba Bolívar... / Enrique Campos Méndez Cuentos impresionantes / Alfonso Bonilla Naar

  10. Sacred Heart Hospital, Pontoon Road, Castlebar, Mayo.

    LENUS (Irish Health Repository)

    Sorensen, Kristine

    2012-01-25

    Abstract Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.

  11. Dos cuentecillos de invierno: Creciente de mayo

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    Adel López Gómez

    1965-04-01

    Full Text Available Provistos de sus largas sogas, los hombres habían bajado del poblado ribereño para enlazar los maderos al paso de la brava corriente. Había cuajado apenas la limpieza del amanecer invernal, pero el aire trémulo, en aquella áspera cuenca del río Cauca, conservaba ese último toque de noche que le da al día sobre la tierra su primera virginidad elemental.

  12. El mundo del libro: mayo de 1963

    Directory of Open Access Journals (Sweden)

    Agustín Rodríguez Garavito

    1963-05-01

    Full Text Available El documento presenta las reseñas de los siguientes títutlos: Huellas -Por Luis Ernesto Puyana. Bucaramanga, Colombia. Panorama del Folklore Venezolano. Biblioteca de Cultura Universitaria - Caracas. Vitral de Bruma. Helvia de Bodmer. Editorial Antares. Bogotá. Una introducción al arte. F. Gil Tovar. La Mala Hora. Gabriel García Márquez. Premio Literario ESSO. 1961. Camus el Justo. C. Hourdin. Editorial Estela. Barcelona, España. Don Antonio Nariño. Fernando Galvis Salazar. -Drama en once cuadros. Bogotá, Colombia.

  13. El mundo del libro: Mayo de 1961

    Directory of Open Access Journals (Sweden)

    Agustín Rodríguez Garavito

    1961-05-01

    Full Text Available Se presentan las reseñas de las siguientes obras y autores: Introducción a la sociología o itinerario para una filosofía de lo social; Bernal Jimenez, Rafael. Mis Respetables jefes; Zacs, Vera. Arte Colombiano; Revista Lampara. Rudimentos de onomatología; Luis López de Mesa. Galería y romance de la historia; Montezuma Hurtado, Alberto. Yanguaro; Vargas, Luis Hernando. Campesinos de los Andes; Fals Borda, Orlando.

  14. El mundo del libro: Mayo de 1967

    Directory of Open Access Journals (Sweden)

    Agustín Rodríguez Garavito

    1967-05-01

    Full Text Available -La subversión en Colombia. Por Orlando Fals Borda. Universidad Nacional. Ediciones Tercer Mundo. Bogotá. Colombia -La educación del adolescente. Por Gabriel Anzola Gómez. Editorial Norma. Cali. Colombia -Conversando... Por Laureano García Ortiz. Biblioteca de Historia Nacional. Volumen CIX. Bogotá. Colombia -El signo. Poesías. Por Lucía Vergara Díaz. Editorial PAX. Bogotá -Poemas italianos. Por Néstor Madrid Malo. Editorial Antares. Tercer Mundo. Bogotá. Colombia -Lágrimas del día. Poemas. Segunda edición. Por Rafael Naranjo Balcázar. Medellín, Colombia

  15. El mundo del libro: Mayo de 1966

    Directory of Open Access Journals (Sweden)

    Agustín Rodríguez Garavito

    1966-05-01

    Full Text Available -DIARIO. Por Hernando Téllez. -DIAS DE BELLO EN CARACAS. Por Héctor Parra Márquez- Italigráfica. Caracas. -CON LOS POBRES DE AMÉRICA. Pensamiento político de Tomic, Montoro, Cornejo, Caldera y Frei. -ACTUALIDADES "ECOPETROL". Publicaciones de Relaciones de ECOPETROL. -REMINISCENCIAS DE SANTAFE Y BOGOTÄ. Por José María Cordovez Moure, Biblioteca Shering. Bogotá. Colombia. -EL ESTADO FUERTE. Por Alfonso López Michelsen, Ediciones Populibro. -LA EDUCACIÓN EN COLOMBIA. Por Alejandro Bernal Escobar, Andrés Benoit, Bertha Corredor e Isaac Wust. Oficina Internacional de Investigaciones Sociales de FERE-Lovaina-Bélgica. -LA PICUA SE VA. Por Lucy Barco de Valderrama. Ediciones Lerner.

  16. Ave Maria Nursing Home, Tooreen, Ballyhaunis, Mayo.

    LENUS (Irish Health Repository)

    Kane, Bridget

    2009-08-01

    This paper provides an analysis of the collaborative work conducted at a multidisciplinary medical team meeting, where a patient’s definitive diagnosis is agreed, by consensus. The features that distinguish this process of diagnostic work by consensus are examined in depth. The current use of technology to support this collaborative activity is described, and experienced deficiencies are identified. Emphasis is placed on the visual and perceptual difficulty for individual specialities in making interpretations, and on how, through collaboration in discussion, definitive diagnosis is actually achieved. The challenge for providing adequate support for the multidisciplinary team at their meeting is outlined, given the multifaceted nature of the setting, i.e. patient management, educational, organizational and social functions, that need to be satisfied.

  17. El mundo del libro: mayo de 1979

    Directory of Open Access Journals (Sweden)

    Agustín Rodríguez Garavito

    1979-05-01

    Full Text Available En el documento se presentan las reseñas de los siguientes títulos: -Cayetano Betancur. Manual del ciudadano. Brevarios Colombianos. Ediciones del Banco de la República. -Alberto Duarte French. Guía practica del derecho de familia. Editorial Temis. Librería. 1978. -Abel Naranjo Villegas. Generaciones colombianas. Brevarios Colombianos. Ediciones Banco de la República. Artes Gráficas Centro Don Bosco. -Flor Alba Uribe Marin. Historia de la pequeña Nubia y su Mercenaria virginidad. Ediciones Tercer mundo. Bogotá, Colombia. -Abelardo Forero Benavides. El siglo XIX. Galería de sombras. Nariño, Bolívar, Santander, Obando, Mosquera, Nuñez. Fundación Centenario del Banco de Colombia. 1978. Impreso por Litoformas de Colombia. -Luis Duque Gómez. Introducción al pasado aborigen. Brevarios Colombianos. Banco de la República. Talleres Editorial Retina. Bogotá. Colombia. -Dibujos de Sergio Trujillo Magnenat. Texto de Germán Rubiano Caballero. Biblioteca Fundación Centenario del Banco de Colombia. -Mauro Torres. Tensión en la Unidad familiar. Padres e hijos. Edición Tercer Mundo. Bogotá, Colombia. -Ciro Medina. Antología. Editado por el Banco de América Latina. Impreso por Publicaciones Cultural Ltda. Bogotá, Colombia.

  18. El mundo del libro: mayo de 1964

    Directory of Open Access Journals (Sweden)

    Agustín Rodríguez Garavito

    1964-05-01

    Full Text Available EL documento presenta las reseñas de los siguientes titulos: Los Ratones Van al Infireno. Gonzalo Arango - Ediciones Tercer Mundo. Bogotá, Colombia. La Administración Pública en los Países en Desarrollo. Ediciones de la ESAP. Bogotá, Colombia. Colombia en Cifras. Plinio Mendoza Neira. - Talleres Gráficos AEDITA. Bogotá, Colombia. Colombia en la Hora Cero. Alfonso López Michelsen. - Ediciones Tercer Mundo. Bogotá, Colombia. Catalina. Elisa Mújica.-Novela- Editorial Aguilar. Madrid.

  19. El mundo del libro: mayo de 1962

    National Research Council Canada - National Science Library

    Agustín Rodríguez Garavito

    1962-01-01

    .... - Ensayo de metodología. • Si Mañana Despierto. Por Jorge Gaitán Durán. - Ediciones MITO. Bogotá, D. E. • Rafael Uribe Uribe. Por: Eduardo Santa. • Mientras Agonizo... Por William Faulkner...

  20. El mundo del libro: mayo de 1965

    Directory of Open Access Journals (Sweden)

    Agustín Rodríguez Garavito

    1965-05-01

    Full Text Available El documento presenta las reseñas de los siguientes títulos: Memorias infantiles- E. Caballero Calderón - Editorial Bedout. Medellín. El Aire y las Colinas- Poemas- Carlos Medellín- Bogotá-Colombia. Crepúsculo y albas- Poemas- Silverio Blanco Gutiérrez- Editorial "Canal Ramírez". Bogotá. El padre las causas-su doble personalidad- Biografía- Ramón Menéndez Pidal- Espasa-Calpe. Madrid.

  1. Claremount Nursing Home, Claremount, Claremorris, Mayo.

    LENUS (Irish Health Repository)

    2011-08-30

    Abstract Before a probiotic bacterium can even begin to fulfill its biological role, it must survive a battery of environmental stresses imposed during food processing and passage through the gastrointestinal tract (GIT). Food processing stresses include extremes in temperature, as well as osmotic, oxidative and food matrix stresses. Passage through the GIT is a hazardous journey for any bacteria with deleterious lows in pH encountered in the stomach to the detergent-like properties of bile in the duodenum. However, bacteria are equipped with an array of defense mechanisms to counteract intracellular damage or to enhance the robustness of the cell to withstand lethal external environments. Understanding these mechanisms in probiotic bacteria and indeed other bacterial groups has resulted in the development of a molecular toolbox to augment the technological and gastrointestinal performance of probiotics. This has been greatly aided by studies which examine the global cellular responses to stress highlighting distinct regulatory networks and which also identify novel mechanisms used by cells to cope with hazardous environments. This review highlights the latest studies which have exploited the bacterial stress response with a view to producing next-generation probiotic cultures and highlights the significance of studies which view the global bacterial stress response from an integrative systems biology perspective.

  2. Stemcell Information: SKIP000917 [SKIP Stemcell Database[Archive

    Lifescience Database Archive (English)

    Full Text Available formation ... Tayaramma Thatava Tayaramma Thatava Department of Molecular Medicine, Mayo Clinic Department... of Molecular Medicine, Mayo Clinic ... Information Only Department of M...olecular Medicine, Mayo Clinic Department of Molecular Medicine, Mayo Clinic ... 22142803 10.1186/scrt89 Su

  3. Leopoldo Fortunato Galtieri ante la Plaza de Mayo el 2 de abril de 1982 : Desafía a Gran Bretaña por la soberanía en las Islas Malvinas y exhibe apoyo regional en la iniciativa bélica

    OpenAIRE

    Galtieri, Leopoldo Fortunato

    1982-01-01

    El presidente de facto, tras haber anunciado el desembarco militar en las Islas Malvinas para disputar la soberanía a Gran Gran Bretaña, se dirige al público reunido en la Plaza de Mayo. Ante lo que él llama "cabildo abierto", desafía al gobierno británico, y exhibe apoyo de países de nuestra región en el emprendimiento bélico. En este discurso pronuncia su conocida frase "si quieren venir que vengan, les presentaremos batalla". Culmina convocando a entonar el Himno Nacional Argentino. Leo...

  4. La salud bucal en los jóvenes de la corporación de residencias universitarias 10 de mayo: una aproximación desde la determinación social con énfasis en pertenencia étnica

    OpenAIRE

    Shirley Andrade Benavides; Santiago Chamorro Guerrero; Mileidy Agreda Yela; Sirena Porras Serrano

    2012-01-01

    Objetivo: Investigar la determinación social de la salud bucal de los estudiantes universitarios pertenecientes a comunidades indígenas y afrocolombianos del sur occidente del país, domiciliarios de las Residencias Universitarias 10 de Mayo. Métodos: Se realizo un estudio descriptivo con apoyo en una encuesta individual fundamentada en la Determinación Social, DS. Resultados: La mayor parte de la población es de género femenino y presenta mejor salud bucal que los hombres. Esto se explica por...

  5. Relación del Nivel de Conocimiento y Práctica de Higiene de las Madres en la Preparación de Alimentos en los Comedores Populares de los Centros Poblados Menores Miguel Grau y Nueva Alianza, Durante el Período de Mayo- Agosto, 2008.

    OpenAIRE

    Jara Pilco, Cinthia Esperanza; Huamán Villanueva, Elena Ruth

    2009-01-01

    Objetivo. Determinar la relación del nivel de conocimiento y la práctica de higiene de las madres en la preparación de alimentos en los comedores populares del centro poblado Miguel Grau y Nueva Alianza, durante los meses mayo y agosto del año 2008. Metodología. El estudio de la investigación fue correlacional transversal; la muestra estuvo conformada por 35 madres a quienes se aplicó dos instrumentos: una encuesta para determinar el nivel de conocimiento y una guía de observación para determ...

  6. Estrategia didáctica sustentada en la teoría de las relaciones humanas de Elton Mayo, para mejorar los niveles de relaciones interpersonales de los docentes del nivel primario de la escuela profesional de Educación de la Universidad Nacional "Pedro Ruiz Gallo", Lambayeque, año 2011.

    OpenAIRE

    Diaz Pita, Omar.

    2015-01-01

    La presente investigación tiene como objetivo Diseñar una Estrategia Didáctica para mejorar las relaciones interpersonales de los Docentes de la Escuela Profesional de Educación, Nivel Primario, de la Universidad Nacional "Pedro Ruiz Gallo" de Lambayeque. Para ello se aplicó una guía de observación, encuestas, entrevistas y testimonios. Luego de haber terminado esta parte se procedió a examinar el problema a la luz de la Teoría de las Relaciones Humanas de Elton Mayo y la Teoría de las Técnic...

  7. Seguimiento domiciliario a la madre adolescente y su recién nacido durante el puerperio. Hospital de Engativá ESE II nivel. Marzo – Mayo de 2009 / Household monitoring to the teen mother and her newborn during the postpartum period. Engativá hospital E.S.E II level March - May 2009

    OpenAIRE

    Rocha Velásquez , Vivian Gisell; Puentes López, Miguel Antonio

    2009-01-01

    El trabajo: “SEGUIMIENTO DOMICILIARIO A LA MADRE ADOLESCENTE Y SU RECIÉN NACIDO DURANTE EL PUERPERIO. HOSPITAL DE ENGATIVÁ ESE II NIVEL. MARZO – MAYO DE 2009”, es una estrategia del cuidado de enfermería, para identificar y evaluar riesgos y signos de alarma permitiendo planear y ejecutar intervenciones en el hogar apoyando a madres adolescentes en la recuperación de su salud, el aprendizaje en la crianza de sus hijos con el apoyo de la familia, identificando los riesgos tempranamente que pue...

  8. Hallazgos clínicos y de laboratorio presentes en mujeres adolescentes embarazadas residentes en Costa Rica y con al menos dos consultas de control prenatal en el Hospital Calderón Guardia del 10 de mayo al 21 de mayo del 2010

    Directory of Open Access Journals (Sweden)

    Yessenia Brenes Madrigal

    2010-09-01

    Full Text Available El presente es un estudio descriptivo observacional de cincuenta y tres expedientes de pacientes de la clínica de adolescentes del Hospital Calderón Guardia de donde se obtuvieron datos de hemoglobina, hematocrito, peso, talla y otros, con el fin de determinar la frecuencia de anemia y los patrones de ganancia de pero adecuados e inadecuados. Menos del 10 % de las pacientes presentaron anemia y aproximadamente la mitad tuvieron una inadecuada ganancia de peso y de estas la gran mayoría por pobre ganancia de peso. No se encontró una alta incidencia de anemia en esta población sin embargo en las que si la presentaron se encontraba asociada a un bajo peso para la edad gestacional, lo cual concuerda en la literatura existente. En cuanto a la ganancia de peso se obtuvieron resultados que demuestran que en las adolescentes embazadas la presencia de una inadecuada ganancia de peso es frecuente por lo que se debe tener en cuenta como factores asociados a este cuando se trabaja en el área de salud.This is an observational descriptive study about fifty-three patients records from the adolescents clinic at Calderon Guardia Hospital. Data about hemoglobin, hematocrit, weight and height, among others, were taken into account in order to determine the frequency of anemia and the adequate and inadequate weight gain patterns. Less than 10% of patients had anemia, and about half of them had inadequate weight gain or poor weight gain. There was not a high incidence of anemia in this population; however, in the ones in which anemia was found, it was due to low weight on gestational age, as it has been shown in the existing literature in this field . Research showed that inadequate weight gain on pregnant teenagers is common, and that this aspect should be taken into account when working in the health area.

  9. Information Management: A Departmental Strategic Analysis, Naval Hospital Jacksonville, FL

    Science.gov (United States)

    2009-06-12

    it into a typed format usable in any word processing software. The voice recognition software provided with their tablets is called Dragon...the software to transform verbal communication into text which interfaces with the hospitals widely used EMR called AHLTA. Another impressive ...Williams C., Asch B., Baron J., Cote 0., Gunn L., Herdt J., Horowitz B., Johnson L., Mooney J., Mopsick J., Rhodes J., Draper, C. F., & Mozhi, A

  10. Metaphrase: an aid to the clinical conceptualization and formalization of patient problems in healthcare enterprises.

    Science.gov (United States)

    Tuttle, M S; Olson, N E; Keck, K D; Cole, W G; Erlbaum, M S; Sherertz, D D; Chute, C G; Elkin, P L; Atkin, G E; Kaihoi, B H; Safran, C; Rind, D; Law, V

    1998-11-01

    Patient descriptors, or "problems," such as "brain metastases of melanoma" are an effective way for caregivers to describe patients. But most problems, e.g., "cubital tunnel syndrome" or "ulnar nerve compression," found in problem lists in an Electronic Medical Record (EMR) are not comparable computationally--in general, a computer cannot determine whether they describe the same or a related problem, or whether the user would have preferred "ulnar nerve compression syndrome." Metaphrase is a scalable, middleware component designed to be accessed from problem-manager applications in EMR systems. In response to caregivers' informal descriptors it suggests potentially equivalent, authoritative, and more formally comparable descriptors. Metaphrase contains a clinical subset of the 1997 UMLS Metathesaurus and some 10,000 "problems" from the Mayo Clinic and Harvard Beth Israel Hospital. Word and term completion, spelling correction, and semantic navigation, all combine to ease the burden of problem conceptualization, entry and formalization.

  11. Mineralogía y termo-barometría de los Complejos máficos Sol de Mayo y Suya Taco, Norte de las Sierras de Comechingones, Córdoba

    Directory of Open Access Journals (Sweden)

    Alina M. Tibaldi

    2008-03-01

    Full Text Available Este trabajo presenta un estudio detallado de la petrografía, mineralogía química y termo-barometría de dos complejos máficos que afloran al norte de la sierra de Comechingones. Se aplicaron un conjunto de termómetros y barómetros empíricos con el propósito de determinar los rangos de P y T absolutas de cristalización de estas rocas. Las temperaturas de equilibrio en pares de piroxenos (cpx-opx se estimaron usando tres termómetros independientes. Dos calibraciones termométricas (Wells 1977, Kretz 1982 dan resultados consistentes y razonables indicando que los piroxenos registran condiciones de cristalización magmática (920-1150ºC, mientras que la tercera calibración (Lindsley 1983 estima temperaturas muy inferiores. Esta discrepancia puede estar relacionada con el hecho de que la última calibración no sería aplicable a rocas que cristalizaron a partir de magmas ricos en hierro. Por su parte, la termometría Amph-Pl sugiere temperaturas de equilibrio comprendidas entre 750-850ºC, para composiciones típicas de núcleos, mientras que para composiciones representativas de los bordes de grano las temperaturas estimadas son significativamente inferiores (< 600ºC comportamiento que sugiere que el anfíbol cristalizó principalmente en una etapa post-magmática. Las temperaturas de intercambio para Fe-Mg entre opx-bt muestran que este par mineral se equilibró entre dos rangos térmicos bien definidos (430-650ºC y 740-1030ºC, lo que sugiere que las biotitas pueden haber cristalizado tanto en una etapa tardío magmática como post-magmática. Las formulaciones barométricas muestran cierta variabilidad en función de las calibraciones utilizadas, no obstante, sistemáticamente presentan un patrón de valores en el cual las presiones de equilibrio determinadas en el Complejo Suya Taco son inferiores (5,5 ± 1 kbar a las obtenidas en el Complejo Sol de Mayo (8 ± 1 kbar. En general, este resultado es consistente con las estimaciones

  12. The absence of longitudinal data limits the accuracy of high-throughput clinical phenotyping for identifying type 2 diabetes mellitus subjects.

    Science.gov (United States)

    Wei, Wei-Qi; Leibson, Cynthia L; Ransom, Jeanine E; Kho, Abel N; Chute, Christopher G

    2013-04-01

    To evaluate the impact of insufficient longitudinal data on the accuracy of a high-throughput clinical phenotyping (HTCP) algorithm for identifying (1) patients with type 2 diabetes mellitus (T2DM) and (2) patients with no diabetes. Retrospective study conducted at Mayo Clinic in Rochester, Minnesota. Eligible subjects were Olmsted County residents with ≥1 Mayo Clinic encounter in each of three time periods: (1) 2007, (2) from 1997 through 2006, and (3) before 1997 (N = 54,283). Diabetes relevant electronic medical record (EMR) data about diagnoses, laboratories, and medications were used. We employed the HTCP algorithm to categorize individuals as T2DM cases and non-diabetes controls. Considering the full 11 years (1997-2007) as the gold standard, we compared gold-standard categorizations with those using data for 10 subsequent intervals, ranging from 1998-2007 (10-year data) to 2007 (1-year data). Positive predictive values (PPVs) and false-negative rates (FNRs) were calculated. McNemar tests were used to determine whether categorizations using shorter time periods differed from the gold standard. Statistical significance was defined as P FNRs, respectively, were 70% and 25% for case identification and 59% and 67% for control identification. All time frames differed significantly from the gold standard, except for the 10-year period. The accuracy of the algorithm reduced remarkably as data were limited to shorter observation periods. This impact should be considered carefully when designing/executing HTCP algorithms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. De Nanterre a Vincennes. La universitat francesa i el maig del 68 From Nanterre to Vincennes: the French University and May 1968 De Nanterre a Vincennes. La universidad francesa y el Mayo del 68

    Directory of Open Access Journals (Sweden)

    Francesc Calvo Ortega

    2008-01-01

    bien au-delà des urgences qui la rendent historiquement nécessaire.The objectives of this article focus principally on the most controversial aspects of what happened to the French university system during the period of reform which General Charles De Gaulle felt obliged to implement after the events of May 1968. Long before the “student revolt”, however, the structures of the educational system had fallen into decadence. The Law of Orientation, which was passed in 1968, failed to solve the deeper conflicts that had been plaguing the university system for years. Nor did it provide the educational community with a project for the future built on guarantees of academic freedom. Two universities are offered as examples: Nanterre, which lay at the core of the student revolt, and Vincennes, a failed educational project of “post-revolutionary” France. Together, they provide a sample of the difficulties faced by any university reform in reaching beyond the urgent conditions that make it historically necessary.El objetivo de este artículo es analizar los aspectos más problemáticos que afectaron a la universidad francesa durante el proceso de Reforma que el gobierno del general Charles De Gaulle se vio obligado a poner en marcha a causa de los sucesos de mayo de 1968. Pero la «revuelta de los estudiantes» estuvo condicionada desde mucho tiempo atrás por un sistema educativo cuyas estructuras estaban en total decadencia. La Ley de Orientación Universitaria aprobada aquel mismo año ni solucionó los conflictos que hacía años arrastraba la universidad ni suministró a la comunidad educativa un proyecto de futuro con garantías de libertad académica. Los ejemplos de dos universidades como la de Nanterre, núcleo central de la revuelta, y la de Vincennes, un proyecto educativo fracasado de la Francia «post-revolucionaria», son la muestra de la dificultad que toda reforma universitaria conlleva más allá de las urgencias que históricamente la hacen necesaria.

  14. Clinical characteristics of Takotsubo cardiomyopathy in North America

    Directory of Open Access Journals (Sweden)

    Saeed Ahmed

    2013-01-01

    Full Text Available Background: Takotsubo cardiomyopathy (TC or transient left ventricular apical ballooning syndrome is an acute cardiac syndrome characterized by transient wall motion abnormalities extending beyond a single epicardial vessel in the absence of significant obstructive coronary artery disease. Aim: This study was to describe the clinical characteristics of TC in North America. Materials and Methods: We identified 10 patients who met the Mayo Clinic criteria for TC using our Electronic Medical Records. We also conducted a systematic review of case series of TC that were done in North America by searching the MEDLINE database. We identified 11 case series that met our eligibility criteria. Results: Our systematic review included 620 patients. Chest pain and ST segment elevation were the cardinal features of this syndrome, but the prevalence was lower than in the European and Asian cohort (50% and 39% as compared with 80% and 70%, respectively. Classic precipitating emotional or physical stress was described in > 80% of patients. Cardiac biomarkers were found to be elevated in >90% of our patients. Conclusions : TC is a worldwide problem and clinical presentation appears to be similar in North American, European, and Asian countries. However, fewer patients in our cohort presented with typical chest pain and electrocardiography (ECG changes, which might suggest ethnic variations in the syndrome or perhaps a more aggressive diagnostic approach in North American countries.

  15. Difficulty and Discrimination Parameters of Boston Naming Test Items in a Consecutive Clinical Series

    Science.gov (United States)

    Pedraza, Otto; Sachs, Bonnie C.; Ferman, Tanis J.; Rush, Beth K.; Lucas, John A.

    2011-01-01

    The Boston Naming Test is one of the most widely used neuropsychological instruments; yet, there has been limited use of modern psychometric methods to investigate its properties at the item level. The current study used Item response theory to examine each item's difficulty and discrimination properties, as well as the test's measurement precision across the range of naming ability. Participants included 300 consecutive referrals to the outpatient neuropsychology service at Mayo Clinic in Florida. Results showed that successive items do not necessarily reflect a monotonic increase in psychometric difficulty, some items are inadequate to distinguish individuals at various levels of naming ability, multiple items provide redundant psychometric information, and measurement precision is greatest for persons within a low-average range of ability. These findings may be used to develop short forms, improve reliability in future test versions by replacing psychometrically poor items, and analyze profiles of intra-individual variability. PMID:21593059

  16. Difficulty and discrimination parameters of Boston naming test items in a consecutive clinical series.

    Science.gov (United States)

    Pedraza, Otto; Sachs, Bonnie C; Ferman, Tanis J; Rush, Beth K; Lucas, John A

    2011-08-01

    The Boston Naming Test is one of the most widely used neuropsychological instruments; yet, there has been limited use of modern psychometric methods to investigate its properties at the item level. The current study used Item response theory to examine each item's difficulty and discrimination properties, as well as the test's measurement precision across the range of naming ability. Participants included 300 consecutive referrals to the outpatient neuropsychology service at Mayo Clinic in Florida. Results showed that successive items do not necessarily reflect a monotonic increase in psychometric difficulty, some items are inadequate to distinguish individuals at various levels of naming ability, multiple items provide redundant psychometric information, and measurement precision is greatest for persons within a low-average range of ability. These findings may be used to develop short forms, improve reliability in future test versions by replacing psychometrically poor items, and analyze profiles of intra-individual variability.

  17. Clinical Research and Clinical Trials

    Science.gov (United States)

    ... NICHD Publications Data Sharing and Other Resources Research Clinical Trials & Clinical Research Skip sharing on social media links ... health care providers, and researchers. Find NICHD-Supported Clinical Trials Use this link to find a list of ...

  18. Clinical Competence/Clinical Credibility.

    Science.gov (United States)

    Goorapah, David

    1997-01-01

    In interviews with 10 nurse teachers and 10 clinicians, respondents could describe clinical competence more fluently than clinical credibility. Responses raised the question of whether nursing teachers must be clinically competent/credible to teach nursing. (SK)

  19. Pathology and sensitivity of current clinical criteria in corticobasal syndrome.

    Science.gov (United States)

    Ouchi, Haruka; Toyoshima, Yasuko; Tada, Mari; Oyake, Mutsuo; Aida, Izumi; Tomita, Itsuro; Satoh, Akira; Tsujihata, Mitsuhiro; Takahashi, Hitoshi; Nishizawa, Masatoyo; Shimohata, Takayoshi

    2014-02-01

    The aim of this study was to investigate corticobasal syndrome with respect to underlying pathologies, the ability of current clinical criteria to detect early stages of disease, and symptoms and signs predicting background pathologies. We retrospectively analyzed the clinicopathological findings from patients with corticobasal syndrome. We also analyzed whether those findings fulfilled the diagnostic criteria for corticobasal degeneration (CBD). Finally, we investigated characteristic clinical features that are specific to each background pathology. Of 10 consecutive autopsied patients who had corticobasal syndrome (mean age ± standard deviation, 67.9 ± 9.3 years; male:female ratio, 6:4), three had corticobasal degeneration pathology, three had progressive supranuclear palsy, three had Alzheimer's disease, and one had atypical four-repeat tauopathy. Nine patients fulfilled Mayo criteria, and all 10 patients fulfilled modified Cambridge criteria at the later stage, but only two patients fulfilled either clinical criteria within 2 years of disease onset. Five patients fulfilled the clinical criteria for possible CBD (p-CBD), and one patient fulfilled the clinical research criteria for probable sporadic CBD (cr-CBD) at the later stage. Only two patients fulfilled the criteria for either p-CBD or cr-CBD within 2 years of disease onset. Although we could not find any predictive characteristic clinical features that were specific to CBD pathology, only patients with progressive supranuclear palsy developed apraxia of eyelid opening and cerebellar ataxia. Myoclonus and memory impairment, especially if they appear at an early stage of the disease, may predict Alzheimer's disease pathology. Sensitivity of the available clinical criteria for corticobasal syndrome was poor within 2 years of disease onset.

  20. Radiological and Clinical Evaluation of the Transosseous Cortical Button Technique in Distal Biceps Tendon Repair.

    Science.gov (United States)

    Caekebeke, Pieter; Vermeersch, Nicolas; Duerinckx, Joris; van Riet, Roger

    2016-12-01

    One of the options to repair a ruptured distal biceps tendon to the radial tuberosity is by means of a transosseous cortical button. Although excellent functional outcomes have been reported, no studies have been performed to quantify the effect of the transosseous fixation technique on the radius. Our study evaluated the clinical outcome and radiological outcome of this technique. The main goal of this study was to evaluate the radiographic evolution of the bone tunnel in the radius. Patients with an acute distal biceps tendon rupture treated with a transosseous cortical button were invited to take part in the study. Fourteen patients were included in the final analysis. All patients were evaluated both clinically and by computed tomography scanning of the proximal radius after a minimum follow-up of 2 years. Outcomes were recorded using the visual analog scale score for pain, the Mayo Elbow Performance Score, and Disabilities of the Arm, Shoulder, and Hand scores. Bone tunnel volume was measured with semiautomated computed tomography segmentation using image-processing software. There were no failures of fixation in the patient group examined. Elbow mobility, arm, and forearm circumference were symmetric for all patients. Average visual analog scale for pain was less than 2. Mean Disabilities of the Arm, Shoulder, and Hand score and Mayo Elbow Performance Score were 2.3 and 97.6, respectively. Computed tomography images showed an average closure of the radial bony tunnel of 64% of the initial volume. Biceps tendon repair with cortical button fixation only shows partial tunnel closure. This could reduce the risk of potential complications due to osteolysis, such as radius fracture or hardware failure. Functional results were excellent and comparable to other fixation methods. The role of interference screws in transosseous cortical button techniques to strengthen the repair and to avoid osteolysis may therefore be questioned. Therapeutic IV. Copyright © 2016

  1. Clinical significance of coryneform Gram-positive rods from blood identified by MALDI-TOF mass spectrometry and their susceptibility profiles - a retrospective chart review.

    Science.gov (United States)

    Mushtaq, Ammara; Chen, Derrick J; Strand, Gregory J; Dylla, Brenda L; Cole, Nicolynn C; Mandrekar, Jayawant; Patel, Robin

    2016-07-01

    With the advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), most Gram-positive rods (GPRs) are readily identified; however, their clinical relevance in blood cultures remains unclear. Herein, we assessed the clinical significance of GPRs isolated from blood and identified in the era of MALDI-TOF MS. A retrospective chart review of patients presenting to the Mayo Clinic, Rochester, MN, from January 1, 2013, to October 13, 2015, was performed. Any episode of a positive blood culture for a GPR was included. We assessed the number of bottles positive for a given isolate, time to positivity of blood cultures, patient age, medical history, interpretation of culture results by the healthcare team and whether infectious diseases consultation was obtained. We also evaluated the susceptibility profiles of a larger collection of GPRs tested in the clinical microbiology laboratory of the Mayo Clinic, Rochester, MN from January 1, 2013, to October 31, 2015. There were a total of 246 GPRs isolated from the blood of 181 patients during the study period. 56% (n = 101) were deemed contaminants by the healthcare team and were not treated; 33% (n = 59) were clinically determined to represent true bacteremia and were treated; and 8% (n = 14) were considered of uncertain significance, with patients prescribed treatment regardless. Patient characteristics associated with an isolate being treated on univariate analysis included younger age (P = 0.02), identification to the species level (P = 0.02), higher number of positive blood culture sets (P blood culture sets (P = 0.0005) and lower time to positivity (P = 0.03) were associated with an isolate being treated. 100, 83, 48 and 34% of GPRs were susceptible to vancomycin, meropenem, penicillin and ceftriaxone, respectively.

  2. Clinical Trials

    Science.gov (United States)

    Clinical trials are research studies that test how well new medical approaches work in people. Each study answers ... prevent, screen for, diagnose, or treat a disease. Clinical trials may also compare a new treatment to a ...

  3. Spot scanning proton therapy plan assessment: design and development of a dose verification application for use in routine clinical practice

    Science.gov (United States)

    Augustine, Kurt E.; Walsh, Timothy J.; Beltran, Chris J.; Stoker, Joshua B.; Mundy, Daniel W.; Parry, Mark D.; Bues, Martin; Fatyga, Mirek

    2016-04-01

    The use of radiation therapy for the treatment of cancer has been carried out clinically since the late 1800's. Early on however, it was discovered that a radiation dose sufficient to destroy cancer cells can also cause severe injury to surrounding healthy tissue. Radiation oncologists continually strive to find the perfect balance between a dose high enough to destroy the cancer and one that avoids damage to healthy organs. Spot scanning or "pencil beam" proton radiotherapy offers another option to improve on this. Unlike traditional photon therapy, proton beams stop in the target tissue, thus better sparing all organs beyond the targeted tumor. In addition, the beams are far narrower and thus can be more precisely "painted" onto the tumor, avoiding exposure to surrounding healthy tissue. To safely treat patients with proton beam radiotherapy, dose verification should be carried out for each plan prior to treatment. Proton dose verification systems are not currently commercially available so the Department of Radiation Oncology at the Mayo Clinic developed its own, called DOSeCHECK, which offers two distinct dose simulation methods: GPU-based Monte Carlo and CPU-based analytical. The three major components of the system include the web-based user interface, the Linux-based dose verification simulation engines, and the supporting services and components. The architecture integrates multiple applications, libraries, platforms, programming languages, and communication protocols and was successfully deployed in time for Mayo Clinic's first proton beam therapy patient. Having a simple, efficient application for dose verification greatly reduces staff workload and provides additional quality assurance, ultimately improving patient safety.

  4. Clinical Pharmacopsychology

    DEFF Research Database (Denmark)

    Fava, Giovanni A; Tomba, Elena; Bech, Per

    2017-01-01

    The aim of this critical review was to outline emerging trends and perspectives of clinical pharmacopsychology, an area of clinical psychology that is concerned with the psychological effects of medications. The historical development of clinical pharmacopsychology is outlined, with discussion......, the vulnerabilities induced by treatment (side effects, behavioral toxicity, iatrogenic comorbidity), and the interactions between drug treatment and psychological variables. Its aim is to provide a comprehensive assessment of the clinical important changes that are concerned with (a) wanted and expected treatment...... of its most representative expressions and reference to current challenges of clinical research, with particular reference to clinimetrics. The domains of clinical pharmacopsychology encompass the clinical benefits of psychotropic drugs, the characteristics that predict responsiveness to treatment...

  5. Clinical virology

    National Research Council Canada - National Science Library

    Hayden, Frederick G; Whitley, Richard J; Richman, Douglas D

    2002-01-01

    .... Covering pathogenesis, epidemiology, diagnosis, treatment, and prevention, Clinical Virology informs scientists and health care professionals about all the medically relevant aspects of this rapidly evolving field...

  6. Is social support associated with improved clinical outcomes in geriatric lung cancer patients? Observations from North Central Cancer Treatment Group Studies N9921 and N0222

    Directory of Open Access Journals (Sweden)

    Aminah Jatoi

    2009-06-01

    Full Text Available Aminah Jatoi1, Shauna L Hillman1, Katie L Allen Ziegler1, Philip J Stella2, Gamini S Soori3, Kendrith M Rowland Jr41Mayo Clinic and Mayo Foundation, Rochester, MN, USA; 2Michigan Cancer Research Consortium, Ann Arbor, MI, USA; 3Missouri Valley Cancer Consortium, Omaha, NE, USA; 4Carle Cancer Center CCOP, Urbana, IL, USABackground: Social support is defined as a network of family/friends who provide practical and emotional help. A sizable literature describes a direct relationship between social support and improved cancer clinical outcomes. This study explored the extent of social support and its potential association with survival and adverse events in geriatric lung cancer patients. Methods: One hundred thirteen patients, who were aged 65 years or older, had incurable cancer, and were enrolled in one of two chemotherapy trials, completed the Lubben Social Network Scale, a validated instrument that measures social support. All were followed for survival and chemotherapy-related adverse events.Results: The median age (range of the cohort was 74 years (65–91, and performance scores of 0, 1, or 2 were observed in 29%, 55%, and 16%, respectively. Forty-two percent were women. This cohort had a high level of social support: 81% reported they “always” had someone to take them to medical appointments. However, there were no gender-based differences in social support and no associations between social support and either survival or adverse events. Conclusion: In this cohort of geriatric lung cancer patients – all of whom were treated during a clinical trial – there was a high level of social support. However, there were no gender-based differences in extent of social support, and the latter did not predict clinical outcomes. Keywords: social support, lung cancer, elderly, adverse events, survival

  7. Innovación tecnológica y humanitarismo en el traslado de heridos de guerra: el informe de Nicasio Landa sobre un nuevo sistema de suspensión elástica de camillas (Pamplona, 29 mayo 1875

    Directory of Open Access Journals (Sweden)

    Jon Arrizabalaga

    Full Text Available Resumen En mayo de 1875, en medio de una sangrienta contienda civil en España conocida como Tercera Guerra Carlista, Nicasio Landa, oficial médico de Sanidad Militar redactó un informe demandando autorización a sus superiores para que Cruz Roja Española, de la que era inspector general, pudiera adoptar un nuevo sistema de suspensión elástica para camillas que había diseñado, desarrollado y probado. Destinado ante todo a carretas de labranza – el medio de transporte de heridos aún más frecuente entonces – se presentaba como un mecanismo económico y resistente para mejorar el confort de los trasladados, que podía también instalarse en carruajes de ambulancia, vagones de ferrocarril y buques-hospitales. Se publica una edición anotada del informe precedida de una presentación del mismo.

  8. Comparison of three prognostic scoring systems in a series of 146 cases of chronic myelomonocytic leukemia (CMML): MD Anderson prognostic score (MDAPS), CMML-specific prognostic scoring system (CPSS) and Mayo prognostic model. A detailed review of prognostic factors in CMML.

    Science.gov (United States)

    Calvo, Xavier; Nomdedeu, Meritxell; Santacruz, Rodrigo; Martínez, Núria; Costa, Dolors; Pereira, Arturo; Estrada, Natalia; Xicoy, Blanca; Esteve, Jordi; Nomdedeu, Benet

    2015-07-23

    Although specific prognostic models for chronic myelomonocytic leukemia (CMML) exist, few are based on large series of patients. MD Anderson prognostic score (MDAPS) has been the most useful for CMML risk assessment. Due to recent emergence of CMML-specific prognostic scoring system (CPSS) and Mayo prognostic model, we compared the three scores. One hundred forty-six CMML patients diagnosed between 1998 and 2014 were retrospectively analyzed. Univariate analysis was performed to assess prognostic impact on overall survival (OS) and leukemia-free survival (LFS) of the variables composing the scores and all items showed prognostic value on OS with the exception of the presence of circulating immature myeloid cells. Regarding LFS, only CPSS variables, bone marrow blast ≥10% and an absolute monocyte count >10×10(9)/L had an impact. When the scores were applied, all showed an impact on OS and retained their significance in multivariate analysis. By using ROC curves and C-index, CPSS showed a slightly better predictive value for mortality and leukemia transformation. Variables composing the three indexes were compared in multivariate analysis and only CPSS parameters and platelets<100×10(9)/L retained their significance. Based on these findings, by adding platelet count to CPSS, a new score was implemented (CPSS-P) showing the best risk prediction capability in our series. This study reinforces the validity of the tested scores.

  9. Clubfoot

    Science.gov (United States)

    ... Self-management More about In-Depth Multimedia Resources Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  10. Hoarding disorder

    Science.gov (United States)

    ... appointment Self-management More about In-Depth Resources Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  11. Clinical Research

    DEFF Research Database (Denmark)

    Christensen, Irene

    2016-01-01

    This paper is about the logic of problem solving and the production of scientific knowledge through the utilisation of clinical research perspective. Ramp-up effectiveness, productivity, efficiency and organizational excellence are topics that continue to engage research and will continue doing s...... for years to come. This paper seeks to provide insights into ramp-up management studies through providing an agenda for conducting collaborative clinical research and extend this area by proposing how clinical research could be designed and executed in the Ramp- up management setting....

  12. Clinical photography.

    Science.gov (United States)

    Jakowenko, Janelle

    2009-01-01

    Digital cameras, when used correctly, can provide the basis for telemedicine services. The increasing sophistication of digital cameras, combined with the improved speed and availability of the Internet, make them an instrument that every health-care professional should be familiar with. Taking satisfactory images of patients requires clinical photography skills. Photographing charts, monitors, X-ray films and specimens also requires expertise. Image capture using digital cameras is often done with insufficient attention, which can lead to inaccurate study results. The procedures in clinical photography should not vary from camera to camera, or from country to country. Taking a photograph should be a standardised process. There are seven main scenarios in clinical photography and health professionals who use cameras should be familiar with all of them. Obtaining informed consent prior to photography should be a normal part of the clinical photography routine.

  13. Clinical vampirism

    African Journals Online (AJOL)

    Clinical vampirism is named after the mythical vam- pire, and is a ... neck and drinking from the wound. A victim ... characteristics of a periodic craving for blood, association with the dead ..... learned later that he died after a surgical operation.

  14. Clinical virology

    National Research Council Canada - National Science Library

    Hayden, Frederick G; Whitley, Richard J; Richman, Douglas D

    2002-01-01

    .... The second section provides agent-specific chapters that detail the virology, epidemiology, pathogenesis, clinical manifestations, laboratory diagnosis, and prevention and treatment of important human viral pathogens" [publisher's web site].

  15. Update on corticosteroids for diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Schwartz SG

    2016-09-01

    Full Text Available Stephen G Schwartz,1 Ingrid U Scott,2,3 Michael W Stewart,4 Harry W Flynn Jr1 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 2Department of Ophthalmology, 3Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, 4Department of Ophthalmology, Mayo Clinic Florida, Jacksonville, FL, USA Abstract: Diabetic macular edema (DME remains an important cause of visual loss. Although anti-vascular endothelial growth factor (VEGF agents are generally used as first-line treatments for patients with center-involving DME, there is an important role for corticosteroids as well. Corticosteroids may be especially useful in pseudophakic patients poorly responsive to anti-VEGF therapies, in patients wishing to reduce the number of required injections, and in pregnant patients. Intravitreal triamcinolone acetonide has been used for many years but is not approved for this indication. An extended-release bioerodable dexamethasone delivery system and an extended-release nonbioerodable fluocinolone acetonide insert have both achieved regulatory approval for the treatment of DME. All intravitreal corticosteroids are associated with risks of cataract progression, elevation of intraocular pressure, and endophthalmitis. There is no current consensus regarding the use of corticosteroids, but they are valuable for selected patients with center-involving DME. Keywords: diabetic macular edema, vascular endothelial growth factor, triamcinolone acetonide, dexamethasone, fluocinolone acetonide, randomized clinical trial

  16. Status epilepticus in the elderly: differential diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Mauricio EA

    2011-03-01

    Full Text Available Elizabeth Ann Mauricio, William David FreemanMayo Clinic, Jacksonville, FL, USADate of Preparation 28th January 2011 Conflict of interest: None declaredAbstract: Seizures are not an uncommon occurrence in older adults, and the incidence of status epilepticus is much greater in the elderly than in younger populations. Status epilepticus is a neurologic emergency and requires prompt intervention to minimize morbidity and mortality. Treatment involves both supportive care as well as initiation of medications to stop all clinical and electrographic seizure activity. Benzodiazepines are used as first-line agents, followed by antiepileptic drugs when seizures persist. In refractory status epilepticus, urgent neurologic consultation is indicated for the titration of anesthetic agents to a level of appropriate background suppression on EEG. In light of our aging population, physician awareness and competence in the management of status epilepticus is imperative and should be recognized as a growing public health concern.Keywords: status epilepticus, convulsive, generalized, nonconvulsive, refractory, elderly, treatment 

  17. Clinical Investigation.

    Science.gov (United States)

    1979-09-30

    Hiller, D.A., Elliott, J.P.: Tubal Ligation Syndrome Myth or Reality. Presented: Armed Forces Division of ACOG, New Orleans, Louisiana, October 1977...Molecular Weight Immunoreactive Glucagon Levels in Patients with the Post Prandial Syndrome . (Abst.) Western Society for Clinical Research, 1979. (3...Glucagon Levels in Patients witl the Post Prandial Syndrome . Presented: Western Society Meetings, Western Society for Clinical Research, February 1979. (3

  18. Clinical supervision.

    Science.gov (United States)

    Goorapah, D

    1997-05-01

    The introduction of clinical supervision to a wider sphere of nursing is being considered from a professional and organizational point of view. Positive views are being expressed about adopting this concept, although there are indications to suggest that there are also strong reservations. This paper examines the potential for its success amidst the scepticism that exists. One important question raised is whether clinical supervision will replace or run alongside other support systems.

  19. Indenta Clinic

    OpenAIRE

    Saifouri, Shillan

    2015-01-01

    In this project assignment I have approached a dentist clinic, suffering from lack of patients and costumers, which is caused by competition in the industry and government policies. These new initiatives made by the public sector are declaring that former healthcare benefits are no longer available. Former grants received, when going to the dentist has been limited to a much smaller group of citizens, this resulting in fewer people willing to visit the dentist office. Dentist clinics are ...

  20. DNA methylation status of epithelial-mesenchymal transition (EMT--related genes is associated with severe clinical phenotypes in ulcerative colitis (UC.

    Directory of Open Access Journals (Sweden)

    Tomomitsu Tahara

    Full Text Available BACKGROUND: Epithelial-to-mesenchymal transition (EMT is a phenomenon that allows the conversion of adherent epithelial cells to a mesenchymal cell phenotype, which enhances migratory capacity and invasiveness. Recent studies have suggested that EMT contributes to the pathogenesis of ulcerative colitis (UC. We investigated the promoter DNA methylation status of EMT-related genes in the colonic mucosa in UC. METHODS: Colonic biopsies were obtained from the rectal inflammatory mucosa of 86 UC patients and the non-inflammatory proximal colonic mucosa of 10 paired patients. Bisulfite pyrosequencing was used to quantify the methylation of 5 candidate CpG island promoters (NEUROG1, CDX1, miR-1247, CDH1, and CDH13 and LINE1. RESULTS: Using an unsupervised hierarchical clustering analysis, inflamed rectal mucosa was well separated from mucosa that appeared normal. The CDH1 and CDH13 promoters were significantly associated with patient age (p = 0.04, 0.03, respectively. A similar trend was found between those genes and the duration of disease (CDH1: p = 0.07, CDH13: p = 0.0002, mean of both: p<0.00001. Several positive associations were found between hypermethylation and severe clinical phenotypes (CDX1 and miR-1247 and a refractory phenotype: p = 0.04 and 0.006, respectively. miR-1247 and CDH1 hyper methylation and a more severe Mayo endoscopic subscore: miR-1247: p = 0.0008, CDH1: p = 0.03, mean of both: p = 0.003. When the severe clinical phenotype was defined as having any of five phenotypes (hospitalized more than twice, highest Mayo endoscopic subscore, steroid dependence, refractory, or a history of surgery miR-1247 hypermethylation was associated with the same phenotype (p = 0.008. CONCLUSIONS: Our data suggest that variability in the methylation status of EMT-related genes is associated with more severe clinical phenotypes in UC.

  1. Impact of Clinical Pharmacist on the Pediatric Intensive Care Practice: An 11-Year Tertiary Center Experience.

    Science.gov (United States)

    Tripathi, Sandeep; Crabtree, Heidi M; Fryer, Karen R; Graner, Kevin K; Arteaga, Grace M

    2015-01-01

    With increasing complexity of critical care medicine comes an increasing need for multidisciplinary involvement in care. In many institutions, pharmacists are an integral part of this team, but long-term data on the interventions performed by pharmacists and their effects on patient care and outcomes are limited. We aimed to describe the role of pediatric clinical pharmacists in pediatric intensive care unit (PICU) practice. We retrospectively reviewed the records of pharmacy interventions in the PICU at the Mayo Clinic in Rochester, Minnesota, from 2003-2013, with a distinct period of increased pharmacist presence in the PICU from 2008 onward. We compared demographic and outcome data on patients who did and who did not have pharmacy interventions during 2 periods (2003-2007 and 2008-2013). We identified 27,773 total interventions by pharmacists during the 11-year period, of which 79.8% were accepted by the clinical team. These interventions were made on 10,963 unique PICU admissions and prevented 5867 order entry errors. Pharmacists' interventions increased year over year, including a significant change in 2008. Patients who required pharmacy involvement were younger, sicker, and had longer intensive care unit, hospital, and ventilator duration. Average central line infections and central line entry rates decreased significantly over the study period. Increased pharmacist presence in the PICU is associated with increased interventions and prevention of adverse drug events. Pharmacist participation during rounds and order entry substantially improved the care of critically sick children and should be encouraged.

  2. Clinical presentation, treatment, and long‑term outcomes in patients with takotsubo cardiomyopathy: experience of a single cardiology center

    Directory of Open Access Journals (Sweden)

    Grzegorz Opolski

    2010-06-01

    Full Text Available INTRODUCTION: Takotsubo cardiomyopathy (TTC is a rare transient cardiomyopathy mimicking acute coronary syndrome (ACS. OBJECTIVES: The aim of the study was to retrospectively analyze the clinical course, treatment strategies, and follow‑up of patients with TTC. PATIENTS AND METHODS: Among all patients hospitalized in the department between January 2005 and January 2010, we identified a group of patients who were fulfilling the modified Mayo Clinic criteria for the diagnosis of TTC. Clinical presentation, hospital course, and clinical outcomes were analyzed. RESULTS: A total of 31 patients with TTC were included into the study; women comprised 93.5% of the study population. The most common symptoms included chest pain and dyspnea caused by emotional or physical stress. Cardiogenic shock was present in 2 subjects and life‑threatening ventricular arrhythmias in 3 other patients. Twenty‑four patients had ST‑segment elevation on the electrocardiogram. A mean left ventricular ejection fraction was 42 ±8.6% during contractility abnormalities, and it increased to 58 ±7.9% during recovery. Troponin I was positive in 30 cases with a mean peak level of 2.7 ±5.1 ng/ml. Follow‑up data were available in 23 patients and a mean follow‑up was 955 ±502.8 days. We did not observe a recurrence of TTC. CONCLUSIONS: TTC is observed mainly in postmenopausal women. Clinical presentation of TTC is almost indistinguishable from ACS, but its course is milder and the outcomes are better.

  3. Stemcell Information: SKIP000921 [SKIP Stemcell Database[Archive

    Lifescience Database Archive (English)

    Full Text Available s Differentiation to three germ layers Yes teratoma formation ... Tayaramma Thatava Tayaramma Thatava Department... of Molecular Medicine, Mayo Clinic Department of Molecular Medicin...e, Mayo Clinic ... Information Only Department of Molecular Medicine, Mayo Clinic Department of Molecular Me

  4. Stemcell Information: SKIP000920 [SKIP Stemcell Database[Archive

    Lifescience Database Archive (English)

    Full Text Available Yes Differentiation to three germ layers Yes teratoma formation ... Tayaramma Thatava Tayaramma Thatava Department... of Molecular Medicine, Mayo Clinic Department of Molecular Medic...ine, Mayo Clinic ... Information Only Department of Molecular Medicine, Mayo Clinic Department of Molecular

  5. 我国高校教学中师生互动现状及改进--基于梅奥人际关系理论的思考%The Current Situation and Improvement of Teacher-student Interaction in Colleges and Universities---Thinking Based on the Mayo Interpersonal Relationship Theory

    Institute of Scientific and Technical Information of China (English)

    黎军; 陈微

    2013-01-01

      目前,我国高等教育已经进入大众化阶段,构建和谐的师生关系、加强师生互动对于提高高校教学质量具有非常重要的作用。然而,纵观我国高校教育教学现状,发现在高校师生互动过程中存在着诸如“互动理念失真化”、“互动时间局限化”、“互动形式单一化”等问题,而这些问题归根结底是人或人与人之间关系的问题,是师生双方缺乏互动动力所致。在人际关系理论中,梅奥人际关系理论以其注重人的因素,研究人的个体行为和群体行为,强调满足人的社会需求等特色,在人际关系的诸多学派中独树一帜。因此,我们借鉴和运用梅奥人际关系理论探讨改善高校师生互动的相应措施,以提高高校师生互动水平,推进拔尖创新人才的培养。%At present , China's higher education has entered into the stage of popularization .Constructing the harmonious teacher -student relationship and strengthening the interaction between teachers and students plays a very important role in improving the teach -ing quality.However, By analyzing the current situation of teacher -student interaction in colleges and universities , The paper pointed out that the problems , such as the"The distortion of the interaction theory ","The localization of Interactive time","The simplifica-tion of interactive form", arising in the process of teacher -student interaction in colleges and universities .In the interpersonal rela-tionship theory , Mayo interpersonal relationship theory focuses on human factors , studies the individual behavior and group behavior , emphasizes the importance of meeting the social needs , so it became the unique in many types of interpersonal relationships .Therefore, this paper attempts to apply the Mayo interpersonal relationship theory to discuss the measures taken to improve the teacher -student in-teraction , It is meaningful to improve the level of

  6. Clinical Trials

    Science.gov (United States)

    ... and her initial results. Nueva Esperanza Para Las Enfermedades Del Corazón 09/23/2014 Milena tuvo un ... Story 09/23/2014 Nueva Esperanza Para Las Enfermedades Del Corazón 09/23/2014 Children and Clinical ...

  7. VALIDACIÓN DE LA PLACA BRUXCHECKER COMO MEDIO DIAGNÓSTICO DE BRUXISMO, COMPARADA CON MODELOS DE ESTUDIO EN LA CLÍNICA DE LA UNIVERSIDAD COOPERATIVA DE COLOMBIA, SEDE BOGOTÁ, DURANTE EL PERIODO COMPRENDIDO ENTRE FEBRERO Y MAYO DEL 2011

    Directory of Open Access Journals (Sweden)

    Claudia Liliana Cabrera Bello

    2012-12-01

    Full Text Available Introducción: El bruxismo es un trastorno del movimiento del sistema masticatorio, caracterizado por apriete,rechinamiento y golpeteo dentario. La ausencia de un elemento diagnóstico para evaluar el patrón de contactos oclusales y diagnosticar el grado de bruxismo llevó a realizar un estudio investigativo para validar la placa bruxchecker. Objetivos: En este estudio se validó la placa bruxchecker como medio diagnóstico para valorar la presencia y ubicación de las interferencias oclusales durante los episodios de bruxismo. Materiales y métodos: Se realizó un estudio de evaluación de pruebas diagnósticas, en una población de 35 pacientes mayores de 18 años que asistieron por primera vez a la clínica de ortodoncia correctiva de la Universidad Cooperativa de Colombia sede Bogotá entre febrero y mayo de  2011, se compararon las marcas en las placas Bruxchecker con los desgastes de las caras oclusales encontrados en los modelos de estudio para determinar la concordancia entre los diagnósticos. Resultados: La placa bruxchecker clasificó correctamente de cada 100 enfermos a 96 y de cada 100 sanos a 57. El valor predictivo positivo es del 96% y del 57% el valor predictivo negativo. La prevalencia de bruxismo medida con la placa  fue de 80% en la población. Conclusiones: Se concluye que la placa es una adecuada herramienta para diagnosticar bruxismo.

  8. La salud bucal en los jóvenes de la Corporación de Residencias Universitarias 10 de mayo: una aproximación desde la determinación social con énfasis en pertenencia étnica

    Directory of Open Access Journals (Sweden)

    Shirley Andrade Benavides

    2012-09-01

    Full Text Available Objetivo: Investigar la determinación social de la salud bucal de los estudiantes universitarios pertenecientes a comunidades indígenas y afrocolombianos del sur occidente del país, domiciliarios de las Residencias Universitarias 10 de Mayo. Métodos: Se realizo un estudio descriptivo con apoyo en una encuesta individual fundamentada en la Determinación Social, DS. Resultados: La mayor parte de la población es de género femenino y presenta mejor salud bucal que los hombres. Esto se explica por los cambios alimentarios, culturales y sociales, así como el choque con nuevas formas de pensamiento. La mayoría pierde acceso a las Empresas Promotoras de Salud (EPS y subsisten solo con la cobertura de los servicios de bienestar universitario y en algunos casos con apoyo de otros servicios sociales. Conclusiones: La desigualdad social y la falta de acceso a políticas de equidad en salud determinan la salud bucal y el bienestar humano. Aunque se pudo constatar que cuentan con la información sobre cuidado en salud bucal, las condiciones de acceso a la educación son mínimas y tienen otras prioridades. Si bien la calidad de vida del individuo y sunúcleo familiar se puede mejorar, se reconoce que la salud bucal puede aportar a este propósito hábitos saludables de higiene, alimentación y autocuidados. Recomendaciones: Es necesario ampliar la cobertura de servicios de salud de los universitarios y especialmente de los grupos étnicos considerados minoría. Se deben hacer realidad los planteamientos de reconocimiento a las minorías por parte del gobierno. Es necesario un acompañamiento oportuno en primeros semestres.

  9. Clinical Studies

    DEFF Research Database (Denmark)

    Pallesen, Ulla

    and repair? Have new materials improved longevity? Are there still clinical and material problems to be solved? And what has the highest impact on longevity of posterior resin restorations – the material, the dentist, the patient or the tooth? These matters will be discussed on the basis of the literature......Within the last 25 years composite resin materials have in many countries successively replaced amalgam as a restorative for posterior teeth. Resin materials and bonding systems are continuously being improved by the manufactures, adhesive procedures are now included in the curriculum of most...... universities and practicing dentists restore millions of teeth throughout the World with composite resin materials. Do we know enough about the clinical performance of these restorations over time? Numerous in vitro studies are being published on resin materials and adhesion, some of them attempting to imitate...

  10. Clinical biochemistry

    Science.gov (United States)

    Alexander, W. C.; Leach, C. S.; Fischer, C. L.

    1975-01-01

    The objectives of the biochemical studies conducted for the Apollo program were (1) to provide routine laboratory data for assessment of preflight crew physical status and for postflight comparisons; (2) to detect clinical or pathological abnormalities which might have required remedial action preflight; (3) to discover as early as possible any infectious disease process during the postflight quarantine periods following certain missions; and (4) to obtain fundamental medical knowledge relative to man's adjustment to and return from the space flight environment. The accumulated data presented suggest that these requirements were met by the program described. All changes ascribed to the space flight environment were subtle, whereas clinically significant changes were consistent with infrequent illnesses unrelated to the space flight exposure.

  11. Clinical practice

    OpenAIRE

    2011-01-01

    Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2–2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity ...

  12. Memory clinics

    OpenAIRE

    Jolley, D; Benbow, S M; Grizzell, M

    2006-01-01

    Memory clinics were first described in the 1980s. They have become accepted worldwide as useful vehicles for improving practice in the identification, investigation, and treatment of memory disorders, including dementia. They are provided in various settings, the setting determining clientele and practice. All aim to facilitate referral from GPs, other specialists, or by self referral, in the early stages of impairment, and to avoid the stigma associated with psychiatric services. They bring ...

  13. Telomere length in non-neoplastic colonic mucosa in ulcerative colitis (UC) and its relationship to the severe clinical phenotypes.

    Science.gov (United States)

    Tahara, Tomomitsu; Shibata, Tomoyuki; Okubo, Masaaki; Kawamura, Tomohiko; Sumi, Kazuya; Ishizuka, Takamitsu; Nakamura, Masakatsu; Nagasaka, Mitsuo; Nakagawa, Yoshihito; Ohmiya, Naoki; Arisawa, Tomiyasu; Hirata, Ichiro

    2015-08-01

    Telomere shortening occurs with human aging in many organs and tissues and is accelerated by rapid cell turnover and oxidative injury. To clarify the clinical importance of telomere shortening in colonic mucosa in ulcerative colitis (UC), we measured average telomere length using quantitative real-time PCR in non-neoplastic colonic mucosa in UC patients and assessed its relationship to various clinical subtypes. Relative telomere length in genomic DNA was measured in colonic biopsies obtained from rectal inflammatory mucosa from 86 UC patients as well as paired non-inflammatory proximal colonic mucosae from 10 patients. Data were correlated with various clinical phenotypes. In paired samples, average relative telomere length of rectal inflammatory mucosa was shortened compared to normal appearing proximal colon in eight out of ten cases (p = 0.01). Telomere length shortening was significantly associated with more severe Mayo endoscopic subscore (p telomere length was significantly shortened in the same phenotypes than the others (p = 0.003). Telomere shortening is associated with more severe clinical phenotypes of UC, reflecting severe inflammatory state in the colonic mucosa.

  14. 76 FR 72615 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Science.gov (United States)

    2011-11-25

    ..., RNAV (GPS) RWY 27, Amdt 1 Jacksonville, FL, Jacksonville Intl, ILS OR LOC RWY 8, ILS RWY 8 (SA CAT I), ILS RWY 8 (CAT II), ILS RWY 8 (CAT III), Amdt 13 Jacksonville, FL, Jacksonville Intl, ILS OR LOC RWY 14, Amdt 7 Jacksonville, FL, Jacksonville Intl, ILS OR LOC RWY 26, Amdt 2 Jacksonville,...

  15. [Chronic inflammatory demyelinating polyradiculoneuropathy: clinical heterogeneity and therapeutic perspectives].

    Science.gov (United States)

    Leger, Jean-Marc; Bombelli, Francesco; Tran-Thanh, Hung; Chassande, Bénédicte; Maisonobe, Thierry; Viala, Karine

    2010-01-01

    Since the first description of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) by PJ Dyck's group at the Mayo Clinic 35 years ago, a wide range of publications have underlined the clinical, electrophysiologic and histopathologic heterogeneity of this disease. Expert consensus opinion is that CIDP should be considered in any patient with progressive symmetrical or asymmetrical polyradiculoneuropathy whose clinical course is relapsing and remitting or progresses for more than two months, especially if there are positive sensory symptoms, proximal weakness, are flexia without wasting, or preferential loss of vibration or joint-position sense. Electrophysiologic features of demyelinating polyneuropathy (especially conduction blocks) and elevated protein levels in cerebrospinal fluid may assist with the diagnosis. However, various clinical pictures have been described in patients with CIDP including pure motor or sensory impairment, and distal, multifocal or focal distribution. Two specific points have recently been emphasized:--while most CIDP patients have chronic onset, acute onset resembling Guillain-Barré syndrome may sometimes occur;--pure sensory forms may require different diagnostic strategies, including the use of somatosensory evoked potentials showing abnormal proximal sensory conduction, and nerve biopsy showing macrophage-associated demyelination, onion bulb formation, demyelinated and partially remyelinated nerve fibres, endoneurial edema, endoneurial mononuclear cell infiltration, and variation between fascicles. Several sets of diagnostic criteria for CIDP have been proposed, with different sensitivities and specificities. The European Federation of Neurological Societies/Peripheral Nerve Society criteria strike a balance between specificity, which needs to be higher for research purposes than for clinical diagnosis, and sensitivity, which, if too low, might lead to some cases being missed. CIDP patients may have a variety of

  16. Kidney Cancer

    Science.gov (United States)

    ... the surgeon uses hand controls that tell a robot how to maneuver surgical tools to perform the ... Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. © 1998-2017 Mayo Foundation for ...

  17. Arthroscopy

    Science.gov (United States)

    ... better for you to be unconscious during the procedure. General anesthesia is delivered through a vein (intravenously). You' ... Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2009. June 17, 2015 Original article: ... . Mayo Clinic Footer ...

  18. Takotsubo cardiomyopathy systematic review: Pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy.

    Science.gov (United States)

    Ono, Ryohei; Falcão, L Menezes

    2016-04-15

    Takotsubo cardiomyopathy (TTC) is characterized by transient left ventricular apical ballooning with the absence of coronary occlusion, which typically occurs in older women after emotional or physical stress. The pathophysiology of TTC is not well established, though several possible causes such as catecholamine cardiotoxicity, metabolic disturbance, coronary microvascular impairment and multivessel epicardial coronary artery spasm have been proposed. A number of diagnostic criteria have been suggested in the world and not unified as single, but the most common accepted one is Mayo Clinic proposed criteria. Since the clinical presentation of TTC is usually similar to acute coronary syndrome, differential diagnosis is essential to exclude other diseases and also for its treatment. Imaging modality including echocardiogram, angio CT and cardiac MRI, and lab tests for catecholamine, troponin T, creatine kinase MB and B-type natriuretic peptide can be useful to differentiate TTC from other diseases. Prognosis is generally favorable and in-hospital mortality is from 0% to within 10%. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Acute lymphoblastic leukemia in adolescents and young adults – from genomics to the clinics

    Directory of Open Access Journals (Sweden)

    Kenderian SS

    2013-04-01

    Full Text Available Saad Sirop Kenderian, Mark R Litzow Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA Abstract: Acute lymphoblastic leukemia (ALL in adolescents and young adults (AYA represents a unique and challenging disease entity. Despite the recent improvement of survival in this population over the last decade, it is still lagging behind the excellent cure rates obtained in pediatric ALL. This special population of AYA receives care from pediatric as well as adult hematologists and can be treated on pediatric or adult protocols. There is a substantial difference in disease biology, response to chemotherapy, and allogeneic stem cell transplantation between pediatric and AYA patients. This review discusses current controversies in the management of AYA, outcomes following treatment with pediatric and adult protocols, and the role of allogeneic stem cell transplantation. It focuses on the unique clinical, biological, and socioeconomic characteristics of this population that might partly explain the inferior outcomes. This review also explores recent advances in genomic profiling and emerging treatments in ALL. Keywords: novel agents, monoclonal antibodies, stem cell transplantation, bone marrow transplantation, Philadelphia positive ALL, genomic profile

  20. Libros colombianos raros y curiosos Mayo de 1961

    Directory of Open Access Journals (Sweden)

    Ignacio Rodríguez Guerrero

    1961-05-01

    Full Text Available FALLON DIEGO. (1834-1905. Arte de leer, escribir y dictar música. Sistema alfabético por Diego Fallon comparado con la notación conocida. Obra destinada para servir de texto de enseñanza. Bogotá, 1885. Imprenta musical de Diego Fallon. 18 x 27. p. 308.

  1. Cruz y raya en los libros: Mayo de 1966

    Directory of Open Access Journals (Sweden)

    Ernesto Cortés Ahumada

    1966-05-01

    Full Text Available RIVERO, MARIO. Poemas urbanos. Bogotá, Antares-Tercer Mundo S. A., 1966, 109 páginas. En un libro sobre Grecia y Roma, pero no de la Grecia y de la Roma gigantescas, herméticas y marmóreas, sino de las cotidianas, íntimas y no pocas veces prosaicas, a las cuales convergen sus hombres con sus amores y odios, sin aquel hieratismo escultórico de la gran historia, Eduardo Schwartz - "autor de la más lograda generación de filólogos"- nos habla del mimos.

  2. St. Fionnan's Community Nursing Unit, Achill Sound, Mayo.

    LENUS (Irish Health Repository)

    Buckley, Stephen T

    2010-01-01

    The receptor for advanced glycation end products (RAGE) is a member of the immunoglobulin superfamily of cell surface molecules. As a pattern-recognition receptor capable of binding a diverse range of ligands, it is typically expressed at low levels under normal physiological conditions in the majority of tissues. In contrast, the lung exhibits high basal level expression of RAGE localised primarily in alveolar type I (ATI) cells, suggesting a potentially important role for the receptor in maintaining lung homeostasis. Indeed, disruption of RAGE levels has been implicated in the pathogenesis of a variety of pulmonary disorders including cancer and fibrosis. Furthermore, its soluble isoforms, sRAGE, which act as decoy receptors, have been shown to be a useful marker of ATI cell injury. Whilst RAGE undoubtedly plays an important role in the biology of the lung, it remains unclear as to the exact nature of this contribution under both physiological and pathological conditions.

  3. Panel. Violencia, Sociedad y Salud. Foro del 11 de Mayo

    Directory of Open Access Journals (Sweden)

    Academia Nacional de Medicina

    1995-12-01

    Full Text Available

    Académico GUSTAVO CRISTO SALDIVIA. Me llama la atención, al ver todo el temario del Foro, que no hay un tema sobre violencia burocrática. No hemos visto lo que de violencia externa pasa a la violencia intrafamiliar. El ciudadano que llega a las puertas de las autoridades y se encuentra con la violencia burocrática, no puede llegar al hogar sino a ejercer violencia, porque está frustrado, porque las autoridades no le remediaron su situación, porque lo trataron como a un cualquiera, porque le negaron la condición de ciudadano, porque le cerraron las puertas. La gente necesita horarios de atención y los burócratas ponen horario de “despacho”.

    Académico JORGE GARCÍA GÓMEZ. El 99% somos católicos y no existe lucha religiosa pero, me pregunto ¿Por qué nos matamos tanto entre católicos? ¿Por qué todos los comunicadores sociales no van a la cárcel si no hacen sino promover crímenes, sexo, violencia? En todos los países del mundo son horas enteras dedicadas a la salud, a la protección familiar.

    En nuestro medio no se estimulan la alimentación materna ni la vacunación. Se presentan 24 horas de TV en las que se habla solamente de crímenes, de violencia. ¿Por qué no los obligan a tener programas de salud? Que a Bienestar Familiar le den horas enteras para estos 35.000 niños abandonados. Las estadísticas de Colombia son dramáticas en relación con los muertos diarios.

    Pregunta el Académico GARCÍA GÓMEZ: ¿Cree usted que el derecho a la intimidad, consagrado por la Constitución de 1991, haya estimulado la violencia intrafamiliar y el estado de impunidad de la misma?

    Respuesta de la doctora MARÍA CRISTINA OCAMPO DE HERRÁN. Van en direcciones distintas la voluntad del constituyente y las situaciones reales de violencia cotidiana. El derecho a la intimidad protege un derecho fundamental: el derecho del ser humano a tener un libre desarrollo de su personalidad. Esto está asociado con la ética. E 1 derecho de cada uno va exactamente hasta donde llegue el derecho del otro. Recuerda los derechos de Abater.

    El de Etica para Amador y política para Amador, donde este filósofo español hace una reflexión en torno a qué es la ética. “La ética no es otra cosa -le dice a su hijo- que el ejercicio de la libertad. Si no hubiera lugar a escoger, tampoco habría lugar para la ética, porque no habría lugar a discernir, al libre albedrío, a diferenciar entre lo bueno y lo malo, como entre maltratar al otro o cuidar del otro”.

    Padre FRANCISCO DE Roux. Yo tengo la convicción, en cuanto a ética política, que esta guerra que ya lleva 35 años es absolutamente perversa, porque falla en el primer criterio de la ética política: los métodos que se están usando deben ser convincentes y cuando un método se vuelve contraproducente, cuando produce lo contrario de lo que se está buscando, hay que entrar a revisarlo con mucha seriedad...

  4. Reseñas de libros: mayo de 1964

    Directory of Open Access Journals (Sweden)

    Antonio Panesso Robledo

    1964-05-01

    Full Text Available El documento presenta las reseñas de los siguientes títulos: Eric J. Hobsbawm. Las Revoluciones Burguesas. (The Age of Revolutions Gabriel García Marquez. Notas sobre la Mala Hora. Montaña, Antonio: Cuando termine la lluvia. Bogotá, Ediciones Tecer Mundo, 1963. 194 págs. Beinhauer Werner: El español coloquial. Madrid, Editorial Gredos, 1963. 445 págs. Hatzfeld, Helmut: Estudios sobre el barroco. Madrid, Editorial Gredos, 1964. 487 págs.

  5. St Anne's Private Nursing Home, Sonnagh, Charlestown, Mayo.

    LENUS (Irish Health Repository)

    Malone, Ailish

    2012-12-01

    Gait impairment is a primary symptom of cervical spondylotic myelopathy (CSM); however, little is known about specific kinetic and kinematic gait parameters. The objectives of the study were: (1) to compare gait patterns of people with untreated CSM to those of age- and gender-matched healthy controls; (2) to examine the effect of gait speed on kinematic and kinetic parameters.

  6. Libros colombianos raros y curiosos Mayo de 1966

    Directory of Open Access Journals (Sweden)

    Ignacio Rodríguez Guerrero

    1966-05-01

    Full Text Available DANIEL SAMPER ORTEGA (1895-1943. Selección Samper Ortega de Literatura Colornbiana-100 vols. y 1 de Índices. 17 x 12 ctms. Aprox. 200 págs. c/ v. El tomo 101, 456 págs.Editorial Minerva S.A. Bogotá, 1935-1937. Cultivó la novela, el ensayo, la historia, el teatro, fue excelente orador académico y editor de la selección literaria que lleva su nombre, en 101 volúmenes, que vino a completar después de aproximadamente un cuarto de siglo la primera selección similar que a fines del pasado siglo y principios del presente editó don Jorge Roa, con el título de Biblioteca popular, en XXV volúmenes.

  7. D'Alton Community Nursing Unit, Claremorris, Mayo.

    LENUS (Irish Health Repository)

    Kilonzo, Isae

    2015-04-23

    Specialist palliative care day care (SPDC) units provide an array of services to patients and their families and can increase continuity of care between inpatient and homecare settings. A multidisciplinary teamwork approach is emphasized, and different models of day care exist. Depending on the emphasis of care, the models can be social, medical, therapeutic, or mixed. We describe our experience of introducing an enhanced therapeutic specialist day care model and using both patient- and carer-rated tools to monitor patient outcomes.

  8. Queen of Peace Nursing Home, Churchfield, Knock, Mayo.

    LENUS (Irish Health Repository)

    Nowostawska, Malgorzata

    2011-04-08

    Abstract Background The use of silica coated magnetic nanoparticles as contrast agents has resulted in the production of highly stable, non-toxic solutions that can be manipulated via an external magnetic field. As a result, the interaction of these nanocomposites with cells is of vital importance in understanding their behaviour and biocompatibility. Here we report the preparation, characterisation and potential application of new "two-in-one" magnetic fluorescent nanocomposites composed of silica-coated magnetite nanoparticles covalently linked to a porphyrin moiety. Method The experiments were performed by administering porphyrin functionalised silica-coated magnetite nanoparticles to THP-1 cells, a human acute monocytic leukaemia cell line. Cells were cultured in RPMI 1640 medium with 25 mM HEPES supplemented with heat-inactivated foetal bovine serum (FBS). Results We have synthesised, characterised and analysed in vitro, a new multimodal (magnetic and fluorescent) porphyrin magnetic nanoparticle composite (PMNC). Initial co-incubation experiments performed with THP-1 macrophage cells were promising; however the PMNC photobleached under confocal microscopy study. β-mercaptoethanol (β-ME) was employed to counteract this problem and resulted not only in enhanced fluorescence emission, but also allowed for elongated imaging and increased exposure times of the PMNC in a cellular environment. Conclusion Our experiments have demonstrated that β-ME visibly enhances the emission intensity. No deleterious effects to the cells were witnessed upon co-incubation with β-ME alone and no increases in background fluorescence were recorded. These results should present an interest for further development of in vitro biological imaging techniques.

  9. St Anne's Private Nursing Home, Sonnagh, Charlestown, Mayo.

    LENUS (Irish Health Repository)

    Conway, Aisling

    2014-10-21

    As the health services in Ireland have become more resource-constrained, pressure has increased to reduce public spending on community drug schemes such as General Medical Services (GMS) drug prescribing and to understand current and future trends in prescribing. The GMS scheme covers approximately 37% of the Irish population in 2011 and entitles them, inter alia, to free prescription drugs and appliances. This paper projects the effects of future changes in population, coverage, claims rates and average claims cost on GMS costs in Ireland.

  10. St. Brendan's High Support Unit, Mulranny, Westport, Mayo.

    LENUS (Irish Health Repository)

    Walsh, Jennifer M

    2014-08-28

    The present study is a secondary analysis of the ROLO study, a randomised control trial of a low-glycaemic index (GI) diet in pregnancy to prevent the recurrence of fetal macrosomia. The objectives of the present study were to identify which women are most likely to respond to a low-GI dietary intervention in pregnancy with respect to three outcome measures: birth weight; maternal glucose intolerance; gestational weight gain (GWG). In early pregnancy, 372 women had their mid-upper arm circumference recorded and BMI calculated. Concentrations of glucose, insulin and leptin were measured in early pregnancy and at 28 weeks. At delivery, infant birth weight was recorded and fetal glucose, C-peptide and leptin concentrations were measured in the cord blood. Women who benefited in terms of infant birth weight were shorter, with a lower education level. Those who maintained weight gain within the GWG guidelines were less overweight in both their first and second pregnancies, with no difference being observed in maternal height. Women who at 28 weeks of gestation developed glucose intolerance, despite the low-GI diet, had a higher BMI and higher glucose concentrations in early pregnancy with more insulin resistance. They also had significantly higher-interval pregnancy weight gain. For each analysis, women who responded to the intervention had lower leptin concentrations in early pregnancy than those who did not. These findings suggest that the maternal metabolic environment in early pregnancy is important in determining later risks of excessive weight gain and metabolic disturbance, whereas birth weight is mediated more by genetic factors. It highlights key areas, which warrant further interrogation before future pregnancy intervention studies, in particular, maternal education level and inter-pregnancy weight gain.

  11. Detection of metabolites in Flor de Mayo common beans (Phaseolus ...

    African Journals Online (AJOL)

    katia

    2012-07-10

    Jul 10, 2012 ... degradation of agrotoxins or in agriculture as an antagonist of plant ... and fresh weight of the seedlings as well as chlorophyll content. Applied ..... novel banana rhizosphere bacterium as fungal antagonist and microbial ...

  12. SISMOS DEL 11 DE MAYO DE 2011 EN LORCA

    Directory of Open Access Journals (Sweden)

    Juan Bautista Martínez Guevara

    2011-01-01

    Full Text Available Los sismos son un fenómeno recurrente en esta zona. Un análisis inicial de datos de los terremotos acaecidos en Lorca, nos permiten apuntar lecciones que deberíamos aprender para la evaluación del riesgo sísmico (peligrosidad, vulnerabilidad y costo, incorporarlas a la norma de construcción sismorresistente, y hacer que el período de resiliencia fuese lo más corto y menos costoso posible. Todo ello permitiría gestionar mejor los futuros planes de protección civil.

  13. St. Augustine's Community Nursing Unit, Cathedral Road, Ballina, Mayo.

    LENUS (Irish Health Repository)

    MacFarlane, Anne

    2011-11-19

    Abstract Background Implementation researchers have attempted to overcome the research-practice gap in e-health by developing tools that summarize and synthesize research evidence of factors that impede or facilitate implementation of innovation in healthcare settings. The e-Health Implementation Toolkit (e-HIT) is an example of such a tool that was designed within the context of the United Kingdom National Health Service to promote implementation of e-health services. Its utility in international settings is unknown. Methods We conducted a qualitative evaluation of the e-HIT in use across four countries--Finland, Norway, Scotland, and Sweden. Data were generated using a combination of interview approaches (n = 22) to document e-HIT users\\' experiences of the tool to guide decision making about the selection of e-health pilot services and to monitor their progress over time. Results e-HIT users evaluated the tool positively in terms of its scope to organize and enhance their critical thinking about their implementation work and, importantly, to facilitate discussion between those involved in that work. It was easy to use in either its paper- or web-based format, and its visual elements were positively received. There were some minor criticisms of the e-HIT with some suggestions for content changes and comments about its design as a generic tool (rather than specific to sites and e-health services). However, overall, e-HIT users considered it to be a highly workable tool that they found useful, which they would use again, and which they would recommend to other e-health implementers. Conclusion The use of the e-HIT is feasible and acceptable in a range of international contexts by a range of professionals for a range of different e-health systems.

  14. Mac Bride Community Nursing Unit, St. Mary's Crescent, Westport, Mayo.

    LENUS (Irish Health Repository)

    Ramasubbu, B

    2017-02-01

    Scaphoid fractures are the most common carpal bone fracture. Up to 40% of scaphoid fractures can be missed at initial presentation and investigation. Follow-up plain film radiograph has overall poor sensitivity and reliability. MRI has been shown to have an almost 100% sensitivity and specificity and so is the gold standard in scaphoid fracture diagnosis. Additionally, early specialist involvement is recommended. We proposed that following a designated pathway, there would be no significant increase in MRI requests. Following implementation of a pathway for the management of suspected scaphoid fractures in St James’s Hospital in 2012 re-auditing demonstrated that management changed to either MRI directly after initial x-ray (16\\/145, 11%), MRI after second x-ray (9\\/28, 32%) or orthopaedic follow-up (19\\/28, 68%). The number of MRIs requested was consistent with our predictors of demand. Thus, our new protocol maximises diagnostics, cost effectiveness and quality of patient care.

  15. Hollymount Private Nursing and Retirement Home, Kilrush, Hollymount, Mayo.

    LENUS (Irish Health Repository)

    Casey, Fergal

    2011-08-22

    Abstract Background Gene and protein interactions are commonly represented as networks, with the genes or proteins comprising the nodes and the relationship between them as edges. Motifs, or small local configurations of edges and nodes that arise repeatedly, can be used to simplify the interpretation of networks. Results We examined triplet motifs in a network of quantitative epistatic genetic relationships, and found a non-random distribution of particular motif classes. Individual motif classes were found to be associated with different functional properties, suggestive of an underlying biological significance. These associations were apparent not only for motif classes, but for individual positions within the motifs. As expected, NNN (all negative) motifs were strongly associated with previously reported genetic (i.e. synthetic lethal) interactions, while PPP (all positive) motifs were associated with protein complexes. The two other motif classes (NNP: a positive interaction spanned by two negative interactions, and NPP: a negative spanned by two positives) showed very distinct functional associations, with physical interactions dominating for the former but alternative enrichments, typical of biochemical pathways, dominating for the latter. Conclusion We present a model showing how NNP motifs can be used to recognize supportive relationships between protein complexes, while NPP motifs often identify opposing or regulatory behaviour between a gene and an associated pathway. The ability to use motifs to point toward underlying biological organizational themes is likely to be increasingly important as more extensive epistasis mapping projects in higher organisms begin.

  16. Mayo/IBM PACS project: phase zero description

    Science.gov (United States)

    Gehring, Dale G.; Salutz, James R.; Brooks, Everett G.; Rothman, Melvyn L.; Morin, Richard L.

    1990-08-01

    A demonstration picture archiving and comniunication system (PACS) was developed using standard networking protocols. The systera was developed primarily to gain experience in digital image communications and optical disk usage as well as to raeasure perforittance factors to be used in the design of a substantially larger system. The system consists of a General Electric SIGNA MRI system connected via Ethernet to an IBM P5/2 Model 70, which serves as a gateway to a token-ring network. Resident on the token-ring, along with the P5/2, is an IBM AS/400 computer, an IBM System/36 with an optical storage subsystem and an IBM PS/2-based image review work station. Custom software was developed on each of the computers to control the flow of data and to manage the storage and retrieval of images. Standard TCP/IP software (File Transfer Protocol) is used to transfer the images from the MRI system to the P5/2. The images are converted into ACR/NEMA file format and made available to the communication and archiving system. Under AS/400 control, P5/2 resident programs copy a subset of the ACR/NEMA header information to an AS/400 database, and copy all of the image files to the optical storage subsystem for permanent storage. AS/400 programs were developed to enable database query operations. User-selected images are transferred from the optical storage subsystem either back to the MRI system or to the P5/2-based image review work station.

  17. Violencia, Sociedad y Salud. Foro del 11 de Mayo

    OpenAIRE

    Academia Nacional de Medicina

    1995-01-01

    Introducción

    La Academia Nacional de Medicina, consciente de su alta responsabilidad social y del deber moral que tiene, como máximo organismo asesor del Gobierno en lo relacionado con la salud, consideró necesario e inaplazable promover un estudio a fondo sobre el problema de la violencia en Colombia, ante el notable recrudecimiento de este preocupante flagelo, que la coloca entre los países más violentos del mundo, y frente a las circu...

  18. Violencia, Sociedad y Salud. Foro del 11 de Mayo

    Directory of Open Access Journals (Sweden)

    Academia Nacional de Medicina

    1995-12-01

    Full Text Available

    Introducción

    La Academia Nacional de Medicina, consciente de su alta responsabilidad social y del deber moral que tiene, como máximo organismo asesor del Gobierno en lo relacionado con la salud, consideró necesario e inaplazable promover un estudio a fondo sobre el problema de la violencia en Colombia, ante el notable recrudecimiento de este preocupante flagelo, que la coloca entre los países más violentos del mundo, y frente a las circunstancias manifiestas de progresiva agresividad que afecta a la familia, al individuo, al funcionario público, a la autoridad, y que ha convertido al delincuente común, al guerrillero y al narcotraficante en crueles destructores de la tranquilidad ciudadana.

    Las graves implicaciones de la violencia sobre la salud del individuo y de la comunidad, no sólo desde el punto de vista psicológico y físico, sino de las consecuencias notables sobre los pre-supuestos del sector y sobre el desarrollo y la economía nacionales, además de la mala imagen internacional, exigen una acción frontal contra este flagelo, de todos los estamentos gubernamentales y privados y los esfuerzos decisivos de la universidad, de las organizaciones gremiales y científicas, en una palabra de todos los conglomerados representativos, entre los cuales la Academia juega papel de liderazgo.

    Organismos Internacionales, liderados por la Organización Panamericana de la Salud, convocaron a fines del año pasado a representantes de los países Americanos para tratar el tema de la violencia y sus implicaciones sobre la sociedad, en particular sobre la salud. En la importante Conferencia Interamericana celebrada en Washington, revisaron a profundidad aspectos como el de la violencia como problema de salud pública, la democracia sin violencia, la cultura de paz para el siglo XXI, la economía política de la no violencia, la construcción de las relaciones sociales no violentas.

    La trascendental reunión concluyó con una histórica declaración en la cual se convocó a los gobiernos, a las comunidades, a la sociedad, a las organizaciones de todo orden, a un esfuerzo conjunto, objetivo y práctico, que debe iniciarse de inmediato con la motivación a todos los niveles y el desplazamiento de todos los recursos posibles...

  19. Libros colombianos raros y curiosos: mayo de 1962

    Directory of Open Access Journals (Sweden)

    Ignacio Rodríguez Guerrero

    1962-05-01

    Full Text Available El documento presenta la reseña del siguiente título: VALENZUEL A TEODORO. ( 1828-1898. El asesúzato político. 20 x 15. 16 págs.-El ejemplar que poseemos carece de portada, y de pie de imprenta. Aparece suscrito en diciembre de 1882.

  20. Mayo del 68 y los católicos catalanes

    Directory of Open Access Journals (Sweden)

    Martínez Hoyos, Francisco

    2013-06-01

    Full Text Available In 1968, the catalonian Church lived in a full post-council crisis. The most progressive sections felt themselves disappointed because the expected changes after the Second Vatican Council did not achieve. The parisian events affect this ecclesiastic context, which is accentuated by division and the marxism influence. This article is focused on the responses of Alfonso Carlos Comín, «El Ciervo» magazine and the clergy represented by the «Correspondència» review.En 1968, la Iglesia catalana vivía en plena crisis postconciliar. Los sectores más progresistas se sentían decepcionados porque no se habían producido los cambios que esperaban tras el Vaticano II. Los acontecimientos parisinos inciden sobre este contexto eclesial, marcado por la división y el influjo del marxismo. El artículo se centra en las reacciones de Alfonso Carlos Comín, El Ciervo y el clero representado por la revista Correspondència.

  1. St Anne's Private Nursing Home, Sonnagh, Charlestown, Mayo.

    LENUS (Irish Health Repository)

    Cleary, A

    2012-01-01

    The aim of this audit was to review current practice within a rural mental health service area on the monitoring and documentation of side effects of antipsychotic depot medication. Following a review of the literature on best practice internationally, an evidence based audit tool was adapted. A sample of 60 case files, care plans and prescriptions were audited between January and May 2010. This represented 31% of the total number of service users receiving depot injections in the mental health service region (n=181). The audit results revealed that most service users had an annual documented medical review and a documented prescription. However, only 5 (8%) case notes examined had documentation recorded describing the condition of the injection site and alternation of the injection site was recorded in only 28 (47%) case notes. No case notes examined had written consent to commence treatment recorded, and only 3 (5%) of case notes had documented that information on the depot injection and side effects was given. In 57 (95%) of case notes no documentation of recorded information on the depot and on side effects was given. Documentation of physical observations and tests revealed that 58% of cases had full blood count, liver function tests, thyroid function tests and fasting lipids recorded. All other tests (i.e. temperature, pulse, respirations, blood pressure, ECG) were recorded in less than 50% of cases. Prolactin levels were not recorded in any case. The lack of written consent was partly attributed to lack of recording of consent. The failure to monitor and record some\\r\

  2. 2013 Suwannee River Water Management District Lidar: Mayo (FL)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Light Detection and Ranging (LiDAR) dataset is a survey of Suwannee River G12PD00242 1.0 Meter LiDAR Survey Area 4, Classified Point Cloud, in north-central...

  3. What Are Clinical Trials?

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Clinical Trials What Are Clinical Trials? Past Issues / Fall 2010 Table of Contents Clinical ... conducted all the time. The Different Phases of Clinical Trials Clinical trials related to drugs are classified into ...

  4. Participating in Clinical Trials

    Science.gov (United States)

    ... this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study With Human Subjects A clinical ... to treat or cure a disease. Phases of Clinical Trials Clinical trials of drugs are usually described based ...

  5. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... Z > Participating in Clinical Trials: About Clinical Trials In This Topic About Clinical Trials Risks and Benefits ... of this page please turn Javascript on. Participating in Clinical Trials About Clinical Trials A Research Study ...

  6. Clinical guidelines.

    Science.gov (United States)

    Uppal, Elaine

    2016-01-01

    This article is part of the Advancing practice series which is aimed at exploring practice issues in more depth, considering topics that are frequently encountered and facilitating the development of new insights. Elaine Uppal focuses on the importance of all midwives developing guideline writing skills to ensure that local, national and international midwifery/maternity guidelines are up to date, relevant and reflect midwifery knowledge alongside 'gold' standard evidence. The article aims to consider the development, use and critical appraisal of clinical guidelines. It will define and explain guidelines; discuss their development and dissemination; and consider issues relating to their use in practice. Techniques to critique and develop guidelines using the AGREE tool will be outlined in the form of practice challenges to be undertaken by the individual or in a group.

  7. Incidence of Monoclonal Gammopathy of Undetermined Significance and Estimation of Duration Before First Clinical Recognition

    Science.gov (United States)

    Therneau, Terry M.; Kyle, Robert A.; Melton, L. Joseph; Larson, Dirk R.; Benson, Joanne T.; Colby, Colin L.; Dispenzieri, Angela; Kumar, Shaji; Katzmann, Jerry A.; Cerhan, James R.; Rajkumar, S. Vincent

    2012-01-01

    Objectives To determine the incidence of monoclonal gammopathy of undetermined significance (MGUS) in the general population and to estimate the duration of occult MGUS before first diagnosis. Methods To estimate incidence we used innovative methods to exploit the Olmsted County, Minnesota, MGUS prevalence data, along with follow-up from a large cohort of patients with clinically detected MGUS. The prevalence cohort consisted of 21,463 persons systematically screened for the presence or absence of MGUS. The clinical cohort consisted of 7472 patients with MGUS diagnosed at Mayo Clinic from January 1, 1990, to May 13, 2010. The incidence of MGUS was estimated using the prevalence estimates, the rate of MGUS progression, and the death rates from MGUS using Markov chain methods. Results We estimate that the annual incidence of MGUS in men is 120 per 100,000 population at the age of 50 years and increases to 530 per 100,000 population at the age of 90 years. The rates for women are 60 per 100,000 population at the age of 50 years and 370 per 100,000 population at the age of 90 years. We estimate that 56% of women 70 years of age diagnosed as having MGUS have had the condition for more than 10 years, including 28% for more than 20 years. Corresponding values for men are 55% and 31%, respectively. At 60 years of age, the proportion of prevalent cases that are clinically recognized is 13%. This rate increases to 33% at the age of 80 years. Conclusion In addition to an accumulation of cases, the age-related increase in prevalence of MGUS is related to a true increase in incidence with age. When first clinically recognized, MGUS has likely been present in an undetected state for a median duration of more than 10 years. PMID:22883742

  8. Assessing the feasibility and quality of shared decision making in China: evaluating a clinical encounter intervention for Chinese patients

    Directory of Open Access Journals (Sweden)

    Huang RC

    2016-11-01

    Full Text Available Rongchong Huang,1,* Xiantao Song,2,* Jian Wu,1 Wei Huang,2 Aaron L Leppin,3 Michael R Gionfriddo,3,4 Yongxian Liu,1 Kasey R Boehmer,3 Henry H Ting,5 Victor M Montori3,6 1Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, 2Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Knowledge and Evaluation Research Unit, 4Mayo Graduate School, Mayo Clinic, Rochester, MN, 5Value Institute, New York-Presbyterian Hospital, The University Hospital of Columbia and Cornell, New York, NY, 6Division of Endocrinology, Mayo Clinic, Rochester, MN, USA *These authors contributed equally to this work Background: The aim of this study was to evaluate the feasibility of using the Statin Choice decision aid to have discussions about starting a statin medication for cardiovascular risk reduction in Chinese patients with stable coronary artery diseases.Methods: A prospective, pilot study of the Statin Choice decision aid in two teaching hospitals in Northern China was conducted. A total of seven clinicians were enrolled and underwent a 12-hour, group-based, in-person training on shared decision making (SDM and the Statin Choice decision aid. Then, these clinicians used the Statin Choice decision aid in patients during a clinical encounter. A total of 86 patients aged 40-80 years, who had stable angina, were enrolled. All clinical encounters were video recorded. A team of three researchers viewed and scored all the encounter recordings to evaluate the SDM process and fidelity to the intervention using the OPTION scale and Fidelity scale, respectively. All the patients were followed up for 12 months to record adherence to statin and any major adverse cardiac events (MACEs.Results: The average scores on the OPTION normalized score and Fidelity scale were 21 (range, 3–32; out of a possible, 48 and 10 (range, 6–10; out of a possible, 10, respectively. This

  9. Enhancing the Clinical Reasoning Skills of Postgraduate Students in Internal Medicine Through Medical Nonfiction and Nonmedical Fiction Extracurricular Books.

    Science.gov (United States)

    Kiran, H S; Chacko, Thomas V; Murthy, K A Sudharshana; Gowdappa, H Basavana

    2016-12-01

    To improve the clinical reasoning skills of postgraduate students in internal medicine through 2 kinds of extracurricular books: medical nonfiction and nonmedical fiction. Clinical reasoning is difficult to define, understand, observe, teach, and measure. This is an educational innovation under an experimental framework based on a cognitive intervention grounded in constructivist and cognitivist theories. This study was conducted from June 1, 2014, through May 31, 2015. It was a pre-post, randomized, controlled, prospective, mixed-methods, small-group study. The intervention was through medical nonfiction and nonmedical fiction books. The process was structured to ensure that the students would read the material in phases and reflect on them. Clinical reasoning (pretests and posttests) was quantitatively assessed using the Diagnostic Thinking Inventory (DTI) and clinical reasoning exercises (CREs) and their assessment using a rubric. A qualitative design was used, and face-to-face semistructured interviews were conducted. Posttest total scores (DTI=188.92; CREs=53.92) were higher for the study group after the intervention compared with its own pretest scores (DTI=165.25; CREs=41.17) and with the pretest (DTI=159.27; CRE=40.73) and posttest (DTI=166.91; CREs=41.18) scores of the control group. Interviews with the study group confirmed that the intervention was acceptable and useful in daily practice. We introduced, evaluated, and proved an approach to teaching-learning clinical reasoning based on the assumption that the clinical reasoning skills of postgraduate students in internal medicine can be enhanced through 2 kinds of extracurricular books and that fun as well as interest will enhance learning. This study is not only about teaching-learning clinical reasoning but also about the humanities in medical education. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  10. Detection and Clinical Patterns of Nephron Hypertrophy and Nephrosclerosis Among Apparently Healthy Adults.

    Science.gov (United States)

    Denic, Aleksandar; Alexander, Mariam P; Kaushik, Vidhu; Lerman, Lilach O; Lieske, John C; Stegall, Mark D; Larson, Joseph J; Kremers, Walter K; Vrtiska, Terri J; Chakkera, Harini A; Poggio, Emilio D; Rule, Andrew D

    2016-07-01

    Even among ostensibly healthy adults, there is often mild pathology in the kidney. The detection of kidney microstructural variation and pathology by imaging and the clinical pattern associated with these structural findings is unclear. Cross-sectional (clinical-pathologic correlation). Living kidney donors at Mayo Clinic (Minnesota and Arizona sites) and Cleveland Clinic 2000 to 2011. Predonation kidney function, risk factors, and contrast computed tomographic scan of the kidneys. These scans were segmented for cortical volume and medullary volume, reviewed for parenchymal cysts, and scored for kidney surface roughness. Nephrosclerosis (glomerulosclerosis, interstitial fibrosis/tubular atrophy, and arteriosclerosis) and nephron size (glomerular volume, mean profile tubular area, and cortical volume per glomerulus) determined from an implantation biopsy of the kidney cortex at donation. Among 1,520 living kidney donors, nephrosclerosis associated with increased kidney surface roughness, cysts, and smaller cortical to medullary volume ratio. Larger nephron size (nephron hypertrophy) associated with larger cortical volume. Nephron hypertrophy and larger cortical volume associated with higher systolic blood pressure, glomerular filtration rate, and urine albumin excretion; larger body mass index; higher serum uric acid level; and family history of end-stage renal disease. Both nephron hypertrophy and nephrosclerosis associated with older age and mild hypertension. The net effect of both nephron hypertrophy and nephrosclerosis associating with cortical volume was that nephron hypertrophy diminished volume loss with age-related nephrosclerosis and fully negated volume loss with mild hypertension-related nephrosclerosis. Kidney donors are selected on health, restricting the spectrum of pathologic findings. Kidney biopsies in living donors are a small tissue sample leading to imprecise estimates of structural findings. Among apparently healthy adults, the microstructural

  11. [Clinical research VI. Clinical relevance].

    Science.gov (United States)

    Talavera, Juan O; Rivas-Ruiz, Rodolfo

    2011-01-01

    Usually, in clinical practice the maneuver selected is the one that achieves a favorable outcome with a direct percentage of superiority of at least 10 %, or when the number needed to treat is approximately equal to 10. While this percentage difference is practical for estimating the magnitude of an association, we need to differentiate the impact measures (attributable risk, preventable fraction), measures of association (RR, OR, HR), and frequency measures (incidence and prevalence) applicable when the outcome is nominal. And we must identify ways to measure the strength of association and the magnitude of the association when the outcome variable is quantitative. It is not uncommon to interpret the measures of association as if they were impact measures. For example, for a RR of 0.68, it is common to assume a 32 % reduction of the outcome, but we must consider that this is a relative reduction, which comes from relations of 0.4/0.6, 0.04/0.06, or 0.00004/0.00006. However the direct reduction is 20 % (60 % - 40 %), 2 %, and 2 per 100,000, respectively. Therefore, to estimate the impact of a maneuver it is important to have the direct difference and/or NNT.

  12. Clinical utility of implantable neurostimulation devices in the treatment of chronic migraine

    Directory of Open Access Journals (Sweden)

    Freeman JA

    2013-11-01

    Full Text Available John A Freeman, Terrance L Trentman Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic Arizona, Phoenix, AZ, USA Abstract: Chronic migraine is a disabling disorder that is costly to individuals and society. Occipital nerve stimulation has been used to treat refractory cases of primary headache disorders including drug-resistant chronic cluster headaches and chronic migraine. The Food and Drug Administration (FDA off-labeled application of equipment used for peripheral nerve (occipital stimulation is borrowed from FDA-labeled spinal cord stimulation. Manufacturer-sponsored randomized trials include a feasibility study (ONSTIM-Medtronic and a safety and efficacy study (St Jude. A non-industry sponsored prospective, randomized crossover study by Serra and Marchiotretto suggests improved quality of life and a significant reduction in medication use. Though preliminary studies suggest occipital nerve stimulation is safe and efficacious in treating chronic migraine headache, complication rates, including lead migration, lead fracture, and surgical site infections remain high. Further studies are needed to demonstrate long-term outcomes, while improved surgical techniques and site-specific equipment are needed to minimize complications. Keywords: headache, occipital nerve stimulation, peripheral nerve stimulation, neuromodulation, electrical stimulation therapy

  13. Morbilidad dermatológica en la unidad sanitaria "1o de mayo", Lanús Este, Buenos Aires, agosto de 2009 a enero de 2010 Dermatological morbididad in the sanitary unit "May, 1st", East Lanus, Buenos Aires, August, 2009 to January, 2010

    Directory of Open Access Journals (Sweden)

    CI Martínez Berré

    2010-06-01

    Full Text Available Las enfermedades cutáneas suponen un porcentaje muy significativo de la carga asistencial en la consulta de atención primaria. Los objetivos son: determinar la frecuencia de las enfermedades cutáneas como motivo de consulta en atención primaria y caracterizarlas. Se realizó un estudio observacional, descriptivo y de corte transversal, realizado del 1o de Agosto de 2009 al 31 de Enero de 2010, en la Unidad Sanitaria "1o de Mayo" de Lanús Este, Buenos Aires. Las consultas por enfermedad dermatológica representaron el 5,36% de todas las consultas recibidas (n=10 388, en el centro de salud para el mismo período. El rango de edad entre 20-34 años presentó mayor número de consultas 29,98% (n=167. El 65,35% (n=364 eran mujeres. El 42,73% (n=238 de los pacientes se agruparon en cinco diagnósticos: eczema (17,59%, n=98, escabiosis (8,08%, n=45, acné (6,82%, n= 38, reacción alérgica (5,75%, n= 32 y forúnculos (4,49%, n=25. Dermatitis y eczema fueron el grupo más diagnosticado. El segundo grupo más frecuente en adultos fue trastorno de los apéndices de la piel, a expensas del acné (8% vs 3,82%. En niños el segundo grupo más detectado fue enfermedades infecciosas y parasitarias, a expensas de la escabiosis (13,38% vs 6%. El acné y la escabiosis fueron más frecuentes en Agosto que en Enero (meses representativos de invierno y verano respectivamente. En el verano las reacciones alérgicas fueron cuatro veces más frecuentes y los forúnculos se sextuplicaron. Las enfermedades dermatológicas representan un porcentaje elevado de la actividad asistencial en la consulta de atención primaria.The cutaneous diseases ocuppy a very significative proportion of the daily consultation in primary care. The objective is to determine the frequency of the cutaneous diseases as a motive of consultation in primary care and to characterize them. An observational and descriptive study, of transverse cut, was performed between August 1st, 2009 and

  14. Clinical use and applications of histone deacetylase inhibitors in multiple myeloma

    Directory of Open Access Journals (Sweden)

    Tandon N

    2016-05-01

    Full Text Available Nidhi Tandon, Vijay Ramakrishnan, Shaji K Kumar Division of Hematology, Mayo Clinic, Rochester, MN, USA Abstract: The incorporation of various novel therapies has resulted in a significant survival benefit in newly diagnosed and relapsed patients with multiple myeloma (MM over the past decade. Despite these advances, resistance to therapy leads to eventual relapse and fatal outcomes in the vast majority of patients. Hence, there is an unmet need for new safe and efficacious therapies for continued improvement in outcomes. Given the role of epigenetic aberrations in the pathogenesis and progression of MM and the success of histone deacetylase inhibitors (HDACi in other malignancies, many HDACi have been tried in MM. Various preclinical studies helped us to understand the antimyeloma activity of different HDACi in MM as a single agent or in combination with conventional, novel, and immune therapies. The early clinical trials of HDACi depicted only modest single-agent activity, but recent studies have revealed encouraging clinical response rates in combination with other antimyeloma agents, especially proteasome inhibitors. This led to the approval of the combination of panobinostat and bortezomib for the treatment of relapsed/refractory MM patients with two prior lines of treatment by the US Food and Drug Administration. However, it remains yet to be defined how we can incorporate HDACi in the current therapeutic paradigms for MM that will help to achieve longer disease control and significant survival benefits. In addition, isoform-selective and/or class-selective HDAC inhibition to reduce unfavorable side effects needs further evaluation. Keywords: HDAC inhibitors, Panobinostat, epigenetics, myeloma, relapse

  15. Current therapeutic strategies for invasive and metastatic bladder cancer

    Directory of Open Access Journals (Sweden)

    Vishnu P

    2011-07-01

    Full Text Available Prakash Vishnu, Jacob Mathew, Winston W TanDivision of Hematology Oncology, Mayo Clinic, Jacksonville, FL, USABackground: Bladder cancer is one of the most common cancers in Europe, the United States, and Northern African countries. Muscle-invasive bladder cancer is an aggressive epithelial tumor, with a high rate of early systemic dissemination. Superficial, noninvasive bladder cancer can most often be cured; a good proportion of invasive cases can also be cured by a combined modality approach of surgery, chemotherapy, and radiation. Recurrences are common and mostly manifest as metastatic disease. Those with distant metastatic disease can sometime achieve partial or complete remission with combination chemotherapy.Recent developments: Better understanding of the biology of the disease has led to the incorporation of molecular and genetic features along with factors such as tumor grade, lympho-vascular invasion, and aberrant histology, thereby allowing identification of ‘favorable’ and ‘unfavorable’ cancers which helps a more accurate informed and objective selection of patients who would benefit from neoadjuvant and adjuvant chemotherapy. Gene expression profiling has been used to find molecular signature patterns that can potentially be predictive of drug sensitivity and metastasis. Understanding the molecular pathways of invasive bladder cancer has led to clinical investigation of several targeted therapeutics such as anti-angiogenics, mTOR inhibitors, and anti-EGFR agents.Conclusion: With improvements in the understanding of the biology of bladder cancer, clinical trials studying novel and targeted agents alone or in combination with chemotherapy have increased the armamentarium for the treatment of bladder cancer. Although the novel biomarkers and gene expression profiles have been shown to provide important predictive and prognostic information and are anticipated to be incorporated in clinical decision-making, their exact utility

  16. Types of Treatment: Clinical Trials

    Science.gov (United States)

    ... Disease Information Treatment Types of Treatment Clinical Trials Clinical Trials Clinical Trials SHARE: Print Glossary Taking part in a clinical ... for cancer are based on previous clinical trials. Clinical Trial Service: LLS provides personalized clinical trial navigation when ...

  17. Clinical professional governance for detailed clinical models.

    Science.gov (United States)

    Goossen, William; Goossen-Baremans, Anneke

    2013-01-01

    This chapter describes the need for Detailed Clinical Models for contemporary Electronic Health Systems, data exchange and data reuse. It starts with an explanation of the components related to Detailed Clinical Models with a brief summary of knowledge representation, including terminologies representing clinic relevant "things" in the real world, and information models that abstract these in order to let computers process data about these things. Next, Detailed Clinical Models are defined and their purpose is described. It builds on existing developments around the world and accumulates in current work to create a technical specification at the level of the International Standards Organization. The core components of properly expressed Detailed Clinical Models are illustrated, including clinical knowledge and context, data element specification, code bindings to terminologies and meta-information about authors, versioning among others. Detailed Clinical Models to date are heavily based on user requirements and specify the conceptual and logical levels of modelling. It is not precise enough for specific implementations, which requires an additional step. However, this allows Detailed Clinical Models to serve as specifications for many different kinds of implementations. Examples of Detailed Clinical Models are presented both in text and in Unified Modelling Language. Detailed Clinical Models can be positioned in health information architectures, where they serve at the most detailed granular level. The chapter ends with examples of projects that create and deploy Detailed Clinical Models. All have in common that they can often reuse materials from earlier projects, and that strict governance of these models is essential to use them safely in health care information and communication technology. Clinical validation is one point of such governance, and model testing another. The Plan Do Check Act cycle can be applied for governance of Detailed Clinical Models

  18. Future requirements. Clinical investigations

    DEFF Research Database (Denmark)

    Qvist, V.

    2002-01-01

    Biocompatability, Cariology, Clinical trials, Dental materials, Helath services research, Human, Pedodontics......Biocompatability, Cariology, Clinical trials, Dental materials, Helath services research, Human, Pedodontics...

  19. Epidemiology and management of chronic constipation in elderly patients

    Directory of Open Access Journals (Sweden)

    Vazquez Roque M

    2015-06-01

    Full Text Available Maria Vazquez Roque, Ernest P Bouras Gastroenterology and Hepatology Department, Mayo Clinic, Jacksonville, FL, USA Abstract: Constipation is a common functional gastrointestinal disorder, with prevalence in the general population of approximately 20%. In the elderly population the incidence of constipation is higher compared to the younger population, with elderly females suffering more often from severe constipation. Treatment options for chronic constipation (CC include stool softeners, fiber supplements, osmotic and stimulant laxatives, and the secretagogues lubiprostone and linaclotide. Understanding the underlying etiology of CC is necessary to determine the most appropriate therapeutic option. Therefore, it is important to distinguish from pelvic floor dysfunction (PFD, slow and normal transit constipation. Evaluation of a patient with CC includes basic blood work, rectal examination, and appropriate testing to evaluate for PFD and slow transit constipation when indicated. Pelvic floor rehabilitation or biofeedback is the treatment of choice for PFD, and its efficacy has been proven in clinical trials. Surgery is rarely indicated in CC and can only be considered in cases of slow transit constipation when PFD has been properly excluded. Other treatment options such as sacral nerve stimulation seem to be helpful in patients with urinary dysfunction. Botulinum toxin injection for PFD cannot be recommended at this time with the available evidence. CC in the elderly is common, and it has a significant impact on quality of life and the use of health care resources. In the elderly, it is imperative to identify the etiology of CC, and treatment should be based on the patient’s overall clinical status and capabilities. Keywords: pelvic floor dysfunction, constipation, elderly 

  20. Clinical toxicology: clinical science to public health.

    Science.gov (United States)

    Bateman, D N

    2005-11-01

    1. The aims of the present paper are to: (i) review progress in clinical toxicology over the past 40 years and to place it in the context of modern health care by describing its development; and (ii) illustrate the use of clinical toxicology data from Scotland, in particular, as a tool for informing clinical care and public health policy with respect to drugs. 2. A historical literature review was conducted with amalgamation and comparison of a series of published and unpublished clinical toxicology datasets from NPIS Edinburgh and other sources. 3. Clinical databases within poisons treatment centres offer an important method of collecting data on the clinical effects of drugs in overdose. These data can be used to increase knowledge on drug toxicity mechanisms that inform licensing decisions, contribute to evidence-based care and clinical management. Combination of this material with national morbidity datasets provides another valuable approach that can inform public health prevention strategies. 4. In conclusion, clinical toxicology datasets offer clinical pharmacologists a new study area. Clinical toxicology treatment units and poisons information services offer an important health resource.

  1. Solar hot water system installed at Days Inn Motel, Jacksonville, Florida

    Science.gov (United States)

    1980-09-01

    The solar system was designed to provide 65 percent of the hot water demand. Water in the liquid flat plate collector (900 square feet) system automatically drains into the 1000 gallon lined and vented steel storage tank when the pump is not running. Heat is transferred from storage to Domestic Hot Water (DHW) tanks through a tube and shell heat exchanger. A circulating pump between the DHW tanks and heat exchanger enables solar heated water to help make up DHW standby losses. All pumps are controlled by differential temperature.

  2. 2007 US Army Corps of Engineers (USACE), Jacksonville District US Virgin Islands LiDAR

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This Light Detection and Ranging (LiDAR) bare-earth classified LAS dataset is a topographic survey conducted for the USACE USVI LiDAR Project. These data were...

  3. New Standard Weir Design for Dredged Material Management Area, Jacksonville District

    Science.gov (United States)

    2014-08-01

    traditional 4-in. x 6-in. timber weir boards are heavy and cumbersome, making the work of adding or removing the boards dangerous. • Leakage of...insert and pull waterlogged timber boards. Other improvements associated with this new design include high- density polyethylene (HDPE) outfall pipes and...including ditching and dewatering operations. One of the primary reasons permanent outfalls are not utilized more often is due to marine wood borers

  4. H08463: NOS Hydrographic Survey , St. Johns River, Jacksonville, Florida, 1959-04-08

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  5. H08464: NOS Hydrographic Survey , St. Johns River, Jacksonville, Florida, 1959-03-31

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  6. H11821: NOS Hydrographic Survey , Brunswick, Georgia to Jacksonville, Florida Recommended Routes, 2008-05-01

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  7. NOAA Office for Coastal Management Coastal Inundation Digital Elevation Model: Jacksonville WFO (Georgia)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This digital elevation model (DEM) is a part of a series of DEMs produced for the National Oceanic and Atmospheric Administration Office for Coastal Management's Sea...

  8. H11216: NOS Hydrographic Survey , Brunswick, Georgia to Jacksonville, Florida, 2003-12-04

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  9. H11218: NOS Hydrographic Survey , Brunswick, Georgia to Jacksonville, Florida, 2004-03-25

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  10. H09373: NOS Hydrographic Survey , Vicinity of Jacksonville, Florida, 1973-10-05

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  11. H09367: NOS Hydrographic Survey , Vicinity of Jacksonville, Florida, 1973-03-24

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  12. H10878: NOS Hydrographic Survey , Approaches to Jacksonville, Florida, 1999-06-07

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  13. F00636: NOS Hydrographic Survey , Approaches to Jacksonville, 2014-05-22

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  14. H11089: NOS Hydrographic Survey , Brunswick, Georgia to Jacksonville, Florida, 2002-04-30

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  15. 77 FR 419 - Drawbridge Operation Regulation; St. Johns River, Jacksonville, FL

    Science.gov (United States)

    2012-01-05

    ... flashing green lights to indicate that vessels may pass. When a train approaches, large signs on both the upstream and downstream sides of the bridge flash ``Bridge Coming Down,'' the lights go to flashing red... circuit is occupied. After the train has cleared, the draw opens and the lights return to flashing green...

  16. 2015 NOAA NGS Ortho-rectified Color Mosaic of Jacksonville Beach to Mosquito Lagoon, Florida

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains ortho-rectified mosaic tiles, created as a product from the NOAA Integrated Ocean and Coastal Mapping (IOCM) initiative. The source imagery...

  17. H11217: NOS Hydrographic Survey , Brunswick, Georgia to Jacksonville, Florida, 2004-03-01

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  18. H11223: NOS Hydrographic Survey , Brunswick, Georgia to Jacksonville, Florida, 2004-08-05

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  19. H11091: NOS Hydrographic Survey , Brunswick, Georgia to Jacksonville, Florida, 2003-02-03

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  20. H11090: NOS Hydrographic Survey , Brunswick, Georgia to Jacksonville, Florida, 2002-08-16

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  1. Predictive models in the diagnosis and treatment of autoimmune epilepsy.

    Science.gov (United States)

    Dubey, Divyanshu; Singh, Jaysingh; Britton, Jeffrey W; Pittock, Sean J; Flanagan, Eoin P; Lennon, Vanda A; Tillema, Jan-Mendelt; Wirrell, Elaine; Shin, Cheolsu; So, Elson; Cascino, Gregory D; Wingerchuk, Dean M; Hoerth, Matthew T; Shih, Jerry J; Nickels, Katherine C; McKeon, Andrew

    2017-07-01

    To validate predictive models for neural antibody positivity and immunotherapy response in epilepsy. We conducted a retrospective study of epilepsy cases at Mayo Clinic (Rochester-MN; Scottsdale-AZ, and Jacksonville-FL) in whom autoimmune encephalopathy/epilepsy/dementia autoantibody testing profiles were requested (06/30/2014-06/30/2016). An Antibody Prevalence in Epilepsy (APE) score, based on clinical characteristics, was assigned to each patient. Among patients who received immunotherapy, a Response to Immunotherapy in Epilepsy (RITE) score was assigned. Favorable seizure outcome was defined as >50% reduction of seizure frequency at the first follow-up. Serum and cerebrospinal fluid (CSF) from 1,736 patients were sent to the Mayo Clinic Neuroimmunology Laboratory for neural autoantibody evaluation. Three hundred eighty-seven of these patients met the diagnostic criteria for epilepsy. Central nervous system (CNS)-specific antibodies were detected in 44 patients. Certain clinical features such as new-onset epilepsy, autonomic dysfunction, viral prodrome, faciobrachial dystonic seizures/oral dyskinesia, inflammatory CSF profile, and mesial temporal magnetic resonance imaging (MRI) abnormalities had a significant association with positive antibody results. A significantly higher proportion of antibody-positive patients had an APE score ≥4 (97.7% vs. 21.6%, p < 0.01). Sensitivity and specificity of an APE score ≥4 to predict presence of specific neural auto-antibody were 97.7% and 77.9%, respectively. In the subset of patients who received immunotherapy (77), autonomic dysfunction, faciobrachial dystonic seizures/oral dyskinesia, early initiation of immunotherapy, and presence of antibodies targeting plasma membrane proteins (cell-surface antigens) were associated with favorable seizure outcome. Sensitivity and specificity of a RITE score ≥7 to predict favorable seizure outcome were 87.5% and 83.8%, respectively. APE and RITE scores can aid diagnosis

  2. Uses of clinical algorithms.

    Science.gov (United States)

    Margolis, C Z

    1983-02-04

    The clinical algorithm (flow chart) is a text format that is specially suited for representing a sequence of clinical decisions, for teaching clinical decision making, and for guiding patient care. A representative clinical algorithm is described in detail; five steps for writing an algorithm and seven steps for writing a set of algorithms are outlined. Five clinical education and patient care uses of algorithms are then discussed, including a map for teaching clinical decision making and protocol charts for guiding step-by-step care of specific problems. Clinical algorithms are compared as to their clinical usefulness with decision analysis. Three objections to clinical algorithms are answered, including the one that they restrict thinking. It is concluded that methods should be sought for writing clinical algorithms that represent expert consensus. A clinical algorithm could then be written for any area of medical decision making that can be standardized. Medical practice could then be taught more effectively, monitored accurately, and understood better.

  3. Dysphagia in inflammatory myopathy: clinical characteristics, treatment strategies, and outcome in 62 patients.

    Science.gov (United States)

    Oh, Terry H; Brumfield, Kathlyn A; Hoskin, Tanya L; Stolp, Kathryn A; Murray, Joseph A; Bassford, Jeffrey R

    2007-04-01

    To assess the clinical characteristics, treatment, and outcome of patients with inflammatory myopathy-associated dysphagia. We retrospectively reviewed the medical records of all patients with inflammatory myopathy-associated dysphagia seen at the Mayo Clinic in Rochester, Minn, between January 1, 1997, and December 31, 2001. A total of 783 patients were diagnosed as having inflammatory myopathy during the 5-year study period. Of these, 62 patients (41 women and 21 men; mean age, 68.6 years) had inflammatory myopathy-associated dysphagia: 26 with inclusion body myositis (IBM), 18 with dermatomyositis, 9 with polymyositis, and 9 with overlap syndrome. Dysphagia was a presenting symptom in 13 patients (21%), with the highest incidence in the IBM group. Videofluoroscopic examinations revealed pharyngeal pooling and impaired oropharyngeal and cricopharyngeal function. The benefits of swallowing compensation techniques and exercises were difficult to establish. Interventional procedures were performed in 24 patients (39%) and most frequently (62%) in patients with IBM, with cricopharyngeal myotomy being most beneficial. Patients with IBM had the least symptomatic improvement. Overall, 11 patients died during the median follow-up of 38 months, with respiratory failure due to aspiration pneumonia as the most common cause. Mortality was high in patients who required percutaneous endoscopic gastrostomy (7/11, 64%), and 1- year mortality was highest (31%) in those with dermatomyositis. Dysphagia is a serious and at times presenting problem in patients with inflammatory myopathy. It occurs most frequently and appears to be most refractory in patients with IBM. The mortality rate was high in patients who required percutaneous endoscopic gastrostomy, and the 1-year mortality rate was the highest in patients with dermatomyositis.

  4. Clinical effectiveness of baclofen for the treatment of alcohol dependence: a review

    Directory of Open Access Journals (Sweden)

    Brennan JL

    2013-07-01

    Full Text Available Jessica L Brennan,2 Jonathan G Leung,1 Jane P Gagliardi,3 Sarah K Rivelli,3 Andrew J Muzyk4 1Department of Hospital Pharmacy Services, Mayo Clinic, Rochester, MN, 2Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, 3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 4Department of Pharmacy Practice, Campbell University School of Pharmacy and Health Sciences, Buies Creek, NC, USA Abstract: Baclofen, an agonist at the B subunit of gaba-aminobutyric acid receptor, possesses pharmacologic properties that may confer utility for the treatment of alcohol dependence. Research suggests that not only can it be useful in promoting maintenance of alcohol abstinence but also it may play a key role in decreasing alcohol cravings and anxiety often associated with alcohol dependence. To assess the benefit of baclofen for alcohol dependence, a review of the literature was conducted to identify published data investigating this off-label treatment. Four randomized controlled trials to date have been published and were included in this review. Although primary outcomes differ between studies, patients randomized to baclofen experience higher rates of abstinence from alcohol than those taking placebo in two of the trials. Secondary analyses indicate that baclofen is safe in patients with alcohol dependence, including those with moderate to severe liver cirrhosis, and may provide beneficial anxiolytic effects. Despite some positive data, the largest available randomized controlled trial failed to find any differences between baclofen and placebo. In all studies, individuals with severe medical comorbidities, seizure disorders, and psychiatric disorders were excluded from trials, which may limit external validity. In summary, there may be beneficial effects from using baclofen for the treatment of alcohol dependence; however, limited conclusions can be drawn from the small number of studies

  5. MORPHOLOGICAL STUDY ON LUMBOSACRAL TRANSITIONAL VERTEBRA IN ADULT INDIAN SACRA AND ITS CLINICAL IMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Kosuri Kalyan Chakravarthi

    2013-12-01

    Full Text Available Lumbosacral transitional vertebra (Sacralization is the fusion of 5Th lumber vertebra with the first segment of the sacrum it may be complete or incomplete. In complete sacralization body of the 5Th lumber vertebra completely fuses with the sacrum, where as in incomplete sacralisation shows a well defined joint line between the transverse process and the sacrum. Both forms may be either unilateral or bilateral. Such kind of abnormalities are importance while reporting the X ray, CT and MRI films, during surgical procedures at the Lumbosacral region and making a differential diagnosis for the low back ache patients. Accordingly the present study was designed to evaluate the incidence and morphological study of Sacralization (Lumbosacral transitional vertebra in adult Indian sacra and its clinical significance. This study was carried out on 150 dry human sacra irrespective of age and sex at Mayo Institute of Medical Sciences- Barabanki,-UP, Melaka Manipal Medical College-Manipal University and Department of Anatomy, KMCT Medical College, Manassery-Calicut. It was observed that out of 150 sacra, 57 (38% sacra showed sacralization. Out of 57 sacralized bones, 38 (25.33% bones showed bilateral sacralization, whereas 19 (12.67% bones showed unilateral sacralization. Such Lumbosacral transitional vertebra may increase the ricks of Disc bulge / herniation or pseudarthrosis (nonunions with the ilium, degenerative sclerosis around the false joint, compression of lumber nerve roots, low back pain, and false administration of epidural or intradural anaesthetics in lumbosacral region. Its sound knowledge is not only enlightening for the orthopaedic surgeons, also vital for the clinical anatomists, forensic experts and morphologists

  6. Surgical pathology of skeletal coccidioidomycosis: a clinical and histopathologic analysis of 25 cases.

    Science.gov (United States)

    Ricciotti, Robert W; Shekhel, Tatyana A; Blair, Janis E; Colby, Thomas V; Sobonya, Richard E; Larsen, Brandon T

    2014-12-01

    Skeletal coccidioidomycosis is a rare complication of pulmonary coccidioidomycosis that remains incompletely characterized, and its histopathologic features have not been systematically evaluated. All skeletal coccidioidal infections (2000 to 2012) were retrieved from the University of Arizona and Mayo Clinic in Arizona pathology archives. Clinical history and histologic features were reviewed. Among 25 patients (median age 40 y; 17 men), infections involved bones (2 cases), joints (6), or both (17), usually in the distal extremities (68%), especially the wrist (32%). History included previously documented coccidioidomycosis (13), autoimmune disease (8), diabetes (6), malignancy (4), and iatrogenic immunosuppression (10). Common symptoms (median 3 mo) included pain/arthralgia (21) and swelling (10). Cultures and serology were positive in 15 of 17 (88%) and 19 of 22 patients (86%), respectively. Treatment included surgical debridement(s) and chronic antifungal medication(s). Histologic review showed granulomas in all cases, ranging from poorly to well formed, with or without necrosis. Spherule density varied widely (mean 4.8/HPF; range <0.1 to 13.5/HPF). Composition of inflammatory infiltrates, degree of necrosis, and extent of fibrosis did not significantly differ between immunocompetent and immunocompromised patients. Eosinophils were only seen in one third of cases; when present, eosinophils were almost always rare. 10 patients experienced recurrent infection, 8 of whom were immunocompromised; the remaining patients recovered. In conclusion, distal extremities are the most common sites of skeletal coccidioidomycosis encountered by surgical pathologists. This condition is strongly associated with autoimmune disorders and immunosuppression. Spherules are sometimes rare, and multiple modalities including serology, culture, and histology may be required for diagnosis.

  7. History of clinical pharmacy and clinical pharmacology.

    Science.gov (United States)

    Miller, R R

    1981-04-01

    The purpose of the Symposium on Clinical Pharmacy and Clinical Pharmacology is to describe the present and future functional roles of clinical pharmacists and clinical pharmacologists in drug research, professional education, and patient care. Clinical pharmacy is a relatively new professional discipline, being only about 15 years old. This new breed of pharmacists is patient rather than drug product oriented. The discipline arose out of dissatisfaction with old practice norms and the pressing need for a health professional with a comprehensive knowledge of the therapeutic use of drugs. The clinical pharmacy movement began at the University of Michigan in the early 1960s, but much of the pioneering work was done by David Burkholder, Paul Parker, and Charles Walton at the University of Kentucky in the latter part of the 1960s. Clinical pharmacology is a professional discipline that combines basic pharmacology and clinical medicine. Its development began in the early 1950s, primarily as a result of the efforts of Harry Gold. It has had a slower growth than clinical pharmacy but it has made many important contributions to our knowledge of human pharmacology and the rational use of drugs.

  8. Three-tiered risk stratification model to predict progression in Barrett's esophagus using epigenetic and clinical features.

    Directory of Open Access Journals (Sweden)

    Fumiaki Sato

    Full Text Available Barrett's esophagus predisposes to esophageal adenocarcinoma. However, the value of endoscopic surveillance in Barrett's esophagus has been debated because of the low incidence of esophageal adenocarcinoma in Barrett's esophagus. Moreover, high inter-observer and sampling-dependent variation in the histologic staging of dysplasia make clinical risk assessment problematic. In this study, we developed a 3-tiered risk stratification strategy, based on systematically selected epigenetic and clinical parameters, to improve Barrett's esophagus surveillance efficiency.We defined high-grade dysplasia as endpoint of progression, and Barrett's esophagus progressor patients as Barrett's esophagus patients with either no dysplasia or low-grade dysplasia who later developed high-grade dysplasia or esophageal adenocarcinoma. We analyzed 4 epigenetic and 3 clinical parameters in 118 Barrett's esophagus tissues obtained from 35 progressor and 27 non-progressor Barrett's esophagus patients from Baltimore Veterans Affairs Maryland Health Care Systems and Mayo Clinic. Based on 2-year and 4-year prediction models using linear discriminant analysis (area under the receiver-operator characteristic (ROC curve: 0.8386 and 0.7910, respectively, Barrett's esophagus specimens were stratified into high-risk (HR, intermediate-risk (IR, or low-risk (LR groups. This 3-tiered stratification method retained both the high specificity of the 2-year model and the high sensitivity of the 4-year model. Progression-free survivals differed significantly among the 3 risk groups, with p = 0.0022 (HR vs. IR and p<0.0001 (HR or IR vs. LR. Incremental value analyses demonstrated that the number of methylated genes contributed most influentially to prediction accuracy.This 3-tiered risk stratification strategy has the potential to exert a profound impact on Barrett's esophagus surveillance accuracy and efficiency.

  9. Death from pulmonary thromboembolism in severe obesity: lack of association with established genetic and clinical risk factors.

    Science.gov (United States)

    Blaszyk, H; Wollan, P C; Witkiewicz, A K; Björnsson, J

    1999-06-01

    Several clinical and environmental conditions are causally related to sudden death from acute pulmonary thromboembolism (APT). Morbid obesity, despite its frequency and association with adverse health effects, is usually considered at most only an additive risk factor for APT. We reviewed protocols and histories from 7227 consecutive autopsies performed between 1985 and 1996 at the Mayo Clinic, including all deaths from APT where no clinical or environmental risk factor could be identified in the study. Body mass indices (BMI) were calculated and compared with those of age- and sex-matched controls who had died suddenly and naturally without evidence of APT. Resistance to activated protein C is the most common molecular clotting defect predisposing to APT, and it is caused by a point mutation in the factor V gene (R506Q). Genomic DNA was extracted from archival tissues of all cases and controls, and the R506Q status was determined by polymerase chain reaction amplification, restriction endonuclease digestion, and direct sequencing. APT was found as the immediate cause of death in 433 patients, with 36 (8%) having no previously established risk factors. Twenty-four of these persons (67%) were morbidly obese (BMI >30 kg/m2). compared with only five controls (14%, P<0.0001). Four patients in both groups, each with a BMI <30 kg/m2. had at least one allele positive for R506Q. Morbid obesity is an independent risk factor in cases of sudden death from APT after the exclusion of previously established clinical, environmental, and molecular risk factors.

  10. Clinical Trials in Vision Research

    Science.gov (United States)

    ... Eye Health Information > Clinical Trials in Vision Research Clinical Trials in Vision Research Clinical studies depend on people ... vision research in the United States. Basics of Clinical Trials What is a clinical trial? Clinical trials are ...

  11. Development of clinical scientists.

    Science.gov (United States)

    Smith, R V

    1987-01-01

    The education and training of clinical scientists has served society in several ways. For academic pharmacy, the emergence of clinical science has provided research and scholarship opportunities for clinical faculty development. Clinical scientists have also begun to play important roles in industrial drug research and development. For all faculty and students, clinical science research reinforces a "research mindset" that will become increasingly important as our society moves from a production/extraction to an information-based economy. Pharmacy will best evolve by increasing its commitment to clinical science research. In the process, academic pharmacy must continue to improve and support excellent education and training programs for clinical scientists.

  12. Clinical monitoring: infliximab biosimilar CT-P13 in the treatment of Crohn’s disease and ulcerative colitis

    Science.gov (United States)

    Keil, Radan; Wasserbauer, Martin; Zádorová, Zdena; Hajer, Jan; Drastich, Pavel; Wohl, Pavel; Beneš, Marek; Bojková, Martina; Svoboda, Pavel; Konečný, Michal; Falt, Přemysl; Vaňásek, Tomáš; Pešta, Martin; Pešek, František; Bouchner, Luděk; Koželuhová, Jana; Novotný, Aleš; Bartůsková, Lucie; Špičák, Julius

    2016-01-01

    Abstract Objective: The infliximab biosimilar CT-P13 (Remsima®, Inflectra®) was approved in Europe for the treatment of inflammatory bowel disease (IBD) based on extrapolation of data from patients with rheumatic disease. Because there are limited published reports on clinical outcomes for IBD patients treated with CT-P13, we monitored responses to induction treatment with this biosimilar in patients with Crohn’s disease (CD) or ulcerative colitis (UC) in centres across the Czech Republic. Material and methods: Fifty-two patients with CD (n = 30) or UC (n = 22) were treated with 5 mg/kg CT-P13 for up to 14 weeks. Effectiveness of therapy was evaluated with the Crohn’s Disease Activity Index (CDAI) or the Mayo Scoring System (MSS) in patients with CD or UC, respectively, before and after 14 weeks. Additional goals were to evaluate weight changes, serum C-reactive protein (CRP) levels, and complications/adverse events. Results: In patients with CD, remission (CDAI herpes labialis, pneumonia and allergic reaction. Conclusions: This prospective observational study provides evidence of the effectiveness of CT-P13 in IBD. PMID:27002981

  13. Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: correlation with laboratory parameters, clinical, endoscopic and histological indexes

    Directory of Open Access Journals (Sweden)

    Rossini Lucio

    2009-10-01

    Full Text Available Abstract Background Research has shown that fecal biomarkers are useful to assess the activity of inflammatory bowel disease (IBD. The aim of the study is: to evaluate the efficacy of the fecal lactoferrin and calprotectin as indicators of inflammatory activity. Findings A total of 78 patients presenting inflammatory bowel disease were evaluated. Blood tests, the Crohn's Disease Activity Index (CDAI, Mayo Disease Activity Index (MDAI, and Crohn's Disease Endoscopic Index of Severity (CDEIS were used for the clinical and endoscopic evaluation. Two tests were performed on the fecal samples, to check the levels of calprotectin and lactoferrin. The performance of these fecal markers for detection of inflammation with reference to endoscopic and histological inflammatory activity was assessed and calculated sensitivity, specificity, accuracy. A total of 52 patient's samples whose histological evaluations showed inflammation, 49 were lactoferrin-positive, and 40 were calprotectin-positive (p = 0.000. Lactoferrin and calprotectin findings correlated with C-reactive protein in both the CD and UC groups (p = 0.006; p = 0.000, with CDAI values (p = 0.043; 0.010, CDEIS values in DC cases (p = 0,000; 0.000, and with MDAI values in UC cases (p = 0.000. Conclusion Fecal lactoferrin and calprotectin are highly sensitive and specific markers for detecting intestinal inflammation. Levels of fecal calprotectin have a proportional correlation to the degree of inflammation of the intestinal mucosa.

  14. Clinical approach to clinical herbal toxicity.

    Science.gov (United States)

    Tovar, Richard T

    2009-02-01

    This article is a review of the history and current status of herbs in the United States. The clinical effects of herbs and herbal medicine will be reviewed with respect to side effects and clinical toxicity. Treatment of herbal toxicity will be described where indicated.

  15. Dual HER2 blockade in the neoadjuvant and adjuvant treatment of HER2-positive breast cancer

    Directory of Open Access Journals (Sweden)

    Advani P

    2015-09-01

    Full Text Available Pooja Advani,1 Lauren Cornell,2 Saranya Chumsri,1 Alvaro Moreno-Aspitia1 1Division of Hematology and Oncology, 2Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA Abstract: Human epidermal growth factor receptor 2 (HER2 is a tyrosine kinase transmembrane receptor that is overexpressed on the surface of 15%–20% of breast tumors and has been associated with poor prognosis. Consistently improved pathologic response and survival rates have been demonstrated with use of trastuzumab in combination with standard chemotherapy in both early and advanced breast cancer. However, resistance to trastuzumab may pose a major problem in the effective treatment of HER2-positive breast cancer. Dual HER2 blockade, using agents that work in a complimentary fashion to trastuzumab, has more recently been explored to evade resistance in both the preoperative (neoadjuvant and adjuvant settings. Increased effectiveness of dual anti-HER2 agents over single blockade has been recently reported in clinical studies. Pertuzumab in combination with trastuzumab and taxane is currently approved in the metastatic and neoadjuvant treatment of HER2-positive breast cancer. Various biomarkers have also been investigated to identify subsets of patients with HER2-positive tumors who would likely respond best to these targeted therapy combinations. In this article, available trial data regarding efficacy and toxicity of treatment with combination HER2 agents in the neoadjuvant and adjuvant setting have been reviewed, and relevant correlative biomarker data from these trials have been discussed. Keywords: HER2, dual blockade, neoadjuvant, adjuvant, breast cancer, trastuzumab

  16. Update on options for treatment of metastatic castration-resistant prostate cancer

    Directory of Open Access Journals (Sweden)

    Prakash Vishnu

    2010-03-01

    Full Text Available Prakash Vishnu, Winston W TanDivision of Hematology Oncology, Mayo Clinic, Jacksonville, FL, USABackground: Prostate cancer is one of the most common cancers in men in US and European countries. Despite having a favorable prognosis, the incidence of incurable metastatic disease and mortality in the US is about 28,000 per year. Although hormone-based androgen deprivation therapies typically result in rapid responses, nearly all patients eventually develop progressive castration-resistant disease state. With readily available prostate-specific antigen (PSA testing, most of these patients are asymptomatic and manifest progression simply as a rising PSA. In patients with castration-resistant prostate cancer (CRPC, the median survival is about 1–2 years, with improvements in survival seen mostly with docetaxel-based regimens. The purpose of this article is to review the recent developments in the treatment of advanced CRPC.Recent findings: Since the two landmark trials (TAX-327 and Southwest Oncology Group 99–16 in CRPC, several newer cytotoxic drugs (epothilones, satraplatin, targeted agents (abiraterone, MDV3100 and vaccines have been tested in phase II and III setting with promising results.Conclusions: The role of newer agents in the treatment of CRPC still needs to be validated by phase III trials, which are currently ongoing. Whilst the novel biomarkers, ‘circulating tumor cells’, have been shown to provide important prognostic information and are anticipated to be incorporated in future clinical decision-making, their exact utility and relevance calls for a larger prospective validation.Keywords: castration-resistant prostate cancer, novel therapies, mechanisms of resistance, circulating tumor cells

  17. Clinical grades: upward bound.

    Science.gov (United States)

    Walsh, Catherine M; Seldomridge, Lisa A

    2005-04-01

    This study examined the relationship of grades earned in paired theory and clinical courses. Data collected during academic years 1997 to 2002 confirmed that grade inflation exists in clinical nursing courses. Problems involved in awarding grades for clinical performance are discussed (e.g., standards of clinical performance, methods used in evaluation of clinical performance, the impossibility of faculty omnipresence, the influence of student effort in grading, the effect of recency, the challenges of keeping good anecdotal records). Solutions to grading problems are proposed, including dividing up performance into agreed-on elements, measurement of these elements on a grading scale that allows for more differentiation of quality in evaluating clinical performance, assigning grades from the beginning of a clinical course, emphasizing all three domains of clinical practice, and evaluating student performance in both laboratory and, clinical settings.

  18. A clinical scoring system to identify patients with sebaceous neoplasms at risk for the Muir-Torre variant of Lynch syndrome.

    Science.gov (United States)

    Roberts, Maegan E; Riegert-Johnson, Douglas L; Thomas, Brittany C; Rumilla, Kandelaria M; Thomas, Colleen S; Heckman, Michael G; Purcell, Jennifer U; Hanson, Nancy B; Leppig, Kathleen A; Lim, Justin; Cappel, Mark A

    2014-09-01

    The Muir-Torre syndrome variant of Lynch syndrome is characterized by the presence of sebaceous neoplasms (adenoma, epithelioma/sebaceoma, carcinoma) and Lynch syndrome-associated cancers (colon, endometrial, and others). Several clinical scoring systems have been developed to identify patients with colon cancer at high risk of Lynch syndrome. However, no such system has been described for patients presenting with sebaceous neoplasms. Based on logistic regression analysis, a scoring system was developed for patients with sebaceous neoplasm to identify those with the highest likelihood of having Muir-Torre syndrome. The final version of the scoring system included variables such as age at presentation of initial sebaceous neoplasm, total number of sebaceous neoplasms, personal history of a Lynch-related cancer, and family history of Lynch-related cancers. Patients with a score of 3 or more were more likely to have Muir-Torre syndrome (28 of 29 patients), those with a score of 2 had intermediate likelihood (12 of 20 patients), and no patient with a score of 0 or 1 was diagnosed with Muir-Torre syndrome. The Mayo Muir-Torre syndrome risk scoring system appears to identify whether patients who present with sebaceous neoplasms are in need of further Lynch syndrome evaluation using easily ascertained clinical information. Abnormal mismatch repair gene immunohistochemistry of a sebaceous neoplasm is a poor predictor in regard to diagnosing Lynch syndrome.

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

    Medline Plus

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

  20. Informed Consent (Clinical Trials)

    Science.gov (United States)

    ... Research Cancer Treatment Types of Treatment Side Effects Clinical Trials Information A to Z List of Cancer Drugs ... Staging Prognosis Treatment Types of Treatment Side Effects Clinical Trials Cancer Drugs Complementary & Alternative Medicine Coping Feelings & Cancer ...

  1. Research Areas - Clinical Trials

    Science.gov (United States)

    Information about NCI programs and initiatives that sponsor, conduct, develop, or support clinical trials, including NCI’s Clinical Trial Network (NCTN) and NCI Community Oncology Research Program (NCORP) initiatives.

  2. NIH Clinical Centers

    Data.gov (United States)

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

  3. Spina Bifida Clinic Directory

    Science.gov (United States)

    ... edu Special Health Care Services Spinal Cord Clinic Wesley Medical Arts Tower Building (pediatric-will refer adults) ... to age 25) Clinic 6L, One Medical Center Dr. Lebanon, NH 03756 (603) 653-9623 http://chad. ...

  4. Evidence of clinical competence.

    Science.gov (United States)

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

    2012-06-01

    This cross-sectional research used a qualitative questionnaire to explore clinical competence in nursing. The aim was to look for evidence of how clinical competence showed itself in practice. In the research, the views from both education and working life are combined to broadly explore and describe clinical competence from the perspective of students, clinical preceptors and teachers. The questions were formulated on how clinical competence is characterised and experienced, what contributes to it and how it is maintained, and on the relation between clinical competence and evidence-based care. The answers were analysed by inductive content analysis. The results showed that clinical competence in practice is encountering, knowing, performing, maturing and improving. Clinical competence is an ongoing process, rather than a state and manifests itself in an ontological and a contextual dimension.

  5. ClinicalTrials.gov

    Science.gov (United States)

    ... to This Site Terms and Conditions Disclaimer ClinicalTrials.gov is a registry and results database of publicly ... of human participants conducted around the world. ClinicalTrials.gov is a registry and results database of publicly ...

  6. Clinical Laboratory Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. The clinical laboratory fee...

  7. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... trial is to find out if an experimental drug, therapy, medical device, lifestyle change, or test will ... disease. Phases of Clinical Trials Clinical trials of drugs are usually described based on their phase. The ...

  8. Fertility Clinic Success Rates

    Science.gov (United States)

    ... and Autism 2013 Assisted Reproductive Technology Fertility Clinic Success Rates Report Recommend on Facebook Tweet Share Compartir 2013 ART Fertility Clinic Success Rates Report [PDF - 1MB] Bookmarks and thumbnails are ...

  9. Clinical ethics revisited

    Directory of Open Access Journals (Sweden)

    Pellegrino Edmund D

    2001-04-01

    Full Text Available Abstract A decade ago, we reviewed the field of clinical ethics; assessed its progress in research, education, and ethics committees and consultation; and made predictions about the future of the field. In this article, we revisit clinical ethics to examine our earlier observations, highlight key developments, and discuss remaining challenges for clinical ethics, including the need to develop a global perspective on clinical ethics problems.

  10. The Clinical Method and the Clinical Dilemmas.

    Directory of Open Access Journals (Sweden)

    Luis Alberto Corona Martinez

    2011-10-01

    Full Text Available The term ‘’clinic’’, among other meanings, refers to any information that suggests the presence of an illness and is obtained through questioning and physical examination processes that take place in the course of doctor-patient relationship. The purpose of this article is to summarize the challenges and dilemmas to be considered by students and young doctors in the patient's clinical approach, which completes the vision of the unquestionable positive role of clinical medical diagnosis. Different factors that can diminish the quality of obtained clinical information, thus interfering with the diagnostic process, have been classified into four groups: dependent on disease process, dependent on the individual patient or the source of information, dependent on the setting where information was obtained and dependent on the physician. As a generalization we state that the existence of the so-called challenges or dilemmas in clinical approach imply limitations to the clinical information obtained to be used with total reliability. Nevertheless, these dilemmas do not detract, nor even slightly, the values of clinical approach in the diagnostic process.

  11. Clinical Judgment: An Overview.

    Science.gov (United States)

    Records, Nancy L.; Weiss, Amy L.

    1990-01-01

    This paper reviews the substantial body of research on clinical judgment and decision making in medicine and psychology and urges the incorporation of clinical judgment into the speech-language pathology field. The accuracy of clinical judgment, methods of its study, and suggestions for incorporating it into professional training are considered.…

  12. How Do Clinical Trials Work?

    Science.gov (United States)

    ... Studies NHLBI Trials Clinical Trial Websites How Do Clinical Trials Work? If you take part in a clinical ... protect patients and help produce reliable study results. Clinical Trial Protocol Each clinical trial has a master plan ...

  13. University cardiology clinic.

    Science.gov (United States)

    Borozanov, V

    2013-01-01

    In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original

  14. General practitioners' attitudes and preparedness towards Clinical Decision Support in e-Prescribing (CDS-eP adoption in the West of Ireland: a cross sectional study

    Directory of Open Access Journals (Sweden)

    O'Brien Timothy

    2010-01-01

    Full Text Available Abstract Background Electronic clinical decision support (CDS is increasingly establishing its role in evidence-based clinical practice. Considerable evidence supports its enhancement of efficiency in e-Prescribing, but some controversy remains. This study evaluated the practicality and identified the perceived benefits of, and barriers to, its future adoption in the West of Ireland. Methods This cross sectional study was carried out by means of a 27-part questionnaire sent to 262 registered general practitioners in Counties Galway, Mayo and Roscommon. The survey domains encompassed general information of individual's practice, current use of CDS and the practitioner's attitudes towards adoption of CDS-eP. Descriptive and inferential analyses were performed to analyse the data collected. Results The overall response rate was 37%. Nearly 92% of respondents employed electronic medical records in their practice. The majority acknowledged the value of electronic CDS in improving prescribing quality (71% and reducing prescribing errors (84%. Despite a high degree of unfamiliarity (73%, the practitioners were open to the use of CDS-eP (94% and willing to invest greater resources for its implementation (62%. Lack of a strategic implementation plan (78% is the main perceived barrier to the incorporation of CDS-eP into clinical practice, followed by i lack of financial incentives (70%, ii lack of standardized product software (61%, iii high sensitivity of drug-drug interaction or medication allergy markers (46%, iv concern about overriding physicians' prescribing decisions(44% and v lack of convincing evidence on the systems' effectiveness (22%. Conclusions Despite favourable attitudes towards the adoption of CDS-eP, multiple perceived barriers impede its incorporation into clinical practice. These merit further exploration, taking into consideration the structure of the Irish primary health care system, before CDS-eP can be recommended for routine

  15. Impact of Plant Extracts and Antibiotics on Biofilm Formation of Clinical Isolates From Otitis Media

    Science.gov (United States)

    Rehman, Saba; Mujtaba Ghauri, Shahbaz; Sabri, Anjum Nasim

    2016-01-01

    Background: Otitis media can lead to severe health consequences, and is the most common reason for antibiotic prescriptions and biofilm-mediated infections. However, the increased pattern of drug resistance in biofilm forming bacteria complicates the treatment of such infections. Objectives: This study was aimed to estimate the biofilm formation potential of the clinical isolates of otitis media, and to evaluate the efficacy of antibiotics and plant extracts as alternative therapeutic agents in biofilm eradication. Materials and Methods: The ear swab samples collected from the otitis media patients visiting the Mayo Hospital in Lahore were processed to isolate the bacteria, which were characterized using morphological, biochemical, and molecular (16S rRNA ribotyping) techniques. Then, the minimum inhibitory concentrations (MICs) of the antibiotics and crude plant extracts were measured against the isolates. The cell surface hydrophobicity and biofilm formation potential were determined, both qualitatively and quantitatively, with and without antibiotics. Finally, the molecular characterization of the biofilm forming proteins was done by amplifying the ica operon. Results: Pseudomonas aeruginosa (KC417303-05), Staphylococcus hemolyticus (KC417306), and Staphylococcus hominis (KC417307) were isolated from the otitis media specimens. Among the crude plant extracts, Acacia arabica showed significant antibacterial characteristics (MIC up to 13 mg/ml), while these isolates exhibited sensitivity towards ciprofloxacin (MIC 0.2 µg/mL). All of the bacterial strains had hydrophobic cellular surfaces that helped in their adherence to abiotic surfaces, leading to strong biofilm formation potential (up to 7 days). Furthermore, the icaC gene encoding polysaccharide intercellular adhesion protein was amplified from S. hemolyticus. Conclusions: The bacterial isolates exhibited strong biofilm formation potential, while the extracts of Acacia arabica significantly inhibited biofilm

  16. Clinical epidemiology of Alzheimer’s disease: assessing sex and gender differences

    Directory of Open Access Journals (Sweden)

    Mielke MM

    2014-01-01

    Full Text Available Michelle M Mielke,1,2 Prashanthi Vemuri,3 Walter A Rocca1,2 1Department of Health Sciences Research, 2Department of Neurology, 3Department of Radiology, Mayo Clinic, Rochester, MN, USA Abstract: With the aging of the population, the burden of Alzheimer's disease (AD is rapidly expanding. More than 5 million people in the US alone are affected with AD and this number is expected to triple by 2050. While men may have a higher risk of mild cognitive impairment (MCI, an intermediate stage between normal aging and dementia, women are disproportionally affected with AD. One explanation is that men may die of competing causes of death earlier in life, so that only the most resilient men may survive to older ages. However, many other factors should also be considered to explain the sex differences. In this review, we discuss the differences observed in men versus women in the incidence and prevalence of MCI and AD, in the structure and function of the brain, and in the sex-specific and gender-specific risk and protective factors for AD. In medical research, sex refers to biological differences such as chromosomal differences (eg, XX versus XY chromosomes, gonadal differences, or hormonal differences. In contrast, gender refers to psychosocial and cultural differences between men and women (eg, access to education and occupation. Both factors play an important role in the development and progression of diseases, including AD. Understanding both sex- and gender-specific risk and protective factors for AD is critical for developing individualized interventions for the prevention and treatment of AD. Keywords: Alzheimer’s disease, dementia, sex, gender, risk factors, dimorphic medicine

  17. The basis of clinical tribalism, hierarchy and stereotyping: a laboratory-controlled teamwork experiment

    Science.gov (United States)

    Braithwaite, Jeffrey; Clay-Williams, Robyn; Vecellio, Elia; Marks, Danielle; Hooper, Tamara; Westbrook, Mary; Westbrook, Johanna; Blakely, Brette; Ludlow, Kristiana

    2016-01-01

    Objectives To examine the basis of multidisciplinary teamwork. In real-world healthcare settings, clinicians often cluster in profession-based tribal silos, form hierarchies and exhibit stereotypical behaviours. It is not clear whether these social structures are more a product of inherent characteristics of the individuals or groups comprising the professions, or attributable to a greater extent to workplace factors. Setting Controlled laboratory environment with well-appointed, quiet rooms and video and audio equipment. Participants Clinical professionals (n=133) divided into 35 groups of doctors, nurses and allied health professions, or mixed professions. Interventions Participants engaged in one of three team tasks, and their performance was video-recorded and assessed. Primary and secondary measures Primary: teamwork performance. Secondary, pre-experimental: a bank of personality questionnaires designed to assess participants’ individual differences. Postexperimental: the 16-item Mayo High Performance Teamwork Scale (MHPTS) to measure teamwork skills; this was self-assessed by participants and also by external raters. In addition, external, arm's length blinded observations of the videotapes were conducted. Results At baseline, there were few significant differences between the professions in collective orientation, most of the personality factors, Machiavellianism and conservatism. Teams generally functioned well, with effective relationships, and exhibited little by way of discernible tribal or hierarchical behaviours, and no obvious differences between groups (F (3, 31)=0.94, p=0.43). Conclusions Once clinicians are taken out of the workplace and put in controlled settings, tribalism, hierarchical and stereotype behaviours largely dissolve. It is unwise therefore to attribute these factors to fundamental sociological or psychological differences between individuals in the professions, or aggregated group differences. Workplace cultures are more likely to

  18. Learning clinical reasoning.

    Science.gov (United States)

    Pinnock, Ralph; Welch, Paul

    2014-04-01

    Errors in clinical reasoning continue to account for significant morbidity and mortality, despite evidence-based guidelines and improved technology. Experts in clinical reasoning often use unconscious cognitive processes that they are not aware of unless they explain how they are thinking. Understanding the intuitive and analytical thinking processes provides a guide for instruction. How knowledge is stored is critical to expertise in clinical reasoning. Curricula should be designed so that trainees store knowledge in a way that is clinically relevant. Competence in clinical reasoning is acquired by supervised practice with effective feedback. Clinicians must recognise the common errors in clinical reasoning and how to avoid them. Trainees can learn clinical reasoning effectively in everyday practice if teachers provide guidance on the cognitive processes involved in making diagnostic decisions.

  19. Integrating clinical research into clinical decision making

    Directory of Open Access Journals (Sweden)

    Mark R Tonelli

    2011-01-01

    Full Text Available Evidence-based medicine has placed a general priority on knowledge gained from clinical research for clinical decision making. However, knowledge derived from empiric, population-based research, while valued for its ability to limit bias, is not directly applicable to the care of individual patients. The gap between clinical research and individual patient care centers on the fact that empiric research is not generally designed to answer questions of direct relevance to individual patients. Clinicians must utilize other forms of medical knowledge, including pathophysiologic rationale and clinical experience, in order to arrive at the best medical decision for a particular patient. In addition, clinicians must also elucidate and account for the goals and values of individual patients as well as barriers and facilitators of care inherent in the system in which they practice. Evidence-based guidelines and protocols, then, can never be prescriptive. Clinicians must continue to rely on clinical judgment, negotiating potentially conflicting warrants for action, in an effort to arrive at the best decision for a particular patient.

  20. Osteoporosis Treatment: Medications Can Help

    Science.gov (United States)

    Osteoporosis treatment: Medications can help Osteoporosis treatment may involve medication along with lifestyle change. A Mayo Clinic specialist answers some of the most common questions about osteoporosis ...

  1. Premature Ventricular Contractions (PVCs)

    Science.gov (United States)

    Diseases and Conditions Premature ventricular contractions (PVCs) By Mayo Clinic Staff Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in one of your heart's two ...

  2. Menorrhagia (Heavy Menstrual Bleeding)

    Science.gov (United States)

    Diseases and Conditions Menorrhagia (heavy menstrual bleeding) By Mayo Clinic Staff Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy ...

  3. Clopidogrel Resistance by P2Y12 Platelet Function Testing in Patients Undergoing Neuroendovascular Procedures: Incidence of Ischemic and Hemorrhagic Complications.

    Science.gov (United States)

    Nordeen, Jerah D; Patel, Alden V; Darracott, Robert M; Johns, Gretchen S; Taussky, Philipp; Tawk, Rabih G; Miller, David A; Freeman, William D; Hanel, Ricardo A

    2013-06-01

    The purpose of the study was to assess clopidogrel resistance and whether "intensified" antiplatelet therapy guided by platelet inhibition tests during neuroendovascular procedures would reduce ischemic complications. We conducted a retrospective review of patients at Mayo Clinic in Jacksonville, Florida, who underwent neuroendovascular (NV) procedures and had P2Y12 platelet function testing from October 1, 2009, to September 30, 2010. The primary end-point was to determine P2Y12 resistance to antiplatelet therapy in patients who underwent NV procedures. Secondary objectives included incidence of hemorrhagic and ischemic events and a correlation between resistance and genetic CYP2C19 testing. 160 patients underwent P2Y12 platelet function tests. Eighty-one patients (81/160, 50.6%) met inclusion criteria. Platelet function tests identified 64 patients (79%) as non-resistant (≥20% P2Y12 inhibition) and 17 (21%) as resistant (Pharmaceuticals, Princeton, NJ, USA) VerifyNow® (Accumetrics Inc., San Diego, CA, USA) Ticlopidine (Ticlid®) (Roche Laboratories, Basel, Switzerland) Prasugrel (Effient®) (Eli Lilly & Co., Indianapolis, IN, USA) Eptifibatide (Integrilin®) (Merck & Co., Inc., Whitehouse Station, NJ, USA) Abciximab (Reopro®) (Janssen Pharmaceuticals, Inc., Titusville, NJ, USA) Tirofiban (Aggrastat®) (MGI Pharma, Inc., Bloomington, MN, USA) Pantoprazole (Protonix®) (Pfizer Inc., New York, NY, USA) Omeprazole (Prilosec®) (Procter and Gamble Pharmaceuticals, Mason, OH, USA) Famotidine (Pepcid®) (McNeil Consumer & Specialty Pharmaceuticals, Fort Washington, PA, USA) Ticagrelor (Brilinta®) (AstraZeneca Pharmaceuticals, Wilmington, NC, USA).

  4. Current strategies for the prevention of breast cancer

    Directory of Open Access Journals (Sweden)

    Advani P

    2014-05-01

    Full Text Available Pooja Advani, Alvaro Moreno-AspitiaDepartment of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USAAbstract: Due to the high incidence of breast cancer in the United States, optimal strategies for its prevention are imperative. This entails identification of women who are at an increased risk for breast cancer and an integrative approach that includes effective screening methods as well as nutritional, pharmacologic, and surgical management. Several breast cancer risk-assessment tools, such as the Gail and Claus models, can help clinicians determine the quantitative risk of breast cancer. The role of selective estrogen receptor modulators, such as tamoxifen and raloxifene, for the prevention of breast cancer has been well established. Several other agents, such as aromatase inhibitors, are currently being investigated. The potential adverse effects of these chemopreventive agents, which include an impact on the quality of life, must be discussed with the patient before deciding on this approach. Additionally, breast cancer risk factors have been identified over the years; some of them are modifiable, but others are not. Although there is no conclusive evidence to suggest the protective role of specific dietary components, alcohol consumption and obesity are associated with an increased breast cancer risk; thus lifestyle changes can lead to a lower risk of developing breast cancer. Surgical approaches, including bilateral risk-reduction mastectomy and salpingo-oophorectomy, are usually limited to women with a hereditary predisposition to development of breast cancer. The objective of this review is to summarize the various approaches directed at reducing the incidence of breast cancer.Keywords: chemoprevention, tamoxifen, raloxifene, prophylactic surgery

  5. Frequency-doubling technology perimetry and multifocal visual evoked potential in glaucoma, suspected glaucoma, and control patients

    Directory of Open Access Journals (Sweden)

    Kanadani FN

    2014-07-01

    Full Text Available Fabio N Kanadani,1 Paulo AA Mello,1 Syril K Dorairaj,2 Tereza CM Kanadani31Federal University of Sao Paulo, Sao Paulo, Brazil; 2Mayo Clinic, Department of Ophthalmology, Jacksonville, Florida, USA; 3Sao Jose University Hospital, Belo Horizonte, BrazilIntroduction: The gold standard in functional glaucoma evaluation is standard automated perimetry (SAP. However, SAP depends on the reliability of the patients’ responses and other external factors; therefore, other technologies have been developed for earlier detection of visual field changes in glaucoma patients. The frequency-doubling perimetry (FDT is believed to detect glaucoma earlier than SAP. The multifocal visual evoked potential (mfVEP is an objective test for functional evaluation.Objective: To evaluate the sensitivity and specificity of FDT and mfVEP tests in normal, suspect, and glaucomatous eyes and compare the monocular and interocuar mf VEP.Methods: Ninety-five eyes from 95 individuals (23 controls, 33 glaucoma suspects, 39 glaucomatous were enrolled. All participants underwent a full ophthalmic examination, followed by SAP, FDT, and mfVEP tests. Results: The area under the curve for mean deviation and pattern standard deviation were 0.756 and 0.761, respectively, for FDT, 0.564 and 0.512 for signal and alpha for interocular mfVEP, and 0.568 and 0.538 for signal and alpha for monocular mfVEP. This difference between monocular and interocular mfVEP was not significant. Conclusion: The FDT matrix was superior to mfVEP in glaucoma detection. The difference between monocular and interocular mfVEP in the diagnosis of glaucoma was not significant. Keywords: standard automated perimetry, electrophysiology, glaucomatous eyes

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

    Medline Plus

    Full Text Available ... Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & Clinical Studies NHLBI Trials Clinical Trial Websites News & ...

  7. Clinical research informatics

    CERN Document Server

    Richesson, Rachel L

    2012-01-01

    This book provides foundational coverage of key areas, concepts, constructs, and approaches of medical informatics as it applies to clinical research activities, in both current settings and in light of emerging policies. The field of clinical research is fully characterized (in terms of study design and overarching business processes), and there is emphasis on information management aspects and informatics implications (including needed activities) within various clinical research environments. The purpose of the book is to provide an overview of clinical research (types), activities, and are

  8. Hepatic ADC map as an adjunct to conventional abdominal MRI to evaluate hepatic fibrotic and clinical cirrhotic severity in biliary atresia patients

    Energy Technology Data Exchange (ETDEWEB)

    Peng, Steven Shinn-Forng [National Taiwan University, Department of Medical Imaging, Medical College and Hospital, Taipei (China); Jeng, Yung-Ming [National Taiwan University, Department of Pathology, Medical College and Hospital, Taipei (China); Hsu, Wen-Ming; Ho, Ming-Chih [National Taiwan University, Department of Surgery, Medical College and Hospital, Taipei, Taiwan (China); Yang, Justin Cheng-Ta [National Taiwan University, Department of Medical Imaging, Medical College and Hospital, Taipei (China); National Taiwan University, Institute of Biomedical Engineering, College of Engineering and College of Medicine, Taipei (China)

    2015-10-15

    Hepatic apparent diffusion coefficient (ADC) values and ADC-related indices were correlated with the Mayo risk score for primary biliary cirrhosis (MRSPBC) and METAVIR scores of liver specimens to determine the clinical and pathological significance of diffusion-weighted magnetic resonance imaging (DWMRI). Thirty-two patients with biliary atresia (BA; mean age 461 days, range 11-4616 days) received magnetic resonance examinations from March 2009 to August 2013. A free-breathing DWMRI sequence was performed with the single-shot echo-planar imaging technique with b = 0 and 500 s/mm{sup 2} in all 32 BA patients and 24 controls. We used the ordinal logistic regression test and Spearman rank correlation test to analyse the relationships between the MRSPBC and METAVIR fibrosis scores and right liver-to-psoas ADC ratios (LTPARs). BA patients had significantly lower LTPARs in both hepatic lobes than controls (p < 0.01). Right LTPARs, showing moderate intraobserver agreement (intraclass correlation coefficient = 0.736) and interobserver reliability (intraclass correlation coefficient = 0.659), were negatively correlated with MRSPBC and METAVIR fibrosis scores (R{sup 2} = 0.398, p = 0.024 and R{sup 2} = 0.628, p < 0.001, respectively). Right LTPARs may be used for long-term follow-up of cirrhosis severity in BA patients. (orig.)

  9. American Association for Clinical Chemistry

    Science.gov (United States)

    ... older adolescents and adults. Read more IN CLINICAL CHEMISTRY Eliminating Wild-Type DNA in Liquid Biopsies Researchers ... Online Harmonization.net Commission on Accreditation in Clinical Chemistry American Board of Clinical Chemistry Clinical Chemistry Trainee ...

  10. Clinical Judgments of Depression.

    Science.gov (United States)

    Jackson, Douglas N.; And Others

    1986-01-01

    Investigated degree to which judges could simulate Basic Personality Inventory (BPI) responses of a clinically depressed patient group. Judgmental profiles of depressed patients indicated very high reliabilities across information conditions, a high association with actual profiles of clinically depressed patients, and differentiation from other…

  11. Overview of clinical cytogenetics.

    Science.gov (United States)

    Korf, B R

    2001-08-01

    This unit provides an introduction to clinical cytogenetics. It opens with indications for prenatal and postnatal chromosome analysis, followed by a brief discussion of the applications of fluorescence in situ hybridization (FISH). It suggests tissue sources for prenatal and postnatal analysis, and closes with a review of numerical and structural chromosome abnormalities. This unit provides an introduction to clinical cytogenetics.

  12. Clinical Supervision in Denmark

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard

    2011-01-01

    on giving and receiving clinical supervision as reported by therapists in Denmark. Method: Currently, the Danish sample consists of 350 clinical psychologist doing psychotherapy who completed DPCCQ. Data are currently being prepared for statistical analysis. Results: This paper will focus primarily...

  13. Developing Clinical Competence

    NARCIS (Netherlands)

    P.F. Wimmers (Paul)

    2006-01-01

    textabstractThe development of clinical competence is the main purpose of medical education. The long road to become clinically competent starts on the first day of medical school, and every institution strives to select the best students. The responsibility of medical schools is to train th

  14. Predictors of Clinical Performance

    Science.gov (United States)

    Turner, Edward; And Others

    1974-01-01

    In a search for predictors of clinical competence, 50 third-year medical students studying pediatrics were videotaped during their interview and physical examination of outpatients. Consideration should be given to the possible value of psychological tests as predictors of clinical competence. (Author)

  15. Developing Clinical Competence

    NARCIS (Netherlands)

    P.F. Wimmers (Paul)

    2006-01-01

    textabstractThe development of clinical competence is the main purpose of medical education. The long road to become clinically competent starts on the first day of medical school, and every institution strives to select the best students. The responsibility of medical schools is to train

  16. Clinical Trial Basics

    Science.gov (United States)

    ... How Am I Protected? Mark Bowden / iStock Ethical guidelines The goal of clinical research is to develop knowledge that improves human ... data and decide whether the results have medical importance. Results from clinical trials are often published in peer-reviewed scientific ...

  17. Situated clinical cognition.

    Science.gov (United States)

    Timpka, T

    1995-10-01

    The features characterizing study of clinical cognition in situ are formulated as: Re-cognition of context, culture, history and affect. Socializing and phenomenalistic elements are again included in the research agenda. Interest for representations: an analysis level is reserved for the symbols, rules and images relevant to define in models of clinical cognition. De-emphasis on computer modeling: investigations focus on the 'functional systems' in which computers are involved. Rootedness in classical philosophical problems: issues concerning situated clinical cognition are connected to the width of available theoretical literature. Belief in interdisciplinary studies: productive interactions between the new and traditional disciplines is anticipated, implying that new shared methods have to be developed. When scientific perspectives are broadened, a new balance has to be found between the relevance of the subject of study and methodological rigor. The situated clinical cognition framework is to allow for moving between models, theories, and perspectives, as it does not presuppose a singular model of clinical thinking.

  18. Collaboration across clinical silos.

    Science.gov (United States)

    Mohler, M Jane

    2013-01-01

    We face significant challenges to healthcare integration as well as tremendous opportunities to advance healthcare reform as we endeavor to provide a coordinated continuum of high-value services to defined populations for which we are clinically and fiscally accountable. As we move away from fee-for-service and poorly coordinated care toward value-based and bundled care, systems such as UnityPoint Health and clinical entities such as Piedmont Heart are leading the way, breaking down their clinical silos, improving value and access, and gaining patient loyalty. Evidence points us to sound principles that can inform the clinical integration process. Health systems must reinvent themselves, reengineer clinical operations, and streamline processes, all of which require collaboration across traditional silos, both inside our organizations and outside into our wider communities, to ensure that our patients receive the safe, high-value care they deserve.

  19. Clinical Pathway for Thyroidectomy.

    Science.gov (United States)

    Villar del Moral, Jesús María; Soria Aledo, Víctor; Colina Alonso, Alberto; Flores Pastor, Benito; Gutiérrez Rodríguez, María Teresa; Ortega Serrano, Joaquín; Parra Hidalgo, Pedro; Ros López, Susana

    2015-05-01

    Clinical pathways are care plans applicable to patient care procedures that present variations in practice and a predictable clinical course. They are designed not as a substitute for clinical judgment, but rather as a means to improve the effectiveness and efficiency of the procedures. This clinical pathway is the result of a collaborative work of the Sections of Endocrine Surgery and Quality Management of the Spanish Association of Surgeons. It attempts to provide a framework for standardizing the performance of thyroidectomy, the most frequently performed operation in endocrine surgery. Along with the usual documents of clinical pathways (temporary matrix, variance tracking and information sheets, assessment indicators and a satisfaction questionnaire) it includes a review of the scientific evidence around different aspects of pre, intra and postoperative management. Among others, antibiotic and antithrombotic prophylaxis, preoperative preparation in hyperthyroidism, intraoperative neuromonitoring and systems for obtaining hemostasis are included, along with management of postoperative hypocalcemia.

  20. Gait analysis: clinical facts.

    Science.gov (United States)

    Baker, Richard; Esquenazi, Alberto; Benedetti, Maria G; Desloovere, Kaat

    2016-08-01

    Gait analysis is a well-established tool for the quantitative assessment of gait disturbances providing functional diagnosis, assessment for treatment planning, and monitoring of disease progress. There is a large volume of literature on the research use of gait analysis, but evidence on its clinical routine use supports a favorable cost-benefit ratio in a limited number of conditions. Initially gait analysis was introduced to clinical practice to improve the management of children with cerebral palsy. However, there is good evidence to extend its use to patients with various upper motor neuron diseases, and to lower limb amputation. Thereby, the methodology for properly conducting and interpreting the exam is of paramount relevance. Appropriateness of gait analysis prescription and reliability of data obtained are required in the clinical environment. This paper provides an overview on guidelines for managing a clinical gait analysis service and on the principal clinical domains of its application: cerebral palsy, stroke, traumatic brain injury and lower limb amputation.

  1. [Arthritis and clinical history].

    Science.gov (United States)

    Silva, Lígia; Sampaio, Luzia; Pinto, José; Ventura, Francisco S

    2011-01-01

    In front of a patient with arthritis, clinical good-sense tells that the most probable diagnosis are the most prevalent ones. Nevertheless, we have to exclude a multiplicity of other aetiologies, less frequent, but with highest implications in the therapeutic conduct. Infections by Brucella and by Borrelia are rare causes of chronic arthritis, yet are diagnosis to consider, even when the clinical manifestations aren't the most typical, as there still exist endemic areas in Portugal. Here we report two clinical cases about patients with arthritis for more than one year, subject to ineffective exams ant treatments. Only the clinical history could put on evidence clinical-epidemiological data, suggestive of Brucellosis and Lyme Disease, namely the professional contact with infected animals, and the history of probable erythema migrans, that pointed toward the correct diagnosis. So, with directed therapeutic, there was complete resolution of the inflammatory symptoms.

  2. The new clinical leader.

    Science.gov (United States)

    Oates, Kim

    2012-06-01

    The complexity and cost of health care, along with a greater need for accountability calls for a new style of clinical leadership. The new clinical leader will lead reform by putting the needs of the patient first and foremost, looking at current and planned services from the patient's point of view as well as the clinician's. Excellent clinical skills will remain essential but will be supplemented by a focus on team work and mentoring, patient safety, clear communication and reduction in waste and inefficiency, leading to better financial outcomes. The new clinical leaders will understand the importance of consulting widely and engaging colleagues in creating change to improve patient care. They will develop trusting and mutually respectful relationships with health service management and be able to negotiate the delicate balance between clinical judgement, resource constraints and personal loyalties by keeping the best outcome for the patient at the forefront of their thinking.

  3. Clinical Research Methodology 2: Observational Clinical Research.

    Science.gov (United States)

    Sessler, Daniel I; Imrey, Peter B

    2015-10-01

    Case-control and cohort studies are invaluable research tools and provide the strongest feasible research designs for addressing some questions. Case-control studies usually involve retrospective data collection. Cohort studies can involve retrospective, ambidirectional, or prospective data collection. Observational studies are subject to errors attributable to selection bias, confounding, measurement bias, and reverse causation-in addition to errors of chance. Confounding can be statistically controlled to the extent that potential factors are known and accurately measured, but, in practice, bias and unknown confounders usually remain additional potential sources of error, often of unknown magnitude and clinical impact. Causality-the most clinically useful relation between exposure and outcome-can rarely be definitively determined from observational studies because intentional, controlled manipulations of exposures are not involved. In this article, we review several types of observational clinical research: case series, comparative case-control and cohort studies, and hybrid designs in which case-control analyses are performed on selected members of cohorts. We also discuss the analytic issues that arise when groups to be compared in an observational study, such as patients receiving different therapies, are not comparable in other respects.

  4. Clinical microbiology informatics.

    Science.gov (United States)

    Rhoads, Daniel D; Sintchenko, Vitali; Rauch, Carol A; Pantanowitz, Liron

    2014-10-01

    The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  5. Clinical PET application

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Moo; Hong, Song W.; Choi, Chang W.; Yang, Seong Dae [Korea Cancer Center Hospital, Seoul (Korea)

    1997-12-01

    PET gives various methabolic images, and is very important, new diagnostic modality in clinical oncology. In Korea Cancer Center Hospital, PET is installed as a research tool of long-mid-term atomic research project. For the efficient use of PET for clinical and research projects, income from the patients should be managed to get the raw material, equipment, manpower, and also for the clinical PET research. 1. Support the clinical application of PET in oncology. 2. Budgetary management of income, costs for raw material, equipment, manpower, and the clinical PET research project. In this year, 250 cases of PET images were obtained, which resulted total income of 180,000,000 won. 50,000,000 won was deposited for the 1998 PET clinical research. Second year PET clinical research should be managed under unified project. Increased demand for {sup 18}FDG in and outside KCCH need more than 2 times production of {sup 18}FDG in a day purchase of HPLC pump and {sup 68}Ga pin source which was delayed due to economic crisis, should be done early in 1998. (author). 2 figs., 3 tabs.

  6. The absolute lymphocyte/monocyte ratio recovery during ABVD treatment cycles is not significantly impacted by the use of myeloid growth factors and predicts clinical outcomes in classical Hodgkin lymphoma regardless of their use

    Directory of Open Access Journals (Sweden)

    Kaufman GP

    2014-07-01

    Full Text Available Gregory P Kaufman,1 Kay M Ristow,1,2 Svetomir N Markovic,1,2 Luis F Porrata1,2 1Department of Internal Medicine, 2Division of Hematology, Mayo Clinic, Rochester, MN, USA Abstract: Risk stratification of patients with classical Hodgkin lymphoma (cHL remains suboptimal. The ratio of the absolute lymphocyte count (ALC to absolute monocyte count (AMC both at diagnosis and during subsequent recovery from serial cycles of chemotherapy predicts survival in cHL, and possesses advantages over other commonly used prognostic markers. Myeloid growth factors (MGFs, while not strongly recommended for use in adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD treatment cycles, are not uncommonly used to prevent the negative consequences of neutropenia. The effect that MGFs have on the ALC/AMC ratio during ABVD treatment cycles, if any, remains unclear. We retrospectively evaluated 208 patients with cHL, who were diagnosed, treated, and followed at Mayo Clinic Rochester between 1990 and 2014, and who had quantifiable records for the use of MGFs during ABVD treatment cycles. Having an ALC/AMC ratio <1.1 during all treatment cycles was confirmed as being a negative predictor of overall and progression free survival (hazard ratio [HR] 0.06, 95% confidence interval [CI] 0.03–0.14 and HR 0.08, 95% CI 0.04–0.17, respectively. Data on both the ALC/AMC ratio and use of MGFs were available for 1,979 half treatment cycles. When stratified to whether or not MGFs were given, the change in the ALC/AMC ratio as compared to the prior half cycle was found to be statistically insignificant (P=0.3445. No survival advantage was found with the administration of MGFs in any cycle of therapy (log rank P=0.5713. Our data validate the prognostic significance of having an ALC/AMC ratio of ≥1.1 regardless of the use of MGFs. Keywords: myeloid growth factors, classical Hodgkin lymphoma, survival ALC/AMC ratio, ABVD chemotherapy

  7. [Midwifery clinical practicum education].

    Science.gov (United States)

    Kao, Chien-Huei; Gau, Meei-Ling

    2013-06-01

    Midwifery is a practical facet of the health sciences that emphasizes professional competence-oriented teaching and learning. Cognitive and practical processes integrate and build midwifery student professional knowledge, attitudes, and skills. Clinical education is a teaching method and strategy used to prepare midwifery students for professional practice. Midwifery clinical teaching plans are designed using literature review, expert opinions, and student comments and determine total required hours and caseloads. Midwifery clinical teaching activities and methods promote self-reflection, childbirth education fundamentals, learning by role model observation, and learning role function through overseas observership programs. This paper discusses midwifery education dilemmas and coping methods in Taiwan.

  8. Automation in Clinical Microbiology

    Science.gov (United States)

    Ledeboer, Nathan A.

    2013-01-01

    Historically, the trend toward automation in clinical pathology laboratories has largely bypassed the clinical microbiology laboratory. In this article, we review the historical impediments to automation in the microbiology laboratory and offer insight into the reasons why we believe that we are on the cusp of a dramatic change that will sweep a wave of automation into clinical microbiology laboratories. We review the currently available specimen-processing instruments as well as the total laboratory automation solutions. Lastly, we outline the types of studies that will need to be performed to fully assess the benefits of automation in microbiology laboratories. PMID:23515547

  9. Mindfulness and clinical psychology.

    Science.gov (United States)

    Childs, David

    2011-09-01

    Does mindfulness offer more to psychology than a useful therapeutic technique? This paper argues that it can also establish a state of presence which is understood in relation to the practice of phenomenology. Mindfulness is then both linked to a Western intellectual tradition and offers that tradition a systematic method. This is an opening for psychological investigation of the non-conceptual basis of everyday experience. The combination of this theoretical stance with the increasingly widespread practical training of clinical psychologists in mindfulness has broad implications for clinical practice; this is illustrated in relation to the descriptive approach to clinical problems, qualitative research, and reflective practice.

  10. Clinical Case Registries (CCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Clinical Case Registries (CCR) replaced the former Immunology Case Registry and the Hepatitis C Case Registry with local and national databases. The CCR:HIV and...

  11. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... a disease. A clinical trial may compare experimental products or tests to those already available or may ... Institutes of Health | U.S. Department of Health & Human Services Customer Support | Accessibility | Copyright | Privacy | Viewers and Players

  12. Celiac disease: clinical observations

    Directory of Open Access Journals (Sweden)

    Yu. A. Emel’yanova

    2016-01-01

    Full Text Available Presented clinical cases of patients with a diagnosis of gluten enteropathy in treatment in the department of gastroenterology Regional Clinical Hospital. The case is of interest to doctors of different specialties for the differential diagnosis of anemia and malabsorption syndrome, demonstrate both the classic version, and atypical forms of the disease course. Diagnosis of celiac disease is based on three key positions: clinical findings, histology and serological markers. The clinical picture of celiac disease is characterized by pronounced polymorphism, by going beyond the a gastroenterological pathology. For screening of gluten sensitive celiac typically used an antibody to tissue transglutaminase. Morphological research of the mucous membrane of the small intestine is the determining criterion in the diagnosis of celiac disease. The use of specific gluten-free diet leads to the positive dynamics of the disease and improve the quality of life of patients.

  13. Hepatitis C: Clinical Trials

    Science.gov (United States)

    ... Care Apply Online Application Process Veteran Eligibility Active Duty Families of Veterans Women Veterans Determine Costs Copays ... VHA Forms & Publications Quality & Safety Quality of Care Ethics VA/DOD Clinical Practice Guidelines Access and Quality ...

  14. Clinical leadership project.

    Science.gov (United States)

    Kling, Vera G

    2010-11-01

    Nurse educators seek innovative strategies to maximize student learning in the classroom and clinical settings. Students enrolled in a nursing leadership and management course often find they spend more clinical time observing leaders than practicing the necessary skills to lead others in the provision of nursing care. In addition, opportunities to explore the nurse educator role often do not exist in baccalaureate nursing education, despite the shortage of nurse educators. An experience was developed in a baccalaureate nursing program to give senior students, under supervision of faculty, the opportunity to lead and evaluate lower-level students providing patient care in the clinical setting and to experience the role of nursing faculty. Feedback from senior students was positive, and students noted increased proficiency in leadership ability and critical thinking. Student interest in the nurse educator role was also enhanced. Program expansion and evaluation with faculty, clinical staff, and patients are planned. Copyright 2010, SLACK Incorporated.

  15. Alagille syndrome: clinical perspectives

    Directory of Open Access Journals (Sweden)

    Saleh M

    2016-06-01

    Full Text Available Maha Saleh,1 Binita M Kamath,2 David Chitayat1,3 1Division of Clinical and Metabolic Genetics, 2Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Hospital for Sick Children, 3Department of Obstetrics and Gynecology, Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada Abstract: Alagille syndrome is an autosomal dominant, complex multisystem disorder characterized by the presence of three out of five major clinical criteria: cholestasis with bile duct paucity on liver biopsy, congenital cardiac defects (with particular involvement of the pulmonary arteries, posterior embryotoxon in the eye, characteristic facial features, and butterfly vertebrae. Renal and vascular abnormalities can also occur. Inter- and intrafamilial variabilities in the clinical manifestations are common. We reviewed the clinical features and management as well as the molecular basis of Alagille syndrome. Keywords: Alagille syndrome, ALGS, genetics, liver 

  16. NIH Pediatric Rheumatology Clinic

    Science.gov (United States)

    ... to diagnose and treat children with arthritis, periodic fever syndromes, and rheumatic diseases. This clinic will also help doctors and ... are juvenile arthritis including spondyloarthritis, lupus, and periodic ... how juvenile rheumatic diseases affect them and what treatments work best. ...

  17. Understanding Clinical Alarm Safety.

    Science.gov (United States)

    Lukasewicz, Carol L; Mattox, Elizabeth Andersson

    2015-08-01

    Patient safety organizations and health care accreditation agencies recognize the significance of clinical alarm hazards. The Association for the Advancement of Medical Instrumentation, a nonprofit organization focused on development and use of safe and effective medical equipment, identifies alarm management as a major issue for health care organizations. ECRI Institute, a nonprofit organization that researches approaches for improving patient safety and quality of care, identifies alarm hazards as the most significant of the "Top Ten Health Technology Hazards" for 2014. A new Joint Commission National Patient Safety Goal focusing on clinical alarm safety contains new requirements for accredited hospitals to be fully implemented by 2016. Through a fictional unfolding case study, this article reviews selected contributing factors to clinical alarm hazards present in inpatient, high-acuity settings. Understanding these factors improves contributions by nurses to clinical alarm safety practice.

  18. Fidelity in clinical simulation

    DEFF Research Database (Denmark)

    Jensen, Sanne; Nøhr, Christian; Rasmussen, Stine Loft

    2013-01-01

    Clinical simulation may be used to identify user needs for context sensitive functionalities in e-Health. The objective with this paper is to describe how user requirements and use cases in a large EHR-platform procurement may be validated by clinical simulation using a very low-fidelity prototype...... without any existing test data. Instead of using test scenarios and use cases, the healthcare professionals who are participating in the clinical simulation are generating both scenario and patient data themselves. We found that this approach allows for an imaginative discussion, not restricted by known...... functionalities and limitations, of the ideal EHR-platform. Subsequently, we discuss benefits and challenges of using an extremely low fidelity environment and discuss the degree of fidelity necessary for conducting clinical simulation....

  19. Clinical Process Intelligence

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus

    2006-01-01

    .e. local guidelines. From a knowledge management point of view, this externalization of generalized processes, gives the opportunity to learn from, evaluate and optimize the processes. "Clinical Process Intelligence" (CPI), will denote the goal of getting generalized insight into patient centered health......, generalized processes de-ducted from many patient cases and clinical guidelines, are all guidelines that may be used in clinical reasoning. The differ-ence is the validity of the suggested actions and decisions. In the case of generalized processes deducted from EMRs, we have "what we usually do" practice i...... care processes by means of statistical, OLAP and data mining tech-niques, with the aim of refining clinical guidelines, develop local guidelines and facilitate outcome predictions....

  20. Clinical specular microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, L.W.; Laing, R.A.

    1987-01-01

    This book provides the general ophthalmologist with a guide to the clinical applications of specular microscopy. Important material is included on laser injury, cataract surgery, corneal transplants, glaucoma, uveitis, and trauma.

  1. ClinicalTrials.gov

    Data.gov (United States)

    U.S. Department of Health & Human Services — Provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases...

  2. Health Clinic Cost Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Independent Rural Health Clinic and Freestanding Federally Qualified Health Center (HCLINIC).This data...

  3. Participating in Clinical Trials

    Medline Plus

    Full Text Available ... experimental drug, therapy, medical device, lifestyle change, or test will help treat, find, or prevent a disease. A clinical trial may compare experimental products or tests to those already available or may compare existing ...

  4. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    Kraus, V B; Blanco, F J; Englund, M

    2015-01-01

    The objective of this work was to describe requirements for inclusion of soluble biomarkers in osteoarthritis (OA) clinical trials and progress toward OA-related biomarker qualification. The Guidelines for Biomarkers Working Group, representing experts in the field of OA biomarker research from...... of reasons but in particular, to determine whether biomarkers are useful in identifying those individuals most likely to receive clinically important benefits from an intervention; and to determine whether biomarkers are useful for identifying individuals at earlier stages of OA in order to institute...... both academia and industry, convened to discuss issues related to soluble biomarkers and to make recommendations for their use in OA clinical trials based on current knowledge and anticipated benefits. This document summarizes current guidance on use of biomarkers in OA clinical trials...

  5. The clinical nanomedicine handbook

    CERN Document Server

    Brenner, Sara

    2013-01-01

    Designed to foster a stronger awareness and exploration of the subject by practicing clinicians, medical researchers and scientists, The Clinical Nanomedicine Handbook discusses the integration of nanotechnology, biology, and medicine from a clinical point of view. The book highlights relevant research and applications by specialty; it examines nanotechnology in depth, and the potential to solve medical problems. It also increases literacy in nanotechnology, and allows for more effective communication and collaboration between disciplines. Details worldwide developments in nanomedicine Provide

  6. Falsificationism and clinical trials.

    Science.gov (United States)

    Senn, S J

    1991-11-01

    The relevance of the philosophy of Sir Karl Popper to the planning, conduct and analysis of clinical trials is examined. It is shown that blinding and randomization can only be regarded as valuable for the purpose of refuting universal hypotheses. The purpose of inclusion criteria is also examined. It is concluded that a misplaced belief in induction is responsible for many false notions regarding clinical trials.

  7. Clinical studies involving probiotics

    OpenAIRE

    Degnan, Fred H

    2012-01-01

    Researchers from a diverse array of scientific disciplines have focused and continue to focus on opportunities and areas for responsible clinical research involving the possible beneficial health effects of “probiotics.” Investigators and researchers should be aware that not all clinical research involving probiotics reasonably falls within the requirements of the “investigational new drug” (IND) rubric administered and enforced by the US Food and Drug Administration. In determining whether a...

  8. Clinical Nursing Records Study

    Science.gov (United States)

    1991-08-01

    for Sam Houston, Texas MAJ Joanne Burton , AN, Clinical Head Nurse, Psychiatry MAJ Shelby Christian, AN, Clinical Head Nurse, OB/GYN MAJ Melissa Opio...Specify Level) Parenting, Potential Alteration In Decubitus Ulcer Self-Care Deficit, Total (Specify Level) Social Isolation Fluid Volume Deficit. Potential...METABOLIC PATTERN Self-Care Dieficit. Total (Specify Level) SiX alizaticni Alterations ifl Decubitus ulcer S-If-Batingrla.v~qene Oeticit 601?Cif Levet

  9. Fundamentals of clinical trials

    CERN Document Server

    Friedman, Lawrence M; DeMets, David L; Reboussin, David M; Granger, Christopher B

    2015-01-01

    This is the fifth edition of a very successful textbook on clinical trials methodology, written by recognized leaders who have long and extensive experience in all areas of clinical trials. The three authors of the first four editions have been joined by two others who add great expertise.  Most chapters have been revised considerably from the fourth edition.  A chapter on regulatory issues has been included and the chapter on data monitoring has been split into two and expanded.  Many contemporary clinical trial examples have been added.  There is much new material on adverse events, adherence, issues in analysis, electronic data, data sharing, and international trials.  This book is intended for the clinical researcher who is interested in designing a clinical trial and developing a protocol. It is also of value to researchers and practitioners who must critically evaluate the literature of published clinical trials and assess the merits of each trial and the implications for the care and treatment of ...

  10. Clinical research: regulatory issues.

    Science.gov (United States)

    Wermeling, D P

    1999-02-01

    The regulatory issues faced by institutions performing clinical research are described. Many institutions do not have on staff an expert who understands the regulatory issues involved in managing investigational new drug research and who knows the institution's obligations under the federal rules. Because pharmacists understand the FDA regulations that apply to the management of drugs in clinical research, institutions are asking pharmacists to expand their role and manage clinical research offices. Many authorities govern various aspects of investigational drug research. FDA has published regulations for good clinical practice (GCP), and the International Conference on Harmonisation is developing an international standard for the proper management of clinical trials. The guidelines published by the Joint Commission on Accreditation of Healthcare Organizations aim to protect patients who are in the institution to receive health care and also participate in clinical trials. The Social Security Administration Acts specifically state that only items and services that are reasonable and necessary for the diagnosis and treatment of injury or disease can be billed to the government; research-related billings are excluded from coverage. Proper management of drug research is crucial to the success of a research program that is integrated with patient care.

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

    Medline Plus

    Full Text Available ... of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & ... Clinical Studies Children have often had to accept medicines and treatments based on what is known to ...

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

    Medline Plus

    Full Text Available ... about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to accept ... treatments based on what is known to work in adults. To improve clinical care of children, more ...

  13. Structured assessments of clinical competence.

    Science.gov (United States)

    Boursicot, Katharine A M

    2010-06-01

    Clinical teachers are often involved in assessing clinical competence in the workplace, in universities and colleges. Assessments commonly used to formally assess clinical competence include long and short cases and the objective structured clinical examination which, if well designed, is a fair and reliable method of assessing clinical competence.

  14. Escuela de las relaciones humanas en la administración: los trabajos del Elton Mayo = The human relations school in administration: the work of Elton Mayo

    OpenAIRE

    Arango Henao, Jorge Eduardo

    2011-01-01

    El documento se estructura en ocho capítulos definidos para una mejor comprensión del lector. El propósito del primero es contextualizar de forma general a las personas sobre la importancia del estudio, la metodología utilizada y los objetivos que se persiguen con el mismo. El segundo capítulo, pretende dar una breve ilustración del movimiento humanista en el transcurrir de la historia, con el fin de ubicar a los lectores en el contexto general de la escuela de relaciones humanas, previo a lo...

  15. De Maistre, J., y Guerrero Alonso, M. L. (Ed.. (2015. Consideraciones sobre Francia (A. García Mayo, Trad.. Madrid, MD: Escolar y Mayo. 200 pp.

    Directory of Open Access Journals (Sweden)

    José Manuel Correoso Rodenas

    2016-06-01

    Full Text Available A lo largo de la historia, el devenir de los acontecimientos ha hecho que determinados autores, que quizá en su época gozaron de fama y popularidad, hayan caído en el olvido o hayan sido forzados al ostracismo. Un caso clásico sería el del poeta y narrador estadounidense William Gilmore Simms quien, antes de la Guerra de Secesión, disfrutó de los laureles de la fama y la admiración de sus contemporáneos. Sin embargo, su apoyo a la causa confederada ha hecho de él un autor prácticamente olvidado hoy en día. El caso de Joseph de Maistre es similar, pues también se enmarca dentro del apoyo a las causas perdidas o, más concretamente, a las causas que, andando el tiempo, no han resultado las vencedoras. Su apoyo a la causa contrarevolucionaria (que no contrarrevolucionaria, como él mismo se encarga de aclarar en el momento en que Europa se abría a la contemporaneidad social y política lo ha convertido en una isla en el pensamiento moderno, a pesar de que en su momento fuera un intelectual conocido y un pensador político respetado en los círculos conservadores. Como bien pone de manifiesto la Dra. Guerrero en su introducción, habría que esperar hasta 2007, para que la figura del senador saboyano volviera a los círculos académicos franceses, cuando Philippe Sollers escribió su ya clásico “Elogio de un maldito”. [...

  16. Epidemiology of adult acute myeloid leukemia: Impact of exposures on clinical phenotypes and outcomes after therapy.

    Science.gov (United States)

    Finn, Laura; Sproat, Lisa; Heckman, Michael G; Jiang, Liuyan; Diehl, Nancy N; Ketterling, Rhett; Tibes, Raoul; Valdez, Ricardo; Foran, James

    2015-12-01

    An increased risk of adult myeloid leukemia (AML) has recently been associated with lifestyle and environmental exposures, including obesity, smoking, some over the counter medications, and rural/farm habitats in case control studies. The association of these exposures with AML cytogenetic categories, outcomes after therapy, and overall survival is unknown. Relevant exposures were evaluated in a cohort of 295 consecutive AML patients diagnosed and treated at Mayo Clinic in Florida and Arizona. Standard cytogenetic risk categories were applied and reviewed in a central cytogenetic laboratory. The association of epidemiologic exposures with cytogenetic risk, complete remission after therapy, and overall survival was evaluated using logistic and Cox regression models. A significant association between obesity and intermediate-abnormal cytogenetics was identified (OR: 1.94, P=0.025). Similarly, those with secondary AML were more likely to have poor risk (OR: 2.55, P<0.001) and less likely to have intermediate normal (OR: 0.48, P=0.003) cytogenetics. In multivariate analysis, overall survival was improved for patients ≥ 60 years receiving intensive (RR: 0.21, P<0.001) and non-intensive therapy (RR: 0.40, P<0.001 compared to no treatment, and was lower for users of tobacco (RR 1.39, P=0.032), and those with poor risk cytogenetics (RR: 3.96, P=0.002) or poor performance status (RR: 1.69, P<0.001). Furthermore, an association between statin use at the time of diagnosis (OR: 2.89, P=0.016) and increased complete remission after intensive chemotherapy was identified, while prior solid organ transplantation was associated with significantly lower complete remission rate after therapy (OR: 0.10, P=0.035). Our results provide evidence that specific epidemiologic exposures, including obesity, are significantly associated with unique AML cytogenetic risk categories and response to therapy. This supports a link between patient lifestyles, clinical exposures, and leukemogenesis

  17. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application and comp......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... and compliance with CPGs in most areas of clinical practice are deficient. Computerization of CPGs has been brought forward as a method to disseminate and to support application of CPGs. Until now, CPG-computerization has focused on development of formal expressions of CPGs. The developed systems have, however......, not gained any extensive application in clinical practice. The basic assumption in this thesis is that the scanty penetration is due to an inappropriate design process when designing computerized CPGs for clinical work practice. This thesis examines the application of guidance within areas where CPG...

  18. Measuring against clinical standards.

    Science.gov (United States)

    Shaw, Charles D

    2003-07-15

    Systematic improvement of health services requires the objective measurement of people, practices and organisations against valid and explicit standards in order to identify and implement appropriate change. Effective quality systems must embrace a wide range of definitions of quality, and a similar variety of approaches to defining, measuring and improving. Clinical performance may be examined from three professional viewpoints--clinical competence: assessment of individual practitioners against explicit criteria to recognise achievement and to promote continuing development. Traditional mechanisms of training, registration and accreditation enable clinicians to reach career grades but responsibility for subsequent support is often unclear between employers, professions and registering bodies. Clinical practice: assessment of actual clinical process and outcomes against research-based "best practice" to identify and reduce variation. Peer review, clinical audit and confidential enquiries are examples of this approach, which may involve single or multiple professional groups and their interface with management. Service accreditation: systems to assess health care organisations against published standards in order to encourage best management practice. These are usually run on a regional or national basis and, though sensitive to expectations of patients, managers, clinicians, paying agencies and government, they are usually managed by an impartial but authoritative organisation.

  19. [Clinical variants of acne].

    Science.gov (United States)

    Jansen, T; Grabbe, S; Plewig, G

    2005-11-01

    Acne is a very common dermatosis with characteristic clinical features. It is a polymorphic disease. The clinical expression ranges from non-inflammatory closed and open comedones to inflammatory papules, pustules, and nodules. Most patients have a mixture of non-inflammatory and inflammatory lesions, although some have predominantly one or the other. Acne varies in severity from a very distressing, socially disabling disorder to a state that has been regarded as physiological by some authors. The most severe forms of acne are acne fulminans and acne inversa. Although acne may occur in all age groups, it is most prevalent during adolescence. It is not known why acne subsides in most patients but persists into adulthood in some. Certain medications may be associated with provocation, perpetuation, or exacerbation of pre-existing acne or with acneiform eruptions. Acne-like disorders include rosacea, pseudofolliculitis barbae, and other conditions that share clinical features with acne.

  20. Pediatric anthrax clinical management.

    Science.gov (United States)

    Bradley, John S; Peacock, Georgina; Krug, Steven E; Bower, William A; Cohn, Amanda C; Meaney-Delman, Dana; Pavia, Andrew T

    2014-05-01

    Anthrax is a zoonotic disease caused by Bacillus anthracis, which has multiple routes of infection in humans, manifesting in different initial presentations of disease. Because B anthracis has the potential to be used as a biological weapon and can rapidly progress to systemic anthrax with high mortality in those who are exposed and untreated, clinical guidance that can be quickly implemented must be in place before any intentional release of the agent. This document provides clinical guidance for the prophylaxis and treatment of neonates, infants, children, adolescents, and young adults up to the age of 21 (referred to as "children") in the event of a deliberate B anthracis release and offers guidance in areas where the unique characteristics of children dictate a different clinical recommendation from adults.

  1. Transgressive first clinical experiences

    DEFF Research Database (Denmark)

    Jensen, Carsten Juul; Jeppesen, Lise Kofoed; Drachmann, Merete

    2014-01-01

    This Study seeks to comprehend learning experiences of nursing students during their first clinical in-service placement. This Paper is part of a longitudinal development project interviewing the Student Nurse after each one of the five clinical in-service placements and then one year after gradu...... to advanced beginner, and adjusting to the workplace community. The conclusion is that the learning of nursing students during their first clinical in-service placement appears informal and not founded on evident best practice....... graduation as a Nurse. The Study has a qualitative methodology, inspired by Michael Eraut’s thoughts on learning in the workplace. When the workplace perspective is applied, learning seems to be concentrated on actual situations which the Learner is in, in contrast to employing constructed concepts...

  2. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    . The analysis focuses on the emergence of general clinical work practice demands on guidance • An analysis of guidance demands from clinical work practice and business strategy, focusing on implications for the design of computerised CPGs. In my research, I have applied observation studies, interviews...... is comprised by fieldwork in three oncology departments and a case study of advanced life support. Although close to all patients within oncology are treated according to a CPG, I found limited application of physical CPGs and web-based CPG portals. However, I found comprehensive application of activity...... feasible • Designed in a way that provides room for local adaptations of guidance • Designed with focus on specific business strategic aims Further, based on my findings, I will suggest that design of computerized CPGs should be based on: 1) scrutinization of the clinical work practice, 2) articulation...

  3. Improving clinical cognitive testing

    Science.gov (United States)

    Gale, Seth A.; Barrett, A.M.; Boeve, Bradley F.; Chatterjee, Anjan; Coslett, H. Branch; D'Esposito, Mark; Finney, Glen R.; Gitelman, Darren R.; Hart, John J.; Lerner, Alan J.; Meador, Kimford J.; Pietras, Alison C.; Voeller, Kytja S.; Kaufer, Daniel I.

    2015-01-01

    Objective: To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. Methods: Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. Results: Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE. Conclusions: We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment. PMID:26163433

  4. Spreadsheets in Clinical Medicine

    CERN Document Server

    Croll, Grenville J

    2006-01-01

    There is overwhelming evidence that the continued and widespread use of untested spreadsheets in business gives rise to regular, significant and unexpected financial losses. Whilst this is worrying, it is perhaps a relatively minor concern compared with the risks arising from the use of poorly constructed and/or untested spreadsheets in medicine, a practice that is already occurring. This article is intended as a warning that the use of poorly constructed and/or untested spreadsheets in clinical medicine cannot be tolerated. It supports this warning by reporting on potentially serious weaknesses found while testing a limited number of publicly available clinical spreadsheets.

  5. Clinical Evaluation of Tinnitus.

    Science.gov (United States)

    Hertzano, Ronna; Teplitzky, Taylor B; Eisenman, David J

    2016-05-01

    The clinical evaluation of patients with tinnitus differs based on whether the tinnitus is subjective or objective. Subjective tinnitus is usually associated with a hearing loss, and therefore, the clinical evaluation is focused on an otologic and audiologic evaluation with adjunct imaging/tests as necessary. Objective tinnitus is divided into perception of an abnormal somatosound or abnormal perception of a normal somatosound. The distinction between these categories is usually possible based on a history, physical examination, and audiogram, leading to directed imaging to identify the underlying abnormality.

  6. Toward transparent clinical policies.

    Science.gov (United States)

    Shiffman, Richard N; Marcuse, Edgar K; Moyer, Virginia A; Neuspiel, Daniel R; Hodgson, Elizabeth Susan; Glade, Gordon; Harbaugh, Norman; Miller, Marlene R; Sevilla, Xavier; Simpson, Lisa; Takata, Glenn

    2008-03-01

    Clinical policies of professional societies such as the American Academy of Pediatrics are valued highly, not only by clinicians who provide direct health care to children but also by many others who rely on the professional expertise of these organizations, including parents, employers, insurers, and legislators. The utility of a policy depends, in large part, on the degree to which its purpose and basis are clear to policy users, an attribute known as the policy's transparency. This statement describes the critical importance and special value of transparency in clinical policies, guidelines, and recommendations; helps identify obstacles to achieving transparency; and suggests several approaches to overcome these obstacles.

  7. OARSI Clinical Trials Recommendations

    DEFF Research Database (Denmark)

    McAlindon, T. E.; Driban, J. B.; Henrotin, Y.;

    2015-01-01

    The goal of this document is to update the original OARSI recommendations specifically for the design, conduct, and reporting of clinical trials that target symptom or structure modification among individuals with knee osteoarthritis (OA). To develop recommendations for the design, conduct...... and index knee, describing interventions, patient-reported and physical performance measures, structural outcome measures, biochemical biomarkers, and reporting recommendations. In summary, the working group identified 25 recommendations that represent the current best practices regarding clinical trials...... that target symptom or structure modification among individuals with knee OA. These updated recommendations incorporate novel technologies (e.g., magnetic resonance imaging (MRI)) and strategies to address the heterogeneity of knee OA....

  8. [Antidotes in clinical toxicology].

    Science.gov (United States)

    Hruby, K

    2013-09-01

    This overview describes antidotes, and their clinical pharmacology, that have an established significance in the currently practiced clinical toxicology because of their proven effectiveness in the treatment of serious poisonings. For the proper, efficient, and targeted use of an antidote, pharmacological knowledge is required, which is a central subject of this article. Current data from the literature are used as reference along with the accumulated experiences about possible adverse effects in order to include them in therapeutic considerations. The dosage of antidotes is the subject of several other review articles and is therefore not included in this synopsis.

  9. Danish clinical databases: An overview

    DEFF Research Database (Denmark)

    Green, Anders

    2011-01-01

    Clinical databases contain data related to diagnostic procedures, treatments and outcomes. In 2001, a scheme was introduced for the approval, supervision and support to clinical databases in Denmark....

  10. Philosophy of Research in Motor Speech Disorders

    Science.gov (United States)

    Weismer, Gary

    2006-01-01

    The primary objective of this position paper is to assess the theoretical and empirical support that exists for the Mayo Clinic view of motor speech disorders in general, and for oromotor, nonverbal tasks as a window to speech production processes in particular. Literature both in support of and against the Mayo clinic view and the associated use…

  11. 5K Run: 7-Week Training Schedule for Beginners

    Science.gov (United States)

    Healthy Lifestyle Fitness By Mayo Clinic Staff Doing a 5K run can add a new level of challenge and ... 04, 2017 Original article: http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/5k-run/art-20050962 . Mayo Clinic ...

  12. CME ON CLINICAL RESEARCH

    Directory of Open Access Journals (Sweden)

    Suneel. I. Majagi

    2012-06-01

    Full Text Available Safety and efficacy are the two major concerns for any drug therapy. Globally clinical research plays an inevitable role in bringing a new molecule into the market after its synthesis by the pharmaceutical industries. Availability of large patient population, highly educated and skilled manpower, wide spectrum of diseases and favorable economic environment imply India’s potential as a global hub for clinical research. Pharmaceutical companies and Clinical Research Organization (CROs will require many trained personnel to carry out the clinical research. Keeping in mind these facts a CME with the theme of “Clinical research” had been jointly organized by the Dept of pharmacology, K.L.E University’s J.N.M.C, Belgaum and Indian Pharmacological Society (I.P.S, Belgaum branch on 20th February 2010. In the first scientific session, Dr.P.A.Patil (JNMC spoke on “Preclinical studies”. In vitro and in vivo experiments of various doses of ‘study drug’ can obtain preliminary efficacy, toxicity and pharmacokinetic information suggesting the scientific merit for further development as an investigational new drug (IND. Local or systemic toxicity studies can be conducted (ex: urine analysis, blood biochemical assay, gross and microscopic pathology etc. Dr. B.J. Mahendra Kumar (KLE University’s College of pharmacy talked on “Role of Drug Controller General of India (DCGI in Clinical Trials”. He explained about Drug and cosmetic acts/rules, requirements/guidelines for permission to import and/or to manufacture new drugs or to undertake clinical trials i.e. Schedule Y and its appendices. Dr.N.M.Patil (JNMC elaborated about “Ethical issues in clinical trials”. Ethics is required to: avoid exploitation of the subjects (maintain safety and wellbeing, protect vulnerable groups, children, disabled, elderly etc. Independent Ethics Committees (IEC and Institutional Review Boards (IRB are concerned with medical ethics. IECs review, regulate

  13. 电针配合康复训练治疗肱骨外上髁炎临床观察%Clinical Observation of Electroacupuncture Combined with Rehabilitation Training on Tennis Elbow

    Institute of Scientific and Technical Information of China (English)

    朱启玉; 吴芳华; 黄伟

    2015-01-01

    Abstracts:Objective To observe the treatment effect of electroacupuncture combined with rehabilitation training on tennis elbow. Methods 60 cases of patients with tennis elbow were randomly divided into two groups.30 cases of treatment group received acupuncture combined with rehabilitation training, 30 cases of control group received warm acupuncture treatment, after treatment, the efficacy was evalu-ated.Results The total effective rate of treatment group was better than that of control group (P <0.05).Mayo elbow function scores in both groups were on the rise, the treatment group was significantly higher (P <0.05);compared with the control group, the difference was statistically significant(P <0.05).Conclusion Electroacupuncture combined with rehabilitation training can be used as an effective meth-od for treatment of tennis elbow, it is worthy to be popularized in clinic.%目的:观察电针配合康复训练治疗肱骨外上髁炎的临床疗效。方法60例肱骨外上髁炎患者随机分为两组。治疗组30例采用电针结合康复训练,对照组30例采用温针灸治疗,疗程结束后进行疗效评定。结果治疗组总有效率优于对照组(P <0.05)。治疗后两组 mayo 肘关节功能评分呈上升趋势,治疗组上升更明显(P <0.05);与对照组治疗后比较,差异具有统计学意义(P <0.05)。结论电针配合康复训练可作为治疗网球肘的一种行之有效的方法,值得在临床上广泛推广。

  14. Clinical Nuclear Pharmacy Clerkship

    Science.gov (United States)

    Dunson, George L.; Christopherson, William J., Jr.

    1977-01-01

    The School of Pharmacy, University of the Pacific, and the Pharmacy Service, Letterman Army Medical Center, initiated a 15-week clinical nuclear pharmacy clerkship in 1975. It includes basic nuclear medical science, technical competency, professional competency, and special interest emphasis. (LBH)

  15. Clinical Process Intelligence

    DEFF Research Database (Denmark)

    Vilstrup Pedersen, Klaus

    2006-01-01

    .e. local guidelines. From a knowledge management point of view, this externalization of generalized processes, gives the opportunity to learn from, evaluate and optimize the processes. "Clinical Process Intelligence" (CPI), will denote the goal of getting generalized insight into patient centered health...

  16. Participating in Clinical Trials

    Medline Plus

    Full Text Available skip navigation Help Search home health topics A-Z Videos A-Z about us Customer Support NIH SeniorHealth Built with You in Mind Resize Text: A A A Change Contrast print sign up Share Home > Health topics A-Z > Participating in Clinical Trials: About ...

  17. Assessment of Clinical Competence.

    Science.gov (United States)

    Newble, David I.

    1979-01-01

    Reviews current approaches to the examination of medical students' clinical competence, mentioning differences in approaches adopted in Australia, Great Britain, and North America. Test methods used in examination are discussed critically and their separate strengths and weaknesses are highlighted. Newer approaches involving multiple methods and…

  18. Validating clinical competence.

    Science.gov (United States)

    Chappell, Kathy; Koithan, Mary

    2012-07-01

    Professional registered nurses must be competent to provide care in today's fast-paced, highly technical clinical environment. Competency programs designed to teach and evaluate essential knowledge, skills, and abilities of registered nurses are one method organizations may use to demonstrate nursing proficiency.

  19. Evaluation of Clinical Competence.

    Science.gov (United States)

    Newble, David I.

    In Australia the usual evaluation of whether a student will perform adequately as a doctor is a subjective evaluation of his clinical performance, usually at the completion of five or six years at medical school. The evaluation is performed on an inadequate and uncontrolled patient sample and appears to be subject to many errors. Recent work…

  20. Clinical Mastery of Hypnosis.

    Science.gov (United States)

    Horevitz, Richard P.

    Hypnosis is an increasingly popular clinical intervention. The number of training courses in hypnosis is growing each year. Research on hypnosis training appears to show that limited exposure to training, as is typical in the common 3 to 5 day format of mass training, produces limited results. Only when training is extended over time do the…

  1. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen

    2008-01-01

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

  2. The Unstructured Clinical Interview

    Science.gov (United States)

    Jones, Karyn Dayle

    2010-01-01

    In mental health, family, and community counseling settings, master's-level counselors engage in unstructured clinical interviewing to develop diagnoses based on the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; "DSM-IV-TR"; American Psychiatric Association, 2000). Although counselors receive education about…

  3. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen

    2008-01-01

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

  4. Clinical neurology of ferrets.

    Science.gov (United States)

    Diaz-Figueroa, Orlando; Smith, Mary O

    2007-09-01

    Neurology represents an important specialty within ferret clinical medicine. Veterinarians should become familiar with the unique anatomic and physiologic differences between ferrets to improve their management of theses cases. In addition, veterinarians should use available diagnostic tests to confirm the presence of neurologic diseases. Recent advances in ferret medicine and veterinary neurology offer new capabilities to investigate and treat neurological disease in ferrets.

  5. Achieving clinical integration.

    Science.gov (United States)

    Redding, John

    2013-11-01

    To develop an effective and sustainable clinically integrated network (CIN) that positions a healthcare organization for value-based payment and other effects of healthcare reform, leaders of CIN initiatives should: Embrace progress rather than perfection; Constrain the development timeline by project managing in reverse; Ensure that physician leaders play an oversight role in the development process.

  6. Hepatitis C: Clinical Trials

    Science.gov (United States)

    ... will not know if you are taking the medicine or the placebo until the clinical trial is over. How do ... can already get by prescription ) or sugar pills ( placebos ) with the new medicine may last longer than Phases I and II ...

  7. Clinical Mastery of Hypnosis.

    Science.gov (United States)

    Horevitz, Richard P.

    Hypnosis is an increasingly popular clinical intervention. The number of training courses in hypnosis is growing each year. Research on hypnosis training appears to show that limited exposure to training, as is typical in the common 3 to 5 day format of mass training, produces limited results. Only when training is extended over time do the…

  8. [Management in clinical nutrition].

    Science.gov (United States)

    Alvarez, J; Monereo, S; Ortiz, P; Salido, C

    2004-01-01

    Terms such as management, costs, efficacy, efficiency, etc. that are so common in the discourse of managers are now beginning to appear in the vocabulary of clinicians. Management in Clinical Nutrition is an innovative aspect of interest among health-care professionals dealing with the needs of undernourished patients or those at risk of malnutrition. The basic goal of this paper is to show that the tools for clinical management of hospitals are applicable to such a multidisciplinary and complex speciality as clinical nutrition and also to propose the measures needed to improve our information systems and optimize management in this field. The very concept of hospitals has changed, as has their activity, over the years. Hospitals are nowadays no longer just a charitable institution but has become a service company, a public utility for the promotion of good health and they have to be managed in accordance with criteria of efficacy, efficiency, equity and quality. The concepts of Evidence-Based Medicine (EBM) and Cost-Effective Medicine (CEM) are of evident importance in the different ways of managing health-care services. Good clinical practice is the combination of EBM and CEM. This review defines the various cost studies of fundamental importance when taking decisions in hospital management and analyzes such clinical management tools as analytical accounting, Minimum Hospital Database Set (MHDS) and encoding systems, among others, thus facilitating an analysis of the usefulness of data in clinical nutrition management systems. Finally, after reviewing some specific examples, measures are proposed to optimize current information systems. The medical staff and those of us responsible for Nutrition Units operate in hospitals as part of a centralized service transferring information to the various departments where the patient is physically located (Surgery, Internal Medicine, Digestive, ICU, etc.). One of the priority goals in micro-management and middle management

  9. Computers and clinical arrhythmias.

    Science.gov (United States)

    Knoebel, S B; Lovelace, D E

    1983-02-01

    Cardiac arrhythmias are ubiquitous in normal and abnormal hearts. These disorders may be life-threatening or benign, symptomatic or unrecognized. Arrhythmias may be the precursor of sudden death, a cause or effect of cardiac failure, a clinical reflection of acute or chronic disorders, or a manifestation of extracardiac conditions. Progress is being made toward unraveling the diagnostic and therapeutic problems involved in arrhythmogenesis. Many of the advances would not be possible, however, without the availability of computer technology. To preserve the proper balance and purposeful progression of computer usage, engineers and physicians have been exhorted not to work independently in this field. Both should learn some of the other's trade. The two disciplines need to come together to solve important problems with computers in cardiology. The intent of this article was to acquaint the practicing cardiologist with some of the extant and envisioned computer applications and some of the problems with both. We conclude that computer-based database management systems are necessary for sorting out the clinical factors of relevance for arrhythmogenesis, but computer database management systems are beset with problems that will require sophisticated solutions. The technology for detecting arrhythmias on routine electrocardiograms is quite good but human over-reading is still required, and the rationale for computer application in this setting is questionable. Systems for qualitative, continuous monitoring and review of extended time ECG recordings are adequate with proper noise rejection algorithms and editing capabilities. The systems are limited presently for clinical application to the recognition of ectopic rhythms and significant pauses. Attention should now be turned to the clinical goals for detection and quantification of arrhythmias. We should be asking the following questions: How quantitative do systems need to be? Are computers required for the detection of

  10. Clinical reasoning of nursing students on clinical placement: Clinical educators' perceptions.

    Science.gov (United States)

    Hunter, Sharyn; Arthur, Carol

    2016-05-01

    Graduate nurses may have knowledge and adequate clinical psychomotor skills however they have been identified as lacking the clinical reasoning skills to deliver safe, effective care suggesting contemporary educational approaches do not always facilitate the development of nursing students' clinical reasoning. While nursing literature explicates the concept of clinical reasoning and develops models that demonstrate clinical reasoning, there is very little published about nursing students and clinical reasoning during clinical placements. Semi-structured interviews were conducted with ten clinical educators to gain an understanding of how they recognised, developed and appraised nursing students' clinical reasoning while on clinical placement. This study found variability in the clinical educators' conceptualisation, recognition, and facilitation of students' clinical reasoning. Although most of the clinical educators conceptualised clinical reasoning as a process those who did not demonstrated the greatest variability in the recognition and facilitation of students' clinical reasoning. The clinical educators in this study also described being unable to adequately appraise a student's clinical reasoning during clinical placement with the use of the current performance assessment tool.

  11. Clinical guidelines, clinical pathways and protocols of care

    OpenAIRE

    Angélica Román

    2012-01-01

    The article points out that the importance of standardization of clinical practices has been established in clinical management, which helps solve the problems of variability by developing documents based on the available scientific evidence. The article claims that healthcare culture has increasingly recognized the importance of standardization of clinical practices and provides a conceptual difference between clinical practice guidelines, protocols and algorithms. Clinical pathways and clin...

  12. Clinical outcome of en-block resection and reconstruction with nonvascularized fibular autograft for the treatment of giant cell tumor of distal radius

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    Mohammad H Taraz-Jamshidi

    2014-01-01

    Full Text Available Background: Although giant cell tumor (GCT is considered to be a primary benign bone tumor, its aggressive behavior makes its diagnosis and treatment, difficult and challenging. This is especially true in distal radius where GCT appears to be more aggressive and difficult to control locally. We report our clinical outcome of en-block resection and reconstruction with non-vascularized fibular autograft in 15 patients with distal radius GCT. Materials and Methods: We retrospectively reviewed 15 patients with GCT (Grade 2 and 3 of distal radius who were treated with en-block resection and non-vascularized fibular autograft. Five of 15 were recurrent GCT treated initially with extended curettage; local adjuvant therapy and filling the cavity with cement or bone graft. We followed the patients for mean 7.2 years post operation (range: 4-11 years. Patients were evaluated post operation with clinical examination, plain radiography of distal radius and chest X-ray and/or computed tomography scan. Furthermore pain, function, range of motion and grip strength of the affected limb were evaluated and mMayo wrist score was assessed. Results: A total of 11 patients were women and 4 were men. Mean age of patients was 29 years (range: 19-48. We had no lung metastasis and bony recurrence occurred in one patient (6.6%. Nearly 53.3% of patients had excellent or good functional wrist score, 80% of the patients were free of pain or had only occasional pain and 80% of patients returned to work. Mean range of motion of the wrist was 77° of flexion-extension and mean grip strength was 70% of the normal hand. Conclusion: En-block resection of distal radius GCT and reconstruction with non-vascularized fibular autograft is an effective technique for treatment in local control of the tumor and preserving function of the limb.

  13. Clinical and Radiographic Outcomes of Unipolar and Bipolar Radial Head Prosthesis in Patients with Radial Head Fracture: A Systemic Review and Meta-Analysis.

    Science.gov (United States)

    Chen, Hongwei; Wang, Ziyang; Shang, Yongjun

    2017-09-13

    To compare clinical outcomes of unipolar and bipolar radial head prosthesis in the treatment of patients with radial head fracture. Medline, Cochrane, EMBASE, Google Scholar databases were searched until April 18, 2016 using the following search terms: radial head fracture, elbow fracture, radial head arthroplasty, implants, prosthesis, unipolar, bipolar, cemented, and press-fit. Randomized controlled trials, retrospective, and cohort studies were included. The Mayo elbow performance score (MEPS), disabilities of the arm, shoulder, and hand (DASH) score, radiologic assessment, ROM, and grip strength following elbow replacement were similar between prosthetic devices. The pooled mean excellent/good ranking of MEPS was 0.78 for unipolar and 0.73 for bipolar radial head arthroplasty, and the pooled mean MEPS was 86.9 and 79.9, respectively. DASH scores for unipolar and bipolar prosthesis were 19.0 and 16.3, respectively. Range of motion outcomes were similar between groups, with both groups have comparable risk of flexion arc, flexion, extension deficit, rotation arc, pronation, and supination (p values bipolar prosthesis). However, bipolar radial head prosthesis was associated with an increased chance of heterotopic ossification and lucency (p values ≤0.049) while unipolar prosthesis was not (p values ≥0.088). Both groups had risk for development of capitellar osteopenia or erosion/wear (p values ≤0.039). Unipolar and bipolar radial head prostheses were similar with respect to clinical outcomes. Additional comparative studies are necessary to further compare different radial head prostheses used to treat radial head fracture.

  14. Variabilidad de la presión arterial pre y post-quirúrgica en pacientes sometidos a cirugía oral que asistieron a la clínica odontológica de la Universidad del Magdalena en los meses de abril y mayo periodo 2008

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    Luis Castillo Castilla

    2013-10-01

    %,(1 for the high frequency in the adult population. Recent advances in the study of the ETS show that the genetic component, determines 50% of high blood pressure (BP and the remaining 50% is determined by the presence of a number of exogenous risk factors. The values of PA in the exercise of dental practice can be changed, so it is important to take into account when implementing surgical procedures, as they may be subject to various risk factors such as stress, alcoholism, smoking, consumption of drugs, sedentary lifestyle, among others, its agents that can cause an increase or decrease, as a whole constitutes a serious risk to the patient 33, life if there is no proper care before any surgery practices. In order to determine the variability of blood pressure generated in the procedures pre and post-surgical samples were taken from 33 patients in the dental clinic at the University of Magdalena to which were conducted taking a blood pressure at each stage of the event in question. The data are tabulated and analyzed using descriptive statistics, which produces 64% of patients had increased blood pressure following the surgical procedure, 18% maintained the pressure was normal and the remaining drop of it.Keyword: Blood pressure; surgical procedures; risk factors; anesthetics; descriptive statistics; oral surgery.

  15. [Clinically documented fungal infections].

    Science.gov (United States)

    Kakeya, Hiroshi; Kohno, Shigeru

    2008-12-01

    Proven fungal infections are diagnosed by histological/microbiological evidence of fungi at the site of infection and positive blood culture (fungemia). However, invasive diagnosing examinations are not always applied for all of immunocompromised patients. Clinically documented invasive fungal infections are diagnosed by typical radiological findings such as halo sign on chest CT plus positive serological/molecular evidence of fungi. Serological tests of Aspergillus galactomannan antigen and beta-glucan for aspergillosis and cryptococcal glucuronoxylomannan antigen for cryptococcosis are useful. Hence, none of reliable serological tests for zygomycosis are available so far. In this article, risk factors, sign and symptoms, and diagnostic methods for clinically documented cases of invasive aspergillosis, pulmonary cryptococcosis, and zygomycosis with diabates, are reviewed.

  16. Mosaicism and clinical genetics.

    Science.gov (United States)

    Spinner, Nancy B; Conlin, Laura K

    2014-12-01

    With the introduction of increasingly sensitive technologies for mutation detection such as chromosomal microarrays and next-generation sequencing, the importance of mosaicism for human disease is being more fully appreciated. Mosaicism can occur for any type of mutation, either at the chromosomal or DNA sequence level, and while in many cases mosaicism can modify the clinical effects of a syndrome, there are many alterations that can only occur in mosaic form as the mutation is lethal when present in every cell. Mosaicism can have a wide range of effects, from early pregnancy loss, to organ specific pathology, to modification of clinical syndromes. Recent evidence reveals that generation of mosaic alterations is associated with aging, and our ability to detect mosaic alterations sheds light on normal and pathologic changes across the lifespan.

  17. Clinical Relevance of Adipokines

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    Matthias Blüher

    2012-10-01

    Full Text Available The incidence of obesity has increased dramatically during recent decades. Obesity increases the risk for metabolic and cardiovascular diseases and may therefore contribute to premature death. With increasing fat mass, secretion of adipose tissue derived bioactive molecules (adipokines changes towards a pro-inflammatory, diabetogenic and atherogenic pattern. Adipokines are involved in the regulation of appetite and satiety, energy expenditure, activity, endothelial function, hemostasis, blood pressure, insulin sensitivity, energy metabolism in insulin sensitive tissues, adipogenesis, fat distribution and insulin secretion in pancreatic β-cells. Therefore, adipokines are clinically relevant as biomarkers for fat distribution, adipose tissue function, liver fat content, insulin sensitivity, chronic inflammation and have the potential for future pharmacological treatment strategies for obesity and its related diseases. This review focuses on the clinical relevance of selected adipokines as markers or predictors of obesity related diseases and as potential therapeutic tools or targets in metabolic and cardiovascular diseases.

  18. Clinical Applications for Estetrol

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    Visser M

    2010-01-01

    Full Text Available In this paper the potential clinical applications for the human fetal estrogen estetrol (E4 are presented based on recently obtained data in preclinical and clinical studies. In the past E4 has been classified as a weak estrogen due to its rather low estrogen receptor affinity. However, recent research has demonstrated that due to its favorable pharmacokinetic properties, especially the slow elimination and long half-life, E4 is an effective orally bioavailable estrogen agonist with estrogen antagonistic effects on the breast in the presence of estradiol. Based on the pharmacokinetic properties, the pharmacological profile and the safety and efficacy results in human studies, E4 seems potentially suitable as a drug for human use in applications such as hormone replacement therapy (vaginal atrophy and vasomotor symptoms, contraception, osteoporosis and breast cancer.

  19. [Clinical diagnosis of dyslexia].

    Science.gov (United States)

    Martínez Hermosillo, A; Balderas Gil, A

    1980-01-01

    In 5 years of experience at the Instituto Nacional de la Comunicacion Humana, 302 clinical histories showed the diagnosis of dyslexia. The following parameters were studied: age, sex, heredofamilial history, gestation, psychomotor development, clinical picture, examination of the language (type, reading, spontaneous writing, dictation, mathematic concepts), laterality, scholarship, scholar failures, psychological study. The following results were obtained: Dyslexia was more important or frequent between 5 to 8.9 years of age. Males predominated 3:1. The heredofamilial history was important. Dyslexia prevailed in products of the first gestations. A high disturbance was found in the psychomotor development of a large percent of dyslexic patients. Examination of language was also important. Dyslexia was more frequent in right-handed patients. Scholar failures in one or more instances were found. The psychological study must be done. If dyslexia is diagnosed on time, it may be prevented and all unwanted sequelae may be avoided.

  20. Clinical physiopathology of hypernatremia

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    F. Sgambato

    2013-05-01

    Full Text Available BACKGROUND The maintenance of sodium levels at normal ranges has to be considered one of the most important and crucial physiological balance in order to preserve life. The increase of natremia determines the leakage of H2O from the inside of cells and the consequent brain cells withering, that causes encephalopathy at different stages and in some cases it can even lead to death. AIM OF THE STUDY The fundamentals of general physiopathology are analysed together with systems of compensation and brain adaptation in the three different aetiopathogenetic forms: primary increase of sodium (hypervolemic and haedematose form; missed introduction of pure water (mainly euvolemic form, with no aedema; loss of hypotonic fluids (hypovolemic form with dehydration. The three different clinical entities with their relative clinical approaches have been described.