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Sample records for meeting clinical studies

  1. Simulating clinical studies of the glucoregulatory system: in vivo meets in silico

    DEFF Research Database (Denmark)

    Wendt, Sabrina Lyngbye; Ranjan, Ajenthen; Møller, Jan Kloppenborg

    metabolism at varying ambient insulin levels. The report compares in vivo and in silico results head-to-head, and discusses similarities and differences. We design and simulate simple studies to emphasize the implications of some glucoregulatory dynamics which are ignored in most previous clinical studies...

  2. Do informed consent documents for chiropractic clinical research studies meet readability level recommendations and contain required elements: a descriptive study.

    Science.gov (United States)

    Twist, Elissa; Lawrence, Dana J; Salsbury, Stacie A; Hawk, Cheryl

    2014-01-01

    Informed consent documents (ICD) in research are designed to educate research participants about the nature of the research project in which he or she may participate. United States (US) law requires the documents to contain specific elements present and be written in a way that is understandable to research participants. The purpose of this research is to determine if ICDs from randomized controlled trials conducted at chiropractic colleges meet recommended readability standards and contain the 13 content items required by US law. This study was approved by Palmer College of Chiropractic's IRB #2012-12-3-T and was conducted between December 3, 2012 and February 14, 2013. We contacted the research directors of five chiropractic colleges that have received federal funding supporting their clinical research. A total of 13 informed consent documents from four chiropractic colleges were analyzed using the Flesch-Kincaid measurement. We assigned a grade-level readability score to the document based on the average of three separate grade level scores conducted on the three largest uninterrupted blocks of text. Content of the 13 ICDs was assessed using a 13-element checklist. A point was given for every element present in the document, giving a score range of "0, no elements are present", to "13, all elements are present." The mean Flesch-Kincaid grade level readability was 10.8 (range 7.2 -14.0). Our sample had a mean readability score 2.8 grade levels above the generally-accepted US average reading level. Content varied among the 13 informed consent forms, ranging from only nine elements present in one document to all 13 required in five documents. Additionally, we collated the risks presented in each document. These results strongly suggest that chiropractic clinical researchers are not developing ICDs at a readability level congruent with the national average acceptable level. The low number of elements in some of the informed consent documents raises concern that not

  3. Health record systems that meet clinical needs

    Directory of Open Access Journals (Sweden)

    Gabriella Negrini

    2012-10-01

    Full Text Available Introduction Increased attention has recently been focused on health record systems as a result of accreditation programs, a growing emphasis on patient safety, and the increase in lawsuits involving allegations of malpractice. Health-care professionals frequently express dissatisfaction with the health record systems and complain that the data included are neither informative nor useful for clinical decision making. This article reviews the main objectives of a hospital health record system, with emphasis on its roles in communication and exchange among clinicians, patient safety, and continuity of care, and asks whether current systems have responded to the recent changes in the Italian health-care system.Discussion If health records are to meet the expectations of all health professionals, the overall information need must be carefully analyzed, a common data set must be created, and essential specialist contributions must be defined. Working with health-care professionals, the hospital management should define how clinical information is to be displayed and organized, identify a functionally optimal layout, define the characteristics of ongoing patient assessment in terms of who will be responsible for these activities and how often they will be performed. Internet technology can facilitate data retrieval and meet the general requirements of a paper-based health record system, but it must also ensure focus on clinical information, business continuity, integrity, security, and privacy.Conclusions The current health records system needs to be thoroughly revised to increase its accessibility, streamline the work of health-care professionals who consult it, and render it more useful for clinical decision making—a challenging task that will require the active involvement of the many professional classes involved.

  4. Family meetings in palliative care: Multidisciplinary clinical practice guidelines

    Directory of Open Access Journals (Sweden)

    O'Hanlon Brendan

    2008-08-01

    Full Text Available Abstract Background Support for family carers is a core function of palliative care. Family meetings are commonly recommended as a useful way for health care professionals to convey information, discuss goals of care and plan care strategies with patients and family carers. Yet it seems there is insufficient research to demonstrate the utlility of family meetings or the best way to conduct them. This study sought to develop multidisciplinary clinical practice guidelines for conducting family meetings in the specialist palliative care setting based on available evidence and consensus based expert opinion. Methods The guidelines were developed via the following methods: (1 A literature review; (2 Conceptual framework; (3 Refinement of the guidelines based on feedback from an expert panel and focus groups with multidisciplinary specialists from three palliative care units and three major teaching hospitals in Melbourne, Australia. Results The literature review revealed that no comprehensive exploration of the conduct and utility of family meetings in the specialist palliative care setting has occurred. Preliminary clinical guidelines were developed by the research team, based on relevant literature and a conceptual framework informed by: single session therapy, principles of therapeutic communication and models of coping and family consultation. A multidisciplinary expert panel refined the content of the guidelines and the applicability of the guidelines was then assessed via two focus groups of multidisciplinary palliative care specialists. The complete version of the guidelines is presented. Conclusion Family meetings provide an opportunity to enhance the quality of care provided to palliative care patients and their family carers. The clinical guidelines developed from this study offer a framework for preparing, conducting and evaluating family meetings. Future research and clinical implications are outlined.

  5. Third Annual Clinical Diabetes Technology Meeting

    National Research Council Canada - National Science Library

    Klonoff, David D

    2007-01-01

    .... The attendance was 378 healthcare providers and scientists. The first day of the meeting covered Technologies for Diabetes Monitoring and the second day covered Technologies for Diabetes Therapy...

  6. Clinical Studies

    DEFF Research Database (Denmark)

    Pallesen, Ulla

    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...... 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...

  7. Meeting the challenges of clinical information provision.

    Science.gov (United States)

    Spring, Hannah

    2017-12-01

    This virtual issue of the Health Information and Libraries Journal (HILJ) has been compiled to mark the 5th International Clinical Librarian Conference 2011. In considering the challenges of clinical information provision, the content selected for the virtual issue offers an international flavour of clinical information provision and covers a variety of different facets of clinical librarianship. The issue broadly covers the areas of information needs and preferences, clinical librarian roles and services, and education and training, and reflects the way in which a normal issue of the HILJ would be presented. This includes a review article, a collection of original articles, and the three regular features which comprise International Perspectives and Initiatives, Learning and Teaching in Action, and Using Evidence in Practice. All papers included in this virtual issue are available free online. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  8. Clinical focus and public accountability in English NHS Trust Board meetings.

    Science.gov (United States)

    Endacott, Ruth; Sheaff, Rod; Jones, Ray; Woodward, Valerie

    2013-01-01

    Previous studies have suggested that greater focus on clinical matters in NHS commissioner and provider Trust Board meetings might improve the range, quality or cost of clinical care. This study reports the extent of clinical focus in Board meetings in three types of NHS Trust and considers the implications for public accountability. (1) Content analysis of published minutes of Board meetings from 105 randomly selected NHS Trusts in 2008/09. (2) Structured observation of 24 Board meetings in a qualitative sub-sample of eight of the above Trusts in 2008/09. The percentage of clinical items among the items discussed by NHS Trust Boards ranged from 0% to 51%, but did not differ by Trust type. Primary Care Trusts (PCTs) recorded more items than NHS Trusts and NHS Foundation Trusts because of PCTs' dual role as service providers and commissioners. There were significant differences between Trusts' board meetings in the numbers of clinical items concerning service design, clinical outcomes and activity levels. The availability and accessibility of supposedly publicly-available minutes from NHS Foundation Trust Board meetings was sometimes problematic. Observation of meetings revealed a number of dynamics not evident in the minutes. Board meetings were generally chair-led (conducted according to the chair's discretion); collegial; had similar levels and extent of discussion from the non-executive directors, with a focus on current policy initiatives. Boards differed in the extent of public questioning, how they exercised internal governance over the provision and quality of patient care, and the extent of pre-planning before the Board meeting. Published minutes were not always an accurate record of meetings. Findings illuminate important transparency issues which should be given careful consideration in the English NHS.

  9. Visual Impairment/Intracranial Pressure Research Clinical Advisory Panel (RCAP) Meeting. [Summary Report

    Science.gov (United States)

    Villarreal, Jennifer

    2014-01-01

    The Visual Impairment/Intracranial Pressure (VIIP) Research and Clinical Advisory Panel convened on December 1, 2014 at the ISS Conference Facility in Houston. The panel members were provided updates to the current clinical cases and treatment plans along with the latest research activities (http://humanresearchroadmap.nasa.gov/Risks/?i=105) and preliminary study results. The following is a summary of this meeting.

  10. Sexual selection studies: A NESCent catalyst meeting

    NARCIS (Netherlands)

    Roughgarden, J.; Adkins-Regan, E.; Akcay, E.; Hinde, C.A.; Hoquet, T.; O'Connor, C.; Prokop, Z.M.; Prum, R.O.; Shafir, S.; Snow, S.S.; Taylor, D.; Cleve, Van J.; Weisberg, M.

    2015-01-01

    A catalyst meeting on sexual selection studies was held in July 2013 at the facilities of the National Evolutionary Synthesis Center (NESCent) in Durham, NC. This article by a subcommittee of the participants foregrounds some of the topics discussed at the meeting. Topics mentioned here include the

  11. Team communication amongst clinical teachers in a formal meeting of post graduate medical training.

    Science.gov (United States)

    Slootweg, Irene A; Scherpbier, Albert; van der Leeuw, Renée; Heineman, Maas Jan; van der Vleuten, Cees; Lombarts, Kiki M J M H

    2016-03-01

    The importance of team communication, or more specifically speaking up, for safeguarding quality of patient care is increasingly being endorsed in research findings. However, little is known about speaking up of clinical teachers in postgraduate medical training. In order to determine how clinical teachers demonstrate speaking up in formal teaching team meetings and what factors influence this, the authors carried out an exploratory study based on ethnographic principles. The authors selected 12 teaching teams and observed, audio recorded and analysed the data. Subsequently, during an interview, the program directors reflected on speaking up of those clinical teachers present during the meeting. Finally, the authors analysed iteratively all data, using a template analysis, based on Edmondson's behaviours of speaking up. The study was conducted from October 2013 to July 2014 and ten teams participated. During the teaching team meetings, the clinical teachers exhibited most of the behaviours of speaking up. "Sharing information" strongly resembles providing information and "talking about mistakes" occurs in a general sense and without commitment of improvement activities. "Asking questions" was often displayed by closed questions and at times several questions simultaneously. The authors identified factors that influence speaking up by clinical teachers: relational, cultural, and professional. The clinical teachers exhibit speaking up, but there is only limited awareness to discuss problems or mistakes and the discussion centred mainly on the question of blame. It is important to take into account the factors that influence speaking up, in order to stimulate open communication during the teaching team meetings.

  12. 77 FR 1696 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2012-01-11

    ...] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General... committee will discuss the clinical pharmacology aspects of pediatric clinical trial design and dosing to...

  13. 76 FR 3912 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2011-01-21

    ...] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General... how to optimally utilize mechanistic biomarkers and apply clinical pharmacology tools, such as...

  14. Meeting

    Indian Academy of Sciences (India)

    1985-11-07

    Nov 7, 1985 ... Business Meeting of Fellows. Evening Lecture. Architecture of the universe- R Cowsik ... and technical capabilities to plan, design and build satellites for earth observations, such as. Bhaskara I and II have ... Water Resources Systems Planning-. Some case studies for India. Edited by. Mahesh C Chaturvedi ...

  15. 76 FR 38668 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2011-07-01

    ...] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General... Clinical Pharmacology (ACPS-CP) meeting, the committee will further discuss the definition and list of NTI...

  16. 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

  17. The clinical content of NHS trust board meetings: an initial exploration.

    Science.gov (United States)

    Watkins, Mary; Jones, Ray; Lindsey, Laura; Sheaff, Rod

    2008-09-01

    To differentiate between English NHS trust board meetings according to the percentage of clinical content and to explore which characteristics of board meetings might explain this. Definition of scoring system for clinical content. Scoring of minutes for a random sample of 60 trusts. Qualitative analysis of a sub-sample, generated hypotheses about factors leading to higher percentage of clinical items was undertaken; testing of hypotheses in a longitudinal sample of minutes from 24 trusts over 1 year. Clinical content varied from 2% to 30%. Boards with a more clinical focus tended to link other issues including finance to clinical issues; have non-executive directors able to question board executives openly; make less use of acronyms in minutes; had more liaison with social services; and accepted questions from the public. Counting items in board minutes has prima facie validity as a means of defining how clinically focussed board meetings are, although more research is required to refine the method. The present method of analysing board minutes may provide one way of assessing board culture. Directors of nursing can help focus trust board meetings on clinical matters. Further research is required to determine whether greater clinical content in trust board meetings has impacts on clinical practice or organizational performance.

  18. European AIDS Clinical Society Second Standard of Care Meeting, Brussels 16-17 November 2016

    DEFF Research Database (Denmark)

    De Wit, S; Battegay, M; D'Arminio Monforte, A

    2018-01-01

    The European AIDS Clinical Society (EACS) organized a second meeting on Standard of Care in Europe on November 16-17 th, 2016. The aims of the meeting were to discuss and propose actions on three topics, namely: Adherence to guidelines for treatment initiation, treatment monitoring and outcomes, ...

  19. 75 FR 8368 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2010-02-24

    ...] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General... responses, both beneficial and harmful, to certain drugs; (2) a new patient-centric clinical pharmacology...

  20. Meeting

    Indian Academy of Sciences (India)

    At the invitation of the Physical Research. Laboratory, the 58th Annual Meeting of the. Academy was held at Ahmedabad from 6 to 9. November 1992. The meetings were held at the. Physical Research Laboratory (PRL) and the. Space Applications Centre (SAC) and were organized by PRl, in cooperation with ~AC, the.

  1. BALANOPOSTHITIS: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Raju

    2015-01-01

    Full Text Available INTRODUCTION: The inflammation of the non - keratinized epithelium of the glans penis (i.e., Balanities and that of prepuce (i.e., posthitis together comprise the term Balanoposthitis. AIMS AND OBJECTIVES: To determine the aetiological and p redisposing factors for the development of Balanoposthitis, and to know its relation with venereal and non - venereal disease, local and systemic precipitatin g factors. To know the prevalence of Balanoposthitis in STD clinic. Study design - retrospective study . MATERIALS AND METHODS: The study material consists of 75 cases of balanoposthitis attending out - patient department Skin & STD clinic during a period exten din g from Feb, 1998 to Feb, 1999 . CRITERIA FOR SELECTION OF A CASE: Only those cases which have a history of redness of glans or mucous surface of prepuce, with or without genital discharge or ulcer on glans or mucosal surface of prepuce with or without discharge or growth on the penis or fissuring of fore skin were selected for the study. RESULTS: Incidence of balanoposthitis during the period from Feb. 98 to Feb.99 was – 11.53%, out of 650 new STD cases. It was observed that maximum number of pat i ents w as in the 21 - 30 age group (33.34%. The next predominant groups affected were 17 - 20 & 31 - 40 age group (20% each. The third most common age group affected was 41 - 50 (16%. In this study 69 patients (92% who presented with balanoposthitis of whatever cause were found to be uncircumcised, only 6 cases (8% were found to be circumcised. Most cases who presented with balanoposthitis gave a history of exposure to STD risk. CONCLUSIONS: Balanoposthitis is very commonly encountered condition in the STD clinics wi th a multi factorial aetiology. Infective causes dominated over the other possible causes, and 30% of the candidial infection had diabetes mellitus as a predisposing factor.

  2. 76 FR 13196 - Clinical Center; Notice of Meeting

    Science.gov (United States)

    2011-03-10

    ..., 2011. Open: 10 a.m. to 1:15 p.m. Agenda: To review the FY12 Clinical Center Budget. Place: National..., including taxicabs, hotel, and airport shuttles will be inspected before being allowed on campus. Visitors...

  3. 77 FR 12602 - Clinical Center Notice of Meeting

    Science.gov (United States)

    2012-03-01

    ..., 2012. Time: 10 a.m. to 1:15 p.m. Agenda: To review the FY13 Clinical Center Budget. Place: National... procedures for entrance onto the NIH campus. All visitor vehicles, including taxicabs, hotel, and airport...

  4. 75 FR 9912 - Clinical Center; Notice of Meeting

    Science.gov (United States)

    2010-03-04

    ..., 2010. Open: 10 a.m. to 1:15 p.m. Agenda: To review the FY11 Clinical Center Budget. Place: National..., including taxicabs, hotel, and airport shuttles will be inspected before being allowed on campus. Visitors...

  5. Good clinical practice in clinical interventional studies.

    Science.gov (United States)

    Pieterse, Herman; Diamant, Zuzana

    2014-01-01

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

  6. 78 FR 11660 - Clinical Center; Notice of Closed Meeting

    Science.gov (United States)

    2013-02-19

    ... evaluation of individual intramural programs and projects conducted by the CLINICAL CENTER, including consideration of personnel qualifications and performance, and the competence of individual investigators, the...:00 p.m. Agenda: To review and evaluate the Department of Laboratory Medicine. Place: National...

  7. 77 FR 42746 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2012-07-20

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General...

  8. 77 FR 41790 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2012-07-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General...

  9. 76 FR 38188 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2011-06-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General...

  10. 78 FR 58314 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2013-09-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General...

  11. 78 FR 42966 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2013-07-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General...

  12. 78 FR 58315 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2013-09-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0001] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General...

  13. 75 FR 10488 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2010-03-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting AGENCY: Food and... of Committee: Advisory Committee for Pharmaceutical Science and Clinical Pharmacology. General...

  14. Superman meets Don Quixote: stereotypes in clinical medicine.

    Science.gov (United States)

    Pinkus, Rosa Lynn

    1986-01-01

    Drawing in part on her experiences as a "humanist-in-residence" on a neurological surgery service, the author discusses how stereotypic views held by and toward physicians and humanists interfere with the teaching of ethics to physicians and, indirectly, to the general public. She traces the development of these stereotypes over the past hundred years and suggests ways that they can be overcome to permit more effective working relationships between physicians and clinical ethicists.

  15. Radiological input during paediatric multidisciplinary team meetings and its influence on clinical patient management.

    Science.gov (United States)

    Llewellyn-Jones, Glyn; Pereira, John

    2016-04-01

    There is little information about the role of the radiologist at multidisciplinary team meetings; in particular their influence on patient management. To evaluate the influence of radiologists on clinical patient management during multidisciplinary meetings. Prospective data were collected over a 5-week period from multidisciplinary team meetings across four paediatric clinical domains. Radiological input was recorded for each case discussion, including the type of influence and its potential effect on clinical patient management. One hundred and forty paediatric cases were reviewed. Radiological advice was requested from the radiologist for 25.7% (N = 36) of cases. In 17.9% (N = 25) this advice was judged to have influenced clinical patient management. There were two cases where new imaging findings were discovered. Radiologists influence clinical patient management during multidisciplinary team meetings primarily by providing differential diagnoses and guidance regarding future imaging, with respect to both the necessity and the modality. Occasionally, when imaging is reviewed at these meetings, new findings are discovered that impact on patient management. © 2016 The Royal Australian and New Zealand College of Radiologists.

  16. Meeting

    Indian Academy of Sciences (India)

    The organization and arrangements for the scientific meetings, cultural event and the visits to Lothal and SAC were superb. The Academy is grateful to the Physical Research Laboratory particularly R K Varma, Director, PRL, to the. Institute for Plasma Research and its Director. P K Kaw, to the Space Applications Centre and.

  17. Meeting

    Indian Academy of Sciences (India)

    the Defence Minister, Government of India on some of his experiences in technology development in India. A summary of his lecture appears in this issue. In the afternoon the .... of steel armour for our Light Tank which has found wide application to meet the ... basic issues: how information is encoded in the structure of DNA ...

  18. ABDOMINAL TRAUMA- CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Vanaja Ratnakumari Billa

    2017-08-01

    Full Text Available BACKGROUND In the recent times there has been increased incidence of abdominal trauma cases due to several causes. Quick and prompt intervention is needed to decrease the mortality of the patients. So we conducted a study to assess the cause and the management of abdominal trauma cases in our institution. The aim of this study was to know the incidence of blunt and penetrating injuries and their causes, age and sex incidence, importance of various investigations, mode of treatment offered and post-operative complications. To study the cause of death and evolve better management. MATERIALS AND METHODS The present study comprises of patients admitted to and operated in various surgical units in the Department of Surgery at Government General Hospital, attached to Guntur Medical College Guntur, from August 2014 to October 2016. RESULTS Increase incidence seen in age group 20-29 years (30%. Male predominance 77.5%. Mechanism of injury–road traffic accidents 65%. Isolated organ injury–colon and rectum 40%. Other associated injuries–chest injuries with rib fractures 7.5%. Complications–wound infection 17.5%. Duration of hospital stay 8–14 days. Bowel injury management–closure of perforation 84.6%. Resection anastomosis 15.38%. CONCLUSION Thorough clinical examination, diagnostic paracentesis, plain X-ray erect abdomen and ultrasound proved to be very helpful in the diagnosis of intra-abdominal injuries. Spleen is the commonest organ involved in blunt trauma and colon is the commonly injured organ in penetrating abdominal trauma, many patients have associated extremity and axial skeleton injuries. With advances in diagnosis and intensive care technologies, most patients of solid visceral injuries with hemodynamic stability can be managed conservatively. Surgical site infection is the most common complication following surgery. The mortality is high; reason might be patient reaching the hospital late, high incidence of postoperative septic

  19. Clinical studies with mazindol.

    Science.gov (United States)

    Inoue, S

    1995-11-01

    An anoerxiant, mazindol suppresses food intake by 1) stimulating beta-adrenergic receptors, 2) inhibiting the feeding center and, 3) stimulating the satiety center in the hypothalamus. In Japan, mazindol is available for clinical use. We examined the effects of mazindol on 1) body weight, appetite, and abnormalities of obesity-related diseases in long-term use 2) maintenance of the reduced body weight after very-low-calorie diet (VLCD) therapy 3) combined use with VLCD therapy and, 4) inhibition of body weight gain in Prader-Willi syndrome. In long-term effects of mazindol, the average reduction of individual body weight was around 6.8 kg. The appetite of 59% of obese subjects was moderately suppressed. Systolic blood pressure, serum GOT, serum triglyceride, serum cholesterol, and glucose tolerance were also improved. With mazindol, 53.3% of obese subjects kept the reduced body weight after VLCD, in contrast, 20.0% of them kept it without mazindol. Combined use of mazindol with VLCD made the VLCD therapy more effective in outpatients. Two of 3 patients with Prader-Willi syndrome inhibited their body weight gain with mazindol. Thus, mazindol produced positive effects in these studies, although the effects were limited.

  20. New, strategic outsourcing models to meet changing clinical development needs

    Directory of Open Access Journals (Sweden)

    Janet Jones

    2010-01-01

    Full Text Available The impact of increasing clinical costs and the need for more data to support higher efficacy demands and overcome regulatory hurdles for market entry means that every Company is faced with the challenge of how to do more with a smaller budget. As budgets get squeezed the pharmaceutical Industry has been looking at how to contain or reduce cost and support an increased number of projects. With the growing sophistication of outsourcing, this is an increasingly important area of focus. Some Pharmaceutical Companies have moved from tactical, case by case, outsourcing to new, more strategic relationships, which involve outsourcing functions that were historically held as core pharmaceutical functions. An increasing number of Sponsors are looking at strategic relationships which are based on more creative outsourcing approaches. As the need and sophistication of these outsourcing models and the sponsors / CROs involved in them, these approaches are becoming more transformational and need to be based on a strong partnership. Lessons learned from working with sponsors in a partnership model have been examined and two key challenges addressed in detail: the need for bilateral central control though a strong governance model and the importance of early planning and commitment.

  1. Multiple Myeloma: Clinical Updates From the American Society of Hematology Annual Meeting 2016.

    Science.gov (United States)

    Terpos, Evangelos

    2017-06-01

    The novel clinical data for plasma cell neoplasms (smoldering myeloma, multiple myeloma (MM) and AL-amyloidosis) that were presented in the 2016 Annual Meeting of the American Society of Hematology are summarized here. Data from large phase 3 studies for newly diagnosed MM patients who are eligible for autologous transplantation (EMN02, MRC XI and StaMINA trials) are described along with the results of phase 2 studies using novel anti-myeloma drug combinations for induction, consolidation and maintenance as first line therapy. Recent updates of previous important studies in the field of both newly diagnosed (FIRST) and relapsed/refractory MM (POLLUX, CASTOR) are also reported. Moreover, the results of clinical studies with the use of anti-myeloma drugs with new mechanisms of action, including pembrolizumab, selinexor, venetoclax and monoclonal antibodies, are discussed. All these data provide the basis for possible changes in the way we manage myeloma in the near future trying to "cure" the disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. European AIDS Clinical Society Standard of Care meeting on HIV and related coinfections: The Rome Statements

    NARCIS (Netherlands)

    Mussini, C.; Antinori, A.; Bhagani, S.; Branco, T.; Brostrom, M.; Dedes, N.; Bereczky, T.; Girardi, E.; Gökengin, D.; Horban, A.; Lacombe, K.; Lundgren, J. D.; Mendao, L.; Mocroft, A.; Oprea, C.; Porter, K.; Podlekareva, D.; Battegay, M.; d'Arminio Monforte, A.; Mulcahy, Fiona; Geretti, Anna Maria; Clumeck, Nathan; Reiss, Peter; Arribas, Jose; Gatell, Jose; Katlama, Christine; Pozniak, Anton; Rockstroh, Jürgen; Youle, Mike; Friis-Møller, Nina; Rusconi, Stefano; Behrens, Georg; de Wit, Stéphane; Furrer, Hansjakob; Wensing, Annemarie; John Gill, M.; Letendre, Scott

    2016-01-01

    The objective of the 1st European AIDS Clinical Society meeting on Standard of Care in Europe was to raise awareness of the European scenario and come to an agreement on actions that could be taken in the future. Data-driven presentations were given on specific topics followed by interactive panel

  3. European AIDS Clinical Society Standard of Care meeting on HIV and related coinfections : The Rome Statements

    NARCIS (Netherlands)

    Mussini, C.; Antinori, A.; Bhagani, S.; Branco, T.; Brostrom, M.; Dedes, N.; Bereczky, T.; Girardi, E.; Gökengin, D.; Horban, A.; Lacombe, K.; Lundgren, J. D.; Mendao, L.; Mocroft, A.; Oprea, C.; Porter, K.; Podlekareva, D.; Battegay, M.; d'Arminio Monforte, A.; Mulcahy, Fiona; Geretti, Anna Maria; Clumeck, Nathan; Reiss, Peter; Arribas, Jose; Gatell, Jose; Katlama, Christine; Pozniak, Anton; Rockstroh, Jürgen; Youle, Mike; Friis-Møller, Nina; Rusconi, Stefano; Behrens, Georg; De Wit, Stéphane; Furrer, Hansjakob; Wensing, Annemarie|info:eu-repo/dai/nl/30817724X; John Gill, M.; Letendre, Scott

    2016-01-01

    Objectives: The objective of the 1st European AIDS Clinical Society meeting on Standard of Care in Europe was to raise awareness of the European scenario and come to an agreement on actions that could be taken in the future. Methods: Data-driven presentations were given on specific topics followed

  4. Proceedings of the 2009 annual meeting of the Fetal Alcohol Spectrum Disorders Study Group.

    Science.gov (United States)

    Zhou, Feng C; Kane, Cynthia J M; Smith, Susan M

    2012-02-01

    The annual meeting of the Fetal Alcohol Spectrum Disorders Study Group (FASDSG) was held on June 20, 2009 in San Diego, CA, as a satellite of the Research Society on Alcoholism Meeting. The FASDSG membership includes clinical, basic, and social scientists who meet to discuss recent advances and issues in Fetal Alcohol Spectrum Disorders research. The main theme of the meeting was "Epigenetics and Development." Two keynote speakers, Dr. Randy Jirtle and Dr. Michael Skinner, addressed the role of epigenetics and environmental inputs, including alcohol, during critical stages of development and their potential critical and long-lasting effects. Members of the FASDSG provided new findings through brief "FASt" data reports, and national agency representatives provided updates on activities and funding priorities. Scientific presentations were made by recipients of the Student Research Merit Award and Rosett Award. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. 77 FR 40030 - Army Science Board Summer Study Meeting

    Science.gov (United States)

    2012-07-06

    ... studies: Strategic Direction for Army Science and Technology and Small Unit Data to Decisions. Proposed Agenda: Thursday 26 July 2012: 1530-1630--The study results for Strategic Direction for Army Science and... DEPARTMENT OF DEFENSE Department of the Army Army Science Board Summer Study Meeting AGENCY...

  6. 1st Annual Meeting of the Future Circular Collider study

    CERN Document Server

    2015-01-01

    This first Annual Meeting of the Future Circular Collider study is an important milestone to conclude the first, exploratory phase, leading to the identification of the baseline for the further study. Organized as an IEEE conference, it will provide the opportunity for re-enforcing the cohesion of the community and to catalyse cross-fertilization within the FCC study.

  7. Graduate Museum Studies Curricula: Meeting the Needs of the Field

    Science.gov (United States)

    Bomar, William Frank

    2012-01-01

    The goal of this study was to assess how graduate museum studies programs are meeting the current and anticipated future needs of the museum profession. A comprehensive assessment was conducted to determine the knowledge and skills most emphasized in graduate museum studies curricula and those most valued by leading museum practitioners. A total…

  8. Meeting

    Indian Academy of Sciences (India)

    1986-11-07

    Nov 7, 1986 ... photo movement of Cyanobacteria. -w Nultsch. Lecture presentations by Fe"ows and Young. Associates. Vibrational spectroscopic studies on structure of liquid water and aqueous solutions - Surjit Singh. Biological implications of soil solarization. -D K Arora. 2D NMR: 'Crystallography' in solution.

  9. Meeting

    Indian Academy of Sciences (India)

    association of maternal and foetal tissues which develops during pregnancy in mammals. It..serves a variety of ... He argued that earthquake studies in the Garhwal agree with geological evidence and suggested that ... held at Roorkee at the Civil Engineering. Auditorium of the University of Roorkee in the forenoon of 9 ...

  10. Sixteenth Meeting of the IMS Study Group "Cantus Planus"

    Czech Academy of Sciences Publication Activity Database

    Vozková, Jana

    2011-01-01

    Roč. 48, 2-3 (2011), s. 310-311 ISSN 0018-7003. [Sixteenth Meeting of the IMS Study Group “Cantus Planus”. Vídeň, 21.08.2011–27.08.2011] Institutional research plan: CEZ:AV0Z90580513 Keywords : plainchant * annual conference * International Musicological Society Subject RIV: AL - Art, Architecture, Cultural Heritage

  11. Planning a study abroad clinical experience.

    Science.gov (United States)

    Wright, Dolores J

    2010-05-01

    Not only is globalization expanding areas of human activity, it is also influencing the variety of educational offerings in universities. Therefore, globalization must be considered by nurse educators as they reevaluate ways of preparing nursing students to meet the health care needs of populations they currently serve and will care for in the future. Study abroad programs have been encouraged to be part of the college experience in the United States for more than 30 years; however, these programs have been relatively lacking in nursing education. Most of the study abroad programs described in the nursing literature are research-based or first-person accounts of an experience and provide little information about planning a study abroad program. This article describes a study abroad learning experience for senior nursing students and discusses the issues such as student selection, student safety, and available clinical experiences that need to be considered before undertaking such an endeavor.

  12. European AIDS Clinical Society Standard of Care meeting on HIV and related coinfections

    DEFF Research Database (Denmark)

    Mussini, C; Antinori, A; Bhagani, S

    2016-01-01

    OBJECTIVES: The objective of the 1st European AIDS Clinical Society meeting on Standard of Care in Europe was to raise awareness of the European scenario and come to an agreement on actions that could be taken in the future. METHODS: Data-driven presentations were given on specific topics followed...... by interactive panel discussions. RESULTS: In Eastern European countries, the epidemic is largely driven by injecting drug use, in contrast with Western Europe where the infection mainly occurs through heterosexual contact. A high proportion of people living with HIV remain unaware of their infection...... diagnosed multi-drug-resistant cases. Hepatitis C is widespread in selected geographical areas and risk groups. CONCLUSIONS: The key conclusion from the meeting was that a high-priority group of actions could be identified, including: increasing HIV awareness and testing, improving training for health care...

  13. 78 FR 31560 - Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test Payment...

    Science.gov (United States)

    2013-05-24

    ... for coding and payment determinations for new clinical diagnostic laboratory tests under Part B of..., and amount of, payment for any clinical diagnostic laboratory test with respect to which a new or... [CMS-1451-N] Medicare Program; Public Meeting in Calendar Year 2013 for New Clinical Laboratory Test...

  14. En Route to the Clinic: Diagnostic Sequencing Applications Using the Ion Torrent (7th Annual SFAF Meeting, 2012)

    Energy Technology Data Exchange (ETDEWEB)

    Muzny, Donna

    2012-06-01

    Donna Muzny on "En route to the clinic: Diagnostic sequencing applications using the Ion Torrent" at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

  15. Efficacy of long-term milnacipran treatment in patients meeting different thresholds of clinically relevant pain relief: subgroup analysis of a randomized, double-blind, placebo-controlled withdrawal study

    Directory of Open Access Journals (Sweden)

    Mease PJ

    2014-11-01

    Full Text Available Philip J Mease,1 Daniel J Clauw,2 Joel M Trugman,3 Robert H Palmer,3 Yong Wang3 1Swedish Medical Center and University of Washington, Seattle, WA, USA; 2Chronic Pain and Fatigue Research Center, University of Michigan Health System, Ann Arbor, MI, USA; 3Forest Research Institute, Jersey City, NJ, USA Background: Fibromyalgia patients from a long-term, open-label study of milnacipran (50–200 mg/day were eligible to participate in a 12-week, randomized, placebo-controlled withdrawal study. The withdrawal study evaluated loss of therapeutic response in patients who achieved ≥50% pain improvements after receiving up to 3.25 years of milnacipran. This post-hoc analysis investigated whether patients who met lower thresholds of pain improvement also experienced worsening of fibromyalgia symptoms upon treatment withdrawal. Method: Among patients who received milnacipran ≥100 mg/day during the long-term study, three subgroups were identified based on percentage of pain reduction at randomization: ≥50% (protocol-defined "responders"; n=150; ≥30% to <50% (patients with clinically meaningful pain improvement; n=61; and <30% (n=110. Efficacy assessments included the visual analog scale (VAS for pain, Fibromyalgia Impact Questionnaire-Revised (FIQR, 36-Item Short-Form Health Survey Physical Component Summary (SF-36 PCS, and Beck Depression Inventory (BDI. Results: In the ≥30 to <50% subgroup, significant worsening in pain was detected after treatment withdrawal. The difference between placebo and milnacipran in mean VAS score changes for this subgroup (+9.0, P<0.05 was similar to the difference in protocol-defined responders (+9.4, P<0.05. In the <30% subgroup, no worsening in pain was observed in either treatment arm. However, patients in this subgroup experienced significant worsening in FIQR scores after treatment withdrawal (placebo, +6.9; milnacipran, -2.8; P<0.001, as well as worsening in SF-36 PCS and BDI scores. Conclusion: Patients who

  16. The subtle field of the meeting: meta-corporeality and the clinic

    Directory of Open Access Journals (Sweden)

    Helia Borges

    2015-06-01

    Full Text Available This article aims to discuss the context of the analytic setting, proposing a clinical approach that encourages reflection on a practice that takes into account the encounter between analyst and patient, from the subtle field triggered by complaints, by corporeality. This meeting, as meta-corporeality, would enable the hold of subjective dynamics that escape the represented field. The flow of forces, the intensive field in Freudian concepts such as, for example, the drive concept, was dropped by a psychoanalytic construction restricted to representation speech. It takes up here the tradition already consolidated since Freud, when approaching art and clinic, thinking the analytical doing and its theoretical production, seeking to expand its devices.

  17. Teaming Up for Women's Health: The 2015 American College of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting.

    Science.gov (United States)

    Breitkopf, Daniel M; Demosthenes, Lauren D; Phelan, Sharon T

    2015-11-01

    63rd Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists, 2-6 May, 2015, San Francisco, CA, USA. In response to major practice changes in obstetrics and gynecology (OB/GYN), the 2015 Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists responded with modification of the program organization, methods of presenting the information (debates, hands on, flip classrooms) and increased emphasis on current clinical research. The Presidential Program covered broad themes of changes in healthcare technology, teamwork in OB/GYN practice and the importance of advocating for patients. Over 400 abstracts representing a broad range of clinical and basic science research were presented. Changes in the Annual Clinical and Scientific Meeting should allow the membership to be more prepared and pro-active as the practice of OB/GYN evolves.

  18. The Fourth Annual Meeting of the International Network for Pediatric Hemophilia: Current Challenges and Recommendations in the Clinical Care of Children with Hemophilia.

    Science.gov (United States)

    Ljung, Rolf; van den Berg, Marijke; Valentino, Leonard A; Manco-Johnson, Michael

    2010-01-01

    The International Network for Pediatric Hemophilia (INPH) comprises a group of physicians committed to the unique care of and challenges facing pediatric hemophilia patients. By collaborating on an international level, extensive experience can be shared on current practice, new trends can be discussed and scientifically valid studies can be developed and performed. The three overall objectives of the group (scientific progress, education and networking) are achieved at each annual meeting starting with a round table on the members' current research and clinical activities, project reports of INPH study initiatives, followed by invited educational presentations and interactive discussions. The meetings close with proposals of new projects, future directions of the group and concluding remarks. The Fourth Annual INPH meeting, held in 2009 in Boston, MA, USA, focused on inhibitor development and hemophilic arthropathy in the clinical care of children with hemophilia.

  19. Report of the consultants' meeting on radioimmunometric assays for non-clinical applications

    International Nuclear Information System (INIS)

    2000-01-01

    A meeting between three experts and various Agency staff with specific areas of expertise was convened to review present status of radiolabelled immunoassays i.e. radioimmunoassay (RIA) and immunradiometric assay (IRMA) and their relevance to non- clinical applications. For many years, the Agency has been active in supporting the devolution of RIA and IRMA expertise in clinical applications, particularly in the field of thyroid disease and its management. The Agency's strategy was based on a perceived need to reduce the high cost of imported reagents and the poor working practices that this encouraged. This has been achieved through the use of bulk reagents (rather than 'kits') and the transfer of existing technology. The success of the Agency's approach is evident from the high degree of self- sufficiency now available in many developing countries. In recent years, the increasing workload for clinical analyses has necessitated an increase in automation, which in turn has required a change to more non-isotopic alternatives. This change seen in the more developed countries, and beginning to be introduced elsewhere, is likely lo continue. However, RIA/IRMA will continue to be used in many parts of the world for some time to come. In recent years there has been an increasing interest in the use of immunoassay technology in non-clinical applications, e.g., environmental monitoring, quality control in food production and livestock management. RIA and IRMA continue to play a major role in research

  20. Training managers to facilitate their meetings: An intervention study

    DEFF Research Database (Denmark)

    Ravn, Ib

    2014-01-01

    . To test this reconceptualisation in a live experiment intended to improve real meetings, we conducted brief training of 103 managers in meeting facilitation in two organisations in Denmark. A pre- and post-intervention survey of a thousand employees who regularly participated in these managers’ meetings......Meetings in organisations are a common object of popular frustration. They are often run by managers who picked up their meeting skills from their superiors a generation previously, thus perpetuating obsolescent practices unsuited to today’s world of work. This paper reports on a research......-based intervention effort to improve organisational meetings. It reconceptualises classical meeting management, offering instead the practice of ‘meeting facilitation’: a more active and supportive approach, in which the manager-as-facilitator guides and directs conversations in meetings towards a positive goal...

  1. Trends in twitter use by physicians at the american society of clinical oncology annual meeting, 2010 and 2011.

    Science.gov (United States)

    Chaudhry, Aafia; Glodé, L Michael; Gillman, Matt; Miller, Robert S

    2012-05-01

    Social media channels such as Twitter are gaining increasing acceptance as mechanisms for instantaneous scientific dialogue. Professional medical societies such as ASCO are using social media to expand the reach of scientific communications at and around their scientific meetings. This article examines the how Twitter use by oncologists expanded at the ASCO Annual Meetings from 2010 to 2011. In both years, tweets that were specifically generated by physicians and that incorporated the official meeting hashtag were harvested from the public domain, and a discourse analysis was performed by three independent raters. Follow-up surveys were conducted to assess physician attitudes toward Twitter and its potential role in clinical practice. A combined total of 12,644 tweets were analyzed for 2010 and 2011. Although the number of physicians authoring tweets was small (14 in 2010, 34 in 2011), this group generated nearly 29% of the total meeting dialogue examined in this analysis in 2010 and 23% in 2011. Physicians used Twitter for reporting clinical news from scientific sessions, for discussions of treatment issues, for promotion, and to provide social commentary. The tangible impact of Twitter discussions on clinical practice remains unclear. Despite the 140-character limit, Twitter was successfully used by physicians at the 2010 and 2011 ASCO Annual Meetings to engage in clinical discussions, whether or not an author was on site as a live attendee. Twitter usage grew significantly from 2010 to 2011. Professional societies should monitor these phenomena to enhance annual meeting attendee user experience.

  2. Case Study: Caregiver Perception of Pediatric Multidisciplinary Feeding Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Thomas F. Fisher PhD, OT, FAOTA

    2014-01-01

    Full Text Available This study explores the perception of satisfaction of caregivers who attended a feeding clinic at a large pediatric hospital in the midwest. The clinic is designed for a multidisciplinary team to meet with the child and the caregiver. Thirty-five participants were involved in the study. Results indicated that most participants were satisfied with the clinic experience. However, there were areas of care not covered by the members of the feeding team, which indicates a need. It is suggested that this need could be filled by occupational therapists.

  3. 76 FR 6623 - Molecular and Clinical Genetics Panel of the Medical Devices Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-02-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0066] Molecular and Clinical Genetics Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY... public. Name of Committee: Molecular and Clinical Genetics Panel of the Medical Devices Advisory...

  4. Core Outcome Domains for early phase clinical trials of sound-, psychology-, and pharmacology-based interventions to manage chronic subjective tinnitus in adults: the COMIT'ID study protocol for using a Delphi process and face-to-face meetings to establish consensus.

    Science.gov (United States)

    Fackrell, Kathryn; Smith, Harriet; Colley, Veronica; Thacker, Brian; Horobin, Adele; Haider, Haúla F; Londero, Alain; Mazurek, Birgit; Hall, Deborah A

    2017-08-23

    The reporting of outcomes in clinical trials of subjective tinnitus indicates that many different tinnitus-related complaints are of interest to investigators, from perceptual attributes of the sound (e.g. loudness) to psychosocial impacts (e.g. quality of life). Even when considering one type of intervention strategy for subjective tinnitus, there is no agreement about what is critically important for deciding whether a treatment is effective. The main purpose of this observational study is, therefore to, develop Core Outcome Domain Sets for the three different intervention strategies (sound, psychological, and pharmacological) for adults with chronic subjective tinnitus that should be measured and reported in every clinical trial of these interventions. Secondary objectives are to identify the strengths and limitations of our study design for recruiting and reducing attrition of participants, and to explore uptake of the core outcomes. The 'Core Outcome Measures in Tinnitus: International Delphi' (COMIT'ID) study will use a mixed-methods approach that incorporates input from health care users at the pre-Delphi stage, a modified three-round Delphi survey and final consensus meetings (one for each intervention). The meetings will generate recommendations by stakeholder representatives on agreed Core Outcome Domain Sets specific to each intervention. A subsequent step will establish a common cross-cutting Core Outcome Domain Set by identifying the common outcome domains included in all three intervention-specific Core Outcome Domain Sets. To address the secondary objectives, we will gather feedback from participants about their experience of taking part in the Delphi process. We aspire to conduct an observational cohort study to evaluate uptake of the core outcomes in published studies at 7 years following Core Outcome Set publication. The COMIT'ID study aims to develop a Core Outcome Domain Set that is agreed as critically important for deciding whether a

  5. 76 FR 19189 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2011-04-06

    ... Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on April... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives...

  6. 76 FR 65781 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2011-10-24

    ... Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee, Notice of Meeting The Department of Veterans Affairs (VA) gives...

  7. 75 FR 79446 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2010-12-20

    ... Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives...

  8. 76 FR 73781 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2011-11-29

    ... Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives...

  9. 75 FR 28686 - Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2010-05-21

    ... Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on June... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service; Cooperative Studies Scientific Evaluation Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives...

  10. 77 FR 31072 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2012-05-24

    ... Research and Development Service Cooperative Studies Scientific Evaluation Committee will be held on July... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives...

  11. Nuclear separations for radiopharmacy : the need for improved separations to meet future research and clinical demands

    International Nuclear Information System (INIS)

    Bond, A.H.; Rogers, R.D.; Dietz, M.L.

    2000-01-01

    Several recent national and international reports have predicted that the demand for radionuclides used in medicine will increase significantly over the next 20 years. Separation science is an integral part of the production and development of new radionuclides for diagnostic and therapeutic applications and will play a major role in process improvements to existing radiopharmaceuticals to meet increasing demands. The role of separation science in the production of radionuclides for medical applications is briefly discussed, followed by an overview of the manuscripts from the American Chemical Society symposium 'Nuclear Separations for Radiopharmacy'. A listing of the most widely used radionuclides in clinical application and medical research serves as a foundation for the discussion of future research opportunities in separation science

  12. Multidisciplinary team meetings (MDTM) in detection of Alzheimer's disease: data from the IDEM study.

    Science.gov (United States)

    Rolland, Y; Tavassoli, N; Gillette-Guyonnet, S; Perrin, A; Hermabessière, S; Ousset, P-J; Nourhashemi, F; Cestac, P; Vellas, B

    2013-02-01

    The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom, the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWIG) in Germany and the Haute Autorité de Santé (HAS) in France have recently set out guidelines on prescription of anti-dementia medication. The HAS proposes in particular that continuation of these drugs for longer than one year should be decided in multidisciplinary team meetings (MDTM). To assess the feasibility of MDTM and the satisfaction of coordinating physicians from institutions for the dependent elderly (nursing home, NH) and expert physicians from memory clinics who have participated in the meetings. Survey carried out among physicians who had participated in the MDTM held as part of the IDEM study (Interest of systematic tracking of dementia cases in NH: analysing the contribution of MDTM in Alzheimer's disease and related diseases; PHRC National 2009, Code 0910701). The survey evaluated the organization of MDTM and the physicians' opinion of these meetings. The cases of 574 patients were discussed in MDTM involving 133 healthcare professionals (32 coordinating physicians, 48 expert physicians, 4 general practitioners and 49 other health professionals). The mean number of participants was 4.2±1.6. About 16 minutes were spent discussing the case of each resident. About 90% of physicians considered that the meetings were useful. Overall assessment of their efficacy was 11.5/20 for the coordinating physicians and 14.1/20 for the expert physicians. The benefits of MDTM in relation to the work entailed were considered important by 60% of expert physicians and 33% of coordinating physicians. Our survey confirmed the feasibility of MDTM in the field of Alzheimer's disease. The overall benefit/workload ratio of the meetings was considered to be favorable for the expert physicians. The benefits of MDTM were turned out to be less appreciated by the coordinating physicians according to high workload

  13. Planning meeting combined analysis, North America residential radon studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    This report describes the Third International Department of Energy/ Commission of European Communities Workshop on Residential Radon Epidemiology held in February 1995 in Baltimore, MD. This culminates a major effort begun 1988, co-sponsored by the DOE and the CEC Radiation Protection Programme to identify and bring together all those scientists worldwide performing epidemiological case control studies of residential radon and lung cancer. Two prior meetings were held in 1989 and 1991. The goal of this effort is to work with the investigators and to pool these studies to increase their limited statistical power and to maximize any information that could be gained from them. That goal has now been met. At this Workshop the task moved from planning and agreement to implementation, as many of the studies were finally being completed and published. This report provides a summary of the Workshop as well as that of the first implementation workgroup meeting hosted by Health Canada. Selected papers have been indexed separately for inclusion in the Energy Science and Technology Database.

  14. Study group meeting on steam generators for LMFBR's. Summary report

    International Nuclear Information System (INIS)

    1975-07-01

    The Meeting organised by IAEA international working group on fast reactors which considered that the subject of sodium heated steam generators was a topic which needed study by the experts of several disciplines. For example: people who design such steam generators, specialists in the field of sodium water reactions, experts in material and water chemistry and members of the utilities who would be the customers for such units. Besides the exchange of large amount of information, it was considered that further special studies were necessary for the following subjects: materials; maintenance and repair; operating procedures and control of steam generators. A separate study of sodium-water reactions was recommended considering the safety aspects related to large water leakage and economic advantage of possible detection and protection against small water leaks

  15. Efficacy of long-term milnacipran treatment in patients meeting different thresholds of clinically relevant pain relief: subgroup analysis of a randomized, double-blind, placebo-controlled withdrawal study.

    Science.gov (United States)

    Mease, Philip J; Clauw, Daniel J; Trugman, Joel M; Palmer, Robert H; Wang, Yong

    2014-01-01

    Fibromyalgia patients from a long-term, open-label study of milnacipran (50-200 mg/day) were eligible to participate in a 12-week, randomized, placebo-controlled withdrawal study. The withdrawal study evaluated loss of therapeutic response in patients who achieved ≥50% pain improvements after receiving up to 3.25 years of milnacipran. This post-hoc analysis investigated whether patients who met lower thresholds of pain improvement also experienced worsening of fibromyalgia symptoms upon treatment withdrawal. Among patients who received milnacipran ≥100 mg/day during the long-term study, three subgroups were identified based on percentage of pain reduction at randomization: ≥50% (protocol-defined "responders"; n=150); ≥30% to Fibromyalgia Impact Questionnaire-Revised (FIQR), 36-Item Short-Form Health Survey Physical Component Summary (SF-36 PCS), and Beck Depression Inventory (BDI). In the ≥30 to subgroup, significant worsening in pain was detected after treatment withdrawal. The difference between placebo and milnacipran in mean VAS score changes for this subgroup (+9.0, Psubgroup, no worsening in pain was observed in either treatment arm. However, patients in this subgroup experienced significant worsening in FIQR scores after treatment withdrawal (placebo, +6.9; milnacipran, -2.8; Pfibromyalgia symptoms after treatment withdrawal. These results suggest that the conventional ≥30% pain responder cutoff may be adequate to demonstrate efficacy in randomized withdrawal studies of fibromyalgia. Patients in the subgroup had worsening scores on the FIQR and other multidimensional measures after treatment withdrawal, indicating the importance of identifying and managing the multiple symptoms of fibromyalgia.

  16. Assessment of Suicidal Ideation and Behavior: Report of the International Society for CNS Clinical Trials and Methodology Consensus Meeting.

    Science.gov (United States)

    Chappell, Phillip B; Stewart, Michelle; Alphs, Larry; DiCesare, Franco; DuBrava, Sarah; Harkavy-Friedman, Jill; Lim, Pilar; Ratcliffe, Sian; Silverman, Morton M; Targum, Steven D; Marder, Stephen R

    2017-06-01

    To develop consensus recommendations for assessment of suicidal ideation/suicidal behavior (SI/SB) in clinical trials. Stakeholders from academia, industry, regulatory agencies, National Institutes of Health, National Institute of Mental Health, and patient advocacy organizations participated in a consensus meeting that was sponsored by the International Society for CNS Clinical Trials and Methodology and held November 17-18, 2015. Prior to the meeting, teams of experts identified key areas of consensus and dissent related to SI/SB. The most critical issues were presented and discussed in the consensus meeting. Literature reviews and a pre-meeting survey were conducted. Findings were discussed in pre-meeting working group sessions and at the consensus meeting. Five pre-meeting working groups reviewed (1) nomenclature and classification schemes for SI/SB, (2) detection and assessment of SI/SB, (3) analysis of SI/SB data, (4) design of clinical trials for new treatments of SI/SB, and (5) public health approaches to SI/SB. A modification of the RAND/UCLA Appropriateness Method was used to combine review of scientific evidence with the collective views of experts and stakeholders to reach the final consensus statements. After discussion, all attendees voted using an electronic interactive audience response system. Areas of agreement and areas of continuing dissent were recorded. All 5 working groups agreed that a major barrier to advancement of the field of SI/SB research and the development of new treatments for SI/SB remains the lack of a universally accepted standardized nomenclature and classification system. Achieving alignment on definitions and classification of suicide-related phenomena is critical to improving the detection and assessment of SI/SB, the design of clinical trials for new treatments, and effective public health interventions. © Copyright 2017 Physicians Postgraduate Press, Inc.

  17. Efficacy of long-term milnacipran treatment in patients meeting different thresholds of clinically relevant pain relief: subgroup analysis of a randomized, double-blind, placebo-controlled withdrawal study

    OpenAIRE

    Mease, Philip J; Clauw, Daniel J; Trugman, Joel M; Palmer, Robert H; Wang, Yong

    2014-01-01

    Philip J Mease,1 Daniel J Clauw,2 Joel M Trugman,3 Robert H Palmer,3 Yong Wang3 1Swedish Medical Center and University of Washington, Seattle, WA, USA; 2Chronic Pain and Fatigue Research Center, University of Michigan Health System, Ann Arbor, MI, USA; 3Forest Research Institute, Jersey City, NJ, USA Background: Fibromyalgia patients from a long-term, open-label study of milnacipran (50–200 mg/day) were eligible to participate in a 12-week, randomized, placebo-controlled withdrawal...

  18. Nutritional clinical studies in dermatology.

    Science.gov (United States)

    Liakou, Aikaterini I; Theodorakis, Michael J; Melnik, Bodo C; Pappas, Apostolos; Zouboulis, Christos C

    2013-10-01

    Nutrition has long been associated with skin health, beauty, integrity and aging through multiple pathways and cofactors implicated in skin biology. The onset and clinical course of various common skin diseases, especially acne, psoriasis, atopic dermatitis, and hair loss, have been suggested to be critically affected by nutrition patterns and habits. The relationship between acne and diet, predominantly the role of high glycemic load diets and dairy consumption have recently gained increased interest. Abnormal nutritional conditions such as obesity or malnutrition often manifest themselves by specific cutaneous features and altered skin function. Skin photoprotection, rendered by various nutrients, is well documented and appropriate nutritional supplementation has been shown to exert beneficial effects upon impaired skin integrity, restore its appearance and promote skin health. It is our intention to provide a comprehensive review of the most recent information on the role of nutrition for common skin diseases and regulation of skin biology. Nutritional clinical studies in dermatology have been reviewed using the MedLine literature source and the terms "diet" or "nutrition" and "skin". The data on the relationship between nutrition and skin are until now controversial and much more work is needed to be done to clarify possible etiological correlations.

  19. A Clinical Study on Hypothyroidism

    International Nuclear Information System (INIS)

    Park, Keun Jo; Park, Sun Yang; Park, Jung Sik; Lee, Myung Chul; Koh, Chang Soon; Lee, Mun Ho

    1976-01-01

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

  20. Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study.

    Science.gov (United States)

    Lamb, Benjamin W; Jalil, Rozh T; Sevdalis, Nick; Vincent, Charles; Green, James S A

    2014-09-08

    The prevalence of multidisciplinary teams (MDT) for the delivery of cancer care is increasing globally. Evidence exists of benefits to patients and healthcare professionals. However, MDT working is time and resource intensive. This study aims to explore members' views on existing practices of urology MDT working, and to identify potential interventions for improving the efficiency and productivity of the MDT meeting. Members of urology MDTs across the UK were purposively recruited to participate in an online survey. Survey items included questions about the utility and efficiency of MDT meetings, and strategies for improving the efficiency of MDT meetings: treating cases by protocol, prioritising cases, and splitting the MDT into subspeciality meetings. 173 MDT members participated (Oncologists n = 77, Cancer Nurses n = 54, Urologists n = 30, other specialities n = 12). 68% of respondents reported that attending the MDT meeting improves efficiency in care through improved clinical decisions, planning investigations, helping when discussing plans with patients, speciality referrals, documentation/patient records. Participants agreed that some cases including low risk, non-muscle invasive bladder cancer and localised, low-grade prostate cancer could be managed by pre-agreed pathways, without full MDT review. There was a consensus that cases at the MDT meeting could be prioritised by complexity, tumour type, or the availability of MDT members. Splitting the MDT meeting was unpopular: potential disadvantages included loss of efficiency, loss of team approach, unavailability of members and increased administrative work. Key urology MDT members find the MDT meeting useful. Improvements in efficiency and effectiveness may be possible by prioritising cases or managing some low-risk cases according to previously agreed protocols. Further research is needed to test the effectiveness of such strategies on MDT meetings, cancer care pathways and patient outcomes in clinical

  1. Controlled clinical studies of homeopathy.

    Science.gov (United States)

    Mathie, Robert T

    2015-10-01

    Observations about controlled clinical trials expressed by Max Haidvogl in the book Ultra High Dilution (1994) have been appraised from a perspective two decades later. The present commentary briefly examines changes in homeopathy research evidence since 1994 as regards: the published number of randomised controlled trials (RCTs), the use of individualised homeopathic intervention, the 'proven efficacy of homeopathy', and the quality of the evidence. The commentary reflects the details of RCTs that are available in a recently published literature review and by scrutiny of systematic reviews of RCTs in homeopathy. The homeopathy RCT literature grew by 309 records in the 18 years that immediately followed Haidvogl's article, with more than a doubling of the proportion that investigated individualised homeopathy. Discounting one prior publication, the entire systematic review literature on homeopathy RCTs post-dates 1994. A total of 36 condition-specific systematic reviews have been identified in the peer-reviewed literature: 16 of them reported positive, or tentatively positive, conclusions about homeopathy's clinical effectiveness; the other 20 were negative or non-conclusive. Reviews typically have been restricted in the strength of their conclusions by the low quality of the original RCT evidence. Three comprehensive systematic reviews concluded, cautiously, that homeopathy may differ from placebo; a fourth such review reached negative conclusions. A recent high-quality meta-analysis concluded that medicines prescribed in individualised homeopathic treatment may have small, specific, effects. Despite important growth in research activity since 1994, concerns about study quality limit the interpretation of available RCT data. The question whether homeopathic intervention differs from placebo awaits decisive answer. Copyright © 2015 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  2. [Changing surgical therapy because of clinical studies?].

    Science.gov (United States)

    Schwenk, W; Haase, O; Müller, J M

    2002-04-01

    The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine.

  3. Delayed allergy-like reactions to X-ray contrast media administration focusing on clinical aspects. First expert meeting

    International Nuclear Information System (INIS)

    Sviridov, N.K.

    1998-01-01

    Materials presented at the first expert meeting of leading specialists in medical radiology are briefly described. The include 14 reports of the scientists of Germany, England, Japan, USA, Finland, Austria. The reports concert delayed allergy-like response to X-ray contrast media accepting on clinical aspects and analysis of nonionic dimeric isotonic media application

  4. Gynecologic Cancer InterGroup (GCIG) endometrial cancer clinical trials planning meeting: taking endometrial cancer trials into the translational era.

    NARCIS (Netherlands)

    Creutzberg, C.L.; Kitchener, H.C.; Birrer, M.J.; Landoni, F.; Lu, K.H.; Powell, M.; Aghajanian, C.; Edmondson, R.; Goodfellow, P.J.; Quinn, M.; Salvesen, H.B.; Thomas, G; Ottevanger, N.; et al.,

    2013-01-01

    OBJECTIVE: The second Gynecologic Cancer InterGroup (GCIG) Endometrial Cancer Clinical Trials Planning Meeting was held on December 1, 2012, and included international multidisciplinary representatives of the 24 member groups. The aims were to review recent advances in molecular pathology of

  5. Clinical research priorities in emergency medicine: results of a consensus meeting and development of a weighting method for assessment of clinical research priorities.

    Science.gov (United States)

    Thom, Ogilvie; Keijzers, Gerben; Davies, Suzanne; McD Taylor, David; Knott, Jonathan; Middleton, Paul M

    2014-02-01

    There is limited evidence regarding clinical research priorities in emergency medicine outside of some special interest groups. The ACEM Clinical Trials Group undertook a consensus meeting with the aim of developing a reproducible weighting matrix for assessing clinical research priorities. A session at the ACEM annual scientific meeting was dedicated to this meeting. Results from a survey of the ACEM researcher database were presented, along with a proposed weighting matrix. After discussion and adjustment, consensus was achieved on the matrix. It was agreed that the following criteria be used in the matrix: research category and sub-category priority ranking from the ACEM researcher database survey, frequency of presentation of potentially eligible participants, the level of pre-existing evidence regarding the proposed research question and the likely clinical impact of the research. Each criterion was given a weighting, with clinical impact given the heaviest weighting. The weighting matrix was subsequently applied to the list of research questions that resulted from the researcher database survey and a list of research priorities determined. The weighting matrix allows reproducible comparison of research questions. The resultant list of research priorities will act as a guide for the ACEM Clinical Trials Group in determining future projects. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  6. Activation Analysis. Proceedings of an Informal Study Group Meeting

    International Nuclear Information System (INIS)

    1971-01-01

    As part of its programme to promote the exchange of information relating to nuclear science and technology, the International Atomic Energy Agency convened in Bangkok, Thailand, from 6-8 July 1970, an informal meeting to discuss the topic of Activation Analysis. The meeting was attended by participants drawn from the following countries: Australia, Burma, Ceylon, Republic of China, India, Indonesia, Prance, Japan, Republic of Korea, New Zealand, Philippines, Singapore, Thailand, United States of America and Vietnam. The proceedings consist of the contributions presented at the meeting with minor editorial changes

  7. Metformin treatment in diabetes and heart failure: when academic equipoise meets clinical reality

    Directory of Open Access Journals (Sweden)

    McAlister Finlay A

    2009-02-01

    Full Text Available Abstract Objective Metformin has had a 'black box' contraindication in diabetic patients with heart failure (HF, but many believe it to be the treatment of choice in this setting. Therefore, we attempted to conduct a pilot study to evaluate the feasibility of undertaking a large randomized controlled trial with clinical endpoints. Study Design The pilot study was a randomized double blinded placebo controlled trial. Patients with HF and type 2 diabetes were screened in hospitals and HF clinics in Edmonton, Alberta, Canada (population ~1 million. Major exclusion criteria included the current use of insulin or high dose metformin, decreased renal function, or a glycosylated hemoglobin Results Fifty-eight patients were screened over a six month period and all were excluded. Because of futility with respect to enrollment, the pilot study was abandoned. The mean age of screened patients was 77 (SD 9 years and 57% were male. The main reasons for exclusion were: use of insulin therapy (n = 23; 40%, glycosylated hemoglobin Conclusion Despite uncertainty in the scientific literature, there does not appear to be clinical uncertainty with regards to the safety or effectiveness of metformin in HF making a definitive randomized trial virtually impossible. Trial registration ClinicalTrials.gov Identifier: NCT00325910

  8. Drugs and having babies: an exploration of how a specialist clinic meets the needs of chemically dependent pregnant women.

    Science.gov (United States)

    Morris, Michelle; Seibold, Carmel; Webber, Ruth

    2012-04-01

    to explore the extent to which a specialist clinic meets the needs of chemically dependent women. a critical ethnography informed by theorists such as Habermas and feminists' interpretation of Foucault. a specialist antenatal clinic for chemically dependent pregnant women at a major metropolitan women's hospital in Melbourne, Australia. a purposive sample of twenty (20) chemically dependent pregnant women who attended the clinic. Data collection and analysis included three taped interviews (two preceding the birth and one post birth), observation of the interactions between the women and the clinic staff over a 25-month period and chart audits. similar to other studies there were multiple factors influencing development and maintenance of chemical dependency in this group of women, including family instability, family history of drug and alcohol abuse, childhood sexual abuse, having a chemically dependent partner and having a dual diagnosis of both drug addiction and mental illness. Initially there was considerable variation between the women and the clinic staff's expectations with regard to attending for antenatal care and conforming to a set regime as the women struggled with the contradictions inherent in their lifestyle and that of the 'normal' expectant mother. Aspects of that struggle included their belief that their opinions and knowledge of their lives was largely ignored, leading to episodes of resistance. Several women alleged the clinics staff's relationship with them was influenced by a belief that the women were 'hopeless addicts in need of expert medical and midwifery care' and that the clinic staff exercised control in an authoritarian manner. However, as they explored possibilities for collaboration, they realised they could exercise power and work towards a more equal relationship with staff. The quality of relationships in most instances improved over time, and if not always strictly collaborative, was situated at various points along a continuum

  9. Clinical spectrum and histopathological study

    African Journals Online (AJOL)

    Manal M. Abd-Elgawad

    2013-04-23

    Apr 23, 2013 ... b Pathology Department, Faculty of Medicine, Alexandria University, Egypt. Received ... Children;. Egypt;. Clinical profile;. Histopathologic changes. Abstract Introduction: Hepatitis C virus (HCV) is a major public health problem and a leading ..... current or past history of IV drug abuse, women who received.

  10. Case study interpretation: Report from the ICCS Annual Meeting, Seattle, 2014.

    Science.gov (United States)

    Fromm, Jonathan R; Tagliente, Damian J; Shaver, Aaron C; Neppalli, Vishala; Craig, Fiona E

    2015-01-01

    The Case Study Interpretation (CSI) cases presented at the 2014 International Clinical Cytometry Society (ICCS) meeting in Seattle illustrate the utility of state-of-the art multiparameter flow cytometry in the diagnosis of hematolymphoid neoplasms. Download the listmode files (Supporting Information) and test your analysis skills before reading the case reports, keeping in mind the following questions. How many separate abnormal mature B-cell populations can you identify, and how many of these represent different subtypes of B-cell neoplasm? How many separate abnormal mature T-cell populations can you identify, and do these represent different subtypes of T-cell neoplasm or phenotypic heterogeneity in one neoplasm? How many separate immature/blastic cell populations can you identify, and do they meet criteria for mixed phenotype leukemia? Is there a population of blasts that lacks T-cell, B-cell, and myeloid lineage defining antigens and if so, what entities should you consider and what additional antigens should you assess for? © 2015 International Clinical Cytometry Society.

  11. Health Care Delivery Meets Hospitality: A Pilot Study in Radiology.

    Science.gov (United States)

    Steele, Joseph Rodgers; Jones, A Kyle; Clarke, Ryan K; Shoemaker, Stowe

    2015-06-01

    The patient experience has moved to the forefront of health care-delivery research. The University of Texas MD Anderson Cancer Center Department of Diagnostic Radiology began collaborating in 2011 with the University of Houston Conrad N. Hilton College of Hotel and Restaurant Management, and in 2013 with the University of Nevada, Las Vegas, William F. Harrah College of Hotel Administration, to explore the application of service science to improving the patient experience. A collaborative pilot study was undertaken by these 3 institutions to identify and rank the specific needs and expectations of patients undergoing imaging procedures in the MD Anderson Department of Diagnostic Radiology. We first conducted interviews with patients, providers, and staff to identify factors perceived to affect the patient experience. Next, to confirm these factors and determine their relative importance, we surveyed more than 6,000 patients by e-mail. All factors considered important in the interviews were confirmed as important in the surveys. The surveys showed that the most important factors were acknowledgment of the patient's concerns, being treated with respect, and being treated like a person, not a "number"; these factors were more important than privacy, short waiting times, being able to meet with a radiologist, and being approached by a staff member versus having one's name called out in the waiting room. Our work shows that it is possible to identify and rank factors affecting patient satisfaction using techniques employed by the hospitality industry. Such factors can be used to measure and improve the patient experience. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.

    Science.gov (United States)

    Gruen, Russell; Bailie, Ross

    2004-10-01

    People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.

  13. Public meeting: Western New York Nuclear Service Center options study

    International Nuclear Information System (INIS)

    1978-04-01

    This document is a transcript of the meeting, with additional written comments. The main topic is the West Valley Processing Plant and how to dispose of it and its high-level wastes. Objective is to get public input on this topic

  14. Age, forgiveness, and meeting behavior: A multilevel study

    NARCIS (Netherlands)

    Schulte, E.-M.; Lehmann-Willenbrock, N.K.; Kauffeld, S.

    2013-01-01

    Purpose: This paper aims to examine the effects of age on counteractive team meeting behaviors (e.g. complaining). Forgiveness is included as a potential buffer against these behaviors. A multilevel model is developed to test individual and team level age effects. Design/methodology/approach: A

  15. 75 FR 82141 - Stakeholder Meetings Regarding the U.S.-Flag Great Lakes Fleet Revitalization Study

    Science.gov (United States)

    2010-12-29

    ... Meetings Regarding the U.S.-Flag Great Lakes Fleet Revitalization Study AGENCY: Maritime Administration... Administration's U.S.-Flag Great Lakes Fleet Revitalization Study. The three meetings will be identical in terms... participation. The U.S.-Flag Great Lakes Fleet Revitalization Study will examine the current and potential...

  16. 78 FR 41198 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2013-07-09

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee, Notice of Meeting The Department of Veterans Affairs gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and...

  17. 78 FR 53015 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2013-08-27

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee, Notice of Meeting The Department of Veterans Affairs gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and...

  18. 77 FR 72438 - Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation...

    Science.gov (United States)

    2012-12-05

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative Studies Scientific Evaluation Committee; Notice of Meeting The Department of Veterans Affairs gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and...

  19. 78 FR 70102 - Clinical Science Research and Development Service Cooperative Studies; Scientific Evaluation...

    Science.gov (United States)

    2013-11-22

    ... DEPARTMENT OF VETERANS AFFAIRS Clinical Science Research and Development Service Cooperative Studies; Scientific Evaluation Committee; Notice of Meeting The Department of Veterans Affairs gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that the Clinical Science Research and...

  20. Anatomy meets dentistry! Linking anatomy and clinical practice in the preclinical dental curriculum.

    Science.gov (United States)

    Rafai, Nicole; Lemos, Martin; Kennes, Lieven Nils; Hawari, Ayichah; Gerhardt-Szép, Susanne; Classen-Linke, Irmgard

    2016-11-25

    Establishing a strong link early on between preclinical coursework and the clinical context is necessary for students to be able to recognize the practical relevance of the curriculum during their preclinical anatomical courses and to transfer knowledge more easily. Our objective was to enhance the clinical relevance of a preclinical anatomy course for second-year medical students of dentistry by implementing an interdisciplinary skills training course on "Palpation of the Head and Neck Muscles" and to measure the learning outcomes. For the curricular development of the expanded course module, Kern's 6-step approach was applied including subjective evaluation. We used a peer-teaching format supported by an e-learning application. A randomized control study measured effects of the two components (skills training, e-module) on learning outcomes. Four learning methods were compared: (1) lecture, (2) lecture + e-module, (3) lecture + skills training, (4) lecture + skills training + e-module. An objective structured clinical examination (OSCE) was used to measure and compare learning outcomes. The two-way variance analysis demonstrated that participation in the skills training had a statistically significant effect on the OSCE results (p = 0.0007). Students who participated in the skills training did better (φ 107.4 ± 14.4 points) than students who only attended the lecture (φ 88.8 ± 26.2 points). Students who used the e-module but did not attend the skills training earned a slightly but not significantly higher average number of points (φ 91.8 ± 31.3 points) than those who only attended the lecture. The learning outcomes of the skills training were again significantly increased when the training was combined with the e-module (φ 121.8 ± 21.8 points), thus making it the ideal method for achieving the learning objectives defined in this study. The "Palpation of the Head and Neck Muscles" interdisciplinary skills training course

  1. Anatomy meets dentistry! Linking anatomy and clinical practice in the preclinical dental curriculum

    Directory of Open Access Journals (Sweden)

    Nicole Rafai

    2016-11-01

    Full Text Available Abstract Background Establishing a strong link early on between preclinical coursework and the clinical context is necessary for students to be able to recognize the practical relevance of the curriculum during their preclinical anatomical courses and to transfer knowledge more easily. Our objective was to enhance the clinical relevance of a preclinical anatomy course for second-year medical students of dentistry by implementing an interdisciplinary skills training course on “Palpation of the Head and Neck Muscles” and to measure the learning outcomes. Methods For the curricular development of the expanded course module, Kern’s 6-step approach was applied including subjective evaluation. We used a peer-teaching format supported by an e-learning application. A randomized control study measured effects of the two components (skills training, e-module on learning outcomes. Four learning methods were compared: (1 lecture, (2 lecture + e-module, (3 lecture + skills training, (4 lecture + skills training + e-module. An objective structured clinical examination (OSCE was used to measure and compare learning outcomes. Results The two-way variance analysis demonstrated that participation in the skills training had a statistically significant effect on the OSCE results (p = 0.0007. Students who participated in the skills training did better (φ 107.4 ± 14.4 points than students who only attended the lecture (φ 88.8 ± 26.2 points. Students who used the e-module but did not attend the skills training earned a slightly but not significantly higher average number of points (φ 91.8 ± 31.3 points than those who only attended the lecture. The learning outcomes of the skills training were again significantly increased when the training was combined with the e-module (φ 121.8 ± 21.8 points, thus making it the ideal method for achieving the learning objectives defined in this study. Conclusions The “Palpation of

  2. 77 FR 60116 - Human Studies Review Board; Notification of a Public Meeting

    Science.gov (United States)

    2012-10-02

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-ORD-2012-0718; FRL-9736-4] Human Studies Review Board; Notification of a Public Meeting AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: The EPA Office of the Science Advisor announces a public meeting of the Human Studies Review Board to...

  3. 78 FR 57383 - Human Studies Review Board; Notification of a Public Meeting

    Science.gov (United States)

    2013-09-18

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-ORD-2013-0626; FRL-9900-98-ORD] Human Studies Review Board; Notification of a Public Meeting AGENCY: U.S. Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: The EPA Office of the Science Advisor announces a public meeting of the Human Studies Review Board to...

  4. 77 FR 74004 - Human Studies Review Board; Notification of a Public Meeting

    Science.gov (United States)

    2012-12-12

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-ORD-2012-0892; FRL-9761-4] Human Studies Review Board; Notification of a Public Meeting AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: The EPA Office of the Science Advisor announces a public meeting of the Human Studies Review Board to...

  5. 76 FR 59697 - Human Studies Review Board (HSRB); Notification of a Public Meeting

    Science.gov (United States)

    2011-09-27

    ... public meeting of the Human Studies Review Board (HSRB) to advise the Agency on EPA's scientific and... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-ORD-2011-0693; FRL-9472-4] Human Studies Review Board (HSRB); Notification of a Public Meeting AGENCY: Environmental Protection Agency (EPA). ACTION: Notice...

  6. 76 FR 80938 - Human Studies Review Board; Notification of a Public Meeting

    Science.gov (United States)

    2011-12-27

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-ORD-2011-0954; FRL-9611-6] Human Studies Review Board; Notification of a Public Meeting AGENCY: U.S. Environmental Protection Agency. ACTION: Notice. SUMMARY: The EPA Office of the Science Advisor announces a public meeting of the Human Studies Review Board to advise the...

  7. Uncertainty sources in radiopharmaceuticals clinical studies

    International Nuclear Information System (INIS)

    Degenhardt, Aemilie Louize; Oliveira, Silvia Maria Velasques de

    2014-01-01

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

  8. Meeting End User Needs in Collaborative Medical Device Technology Development Research Projects: A Qualitative Case Study.

    Science.gov (United States)

    Strisland, Frode; Svagård, Ingrid Storruste; Austad, Hanne Opsahl; Reitan, Jarl

    2017-01-01

    The aim of this case study has been to investigate to what extent user centered design (UCD) methodologies have been applied, how the process and outcomes were perceived by project team members, and what were potential barriers towards meeting end user needs. The case studied was the European Union Framework 7 integrated project d-LIVER (2011-2015), which aimed at developing an integrated care system for chronic liver disease patient management. d-LIVER is an example of a public funded, international, multidisciplinary, collaborative research project where development starts from a low technology readiness level, but where research is motivated by societal needs for better health care solutions. Awareness of central end user needs are therefore crucial. 14 project participants were interviewed. To meet societal and end user needs represent a prominent motivation factor for participants. The project organization with only clinical partners interacting with end users was accepted as a fact of life and not as a project pain point. A summary of observations and recommendations for good practice is given.

  9. CLINICAL STUDY OF FEVER WITH THROMBOCYTOPENIA

    OpenAIRE

    Rekha; Sumangala; Ishwarya

    2014-01-01

    BACKGROUND: In recent days fever with Thrombocytopenia is a common clinical presentation in the medical wards. This study has been undertaken to know the modes of clinical presentations and possible causes of fever with Thrombocytopenia. OBJECTIVE: 1. To determine possible infective etiology for fever with Thrombocytopenia. 2. To correlate clinical features, laboratory studies and infective etiology. METHODS: Case record analysis of fever with Thrombocytopenia admitted to ...

  10. Less than meets the eye: reappraising the clinical relevance of attentional bias in addiction.

    Science.gov (United States)

    Christiansen, Paul; Schoenmakers, Tim M; Field, Matt

    2015-05-01

    Recent years have seen an explosion of interest in attentional bias in addiction, particularly its clinical relevance. Specifically, numerous articles claimed to demonstrate either that (1) attentional bias measured in treatment settings could predict subsequent relapse to substance use, or (2) direct modification of attentional bias reduced substance use and improved treatment outcomes. In this paper, we critically evaluate empirical studies that investigated these issues. We show that the evidence regarding both of these claims is decidedly mixed, and that many of the studies that appear to yield positive findings have serious methodological and statistical limitations. We contend that the available literature suggests that attentional bias for drug cues fluctuates within individuals because it is an output of the underlying motivational state at that moment in time, but there is no convincing evidence that it exerts a causal influence on substance use. Future research should make use of experience sampling methodology to characterise the clinical significance of fluctuations in attentional bias over time. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. International Meeting on Needs and Challenges in Translational Medicine: filling the gap between basic research and clinical applications. Book of abstract

    International Nuclear Information System (INIS)

    Moretti, F.; Belardelli, F.; Romero, M.

    2008-01-01

    This multidisciplinary international meeting is organized by the Istituto Superiore di Sanita, in collaboration with Alleanza Contro il Cancro (Alliance Against Cancer, the Network of the Italian Comprehensive Cancer Centres) and EATRIS (European Advanced Translational Research Infrastructure in Medicine). The primary goal of the meeting is to provide a scientific forum to discuss the recent progress in translational research. Moreover, a particular focus will be devoted to the identification of needs, obstacles and new opportunities to promote translational research in biomedicine. The scientific programme will cover a broad range of fields including: cancer; neurosciences; rare diseases; cardiovascular diseases and infectious and autoimmune diseases. Furthermore, special attention will be given to the discussion of how comprehensive initiatives for addressing critical regulatory issues for First-In-Man - Phase I clinical studies can potentially improve the efficiency and quality of biomedical and translational research at an international level [it

  12. Phase I Clinical Pharmacology Studies

    Science.gov (United States)

    1993-09-28

    Luagent to tra fteumct ’s~~j. citArin.L saymptrauns wiletoon. of even o disecte irdctin. Children I - tOE0 pneumonia To find a dose that uouid provede...RSV) Isolates 5tWmYAW .0 AbTINN.1.NE111119kMXt. 21MJ. frog a study of Nosocosial Infection. CA PWC)•NQ. Un~tv0yTesin~edaeli d dSeyltlO ef Storchc C5

  13. CLINICAL STUDY OF CONCOMITANT SQUINT

    Directory of Open Access Journals (Sweden)

    Vijay Chopra

    2017-07-01

    Full Text Available BACKGROUND Malalignment in the visual axes of the two eyes is called strabismus. Fusion of both images is replaced either by diplopia or suppression of one image. Squint leads to loss of binocular single vision. Concomitant squint is a type of manifest squint in which the amount of deviation in the squinting eye is same in all gazes. Binocular single vision and ocular movement coordination are not present since birth, but are acquired in the early childhood. This process starts by the age of 3-6 months and is completed up to 5-6 years. Any hindrance in the development of these processes may result in concomitant squint. MATERIALS AND METHODS In 100 cases of concomitant squint, patients were included in our study. Detailed history was taken regarding the onset of squint and duration. Past history and family history was also elicited. General examination was done to detect any abnormalities of central nervous system. Routine ophthalmic examination including best corrected visual acuity, cover test performed to detect the type of deviation whether uniocular or alternating and the type of fixation. Angle of deviation was measured by Hirschberg’s test and on the synoptophore. Binocular single vision was assessed using Worth’s 4-dot test and synoptophore. Cycloplegic refraction and fundus evaluation done in all patients. Inclusion Criteria- All primary non-paralytic deviations, sensory deprivation strabismus. Exclusion Criteria- Paralytic strabismus, strabismus associated with neurological disorders, consecutive strabismus and palpebral fissure abnormalities patients. RESULTS Majority of cases of concomitant squint were of esotropic type. Most common form of esotropia seen was infantile esotropia. Most common form of exotropia was intermittent exotropia. 19% of cases were secondary to other ocular diseases namely cataract, macular lesion, high myopia, etc. Amblyopia was present in 54% patients and of very dense type, which could not be treated

  14. Meeting sex partners through the Internet, risky sexual behavior, and HIV testing among sexually transmitted infections clinic patients.

    Science.gov (United States)

    Brown, Monique J; Pugsley, River; Cohen, Steven A

    2015-02-01

    The Internet has now become a popular venue to meet sex partners. People who use the Internet to meet sex partners may be at a higher risk for contracting HIV and STIs. This study examined the association between meeting sex partners from the Internet, and HIV testing, STI history, and risky sexual behavior. Data were obtained from the Virginia Department of Health STD Surveillance Network. Logistic regression models were used to obtain crude and adjusted odds ratios, and 95 % confidence intervals for the associations between meeting sex partners through the Internet and ever tested for HIV, HIV testing in the past 12 months, STI history, and risky sexual behavior. Logistic regression was also used to determine if gender and men who have sex with men interaction terms significantly improved the model. Women who met a sex partner from the Internet were more likely to have had an HIV test in the past 12 months than women who did not meet a partner in this way. On the other hand, men who met a sex partner through the Internet were more likely to have ever had an HIV test than other men, but this was only seen for heterosexual men. All populations who met a sex partner from the Internet were more likely to take part in risky sexual behavior. HIV prevention strategies should emphasize annual testing for all populations.

  15. In Absentia: An Exploratory Study of How Patients Are Considered in Multidisciplinary Cancer Team Meetings

    NARCIS (Netherlands)

    Hahlweg, P.; Hoffmann, J.; Harter, M.; Frosch, D.L.; Elwyn, G.; Scholl, I.

    2015-01-01

    BACKGROUND: Multidisciplinary team meetings and shared decision-making are potential means of delivering patient-centred care. Not much is known about how those two paradigms fit together in cancer care. This study aimed to investigate how decisions are made in multidisciplinary team meetings and

  16. 76 FR 2107 - Human Studies Review Board; Notice of Public Meeting

    Science.gov (United States)

    2011-01-12

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-ORD-2011-0970; FRL-9252-3] Human Studies Review Board; Notice of Public Meeting AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: The U.S. Environmental Protection Agency (EPA or Agency) Office of the Science Advisor (OSA) announces a public meeting...

  17. 75 FR 32461 - Human Studies Review Board; Notice of Public Meeting

    Science.gov (United States)

    2010-06-08

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-ORD-2010-0381; FRL-9159-9] Human Studies Review Board; Notice of Public Meeting AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: The U.S. Environmental Protection Agency's (EPA or Agency) Office of the Science Advisor (OSA) announces a public meeting...

  18. 76 FR 17121 - Human Studies Review Board (HSRB); Notification of a Public Meeting

    Science.gov (United States)

    2011-03-28

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-ORD-2011-0124; FRL-9287-1] Human Studies Review Board (HSRB); Notification of a Public Meeting AGENCY: Environmental Protection Agency (EPA). ACTION: Notice... public meeting of the HSRB to advise the Agency on EPA's scientific and ethical reviews of research with...

  19. 75 FR 61748 - Human Studies Review Board; Notice of Public Meeting

    Science.gov (United States)

    2010-10-06

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-ORD-2010-0797' FRL-9211-1] Human Studies Review Board; Notice of Public Meeting AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: The U.S. Environmental Protection Agency (EPA or Agency) Office of the Science Advisor (OSA) announces a public meeting...

  20. Clinical study of CT colonography

    International Nuclear Information System (INIS)

    Nakazawa, Saburo; Hattori, Toshiyuki; Inui, Kazuo

    2011-01-01

    We studied the usefulness of CT colonography (CTC) for colon cancer diagnosis. CTC and optical colonoscopy were performed for 150 cases mainly including patients with a positive fecal occult blood test (FOBT). The results were compared and analyzed. The following are the final diagnoses given to the patients: advanced colon cancer: 41 cases; early cancer: 25 cases; adenoma: 74 cases; hyperplasia: 3 cases; submucosal tumor: 1 case; and no lesion: 6 cases. In terms of diagnostic performance of CTC, accuracy was found to be 96%, sensitivity was found to be 97.9%, and specificity was found to be 50%. Cancer stage-specific sensitivity was as follows: advanced colon cancer: 100%; early cancer: 96.3%; adenoma: 71.2%; and hyperplasia: 47.4%. Lesion site-specific sensitivity was as follows: caecum: 76.2%; ascending colon: 57.6%; transverse colon: 66.2%; descending colon: 83.3%; sigmoid colon: 85.1%; and rectum: 78.0%. Lesion size-specific sensitivity was as follows: 2 to 5 mm: 56.7%; 6 to 9 mm: 88.1%; 10 mm or more: 92.5%; and 6 mm or more: 90.9%. Therefore, the diagnostic sensitivity of CTC was confirmed to be high. The results suggest that CTC would be useful for colon cancer screening. (author)

  1. Clinical studies on Bell's palsy

    International Nuclear Information System (INIS)

    Yamada, Yoshio

    1985-01-01

    The purpose of this study was to evaluate the diagnostic value of the salivary gland scintigraphy using sup(99m)Tc-pertechnetate for the prognosis of Bell's palsy. The salivary gland scintigraphy was performed in 40 patients with Bell's palsy and 15 normal subjects. After intravenous injection of 10 mCt of sup(99m)Tc-pertechnetate, sequential scintigrams were taken with a scintillation camera every one minute for 25 minutes. At 15 minutes after injection, both of normal subjects and patients were given ascorbic acid to stimulate the secretion of saliva. By the present method, the time activity curve was examined for the regions of interest over the parotid and submandibular glands and backgrounds. In normal subjects, values of the concentration and excretory ratio between the right and left sides of the parotid and submandibular glands were more than 80%. Some patients with Bell's palsy showed a decreased concentration and/or excretory ratio less than 80% between the normal and affected sides of the parotid glands. This suggests a functional involvement of the facial nerve in the salivary secretion from the parotid glands. On examination within 10 days of the onset of Bell's palsy, 31 cases with complete recovery showed values of the concentration ratio and/or excretory ratio more than 80% between the normal and affected sides of the submandibular glands. In contrast, 9 cases with imcomplete recovery showed low values of the concentration ratio and excretory ratio less than 80%. In the latter, more active treatments such as decompression operation should be considerd in the early stage of the palsy. The salivary scintigraphy using sup(99m)Tc-pertechnetate is more valuable as an early prognostic indicator for Bell's palsy compared with other prognostic tests such as the lid vibration test, the stapedial reflex test, the electrogustometry, the nerve excitability test and the evoked electromyography. (author)

  2. Electronic data-capturing technology for clinical trials: experience with a global postmarketing study.

    Science.gov (United States)

    Lu, Zengwu

    2010-01-01

    The purpose of this article was to address three questions: What were the electronic data-capturing (EDC) technologies employed in a typical industry-sponsored clinical study? How is the developed system meeting the clinical research need? What would we want more from this EDC technology? This article is prepared from industry perspectives to present and analyze the advantages, benefits, and challenges in applying EDC technologies to address industry's clinical trial operational needs based on a systematic overview.

  3. 8th Argentinean Bioengineering Society Conference (SABI 2011) and 7th Clinical Engineering Meeting

    Science.gov (United States)

    Meschino, Gustavo Javier; Ballarin, Virginia L.

    2011-12-01

    In September 2011, the Eighteenth Edition of the Argentinean Bioengineering Society Conference (SABI 2011) and Seventh Clinical Engineering Meeting were held in Mar del Plata, Argetina. The Mar del Plata SABI Regional and the School of Engineering of the Universidad Nacional de Mar del Plata invited All bioengineers, engineers, physicists, mathematicians, biologists, physicians and health professionals working in the field of Bioengineering to participate in this event. The overall objectives of the Conference were: To provide discussion of scientific research results in Bioengineering and Clinical Engineering. To promote technological development experiences. To strengthen the institutional and scientific communication links in the area of Bioengineering, mainly between Universities of Latin America. To encourage students, teachers, researchers and professionals to establish exchanges of experiences and knowledge. To provide biomedical engineering technology solutions to the society and contributing ideas for low cost care. Conference photograph Conference photograph Conference photograph Conference photograph EXECUTIVE COMMITTEE SABI 2011 Chair Dra Virginia L Ballarin Universidad Nacional de Mar del Plata Co-Chair Dra Teresita R Cuadrado Universidad Nacional de Mar del Plata - CONICET Local Comittee Dr Gustavo Abraham Universidad Nacional de Mar del Plata - CONICET Dra Josefina Ballarre Universidad Nacional de Mar del Plata - CONICET Dr Eduardo Blotta Universidad Nacional de Mar del Plata Dra Agustina Bouchet Universidad Nacional de Mar del Plata Dr Marcel Brun Universidad Nacional de Mar del Plata Dra Silvia Ceré Universidad Nacional de Mar del Plata - CONICET Dra Mariela Azul Gonzalez Universidad Nacional de Mar del Plata - CONICET Dra Lucia Isabel Passoni Universidad Nacional de Mar del Plata Dr Juan Ignacio Pastore Universidad Nacional de Mar del Plata - CONICET Dra Adriana Scandurra Universidad Nacional de Mar del Plata SCIENTIFIC ADVISORY COMMITTEE

  4. Advances in clinical study of curcumin.

    Science.gov (United States)

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

    2013-01-01

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

  5. Potential clinical impact of radionuclide imaging technologies: highlights of the ITBS 2003 meeting

    Science.gov (United States)

    Itti, Roland

    2004-07-01

    Radiopharmaceuticals are major determinants of progress in Nuclear Medicine. Besides 18FDG, the most common PET tracer, several other molecules are under evaluation, such as 18F-fluoride for bone studies, numerous ligands for neurotransmission, 18F-DOPA for neuro-endocrine tumors or generator produced 68Ga-peptides for various cancers. Nuclear medicine gradually changes for "molecular imaging" and medical imaging, which was at the beginning mainly anatomic, has progressed in the direction of functional and metabolic imaging. The present challenge is to achieve some degree of "in vivo" biochemistry or even histology or genetics. The importance of anatomic/functional image fusion justifies the development of combined PET-CT instrumentation, whose objectives have to be discussed in terms of anatomical landmarks and/or additional clinical information. The question of "hard" or "soft" image co-registration remains open, involving not only CT, but also SPECT or MRI. Development of dedicated imaging devices, whether single photon or positron, is of major interest for breast imaging, allowing optimal imaging conditions, with results definitely superior to classical gamma-cameras or PET. The patient population concerned with scintimammography is still controversial, as well as the imaging modalities: FDG or sestaMIBI, planar or tomographic, scintillators or semi-conductors, and the research field remains open. This is also valid for external or per-operative probe systems for tumor or lymph nodes localization.

  6. A clinical learning experience: enhancing baccalaureate nursing students' self-efficacy in meeting the psychosocial needs of clients with dementia.

    Science.gov (United States)

    Jordan, Kerry; Church, Terri

    2013-03-01

    Today's health care landscape requires expert nursing care for clients with dementia. Unfortunately, most nursing students dislike providing dementia care. Lack of students' self-efficacy may account for some of the negativity surrounding dementia care, and learning activities to increase self-efficacy may be one means for increasing positive feelings. The purpose of this article is to describe and evaluate a clinical learning activity designed to increase the self-efficacy of students in meeting the psychosocial needs of clients with dementia. The experience involved 39 baccalaureate nursing students and included the implementation of a therapeutic activity in a long-term care setting. Evaluation involved discussing the activity before and after implementation, observing the students perform the activity, administering a survey before and after the activity, and completing a clinical log addressing the major objectives. Evidence from the evaluation suggests that the experience promoted increased self-efficacy in students. Copyright 2013, SLACK Incorporated.

  7. 75 FR 2549 - Clinical Accuracy Requirements for Point of Care Blood Glucose Meters; Public Meeting; Request...

    Science.gov (United States)

    2010-01-15

    .... When registering, you must provide your name, title, company or organization (if applicable), address... and clinical use of blood glucose meters, to share ideas on the challenges associated with their use...

  8. Clinically unrecognized miliary tuberculosis: an autopsy study.

    Science.gov (United States)

    Savic, Ivana; Trifunovic-Skodric, Vesna; Mitrovic, Dragan

    2016-01-01

    Miliary tuberculosis (TB) usually presents with atypical clinical manifestations; thus it is often recognized only at autopsy. Our objectives were to study the frequency of MT diagnosed at autopsy and determine clinical diagnoses that masked TB, as well as causes of death and comorbidities. Retrospective study of all autopsies performed between 2008 and 2014. Institute of Pathology, Belgrade, Serbia. in subjects where autopsy showed the presence of MT that was not recognized clinically, we recorded the clinical diagnoses (presumed causes of death) as reported in autopsy request forms, as well as actual cause of death and comorbidities as determined at autopsy. Clinically unrecognized MT. The total number of autopsies in this period was 6206. thirty-five individuals showed clinically unrecognized MT (0.56% of all autopsies, age: 62.2 [17.2] years, M:F=2:3). Common clinical diagnoses masking pulmonary MT were exacerbation of COPD (25%) and pulmonary thromboembolism (25%), with common radiological presentation of diffuse pulmonary infiltrates (56.3%). Dominant clinical diagnoses in patients with generalized MT were adult respiratory distress syndrome, sepsis, gastrointestinal bleeding and meningoencephalitis. Disseminated MT was often associated with secondary anemia or thrombocytopenia (15.8%) and recent surgery (15.8%). Frequent comorbidities included chronic renal failure and malignancies, whereas MT was a dominant cause of death. Greater awareness of MT is needed to improve recognition in clinical settings. In particular, MT should be considered in patients with atypical clinical presentation and diffuse pulmonary infiltrates on chest X-ray, particularly if they have chronic renal failure, malignancy, hematological disorders or a history of recent surgery. None.

  9. Successful participation of patients in interprofessional team meetings: A qualitative study.

    Science.gov (United States)

    van Dongen, Jerôme Jean Jacques; Habets, Iris Gerarda Josephine; Beurskens, Anna; van Bokhoven, Marloes Amantia

    2017-08-01

    The number of people with multiple chronic conditions increases as a result of ageing. To deal with the complex health-care needs of these patients, it is important that health-care professionals collaborate in interprofessional teams. To deliver patient-centred care, it is often recommended to include the patient as a member of the team. To gain more insight into how health-care professionals and patients, who are used to participate in interprofessional team meetings, experience and organize patient participation in the team meetings. A qualitative study including observations of meetings (n=8), followed by semi-structured interviews with participating health-care professionals (n=8), patients and/or relatives (n=11). Professionals and patients were asked about their experiences of patient participation immediately after the team meetings. Results from both observations and interviews were analysed using content analysis. The findings show a variety of influencing factors related to patient participation that can be divided into five categories: (i) structure and task distribution, (ii) group composition, (iii) relationship between professionals and patients or relatives, (iv) patients' characteristics and (v) the purpose of the meeting. Patient participation during team meetings was appreciated by professionals and patients. A tailored approach to patient involvement during team meetings is preferable. When considering the presence of patients in team meetings, it is recommended to pay attention to patients' willingness and ability to participate, and the necessary information shared before the meeting. Participating patients seem to appreciate support and preparation for the meeting. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  10. Future Circular Collider Study (FCC) kick-off meeting | 12-15 February

    CERN Multimedia

    2014-01-01

    The kick-off meeting of the international "Future Circular Collider Study" (FCC) will take place in Geneva from 12 to 15 February 2014 at the University of Geneva, Unimail site. The programme and registration details can be found on the meeting's website. This meeting is the starting point of the five-year international "Future Circular Collider Study" (FCC). The main emphasis of the conceptual design study will be on a hadron collider with a centre-of-mass energy of the order of 100 TeV in a new tunnel with a 80-100 km circumference for the purposes of studying physics at the highest energies. The study will also include a lepton collider, as a potential intermediate step towards realisation of the hadron facility. Options for e-p scenarios will also be considered. The main purpose of this meeting is to discuss the study topics and to prepare international collaborations. The meeting is a public meeting with a registration deadline closing on Friday 31 Janua...

  11. Are neurocognitive, clinical and social dysfunctions in schizotaxia reversible pharmacologically?: Results from the Changsha study

    OpenAIRE

    Stone, William S.; Hsi, Xiaolu; Giuliano, Anthony J.; Tan, Liwen; Zhu, Shaochun; Li, Lingjiang; Seidman, Larry J.; Tsuang, Ming T.

    2012-01-01

    The Changsha study identifies adult, non-psychotic relatives of patients with schizophrenia who show deficits in neurocognitive, social, clinical and other dimensions, and who meet provisional criteria for a liability syndrome for schizophrenia (‘schizotaxia’). In this study, we investigated whether negative symptoms, neurocognitive deficits, or other measures of clinical and social function in subjects who met our research criteria for schizotaxia were amenable to pharmacological remediation...

  12. Analysis of the Use and Impact of Twitter During American Society of Clinical Oncology Annual Meetings From 2011 to 2016: Focus on Advanced Metrics and User Trends.

    Science.gov (United States)

    Pemmaraju, Naveen; Thompson, Michael A; Mesa, Ruben A; Desai, Tejas

    2017-07-01

    The use of social media, in particular Twitter, has substantially increased among health care stakeholders in the field of hematology and oncology, with an especially sharp increase in the use of Twitter during times of major national meetings. The most attended meeting in the oncology field is the ASCO annual meeting. Little is known about the detailed metrics involved in the use, volume, and impact of Twitter during the ASCO annual meeting. We conducted a retrospective review of tweets during the ASCO annual meetings from 2011 to 2016. The total data set encompassed 190,732 tweets from 39,745 authors over six consecutive ASCO meetings from 2011 to 2016 (inclusive). Tweets, all publically available, were collected by Nephrology On-Demand Analytics. The number of individual authors increased from 1,429 during the 2011 ASCO meeting to 15,796 during the 2016 ASCO meeting, an 11-fold increase over the total 5-year period. There was a notable increase in tweets from the 2011 ASCO meeting (n = 7,746) to the 2016 ASCO meeting (n = 72,698), a nine-fold increase during the study period. The most commonly tweeted term or topic changed over time, generally reflecting the breakthroughs of each designated year; these terms were "melanoma" for both the 2011 and 2012 ASCO meetings; "breast cancer" for the 2013 ASCO meeting; "lung cancer" for the 2014 ASCO meeting; and "ImmunOnc" or "immunotherapy/immuno-oncology" for both the 2015 and 2016 ASCO meetings. The use of Twitter among health care stakeholders during the ASCO meeting has markedly increased over time, demonstrating the increasing role of social media in the dissemination of findings at the most highly attended hematology and oncology conference of the year.

  13. Less than meets the eye: reappraising the clinical relevance of attentional bias in addiction.

    NARCIS (Netherlands)

    Christiansen, P.; Schoenmakers, T.M.; Field, M.

    2015-01-01

    Recent years have seen an explosion of interest in attentional bias in addiction, particularly its clinical relevance. Specifically, numerous articles claimed to demonstrate either that (1) attentional bias measured in treatment settings could predict subsequent relapse to substance use, or (2)

  14. Summary reports for key Hoodia clinical studies

    CSIR Research Space (South Africa)

    Maharaj, VJ

    2011-12-01

    Full Text Available The CSIR has acquired the reports to 14 clinical studies in which Hoodia has been assesses, using crude extracts and concentrated active ingredients formulated in a number of different ways. In many of the studies Hoodia was found to be generally...

  15. Implementing screening for Lynch syndrome among patients with newly diagnosed colorectal cancer: summary of a public health/clinical collaborative meeting.

    Science.gov (United States)

    Bellcross, Cecelia A; Bedrosian, Sara R; Daniels, Elvan; Duquette, Debra; Hampel, Heather; Jasperson, Kory; Joseph, Djenaba A; Kaye, Celia; Lubin, Ira; Meyer, Laurence J; Reyes, Michele; Scheuner, Maren T; Schully, Sheri D; Senter, Leigha; Stewart, Sherri L; St Pierre, Jeanette; Westman, Judith; Wise, Paul; Yang, Vincent W; Khoury, Muin J

    2012-01-01

    Lynch syndrome is the most common cause of inherited colorectal cancer, accounting for approximately 3% of all colorectal cancer cases in the United States. In 2009, an evidence-based review process conducted by the independent Evaluation of Genomic Applications in Practice and Prevention Working Group resulted in a recommendation to offer genetic testing for Lynch syndrome to all individuals with newly diagnosed colorectal cancer, with the intent of reducing morbidity and mortality in family members. To explore issues surrounding implementation of this recommendation, the Centers for Disease Control and Prevention convened a multidisciplinary working group meeting in September 2010. This article reviews background information regarding screening for Lynch syndrome and summarizes existing clinical paradigms, potential implementation strategies, and conclusions which emerged from the meeting. It was recognized that widespread implementation will present substantial challenges, and additional data from pilot studies will be needed. However, evidence of feasibility and population health benefits and the advantages of considering a public health approach were acknowledged. Lynch syndrome can potentially serve as a model to facilitate the development and implementation of population-level programs for evidence-based genomic medicine applications involving follow-up testing of at-risk relatives. Such endeavors will require multilevel and multidisciplinary approaches building on collaborative public health and clinical partnerships.

  16. Targeted NGS meets expert clinical characterization: Efficient diagnosis of spastic paraplegia type 11

    Directory of Open Access Journals (Sweden)

    Cristina Castro-Fernández

    2015-06-01

    Full Text Available Next generation sequencing (NGS is transforming the diagnostic approach for neurological disorders, since it allows simultaneous analysis of hundreds of genes, even based on just a broad, syndromic patient categorization. However, such an approach bears a high risk of incidental and uncertain genetic findings. We report a patient with spastic paraplegia whose comprehensive neurological and imaging examination raised a high clinical suspicion of SPG11. Thus, although our NGS pipeline for this group of disorders includes gene panel and exome sequencing, in this sample only the spatacsin gene region was captured and subsequently searched for mutations. Two probably pathogenic variants were quickly and clearly identified, confirming the diagnosis of SPG11. This case illustrates how combination of expert clinical characterization with highly oriented NGS protocols leads to a fast, cost-efficient diagnosis, minimizing the risk of findings with unclear significance.

  17. New technology and clinical applications of nanomedicine: highlights of the second annual meeting of the American Academy of Nanomedicine (Part I).

    Science.gov (United States)

    Wei, Chiming; Lyubchenko, Yuri L; Ghandehari, Hamid; Hanes, Justin; Stebe, Kathleen J; Mao, Hai-Quan; Haynie, Donald T; Tomalia, Donald A; Foldvari, Marianna; Monteiro-Riviere, Nancy; Simeonova, Petia; Nie, Shuming; Mori, Hidezo; Gilbert, Susan P; Needham, David

    2006-12-01

    The Second Annual Meeting of the American Academy of Nanomedicine (AANM) was held at the National Academy of Science Building in Washington, DC, September 9-10, 2006. The program included two Nobel Prize Laureate Lectures, two Keynote Lectures, and 123 invited outstanding State-in-Art lectures presenting in 23 special concurrent symposia. In addition, there were 22 poster presentations in the meeting addressing different areas in nanomedicine research. All of the presenters at the meeting are outstanding investigators and researchers in the field. The Second Annual Meeting of the AANM was a great success. The meeting provides investigators from different world areas a forum and an opportunity for discussion. We believe that nanomedicine research will develop rapidly in the future. The AANM invites basic and clinical researchers from the world to join this exciting research.

  18. Trends in clinical hemapheresis 1986. Progress report on the 4th annual meeting of the European Society for Hemapheresis.

    Science.gov (United States)

    Nydegger, U E; Vaudaux, P; Castelli, D

    1987-09-01

    After a rather long initial period fraught with difficulties, plasma exchange has become an adjunct to the treatment of numerous diseases, such as hyperviscosity syndrome, where it alleviates disease symptoms, hemophilia due to inhibitors to clotting factor VIII, thrombotic thrombocytopenic purpura, rapidly progressing and Goodpasture glomerulonephritis, myasthenia gravis and Guillain Barré syndrome. In addition, plateletpheresis has also grown from being a procedure of experimental clinical application to one of practical routine importance; at the Berne University Hospital, approximately 25% of all transfused platelets in 1986 were apheresis platelets, a proportion that elsewhere may reach 40%. Despite the successes so far obtained with apheresis, many aspects of this therapy remain to be reconsidered. Improvement of donor-recipient matching and of yield in plateletpheresis, better selection of replacement fluids, and increased donor and patient safety and comfort may further strengthen the value of apheresis in therapeutic protocols. This was the major background for the scientific program of the 4th Annual Meeting of the European Society for Hemapheresis that was assembled to shed light on those aspects of the apheresis field which are still unclear. A total of 31 lectures and 76 individual contributions were debated by 280 participants from Europe and overseas. The present essay is a review of the highlights of this meeting, the main lectures of which were published in Plasma Therapy and Transfusion Technology, vol. 7, 1986.

  19. Marketing and clinical trials: a case study.

    Science.gov (United States)

    Francis, David; Roberts, Ian; Elbourne, Diana R; Shakur, Haleema; Knight, Rosemary C; Garcia, Jo; Snowdon, Claire; Entwistle, Vikki A; McDonald, Alison M; Grant, Adrian M; Campbell, Marion K

    2007-11-20

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

  20. In Absentia: An Exploratory Study of How Patients Are Considered in Multidisciplinary Cancer Team Meetings.

    Science.gov (United States)

    Hahlweg, Pola; Hoffmann, Jana; Härter, Martin; Frosch, Dominick L; Elwyn, Glyn; Scholl, Isabelle

    2015-01-01

    Multidisciplinary team meetings and shared decision-making are potential means of delivering patient-centred care. Not much is known about how those two paradigms fit together in cancer care. This study aimed to investigate how decisions are made in multidisciplinary team meetings and whether patient perspectives are incorporated in these decisions. A qualitative study was conducted using non-participant observation at multidisciplinary team meetings (also called tumor boards) at the University Cancer Center Hamburg-Eppendorf, Germany. Two researchers recorded structured field notes from a total of N = 15 multidisciplinary team meetings. Data were analyzed using content analysis and descriptive statistics. Physicians mainly exchanged medical information and based their decision-making on this information. Individual patient characteristics or their treatment preferences were rarely considered or discussed. In the few cases where patient preferences were raised as a topic, this information did not seem to be taken into account in decision-making processes about treatment recommendations. The processes in multidisciplinary team meetings we observed did not exhibit shared decision-making. Patient perspectives were absent. If multidisciplinary team meetings wish to become more patient-centred they will have to modify their processes and find a way to include patient preferences into the decision-making process.

  1. Clinical Neuropathology practice news 1-2014: pyrosequencing meets clinical and analytical performance criteria for routine testing of MGMT promoter methylation status in glioblastoma.

    Science.gov (United States)

    Preusser, Matthias; Berghoff, Anna S; Manzl, Claudia; Filipits, Martin; Weinhäusel, Andreas; Pulverer, Walter; Dieckmann, Karin; Widhalm, Georg; Wöhrer, Adelheid; Knosp, Engelbert; Marosi, Christine; Hainfellner, Johannes A

    2014-01-01

    Testing of the MGMT promoter methylation status in glioblastoma is relevant for clinical decision making and research applications. Two recent and independent phase III therapy trials confirmed a prognostic and predictive value of the MGMT promoter methylation status in elderly glioblastoma patients. Several methods for MGMT promoter methylation testing have been proposed, but seem to be of limited test reliability. Therefore, and also due to feasibility reasons, translation of MGMT methylation testing into routine use has been protracted so far. Pyrosequencing after prior DNA bisulfite modification has emerged as a reliable, accurate, fast and easy-to-use method for MGMT promoter methylation testing in tumor tissues (including formalin fixed and paraffin-embedded samples). We performed an intra- and inter-laboratory ring trial which demonstrates a high analytical performance of this technique. Thus, pyrosequencing- based assessment of MGMT promoter methylation status in glioblastoma meets the criteria of high analytical test performance and can be recommended for clinical application, provided that strict quality control is performed. Our article summarizes clinical indications, practical instructions and open issues for MGMT promoter methylation testing in glioblastoma using pyrosequencing.

  2. Clinical impact of inflammation in dry eye disease: proceedings of the ODISSEY group meeting.

    Science.gov (United States)

    Baudouin, Christophe; Irkeç, Murat; Messmer, Elisabeth M; Benítez-Del-Castillo, José M; Bonini, Stefano; Figueiredo, Francisco C; Geerling, Gerd; Labetoulle, Marc; Lemp, Michael; Rolando, Maurizio; Van Setten, Gysbert; Aragona, Pasquale

    2018-03-01

    Dry eye disease (DED) is a common, multifactorial ocular condition with major impact on vision and quality of life. It is now well recognized that the pathophysiology of chronic DED can include a cycle of inflammation involving both innate and adaptive immune responses. Recently, in vitro/in vivo models have been used to obtain a better understanding of DED-related inflammatory processes at molecular/cellular levels although they do not truly reproduce the complex and chronic hallmarks of human DED. In clinical DED research, advanced techniques such as impression cytology, conjunctival biopsy, in vivo confocal microscopy and multiplex tear analyses have allowed an improved assessment of inflammation in DED patients. This was supported by the identification of reliable inflammatory markers including matrix metalloproteinase-9, human leucocyte antigen-DR or intercellular adhesion molecule-1 in tears and impression cytology samples. One of the current therapeutic strategies focuses on breaking the inflammatory cycle perpetuating the ocular surface disease, and preclinical/clinical research has led to the development of promising anti-inflammatory compounds. For instance, cyclosporine, already approved in the United States, has recently been authorized in Europe to treat DED associated with severe keratitis. In addition, other agents such as corticosteroids, doxycycline and essential fatty acids, through their anti-inflammatory properties, show encouraging results. We now have a clearer understanding of the inflammatory processes involved in DED, and there is hope that the still emerging preclinical/clinical findings will be translated into new and highly effective therapies for patients in the near future. © 2017 The Authors Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

  3. Trueness investigation of routine creatinine assays on nine homogeneous systems in Beijing demonstrates an encouraging outcome that meets clinical requirements.

    Science.gov (United States)

    Liu, Yan; Xu, Guo-bin

    2010-09-01

    Serum creatinine (Scr) measurement plays a key role in glomerular filtration rate estimation (eGFR), chronic kidney disease (CKD) diagnosis as well as CKD treatment. However, the test results of Scr from different laboratories vary significantly. In order to get comparable results, the European in vitro diagnostic (IVD) directive requires traceability to reference methods and materials. The purpose of this study was to verify the effect of traceability implementation by investigating the trueness of creatinine measurement on nine homogenous systems in Beijing. Commutable frozen human serum reference material, National Institute of Standards & Technology (NIST) Standard Reference Material (SRM) 967, was used to verify the trueness of Scr measurement results from nine homogeneous analytical systems of seven companies which are the most widely used systems in Beijing's third-grade hospitals. The methods referred to the Jaffe's and Enzymatic methods. from nine routine measurement systems were assessed using two criteria: biological variability and Clinical Laboratory Improvement Amendments' 88 (CLIA' 88). We simulated a series of broken lines representing the limits of SD and bias that would produce a relative increase (or decrease) of 10% and 20% in the measurement error when estimating GFR (MEeGFR) using the isotope dilution mass spectrometry (IDMS)-traceable Modification of Diet in Renal Disease (MDRD) Study equation. of the College of American Pathologists (CAP) 2008-B LN24 Survey were compared with our investigation results. Compared with the total error criteria of biological variability, Ortho (traceable to IDMS) met the minimum acceptable criteria; Roche (Jaffe), Roche (Enzymatic), Shino and Daiichi met the desirable criteria at level I. At level II, Ortho (traceable to gas chromatography/isotope dilution mass spectrometry, GC/IDMS), Dade Behring and Beckman (traceable to rate Jaffe) met the minimum acceptable criteria; Roche (Enzymatic) met the optimum

  4. Consensus for Radiotherapy in Hepatocellular Carcinoma from The 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014): Current Practice and Future Clinical Trials

    Science.gov (United States)

    Park, Hee Chul; Yu, Jeong Il; Cheng, Jason Chia-Hsien; Zeng, Zhao Chong; Hong, Ji Hong; Wang, Michael Lian Chek; Kim, Mi Sook; Chi, Kwan Hwa; Liang, Po-Ching; Lee, Rheun-Chuan; Lau, Wan-Yee; Han, Kwang Hyub; Chow, Pierce Kah-Hoe; Seong, Jinsil

    2016-01-01

    A consensus meeting to develop practice guidelines and to recommend future clinical trials for radiation therapy (RT), including external beam RT (EBRT), and selective internal RT (SIRT) in hepatocellular carcinoma (HCC) was held at the 5th annual meeting of the Asia-Pacific Primary Liver Cancer Expert consortium. Although there is no randomized phase III trial evidence, the efficacy and safety of RT in HCC has been shown by prospective and retrospective studies using modern RT techniques. Based on these results, the committee came to a consensus on the utility and efficacy of RT in the management of HCC according to each disease stage as follows: in early and intermediate stage HCC, if standard treatment is not compatible, RT, including EBRT and SIRT can be considered. In locally advanced stage HCC, combined EBRT with transarterial chemoembolization or hepatic arterial infusion chemotherapy, and SIRT can be considered. In terminal stage HCC, EBRT can be considered for palliation of symptoms and reduction of morbidity caused by the primary tumor or its metastases. Despite the currently reported benefits of RT in HCC, the committee agreed that there is a compelling need for large prospective studies, including randomized phase III trial evidence evaluating the role of RT. Specifically studies evaluating the efficacy and safety of sequential combination of EBRT and SIRT are strongly recommended. PMID:27493892

  5. A Preliminary Study of Staff Meetings as Viewed by Dental Hygienists

    Directory of Open Access Journals (Sweden)

    Patrick Anderson

    2011-12-01

    Full Text Available Staff meetings in general dental practices represent what is be-lieved to be a key management strategy to build teams and to enhance efficiency and effec-tiveness. However, very little research has been done regarding staff meetings in dental offices. This study examined staff meetings from the viewpoint of dental hygienists who grow in unique careers in that they work largely independently of the dentist and yet typically within a dental practice while providing patient care and education. One-hundred-six dental hygienists completed a survey about staff meetings in dental offices. Key findings include: only approximately 43% of dental offices conduct morning huddles to get the day off to a smooth and organized start, 72% of dental practices conduct longer staff meetings with largely positive outcomes, including increasing practice efficiency and productivity, few practices (12% hold specific meetings only for the hygiene-department (and probably thereby miss some opportunities for practice im-provement, the most important variable by far to hygienists' job satisfaction is respect from the owner-dentist, and there exists an important and synergistic relationship among job sa-tisfaction, relationships with other staff and relationship with the owner-dentist.

  6. Left ventricular noncompaction: Clinical-echocardiographic study

    Directory of Open Access Journals (Sweden)

    Nikolić Aleksandra

    2012-01-01

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

  7. 77 FR 43117 - Meeting of the Cold War Advisory Committee for the Cold War Theme Study

    Science.gov (United States)

    2012-07-23

    ... the Cold War Advisory Committee for the Cold War Theme Study AGENCY: National Park Service, Interior... Committee Act, 5 U.S.C. Appendix, that the Cold War Advisory Committee for the Cold War Theme Study will... National Park Service (NPS) concerning the Cold War Theme Study. DATES: The teleconference meeting will be...

  8. Perceptions of Parents of Students with Autism towards the IEP Meeting: A Case Study of One Family Support Group Chapter

    Science.gov (United States)

    Fish, Wade W.

    2006-01-01

    This case study investigated parental perceptions of students with autism towards the IEP meeting from one family support group chapter in the north Texas area. Participants were asked to share their experiences of previous IEP meetings and to provide input regarding not only measures that school districts may take towards improving IEP meetings,…

  9. Doctors' experience with handheld computers in clinical practice: qualitative study.

    Science.gov (United States)

    McAlearney, Ann Scheck; Schweikhart, Sharon B; Medow, Mitchell A

    2004-05-15

    To examine doctors' perspectives about their experiences with handheld computers in clinical practice. Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. Six practice settings across the United States and two additional focus group sessions held at a national meeting of general internists. 54 doctors who did or did not use handheld computers. Doctors who used handheld computers in clinical practice seemed generally satisfied with them and reported diverse patterns of use. Users perceived that the devices helped them increase productivity and improve patient care. Barriers to use concerned the device itself and personal and perceptual constraints, with perceptual factors such as comfort with technology, preference for paper, and the impression that the devices are not easy to use somewhat difficult to overcome. Participants suggested that organisations can help promote handheld computers by providing advice on purchase, usage, training, and user support. Participants expressed concern about reliability and security of the device but were particularly concerned about dependency on the device and over-reliance as a substitute for clinical thinking. Doctors expect handheld computers to become more useful, and most seem interested in leveraging (getting the most value from) their use. Key opportunities with handheld computers included their use as a stepping stone to build doctors' comfort with other information technology and ehealth initiatives and providing point of care support that helps improve patient care.

  10. Clinical Pharmacology Studies in Critically Ill Children

    Science.gov (United States)

    Thakkar, Nilay; Salerno, Sara; Hornik, Christoph P.; Gonzalez, Daniel

    2016-01-01

    Developmental and physiological changes in children contribute to variation in drug disposition with age. Additionally, critically ill children suffer from various life-threatening conditions that can lead to pathophysiological alterations that further affect pharmacokinetics (PK). Some factors that can alter PK in this patient population include variability in tissue distribution caused by protein binding changes and fluid shifts, altered drug elimination due to organ dysfunction, and use of medical interventions that can affect drug disposition (e.g., extracorporeal membrane oxygenation and continuous renal replacement therapy). Performing clinical studies in critically ill children is challenging because there is large inter-subject variability in the severity and time course of organ dysfunction; some critical illnesses are rare, which can affect subject enrollment; and critically ill children usually have multiple organ failure, necessitating careful selection of a study design. As a result, drug dosing in critically ill children is often based on extrapolations from adults or non-critically ill children. Dedicated clinical studies in critically ill children are urgently needed to identify optimal dosing of drugs in this population. This review will summarize the effect of critical illness on pediatric PK, the challenges associated with performing studies in this vulnerable subpopulation, and the clinical PK studies performed to date for commonly used drugs. PMID:27585904

  11. Tetralogy of Fallot and Hypoplastic Left Heart Syndrome – Complex Clinical Phenotypes Meet Complex Genetic Networks

    Science.gov (United States)

    Lahm, Harald; Schön, Patric; Doppler, Stefanie; Dreßen, Martina; Cleuziou, Julie; Deutsch, Marcus-André; Ewert, Peter; Lange, Rüdiger; Krane, Markus

    2015-01-01

    In many cases congenital heart disease (CHD) is represented by a complex phenotype and an array of several functional and morphological cardiac disorders. These malformations will be briefly summarized in the first part focusing on two severe CHD phenotypes, hypoplastic left heart syndrome (HLHS) and tetralogy of Fallot (TOF). In most cases of CHD the genetic origin remains largely unknown, though the complexity of the clinical picture strongly argues against a dysregulation which can be attributed to a single candidate gene but rather suggests a multifaceted polygenetic origin with elaborate interactions. Consistent with this idea, genome-wide approaches using whole exome sequencing, comparative sequence analysis of multiplex families to identify de novo mutations and global technologies to identify single nucleotide polymorphisms, copy number variants, dysregulation of the transcriptome and epigenetic variations have been conducted to obtain information about genetic alterations and potential predispositions possibly linked to the occurrence of a CHD phenotype. In the second part of this review we will summarize and discuss the available literature on identified genetic alterations linked to TOF and HLHS. PMID:26069455

  12. Recent advances in gastrointestinal oncology - updates and insights from the 2009 annual meeting of the American Society of Clinical Oncology

    Directory of Open Access Journals (Sweden)

    Hsueh Chung-Tsen

    2010-03-01

    Full Text Available Abstract We have reviewed the pivotal presentations related to gastrointestinal malignancies from 2009 annual meeting of the American Society of Clinical Oncology with the theme of "personalizing cancer care". We have discussed the scientific findings and the impact on practice guidelines and ongoing clinical trials. Adding trastuzumab to chemotherapy improved the survival of patients with advanced gastric cancer overexpressing human epidermal growth factor receptor 2. Gemcitabine plus cisplatin has become a new standard for first-line treatment of advanced biliary cancer. Octreotide LAR significantly lengthened median time to tumor progression compared with placebo in patients with metastatic neuroendocrine tumors of the midgut. Addition of oxaliplatin to fluoropyrimidines for preoperative chemoradiotherapy in patients with stage II or III rectal cancer did not improve local tumor response but increased toxicities. Bevacizumab did not provide additional benefit to chemotherapy in adjuvant chemotherapy for stage II or III colon cancer. In patients with resected stage II colon cancer, recurrence score estimated by multigene RT-PCR assay has been shown to provide additional risk stratification. In stage IV colorectal cancer, data have supported the routine use of prophylactic skin treatment in patients receiving antibody against epidermal growth factor receptor, and the use of upfront chemotherapy as initial management in patients with synchronous metastasis without obstruction or bleeding from the primary site.

  13. Workplace Correlates and Scholarly Performance of Clinical Pharmacy Faculty. ASHE Annual Meeting Paper.

    Science.gov (United States)

    Jungnickel, Paul W.; Creswell, John W.

    This study examined workplace correlates (departmental and college) of scholarly performance in 296 college faculty members from 67 schools of pharmacy in the United States. The study estimated a model of 3-year scholarly performance through the exploration of six sets of correlates: demographic; affiliation; collaboration; research experiences…

  14. CLINICAL STUDY OF PENETRATING INJURIES OF ABDOMEN

    Directory of Open Access Journals (Sweden)

    Raghu

    2016-03-01

    Full Text Available Penetrating trauma forms an important component of surgical emergencies. The importance of this category becomes further apparent when one realises that most of such trauma victims are essentially healthy people and in the prime of their life. Over the past century, great advances were made in the management of such wounds. The operative management replaced the expectant therapy and reduced mortality rates. So this study is being done to evaluate the various indications for early mandatory laparotomy in penetrating abdominal injuries. AIM Aim of the study is to study various modes of injuries of penetrating injuries of abdomen, clinical presentation and their management. MATERIALS AND METHODS The study includes 60 cases of penetrating injury to abdomen admitted to our hospital during the period August 2013 to August 2015. After initial resuscitation and achieving haemodynamic stability, all patients were subjected to careful clinical examination. Depending on the clinical findings decision for further investigations such as local wound exploration, X-ray abdomen and ultrasound abdomen taken. The resuscitation begins in the causality and based on the vitals, patients were submitted to immediate laparotomy or shifted to T.M.T ward for further evaluation. The decision for operative or nonoperative depends on the clinical examination and results of diagnostic tests. They were subsequently investigated and managed according to the standard protocol. RESULTS 81.67% of cases of penetrating abdominal trauma underwent exploratory laparotomy. Laparotomy was therapeutic in 79.59% of cases. Commonest organ injured in the descending order of frequency: Small bowel, liver, stomach, mesentery, large bowel, spleen, gall bladder and diaphragm. Average duration of hospital stay was 7 days. Mortality rate was 3.3%. CONCLUSION Penetrating abdominal trauma is one of the surgical emergencies. Majority of patients who present with evisceration after penetrating wound

  15. Nail disorders in children, a clinical study

    Directory of Open Access Journals (Sweden)

    Ayşe Akbaş

    2016-04-01

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

  16. Non confirmatory electroencephalography in patients meeting clinical criteria for brain death: scenario and impact on organ donation.

    Science.gov (United States)

    Fernández-Torre, José L; Hernández-Hernández, Miguel A; Muñoz-Esteban, Cristina

    2013-12-01

    To describe the causes and outcome of adult patients with preserved electroencephalographic activity despite clinical findings suggesting brain death (BD), and its impact on organ donation. Retrospective study of the clinical and electroencephalography (EEG) data of all adult patients admitted to our hospital between January 2001 and December 2011 in whom a comprehensive clinical diagnosis of BD was reached following absence of brainstem reflexes and confirmatory apnea tests, were obtained. All patients with clinical findings suggesting BD and an EEG showing brain activity were selected for the analysis. We calculated the brain death interval (BDI) as the time between the first complete clinical examination and confirmatory ancillary test, or the time between the first and second complete clinical examination for BD, in order to analyze the impact on family consent for organ donation. A complete clinical examination and EEG were diagnostic in 289 patients. In 279 (96.5%), the first EEG showed electrocerebral inactivity corroborating the clinical findings of BD. The mean BDI in this group was 4.2 ± 5.8h (median; 1.8[1.0-3.5]). This value was significantly lower than in the group in which only two full clinical evaluations were performed (p6h, was positively associated with a family refusal for organ donation (p=0.02). The rate of EEGs with electrocerebral activity despite clinical findings suggesting BD was only 3.5%. It occurred most frequently with severe brainstem damage. Although in this small percentage of patients, BD diagnosis was notably delayed, in the great majority of cases the use of EEG shortened the BDI. In our series, a BD diagnosis delay >6h negatively affected consent for organ donation. The use of EEG can decrease the time interval for brain death diagnosis. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  17. Clinical and Statistical Study on Canine Impaction

    Directory of Open Access Journals (Sweden)

    Adina-Simona Coșarcă

    2013-08-01

    Full Text Available Aim: The aim of this study was to perform a clinical and statistical research on permanent impacted canine patients among those with dental impaction referred to and treated at the Oral and Maxillo-Facial Surgery Clinic of Tîrgu Mureș, over a four years period (2009-2012. Materials and methods: The study included 858 patients having dental impaction, and upon clinical records, different parameters, like frequency, gender, age, quadrant involvement, patient residence, associated complications, referring specialist and type of treatment, related to canine impaction, were assessed. Results: The study revealed: about 10% frequency of canine impaction among dental impactions; more frequent in women, in the first quadrant (tooth 13; most cases diagnosed between the age of 10-19 years; patients under 20 were referred by an orthodontist, those over 20 by a dentist; surgical exposure was more often performed than odontectomy. Conclusions: Canine impaction is the second-most frequent dental impaction in dental arch after third molars; it occurs especially in women. Due to its important role, canine recovery within dental arch is a goal to be achieved, whenever possible. Therefore, diagnose and treatment of canine impaction requires an interdisciplinary approach (surgical and orthodontic

  18. Meeting the Demand for College Student Concerns in College Counseling Centers: Evaluating a Clinical Triage System

    Science.gov (United States)

    Hardy, Jennifer A.; Weatherford, Ryan D.; Locke, Benjamin D.; DePalma, Natalie Hernandez; D'Iuso, Nadia T.

    2011-01-01

    University counseling centers, experiencing an imbalance between student demand and available resources, respond in various ways. The current mixed-method study evaluated one university counseling center transitioning from a wait-list system to a triage method of managing demand. Significant reductions in wait time and increase in attendance were…

  19. Gamification as an instrument for organizational behaviour change during the meeting: case study «ROBATIEMPOS»

    Directory of Open Access Journals (Sweden)

    Dulskaia Iana

    2017-07-01

    Full Text Available During the last years, gamification has been a burning issue and a subject of scientific discussions. Gamification is an innovative solution to foster motivation. It relates to the use of game elements in non-game contexts. By applying game mechanics to training and other business critical processes, organizations can improve employee engagement, boost productivity and lift operational performance. Over the last few decades, it has been noticed the significant enhancement of time spent attending meetings. Meetings are essential for the organizations, they improve the effectiveness of a company team working and are necessary for human relations. Nevertheless, in many cases meetings are considered as a waste of time. There are very few scientific papers that regarding the use of gamification for business meeting changes. The study seeks to explore the behavioural change of participants towards business meetings after introducing a business game, in order to come up with an interesting solution that might be useful for other researchers and practitioners in understanding the use of gamification in similar contexts. With regard to this aim, a single-case holistic design methodology is used and qualitative approach using semi-structured interviews with gamification experts and project managers is applied. This paper contributes both to the scientific literature and to managerial implication.

  20. Clinical case review: A method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia

    OpenAIRE

    Puumalainen, Taneli; Quiambao, Beatriz; Abucejo-Ladesma, Erma; Lupisan, Socorro; Heiskanen-Kosma, Tarja; Ruutu, Petri; Lucero, Marilla G; Nohynek, Hanna; Simoes, Eric AF; Riley, Ian

    2008-01-01

    Abstract Background The World Health Organization's (WHO) case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. Methods A group of paediatricians conducted a retrospective review of clinical and laboratory da...

  1. Resilience to meet the challenge of addiction: psychobiology and clinical considerations.

    Science.gov (United States)

    Alim, Tanja N; Lawson, William B; Feder, Adriana; Iacoviello, Brian M; Saxena, Shireen; Bailey, Christopher R; Greene, Allison M; Neumeister, Alexander

    2012-01-01

    Acute and chronic stress-related mechanisms play an important role in the development of addiction and its chronic, relapsing nature. Multisystem adaptations in brain, body, behavioral, and social function may contribute to a dysregulated physiological state that is maintained beyond the homeostatic range. In addition, chronic abuse of substances leads to an altered set point across multiple systems. Resilience can be defined as the absence of psychopathology despite exposure to high stress and reflects a person's ability to cope successfully in the face of adversity, demonstrating adaptive psychological and physiological stress responses. The study of resilience can be approached by examining interindividual stress responsibility at multiple phenotypic levels, ranging from psychological differences in the way people cope with stress to differences in neurochemical or neural circuitry function. The ultimate goal of such research is the development of strategies and interventions to enhance resilience and coping in the face of stress and prevent the onset of addiction problems or relapse.

  2. Advisory group meeting on stable isotope labelled compounds in biomedical studies

    International Nuclear Information System (INIS)

    Vera Ruiz, H.; Parr, R.M.

    1985-11-01

    The programme of the meeting was restricted to topics involving applications of stable isotopes of the lighter elements (H, C, N, O). The current status of stable isotope techniques and applications in nutritional and biomedical studies, the applicability of these techniques in developing countries and the IAEA's future programmes on this topic were discussed

  3. Global Change and Forestry: Socioeconomic Studies from the 1994 SOFEW Meeting

    Science.gov (United States)

    Joseph E. de Steiguer; [Technical Editor

    1995-01-01

    The five papers in this book were originally presented at the 1994 Southern Forest Economic Workers meeting. They discuss the socioeconomic aspect of global climate change on forests. The research represented by the studies will assist decision makers in the formulation of policies concerening global climate change.

  4. How Zoos Are Meeting the Challenges Facing Biodiversity: Bristol Zoo Gardens as a Case Study

    Science.gov (United States)

    Garrett, Simon

    2010-01-01

    As ideas about effective conservation of biodiversity develop, zoos are adapting their roles to meet the new challenges. This article considers these changes, using the work of Bristol and other UK zoos as a case study. The significance of zoos in both global and local conservation of biodiversity, their role in promoting public engagement and…

  5. Embodying the institution - Object manipulation in developing interaction in study counselling meetings

    DEFF Research Database (Denmark)

    Hazel, Spencer; Mortensen, Kristian

    2014-01-01

    on how objects in the material surround are used in conjunction with talk, gaze and postural orientation to construct local social order in study guidance counselling meetings at a university. We explore here how co-participants utilize aggregates of interactional components to construct...

  6. First-in-class, first-in-human phase I results of targeted agents: highlights of the 2008 American society of clinical oncology meeting.

    Science.gov (United States)

    Molckovsky, Andrea; Siu, Lillian L

    2008-10-29

    This review summarizes phase I trial results of 11 drugs presented at the American Society of Clinical Oncology meeting held in Chicago IL from May 30 to June 3rd 2008: BMS-663513, CT-322, CVX-045, GDC-0449, GRN163L, LY2181308, PF-00562271, RAV12, RTA 402, XL765, and the survivin vaccine.

  7. First-in-class, first-in-human phase I results of targeted agents: Highlights of the 2008 American Society of Clinical Oncology meeting

    Directory of Open Access Journals (Sweden)

    Siu Lillian L

    2008-10-01

    Full Text Available Abstract This review summarizes phase I trial results of 11 drugs presented at the American Society of Clinical Oncology meeting held in Chicago IL from May 30 to June 3rd 2008: BMS-663513, CT-322, CVX-045, GDC-0449, GRN163L, LY2181308, PF-00562271, RAV12, RTA 402, XL765, and the survivin vaccine.

  8. Serratia corneal ulcers: a retrospective clinical study.

    Science.gov (United States)

    Mah-Sadorra, Jeane Haidee; Najjar, Dany M; Rapuano, Christopher J; Laibson, Peter R; Cohen, Elisabeth J

    2005-10-01

    To study the clinical and microbiological profile of Serratia corneal ulcers at the Cornea Service of the Wills Eye Hospital. This was a retrospective, observational case series. The clinical records of patients with Serratia marcescens corneal ulcers seen at the Cornea Service of the Wills Eye Hospital between January 1, 1998 and December 31, 2002 were reviewed. Twenty-four cases of Serratia keratitis were identified in 21 patients. Two patients (9.5%) had recurrent keratitis, 1 of which recurred twice. Both had corneal graft edema and were on topical steroids and antiglaucoma drops. The Serratia infection in 15 patients (71%) was associated with an abnormal corneal surface. Twelve of these patients (57%) had the ulcer in a corneal graft, 4 (19%) of which were associated with suture infiltrates. Fifteen patients (71%) were on topical medications-15 used corticosteroids and 13 used antiglaucoma drops. Six patients (29%) were contact lens wearers-1 had a concomitant suture infiltrate associated with a corneal graft, and 5 had otherwise healthy corneas. One isolate lacked in vitro susceptibility to ciprofloxacin and ofloxacin but was susceptible to gentamicin and tobramycin. Nineteen patients had a favorable response to medical therapy. Two patients with poor outcome had large corneal ulcers with severe necrosis and thinning associated with delay in treatment. Serratia marcescens keratitis is associated with the presence of an abnormal corneal surface, use of topical medications, and contact lens wear. Prompt medical therapy results in a good clinical response in the majority of cases.

  9. A clinical study of papular urticaria

    International Nuclear Information System (INIS)

    Raza, N.; Lodhi, M.S.; Ali, L.

    2008-01-01

    To determine the clinical features and demographic profile of the patients having papular urticaria. Individuals of all age groups and either gender either suspected of or having definite history of insect bite were included in the study. A specially-designed proforma was filled for each patient separately. The proforma included demographic features, information regarding clothing and sleeping habits, personal or family history of atopy and clinical patterns of the lesions. Computer programme SPSS 10 was used to manage and analyze the data. Out of 280 patients, 201 (71.8%) were children upto 12 years of age, 178 (63.6%) were males, 91 (32.5%) had atopy, 194 (69.3%) were non-locals, 212 (75.7%) came from urban/peri-urban areas and 173 (61.8%) presented during May-August. Lesions were present over exposed parts of the body in 36 (12.9%), arranged in groups in 152 (54.3%) and were papular urticaria in 185 (66.1%) patients. Children, adult males, non-locals and those belonging to urban/peri-urban areas are more vulnerable to papular urticaria in a particular region. Papular and urticarial lesions arranged in groups over both exposed as well as covered body parts of a single patient is the most common clinical pattern. (author)

  10. Report on ISCTM Consensus Meeting on Clinical Assessment of Response to Treatment of Cognitive Impairment in Schizophrenia.

    Science.gov (United States)

    Keefe, Richard S E; Haig, George M; Marder, Stephen R; Harvey, Philip D; Dunayevich, Eduardo; Medalia, Alice; Davidson, Michael; Lombardo, Ilise; Bowie, Christopher R; Buchanan, Robert W; Bugarski-Kirola, Dragana; Carpenter, William T; Csernansky, John T; Dago, Pedro L; Durand, Dante M; Frese, Frederick J; Goff, Donald C; Gold, James M; Hooker, Christine I; Kopelowicz, Alex; Loebel, Antony; McGurk, Susan R; Opler, Lewis A; Pinkham, Amy E; Stern, Robert G

    2016-01-01

    If treatments for cognitive impairment are to be utilized successfully, clinicians must be able to determine whether they are effective and which patients should receive them. In order to develop consensus on these issues, the International Society for CNS Clinical Trials and Methodology (ISCTM) held a meeting of experts on March 20, 2014, in Washington, DC. Consensus was reached on several important issues. Cognitive impairment and functional disability were viewed as equally important treatment targets. The group supported the notion that sufficient data are not available to exclude patients from available treatments on the basis of age, severity of cognitive impairment, severity of positive symptoms, or the potential to benefit functionally from treatment. The group reached consensus that cognitive remediation is likely to provide substantial benefits in combination with procognitive medications, although a substantial minority believed that medications can be administered without nonpharmacological therapy. There was little consensus on the best methods for assessing cognitive change in clinical practice. Some participants supported the view that performance-based measures are essential for measurement of cognitive change; others pointed to their cost and time requirements as evidence of impracticality. Interview-based measures of cognitive and functional change were viewed as more practical, but lacking validity without informant involvement or frequent contact from clinicians. The lack of consensus on assessment methods was viewed as attributable to differences in experience and education among key stakeholders and significant gaps in available empirical data. Research on the reliability, validity, sensitivity, and practicality of competing methods will facilitate consensus. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

  11. Receiving group clinical supervision: a phenomenological study.

    Science.gov (United States)

    Taylor, Claire

    This study examined the process of group supervision as experienced by one team of biofeedback therapists working in the south of England. A phenomenological study was undertaken to examine the team's perceptions of attending group supervision over time. Ten one-to-one in-depth interviews were conducted, six of which were with biofeedback therapists currently receiving supervision, three with nurses who used to receive this supervision and one interview with the supervisor. A four-stage model detailing how supervisees' experiences changed as a consequence of continued group supervision was developed. Study data revealed how this process allowed the biofeedback therapists to examine their clinical interventions and align their approach and perspective alongside other team members. This was a valuable and safe way of learning 'on the job' for the newer members of the team. The opportunity for free-thinking and reflection on practice supported clinical decision-making and therapeutic nursing. The more experienced supervisees demonstrated how their continued attendance of the group supervision sessions not only confirmed their expertise in role, but also facilitated their colleagues' development, which enhanced role satisfaction. The data also indicated some of the essential supervisory features of this process.

  12. [Cushing's syndrome: clinical study of fifteen cases].

    Science.gov (United States)

    Calvo Romero, J M; Morales Pérez, F; Alvarez Barreiro, J A; Diaz Pérez de Madrid, J

    1998-05-01

    To study the epidemiological and clinical features and diagnostic tests of Cushing's syndrome (CS) of non-iatrogenic etiology, because of there are few similar studies in the last ten years. Fifteen cases of CS were diagnosed from 1992 to 1997 at our hospital. We describe the epidemiological, clinical, biochemical, radiologic, therapeutic and evolutive characteristics. Both diabetes mellitus and hypertension were observed in 40% of patients. The frequency of etiologies was: Cushing's disease, 66.6%; ectopic ACTH syndrome, 13.3%; adrenal adenoma, 6.6%; adrenal carcinoma, 6.6%; and undiagnosed, 6.6%. The 24-hour urine free cortisol (UFC) and the overnight 1 mg oral dexamethasone suppression test yielded 93.3 and 100% diagnostic sensitivity for CS, respectively. The overnight 8 mg oral dexamethasone suppression test, the metyrapone test and the 7 mg intravenous dexmethasone test had 75, 50 and 60% diagnostic sensitivity for Cushing's disease, respectively. Ketoconazole treatment had success in to normalize the 24-hour UFC in all patients, except for the case of adrenal carcinoma. The Cushing's disease was the most common form of CS. The 24-hour UFC and overnight 1 mg oral dexamethasone suppression test were good screening studies. Ketoconazole was successful in normalizing the adrenal cortex function.

  13. Clinical and neuroradiological studies on internuclear ophthalmoplegia

    International Nuclear Information System (INIS)

    Ito, Michiko; Uchiyama, Shinichiro; Endo, Riuko; Aikawa, Takashi; Kobayashi, Itsuro; Takemiya, Toshiko; Maruyama, Shoichi

    1989-01-01

    In this study 14 cases of internuclear ophthalmoplegia (INO) were analysed. The correlation of clinical symptoms with localization of the responsible lesions was studied in these patients. The subjects included 9 patients with CVD, 2 with MS, 1 with Fisher's syndrome, 1 with cranial polyneuritis and one with unknown etiology. Nine patients with unilateral INO are all associated with brainstem infarction. The other 5 patients including 2 MS had bilateral INO. CT showed abnormal findings in brain stem in 7 out of 14 patients. As for MRI an abnormality was found in 5 out of the 8 patients examined. Two of the 7 patients without any abnormality on CT had abnormal signals on MRI. We divided INO into 3 groups based on the clinical symptoms: 1) anterior type in which convergence was involved concomitantly with adduction paralysis, 2) typical type in which dissociated nystagmus was more marked in the abducting eye, and convergence was preserved, 3) posterior type in which abduction is impaired without adduction disturbance. There were 5 cases of anterior type, 9 of typical type, and none of posterior type. On MRI two patients of anterior type had abnormalities in the dorsal midbrain, and one patient had an abnormality in the pons, and two patients of typical type had abnormalities in the upper or middle dorsal pons to the dorsal midbrain. CT failed to demontrate any responsible lesions in 2 patients in whom the responsible legions were clearly identified on MRI. (J.P.N.)

  14. A Study of Clinical Characteristicsof Mediastinal Mass

    Science.gov (United States)

    Aroor, Akshatha Rao; Prakasha S., Rama; Seshadri, Shubha; S., Teerthanath; Raghuraj, Uppoor

    2014-01-01

    Background: Mediastinal tumours are uncommon lesions encountered in clinical practice. There has been a significant increase in the incidence of malignant mediastinal tumours over the past four decades. The presentation varies from asymptomatic lesions detected incidentally on imaging to severe life threatening presentations. Aim and Objectives: The study was conducted to assess the clinical characteristics, types, treatment modalities and outcome of mediastinal masses. Materials and Methods: In this two year prospective study, a total of 35 cases with or without symptoms of mediastinal mass, confirmed by Computed Tomography (CT) imaging were included. The results were expressed as percentages or proportions. Results: Maximum numbers of patients (25.71%) were seen in the 3rd decade and majority (94.3%) was symptomatic at presentation. Malignant lesions (68.57%) were more common than benign (31.43%) and lymphoma was the commonest malignant tumour (50%). Mediastinal widening on chest X-ray was seen in 27 cases (77.14%), pleural effusion and lung mass in 5 cases each (14.29%). On CT imaging and sub-classification, anterior mediastinum was the commonest compartment involved (42.86%). Conclusion: Mediastinal masses are usually symptomatic at presentation. Majority of the masses were malignant lesions and the symptoms of mediastinal obstruction was significantly higher in malignant lesions and anterior mediastinal masses. Lymphoma was the most frequent primary mediastinal mass and thymoma constituted the commonest benign anterior mediastinal tumour. PMID:24701488

  15. Clinical and neuroradiological studies on internuclear ophthalmoplegia

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Michiko; Uchiyama, Shinichiro; Endo, Riuko; Aikawa, Takashi; Kobayashi, Itsuro; Takemiya, Toshiko; Maruyama, Shoichi (Tokyo Women' s Medical Coll. (Japan))

    1989-06-01

    In this study 14 cases of internuclear ophthalmoplegia (INO) were analysed. The correlation of clinical symptoms with localization of the responsible lesions was studied in these patients. The subjects included 9 patients with CVD, 2 with MS, 1 with Fisher's syndrome, 1 with cranial polyneuritis and one with unknown etiology. Nine patients with unilateral INO are all associated with brainstem infarction. The other 5 patients including 2 MS had bilateral INO. CT showed abnormal findings in brain stem in 7 out of 14 patients. As for MRI an abnormality was found in 5 out of the 8 patients examined. Two of the 7 patients without any abnormality on CT had abnormal signals on MRI. We divided INO into 3 groups based on the clinical symptoms: (1) anterior type in which convergence was involved concomitantly with adduction paralysis, (2) typical type in which dissociated nystagmus was more marked in the abducting eye, and convergence was preserved, (3) posterior type in which abduction is impaired without adduction disturbance. There were 5 cases of anterior type, 9 of typical type, and none of posterior type. On MRI two patients of anterior type had abnormalities in the dorsal midbrain, and one patient had an abnormality in the pons, and two patients of typical type had abnormalities in the upper or middle dorsal pons to the dorsal midbrain. CT failed to demontrate any responsible lesions in 2 patients in whom the responsible legions were clearly identified on MRI. (J.P.N.).

  16. A CLINICAL STUDY ON BLUNT INJURY ABDOMEN

    Directory of Open Access Journals (Sweden)

    G. Kishore Babu

    2016-10-01

    Full Text Available BACKGROUND Abdominal trauma continues to account for a large number of trauma-related injuries and deaths. Motor vehicle accidents and urban violence, respectively, are the leading causes of blunt and penetrating trauma to this area of the body. Unnecessary deaths and complications can be minimized by improved resuscitation, evaluation and treatment. The new techniques and diagnostic tools available are important in the management of abdominal trauma. These improved methods, however, still depend on experience and clinical judgment for application and determination of the best care for the injured patient. The aim of the study is to 1. Analyse the incidence, clinical characteristics, diagnosis, indications for laparotomy, therapeutic methods and morbidity & mortality rates. 2. To study nature of blunt abdominal trauma. 3. To assess patient for surgical intervention and to avoid negative laparotomy. 4. To assess morbidity rate in different organs injury. 5. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS This study is a prospective study on 97 patients with Blunt injuries to the abdomen admitted in S.V.R.R.G.G. Hospital, Tirupati during October 2013-15. Inclusion Criteria Patients > 13 years, with Blunt injury to abdomen either by RTA, fall, object contact, assault giving written informed consent. Exclusion Criteria Patients <13 yrs. Blunt injuries due to blasts, patients with severe cardiothoracic and head injuries who are hemodynamically unstable. CONCLUSION Blunt Trauma to abdomen is on rise due to excessive use of motor vehicles. It poses a therapeutic and diagnostic dilemma for the attending surgeon due to wide range of clinical manifestations ranging from no early physical findings to progression to shock. So, the Trauma surgeon should rely on his physical findings in association with use of modalities like x-ray abdomen, USG abdomen and abdominal paracentesis. Hollow viscus perforations are

  17. Clinical and radiologic study of odontogenic keratocyst

    International Nuclear Information System (INIS)

    Kim, Sang Rae; Park, Tae Won

    1984-01-01

    The purpose of this article is to define further clinical behaviors and radiographic appearances of odontogenic keratocyst developed in jaws, with special interest in recurrent rate which is generally high. 32 patients whose microscopic examinations were verified as odontogenic keratocyst were examined in this study. The results of this study were as follows. 1. There was an apparent sex predilection for male. 2. The peak incidence was the second and third decades with gradual decline thereafter with a mean age of 31 years 7 months. 3. The most common site was a mandibular molar-ramus region, 22 cases (68.8%) occurred in the mandible and 10 cases (31.3%) in the maxilla.

  18. A CLINICAL STUDY OF GALL STONE DISEASE

    Directory of Open Access Journals (Sweden)

    K. Lokesh

    2017-12-01

    Full Text Available BACKGROUND Gallbladder disorders rank among the most common and costly of all digestive system diseases. This disease is more common in Western world. Prevalence rates vary from 15– 25% in developed countries. In India, it varies from 5 – 10%. Incidence of cholelithiasis is increasing considerably in India, possibly due to change in the dietary habits, which is becoming westernized and changing life style. Northern India show 7 times more incidence than that in southern parts. Because of the extensive studies on aetiology of gallstones, better understanding of the pathogenesis in the past two decades, the management has become more appropriate and effective. The operations on biliary tree and gall bladder rank next only to hernia repair and appendicectomy. Minimally invasive surgery improves patient’s compliance and reduces morbidity rates. The objectives of this study were1. To study age and sex distribution, various types of clinical presentations in patients with gall stone disease, 2. To study the bacteriology of the bile collected from all cholecystectomy cases and 3. To determine the composition of gallstones removed from patients. MATERIALS AND METHODS Study Type- Prospective observational study, Study Setting- Department of General surgery, Narayana medical college and Hospital. Study Period- Study is done from November 2014 to October 2016. Study sample: 100 cases of clearly documented gall stones on USG abdomen. Inclusion Criteria- Patient aged > 11 years and <70 years, All patients of gallstone disease who got admitted to the hospital and who underwent cholecystectomy either open or laparoscopic procedures. Exclusion Criteria- Acalculous cholecystitis, Primary CBD stones. Method of Study- A detailed history of demographic data, clinical presentation, complications if any, and previous treatment are recorded in a proforma. Thorough clinical examination was done in them and was subjected to investigations. Relevant preoperative

  19. Cycloid psychosis: a clinical and nosological study.

    Science.gov (United States)

    Peralta, Victor; Cuesta, Manuel J

    2003-04-01

    Despite its clinical relevance, the diagnosis of cycloid psychosis has been relatively neglected in the psychiatric literature and in the current nosological systems. This study examined the clinical validity and nosological status of the cycloid psychosis concept. Six-hundred and sixty psychotic in-patients were assessed for psychosis-related variables and diagnosed according to DSM-III-R, DSM-IV, ICD-10 and the Perris & Brockington criteria forcycloid psychosis. The cycloid psychosis diagnosis (N = 68, 10.3%) was examined in regard to its discriminant validity, concordance with other psychotic disorders, and predictive validity in relation to schizophrenia and psychotic mood disorders. To address putative heterogeneity within cycloid psychosis, affective (N = 38) and non-affective (N = 30) subgroups were examined. Cycloid psychosis had good discriminant validity regarding other psychoses (95% of correctly classified cases) and poor concordance with individual diagnoses from the formal diagnostic systems (K Cycloid patients had levels of psychotic, disorganization and first-rank symptoms comparable to schizophrenia, and levels of affective symptoms in-between schizophrenia and mood disorders. Regarding most clinical variables and morbidity risk of mood disorders, cycloid psychosis was closer to mood disorders. Cycloid psychosis had higher psychosocial stressors than schizophrenia and mood disorders. Affective and non-affective groups of cycloid psychosis differed in a number of variables indicating an overall better outcome for the non-affective group. Cycloid psychosis does not correspond closely to any DSM-III-R, DSM-IV or ICD-10 category of psychosis, and more specifically this nosological concept is not well represented by the different formal definitions of remitting psychotic disorders. Cycloid psychosis seems to be an heterogeneous condition in that affective and non-affective subgroups can be differentiated.

  20. Multidisciplinary team meetings about a patient in primary care: an explorative study.

    Science.gov (United States)

    Van Houdt, Sabine; De Lepeleire, Jan; Driessche, Kristel Vanden; Thijs, Gabie; Buntinx, Frank

    2011-04-01

    Multidisciplinary team meetings (MTM) about a patient are a way to coordinate fragmented care. The Minimal Data Set/Resident Assessment Instrument (MDS/RAI) is a tool to prepare and support these meetings. An exploratory, qualitative study was used to examine the factors that influence the need for an MTM and to determine the value of MDS/RAI supporting the MTM. Key elements are awareness of the health care professionals that "something is wrong" and the presence of sufficient family caregivers with enough capacity. The MDS/RAI is an aid because registration provides all health care professionals with the same type of preparation, allows possible blind spots to be discovered, and provides structure to the multidisciplinary meeting. Multidisciplinary meetings were found to contribute to sharing of information, knowledge, goals, and mutual respect. The evaluation of the patient's care needs by MDS/RAI registration, performed by health care professionals involved in the care, and discussion of the results leads to more efficient MTMs.

  1. Controlled outcome studies of child clinical hypnosis.

    Science.gov (United States)

    Adinolfi, Barbara; Gava, Nicoletta

    2013-09-01

    Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem.

  2. [Cardiac myxoma in the elderly. Clinical study].

    Science.gov (United States)

    Pentimone, F; Del Corso, L; Siuti, E; Verunelli, F; Bortolotti, U; Salvatore, L

    1997-01-01

    Cardiac mixoma in the elderly. A clinical study. The clinical features of 13 cardiac myxomas surgically resected are presented. The mean age at presentation was 68 years. Ten were in the left atrium, 5 near the fossa ovalis, 3 at the base of the atrial septum, 1 at the inferior wall and 1 on the anterior leaflet of mitral valve, 3 were in the right atrium, 1 of these was accompanied with a myxoma at the apex of left ventricle. The ECG and the chest X-ray were normal in 9 and in 8 patients, respectively. In 3 patients, the diagnosis was occasionally made by routine 2-dimensional echocardiography. 5 patients presented with fever of unknown origin, arthralgias, weakness, weight loss. None had intracardiac or extracardiac recurrence in the 73 months follow-up. The presentation with constitutional symptoms only like fever of UO, may mimic collagen and neoplastic diseases, vasculitis, lymphomas: the 2-dimensional echocardiography is mandatory to esclude a cardiac myxoma in the elderly.

  3. Evidence Based Studies in Clinical Transfusion Medicine

    NARCIS (Netherlands)

    A.J.G. Jansen (Gerard)

    2007-01-01

    textabstractAfter the introduction of blood component therapy in the 1960s, more and more attention is given to clinical transfusion medicine. Although blood transfusion is an important treatment in different clinical settings, there are still lack of much randomized clinical trials. Nowadays

  4. Hormones, Nicotine and Cocaine: Clinical Studies

    Science.gov (United States)

    Mello, Nancy K.

    2009-01-01

    Nicotine and cocaine each stimulate hypothalamic-pituitary-adrenal and -gonadal axis hormones, and there is increasing evidence that the hormonal milieu may modulate the abuse-related effects of these drugs. This review summarizes some clinical studies of the acute effects of cigarette smoking or IV cocaine on plasma drug and hormone levels, and subjective effects ratings. The temporal covariance between these dependent measures was assessed with a rapid (two min) sampling procedure in nicotine-dependent volunteers or current cocaine users. Cigarette smoking and IV cocaine each stimulated a rapid increase in LH and ACTH, followed by gradual increases in cortisol and DHEA. Positive subjective effects ratings increased immediately after initiation of cigarette smoking or IV cocaine administration. However, in contrast to cocaine’s sustained positive effects (hormones on nicotine dependence and cocaine abuse, and implications for treatment of these addictive disorders is discussed. PMID:19835877

  5. Nurse teacher models in clinical education from the perspective of student nurses--A mixed method study.

    Science.gov (United States)

    Gustafsson, Margareta; Kullén Engström, Agneta; Ohlsson, Ulla; Sundler, Annelie J; Bisholt, Birgitta

    2015-12-01

    The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses. The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design. The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study. A questionnaire including the CLES+T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception. Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor. In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Mesiodens: a clinical and radiographic study.

    Science.gov (United States)

    Kim, Su-Gwan; Lee, Sang-Ho

    2003-01-01

    The term 'mesiodens' refers to a supernumerary tooth present in the midline of the maxilla between the two central incisors. This study seeks to investigate the characteristics of mesiodens among children in Korea. The study population consisted of 40 children whose ages ranged from 4 to-26-years. The characteristics of mesiodens were obtained from radiographs and clinical examination results, and were confirmed by surgical intervention. Results showed that males were affected approximately 4 times as frequendy as females. Twenty-five percent of the patients had more than 1 supernumerary tooth. About 66% of the mesiodens were conical in shape and about 52% of the mesiodens were in the upward position. The age and sex distribution, number of mesiodens per patient, shape, direction, size, and effect on permanent maxillary incisors are also presented in this study. The incidence of mesiodens has been estimated at 0.15% to 1% of the population. It occurs more frequently in boys than in girls, with the ratio being approximately 2:1. In this study, a male:female ratio of 4:1 for the prevalence for mesiodens was found. Ten (25%) out of the 40 patients had 2 mesiodens.

  7. Experimental and clinical studies with intraoperative radiotherapy

    International Nuclear Information System (INIS)

    Sindelar, W.F.; Kinsella, T.; Tepper, J.; Travis, E.L.; Rosenberg, S.A.; Glatstein, E.

    1983-01-01

    Studies of normal tissue tolerance to intraoperative radiotherapy were done upon 65 dogs subjected to laparotomy and 11 million electron volt electron irradiation in doses ranging from zero to 5,000 rads. Results of studies indicated that intact aorta and vena cava tolerate up to 5,000 rads without loss of structural integrity. Ureteral fibrosis and stenosis develop at doses of 3,000 rads or more. Arterial anastomoses heal after doses of 4,500 rads, but fibrosis can lead to occlusion. Intestinal suture lines heal after doses of 4,500 rads. Bile duct fibrosis and stenosis develop at doses of 2,000 rads or more. Biliary-enteric anastomoses fail to heal at any dose level. A clinical trial of intraoperative radiotherapy combined with radical surgery was performed upon 20 patients with advanced malignant tumors which were considered unlikely to be cured by conventional therapies and which included carcinomas of the stomach, carcinomas of the pancreas, carcinomas involving the hilus of the liver, retroperitoneal sarcomas and osteosarcomas of the pelvis. All patients underwent resection of gross tumor, followed by intraoperative irradiation of the tumor bed and regional nodal basins. Some patients received additional postoperative external beam radiotherapy. Treatment mortality for combined operation and radiotherapy occurred in four of 20 patients. Postoperative complications occurred in four of the 16 surviving patients. Local tumor control was achieved in 11 of the 16 surviving patients, with an over-all median follow-up period of 18 months. The clinical trial suggested that intraoperative radiotherapy is a feasible adjunct to resection in locally advanced tumors, that the resulting mortality and morbidity is similar to that expected from operation alone and that local tumor control may be improved

  8. The Journey to Meet Emerging Community Benefit Requirements in a Rural Hospital: A Case Study

    Science.gov (United States)

    Sabin, Allison V; Levin, Pamela F

    2015-10-22

    The Affordable Care Act requires nonprofit hospitals to collaborate with public health agencies and community stakeholders to identify and address community health needs. As a rural organization, Wabash County (Indiana) Hospital pursued new approaches to achieve these revised requirements of the community benefit mandate. Using a case study approach, the authors provide a historical review of governmental relationships with nonprofit community hospitals, offer a case study application for implementing legislative mandates and community benefit requirements, share the insights they garnered on their journey to meet the mandates, and conclude that drawing upon the existing resources in the community and using current community assets in novel ways can help conserve time, and also financial, material, and human resources in meeting legislative mandates.

  9. Clinical application of cerebral dynamic perfusion studies

    International Nuclear Information System (INIS)

    DeLand, F.H.

    1975-01-01

    Radionuclide cerebral perfusion studies are assuming a far greater importance in the detection and differential diagnosis of cerebral lesions. Perfusion studies not only contribute to the differential diagnosis of lesions but in certain cases are the preferred methods by which more accurate clinical interpretations can be made. The characteristic blood flow of arterio-venous malformations readily differentiates this lesion from neoplasms. The decreased perfusion or absent perfusion observed in cerebral infarctions is diagnostic without concurrent evidence from static images. Changes in rates and direction of blood flow contribute fundamental information to the status of stenosis and vascular occlusion and, in addition, offer valuable information on the competency and routes of collateral circulation. The degree of cerebral perfusion after cerebral vascular accidents appears to be directly related to patient recovery, particularly muscular function. Cerebral perfusion adds a new parameter in the diagnosis of subdural haematomas and concussion and in the differentiation of obscuring radioactivity from superficial trauma. Although pictorial displays of perfusion blood flow will offer information in most cerebral vascular problems, the addition of computer analysis better defines temporal relationships of regional blood flow, quantitative changes in flow and the detection of the more subtle increases or decreases in cerebral blood flow. The status of radionuclide cerebral perfusion studies has taken on an importance making it the primary modality for the diagnosis of cerebral lesions. (author)

  10. Statistical Issues in TBI Clinical Studies

    Directory of Open Access Journals (Sweden)

    Paul eRapp

    2013-11-01

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

  11. A study on job satisfaction among clinical and non-clinical hospital ...

    African Journals Online (AJOL)

    Methods: Two hundred clinical and non-clinical hospital staff were invited to take part in the study. They completed a sociodemographic questionnaire and the Job Descriptive Index (JDI). Results: The results indicated that majority clinical and non-clinical staff were satisfied with their jobs as regards the parameters of the ...

  12. Developments in Clinical Practice: Follow up Clinic for BRCA Mutation Carriers: a Case Study Highlighting the "Virtual Clinic"

    OpenAIRE

    Ardern-Jones Audrey; Eeles Rosalind

    2004-01-01

    Abstract This paper highlights the need for carriers to be followed up by health professionals who understand the complexities of the BRCA syndrome. A BRCA carrier clinic has been established in London and regular follow up is an essential part of the care for families. An open door policy has been set up for patients who may meet or telephone the cancer genetic nurse specialist for support and care at any time. An example of the follow up work is discussed in the format of a case of a young ...

  13. CLINICAL STUDY OF EARLY BREAST CARCINOMA

    Directory of Open Access Journals (Sweden)

    Kiran Kumar

    2016-01-01

    Full Text Available Carcinoma of the breast is one of the commonest cancers occurring in female and accounts for 1/3rd of all the malignant diseases occurring in them. It is mainly a disease of the developed countries and accounts for 1,00,000 deaths annually. Breast carcinoma is classified as Early breast cancer, Locally advanced breast cancer and Metastatic breast cancer. By definition early stage breast cancer constitutes breast tumors of clinical stages I, IIa and T2N1M0. Early breast cancer is the one diagnosed by mammography. Women when approaches at this stage, they can go for breast conservation surgery. Not all women are candidates for this approach, and some require mastectomy as part of their treatment. AIM To observe the incidence of early breast carcinoma with particular reference to the time taken by the patients to seek medical advice after the symptoms have developed i.e. the average time taken by the patients to seek medical advice, their appropriate management and prognosis. MATERIALS AND METHODS This prospective study was conducted over a period of 2 years from Oct-2012 to Oct-2014 in 30 female patients aged between 25-65 years who were presented with lump in breast of size ≤5cms with or without pain, with or without lymph nodes to the outpatient department. All the patients were thoroughly asked about history, examined clinically, investigated, staged and managed by surgery either Breast Conservation Surgery or Modified Radical Mastectomy. Postoperative complications were recorded and followed up regularly. RESULTS The incidence of early breast cancer in this study was 0.98% with peak age incidence between 40-60 years and duration of symptoms <6 months in 18 patients. Breast Conservation Surgery + axillary dissection + Radiotherapy was done in 23%. Prognosis was good in these patients with no local recurrence and death. CONCLUSION The prognosis of early stage breast carcinoma patients in this study was good. To have long term tumor free and

  14. Periodontal conditions in vegetarians: a clinical study.

    Science.gov (United States)

    Staufenbiel, I; Weinspach, K; Förster, G; Geurtsen, W; Günay, H

    2013-08-01

    Investigations about possible correlations between vegetarian diet and periodontal conditions are rare and characterized by small case numbers. The aim of this clinical study was to investigate the influence of a vegetarian diet on periodontal parameters with an appropriate sample size. A total of 200 patients, 100 vegetarians and 100 non-vegetarians, were included in the study. All patients were examined including a full mouth assessment of the periodontal and dental conditions. In addition, a questionnaire was handed out to ask for patients' oral hygiene habits and level of education. For statistical analysis the Mann-Whitney Test (χ(2) for analysis of the questionnaire) was applied (level of significance: Pvegetarians versus 41.72 years non-vegetarians). Vegetarians had significantly lower probing pocket depths (P=0.039), bleeding on probing (P=0.001), periodontal screening index (P=0.012), a better hygiene index (Pvegetarians. Furthermore, vegetarians had a higher level of education (PVegetarians revealed better periodontal conditions (less inflammation signs, less periodontal damage and a better dental home care). However, it should be considered that vegetarians are not only avoiding meat in their nutrition but are also characterized by an overall healthier life style.

  15. A CLINICAL STUDY ON GASTRIC OUTLET OBSTRUCTION

    Directory of Open Access Journals (Sweden)

    Latchu

    2015-11-01

    Full Text Available INTRODUCTION Gastric outlet obstruction (GOO is obstruction in the first part of duodenum secondary to cicatrised duodenal ulcer or proximally where the diagnosis of carcinoma is most probable. GOO can be a diagnostic and treatment dilemma. Once a mechanical obstruction is confirmed, differentiate between benign and malignant processes. Cicatrized duodenal ulcer was the most common cause of GOO. But with increased awareness, change in the dietary habits and availability of H2 receptor blockers and Proton Pump Inhibitors and H pylori kits all have resulted in decreased incidence of patients requiring surgery and also the complications like pyloric stenosis have reduced. At the same time the incidence of antral carcinoma of stomach producing GOO has comparatively increased, which may be due to increased early diagnosis of the condition with the help of flexible fibro optic endoscope. AIMS & OBJECTIVES To study and identify the cause of cases of GOO with respect to benign peptic ulcer and malignancy of stomach. MATERIALS AND METHODS An observational study comparing of 30 cases of GOO. An elaborate study of the cases with regard to history, clinical features, routine and special investigation, pre operative treatment, operative findings, post operative management and complications in the post operative period is done. Apart from routine surgical profile special investigations like serum electrolytes, barium meal study, Upper GI Endoscopy and ultrasound abdomen and pelvis will be carried. For peptic ulcer disease truncal vagotomy with posterior gastrojejunostomy was done and for carcinoma partial gastrectomy with Billroth II reconstruction or anterior GJ or palliative resection with anterior GJ were done. INCLUSION CRITERIA 1. Peptic ulcer disease 2. Carcinoma pyloric antrum, 3. Benign neoplasm of stomach. EXCLUSION CRITERIA 1. Carcinoma stomach with liver metastasis, ascites, peritoneal implantation, 2. Gastro duodenal tuberculosis. ETHICAL ISSUES

  16. CLINICAL STUDY OF FISTULA IN ANO

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    Sushma Ramteke

    2017-02-01

    Full Text Available BACKGROUND Fistula in ano is one of the common problem faced in today’s world. Fistula in ano is track lined by granulation tissue that connect deeply in the anal canal or rectum and superficially on the skin around the anus. It usually results from cryptoglandular infection causing abscess, which burst spontaneously or was drained inadequately. The study is conducted to find most common aetiological factor and to evaluate various surgical technique and their outcome. The aim of the study is to- 1. Study the incidence of various aetiologies of fistula in ano. 2. Study the clinical presentation of fistula in ano. 3. Evaluate different modalities of surgical approach and their outcome. MATERIALS AND METHODS This prospective study was conducted at Late Lakhiram Agrawal Memorial Government Medical College, Raigarh, during the study period of July 2015 to July 2016. All the 50 cases were included in this study who were above 15 year of age diagnosed with fistula in ano on the basis of clinical examination who underwent surgical procedure. RESULTS In present study of 50 cases, 60% of cases were in the age group of 31-50 years. Male:female ratio was 9:1. 80% of cases belong to low socioeconomic status. The most common mode of presentation was discharging sinus in 96% of cases. 70% of patient had past history of burst abscess or surgical drainage of abscess. 90% of cases have single external opening. 80% of cases had posterior external opening. Most of the fistula are of low anal type, which was 92% and rest of the patient had an internal opening situated above the anorectal ring. The most common surgical approach done was fistulectomy. Only fistulectomy was done in 80% of patients. Fistulectomy with sphincterectomy was done in two patients. These two patients had associated anal fissure. Fistulectomy with seton placement was done in two patients of high level of fistula type. Fistulotomy was done in four patients (8%, these were of low fistula type

  17. A CLINICAL STUDY OF ACNE VULGARIS

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    Melathil Sadanandan Sadeep

    2017-11-01

    Full Text Available BACKGROUND Acne vulgaris is a highly prevalent chronic inflammatory disease of pilosebaceous unit affecting teenagers and young adults. Prognosis of acne is generally good, especially in mild acne. But, this disease reduces the self-esteem, their sense of identity and can severely compromise quality of life. All clinicians caring for children and adolescents should be familiar with this problem. Early diagnosis, proper treatment and timely counselling reduce the overall impact of disease to individuals. MATERIALS AND METHODS This is a prospective study conducted in the Department of Dermatology at Government Medical College, Kottayam, Kerala, in 200 patients who presented to the outpatient clinic with a clinical diagnosis of acne vulgaris who have not yet received any medical treatment for the disease and consented to participate in the study. RESULTS Male-to-female ratio of 1.43:1. 61.5% patients were in the 2nd decade. 4% were more than 30 years old. Duration of the disease at the time of presentation ranged from 3 weeks to 30 years. 42.5% complained of mild itching and 18.5% had burning sensation. 48.5% attribute exacerbation of disease after food intake. 72.5% acne patients had seborrhoea. Hirsutism and Acanthosis nigricans were present in 7.31% and 4.87% female patients, respectively. 50% with hirsutism and 25% with Acanthosis nigricans had polycystic ovarian disease and severe grades of acne. 25.6% females complained of premenstrual exacerbation of the disease. 26% of the patients showed exacerbation in summer. Smokers had severe grades of acne vulgaris compared to nonsmokers. Comedones were present in all and they were the predominant lesions in majority. Inflammatory papules were the 2nd most common lesions. Severe grades of acne were more common in patients with age ≥20 years. Severity of the disease increases with long duration of the disease. Relatively high incidence of post-acne scarring and post-inflammatory hyperpigmentation was

  18. Determinants of treatment plan implementation in multidisciplinary team meetings for patients with chronic diseases: a mixed-methods study.

    Science.gov (United States)

    Raine, Rosalind; Xanthopoulou, Penny; Wallace, Isla; Nic A' Bháird, Caoimhe; Lanceley, Anne; Clarke, Alex; Livingston, Gill; Prentice, Archie; Ardron, Dave; Harris, Miriam; King, Michael; Michie, Susan; Blazeby, Jane M; Austin-Parsons, Natalie; Gibbs, Simon; Barber, Julie

    2014-10-01

    Multidisciplinary team (MDT) meetings are assumed to produce better decisions and are extensively used to manage chronic disease in the National Health Service (NHS). However, evidence for their effectiveness is mixed. Our objective was to investigate determinants of MDT effectiveness by examining factors influencing the implementation of MDT treatment plans. This is a proxy measure of effectiveness, because it lies on the pathway to improvements in health, and reflects team decision making which has taken account of clinical and non-clinical information. Additionally, this measure can be compared across MDTs for different conditions. We undertook a prospective mixed-methods study of 12 MDTs in London and North Thames. Data were collected by observation of 370 MDT meetings, interviews with 53 MDT members, and from 2654 patient medical records. We examined the influence of patient-related factors (disease, age, sex, deprivation, whether their preferences and other clinical/health behaviours were mentioned) and MDT features (as measured using the 'Team Climate Inventory' and skill mix) on the implementation of MDT treatment plans. The adjusted odds (or likelihood) of implementation was reduced by 25% for each additional professional group represented at the MDT meeting. Implementation was more likely in MDTs with clear goals and processes and a good 'Team Climate' (adjusted OR 1.96; 95% CI 1.15 to 3.31 for a unit increase in Team Climate Inventory (TCI) score). Implementation varied by disease category, with the lowest adjusted odds of implementation in mental health teams. Implementation was also lower for patients living in more deprived areas (adjusted odds of implementation for patients in the most compared with least deprived areas was 0.60, 95% CI 0.39 to 0.91). Greater multidisciplinarity is not necessarily associated with more effective decision making. Explicit goals and procedures are also crucial. Decision implementation should be routinely monitored to

  19. ASCO 2007: “Translating Research into Practice”. Report from the 34th Annual Meeting of the American Society of Clinical Oncology

    Directory of Open Access Journals (Sweden)

    Camillo Porta

    2011-12-01

    Full Text Available This year, for the 34th time in its history, the mastodontic machinery of the American Society of Clinical Oncology (ASCO once again welcomed thousand of members and participants from all over the world to the Society’s annual meeting, which, this year, took place in the ample and well-appointed, McCormick’s Convention Center in Chicago, Illinois...

  20. 1st IAEA research co-ordination meeting on charge exchange cross section data for fusion plasma studies. Summary report

    International Nuclear Information System (INIS)

    Janev, R.K.

    1999-02-01

    A brief description of the proceedings and the conclusions of the 1st Research Coordination Meeting on 'Charge Exchange Cross Section Data for Fusion Plasma Studies', held on September 24-25, 1999, at the IAEA Headquarters in Vienna, Austria, is provided. The conclusions of the Meeting regarding the data collection, assessment and generation priorities are also included in the report. (author)

  1. Clinical case review: a method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia.

    Science.gov (United States)

    Puumalainen, Taneli; Quiambao, Beatriz; Abucejo-Ladesma, Erma; Lupisan, Socorro; Heiskanen-Kosma, Tarja; Ruutu, Petri; Lucero, Marilla G; Nohynek, Hanna; Simoes, Eric A F; Riley, Ian

    2008-07-21

    The World Health Organization's (WHO) case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. A group of paediatricians conducted a retrospective review of clinical and laboratory data including C-reactive protein concentration and chest radiograph findings among Filipino children hospitalised in the Bohol Regional Hospital who were enrolled in a pneumococcal vaccine efficacy study and had an episode of respiratory disease fulfilling the WHO case definition for clinical pneumonia. Our aim was to evaluate which disease entities the WHO definition actually captures and what is the probable aetiology of respiratory infections among these episodes diagnosed in this population. Among the 12,194 children enrolled to the vaccine study we recorded 1,195 disease episodes leading to hospitalisation which fulfilled the WHO criteria for pneumonia. In total, 34% of these episodes showed radiographic evidence of pneumonia and 11% were classified as definitive or probable bacterial pneumonia. Over 95% of episodes of WHO-defined severe pneumonia (with chest indrawing) had an acute lower respiratory infection as final diagnosis whereas 34% of those with non-severe clinical pneumonia had gastroenteritis or other non-respiratory infection as main cause of hospitalisation. The WHO definition for severe pneumonia shows high specificity for acute lower respiratory infection and provides a tool to compare the total burden of lower respiratory infections in different settings. ISRCTN62323832.

  2. Clinical case review: A method to improve identification of true clinical and radiographic pneumonia in children meeting the World Health Organization definition for pneumonia

    Directory of Open Access Journals (Sweden)

    Ruutu Petri

    2008-07-01

    Full Text Available Abstract Background The World Health Organization's (WHO case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies. Methods A group of paediatricians conducted a retrospective review of clinical and laboratory data including C-reactive protein concentration and chest radiograph findings among Filipino children hospitalised in the Bohol Regional Hospital who were enrolled in a pneumococcal vaccine efficacy study and had an episode of respiratory disease fulfilling the WHO case definition for clinical pneumonia. Our aim was to evaluate which disease entities the WHO definition actually captures and what is the probable aetiology of respiratory infections among these episodes diagnosed in this population. Results Among the 12,194 children enrolled to the vaccine study we recorded 1,195 disease episodes leading to hospitalisation which fulfilled the WHO criteria for pneumonia. In total, 34% of these episodes showed radiographic evidence of pneumonia and 11% were classified as definitive or probable bacterial pneumonia. Over 95% of episodes of WHO-defined severe pneumonia (with chest indrawing had an acute lower respiratory infection as final diagnosis whereas 34% of those with non-severe clinical pneumonia had gastroenteritis or other non-respiratory infection as main cause of hospitalisation. Conclusion The WHO definition for severe pneumonia shows high specificity for acute lower respiratory infection and provides a tool to compare the total burden of lower respiratory infections in different settings. Trial registration ISRCTN62323832

  3. Primary pontine hemorrhage. A clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Jun; Kagimoto, Hiroshi; Maeda, Masanobu; Soda, Takao [Shimane Prefectural Central Hospital, Izumo (Japan)

    2002-07-01

    We studied the relationship between outcome and clinical symptoms or CT findings of 34 cases with primary pontine hemorrhage diagnosed by CT scan from April 1994 to March 1999. This series comprised 19 males and 15 females ranging in age from 45 to 89 years with a mean of 67.1 years. According to their outcome at discharge, the cases were divided into 6 groups. Sixteen cases died within 2 weeks after onset (group AD), 4 cases died with complication in the chronic phase (group D), 3 cases were severely disabled to bed-ridden state (group C), 2 cases recovered to a daily life with wheelchair (group B), 4 cases recovered to a daily life with partial assistance (group A), and 5 cases showed a full recovery (group J). The factors significantly correlated with bed outcome are as follows: young age, consciousness disturbance, respiratory disturbance, tachycardia over 90 beats per minute, hyperthermia over 39 deg C, abnormal pupils, loss of oculocephalic reflex, tetraplegia, decerebrate rigidity, bilateral extension or over 30 mm transverse diameter of the hematoma. (author)

  4. Clinical study of internal carotid artery occlusion

    International Nuclear Information System (INIS)

    Okada, Kyoko

    1989-01-01

    Fourteen patients with internal carotid artery (ICA) occlusion identified by cerebral angiography were studied for clinical features, computed tomographic findings, collateral circulation and risk factors. Eleven patients were males, and at age distribution it occurred more frequently in patients over 50 years to 60 years of age rather than other ages. As for the risk factors of cerebral infarction, smoking was more frequent in patients with thrombosis, and heart disease was more common in those with embolism. Stroke occurred progressively in patients with thrombosis whereas it occurred suddenly in those with embolism. The consciousness was more severely disturbed in patients with embolism than in those with thrombosis. On neuro-radiological findings, in the patients with thrombosis, the infarcted area on CT were small and emerged as deep or watershed types, and on the angiograms, occlusion at carotid bifurcation were found more frequently and the collateral circulation were well developed. In those with embolism, the infarcted areas were large and emerged as cortical types, and on the angiograms, occlusions were observed more frequently in the intracranial portion and collateral circulation were poorly developed. In many patients with thrombosis, platelet aggregation, hematocrit and blood viscosity increased, but in those with embolism did not. (author)

  5. Report of the Second Asian Prostate Cancer (A-CaP Study Meeting

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    Choung-Soo Kim

    2017-09-01

    Full Text Available The Asian Prostate Cancer (A-CaP Study is an Asia-wide initiative that has been developed over the course of 2 years. The study was launched in December 2015 in Tokyo, Japan, and the participating countries and regions engaged in preparations for the study during the course of 2016, including patient registration and creation of databases for the purpose of the study. The Second A-CaP Meeting was held on September 8, 2016 in Seoul, Korea, with the participation of members and collaborators from 12 countries and regions. Under the study, each participating country or region will begin registration of newly diagnosed prostate cancer patients and conduct prognostic investigations. From the data gathered, common research themes will be identified, such as comparisons among Asian countries of background factors in newly diagnosed prostate cancer patients. This is the first Asia-wide study of prostate cancer and has developed from single country research efforts in this field, including in Japan and Korea. At the Second Meeting, participating countries and regions discussed the status of preparations and discussed various issues that are being faced. These issues include technical challenges in creating databases, promoting participation in each country or region, clarifying issues relating to data input, addressing institutional issues such as institutional review board requirements, and the need for dedicated data managers. The meeting was positioned as an opportunity to share information and address outstanding issues prior to the initiation of the study. In addition to A-CaP-specific discussions, a series of special lectures was also delivered as a means of providing international perspectives on the latest developments in prostate cancer and the use of databases and registration studies around the world.

  6. Clinical Study of Uric Acid Urolithiasis

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    Yii-Her Chou

    2007-06-01

    Full Text Available Uric acid urolithiasis develops from various causes. To investigate the clinical and biochemical presentation of patients with uric acid urolithiasis, a retrospective study was designed. A total of 46 cases were enrolled between January 2004 and December 2005. The compositions of the stones were analyzed by infrared spectrophotometry. There were 39 males (84.8% and seven females (15.2%, with a mean age of 61.5 ± 10.6 years and mean body mass index (BMI of 26.7 ± 3.1 kg/m2. The stone location was kidney in 10 (21.7%, ureter in 22 (41.8%, and bladder in 14 (30.5%. Multiple stones were diagnosed in 36 patients (78.3%. Pre-existing comorbidities included diabetes mellitus in 11 patients (23.9%, hypertension in 23 (50%, gout in 13 (28.2%, and benign prostatic hyperplasia in 14 (30.4%. Mean serum creatinine and uric acid was 1.6 ± 0.6 mg/dL and 7.6 ± 1.8 mg/dL, respectively. There were 27 patients (58% with creatinine > 1.4 mg/dL. The mean urinary pH was 5.42 ± 0.46. Patients with uric acid urolithiasis were predominantly male, older, with higher BMI, multiple stone presentation, with lower urinary pH, and hyperuricemia. Exacerbation of the renal function should also be of concern because of the high proportion of patients with renal insufficiency diagnosed in this study.

  7. A longitudinal study of empathy in pre-clinical and clinical medical students and clinical supervisors.

    Science.gov (United States)

    Mahoney, Sarah; Sladek, Ruth M; Neild, Tim

    2016-10-18

    Although appropriate empathy in health professionals is essential, a loss of empathy can occur during medical education. The structure of clinical learning may be one factor that is implicated in a loss of empathy. This study examines student and doctor empathy, and possible associations between empathy and the structure of clinical learning. There were three groups of participants: medical students (n = 281), who completed a longitudinal survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the beginning and end of the 2013 academic year; private doctors (medical practitioners) in South Australia (n = 78) who completed a survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the end of the students' academic year; and doctors (medical practitioners) from public teaching hospitals (n = 72) in southern Adelaide, South Australia who completed a survey consisting of the Jefferson Scale of Empathy at the end of the students' academic year . Year one students' empathy scores at the end of the year (102.8 ± 17.7) were significantly lower than at the start of the year (112.3 ± 9.6) p empathy scores by year groups or across the two time points. Empathy scores were almost identical for private and hospital clinicians and higher than average scores for students. Free-text comments highlighted the importance students and doctors place on empathy. Students described issues that adversely affected their empathy, including specific incidents, systemic issues, and course structure, but also described some positive role models. Doctors' comments focused on the importance of empathy but qualified its meaning in the therapeutic setting. Medical students and practitioners alike ascribe importance to empathy in clinical practice, yet its developmental course remains poorly understood with possible decrement across the course of medical education. A more sophisticated understanding of empathy

  8. Comparing the Effectiveness of a Clinical Registry and a Clinical Data Warehouse for Supporting Clinical Trial Recruitment: A Case Study

    Science.gov (United States)

    Weng, Chunhua; Bigger, J Thomas; Busacca, Linda; Wilcox, Adam; Getaneh, Asqual

    2010-01-01

    This paper reports a case study comparing the relative efficiency of using a Diabetes Registry or a Clinical Data Warehouse to recruit participants for a diabetes clinical trial, TECOS. The Clinical Data Warehouse generated higher positive predictive accuracy (31% vs. 6.6%) and higher participant recruitment than the Registry (30 vs. 14 participants) in a shorter time period (59 vs. 74 working days). We identify important factors that increase clinical trial recruitment efficiency and lower cost. PMID:21347102

  9. Level of clinical evidence presented at the Society for Vascular Surgery Annual Meeting during a 5-year period (2012-2016).

    Science.gov (United States)

    Naji, Faysal; Javidan, Arshia Pedram; Khan, Shawn; Srivatsav, Varun; Rapanos, Theodore; Harlock, John

    2018-03-01

    During the past decades, there has been an increasing emphasis on the use of high-quality evidence to inform clinical decision-making. The purpose of our study was to assess trends in the level of evidence (LOE) of abstracts presented at the Vascular Annual Meeting from 2012 to 2016. All Vascular Annual Meeting abstracts for 2012 to 2016 were obtained through the Journal of Vascular Surgery. Two reviewers independently screened abstracts for eligibility. Research with a nonclinical focus was excluded from the study. Data extracted from eligible abstracts included study type (therapeutic, prognostic, diagnostic), study size, country of academic institution of primary author, presentation type, and whether the sample was recruited or from a database. Abstracts were assigned an LOE using the 2011 Oxford Centre for Evidence-Based Medicine classification scheme based on study design (eg, case series, randomized controlled trial). A χ 2 test and analysis of variance test were conducted to assess nonrandom changes in LOE during the study period. Of the 1403 abstracts screened, 1147 were included. Inter-rater agreement was high (κ value for abstract screening was 0.93; κ value for data extraction was 0.89). Therapeutic studies were the most common study type (58%), followed by prognostic studies (37%), then diagnostic studies (5%). The majority of abstracts (75.0%) were submitted from North American institutions. Overall, 0.35% of the presentations were level I evidence, 3.1% level II, 52.8% level III, 38.0% level IV, and 5.7% level V. The average LOE per year fluctuated between 3.54 and 3.32, with a mean LOE of 3.45. The proportion of high-quality evidence (level I and level II) increased in the years 2015 and 2016, representing 78% of all level I and level II abstracts presented in the 5-year period. A χ 2 test between LOE and year yielded a P value of .0084, indicating significant nonrandom change in LOE between 2012 and 2016. The majority of high LOE research was

  10. Full text publication rates of studies presented at an international emergency medicine scientific meeting.

    Science.gov (United States)

    Chan, Jannet W M; Graham, Colin A

    2011-09-01

    The publication rate of full text papers following an abstract presentation at a medical conference is variable, and few studies have examined the situation with respect to international emergency medicine conferences. This retrospective study aimed to identify the publication rate of abstracts presented at the 2006 International Conference on Emergency Medicine (ICEM) held in Halifax, Canada. The full text publication rate was 33.2%, similar to previous emergency medicine meetings. English language barriers may play a role in the low publication rate seen.

  11. A CLINICAL STUDY OF STROKE IN YOUNG

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    Kumbha Thulasi Ram

    2015-02-01

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

  12. Corneal stromal dystrophies: a clinical pathologic study

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    Elvira Barbosa Abreu

    2012-12-01

    Full Text Available INTRODUCTION: Corneal dystrophy is defined as bilateral and symmetric primary corneal disease, without previous associated ocular inflammation. Corneal dystrophies are classified according to the involved corneal layer in superficial, stromal, and posterior dystrophy. Incidence of each dystrophy varies according to the geographic region studied. PURPOSE: To evaluate the prevalence of stromal corneal dystrophies among corneal buttons specimens obtained by penetrating keratoplasty (PK in an ocular pathology laboratory and to correlate the diagnosis with patient age and gender. METHODS: Corneal button cases of penetrating keratoplasty from January-1996 to May-2009 were retrieved from the archives of The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry, Montreal, Canada. The cases with histopathological diagnosis of stromal corneal dystrophies were stained with special stains (Peroxid acid Schiff, Masson trichrome, Congo red analyzed under polarized light, and alcian blue for classification and correlated with epidemiological information (age at time of PK and gender from patients' file. RESULTS: 1,300 corneal buttons cases with clinical diagnose of corneal dystrophy were retrieved. Stromal corneal dystrophy was found in 40 (3.1% cases. Lattice corneal dystrophy was the most prevalent with 26 cases (65%. Nineteen were female (73.07% and the PK was performed at average age of 59.3 years old. Combined corneal dystrophy was found in 8 (20% cases, 5 (62.5% of them were female and the average age of the penetrating keratoplasty was 54.8 years old. Granular corneal dystrophy was represented by 5 (12.5% cases, and 2 (40% of them were female. Penetrating keratoplasty was performed at average age of 39.5 years old in granular corneal dystrophy cases. Macular corneal dystrophy was present in only 1 (2.5% case, in a 36 years old female. CONCLUSION: Systematic histopathological approach and evaluation, including special stains in all stromal

  13. Clinical feasibility studies with newly devised instruments

    International Nuclear Information System (INIS)

    Cooper, M.

    1980-01-01

    This report summarizes work done in the production of C-11-labelled amino acids. The goals of this work are to minimize synthesis and purification times, to maximize reproducibility and to increase the radiochemical yield so that these tracers can be used clinically

  14. Epidemiological Studies on Proteeae Isolates from Clinical ...

    African Journals Online (AJOL)

    Specimens were collected from patients and screened for Proteeae using standard microbiological and biochemical methods (API 20 Enterobacteriaceae gallery). Of the 3414 clinical specimens made of 2712 urine, 264 blood, 243 CSF and 195 wounds and burns, 1136 (33.3%) yielded a positive bacterial growth, of which ...

  15. 77 FR 48491 - Regulatory New Drug Review: Solutions for Study Data Exchange Standards; Notice of Meeting...

    Science.gov (United States)

    2012-08-14

    ... many years, it is not an extensible modern technology. Moreover, it is not supported and maintained by..., structured documents and Clinical Data Architecture) be a viable study data exchange standard? Please explain...

  16. [Clinical study on vaginal birth after cesarean].

    Science.gov (United States)

    He, L; Chen, M; He, G L; Liu, X X

    2016-08-25

    To investigate the incidence and pregnant outcome on vaginal birth after cesarean (VBAC). From January 2005 to December 2015, clinical data of 507 cases with VBAC in West China Second Hospital were studied retrospectively. There were 370 cases of VBAC from January 2013 to December 2015 as study group (VBAC group), in contrast, 740 cases of elective repeat cesarean section (ERCS group) and 740 primiparas of vaginal delivery without history of cesarean section as control groups, the pregnancy outcome were analyzed between the study group and control groups respectively. (1) There were 76 547 total births from January 2005 to December 2015. Among these, 10 178 (13.296%, 10 178/76 547) patients had a single prior low transverse cesarean section, of which 4.981% (507/10 178) had VBAC. The incidence of VBAC was rising from 1.020%-3.704% during 2005-2012 to 6.028%-7.662% during 2013-2015. The rate of scared uterus during 2013-2015 was 18.269% (5 539/30 319), of which 9.26% (513/5 539) chose trial of labor after cesarean section (TOLAC). Successful VBAC occurred in 72.12% (370/513) of patients with TOLAC, and 27.88% (143/513) delivered by emergency cesarean. (2) The following parameters of the successful group and the unsuccessful VBAC group were compared, maternal age (29±4) versus (34±4) years, body mass index at prenatal visit (22.2±1.4) versus (22.6±1.4) kg/m(2), gestational age (38.7±0.9) versus (39.6±1.3) weeks, birth weight (3 326±317) versus (3 404±285) g, and the rate of induction of labor 0 (0/370) and 6.29% (9/143), there were significant differences (all Pdelivery without history of cesarean section was compared, (10.3±1.8) versus (11.5±2.0) hours, there was significant difference (P0.05). (4) The postpartum hemorrhage and hospitalization duration in VBAC group incidence were respectively (194±34) ml and (2.32±0.49) days, and the indexes of the ERCS group were respectively (419±57) ml and (4.14±0.78) days, there were significant differences (all P

  17. Meeting the Demand for Accountability: Case Study of a Teacher Education Program in China

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    Tak Cheung CHAN

    2009-02-01

    Full Text Available To meet the demand for accountability, a teacher education program in a university located in South China has established processes at the college, the program, and the faculty levels to assure its program quality. Highlights of the processes are: involvement of stakeholders and the examination of program effectiveness. Although much has been done to help program candidates succeed, more effort is needed in the areas of program assessment and continuous improvement to assure program quality. An accountability implementation plan, a beginning teacher mentoring program, and a comparative study of beginning teacher performance were recommended to further enforce its strategies toward program accountability.

  18. Using Clinical Gait Case Studies to Enhance Learning in Biomechanics

    Science.gov (United States)

    Chester, Victoria

    2011-01-01

    Clinical case studies facilitate the development of clinical reasoning strategies through knowledge and integration of the basic sciences. Case studies have been shown to be more effective in developing problem-solving abilities than the traditional lecture format. To enhance the learning experiences of students in biomechanics, clinical case…

  19. Norwegian GPs' participation in multidisciplinary meetings: A register-based study from 2007

    Directory of Open Access Journals (Sweden)

    Gjesdal Sturla

    2010-11-01

    Full Text Available Abstract Background An increasing number of patients with chronic disorders and a more complex health service demand greater interdisciplinary collaboration in Primary Health Care. The aim of this study was therefore to identify factors related to general practitioners (GPs, their list populations and practice municipalities associated with a high rate of GP participation in multidisciplinary meetings (MDMs. Methods A national cross-sectional register-based study of Norwegian general practice was conducted, including data on all GPs in the Regular GP Scheme in 2007 (N = 3179. GPs were grouped into quartiles based on the annual number of MDMs per patient on their list, and the groups were compared using one-way analysis of variance. Binary logistic regression was used to analyse associations between high rates of participation and characteristics of the GP, their list population and practice municipality. Results On average, GPs attended 30 MDMs per year. The majority of the meetings concerned patients in the age groups 20-59 years. Psychological disorders were the motivation for 53% of the meetings. In a multivariate logistic regression model, the following characteristics predicted a high rate of MDM attendance: younger age of the GP, with an OR of 1.6 (95% CI 1.2-2.1 for GPs Conclusions Psychological problems including substance addiction gave grounds for the majority of MDMs. GPs with a high proportion of consultations with such problems also participated more frequently in MDMs. List size was negatively associated with the rate of MDMs, while a more disadvantaged list population was positively associated. Working in smaller organisational units seemed to facilitate cooperation between different professionals. There may be a generation shift towards more frequent participation in interdisciplinary work among younger GPs.

  20. Abnormal neuronal migration: radiologic-clinic study

    International Nuclear Information System (INIS)

    Martinez Fernandez, M.; Menor Serrano, F.; Bordon Ferre, F.; Garcia Tena, J.; Esteban Hernandez, E.; Sanguesa Nebot, C.; Marti Bonnati, L.

    1994-01-01

    We present our experience in 18 pediatric patients with abnormal neuronal migration. Seven cases of heterotopia of the gray matter, 7 agyria-pachygyria complexes, 1 case of polymicrogyria, 2 cases of schizencephaly and 1 case of hemimegalencephaly were diagnosed by means of ultrasonography, computed tomography and magnetic resonance. The clinical picture was reviewed in each case, with special attention to the occurrence of convulsions, psycho motor development and visual changes. In general, the greater the morphological change, the greater the neurological involvement in these patients. However, the two cases of schizencephaly presented mild clinical expression. Magnetic resonance increases the diagnostic yield in neuronal migration disorders. Nevertheless, either ultrasonography or, especially, computed tomography is useful as a first diagnostic approach in these malformative disorders. (Author)

  1. Occupational Therapists\\' Clinical Reasoning: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Narges Shafaroodi

    2017-09-01

    Discussion: Findings showed that achieving an observable change in the client was the main consequence of the action/interaction strategies. Some facilitating factors related to the therapist, helped to process reasoning with a holistic and client-centered view, while also helping to develop the self-belief and professional identity. The dominance of medical views and a lack of health insurance were two intervening factors that constrained the dynamics of clinical reasoning within the context of practice.

  2. Celiac Patients: A Randomized, Controlled Clinical Study

    Directory of Open Access Journals (Sweden)

    Giuseppe Mazzarella

    2012-01-01

    Full Text Available A lifelong gluten-free diet (GFD is mandatory for celiac disease (CD but has poor compliance, justifying novel strategies. We found that wheat flour transamidation inhibited IFN-γ secretion by intestinal T cells from CD patients. Herein, the primary endpoint was to evaluate the ability of transamidated gluten to maintain GFD CD patients in clinical remission. Secondary endpoints were efficacy in prevention of the inflammatory response and safety at the kidney level, where reaction products are metabolized. In a randomized single blinded, controlled 90-day trial, 47 GFD CD patients received 3.7 g/day of gluten from nontransamidated (12 or transamidated (35 flour. On day 15, 75% and 37% of patients in the control and experimental groups, respectively, showed clinical relapse (=0.04 whereas intestinal permeability was mainly altered in the control group (50% versus 20%, =0.06. On day 90, 0 controls and 14 patients in the experimental group completed the challenge with no variation of antitransglutaminase IgA (=0.63, Marsh-Oberhuber grading (=0.08, or intestinal IFN-γ mRNA (>0.05. Creatinine clearance did not vary after 90 days of treatment (=0.46. In conclusion, transamidated gluten reduced the number of clinical relapses in challenged patients with no changes of baseline values for serological/mucosal CD markers and an unaltered kidney function.

  3. 75 FR 30041 - Medicare Program; Public Meeting in Calendar Year 2010 for New Clinical Laboratory Tests Payment...

    Science.gov (United States)

    2010-05-28

    ... clinical diagnostic laboratory tests under Part B of title XVIII of the Social Security Act (the Act) that... tests are any clinical diagnostic laboratory tests with respect to which a new or substantially revised... Year 2010 for New Clinical Laboratory Tests Payment Determinations AGENCY: Centers for Medicare...

  4. 76 FR 10600 - Medicare Program; Public Meeting in Calendar Year 2011 for New Clinical Laboratory Tests Payment...

    Science.gov (United States)

    2011-02-25

    ... payment determinations for new clinical diagnostic laboratory tests under Part B of title XVIII of the... amount of, payment for any clinical diagnostic laboratory tests with respect to which a new or... Year 2011 for New Clinical Laboratory Tests Payment Determinations AGENCY: Centers for Medicare...

  5. Scientific meetings

    International Nuclear Information System (INIS)

    1973-01-01

    One of the main aims of the IAEA is to foster the exchange of scientific and technical information and one of the main ways of doing this is to convene international scientific meetings. They range from large international conferences bringing together several hundred scientists, smaller symposia attended by an average of 150 to 250 participants and seminars designed to instruct rather than inform, to smaller panels and study groups of 10 to 30 experts brought together to advise on a particular programme or to develop a set of regulations. The topics of these meetings cover every part of the Agency's activities and form a backbone of many of its programmes. (author)

  6. Can Hawaii Meet Its Renewable Fuel Target? Case Study of Banagrass-Based Cellulosic Ethanol

    Directory of Open Access Journals (Sweden)

    Chinh Tran

    2016-08-01

    Full Text Available Banagrass is a biomass crop candidate for ethanol production in the State of Hawaii. This study examines: (i whether enough banagrass can be produced to meet Hawaii’s renewable fuel target of 20% highway fuel demand produced with renewable sources by 2020 and (ii at what cost. This study proposes to locate suitable land areas for banagrass production and ethanol processing, focusing on the two largest islands in the state of Hawaii—Hawaii and Maui. The results suggest that the 20% target is not achievable by using all suitable land resources for banagrass production on both Hawaii and Maui. A total of about 74,224,160 gallons, accounting for 16.04% of the state’s highway fuel demand, can be potentially produced at a cost of $6.28/gallon. Lower ethanol cost is found when using a smaller production scale. The lowest cost of $3.31/gallon is found at a production processing capacity of about 9 million gallons per year (MGY, which meets about 2% of state demand. This cost is still higher than the average imported ethanol price of $3/gallon. Sensitivity analysis finds that it is possible to produce banagrass-based ethanol on Hawaii Island at a cost below the average imported ethanol price if banagrass yield increases of at least 35.56%.

  7. Meeting Report- EASD Postgraduate Course on Clinical Diabetes and Its Complications, 29 – 31 October 2015, Prague, Czech Republic

    Directory of Open Access Journals (Sweden)

    Stoica Roxana Adriana

    2016-03-01

    Full Text Available Since 2005 the European Association for the Study of Diabetes (EASD invests in the education of diabetologists and facilitates the implementation of patient care by organizing postgraduate courses in different countries. I attended at one of these courses that was held in Prague between 29 and 31 October 2015. The course consisted of six sessions of state of the art lectures entitled: type 1 diabetes update, diabetes and cardiovascular diseases, special situations, therapy, complications and the last one, diabetes treatment- what is on the horizon?. These sessions alternated with interactive workshops held in parallel sessions. I consider that this experience helped me improve my practice skills. I had the opportunity to interact with doctors from other European countries and exchange our experience in the field of diabetes. I hope Romania will organize again such constructive EASD postgraduate courses on clinical diabetes.

  8. Proceedings of the Twentieth NASA Propagation Experimenters Meeting (NAPEX 20) and the Advanced Communications Technology Satellite (ACTS) Propagation Studies Miniworkshop

    Science.gov (United States)

    Golshan, Nasser (Editor)

    1996-01-01

    The NASA Propagation Experimenters (NAPEX) Meeting is convened each year to discuss studies supported by the NASA Propagation Program. Representatives from the satellite communications (satcom) industry, academia, and government who have an interest in space-ground radio wave propagation are invited to NAPEX meetings for discussions and exchange of information. The reports delivered at these meetings by program managers and investigators present recent activities and future plans. This forum provides an opportunity for peer discussion of work in progress, timely dissemination of propagation results, and close interaction with the satcom industry.

  9. A clinical study of Noonan syndrome.

    Science.gov (United States)

    Sharland, M; Burch, M; McKenna, W M; Paton, M A

    1992-01-01

    Clinical details are presented on 151 individuals with Noonan syndrome (83 males and 68 females, mean age 12.6 years). Polyhydramnios complicated 33% of affected pregnancies. The commonest cardiac lesions were pulmonary stenosis (62%), and hypertrophic cardiomyopathy (20%), with a normal echocardiogram present in only 12.5% of all cases. Significant feeding difficulties during infancy were present in 76% of the group. Although the children were short (50% with a height less than 3rd centile), and underweight (43% with a weight less than 3rd centile), the mean head circumference of the group was on the 50th centile. Motor milestone delay was usual, the cohort having a mean age of sitting unsupported of 10 months and walking of 21 months. Abnormal vision (94%) and hearing (40%) were frequent findings, but 89% of the group were attending normal primary or secondary schools. Other associations included undescended testicles (77%), hepatosplenomegaly (50%), and evidence of abnormal bleeding (56%). The mean age at diagnosis of Noonan syndrome in this group was 9.0 years. Earlier diagnosis of this common condition would aid both clinical management and genetic counselling. Images Figure 1 Figure 2 Figure 3 PMID:1543375

  10. New graduate nurses' clinical competence, clinical stress, and intention to leave: a longitudinal study in Taiwan.

    Science.gov (United States)

    Cheng, Ching-Yu; Tsai, Hsiu-Min; Chang, Chia-Hao; Liou, Shwu-Ru

    2014-01-01

    This longitudinal research study aimed to develop a pregraduation clinical training program for nursing students before graduation and evaluate its effect on students' self-perceived clinical competence, clinical stress, and intention to leave current job. A sample of 198 students returned the questionnaires before and after the program. They were followed up at 3, 6, and 12 months after graduation. Results showed that posttest clinical competence was significantly higher than pretest competence, positively related to clinical competence at 3 and 12 months, and negatively related to clinical stress at 3 months. The clinical competence at 3 months was positively related to clinical competence at 6 and 12 months, and clinical competence at 6 months was related to intention to leave at 12 months. Intention to leave at 6 months was positively related to intention to leave at 3 and 12 months. Clinical stress at 3 months was positively related to clinical stress at 6 and 12 months, but not related to intention to leave at any time points. The training program improved students' clinical competence. The stressful time that was correlated with new graduate nurses' intention to leave their job was between the sixth and twelfth months after employment.

  11. The pediatric heart network: meeting the challenges to multicenter studies in pediatric heart disease.

    Science.gov (United States)

    Burns, Kristin M; Pemberton, Victoria L; Pearson, Gail D

    2015-10-01

    Because of the relatively small numbers of pediatric patients with congenital heart disease cared for in any individual center, there is a significant need for multicenter clinical studies to validate new medical or surgical therapies. The Pediatric Heart Network (PHN), with 15 years of experience in multicenter clinical research, has tackled numerous challenges when conducting multicenter studies. This review describes the challenges encountered and the strategies employed to conduct high-quality, collaborative research in pediatric cardiovascular disease. Sharing lessons learned from the PHN can provide guidance to investigators interested in conducting pediatric multicenter studies.

  12. [Carcinomatous lymphangitis. Clinical study of 10 cases].

    Science.gov (United States)

    Martínez Avilés, P; Perpiñá, M; Solís Villa, J; Valiente Velasco, B

    1994-08-01

    We analyze the clinical characteristics, the diagnostic criteria and the radiological aspects of 10 cases of Carcinomatous Lymphangitis. The quickly progressing exercise dyspnea and the constitutional syndrome were the most frequent symptoms. In nine patients, the tumor was previously unknown. The image methods (adbominal CAT and Echography) and the fibrobronchoscopic exam allowed a correct diagnosis. The most frequent neoplasia had a pulmonary origin and the most frequent histology was adenocarcinoma. The histological tests (bronchial and transbronchial biopsies) were more effective for the diagnosis than the cytological test (bronchoalveolar lavage, bronchoaspiration and bronchial brushing), although these were complemented. The radiology showed a reticulo-linear pattern in all the cases. The finding of macroscopic disorders in the fibrobronchoscopy, the presence of a local infiltration or a node/mass image in the thoracic radiography were highly suggestive of primary pulmonary neoplasia.

  13. Clinical methods of goniometry: a comparative study.

    Science.gov (United States)

    Goodwin, J; Clark, C; Deakes, J; Burdon, D; Lawrence, C

    1992-01-01

    This investigation compared the reliability and interchangeable use of three currently available goniometers--a universal goniometer, a fluid goniometer, and an electrogoniometer. Three consecutive readings of the active range of movement of the right elbow joint were taken from each of 23 healthy female volunteers; three experienced observers each used each type of goniometer on two occasions. A balanced experimental design was used to eliminate order effects with respect to subject, tester, or goniometer, and a rigid protocol was employed to reduce error due to diurnal or methodological variations. The results show that there are significant differences between the goniometers used, the testers, and the replications. Significant interaction effects also exist between the goniometers and the occasion, the goniometers and the testers, and the testers and replications. The data suggest that the interchangeable use of different types of goniometer in a clinical setting is inadvisable.

  14. Learning challenges of nursing students in clinical environments: A qualitative study in Iran.

    Science.gov (United States)

    Baraz, Shahram; Memarian, Robabeh; Vanaki, Zohreh

    2015-01-01

    Clinical learning environment is a complex social entity. This environment is effective on the learning process of nursing students in the clinical area. However, learning in clinical environment has several benefits, but it can be challenging, unpredictable, stressful, and constantly changing. In attention to clinical experiences and factors contributing to the learning of these experiences can waste a great deal of time and energy, impose heavy financial burden on educational systems, cause mental, familial and educational problems for students, and compromise the quality of patient care. Therefore, this study was carried out with the goal of determining the learning challenges of nursing students in clinical environments in Iran. In this qualitative study carried out in 2012-2013, 18 undergraduate nursing students were selected by using purposive sampling method from the Faculty of Nursing and Midwifery of Tehran and Shahid Beheshti Universities. Semi-structured interviews were used to collect data. The content analysis method was used to determine relevant themes. Two themes were derived from the data analysis, which represented the students' clinical learning challenges. These two themes included insufficient qualification of nursing instructors and unsupportive learning environment. Identification of the students' clinical learning challenges and actions to remove or modify them will create more learning opportunities for the students, improve the achievement of educational goals, provide training to nursing students with the needed competencies to meet the complex demands of caring and for application of theories in practice, and improve the quality of healthcare services.

  15. Learning challenges of nursing students in clinical environments: A qualitative study in Iran

    Science.gov (United States)

    Baraz, Shahram; Memarian, Robabeh; Vanaki, Zohreh

    2015-01-01

    Background: Clinical learning environment is a complex social entity. This environment is effective on the learning process of nursing students in the clinical area. However, learning in clinical environment has several benefits, but it can be challenging, unpredictable, stressful, and constantly changing. In attention to clinical experiences and factors contributing to the learning of these experiences can waste a great deal of time and energy, impose heavy financial burden on educational systems, cause mental, familial and educational problems for students, and compromise the quality of patient care. Therefore, this study was carried out with the goal of determining the learning challenges of nursing students in clinical environments in Iran. Materials and Methods: In this qualitative study carried out in 2012–2013, 18 undergraduate nursing students were selected by using purposive sampling method from the Faculty of Nursing and Midwifery of Tehran and Shahid Beheshti Universities. Semi-structured interviews were used to collect data. The content analysis method was used to determine relevant themes. Results: Two themes were derived from the data analysis, which represented the students’ clinical learning challenges. These two themes included insufficient qualification of nursing instructors and unsupportive learning environment. Conclusions: Identification of the students’ clinical learning challenges and actions to remove or modify them will create more learning opportunities for the students, improve the achievement of educational goals, provide training to nursing students with the needed competencies to meet the complex demands of caring and for application of theories in practice, and improve the quality of healthcare services. PMID:26430679

  16. Importance of observational studies in clinical practice.

    Science.gov (United States)

    Ligthelm, Robert J; Borzì, Vito; Gumprecht, Janusz; Kawamori, Ryuzo; Wenying, Yang; Valensi, Paul

    2007-06-01

    In this era of evidence-based medicine, clinicians require a comprehensive range of well-designed studies to support prescribing decisions and patient management. In recent years, data from observational studies have become an increasingly important source of evidence because of improvements in observational-study methods and advances in statistical analysis. This article reviews the current literature and reports some of the key studies indicating that observational studies can both complement and build on the evidence base established by randomized controlled trials (RCTs). A literature search using the MEDLINE/PubMed database (years: 1966-present) was carried out using the search terms observational or observational study(ies), historical control, nonrandomized, and postmarketing surveillance. All references comparing observational studies with randomized controlled trials were obtained and reviewed and were also hand-checked for studies not identified in the database searches. Observational studies play an important role in investigating treatment outcomes. Data from large observational studies can clarify the tolerability profile of marketed medicines. In particular, observational studies can be of benefit in the study of large, heterogeneous patient populations with complex, chronic diseases such as diabetes mellitus. Observational studies have played a key role in supporting the results of Phase III studies of insulin analogues for the treatment of patients with type 1 and type 2 diabetes. Future observational studies in the field of diabetes such as PREDICTIVE (Predictable Results and Experience in Diabetes through Intensification and Control to Target: an International Variability Evaluation) and IMPROVE will further our understanding of this global pandemic. Well-designed observational studies can play a key role in supporting the evidence base for drugs and therapies. Current evidence suggests that observational studies can be conducted using the same

  17. Facilitating Case Studies in Massage Therapy Clinical Education

    OpenAIRE

    Baskwill, Amanda

    2013-01-01

    The integration of evidence into reflective health care practice has been on the rise in recent years and is a phenomenon that has affected all health care professions, including massage therapy. Clinical case studies are a research design that follows one patient or subject, making the studies ideal for use in clinical practice. They are valuable for communicating information from clinical practice to the broader community. Case studies have face validity that may be more valuable to individ...

  18. Development of radioimmunometric assays and kits for non-clinical applications. Proceedings of a final research coordination meeting

    International Nuclear Information System (INIS)

    2006-04-01

    Immunoassays are versatile analytical techniques that had a leading role in various clinical applications, during the last four decades. The studies carried out by Rosalyn Yalow, Solomon Berson and Roger Ekins in the 1960s gave a breakthrough in the development of this novel analytical method. Sensitivity up to femtomolar concentrations, high specificity and universal application to different classes of molecular species made immunoassay a very useful tool in analytical investigation. The expertise acquired by immunochemists in producing antibodies against any antigen and the ability of radiochemists in labeling the antigens with 125 I without affecting the active site are the two main factors responsible for the above development. There are concerns about the safety and health of humans due to the high-level contamination of environment by pesticides, industrial compounds and metals, anabolic steroids in milk and meat products, and presence of mycotoxins in food and feed attributable to improper storage of agricultural commodities. Accordingly, the need to rapidly and inexpensively monitor contaminants has gained prime importance. Hence, there is a need for low-cost, rapid and automated analytical systems. Immunoassay procedures satisfy the above requirements and provide a useful adjunct to traditional methods of analysis. The knowledge of the levels of various chemicals or other contaminants in food, milk, soil, water and other significant matrices will help in improving quality of livestock and crops, in regulating anabolic steroids and monitoring of toxic compounds in food products. The immunoassay technique, which was introduced for clinical applications, has now traversed to non-clinical fields such as food industry, environmental surveillance, industrial hygiene, drug research, veterinary science and forensic science. The International Agency for Research on Cancer (IARC) has categorized aflatoxin B1 as the most potent carcinogen among mycotoxins. Many

  19. External Factors That Influence the Practice of Radiology: Proceedings of the International Society for Strategic Studies in Radiology Meeting.

    Science.gov (United States)

    Rubin, Geoffrey D; McNeil, Barbara J; Palkó, András; Thrall, James H; Krestin, Gabriel P; Muellner, Ada; Kressel, Herbert Y

    2017-06-01

    In both the United States and Europe, efforts to reduce soaring health care costs have led to intense scrutiny of both standard and innovative uses of imaging. Given that the United States spends a larger share of its gross domestic product on health care than any other nation and also has the most varied health care financing and delivery systems in the world, it has become an especially fertile environment for developing and testing approaches to controlling health care costs and value. This report focuses on recent reforms that have had a dampening effect on imaging use in the United States and provides a glimpse of obstacles that imaging practices may soon face or are already facing in other countries. On the basis of material presented at the 2015 meeting of the International Society for Strategic Studies in Radiology, this report outlines the effects of reforms aimed at (a) controlling imaging use, (b) controlling payer expense through changes in benefit design, and (c) controlling both costs and quality through "value-based" payment schemes. Reasons are considered for radiology practices on both sides of the Atlantic about why the emphasis needs to shift from providing a large volume of imaging services to increasing the value of imaging as manifested in clinical outcomes, patient satisfaction, and overall system savings. Options for facilitating the shift from volume to value are discussed, from the use of advanced management strategies that improve workflow to the creation of programs for patient engagement, the development of new clinical decision-making support tools, and the validation of clinically relevant imaging biomarkers. Radiologists in collaboration with industry must enhance their efforts to expand the performance of comparative effectiveness research to establish the value of these initiatives, while being mindful of the importance of minimizing conflicts of interest. © RSNA, 2017.

  20. Theoretical and experimental studies of heavy liquid metal thermal hydraulics. Proceedings of a technical meeting

    International Nuclear Information System (INIS)

    2006-10-01

    Through the Nuclear Energy Department's Technical Working Group on Fast Reactors (TWG-FR), the IAEA provides a forum for exchange of information on national programmes, collaborative assessments, knowledge preservation, and cooperative research in areas agreed by the Member States with fast reactor and partitioning and transmutation development programmes (e.g. accelerator driven systems (ADS)). Trends in advanced fast reactor and ADS designs and technology development are periodically summarized in status reports, symposia, and seminar proceedings prepared by the IAEA to provide all interested IAEA Member States with balanced and objective information. The use of heavy liquid metals (HLM) is rapidly diffusing in different research and industrial fields. The detailed knowledge of the basic thermal hydraulics phenomena associated with their use is a necessary step for the development of the numerical codes to be used in the engineering design of HLM components. This is particularly true in the case of lead or lead-bismuth eutectic alloy cooled fast reactors, high power particle beam targets and in the case of the cooling of accelerator driven sub-critical cores where the use of computational fluid dynamic (CFD) design codes is mandatory. Periodic information exchange within the frame of the TWG-FR has lead to the conclusion that the experience in HLM thermal fluid dynamics with regard to both the theoretical/numerical and experimental fields was limited and somehow dispersed. This is the case, e.g. when considering turbulent exchange phenomena, free-surface problems, and two-phase flows. Consequently, Member States representatives participating in the 35th Annual Meeting of the TWG-FR (Karlsruhe, Germany, 22-26 April 2002) recommended holding a technical meeting (TM) on Theoretical and Experimental Studies of Heavy Liquid Metal Thermal Hydraulics. Following this recommendation, the IAEA has convened the Technical Meeting on Theoretical and Experimental Studies of

  1. Study progress of clinical electrophysiology on amblyopia

    Directory of Open Access Journals (Sweden)

    Ao Zhang

    2016-07-01

    Full Text Available Electrophysiology examination is an important technique in studying amblyopia, which mainly includes electrooculography(EOG, electroretinography(ERG, visual evoked potential(VEP. This study does not only summarizes the definition, the mechanisms and the meaning of these indexes in the relevant research progress in recent years, but also makes a comment on the controversies among the relevant research conclusions.

  2. Clinical grading: A pilot study to evaluate the implementation and effectiveness of mentor and student preparation for clinical grading

    OpenAIRE

    Lockyer, L.; James, J.; Holman, A.; Horrocks, S.; Crabtree, T.

    2015-01-01

    Background\\ud Clinical grading is one approach to assuring newly registered nurses have the knowledge and skills to provide safe and competent nursing care; that offers employers the chance to differentiate between newly qualified nurses’ clinical abilities, assists newly qualified staff to identify ongoing learning needs and meets Nursing and Midwifery Council standards for assessing practice (Amicucci, 2012; NMC, 2010). The development of new curricula from September 2013 enabled changes to...

  3. Meeting report: present state of molecular genetics in clinical laboratories. Report on the VII European Symposium on Clinical Laboratory and In Vitro Diagnostic Industry in Barcelona.

    Science.gov (United States)

    Padró-Miquel, Ariadna; Candás-Estébanez, Beatriz

    2015-02-01

    The VII European Symposium of the Clinical Laboratory and In Vitro Diagnostic Industry, co-organized between the Catalan Association for Clinical Laboratory Sciences (ACCLC) and the Catalan Society of Biology, was held on May 28th-29th, 2013 in Barcelona (Catalonia, Spain) under the IFCC auspices and the IUPAC sponsorship. The subject of the present Symposium was "Molecular Genetics in the Clinical Laboratory" and began with an opening conference that was a stroll through the history of molecular genetics in the context of the clinical laboratory. The scientific program was structured in several 2-h length roundtables that dealt with the following topics: recent advances in molecular genetics for clinical microbiology, latest evidences and real applicability of pharmacogenetics in the clinical practice, quality assurance of a molecular genetics laboratory, and latest trends in prenatal genetic diagnosis. The aim of the Symposium was the discussion of the transformation that molecular genetics has generated on clinical laboratories in terms of organization, specialization, interpretation of results and fast technical and knowledge evolution. High-qualified professionals from several countries together with in-country experts formed the roundtables. Attendants participated actively in the debates, increasing the overall interest.

  4. Selected topics of the 4th International Cooperative Study Group meeting on immune thrombocytopenia revisited.

    Science.gov (United States)

    Nydegger, Urs E; Risch, Lorenz

    2013-01-01

    The Intercontinental Cooperative immune thrombocytopenia (ITP) Study Group (ICIS) held its 4th Expert Meeting in September 2012 in Montreux, Switzerland. The program reunited researchers and clinicians from all over the globe and was organized with lectures and seminars for real-time exchange of latest information. Platelets target victims of autoimmune disease on their own, participating under physiological conditions in the immune network; these small cells are more immunologically savvy than previously thought. Currently, researchers focus their attention on regulatory T and regulatory B cells, ie, cells that might have a decisive impact on how ITP spontaneously resolves or evolves into chronic disease. Diagnostic criteria and prognosis are increasingly benefiting from molecular biological tests, and therapy has evolved with the availability of biosimilar agents and recombinant hormones or blockers of their receptors. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. 2010 Society for Neuro-Oncology Annual Meeting: a report of selected studies.

    Science.gov (United States)

    Ahluwalia, Manmeet S

    2011-02-01

    A number of important studies were presented at the Society for Neuro-Oncology annual meeting in Montréal, Canada, on 18-21 November 2010. Cediranib as monotherapy or in combination with lomustine did not show increased efficacy when compared with lomustine alone in patients with recurrent glioblastoma (GBM). Addition of temozolomide (TMZ) or irinotecan (CPT) to bevacizumab (BEV) in patients with recurrent GBM was well tolerated, with similar efficacy to BEV alone. The addition of BEV to radiation and TMZ in newly diagnosed GBM improved progression-free survival but did not improve overall survival. TMZ alone may be a reasonable approach in elderly GBM patients with poor performance status. Two Phase II trials with sunitinib and vatalanib showed a hint of activity in patients with recurrent or progressive meningiomas.

  6. Seniors' perspectives on care: a case study of the Alex Seniors health clinic, Calgary.

    Science.gov (United States)

    Shaw, Marta; Rypien, Candace; Drummond, Neil; Harasym, Patricia; Nixon, Lara

    2015-02-25

    Primary care initiatives face an imperative to not only reduce barriers to care for their patients but also to uniquely accommodate the complex needs of at-risk patient populations. Patient-centered multidisciplinary care team models for primary care, like the Alex Seniors Clinic, are one approach for providing comprehensive care for marginalized seniors. The purpose of this qualitative study was to explore patient perspectives on the responsiveness of the Alex Seniors Clinic to their stated health needs. Themes reflected participants' perspectives on factors impacting their health needs as vulnerable seniors as well as on the measures that the Alex Seniors Clinic has taken to meet those needs. Factors impacting health included: the nature of their relationships to the physical environment in which they lived, the nature of the relationships they had to others in that environment, and independence and autonomy. Participants identified accessibility, respect and support, and advocacy as the ways in which the clinic was working to address those health needs. While respect and support, as well as advocacy, effectively addressed some patient needs, participants felt that accessibility problems continue to be health-related barriers for clinic patients. This may be due to the fact that issues of accessibility reflect larger community and social problems. Nevertheless, it is only through engaging the patient community for input on clinic approaches that an understanding can be gained of how closely a clinic's care goals are currently aligning with patient perspectives of the care and services they receive.

  7. Congenital Rubella: Clinical and Related Studies

    Science.gov (United States)

    Menser, Margaret A.

    1977-01-01

    Briefly described are four studies currently being undertaken in Australia to determine the effectiveness of vaccination in the prevention of rubella and to examine the relationship between rubella and diabetes. (CL)

  8. Alopecia areata and autoimmunity: A clinical study

    Directory of Open Access Journals (Sweden)

    Thomas Emy

    2008-01-01

    Full Text Available Alopecia areata (AA frequently occur in association with other autoimmune diseases such as thyroid disorders, anemias and other skin disorders with autoimmune etiology. Despite numerous studies related to individual disease associations in alopecia areata, there is paucity of literature regarding comprehensive studies on concomitant cutaneous and systemic diseases. The present study has been designed to determine if there is a significant association between alopecia areata and other autoimmune diseases. This study covers 71 patients with the diagnosis of alopecia areata as the case group and 71 patients with no evidence of alopecia areata as the control group. Among the cutaneous diseases associated with AA, atopic dermatitis (AD showed maximum frequency with an O/E ratio of 2.5, which indicates that it is two to three times more common in patients with alopecia areata. In our study, thyroid disorders showed the highest frequency with on O/E ratio of 3.2 and a P value of 0.01, which is statistically highly significant. Among the thyroid disorders, hypothyroidism was the most frequent association (14.1% in our study. Since systemic involvement is not infrequent in patients with alopecia areata, it is imperative to screen these patients for associated disorders, particularly atopy, thyroid diseases, anemias and other autoimmune disorders, especially if alopecia areata is chronic, recurrent and extensive.

  9. Couples Counseling in Alzheimer’s Disease: Additional Clinical Findings from a Novel Intervention Study

    Science.gov (United States)

    AUCLAIR, URSULA; EPSTEIN, CYNTHIA; MITTELMAN, MARY

    2009-01-01

    This article describes the clinical findings of a study designed to assess the benefit of counseling for couples, one of whom is in the early stage of Alzheimer’s disease (AD). We previously reported our findings based on the first 12 couples that enrolled in the study. Based on the treatment of 30 additional couples, we have refined our treatment strategy to include concepts of Gestalt Therapy and Transactional Analysis and identified prevalent issues of concern to this cohort. The study design has remained as described in the earlier article (Epstein et al., 2006), and has proven to be appropriate to meet the goals of this intervention as indicated by our clinical experience and feedback from the participating couples. Case vignettes demonstrate how to conduct the sessions so that the experience of each member of the dyad is validated, while acknowledging the differential impact of the disease on them. PMID:19865591

  10. Couples Counseling in Alzheimer's Disease: Additional Clinical Findings from a Novel Intervention Study.

    Science.gov (United States)

    Auclair, Ursula; Epstein, Cynthia; Mittelman, Mary

    2009-04-01

    This article describes the clinical findings of a study designed to assess the benefit of counseling for couples, one of whom is in the early stage of Alzheimer's disease (AD). We previously reported our findings based on the first 12 couples that enrolled in the study. Based on the treatment of 30 additional couples, we have refined our treatment strategy to include concepts of Gestalt Therapy and Transactional Analysis and identified prevalent issues of concern to this cohort. The study design has remained as described in the earlier article (Epstein et al., 2006), and has proven to be appropriate to meet the goals of this intervention as indicated by our clinical experience and feedback from the participating couples. Case vignettes demonstrate how to conduct the sessions so that the experience of each member of the dyad is validated, while acknowledging the differential impact of the disease on them.

  11. [Clinical application of extracts of Echinacea purpurea or Echinacea pallida. Critical evaluation of controlled clinical studies].

    Science.gov (United States)

    Dorsch, W

    1996-04-01

    The phytotherapy should be understood as being integrated into the rational pharmacotherapy. The modern phytotherapy tries hard to proof effects with pharmacological and clinical studies. The task force E of the federal bureau of health of Germany has made a statement regarding this problem. This article reviews only controlled clinical trials about the application of extracts of echinacea purpura or echinacea pallida.

  12. Document clustering of clinical narratives: a systematic study of clinical sublanguages.

    Science.gov (United States)

    Patterson, Olga; Hurdle, John F

    2011-01-01

    It is widely believed that different clinical domains use their own sublanguage in clinical notes, complicating natural language processing, but this has never been demonstrated on a broad selection of note types. Starting from formal sublanguage theory, we constructed a feature space based on vocabulary and semantic types used in 17 different clinical domains by three author types (physicians, nurses, and social workers) in both the in- and outpatient settings. We supplied the resulting vectors to CLUTO, a robust clustering tool suitable for this high-dimensional space. Our results confirm that note types with a broad clinical scope, e.g, History & Physicals and Discharge Summaries, cluster together, while note types with a narrow clinical scope form surprisingly pure, disjoint sublanguages. A reasonable conclusion from this study is that any tool relying on term statistics or semantics trained on one clinical note type may not work well on any other.

  13. Exploratory study of the role of knowledge brokers in translating knowledge to action following global maternal and newborn health technical meetings.

    Science.gov (United States)

    Norton, T C; Howell, C; Reynolds, C

    2016-11-01

    There have been increasing calls for more research on interventions to successfully translate evidence-based knowledge into improved health policy and practices. This paper reports on an exploratory study of knowledge translation interventions conducted with participants of global health meetings held in Bangladesh in 2012 and in South Africa in 2013. We measured stakeholders' uptake of evidence-based knowledge in terms of their translation of this knowledge into actions around public health policy and practice. The research sought to determine whether participants shared and used knowledge from the meetings to improve health policy and practices in their settings and the factors influencing sharing and use. An exploratory study employed quantitative and qualitative methods of online surveys and in-depth interviews to collect data from all meeting participants. All participants in the Bangladesh and South Africa meetings were invited to complete an online survey during the meetings and over the following six weeks. Of 411 participants in the 2012 Bangladesh meeting, 148 participants from 22 countries completed the survey. Eleven of these respondents (from eight countries) were interviewed. Of the 436 participants in the 2013 South Africa meeting, 126 respondents from 33 countries completed an online survey; none of these respondents were interviewed. The analysis revealed that most respondents used new knowledge to advocate for policy change (2012: 65.5%; 2013: 67.5%) or improve service quality (2012: 60.1%; 2013: 70.6%). The type of knowledge that respondents most commonly shared was clinical or scientific information (2012: 79.1%; 2013: 66.7%) and country-specific information (2012: 73.0%; 2013: 71.4%). Most 2012 respondents shared knowledge because they thought it would be useful to a co-worker or colleague (79.7%). Findings on knowledge use and sharing suggest that most respondents saw themselves as knowledge brokers or intermediaries in a position to influence

  14. Nursing students' perceptions of using the Clinical Education Assessment tool AssCE and their overall perceptions of the clinical learning environment - A cross-sectional correlational study.

    Science.gov (United States)

    Engström, Maria; Löfmark, Anna; Vae, Karen Johanne Ugland; Mårtensson, Gunilla

    2017-04-01

    Clinical education is a vital part of nursing students' learning; the importance of assessment tools and feedback in stimulating student learning has been stressed, but this needs to be studied in more detail. To examine relationships between nursing students' perceptions of using an Assessment tool in Clinical Education (AssCE) during their mid-course discussion and final assessment, the content discussed during these meetings between the student, preceptor and nurse teacher and the students' overall perception of the clinical learning environment. A cross-sectional, correlational design was used. A convenience sample of 110 nursing students from one Norwegian university college with two campuses. Data were collected with self-developed questionnaires and analysed using logistic regression with SPSS and the PROCESS macro for mediation analysis. There was a positive relationship between nursing students' perceptions of using the assessment tool AssCE and their overall perception of the clinical learning environment. This relationship was, in turn, mediated by the content discussed during the formative mid-course discussion and summative final assessment. Our conclusion is that the assessment tool AssCE supported students' clinical learning and that this relationship, in turn, was mediated by the degree to which the conversation during the assessment meeting focused on the student's knowledge, skills and professional judgement. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. 78 FR 20647 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

    Science.gov (United States)

    2013-04-05

    ...: [email protected]bioethics.gov . Additional information may be obtained at www.bioethics.gov . SUPPLEMENTARY... Bioethical Issues (the Bioethics Commission). The meeting will be held from 9:00 a.m. to approximately 5:15 p... attendance limited to space available. The meeting will also be webcast at www.bioethics.gov . Under...

  16. Catholic School Faculty Meetings: A Case Study Linking Catholic Identity, School Improvement, and Teacher Engagement

    Science.gov (United States)

    Hagan, Daryl C.; Houchens, Gary

    2016-01-01

    While research on faculty meetings is limited, existing literature suggests that meetings could be an arena where schools can address their most pressing challenges (Brandenburg, 2008; Michel, 2011; Riehl, 1998). Building on Macey and Schneider's (2008) Model of Employee Engagement and McGrath's Model of Group Effectiveness (1964), this case study…

  17. Incisional Hernia: An Experimental and Clinical Study

    NARCIS (Netherlands)

    M. van 't Riet (Martijne)

    2004-01-01

    markdownabstract__Abstract__ Incisional hernia is one of the most common long-term complications of abdominal surgery. In prospective studies with sufficient follow-up, incidences of incisional hernia after laparotomy up to 20% are reported. Incisional hernia can be defined as an internal

  18. Clinical findings versus imaging studies in the diagnosis of infantile ...

    African Journals Online (AJOL)

    Background: Infantile hypertrophic pyloric stenosis is the most common surgical cause of vomiting in early infancy and can be diagnosed clinically or by imaging studies. Objectives: The aim of this study was to assess the accuracy of clinical examination compared with ultrasound and upper gastrointestinal contrast imaging ...

  19. Challenges in implementing clinical governance: A qualitative study ...

    African Journals Online (AJOL)

    Design: A qualitative study. Setting: Hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd, Iran. Subjects: Thirteen participants selected among clinical governance executives of under study hospitals and members of clinical governance office in curative deputy of the University. Results: Eight major ...

  20. Preparing clinical pharmacy scientists for careers in clinical/translational research: can we meet the challenge?: ACCP Research Affairs Committee Commentary.

    Science.gov (United States)

    Parker, Robert B; Ellingrod, Vicki; DiPiro, Joseph T; Bauman, Jerry L; Blouin, Robert A; Welage, Lynda S

    2013-12-01

    Developing clinical pharmacists' research skills and their ability to compete for extramural funding is an important component of the American College of Clinical Pharmacy's (ACCP) vision for pharmacists to play a prominent role in generating the new knowledge used to guide patient pharmacotherapy. Given the recent emphasis on clinical/translational research at the National Institutes of Health (NIH) and the key role of drug therapy in the management of many diseases, there is an unprecedented opportunity for the profession to contribute to this enterprise. A crucial question facing the profession is whether we can generate enough appropriately trained scientists to take advantage of these opportunities to generate the new knowledge to advance drug therapy. Since the 2009 publication of the ACCP Research Affairs Committee editorial recommending the Ph.D. degree (as opposed to fellowship training) as the optimal method for preparing pharmacists as clinical/translational scientists, significant changes have occurred in the economic, professional, political, and research environments. As a result, the 2012 ACCP Research Affairs Committee was charged with reexamining the college's position on training clinical pharmacy scientists in the context of these substantial environmental changes. In this commentary, the potential impact of these changes on opportunities for pharmacists in clinical/translational research are discussed as are strategies for ACCP, colleges of pharmacy, and the profession to increase the number and impact of clinical pharmacy scientists. Failure of our profession to take advantage of these opportunities risks our ability to contribute substantively to the biomedical research enterprise and ultimately improve the pharmacotherapy of our patients. © 2013 Pharmacotherapy Publications, Inc.

  1. Reports from the 2010 Clinical and Translational Cancer Research Think Tank meeting: design strategies for personalized therapy trials.

    Science.gov (United States)

    Berry, Donald A; Herbst, Roy S; Rubin, Eric H

    2012-02-01

    It has long been evident that cancer is a heterogeneous disease, but only relatively recently have we come to realize the extent of this heterogeneity. No single therapy is effective for every patient with tumors having the same histology. A clinical strategy based on a single-therapy approach results in overtreatment for the majority of patients. Biomarkers can be considered as knives that dissect the disease ever more finely. The future of clinical research will be based on learning whether certain therapies are more appropriate than others for biomarker-defined subsets of patients. Therapies will eventually be tailored to narrow biomarker subsets. The ability to determine which therapies are appropriate for which patients requires information from biological science as well as empirical evidence from clinical trials. Neither is easy to achieve. Here we describe some nascent approaches for designing clinical trials that are biomarker-based and adaptive. Our focus is on adaptive trials that address many questions at once. In a way, these clinical experiments are themselves part of a much larger experiment: learning how (or whether it is possible) to design experiments that match patients in small subsets of disease with therapies that are especially effective and possibly even curative for them.

  2. Odontogenic myxoma - clinical concept and morphological studies.

    Science.gov (United States)

    Gundlach, K K; Schulz, A

    1977-11-01

    Our experience with the odontogenic myxoma of the mandible is presented. Although it is a benign, slow growing neoplasm, it is locally aggresive. Patients rarely complain of any symptoms produced by this tumor. Morphological studies included enzymes histochemistry, as well as light and electron microscopy. Two major types of tumor cells were identified. One resembled a mature fibroblast, while the other had the morphological and functional criteria of a so-called myxoblast. We would recommend therapy comprising wide resection and consecutive primary osteoplasty.

  3. Clinical cosmobiology: The Lithuanian study 1990 1992

    Science.gov (United States)

    Stoupel, Eliyahu; Petrauskiene, Jadviga; Kalediene, Ramune; Abramson, Evgeny; Sulkes, Jacqueline

    1995-12-01

    The numbers of deaths from ischaemic heart disease (IHD), stroke (CVA), all accidents except vehicular, vehicular accidents and suicide (overall total, totals for men and women) per month for 36 months (1990 1992) in Lithuania were analysed in relation to: (1) month of the year (1 12); (2) geomagnetic activity; and (3) solar activity. A total of 122227 deaths (64490 men and 57737 women) was studied, and the results compared with those obtained in an earlier study in Israel, differing geographically and climatically from Lithuania. It was shown that the time of year, solar activity, and geomagnetic activity were related to the monthly death distribution, especially regarding death from IHD and suicide. Age and gender differences were apparent in the relationship between death distribution and physical environmental factors. At age >70 years, many of these relationships change. The monthly distribution of deaths from IHD and suicide are adversely correlated with solar activity and with each other. Differences are presumed in serotoninergic effects as caused by environmental influences.

  4. Experiencing virtual patients in clinical learning: a phenomenological study.

    Science.gov (United States)

    Edelbring, Samuel; Dastmalchi, Maryam; Hult, Håkan; Lundberg, Ingrid E; Dahlgren, Lars Owe

    2011-08-01

    Computerised virtual patients (VPs) are increasingly being used in medical education. With more use of this technology, there is a need to increase the knowledge of students' experiences with VPs. The aim of the study was to elicit the nature of virtual patients in a clinical setting, taking the students' experience as a point of departure. Thirty-one students used VPs as a mandatory part of an early clinical rotation in rheumatology. Using the qualitative approach of phenomenology, we interviewed these students and then analysed data regarding their experiences of VPs as a learning activity. The result shows that students perceived VP activities in relation to actual patients, the clinical context and other learning activities. The VPs represented typical clinical cases which encouraged clinical reasoning and allowed for decision making. The students experienced the activities as integrating biomedical knowledge and clinical experience, providing structure that prepared for the unstructured clinical environment and patient encounters under unstressful conditions. However, the VPs were experienced as lacking the emotional interactivity and complexity of actual patients. Theoretical frameworks of clinical reasoning and experiential learning are suggested as foundations for further educational integration of VPs in the clinical environment. VP activities during clinical rotations provide experiences of clinical reality and allow students to solve problems actively. These features are dependent on VP technology but are also contingent on the surrounding environment.

  5. [Anatomo-clinical study of arterioventricular disorders].

    Science.gov (United States)

    Attié, F; Bassotti, R; Arteaga, M; Kuri, J; Zamora, C

    1976-01-01

    The relationship of the great arteries with their respective ventricles in the three toncoconal morphologies depends on the orientation and rotation of the septum of the trunk and cone. In this work we study a case of crossed great arteries and another of partial distortion of the great arteries and one of transposition of the great arteries, all with arterioventricular concordance. In the anatomic and angiocardiographic examples an analysis is made of the arterioventricular relation in each type of arterial pedicle. We say that arterioventricular concordance exists with crossed great arteries when the pulmonary originated from the anterior infundibulum and its direction of right to left or from left to right in the frontal plane shows the spacial position of the anatomically right ventricle. In the transposition of the great arteries or in the partial distortion of the great arteries with arterioventricular concordance the aorta in the frontal plane shows the spacial position of the anatomically right ventricle. In the first group the aorta originates from the anterior infundibulum while in the second, from the posterior infundibulum. We review the examples of arterioventricular discordance diagnosed by necropsy or by laboratory studies. We study 5 cases; 1 with crossed great arteries, 3 with transposition of great arteries and the last with partial distortion of the great arteries. In the arterioventricular discordances with crossed great arteries in the lateral position, we observe that the pulmonary artery originates from the anterior infudnibulum whereas in the transposition, the aorta emerges from the anterior infundibulum. In the partial distortion of the great arteries the vessels are side by side or the aorta a little bit anterior to the pulmonary which is connected with the anterior infundibulum. In the posteroanterior incidence when there exists an arterioventricular discordance with crossed great arteries, the direction of the pulmonary does not

  6. 18 CFR 5.11 - Potential Applicant's proposed study plan and study plan meetings.

    Science.gov (United States)

    2010-04-01

    ... study: (1) A detailed description of the study and the methodology to be used; (2) A schedule for... each study proposal and the information to be obtained; (2) Address any known resource management goals...; (4) Explain any nexus between project operations and effects (direct, indirect, and/or cumulative) on...

  7. An Overview of Clinical Studies on Fiber Post Systems

    Directory of Open Access Journals (Sweden)

    Idil Dikbas

    2013-01-01

    Full Text Available Intraradicular posts are useful adjuncts in the restoration of endodontically treated teeth. These systems have undergone a significant evolution in recent years, and fiber-reinforced systems have started to be incorporated into routine clinical care more frequently. Despite the high number of laboratory studies pertaining to the characteristics of fiber posts, clinical studies evaluating their general success rates are rather limited. Since clinical investigations are reliable means to achieve information about the general behavior pattern of materials or techniques, assessment of this data will be beneficial to have a better understanding of fiber-reinforced intraradicular post systems. The purpose of this paper was to make a summary of clinical studies regarding various fiber posts. A PubMed search was conducted and articles dating back to 1990 were retrieved. The paper provides an overview of clinical studies on fiber posts specifically in the last decade as well as commentary analysis.

  8. Classified study and clinical value of the phase imaging features

    International Nuclear Information System (INIS)

    Dang Yaping; Ma Aiqun; Zheng Xiaopu; Yang Aimin; Xiao Jiang; Gao Xinyao

    2000-01-01

    445 patients with various heart diseases were examined by the gated cardiac blood pool imaging, and the phase was classified. The relationship between the seven types with left ventricular function index, clinical heart function, different heart diseases as well as electrocardiograph was studied. The results showed that the phase image classification could match with the clinical heart function. It can visually, directly and accurately indicate clinical heart function and can be used to identify diagnosis of heart disease

  9. Issues and promise in clinical studies of botanicals with anticonvulsant potential.

    Science.gov (United States)

    Ekstein, Dana

    2015-11-01

    Botanicals are increasingly used by people with epilepsy worldwide. However, despite abundant preclinical data on the anticonvulsant properties of many herbal remedies, there are very few human studies assessing safety and efficacy of these products in epilepsy. Additionally, the methodology of most of these studies only marginally meets the requirements of evidence-based medicine. Although the currently available evidence for the use of cannabinoids in epilepsy is similarly lacking, several carefully designed and well controlled industry-sponsored clinical trials of cannabis derivatives are planned to be completed in the next couple of years, providing the needed reliable data for the use of these products. The choice of the best botanical candidates with anticonvulsant properties and their assessment in well-designed clinical trials may significantly improve our ability to effectively and safely treat patients with epilepsy. This article is part of a Special Issue entitled "Botanicals for Epilepsy". Copyright © 2015 Elsevier Inc. All rights reserved.

  10. MIH: epidemiologic clinic study in paediatric patient.

    Science.gov (United States)

    Condò, R; Perugia, C; Maturo, P; Docimo, R

    2012-04-01

    The Molar Incisor Hypomineralization (MIH) is a qualitative and quantitative defect of the enamel structure of the first permanent molars, which may vary from 1 to 4 with involvement of maxillary and jaw permanent incisors. AIM.: Aim of this study is that to evaluate, among 1500 paediatric patients chosen at random aged between 0 and 14 years, afferent by the Paediatric Dentistry of the Azienda Ospedialiera Policlinico Tor Vergata of Rome from 1996 to 2011, the incidents and the prevalence of the MIH distribution, and furthermore to ascertain the possible relationship with the data described in the literature. RESULTS AND DISCUSSION.: From the sample of 1500 paediatric patients, the number of those affections from MIH has turned out to be pairs to 110 (7.3%) aged between 4 and 15 years, and an average age equal to 9.7. The incidence of the hypoplastic defects is greater in the elements of the permanents series in which the functional class mainly interested is that of the first molars, with a percentage of 39.8%. Regarding the elements of the deciduous series affections from hypoplasia, they turn out to be in all in number of 20 represented in 80% of the cases from the seconds molars while in the remaining 20% of the cases the items involved are the central incisors. About the percentage of elements involved in the MIH: the molars, involved with a frequency of 56%, turn out to be more hit regarding incisors (44%). As reported in the literature, it can be asserted that the MIH can hit in equal measure both the male sex that feminine one. CONCLUSIONS.: MIH represents a condition quite frequent in the paediatric population. In managing this anomaly takes an essential role in the early diagnosis and in the differential one. The study done underlined the importance of a correct application of the therapeutic protocol which, starting from a careful diagnosis and articulating themselves in the execution of preventive treatments and in severe cases restorative and

  11. MIH: epidemiologic clinic study in paediatric patient

    Science.gov (United States)

    CONDÒ, R.; PERUGIA, C.; MATURO, P.; DOCIMO, R.

    2012-01-01

    SUMMARY The Molar Incisor Hypomineralization (MIH) is a qualitative and quantitative defect of the enamel structure of the first permanent molars, which may vary from 1 to 4 with involvement of maxillary and jaw permanent incisors. Aim. Aim of this study is that to evaluate, among 1500 paediatric patients chosen at random aged between 0 and 14 years, afferent by the Paediatric Dentistry of the Azienda Ospedialiera Policlinico Tor Vergata of Rome from 1996 to 2011, the incidents and the prevalence of the MIH distribution, and furthermore to ascertain the possible relationship with the data described in the literature. Results and discussion. From the sample of 1500 paediatric patients, the number of those affections from MIH has turned out to be pairs to 110 (7.3%) aged between 4 and 15 years, and an average age equal to 9.7. The incidence of the hypoplastic defects is greater in the elements of the permanents series in which the functional class mainly interested is that of the first molars, with a percentage of 39.8%. Regarding the elements of the deciduous series affections from hypoplasia, they turn out to be in all in number of 20 represented in 80% of the cases from the seconds molars while in the remaining 20% of the cases the items involved are the central incisors. About the percentage of elements involved in the MIH: the molars, involved with a frequency of 56%, turn out to be more hit regarding incisors (44%). As reported in the literature, it can be asserted that the MIH can hit in equal measure both the male sex that feminine one. Conclusions. MIH represents a condition quite frequent in the paediatric population. In managing this anomaly takes an essential role in the early diagnosis and in the differential one. The study done underlined the importance of a correct application of the therapeutic protocol which, starting from a careful diagnosis and articulating themselves in the execution of preventive treatments and in severe cases restorative and

  12. Proceedings of the specialist meeting on positron annihilation study for science and engineering 2011

    International Nuclear Information System (INIS)

    Shirai, Yasuharu; Yoshiie, Toshimasa

    2012-01-01

    The utilization of positron beams in the field of materials science and engineering has increased remarkably in these years. It is meaningful for researches working in this field to gather together to promote and exchange views and information between them. For this purpose, the Specialist Research Meeting on Positron Beam Techniques for Science and Engineering was held on December 2nd and 3rd, 2011 at the Research Reactor Institute, Kyoto University. 66 participants jointed the Meeting and 28 papers were presented. This volume contains the summary and selected transparencies presented in the meeting. (J.P.N.)

  13. Assessing emergency nurses' clinical competency: An exploratory factor analysis study

    Directory of Open Access Journals (Sweden)

    Atefeh Ghanbari

    2017-01-01

    Full Text Available Background: Nursing as a clinical discipline is developing in the emergency wards. Health care systems should continuously assess and prioritize indicators of clinical competency in these wards. The lack of clear standards of clinical competency indicators challenges evaluation. The purpose of this study was to determine clinical competency indicators and its priority based on nurses' views in educational and therapeutic centers in Guilan. Materials and Methods: The Q methodology was conducted in three phases, that is, phase I (determining the clinical competency indicators, phase II (classifying clinical competency indicators by an expert panel, and phase III (prioritizing clinical competency indicators. The subjects were selected by convenience sampling among nurses working in the emergency wards of teaching hospitals affiliated to Guilan in 2013. Finally, clinical competency indicators were prioritized using exploratory factor analysis. Results: In the prioritizing phase, data were collected from 710 nurses over two months. Five factors with 30 general competencies were found in three domains: communication, professional maturity, and personality characteristics. Six factors with 37 specific competencies were also found in two domains: scientific and technical capabilities and basic clinical skills that can provide a structured instrument for assessing clinical competence in emergency nurses. Conclusions: Achieved competencies can be used as a reference for nursing education and practice in emergency. Further research on health care system is needed in order to achieve a reliable and valid instrument.

  14. Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa

    Directory of Open Access Journals (Sweden)

    Joris Hamm

    2016-03-01

    Full Text Available Background: The National Department of Health of South Africa decided to start a programme to train mid-level healthcare workers, called clinical associates, as one of the measures to increase healthcare workers at district level in rural areas. Unfortunately, very little is known about the cost effectiveness of clinical associates.Aims: To determine, on a provincial level, the cost effectiveness of training and employing clinical associates and medical practitioners compared to the standard strategy of training and employing only more medical practitioners.Methods: A literature study was performed to answer several sub questions regarding the costs and effectiveness of clinical associates. The results were used to present a case study.Results: The total cost for a province to pay for the full training of a clinical associate is R 300 850. The average employment cost per year is R196 329 and for medical practitioners these costs are R 730 985 and R 559 397, respectively.Effectiveness: Clinical associates are likely to free up the time of a medical practitioner by 50–76%. They can provide the same quality of care as higher level workers, provided that they receive adequate training, support and supervision. Furthermore, they seem more willing to work in rural areas compared to medical practitioners.Conclusions: The case study showed that training and employing clinical associates is potentially a cost-effective strategy for a province to meet the increasing demand for rural healthcare workers. This strategy will only succeed when clinical associates receive adequate training, support and supervision and if the province keeps investing in them.

  15. 76 FR 1665 - Stakeholder Meetings Regarding the U.S.-Flag Great Lakes Fleet Revitalization Study; Correction

    Science.gov (United States)

    2011-01-11

    ... DEPARTMENT OF TRANSPORTATION Maritime Administration [Docket No. MARAD-2010-0111] Stakeholder Meetings Regarding the U.S.-Flag Great Lakes Fleet Revitalization Study; Correction AGENCY: Maritime... Lakes Fleet Revitalization Study. MARAD inadvertently listed the incorrect time zone for the listening...

  16. Dutch transmural nurse clinics for chronic patients: a descriptive study.

    NARCIS (Netherlands)

    Temmink, D.; Francke, A.L.; Kerkstra, A.; Huyer Abu-Saad, H.

    2000-01-01

    'Transmural care' can be defined as patient-tailored care provided on the basis of close collaboration and joint responsibility between hospitals and home care organizations. One form of transmural care is transmural nurse clinics for chronically ill. This study describes 62 transmural nurse clinics

  17. Regional enteritis and gluten-free diet. A clinical study

    NARCIS (Netherlands)

    Merwe, Christiaan Frederik van der

    1974-01-01

    The purpose of this clinical study was to determine whether the use of a gluten-free diet influenced the course and prognosis of regional enteritis. Following a few clinical communications in the Dutch medical literature reporting favourable results obtained with the gluten-free diet in the

  18. Clinical rehabilitation of the amputee : A retrospective study

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Groothoff, JW; Eisma, WH

    The aim of this study was to determine the rehabilitation outcome of lower limb amputee patients after clinical rehabilitation. Altogether 183 amputee patients admitted for clinical rehabilitation in the years 1987-1991 were reviewed by retrospective analysis of medical record data. Three groups of

  19. Rethinking clinical governance : Healthcare professionals' views: a Delphi study

    NARCIS (Netherlands)

    Veenstra, Gepke L.; Ahaus, Kees; Welker, Gera A.; Heineman, Erik; van der Laan, Maarten J.; Muntinghe, Friso L. H.

    OBJECTIVE: Although the guiding principle of clinical governance states that healthcare professionals are the leading contributors to quality and safety in healthcare, little is known about what healthcare professionals perceive as important for clinical governance. The aim of this study is to

  20. Evaluation systems for clinical governance development: a comparative study.

    Science.gov (United States)

    Hooshmand, Elaheh; Tourani, Sogand; Ravaghi, Hamid; Ebrahimipour, Hossein

    2014-01-01

    Lack of scientific and confirmed researches and expert knowledge about evaluation systems for clinical governance development in Iran have made studies on different evaluation systems for clinical governance development a necessity. These studies must provide applied strategies to design criteria of implementing clinical governance for hospital's accreditation. This is a descriptive and comparative study on development of clinical governance models all over the world. Data have been gathered by reviewing related articles. Models have been studied in comprehensive review method. The evaluated models of clinical governance development were Australian, NHS, SPOCK and OPTIGOV. The final aspects extracted from these models were Responsiveness, Policies and Strategies, Organizational Structure, Allocating Resources, Education and Occupational Development, Performance Evaluation, External Evaluation, Patient Oriented Approach, Risk Management, Personnel's Participation, Information Technology, Human Resources, Research and Development, Evidence Based Medicine, Clinical Audit, Health Technology Assessment and Quality. These results are applicable for completing the present criteria which evaluating clinical governance application and provide practical framework to evaluate country's hospital on the basis of clinical governance elements.

  1. Financial Conflicts of Interest Checklist 2010 for clinical research studies.

    Science.gov (United States)

    Rochon, Paula A; Hoey, John; Chan, An-Wen; Ferris, Lorraine E; Lexchin, Joel; Kalkar, Sunila R; Sekeres, Melanie; Wu, Wei; Van Laethem, Marleen; Gruneir, Andrea; Maskalyk, James; Streiner, David L; Gold, Jennifer; Taback, Nathan; Moher, David

    2010-01-01

    A conflict of interest is defined as "a set of conditions in which professional judgment concerning a primary interest (such as a patient's welfare or the validity of research) tends to be unduly influenced by a secondary interest (such as financial gain)" [Thompson DF. Understanding financial conflicts of interest. N Engl J Med 1993;329(8):573-576]. Because financial conflict of interest (fCOI) can occur at different stages of a study, and because it can be difficult for investigators to detect their own bias, particularly retrospectively, we sought to provide funders, journal editors and other stakeholders with a standardized tool that initiates detailed reporting of different aspects of fCOI when the study begins and continues that reporting throughout the study process to publication. We developed a checklist using a 3-phase process of pre-meeting item generation, a stakeholder meeting and post-meeting consolidation. External experts (n = 18), research team members (n = 12) and research staff members (n = 4) rated or reviewed items for some or all of the 7 major iterations. The resulting Financial Conflicts of Interest Checklist 2010 consists of 4 sections covering administrative, study, personal financial, and authorship information, which are divided into 6 modules and contain a total of 15 items and their related sub-items; it also includes a glossary of terms. The modules are designed to be completed by all investigators at different points over the course of the study, and updated information can be appended to the checklist when it is submitted to stakeholder groups for review. We invite comments and suggestions for improvement at http://www.openmedicine.ca/fcoichecklist and ask stakeholder groups to endorse the use of the checklist.

  2. Nurse students' experiences with clinical placement in outpatient unit - a qualitative study.

    Science.gov (United States)

    Helgesen, Ann Karin; Gregersen, Anne Grethe; Roos, Anne Karine Østbye

    2016-01-01

    The recent reforms in the health care sector have changed the requirements for professional nursing competence in the clinical field. The reforms have also required nursing education to consider different areas for clinical placements for their students, and outpatient units in hospitals have been increasingly formalized as clinical learning environments. The complex technologies in some of these units represent a challenge for students who have limited existing knowledge or experience. More focus on outpatient care has also led to fewer opportunities for studying the continuity of a patient's life situation. In order to meet these challenges, structured learning activities with special forms were developed by nursing educators and nurses at outpatient units. The aim of this study was to explore students' experiences of using structured learning activities as unit-specific learning outcomes and targeted reflection during clinical placements in an outpatient unit. Two focus group interviews were conducted with a total of seven nursing students who had experienced structured learning activities during clinical placements in an outpatient unit. Data were analyzed by means of content analyses. This study shows that preparedness and guidance during placement were imperative for making the week in the outpatient unit meaningful. 'Being prepared', which was one of the categories, incorporated the subcategories 'being able to understand what to do', 'being at the right place at the right time' and 'being alert for new experiences'. The category 'being guided' which incorporated the subcategories 'from uncertainty to more confidence', 'from observer to seeking knowledge' and 'from focusing on technology to seeing the person' showed that the forms guided the students through the placement in the outpatient unit. Students take a more active approach to seeking knowledge when given structured learing activities during clinical placement in outpatient unit. This study shows

  3. Uses of Activation Analysis in Studies of Mineral Element Metabolism in Man. Papers Given at a Panel Meeting

    International Nuclear Information System (INIS)

    1970-01-01

    In June, 1968, the International Atomic Energy Agency held a panel meeting in Teheran, Iran, to discuss some of the uses of activation analysis in studies of mineral element metabolism in man. The aims of the meeting were to identify and draw attention to specific medical problems to which activation analysis could be fruitfully applied, to review the capabilities of the technique itself, and to recommend specific action which the Agency might take to support further work in this field. The scientific papers presented at the meeting have been gathered together in this report, and it is hoped that their publication will be of interest to all concerned with mineral element metabolism in man, whether studied by activation analysis or by other methods

  4. Using peer observers to assess the quality of cancer multidisciplinary team meetings: a qualitative proof of concept study

    Directory of Open Access Journals (Sweden)

    Harris J

    2014-08-01

    Full Text Available Jenny Harris,1 James SA Green,2,3 Nick Sevdalis,4 Cath Taylor1 1Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK; 2Department of Urology, Whipps Cross University Hospital, London, UK; 3Department of Health and Social Care, London South Bank University, London, UK; 4Department of Surgery and Cancer, Imperial College London, London, UK Background: Multidisciplinary team (MDT working is well established as the foundation for providing cancer services in the UK and elsewhere. A core activity is the weekly meeting (or case conference/tumor boards where the treatment recommendations for individual patients are agreed. Evidence suggests that the quality of team working varies across cancer teams, and this may impact negatively on the decision-making process, and ultimately patient care. Feedback on performance by expert observers may improve performance, but can be resource-intensive to implement. This proof of concept study sought to: develop a structured observational assessment tool for use by peers (managers or clinicians from the local workforce and explore its usability; assess the feasibility of the principle of observational assessment by peers; and explore the views of MDT members and observers about the utility of feedback from observational assessment. Methods: For tool development, the content was informed by national clinical consensus recommendations for best practice in cancer MDTs and developed in collaboration with an expert steering group. It consisted of ten subdomains of team working observable in MDT meetings that were rated on a 10-point scale (very poor to very good. For observational assessment, a total of 19 peer observers used the tool (assessing performance in 20 cancer teams from four hospitals. For evaluation, telephone interviews with 64 team members and all peer observers were analyzed thematically. Results: The tool was easy to use and areas for refinement were identified. Peer

  5. Remedial action programs annual meeting: Meeting notes

    International Nuclear Information System (INIS)

    1987-01-01

    The US Department of Energy Grand Junction Projects Office was pleased to host the 1987 Remedial Action programs Annual Meeting and herein presents notes from that meeting as prepared (on relatively short notice) by participants. These notes are a summary of the information derived from the workshops, case studies, and ad hoc committee reports rather than formal proceedings. The order of the materials in this report follows the actual sequence of presentations during the annual meeting

  6. How valid are claims for synergy in published clinical studies?

    Science.gov (United States)

    Ocana, A; Amir, E; Yeung, C; Seruga, B; Tannock, I F

    2012-08-01

    Clinical trials evaluating drug combinations are often stimulated by claims of synergistic interactions in preclinical models. Overuse or misuse of the term synergy could lead to poorly designed clinical studies. We searched PubMed using the terms 'synergy' or 'synergistic' and 'cancer' to select articles published between 2006 and 2010. Eligible studies were those that referred to synergy in preclinical studies to justify a drug combination evaluated in a clinical trial. Eighty-six clinical articles met eligibility criteria and 132 preclinical articles were cited in them. Most of the clinical studies were phase I (43%) or phase II trials (56%). Appropriate methods to evaluate synergy in preclinical studies included isobologram analysis in 18 studies (13.6%) and median effect in 10 studies (7.6%). Only 26 studies using animal models (39%) attempted to evaluate therapeutic index. There was no association between the result of the clinical trial and the use of an appropriate method to evaluate synergy (P=0.25, chi-squared test). Synergy is cited frequently in phase I and phase II studies to justify the evaluation of a specific drug combination. Inappropriate methods for evaluation of synergy and poor assessment of therapeutic index have been used in most preclinical articles.

  7. Conducting clinical post-conference in clinical teaching: a qualitative study.

    Science.gov (United States)

    Hsu, Li-Ling

    2007-08-01

    The aim of this study was to explore nurse educators' perceptions regarding clinical postconferences. Additional aims included the exploration of interaction characteristics between students and faculty in clinical postconferences. Nursing students are challenged to think and learn in ways that will prepare them for practice in a complex health care environment. Clinical postconferences give students the opportunity to share knowledge gained through transformative learning and provide a forum for discussion and critical thinking. Faculty members must guide students as the latter participate in discussions, develop problem-solving skills and express feedings and attitudes in clinical conferences. The study used qualitative research methods, including participant observation and an open-ended questionnaire. Participant observers watched interaction activities between teachers and students in clinical postconferences. A total of 20 clinical postconferences, two conferences per teacher, were observed. The Non-Numerical Unstructured Data Indexing Searching and Theory-building qualitative software program was used in data analysis. Research findings indicated that, of the six taxonomy questions, lower-level questions (knowledge and comprehensive questions) were mostly asked by faculty members' postclinical conferences. The most frequently used guideline was task orientation, which is related to practice goals and was found in discussions of assignments, reading reports, discussions of clinical experiences, role plays, psychomotor skill practice, quizzes and student evaluations. It is an essential responsibility of nurse educators to employ postconferences to assist students in applying their knowledge in practical situations, in developing professional values and in enhancing their problem solving abilities.

  8. Advanced practice nurses' scope of practice: a qualitative study of advanced clinical competencies.

    Science.gov (United States)

    Nieminen, Anna-Lena; Mannevaara, Bodil; Fagerström, Lisbeth

    2011-12-01

    To describe and explore Advanced Practice Nurses' clinical competencies and how these are expressed in clinical practice. Discussion concerning advanced clinical practice has been ongoing in the USA since the 1960s and in the UK since the late 1980s. Approximately 24 countries, excluding the USA, have implemented the role of Advance Practice Nurse (APN). In the Nordic countries, especially Sweden and Finland, APNs have been introduced in some organizations but their competency domains have not yet been clearly defined. The study's theoretical framework emanates from Aristotle's three-dimensional view of knowledge that is epistêmê, technê, and phronesis. Between October 2005 and January 2006, focus group interviews of Clinical Nurse Specialists who provide expert functions in pediatric, internal medicine, and surgical units (n = 26) and APN students (n = 8) were conducted. The data material was analyzed using inductive content analysis. Grouped into five main themes, the study results indicate that APNs possess advanced level clinical competencies in: (A) assessment of patients' caring needs and nursing care activities, (B) the caring relationship, (C) multi-professional teamwork, (D) development of competence and nursing care, and (E) leadership in a learning and caring culture. Clinical competencies consist of advanced skills, which typify an expanding role that offers new possibilities for holistic patient care practice. APNs' scope of practice is characterized by responsibility and competence in making autonomous judgments based on expanded clinical competence. On an advanced level, clinical competence consists not merely of advanced skills for assessing and meeting the needs of patients but also the creation of safe and trustful relationships with patients and collaboration with colleagues. APNs can realize advanced skills in their actions through their manner of knowing, doing, and being. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011

  9. A study of clinical and information management processes in the surgical pre-assessment clinic.

    Science.gov (United States)

    Bouamrane, Matt-Mouley; Mair, Frances S

    2014-03-25

    Establishing day-case surgery as the preferred hospital admission route for all eligible patients requires adequate preoperative assessment of patients in order to quickly distinguish those who will require minimum assessment and are suitable for day-case admission from those who will require more extensive management and will need to be admitted as inpatients. As part of a study to elucidate clinical and information management processes within the patient surgical pathway in NHS Scotland, we conducted a total of 10 in-depth semi-structured interviews during 4 visits to the Dumfries & Galloway Royal Infirmary surgical pre-assessment clinic. We modelled clinical processes using process-mapping techniques and analysed interview data using qualitative methods. We used Normalisation Process Theory as a conceptual framework to interpret the factors which were identified as facilitating or hindering information elucidation tasks and communication within the multi-disciplinary team. The pre-assessment clinic of Dumfries & Galloway Royal Infirmary was opened in 2008 in response to clinical and workflow issues which had been identified with former patient management practices in the surgical pathway. The preoperative clinic now operates under well established processes and protocols. The use of a computerised system for managing preoperative documentation substantially transformed clinical practices and facilitates communication and information-sharing among the multi-disciplinary team. Successful deployment and normalisation of innovative clinical and information management processes was possible because both local and national strategic priorities were synergistic and the system was developed collaboratively by the POA staff and the health-board IT team, resulting in a highly contextualised operationalisation of clinical and information management processes. Further concerted efforts from a range of stakeholders are required to fully integrate preoperative assessment

  10. Clinical waste incinerators in Cameroon--a case study

    DEFF Research Database (Denmark)

    Mochungong, Peter Ikome Kuwoh; Gulis, Gabriel; Sodemann, Morten

    2012-01-01

    Incinerators are widely used to treat clinical waste in Cameroon's Northwest Region. These incinerators cause public apprehension owing to purported risks to operators, communities and the environment. This article aims to summarize findings from an April 2008 case study....

  11. Facilitating case studies in massage therapy clinical education.

    Science.gov (United States)

    Baskwill, Amanda

    2013-01-01

    The integration of evidence into reflective health care practice has been on the rise in recent years and is a phenomenon that has affected all health care professions, including massage therapy. Clinical case studies are a research design that follows one patient or subject, making the studies ideal for use in clinical practice. They are valuable for communicating information from clinical practice to the broader community. Case studies have face validity that may be more valuable to individual practitioners than homogeneous randomized controlled trials, as the practitioner may recognize a complex patient in the case report. At Humber College, Student Massage Therapists (SMTs) create, conduct, and communicate results of a clinical case study prior to graduation. This article describes the process and experience.

  12. Family Medicine needs assessment: Studying the clinical work of ...

    African Journals Online (AJOL)

    Family Medicine needs assessment: Studying the clinical work of general practitioners in Ethiopia. J Philpott, S Shiferaw, K Rouleau, D Cole, E Nicolle, K Bezanson, N Pimlott, C Meaney, G Nasmith, M Abbyad, M Derbew, A Mekasha ...

  13. Clinical patterns of primary stabbing headache: a single clinic-based prospective study.

    Science.gov (United States)

    Kim, Dong Yeop; Lee, Mi Ji; Choi, Hyun Ah; Choi, Hanna; Chung, Chin-Sang

    2017-12-01

    The clinical features and disease courses of primary stabbing headache (PSH) are diverse. We aimed to identify distinct clinical patterns of PSH. We prospectively screened consecutive first-visit patients who presented with stabbing headache at the Samsung Medical Centre Headache Clinic from June 2015 to March 2016. Demographics, headache characteristics, and disease courses were prospectively evaluated. After discerning factors related to the chronicity at the time of presentation, clinical patterns were identified based on the frequency (daily vs. intermittent), clinical course (remitted or not), and total disease duration (3 months). In the 65 patients with PSH included in this study, monophasic (n = 31), intermittent (n = 17), and chronic daily (n = 12) patterns were identified. The median disease durations were 9 days for monophasic PSH, 9 months for chronic daily PSH, and 2 years for intermittent PSH. The features of monophasic PSH were greater severity, single and side-locked locations, more attacks per day, daily occurrence, and good treatment response. Chronic daily PSH was associated with female predominance, longer-lasting stabs, and multiple or migrating locations on bilateral or alternating sides. The characteristics of intermittent PSH included female predominance and sporadic stabs with less intensity. Our study demonstrated distinct clinical patterns of PSH. In addition to help early recognition of disease, our findings suggest different pathophysiologic mechanisms. Future prospective studies are required to reveal the etiologies of these different PSH patterns and their optimal treatment strategies.

  14. Merging clinical chemistry biomarker data with a COPD database - building a clinical infrastructure for proteomic studies.

    Science.gov (United States)

    Eriksson, Jonatan; Andersson, Simone; Appelqvist, Roger; Wieslander, Elisabet; Truedsson, Mikael; Bugge, May; Malm, Johan; Dahlbäck, Magnus; Andersson, Bo; Fehniger, Thomas E; Marko-Varga, György

    2016-01-01

    Data from biological samples and medical evaluations plays an essential part in clinical decision making. This data is equally important in clinical studies and it is critical to have an infrastructure that ensures that its quality is preserved throughout its entire lifetime. We are running a 5-year longitudinal clinical study, KOL-Örestad, with the objective to identify new COPD (Chronic Obstructive Pulmonary Disease) biomarkers in blood. In the study, clinical data and blood samples are collected from both private and public health-care institutions and stored at our research center in databases and biobanks, respectively. The blood is analyzed by Mass Spectrometry and the results from this analysis then linked to the clinical data. We built an infrastructure that allows us to efficiently collect and analyze the data. We chose to use REDCap as the EDC (Electronic Data Capture) tool for the study due to its short setup-time, ease of use, and flexibility. REDCap allows users to easily design data collection modules based on existing templates. In addition, it provides two functions that allow users to import batches of data; through a web API (Application Programming Interface) as well as by uploading CSV-files (Comma Separated Values). We created a software, DART (Data Rapid Translation), that translates our biomarker data into a format that fits REDCap's CSV-templates. In addition, DART is configurable to work with many other data formats as well. We use DART to import our clinical chemistry data to the REDCap database. We have shown that a powerful and internationally adopted EDC tool such as REDCap can be extended so that it can be used efficiently in proteomic studies. In our study, we accomplish this by using DART to translate our clinical chemistry data to a format that fits the templates of REDCap.

  15. Studies on production planning of IPEN fuel-element plant in order to meet RMB demand

    International Nuclear Information System (INIS)

    Negro, Miguel L.M.; Saliba-Silva, Adonis M.; Durazzo, Michelangelo

    2015-01-01

    The plant of the Nuclear Fuel Center (CCN) will have to change its current laboratorial production level to an industrial level in order to meet the fuel demand of RMB and of IEA-R1. CCN's production process is based on the hydrolysis of UF6, which is not a frequent production route for nuclear fuel. The optimization of the production capacity of such a production route is a new field of studies. Two different approaches from the area of Operations Research (OR) were used in this paper. The first one was the PERT/CPM technique and the second one was the creation of a mathematical linear model for minimization of the production time. PERT/CPM's results reflect the current situation and disclose which production activities may not be critical. The results of the second approach show a new average time of 3.57 days to produce one Fuel Element and set the need of inventory. The mathematical model is dynamic, so that it issues better results if performed monthly. CCN's management team will therefore have a clearer view of the process times and production and inventory levels. That may help to shape the decisions that need to be taken for the enlargement of the plant's production capacity. (author)

  16. Infections in orthopaedic surgery : clinical and experimental studies

    OpenAIRE

    Vogely, Henri Charles

    2000-01-01

    The diagnostic difficulties, variability in outcome and the heterogeinity of the problem of orthopaedic infections stimulated the author to a study of the literature, and several clinical and experimental studies. The diagnosis prosthesis-related infection can only be reached with an acceptable degree of certainty by combination of clinical, laboratory and imaging investigations. Fourty-seven patients with a prosthetic hip infection treated in our hospital were retrospectively divided into th...

  17. Patient advocacy from the clinical nurses' viewpoint: a qualitative study

    OpenAIRE

    Davoodvand, Shirmohammad; Abbaszadeh, Abbas; Ahmadi, Fazlollah

    2016-01-01

    One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. Th...

  18. Best herbs for managing diabetes: a review of clinical studies

    OpenAIRE

    Ghorbani, Ahmad

    2013-01-01

    Diabetes mellitus is a public health problem which leads to serious complications over time. Experimentally, many herbs have been recommended for treating diabetes. In most cases, however, the recommendations are based on animal studies and limited pieces of evidence exist about their clinical usefulness. This review focused on the herbs, the hypoglycemic actions of which have been supported by three or more clinical studies. The search was done in Google Scholar, Medline and Science Direct d...

  19. Opportunities for Increased Physical Activity in the Workplace: the Walking Meeting (WaM) Pilot Study, Miami, 2015.

    Science.gov (United States)

    Kling, Hannah E; Yang, Xuan; Messiah, Sarah E; Arheart, Kristopher L; Brannan, Debi; Caban-Martinez, Alberto J

    2016-06-23

    Despite the positive impact walking has on human health, few opportunities exist for workers with largely sedentary jobs to increase physical activity while at work. The objective of this pilot study was to examine the implementation, feasibility, and acceptability of using a Walking Meeting (WaM) protocol to increase the level of work-related physical activity among a group of sedentary white-collar workers. White-collar workers at a large university were invited to participate in a newly developed WaM protocol. Workers who conducted weekly meetings in groups of 2 or 3 individuals were recruited for the pilot study (n = 18) that took place from January 2015 to August 2015. Seventeen participants wore an accelerometer to measure physical activity levels during 3 consecutive weeks (first week baseline, followed by 2 weeks of organized WaMs) and participated in focus groups conducted during week 3 to document experiences with the WaM protocol. The WaM protocol met study criteria on feasibility, implementation, and acceptability among study participants. The average number of minutes (standard deviation) participants engaged in combined work-related moderate/vigorous physical activity per week during the 3 weeks increased from an average of 107 (55) minutes during the baseline week to 114 (67) minutes at week 2 and to 117 (65) minutes at week 3. White- collar workers were supportive of transforming regular seated meetings into walking meetings and increased their work-related physical activity levels.

  20. A Case Study of a Rural Iowa School Preparing to Meet New State Guidelines for School Libraries

    Science.gov (United States)

    Krueger, Karla Steege

    2009-01-01

    A qualitative case study highlighting one rural Iowa elementary school provided insight into the issue of small schools without library programs as they are preparing to meet the Iowa reinstatement of the requirement for school library programs. The site was purposefully chosen because it has been operating without a school library program or…

  1. Microneedle delivery: clinical studies and emerging medical applications.

    Science.gov (United States)

    Pettis, Ronald J; Harvey, Alfred J

    2012-03-01

    The concept of microneedle drug delivery was described three decades ago; however, effective clinical demonstration has only occurred within the past 10-15 years. Substantial progress in microneedle design and fabrication including extensive in vitro, ex vivo, and in vivo preclinical evaluation with various drugs, vaccines and other agents has transpired over the last decade. In contrast with this large volume of preclinical data, there are relatively few published microneedle clinical studies. To date, the clinical investigative focus has included testing to reduce dermal barrier properties and enhance transdermal delivery; evaluation of enhanced vaccine antigenicity, including development of the first commercial microneedle product for intradermal influenza vaccination; evaluation of altered microneedle protein pharmacokinetics and pharmacodynamics, especially for insulin; and evaluation of the pain and other perceptions associated with microneedle usage. This review summarizes the various aspects of microneedle clinical evaluation to date and identifies areas requiring further clinical evaluation.

  2. Enhancing Clinical Reasoning Through Simulation Debriefing: A Multisite Study.

    Science.gov (United States)

    Forneris, Susan G; Neal, Diana O; Tiffany, Jone; Kuehn, Mary Beth; Meyer, Heidi M; Blazovich, Linda M; Holland, Ann E; Smerillo, Melanie

    2015-01-01

    The aim of this research was to replicate Dreifuerst's 2012 findings of enhanced clinical reasoning scores using a structured debriefing: Debriefing for Meaningful Learning (DML). The direct effect of debriefing on clinical reasoning is not well studied. The nursing education literature supports debriefing as a reflective dialogue necessary to enhance clinical reasoning. A quasi-experimental, pretest-posttest, repeated measure research design was used to evaluate nursing students' clinical reasoning using the Health Sciences Reasoning Test (HSRT). The change in HSRT mean scores was determined to be significant for the intervention group at the .05 level and insignificant for the control group. The change in HSRT mean scores between the intervention and control groups was determined to be significant at the .10 level. Nursing students who had the DML debriefing scored significantly higher in their clinical reasoning than nursing students who had usual and customary debriefing.

  3. Studies on fuels with low fission gas release. Proceedings of a technical committee meeting

    International Nuclear Information System (INIS)

    1997-10-01

    For more than a decade, the IAEA has organized various specialists meetings to discuss advances in nuclear fuel technology for non-water cooled reactors. In order to review progress in research and development of fuels with low fission gas release for light water reactors, fast reactors and research reactors, an IAEA Technical Committee meeting was organized in October 1996. At the invitation of the Government of the Russian Federation, the meeting was held in Moscow. Experts from seven Member States and one international organization participated. The objective of the meeting was to exchange topical information on such fuels, to evaluate their advantages and drawbacks, and to explore their commercial utilization. The present volume contains the full text of the sixteen papers presented at the meeting. The information compiled in these proceedings should be useful for engineers, scientists and managers from nuclear fuel development organizations, fuel fabrication plants, utilities and regulatory bodies who are involved in the analysis of fuel behaviour under normal and accident conditions. Refs, figs, tabs

  4. [Evidence-based medicine and real world study in clinical study of acupuncture and moxibustion].

    Science.gov (United States)

    Cai, Ronglin; Hu, Ling; Wu, Zijian

    2015-09-01

    Evidence-based medicine (EBM) has been widely applied in clinical study of acupuncture and moxibustion, and the real-world study (RWS) has gradually become an important way of clinical research in the world in recent years. It is worthy of our in-depth study and discussion that how to evaluate the advantages and limitations of EBM and RWS as well as their reasonable application in clinical study of acupuncture and moxibustion. The characteristics and difference between RWS and EBM, and the situation of acupuncture clinical research methods are discussed in this paper. It is proposed that we should understand the advantages of RWS in acupuncture clinical research, fully realize the limitations of EBM and RWS, recognize the complexity and particularity of RWS, and apply EBM and RWS into acupuncture clinical research. Meanwhile acupuncture clinical manipulation standardization should be further promoted, which is benefit to develop clinical study, improve clinical efficacy and promote the popularization of acupuncture and moxibustion.

  5. Kraepelin’s description of chronic mania: a clinical picture that meets the behavioral variant frontotemporal dementia phenotype

    Directory of Open Access Journals (Sweden)

    Leandro Boson Gambogi

    Full Text Available ABSTRACT Chronic mania is an under-investigated condition and few reports have associated this disorder with an organic background. The present work examines Kraepelin’s reliable description of chronic mania from a current behavioral neurology viewpoint. Kraepelin had described a cluster of symptoms that are now recognized as core manifestations of the behavioral variant frontotemporal dementia (bvFTD clinical phenotype. We also carried out additional reviews of original manuscripts from Kraepelin’s peers, in order to find any case reports that might fulfill the current diagnostic proposal for bvFTD. Even though we failed to find an ideal case, we found some scholars who seemed to agree that chronic mania should be considered a special form of dementia. The present work highlights, through historical data, the possible overlapping features between primary psychiatric disorders and neuropsychiatric symptoms secondary to neurodegenerative conditions.

  6. Meet interesting abbreviations in clinical mass spectrometry: from compound classification by REIMS to multimodal and mass spectrometry imaging (MSI).

    Science.gov (United States)

    Luptáková, D; Pluháček, T; Palyzová, A; Přichystal, J; Balog, J; Lemr, K; Juránek, I; Havlíček, V

    This feature article discusses two modern mass spectrometry abbreviations in their clinical applications. Rapid evaporative ionization mass spectrometry (REIMS) is reported as a molecular classification tool useful for spectral features definition prior to mass spectrometry imaging (MSI). REIMS is appreciated not only as an ionization technique coupled with a surgical device but particularly as a biomarker discovery tool. For more complex understanding of pathological processes at cellular and molecular levels, the importance of multimodal approach in imaging applications is documented in the context of fiducial markers needed for hyperspectral data fusion collected by optical microscopy, elemental and molecular MSI. Finally, pathogen inactivation needed prior to the sectioning of the infected tissue is reported, and the impact of formaldehyde crosslinking to signal reduction is discussed.

  7. Older patients' participation in team meetings-a phenomenological study from the nurses' perspective.

    Science.gov (United States)

    Lindberg, Elisabeth; Persson, Eva; Hörberg, Ulrica; Ekebergh, Margaretha

    2013-12-20

    Although the importance of patient participation is acknowledged in today's healthcare, many challenges remain before patient participation can become an integral part of care provision. The ward round has traditionally been the forum for crucial decisions about patient care, but often with limited possibilities for patient participation. As part of the process of improving patient participation, the round in the present study has been replaced by a team meeting (TM) to which the patient has been invited. The aim of this study is to highlight nurses' experiences of older patients' participation in TMs. The research process was guided by the principles of phenomenological reflective life world research. Data were collected in a Swedish hospital, in a ward specializing in older patients. Nine nurses, who had invited and planned for a patient to participate in TMs and/or had experienced TMs in which patients participated, were interviewed. The essential meaning of patient participation in the TM, as experienced by the nurses, is that patient participation can be supported by a safe relationship in which the patient can make his or her voice heard. Participation is challenged by the patients' vulnerability and by the subordinated role assigned to the patient. The essential meaning is further described by its constituents: "the need for a guide," "patient participation challenged by structures," and "creating space for the whole human being." In conclusion, the nurse plays a core role in guiding the patient in an unfamiliar situation. The meaning of patient participation in the TM needs to be discussed by professionals so that the patient perspective is present.

  8. Process quality of decision-making in multidisciplinary cancer team meetings: a structured observational study.

    Science.gov (United States)

    Hahlweg, Pola; Didi, Sarah; Kriston, Levente; Härter, Martin; Nestoriuc, Yvonne; Scholl, Isabelle

    2017-11-17

    The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation. An adaptation of the observer rating scale Multidisciplinary Tumor Board Metric for the Observation of Decision-Making (MDT-MODe) was used to assess the quality of the presented information and team processes in MDTMs. Data was analyzed using descriptive statistics and mixed logistic regression analysis. N = 249 cases were observed in N = 29 MDTMs. While cancer-specific medical information was judged to be of high quality, psychosocial information and information regarding patient views were considered to be of low quality. In 25% of the cases no, in 64% one, and in 10% more than one treatment recommendations were given (1% missing data). Giving no treatment recommendation was associated with duration of case discussion, duration of the MDTM session, quality of case history, quality of radiological information, and specialization of the MDTM. Higher levels of medical and treatment uncertainty during discussions were found to be associated with a higher probability for more than one treatment recommendation. The quality of different aspects of information was observed to differ greatly. In general, we did not find MDTMs to be in line with the principles of patient-centered care. Recommendation outcome varied substantially between different specializations of MDTMs. The quality of certain information was associated with the recommendation outcome. Uncertainty during discussions was related to more than one recommendation being considered. Time constraints

  9. Proceedings of the meeting on computational and experimental studies for modeling of radionuclide migration in complex aquatic ecosystems

    International Nuclear Information System (INIS)

    Matsunaga, Takeshi; Hakanson, Lars

    2010-09-01

    The Research Group for Environmental Science of JAEA held a meeting on computational and experimental studies for modeling of radionuclide migration in complex aquatic ecosystems during November 16-20 of 2009. The aim was to discuss the relevance of various computational and experimental approaches to that modeling. The meeting was attended by a Swedish researcher, Prof. Dr. Lars Hakanson of Uppsala University. It included a joint talk at the Institute for Environmental Sciences, in addition to a field and facility survey of the JNFL commercial reprocessing plant located in Rokkasho, Aomori. The meeting demonstrated that it is crucial 1) to make a model structure be strictly relevant to the target objectives of a study and 2) to account for inherent fluctuations in target values in nature in a manner of qualitative parameterization. Moreover, it was confirmed that there can be multiple different approaches of modeling (e.g. detailed or simplified) with relevance for the objectives of a study. These discussions should be considered in model integration for complex aquatic ecosystems consisting catchments, rivers, lakes and coastal oceans which can interact with the atmosphere. This report compiles research subjects and lectures presented at the meeting with associated discussions. The 10 of the presented papers indexed individually. (J.P.N.)

  10. Guidelines for clinical studies with compression devices in patients with venous disorders of the lower limb.

    Science.gov (United States)

    Rabe, E; Partsch, H; Jünger, M; Abel, M; Achhammer, I; Becker, F; Cornu-Thenard, A; Flour, M; Hutchinson, J; Issberner, K; Moffatt, Ch; Pannier, F

    2008-04-01

    The scientific quality of published clinical trials is generally poor in studies where compression devices have been assessed in the management of venous disease. The authors' aim was to establish a set of guidelines which could be used in the design of future clinical trials of compression treatments for venous diseases. Consensus conference leading to a consensus statement. The authors form a expert consensus group known as the International Compression Club (ICC). This group obtained published medical literature in the field of compression treatment in venous disease by searching medical literature databases. The literature was studied by the group which attended a consensus meeting. A draft document was circulated to ICC members and revised until agreement between contributors was reached. The authors have prepared a set of guidelines which should be given consideration when conducting studies to assess the efficacy of compression in venous disease. The form of compression therapy including the comparators used in the clinical study must be clearly characterised. In future studies the characteristics of the material provided by the manufacturer should be described including in vivo data on pressure and stiffness of the final compression system. The pressure exerted on the distal lower leg should be stated in mmHg and the method of pressure determination must be quoted.

  11. Large clinical study shows value of therapeutic touch program.

    Science.gov (United States)

    Newshan, Gayle; Schuller-Civitella, Donna

    2003-01-01

    Representing the largest published sample size of therapeutic touch (TT) outcomes to date, data from this continuous quality improvement (CQI) clinical study suggests that TT, when provided in the clinical setting, promotes comfort, calmness, and well-being among hospitalized patients. In addition, patients are highly satisfied with TT. The newly developed Patient Satisfaction Survey and TT Performance Improvement Tool provide an effective means by which to evaluate a TT program.

  12. Meeting report of the International Consortium of Stem Cell Networks' Workshop Towards Clinical Trials Using Stem Cells for Amyotrophic Lateral Sclerosis/Motor Neuron Disease.

    Science.gov (United States)

    Chaddah, Maya R; Dickie, Brian G; Lyall, Drew; Marshall, Caroline J; Sykes, J Ben; Bruijn, Lucie I

    2011-09-01

    The International Consortium of Stem Cell Networks' (ICSCN) Workshop Towards Clinical Trials Using Stem Cells for Amyotrophic Lateral Sclerosis (ALS)/Motor Neuron Disease (MND) was held on 24-25 January 2011. Twenty scientific talks addressed aspects of cell derivation and characterization; preclinical research and phased clinical trials involving stem cells; latest developments in induced pluripotent (iPS) cell technology; industry involvement and investment. Three moderated panel discussions focused on unregulated ALS/MND treatments, and the state of the art and barriers to future progress in using stem cells for ALS/MND. This review highlights the major insights that emanated from the workshop around the lessons learned and barriers to progress for using stem cells for understanding disease mechanism, drug discovery, and as therapy for ALS/MND. The full meeting report is only available in the online version of the journal. Please find this material with the following direct link to the article: http://www.informahealthcare.com/als/doi/10.3109/17482968.2011.590992 .

  13. Report of special study meeting on 'Atomic energy research aiming at consistent nuclear fuel cycle', fiscal year 1992

    International Nuclear Information System (INIS)

    Nishina, Kojiro; Nishihara, Hideaki; Mishima, Kaichiro

    1994-12-01

    This meeting was held on March 4, 1993. Since the first power generation with the JPDR and the initial criticality of the KUR, 30 years, and since the initial criticality of the KUCA, 20 years have elapsed. The researchers in universities have contributed greatly to the research and education of atomic energy, but the perspective of leading the world hereafter in this field is very uncertain. This study meeting was held to seek the way to make the proper contribution. In the meeting, lectures were given on Japanese policy on nuclear fuel cycle, the present state of the upstream research and the downstream research in Japan, the experimental plan in NUCEF, the present state of the researches on TRU decay heat data and TRU nucleus data, the present state of the experimental researches at KUCA and at FCA, the present state of the research on the heat removal from high conversion LWRs and the KUR, the present state of the research on radioactive waste treatment, and the present state of TRU chemical research. The record of the holding of this study meeting is added. (K.I.)

  14. Acute radiation proctitis. A clinical, histopathological and histochemical study

    International Nuclear Information System (INIS)

    Hovdenak, Nils

    2004-01-01

    The aim of the study is: 1) A sequential description of the clinical course of acute radiation proctitis during pelvic RT. 2) A sequential description of the rectal mucosal histopathology during pelvic RT as a possible substrate for clinical toxicity. 3) To assess the mucosal protease activity during RT as a possible explanation of the observed tissue changes. 4) To assess the efficacy of prophylactic sucralfate in acute radiation proctitis a randomised study was initiated and carried out together with a meta-analysis of previously available data. 5) Most studies on clinical acute toxicity in pelvic RT use either the RTOG/EORTC score system or focus on diarrhoea/stool frequency. A more differentiated and sensitive recording was developed and tested to pick up symptoms escaping the commonly used scores. 6) Study the relation between histopathological findings and the clinical picture. 4 papers presenting various studies are included. The titles are: 1) Acute radiation proctitis: a sequential clinicopathologic study during pelvic radiotherapy. 2) Clinical significance of increased gelatinolytic activity in the rectal mucosa during external beam radiation therapy of prostate cancer. 3) Profiles and time course of acute radiation toxicity symptoms during conformal radiotherapy for cancer of the prostate. 4) Sucralfate does not ameliorate acute radiation proctitis. Some future prospects are discussed

  15. Acute radiation proctitis. A clinical, histopathological and histochemical study

    Energy Technology Data Exchange (ETDEWEB)

    Hovdenak, Nils

    2004-07-01

    The aim of the study is: 1) A sequential description of the clinical course of acute radiation proctitis during pelvic RT. 2) A sequential description of the rectal mucosal histopathology during pelvic RT as a possible substrate for clinical toxicity. 3) To assess the mucosal protease activity during RT as a possible explanation of the observed tissue changes. 4) To assess the efficacy of prophylactic sucralfate in acute radiation proctitis a randomised study was initiated and carried out together with a meta-analysis of previously available data. 5) Most studies on clinical acute toxicity in pelvic RT use either the RTOG/EORTC score system or focus on diarrhoea/stool frequency. A more differentiated and sensitive recording was developed and tested to pick up symptoms escaping the commonly used scores. 6) Study the relation between histopathological findings and the clinical picture. 4 papers presenting various studies are included. The titles are: 1) Acute radiation proctitis: a sequential clinicopathologic study during pelvic radiotherapy. 2) Clinical significance of increased gelatinolytic activity in the rectal mucosa during external beam radiation therapy of prostate cancer. 3) Profiles and time course of acute radiation toxicity symptoms during conformal radiotherapy for cancer of the prostate. 4) Sucralfate does not ameliorate acute radiation proctitis. Some future prospects are discussed.

  16. Second Mesiobuccal Canal Treatment in a Predoctoral Dental Clinic: A Retrospective Clinical Study.

    Science.gov (United States)

    Coelho, Marcelo Santos; Parker, Jeffrey M; Tawil, Peter Z

    2016-06-01

    The aim of this retrospective clinical study was to evaluate the location and treatment of second canals in mesiobuccal roots (MB2) of first and second maxillary molars in a predoctoral endodontic clinic by the graduating classes of 2008 to 2015. These results were compared to similar clinical studies. Included in the study were 368 root canal treatments performed by 310 third- and fourth-year dental students at one U.S. dental school. All cases were done under faculty supervision, and the students were instructed to use dental loupe magnification. Students' evaluation sheets were used to deteremine the total MB2 canals treated in first and second maxillary molars. The results showed that, overall, 72.55% of the teeth had an MB2 canal treated. The frequency was higher in first molars (75.91%) than in second molars (56.92%) (p0.05). Under proper supervision by experienced endodontists, these dental students were capable of treating MB2 canals in maxillary molars. The frequency of MB2 canals located and treated by dental students with the assistance of experienced professionals was higher in first than in second molars. No significant difference was found between third- and fourth-year students. The incidence of MB2 canals located and treated in this study was found to be similar to that in other clinical studies.

  17. Multivariate analysis of the population representativeness of related clinical studies.

    Science.gov (United States)

    He, Zhe; Ryan, Patrick; Hoxha, Julia; Wang, Shuang; Carini, Simona; Sim, Ida; Weng, Chunhua

    2016-04-01

    To develop a multivariate method for quantifying the population representativeness across related clinical studies and a computational method for identifying and characterizing underrepresented subgroups in clinical studies. We extended a published metric named Generalizability Index for Study Traits (GIST) to include multiple study traits for quantifying the population representativeness of a set of related studies by assuming the independence and equal importance among all study traits. On this basis, we compared the effectiveness of GIST and multivariate GIST (mGIST) qualitatively. We further developed an algorithm called "Multivariate Underrepresented Subgroup Identification" (MAGIC) for constructing optimal combinations of distinct value intervals of multiple traits to define underrepresented subgroups in a set of related studies. Using Type 2 diabetes mellitus (T2DM) as an example, we identified and extracted frequently used quantitative eligibility criteria variables in a set of clinical studies. We profiled the T2DM target population using the National Health and Nutrition Examination Survey (NHANES) data. According to the mGIST scores for four example variables, i.e., age, HbA1c, BMI, and gender, the included observational T2DM studies had superior population representativeness than the interventional T2DM studies. For the interventional T2DM studies, Phase I trials had better population representativeness than Phase III trials. People at least 65years old with HbA1c value between 5.7% and 7.2% were particularly underrepresented in the included T2DM trials. These results confirmed well-known knowledge and demonstrated the effectiveness of our methods in population representativeness assessment. mGIST is effective at quantifying population representativeness of related clinical studies using multiple numeric study traits. MAGIC identifies underrepresented subgroups in clinical studies. Both data-driven methods can be used to improve the transparency of

  18. Status quo, issues, and challenges for acupuncture research evidence: an overview of clinical and fundamental studies.

    Science.gov (United States)

    Cai, Yujia; Shen, Jiantong; Zhong, Dake; Li, Youping; Wu, Taixiang

    2012-02-01

    that CSR. All information provided above demonstrates a deficiency of high-quality evidence from China affirming the efficiency of acupuncture. (3) Nine CSRs published by Chinese researchers included 38 RCTs (44%) from China, as well as 48 foreign RCTs; four of these CSRs included RCTs from China only. (4) Over 70% of acupuncture fundamental RCTs were carried out by China alone while only 11% of acupuncture clinical RCTs included in SCI were from China, both of which suggest the methodology quality of acupuncture clinical RCTs in China should be raised to meet international standards. (5) Clinical research was the primary focus of acupuncture studies in Europe and the US. (6) Acupuncture studies were divided into nine research areas according to the top 50 disease-related high-frequency words in acupuncture RCTs. The first three disease categories, comprehensively ranked using published clinical RCTs, were pain and analgesia, cardio-cerebrovascular diseases, and the neuropsychological system. The top three disease categories of both on-going clinical RCTs and acupuncture fundamental RCTs, respectively, were in accordance with those of published clinical RCTs. (1) CL CTRD is the key database in searching for published acupuncture clinical RCTs, and thus should be used first. Databases such as MEDLINE, SCI, and CNKI are all indispensable in retrieving acupuncture fundamental RCTs. (2) China leads the world in terms of both clinical and acupuncture fundamental RCTs, but while publication occurs rapidly, there is a lack of high-quality RCTs, suggesting future acupuncture clinical RCTs in China should place a higher emphasis on quality. Further development of acupuncture fundamental studies with little clinical research is a coming challenge for China. The US provides many of the RCTs published in SCI and on-going RCTs registered in WHO-ICTRP. Its small but high-quality publication will increasingly strengthen its impact on acupuncture research. (3) The fact that the top

  19. Public meeting: Western New York Nuclear Service Center options study. [Problem of West Valley plant

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-04-01

    This document is a transcript of the meeting, with additional written comments. The main topic is the West Valley Processing Plant and how to dispose of it and its high-level wastes. Objective is to get public input on this topic. (DLC)

  20. 75 FR 66378 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

    Science.gov (United States)

    2010-10-28

    ... approximately 11:30 a.m. ADDRESSES: Emory Conference Center Hotel, 1615 Clifton Road, Atlanta, GA 30329. Phone... Conference Center Hotel, Atlanta, GA. The meeting will be open to the public with attendance limited to space... technological innovation. In undertaking these duties, the Commission will examine specific bioethical, legal...

  1. 76 FR 21369 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

    Science.gov (United States)

    2011-04-15

    ... approximately 1:15 p.m. ADDRESSES: The Warwick New York Hotel, 65 West 54th Street, New York, NY 10019. Phone... p.m. on Thursday, May 19, 2011, at the Warwick New York Hotel, New York, NY. The meeting will be... will examine specific bioethical, legal, and social issues related to potential scientific and...

  2. 76 FR 48864 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

    Science.gov (United States)

    2011-08-09

    ..., DC 20005. Telephone: 202-233-3960. E-mail: [email protected]bioethics.gov . Additional information may be obtained at http://www.bioethics.gov . SUPPLEMENTARY INFORMATION: Pursuant to the Federal Advisory... attendance limited to space available. The meeting will also be webcast at http://www.bioethics.gov . Under...

  3. 77 FR 76042 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

    Science.gov (United States)

    2012-12-26

    ...-233-3960. Email: [email protected]bioethics.gov . Additional information may be obtained at www.bioethics... with attendance limited to space available. The meeting will also be webcast at www.bioethics.gov....bioethics.gov . The Commission welcomes input from anyone wishing to provide public comment on any issue...

  4. 78 FR 46335 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

    Science.gov (United States)

    2013-07-31

    ..., 2013. At this meeting, the Bioethics Commission will continue to discuss the ethical implications of incidental findings. The Bioethics Commission will also discuss the BRAIN Initiative and ongoing work in.... Telephone: 202-233-3960. Email: [email protected]bioethics.gov . Additional information may be obtained at www...

  5. 78 FR 71615 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

    Science.gov (United States)

    2013-11-29

    ...: [email protected]bioethics.gov . Additional information may be obtained at www.bioethics.gov . SUPPLEMENTARY... with attendance limited to space available. The meeting will also be webcast at www.bioethics.gov... bioethics, science, medicine, technology, engineering, law, philosophy, theology, or other areas of the...

  6. 75 FR 34451 - Public Meeting of the Presidential Commission for the Study of Bioethical Issues

    Science.gov (United States)

    2010-06-17

    ...., Suite C-100, Washington, DC 20005. Telephone: 202/233-3960. E-mail: [email protected]bioethics.gov . Web site: http://www.bioethics.gov . SUPPLEMENTARY INFORMATION: The meeting agenda will be posted at http://www.bioethics.gov . The Commission encourages public comment, either in person or in writing. Interested members...

  7. Proceedings of the 13th annual meeting on upper atmosphere studies by optical methods

    International Nuclear Information System (INIS)

    Maaseide, K.

    1986-12-01

    A total of 41 papers were presented under the following session topics: Atmospheric emissions; auroral features and dynamics; auroral pulsations; airglow and atmospheric parameters; atmospheric constituents; instrumentation and data handling; and observation programs. The report presents the full text or abstracts of 31 of the lectures given at the meeting. 25 of the papers are seperate input to the data base from this report

  8. 77 FR 57055 - Regulatory New Drug Review: Solutions for Study Data Exchange Standards; Notice of Meeting...

    Science.gov (United States)

    2012-09-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Chapter I Regulatory New Drug Review: Solutions for..., 2012 (77 FR 48491). The document announced a meeting entitled ``Regulatory New Drug Review: Solutions...

  9. Hydroxyurea revisited: a decade of clinical effects studies

    International Nuclear Information System (INIS)

    Sinclair, W.K.

    1981-01-01

    Over a decade ago hydroxyurea was shown to selectively kill cells in the S phase in a proliferating cell population and to block cells at the G 1 -S border. Consequently, blocked cells became sensitized to irradiation and were further sensitized when the drug was present after exposure. In the ensuing decade, many in vivo studies on hydroxyurea have confirmed that the main properties of hydroxyurea identified in the dish are also evident in vivo. During a period of about ten years, a considerable number of clinical studies have been performed, the results of which have been mixed, ranging from indeterminate to encouraging, depending to some extent on the site treated and whether careful randomized studies were done. The question arises whether the clinical studies have represented adequate tests, by laboratory standards, of the likely effectiveness of the drug in clinical circumstances. The clinical studies with hydroxyurea have been examined in this light, since the results might also bear on the use of many other such agents in combination therapy. This examination revealed that no attempts have been made to determine the concentration of hydroxyurea in the tumor and other relevant tissues as a function of time or to assess the cell kinetic features of the tumor and thus estimate the appropriate dose regimen. It would seem that a wide gap still exists between laboratory research and clinical application

  10. [Clinical stages of patients with Alzheimer disease treated in specialist clinics in Spain. The EACE study].

    Science.gov (United States)

    Alom Poveda, J; Baquero, M; González-Adalid Guerreiro, M

    2013-10-01

    The diagnostic paradigm of Alzheimer disease (AD) is changing; there is a trend toward diagnosing the disease in its early stages, even before the complete syndrome of dementia is apparent. The clinical stage at which AD is usually diagnosed in our area is unknown. Therefore, the purpose of this study is to describe the clinical stages of AD patients at time of diagnosis. Multicentre, observational and cross-sectional study. Patients with probable AD according to NINCDS-ARDRA criteria, attended in specialist clinics in Spain, were included in the study. We recorded the symptom onset to evaluation and symptom onset to diagnosis intervals and clinical status of AD (based on MMSE, NPI questionnaire, and CDR scale). Participants in this study included 437 specialists representing all of Spain's autonomous communities and a total of 1,707 patients, of whom 1,694 were included in the analysis. Mean MMSE score was 17.6±4.8 (95% CI:17.4-17.9). Moderate cognitive impairment (MMSE between 10 and 20) was detected in 64% of the patients, and severe cognitive impairment (MMSEde Neurología. Published by Elsevier Espana. All rights reserved.

  11. Clinical and Para Clinical Information Needs of Infertility Electronic Health Records in Iran: A Delphi Study.

    Science.gov (United States)

    Farzandipour, Mehrdad; Jeddi, Fateme Rangraz; Gilasi, Hamid Reza; Shirzadi, Diana

    2017-09-01

    infertility is referred to the person's inability to conceive pregnancy after one year of intercourse without using protection. This study paves the ground for creating a complete, united, and coherent source of patients' medical information. this is an applied research of descriptive-cross sectional type which has been carried out through qualitative - quantitative methods. The sample of the present study was 50 specialists in the field of infertility which has been chosen based on purposive sampling method. Designing the questionnaire was done based on library studies and Gathering experts' views was done based on Delphi technique. 261 items from clinical and Para clinical information of infertile patients' electronic health records were subjected to an opinion poll by experts. During this process 223 items were accepted and 38 items have been rejected after two sessions of surveys by infertility experts. Para clinical information section consisted of 57 items that all of them have been accepted by the experts. Also, clinical information section consisted of 242 items from which 204 items were accepted and 38 items were rejected by the experts. existence of a structured electronic record system of infertile patients' information leads to the integration of patients' information, improvement of health care services and a decrease in treatment costs: all working to increase information safety. Furthermore, only essential and relevant information would be provided for the specialists and it will facilitate and direct the future infertility related studies due to the coherence, unity and relevance of the information.

  12. Psychological functioning in adolescents referred to specialist gender identity clinics across Europe: a clinical comparison study between four clinics.

    Science.gov (United States)

    de Graaf, Nastasja M; Cohen-Kettenis, Peggy T; Carmichael, Polly; de Vries, Annelou L C; Dhondt, Karlien; Laridaen, Jolien; Pauli, Dagmar; Ball, Juliane; Steensma, Thomas D

    2017-12-18

    Adolescents seeking professional help with their gender identity development often present with psychological difficulties. Existing literature on psychological functioning of gender diverse young people is limited and mostly bound to national chart reviews. This study examined the prevalence of psychological functioning and peer relationship problems in adolescents across four European specialist gender services (The Netherlands, Belgium, the UK, and Switzerland), using the Child Behavioural Checklist (CBCL) and the Youth Self-Report (YSR). Differences in psychological functioning and peer relationships were found in gender diverse adolescents across Europe. Overall, emotional and behavioural problems and peer relationship problems were most prevalent in adolescents from the UK, followed by Switzerland and Belgium. The least behavioural and emotional problems and peer relationship problems were reported by adolescents from The Netherlands. Across the four clinics, a similar pattern of gender differences was found. Birth-assigned girls showed more behavioural problems and externalising problems in the clinical range, as reported by their parents. According to self-report, internalising problems in the clinical range were more prevalent in adolescent birth-assigned boys. More research is needed to gain a better understanding of the difference in clinical presentations in gender diverse adolescents and to investigate what contextual factors that may contribute to this.

  13. A Prospective Randomized Clinical Study of the Influence of Primary ...

    African Journals Online (AJOL)

    Objective: The aim of the following study is to determine the effect of primary closure or dressing on post‑operative morbidity after impacted lower third molar surgery. Materials and Methods: This was a randomized clinical study of 72 patients who had surgical extraction of impacted mandibular third molars. The subjects ...

  14. Clinical findings versus imaging studies in the diagnosis of infantile ...

    African Journals Online (AJOL)

    Objectives The aim of this study was to assess the accuracy of clinical examination compared with ultrasound and upper .... patients, and increased muscle diameter of more than. 14mm in 54 (90%) patients with both longitudinal and transverse images. A barium study was performed in all patients and different signs were ...

  15. Infections in orthopaedic surgery : clinical and experimental studies

    NARCIS (Netherlands)

    Vogely, Henri Charles

    2000-01-01

    The diagnostic difficulties, variability in outcome and the heterogeinity of the problem of orthopaedic infections stimulated the author to a study of the literature, and several clinical and experimental studies. The diagnosis prosthesis-related infection can only be reached with an acceptable

  16. PRELIMINARY CLINICAL STUDY OF KALANCHOE SPATHULATA DC. ON INFLAMMATORY WOUND

    Science.gov (United States)

    Yadav, C. L.; Yadav, C. S.

    1985-01-01

    Here, an attempt is made to study the clinical aspect of Kalanchoe spathulata Dc. It has been observed that would heals rapidly leaving no scar. The study clearly validates the ancient concept of Ayurveda, that without taking the help of surgery, there are several medicinal plants which may cure diseases very well. PMID:22557495

  17. A structured women's preventive health clinic for residents: a quality improvement project designed to meet training needs and improve cervical cancer screening rates.

    Science.gov (United States)

    Singh, Mamta K; Einstadter, Douglas; Lawrence, Renee

    2010-10-01

    Multiple resident-related factors contribute to 'missed opportunities' in providing comprehensive preventive care for female patients, including comfort level, knowledge and experience--all of which are compounded by resident turnover rates. Of particular concern among Internal Medicine (IM) residents is their knowledge and comfort level in performing pelvic exams. To evaluate the impact of a quality improvement project of implementing a Women's Preventive Health Clinic (WPHC) on addressing gaps identified by needs assessments: residents' comfort and knowledge with female preventive care and cervical cancer screening. The WPHC, a multidisciplinary weekly clinic, focused on preventive services for women with chronic conditions. The alternating didactic and clinic sessions emphasised women's preventive health topics for IM residents. Sixty-three IM residents participated in WPHC between 2002 and 2005. Pre- and post-test design was used to assess resident knowledge and comfort levels. Cervical cancer screening rates of residents' patients were assessed pre- and post-WPHC initiation. There was a significant improvement in general knowledge (64% correct at pretest vs 73% at post-test, p=0.0002), resident comfort level in discussing women's health topics and performing gynaecological exams (p<0.0002). Cervical cancer screening rates among IM residents' patients improved from 54% (pre-WPHC initiation) to 65% (post-WPHC initiation period). The results indicate that a focused resident preventive programme can meet gaps identified by education and needs assessments, and simultaneously have a positive impact on cervical cancer screening rates and thus may serve as a model for other residency programmes.

  18. Ambulance clinical placements – A pilot study of students' experience

    Directory of Open Access Journals (Sweden)

    Adams Bridget

    2008-04-01

    Full Text Available Abstract Background Undergraduate paramedic students undertake clinical placements in a variety of locations. These placements are considered an essential element for paramedic pre-employment education. However, anecdotal evidence suggests some students have not had positive experiences on their emergency ambulance placements. The objective of this study was to identify the type of experiences had by students during ambulance clinical placements and to provide feedback to the ambulance services. Methods In this pilot study we employed a cross-sectional study methodology, using a convenience sample of undergraduate paramedic students available in semester one of 2007 to ascertain the students' views on their reception by on-road paramedics and their overall experience on emergency ambulance clinical placements. Ethics approval was granted. Results There were 77 students who participated in the survey, 64% were females, with 92% of students Conclusion This study demonstrates that for a small group of students, emergency ambulance clinical placements were not a positive experience clinically or educationally. Some qualified paramedics doubt if a number of female students can perform the physical role of a paramedic.

  19. Rethinking clinical governance: healthcare professionals’ views: a Delphi study

    Science.gov (United States)

    Veenstra, Gepke L; Ahaus, Kees; Welker, Gera A; Heineman, Erik; van der Laan, Maarten J; Muntinghe, Friso L H

    2017-01-01

    Objective Although the guiding principle of clinical governance states that healthcare professionals are the leading contributors to quality and safety in healthcare, little is known about what healthcare professionals perceive as important for clinical governance. The aim of this study is to clarify this by exploring healthcare professionals' views on clinical governance. Design Based on a literature search, a list of 99 elements related to clinical governance was constructed. This list was refined, extended and restricted during a three-round Delphi study. Setting and participants The panel of experts was formed of 24 healthcare professionals from an academic hospital that is seen as a leader in terms of its clinical governance expertise in the Netherlands. Main outcome measures Rated importance of each element on a four-point scale. Results The 50 elements that the panel perceived as most important related to adopting a bottom-up approach to clinical governance, ownership, teamwork, learning from mistakes and feedback. The panel did not reach a consensus concerning elements that referred to patient involvement. Elements that referred to a managerial approach to clinical governance and standardisation of work were rejected by the panel. Conclusions In the views of the panel of experts, clinical governance is a practice-based, value-driven approach that has the goal of delivering the highest possible quality care and ensuring the safety of patients. Bottom-up approaches and effective teamwork are seen as crucial for high quality and safe healthcare. Striving for high quality and safe healthcare is underpinned by continuous learning, shared responsibility and good relationships and collaboration between healthcare professionals, managers and patients. PMID:28082364

  20. Rethinking clinical governance: healthcare professionals' views: a Delphi study.

    Science.gov (United States)

    Veenstra, Gepke L; Ahaus, Kees; Welker, Gera A; Heineman, Erik; van der Laan, Maarten J; Muntinghe, Friso L H

    2017-01-12

    Although the guiding principle of clinical governance states that healthcare professionals are the leading contributors to quality and safety in healthcare, little is known about what healthcare professionals perceive as important for clinical governance. The aim of this study is to clarify this by exploring healthcare professionals' views on clinical governance. Based on a literature search, a list of 99 elements related to clinical governance was constructed. This list was refined, extended and restricted during a three-round Delphi study. The panel of experts was formed of 24 healthcare professionals from an academic hospital that is seen as a leader in terms of its clinical governance expertise in the Netherlands. Rated importance of each element on a four-point scale. The 50 elements that the panel perceived as most important related to adopting a bottom-up approach to clinical governance, ownership, teamwork, learning from mistakes and feedback. The panel did not reach a consensus concerning elements that referred to patient involvement. Elements that referred to a managerial approach to clinical governance and standardisation of work were rejected by the panel. In the views of the panel of experts, clinical governance is a practice-based, value-driven approach that has the goal of delivering the highest possible quality care and ensuring the safety of patients. Bottom-up approaches and effective teamwork are seen as crucial for high quality and safe healthcare. Striving for high quality and safe healthcare is underpinned by continuous learning, shared responsibility and good relationships and collaboration between healthcare professionals, managers and patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology

    Science.gov (United States)

    De Ieso, P B; Coward, J I; Letsa, I; Schick, U; Nandhabalan, M; Frentzas, S; Gore, M E

    2013-01-01

    Background: The benefits of multidisciplinary working in oncology are now accepted as the norm and widely accepted as being pivotal to the delivery of optimal cancer care. Central to this are the multidisciplinary meetings (MDMs) and we have evaluated decision outcomes and financial costs of these. Methods: We reviewed the electronic patient records of 551 newly referred patients, discussed at 14 tumour site-specific MDMs for adult solid tumours and lymphoma (paediatric oncology and acute leukaemia were excluded) over a 1-month period, a total of 52 MDMs were studied. In addition, the records of a further 81 patients from 10 different MDMs were reviewed where the treating consultant had clearly recorded their opinion of how the patient should be managed and this was compared with the final MDM's consensus view. We also costed the MDMs utilising two different methodologies. Results: The mean age of the 551 patients in the study was 62 years. In all, 536 (97.3%) patients were treatment naive before MDM discussion and 15 (2.7%) had prior treatment. Median time to treatment after the MDM was 16 days. In 535 (97.1%) cases, the MDM discussions were clearly documented, 16 (2.9%) were not clearly documented. In total, 319 (57.9%) patients were discussed once, and 232 (42.1%) were re-discussed (one to six occasions). In 62 (12.7%) patients, there were delays in MDM discussion, 30 (48.4%) were related to radiology, 26 (41.9%) to histopathology and 6 (9.7%) a combination of both. Adherence to the MDM management plan decision occurred 503 times (91.3%) with 48 (8.7%) deviations. In the smaller cohort of 81 patients, the consultant management plan and MDM consensus was compatible 71 (87.6%) times. On four occasions, there were major alterations in management while six were minor. The cost per month of our MDMs ranged from £2192 to £10 050 (median £5136) with total cost of £80 850 per month and the cost per new patient discussed was £415. Conclusion: Adherence to MDM

  2. Proceedings of the Fourteenth NASA Propagation Experimenters Meeting (NAPEX 14) and the Advanced Communications Technology Satellite (ACTS) Propagation Studies Miniworkshop

    Science.gov (United States)

    Davarian, Faramaz (Editor)

    1990-01-01

    The NASA Propagation Experimenters Meeting (NAPEX), supported by the NASA Propagation Program, is convened annually to discuss studies made on radio wave propagation by investigators from domestic and international organizations. NAPEX XIV was held on May 11, 1990, at the Balcones Research Centers, University of Texas, Austin, Texas. The meeting was organized into two technical sessions: Satellite (ACTS) and the Olympus Spacecraft, while the second focused on the fixed and mobile satellite propagation studies and experiments. Following NAPEX XIV, the ACTS Miniworkshop was held at the Hotel Driskill, Austin, Texas, on May 12, 1990, to review ACTS propagation activities since the First ACTS Propagation Studies Workshop was held in Santa Monica, California, on November 28 and 29, 1989.

  3. [Clinical and histological study of lupoid cutaneous leishmaniasis (16 cases)].

    Science.gov (United States)

    Masmoudi, Abderrahmen; Boudaya, Sonia; Ayadi, Narjes; Bouassida, Samir; Khabir, Abdelmajid; Meziou, Taha Jalel; Akrout, Feryel; Sallemi, Tahia; Turki, Hamida; Zahaf, Abdelmajid

    2007-12-01

    Zoonotic cutaneous leishmaniasis (CL) is characterised by a major clinical polymorphism, especially the lupoid type. The aim of our study was to precise the anatomic and clinical particularities of this clinical form of CL. The present work was a prospective 1-year study. In all patients, the epidemiologic and clinical characteristics were identified, together with those regarding disease progression. Standard cutaneous biopsies were carried out for all study patients. The lupoid form was observed in 15% of the patients. It was clinically characterised by a lupoid aspect with papular and squamous placard surrounded by a satellite papule, a short duration of disease progression (28 months in average) and a preferential localisation at the level of the face and the elbow, statistically proven. At the histological level, epidermic hyperplasia was found in 93.8% of the cases; an inflammatory polymorphic dermic infiltrate consisting of lymphocytes and plasmocytes was found in all patients; granulomas were noted in 50% of the cases, and isolated epitheloid cells were observed in the derm of 3 patients. Amastigotes were rarely observed. In our series, the lupoid form was characterised with a short and non chronic evolution and two preferential sites for the affection: the face and the elbow. At the histological level, the lupoid type of CL appeared characterized by a high frequency of granuloma, usually organized, and rare amastigotes. However, the histology of authentic lupoid forms can be non granolomatosic.

  4. Multicentre evaluation of multidisciplinary team meeting agreement on diagnosis in diffuse parenchymal lung disease: a case-cohort study.

    Science.gov (United States)

    Walsh, Simon L F; Wells, Athol U; Desai, Sujal R; Poletti, Venerino; Piciucchi, Sara; Dubini, Alessandra; Nunes, Hilario; Valeyre, Dominique; Brillet, Pierre Y; Kambouchner, Marianne; Morais, António; Pereira, José M; Moura, Conceição Souto; Grutters, Jan C; van den Heuvel, Daniel A; van Es, Hendrik W; van Oosterhout, Matthijs F; Seldenrijk, Cornelis A; Bendstrup, Elisabeth; Rasmussen, Finn; Madsen, Line B; Gooptu, Bibek; Pomplun, Sabine; Taniguchi, Hiroyuki; Fukuoka, Junya; Johkoh, Takeshi; Nicholson, Andrew G; Sayer, Charlie; Edmunds, Lilian; Jacob, Joseph; Kokosi, Maria A; Myers, Jeffrey L; Flaherty, Kevin R; Hansell, David M

    2016-07-01

    Diffuse parenchymal lung disease represents a diverse and challenging group of pulmonary disorders. A consistent diagnostic approach to diffuse parenchymal lung disease is crucial if clinical trial data are to be applied to individual patients. We aimed to evaluate inter-multidisciplinary team agreement for the diagnosis of diffuse parenchymal lung disease. We did a multicentre evaluation of clinical data of patients who presented to the interstitial lung disease unit of the Royal Brompton and Harefield NHS Foundation Trust (London, UK; host institution) and required multidisciplinary team meeting (MDTM) characterisation between March 1, 2010, and Aug 31, 2010. Only patients whose baseline clinical, radiological, and, if biopsy was taken, pathological data were undertaken at the host institution were included. Seven MDTMs, consisting of at least one clinician, radiologist, and pathologist, from seven countries (Denmark, France, Italy, Japan, Netherlands, Portugal, and the UK) evaluated cases of diffuse parenchymal lung disease in a two-stage process between Jan 1, and Oct 15, 2015. First, the clinician, radiologist, and pathologist (if lung biopsy was completed) independently evaluated each case, selected up to five differential diagnoses from a choice of diffuse lung diseases, and chose likelihoods (censored at 5% and summing to 100% in each case) for each of their differential diagnoses, without inter-disciplinary consultation. Second, these specialists convened at an MDTM and reviewed all data, selected up to five differential diagnoses, and chose diagnosis likelihoods. We compared inter-observer and inter-MDTM agreements on patient first-choice diagnoses using Cohen's kappa coefficient (κ). We then estimated inter-observer and inter-MDTM agreement on the probability of diagnosis using weighted kappa coefficient (κw). We compared inter-observer and inter-MDTM confidence of patient first-choice diagnosis. Finally, we evaluated the prognostic significance of a

  5. Association between barriers and facilitators to meeting the Dietary Guidelines for Americans and body weight status of caregiver-child dyads: The HEALTH study

    Science.gov (United States)

    Few Americans meet the Dietary Guidelines for Americans (DGA) yet, a large percentage are overweight. The goal of this research was to examine the association between barriers and facilitators to meeting the DGA and weight in a multi-site study. In a cross-sectional study, a total of 836 caregiver-c...

  6. Evidence that women meeting physical activity guidelines do not sit less: An observational inclinometry study

    Directory of Open Access Journals (Sweden)

    Craft Lynette L

    2012-10-01

    Full Text Available Abstract Background The inactivity physiology paradigm proposes that sedentary behaviors, including sitting too much, are independent of the type of physical activity delineated for health in the Physical Activity Guidelines for Americans. Thus, we hypothesized that, when accounting for behaviors across the entire day, variability in the amount of time spent sitting would be independent of the inter-and intra-individual time engaged in sustained moderate-to-vigorous physical activity (MVPA. Methods Ninety-one healthy women, aged 40–75 years, completed a demographic questionnaire and assessment of height and weight. Participants wore the activPAL activity monitor for one week and time (minutes/day spent sitting, standing, stepping, and in sustained bouts (bouts ≥10 minutes of MVPA were quantified. The women were then stratified into groups based on weekly sustained MVPA. Additionally, each day of data collection for each participant was classified as either a “sufficient” MVPA day (≥ 30 min of MVPA or an “insufficient” MVPA day for within-participant analyses. Results Time spent sitting, standing, and in incidental non-exercise stepping averaged 64, 28, and 11 hrs/week, respectively, and did not differ between groups with individuals meeting/exceeding the current exercise recommendation of 150 min/week of sustained MVPA in ≥10 minutes bouts (M = 294 min/week, SD = 22 compared to those with none or minimal levels (M= 20min/week, SD = 4. Time spent sitting (M = 9.1 hr/day, SD = 0.19 vs. M = 8.8 hr/day, SD = 0.22, standing (M = 3.9 hr/day, SD = 0.16 vs. M = 3.9 hr/day, SD = 0.15, and in intermittent stepping (M = 1.6 hr/day, SD = 0.07 vs. M = 1.6 hr/day, SD = 0.06 did not differ between days with (~55 min/day and without recommended MVPA. Conclusions This study provides the first objective evidence that participation in sustained MVPA is unrelated to daily sitting duration in relatively healthy, middle and older-aged women. More

  7. Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic

    Directory of Open Access Journals (Sweden)

    Oguzhan Sıtkı Dizdar

    2016-02-01

    Full Text Available Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002 and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40, 46.6% (n = 29, 39.7% (n = 27, 35.3% (n = 24, 14.1% (n = 9, respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission.

  8. Clinical and histopathological study of primary cutaneous macular amyloidosis

    Directory of Open Access Journals (Sweden)

    Fatima Razvi

    2013-02-01

    Full Text Available Primary cutaneous amyloidosis often presents with pigmentary dystonias of the skin in the form of asymptomatic reticulate hyper-pigmentation or pruritic lichenoid papular lesions. The aim of this study was to evaluate the incidence of primary cutaneous macular amyloidosis and also to find out the possible etiological agents, to correlate their clinical disease with histopathological positivity for amyloid deposition, and to find out the percentage of positive cas-es by special stains. A total of 24 patients attending dermatology out-patient clinic of Princess Esra Hospital, Hyderabad over a pe-riod of 1 year presenting with hyperpigmented skin lesions and clinically diagnosed as macular amyloidosis were taken up for this study.

  9. A qualitative study of constructive clinical learning experiences.

    Science.gov (United States)

    van der Hem-Stokroos, H H; Daelmans, H E M; van der Vleuten, C P M; Haarman, H J Th M; Scherpbier, A J J A

    2003-03-01

    Little is known about the effectiveness of clinical education. A more educational structure is considered to be potentially beneficial. The following structured components were added to a surgical clerkship: logbooks, an observed student-patient encounter, individual appraisals, feedback on patient notes, and (case) presentations by students. The authors organized two focus-group sessions in which 19 students participated to explore their perceptions about effective clinical learning experiences and the newly introduced structured components. The analysis of the transcripts showed that observation and constructive feedback are key features of clinical training. The structured activities were appreciated and the results show the direction to be taken for further improvement. Learning experiences depended vastly on individual clinicians' educational qualities. Students experienced being on call, assisting in theatre and time for self-study as instructive elements. Recommended clerkship components are: active involvement of students, direct observation, selection of teachers, a positive learning environment and time for self-study.

  10. Proceedings of study meeting on microscopic and phenomenological research of interaction for light heavy-ion systems

    International Nuclear Information System (INIS)

    1991-06-01

    The Research Center for Nuclear Physics study meeting 'Microscopic and phenomenological research of interaction for light heavy-ion systems was held on March 7-9, 1990 as the study meeting in the second half of 1990, and 25 researchers took part in it. As the background of holding this study meeting, the fact that recently the rainbow scattering due to nuclear force was discovered experimentally in 16 O- 16 O system, and phenomenologically it was explained only by deep inter-nucleus potential. This should be evaluated as an important foothold for the research on the interaction for light heavy-ion systems and nuclear reaction mechanism. Accordingly, most of the papers presented this time were those related to the inter-nucleus potential and nuclear reaction mechanism. Also the development of theoretical analysis method was carried out and reported. Further, recently the experimental study on the structure and reaction of the neutron rich nucleus has advanced, and the theoretical research related to this topic was reported. (K.I.)

  11. Ethical formation in the meeting with vulnerability and suffering from the perspective of nursing students in Scandinavia: A qualitative, empirical study

    DEFF Research Database (Denmark)

    Pedersen, Birgith; Sivonen, Kerstin

    Aim The aim of this paper is to deepen our understanding of how nursing students’ ethical formation is affected by their meeting with vulnerability and suffering in clinical practice. Background In clinical practice the students can learn authentic, caring, and respectful nursing adjusted...... to the patients’ situation and the practice of distant and general nursing. Reflective processes can support the ethical dimension of nursing, but there is a lack of knowledge concerning the source of students’ ability to maintain and develop their moral integrity. Methods Twenty-four students were interviewed...... for their ethical formation but the students’ ethical formation may decline in the course of clinical practice. Conclusion Nursing students possess moral sensitivity which is challenged when they meet a clinical practice culture that is incongruent with their ethical ideals. In clinical practice the students seek...

  12. Radiographic demonstration of small intestinal villi on routine clinical studies

    International Nuclear Information System (INIS)

    Gelfand, D.W.; Ott, D.J.

    1981-01-01

    The radiographic demonstration of the small intestinal villi is reported. The villi were demonstrable with both single- and double-contrast methods on routine clinical studies. The primary requirement for their delineation appears to be employment of a high-resolution radiographic system. (orig.) [de

  13. Improving clinical practice through simulation: A case study of ...

    African Journals Online (AJOL)

    Acquisition of knowledge and skills by nursing students before real-life practice is a familiar nursing education challenge. The use of clinical simulation in nursing education provides many opportunities for students to learn and apply theoretical principles of nursing care in a safe environment. The purpose of this study was ...

  14. A study of symptom profile and clinical subtypes of delirium

    OpenAIRE

    Meagher, David

    2012-01-01

    Delineating delirium phenomenology facilitates detection, understanding neuroanatomical endophenotypes, and patient management. This compendium reflects an integrated research plan executed over a five year period, employing detailed, standardized phenomenological assessments cross-sectionally and longitudinally. Motor activity studies were controlled and included both subjective and objective measures, aimed at identifying a new approach to defining this clinical subtype as a more pure motor...

  15. Clinical Experience of Patients Referred to a Multidisciplinary Cardiac Oncology Clinic: An Observational Study

    Directory of Open Access Journals (Sweden)

    Jeffrey Sulpher

    2015-01-01

    Full Text Available Cardiotoxicity is the second leading cause of long-term morbidity and mortality among cancer survivors. The purpose of this retrospective observational study is to report on the clinical and cardiac outcomes in patients with early stage and advanced cancer who were referred to our multidisciplinary cardiac oncology clinic (COC. A total of 428 patients were referred to the COC between October 2008 and January 2013. The median age of patients at time of cancer diagnosis was 60. Almost half of patients who received cancer therapy received first-line chemotherapy alone (169, 41.7%, of which 84 (49.7% were exposed to anthracyclines. The most common reasons for referral to the cardiac oncology clinic were decreased LVEF (34.6%, prechemotherapy assessment (11.9%, and arrhythmia (8.4%. A total of 175 (40.9% patients referred to the COC were treated with cardiac medications. The majority (331, 77.3% of patients were alive as of January 2013, and 93 (21.7% patients were deceased. Through regular review of cardiac oncology clinic referral patterns, management plans, and patient outcomes, we aim to continuously improve delivery of cardiac care to our patient population and optimize cardiac health.

  16. Clinical Experience of Patients Referred to a Multidisciplinary Cardiac Oncology Clinic: An Observational Study.

    Science.gov (United States)

    Sulpher, Jeffrey; Mathur, Shrey; Graham, Nadine; Crawley, Freya; Turek, Michele; Johnson, Christopher; Stadnick, Ellamae; Law, Angeline; Wentzell, Jason; Dent, Susan

    2015-01-01

    Cardiotoxicity is the second leading cause of long-term morbidity and mortality among cancer survivors. The purpose of this retrospective observational study is to report on the clinical and cardiac outcomes in patients with early stage and advanced cancer who were referred to our multidisciplinary cardiac oncology clinic (COC). A total of 428 patients were referred to the COC between October 2008 and January 2013. The median age of patients at time of cancer diagnosis was 60. Almost half of patients who received cancer therapy received first-line chemotherapy alone (169, 41.7%), of which 84 (49.7%) were exposed to anthracyclines. The most common reasons for referral to the cardiac oncology clinic were decreased LVEF (34.6%), prechemotherapy assessment (11.9%), and arrhythmia (8.4%). A total of 175 (40.9%) patients referred to the COC were treated with cardiac medications. The majority (331, 77.3%) of patients were alive as of January 2013, and 93 (21.7%) patients were deceased. Through regular review of cardiac oncology clinic referral patterns, management plans, and patient outcomes, we aim to continuously improve delivery of cardiac care to our patient population and optimize cardiac health.

  17. Analgesia in Amphibians: Preclinical Studies and Clinical Applications

    Science.gov (United States)

    Stevens, Craig W.

    2010-01-01

    SYNOPSIS Preclinical studies of analgesia in amphibians or recommendations for clinical use of analgesics in amphibian species are extremely limited. This article briefly reviews the issues surrounding the use of analgesics in amphibians starting with common definitions of pain and analgesia when applied to non-human animals. Nociceptive and endogenous opioid systems in amphibians are reviewed and results of preclinical research on opioid and non-opioid analgesics summarized. Recommended opioid and non-opioid analgesics are summarized and practical recommendations made for their clinical use. PMID:21074701

  18. Technical Meeting (Research Coordination Meeting) of the Coordinated Research Project (CRP) on 'Studies of advanced reactor technology options for effective incineration of radioactive waste'. Working material

    International Nuclear Information System (INIS)

    2005-01-01

    The Technical Meeting held at the Institute of Plasma Physics, Chinese Academy of Sciences (ASIPP) in Hefei was the second Research Coordination Meeting (RCM) of the CRP on 'Studies of Innovative Reactor Technology Options for Effective Incineration of Radioactive Waste'. All but one Member States participating in the CRP were attending: in all, 26 participants from 13 Member States and three international organizations. The overall objective of the CRP is to increase the capability of Member States in developing and applying advanced nuclear technologies in the area of long-lived radioactive waste utilization and transmutation. The final goal of the CRP is to deepen the understanding of the dynamics of transmutation systems, e.g., the accelerator driven system, especially of systems with deteriorated safety parameters, to qualify the available methods, specify the range of validity of these methods, and formulate requirements for future theoretical developments. Should transient experiments be available, the CRP will pursue experimental benchmarking work. Based on the results, the CRP will conclude on the potential need of transient experiments and make appropriate proposals for experimental programs. The scope of the second RCM was to review the progress achieved with regard on the technical work of the CRP. In particular, the main objectives of the RCM were to (a) analyse and inter-compare the individual results; (b) identify of eventual changes/improvements to the tasks and/or work plans; (c) plan the next stage(s); and (d) start preparation of the final CRP report. The participants were given a brief overview of the Institute's mission and accomplishments. ASIPP (Academia Sinica, Institute of Plasma Physics) was founded in 1978 as the leading centre for high temperature plasma physics, magnetically confined fusion technology, as well as R and D in related technological areas. ASIPP employs nearly 500 staff, of which more than 70% are scientists or engineers

  19. The proportion of clinically relevant alarms decreases as patient clinical severity decreases in intensive care units: a pilot study

    OpenAIRE

    Inokuchi, Ryota; Sato, Hajime; Nanjo, Yuko; Echigo, Masahiro; Tanaka, Aoi; Ishii, Takeshi; Matsubara, Takehiro; Doi, Kent; Gunshin, Masataka; Hiruma, Takahiro; Nakamura, Kensuke; Shinohara, Kazuaki; Kitsuta, Yoichi; Nakajima, Susumu; Umezu, Mitsuo

    2013-01-01

    Objectives To determine (1) the proportion and number of clinically relevant alarms based on the type of monitoring device; (2) whether patient clinical severity, based on the sequential organ failure assessment (SOFA) score, affects the proportion of clinically relevant alarms and to suggest; (3) methods for reducing clinically irrelevant alarms in an intensive care unit (ICU). Design A prospective, observational clinical study. Setting A medical ICU at the University of Tokyo Hospital in To...

  20. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations

    Science.gov (United States)

    Turk, Dennis C.; O’Connor, Alec B.; Dworkin, Robert H.; Chaudhry, Amina; Katz, Nathaniel P.; Adams, Edgar H.; Brownstein, John S.; Comer, Sandra D.; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A.; Klein, Michael; Leiderman, Deborah B.; Lubran, Robert; Rappaport, Bob A.; Zacny, James P.; Ahdieh, Harry; Burke, Laurie B.; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S.; Raja, Srinivasa N.; Rauschkolb, Christine; Roland, Carl L.; Webster, Lynn R.; Weiss, Roger D.; Wolf, Kerry

    2013-01-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Due to the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs in order to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability; (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation; (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse; and (4) post-marketing epidemiological studies. PMID:22770841

  1. The clinical relevance and newsworthiness of NIHR HTA-funded research: a cohort study.

    Science.gov (United States)

    Wright, D; Young, A; Iserman, E; Maeso, R; Turner, S; Haynes, R B; Milne, R

    2014-05-07

    To assess the clinical relevance and newsworthiness of the UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme funded reports. Retrospective cohort study. The cohort included 311 NIHR HTA Programme funded reports publishing in HTA in the period 1 January 2007-31 December 2012. The McMaster Online Rating of Evidence (MORE) system independently identified the clinical relevance and newsworthiness of NIHR HTA publications and non-NIHR HTA publications. The MORE system involves over 4000 physicians rating publications on a scale of relevance (the extent to which articles are relevant to practice) and a scale of newsworthiness (the extent to which articles contain news or something clinicians are unlikely to know). The proportion of reports published in HTA meeting MORE inclusion criteria and mean average relevance and newsworthiness ratings were calculated and compared with publications from the same studies publishing outside HTA and non-NIHR HTA funded publications. 286/311 (92.0%) of NIHR HTA reports were assessed by MORE, of which 192 (67.1%) passed MORE criteria. The average clinical relevance rating for NIHR HTA reports was 5.48, statistically higher than the 5.32 rating for non-NIHR HTA publications (mean difference=0.16, 95% CI 0.04 to 0.29, p=0.01). Average newsworthiness ratings were similar between NIHR HTA reports and non-NIHR HTA publications (4.75 and 4.70, respectively; mean difference=0.05, 95% CI -0.18 to 0.07, p=0.402). NIHR HTA-funded original research reports were statistically higher for newsworthiness than reviews (5.05 compared with 4.64) (mean difference=0.41, 95% CI 0.18 to 0.64, p=0.001). Funding research of clinical relevance is important in maximising the value of research investment. The NIHR HTA Programme is successful in funding projects that generate outputs of clinical relevance.

  2. [Research development and thinking of clinical study of Polygonum multiflorum].

    Science.gov (United States)

    Wu, Cheng-Sheng; Sun, Rong

    2017-01-01

    In order to offer the accordance and research ideas for further research of effect, indication and ensure the safety and effectiveness of clinical medication, the current states of clinical application and adverse reaction of Polygonum multiflorum were summarized. The related literatures in recent years were collated, analyzed and summed up. P. multiflorum is widely used and has variety of adverse reactions. At present, it's used to treat hyperlipidemia, white hair, hair loss, hypertension, vitiligo, etc. Adverse reactions are liver damage, allergic reactions, mental symptoms, chronic enteritis, etc. The effect, indication and adverse reaction research of P. multiflorum is still insufficient, further study should be based on clinical practice, in the aspects of the authenticity of the drug, the disease syndrome, the phase of adverse reactions, individual heterogeneity and compatibility. Copyright© by the Chinese Pharmaceutical Association.

  3. Equine pastern vasculitis: a clinical and histopathological study.

    Science.gov (United States)

    Psalla, Dimitra; Rüfenacht, Silvia; Stoffel, Michael H; Chiers, Koen; Gaschen, Véronique; Doherr, Marcus G; Gerber, Vincent; Welle, Monika M

    2013-11-01

    Equine pastern vasculitis is clinically challenging and the underlying aetiopathogenesis is unclear. The aims of this retrospective study were to establish histopathological criteria for pastern vasculitis, to look for an underlying cause, to investigate whether the histopathological lesions are associated with a distinct clinical picture, to assess if and how the clinical picture varies, and to determine the treatment response. Skin biopsies and clinical data from 20 horses with a diagnosis of vasculitis of the distal extremities were investigated and histology was compared to biopsies from healthy horses. It was concluded that intramural inflammatory cells, leukocytoclasia with nuclear dust, thickening and oedema of the vessel walls, and microhaemorrhages are highly specific histological findings in equine pastern vasculitis. Based on the feedback from the clinicians, the lesions were mostly seen on the lateral and medial aspects of un-pigmented legs. Lesions in white skin were characterised by exudation and crusts, whereas those in pigmented skin were alopecic and characterised by scaling. The response to treatment was poor and the prognosis guarded. No association was found between any of the histopathological findings and a distinct clinical picture. An underlying cause of equine pastern vasculitis could not be identified. Considering the large number of confounding factors, the causative agents are difficult to identify, but may involve drugs or a hypersensitivity reactions to yet unknown antigens. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. The oral mucosa in leprosy: a clinical and histopathological study.

    Science.gov (United States)

    de Abreu, Marilda Aparecida Milanez Morgado; Michalany, Nilceo Schwery; Weckx, Luc Louis Maurice; Neto Pimentel, Dalva Regina; Hirata, Cleonice Hitomi Watashi; de Avelar Alchorne, Maurício Mota

    2006-01-01

    Multibacillary leprosy may involve the oral mucosa, with or without apparent lesions. There are few studies that deal with this issue in the era of multidrug therapy. To assess the frequency of oral mucosa involvement in multibacillary leprosy patients. A transversal study with twenty non-treated multibacillary leprosy patients. The patients were treated in Dracena, São Paulo, between 2000 and 2002. Clinical examination of the oral mucosa was carried out. All patients were submitted to jugal mucosa, soft palate and tongue biopsies, in altered or in pre-established sites. The cross-sections were stained by techniques of hematoxilin-eosin and Ziehl-Neelsen. Granuloma and alcohol-acid-resistant bacilli findings determined the specific histopathological involvement. The study involved 19 patients with an average of 2.5 years of disease progression. Specific histopathological involvement occurred in the tongue and soft palate of one lepromatous patient with an apparently normal oral mucosa. (1) Clinical alterations in the oral mucosa does not imply disease involvement, it is necessary to have histopathological confirmation. (2) Apparent specific clinical alterations are rare. (3) The clinically normal oral mucosa can show specific histopathological involvement.

  5. Integrating data to facilitate clinical research: a case study

    Directory of Open Access Journals (Sweden)

    Ilana Ackerman

    2005-12-01

    Full Text Available The integration of routine clinical administrative activities into ongoing rigorous clinical research poses challenges for both clinicians and researchers. This case study describes the development of a responsive database system used to facilitate comprehensive longitudinal research into the outcomes of patients waiting for hip and knee replacement surgery in a large public teaching hospital. The initial research procedure was paper-based, with manual patient matching and data entry. This process was time-consuming and associated with substantial risk of error and omissions, necessitating the design of a better system. An integrated database system was designed to receive daily electronic updates of the orthopaedic waiting-list and scheduled clinic and surgery dates. Using readily available software (Microsoft Access, new patients were identified through specifying inclusion and exclusion criteria which allowed rapid and complete recruitment at time of entry to the waiting-list. The integrated system specified the appropriate timing of multiple follow-up assessments, provided prompt information on recruitment for reporting purposes and integrated multiple linked research projects within one database. Seamless exporting of data to statistical programs for analysis was also enabled. This simple integrated approach facilitated efficient execution of a longitudinal study from recruitment to statistical analysis while maximising confidentiality and minimising resources required. This case study describes the development and design of a simple system which could be easily adapted for database management in hospital or clinic-based settings according to local requirements.

  6. A study protocol: using demand-side financing to meet the birth spacing needs of the underserved in Punjab Province in Pakistan

    Science.gov (United States)

    2014-01-01

    Background High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women’s health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan. Methods/Design This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as ‘Suraj’ (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period. Discussion The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group. PMID:24885657

  7. Clinical Laboratory Stressors Used to Study Alcohol?Stress Relationships

    OpenAIRE

    Thomas, Suzanne; Bacon, Amy K.; Sinha, Rajita; Uhart, Magdalena; Adinoff, Bryon

    2012-01-01

    Understanding the biologic systems that underlie the relationship between stress and alcohol consumption may lead to better prevention efforts and more effective treatments for alcoholism. Clinical laboratory studies offer a unique opportunity to examine these relationships by using a controlled environment to study how an acute stressor affects alcohol drinking and alcohol craving, how individuals in recovery or those at risk for alcoholism may respond differently to stressors relative to co...

  8. A CLINICAL AND HISTOPATHOLOGICAL STUDY OF LICHEN PLANUS

    OpenAIRE

    Ch. Madhu Babu; P. Padmaja; M. Roopa Shree

    2016-01-01

    BACKGROUND Lichen planus is an idiopathic subacute or chronic inflammatory disease of the skin, mucous membranes, and nails. We studied the clinicopathological profile of 50 cases of Lichen planus in Osmania General Hospital from September 2010-April 2012. METHODS A total of 50 cases Lichen planus attending DVL OPD at OGH were studied. Clinical features like age, sex, type of Lichen planus, location were recorded in the case record form. Histological features of Lichen planus...

  9. Factors influencing change in clinical practice: A qualitative evaluation of the implementation of the quality improvement in colonoscopy study.

    Science.gov (United States)

    Rajasekhar, Praveen T; Rees, Colin J; Nixon, Catherine; East, James E; Brown, Sally

    2016-01-01

    The quality improvement in colonoscopy study was a region wide service improvement study to improve adenoma detection rate at colonoscopy by implementing evidence into routine colonoscopy practice. Implementing evidence into clinical practice can be challenging. The purpose of this paper is to perform a qualitative interview study to evaluate factors that influenced implementation within the study. Semi-structured interviews were conducted with staff in endoscopy units taking part in the quality improvement in colonoscopy study, after study completion. Units and interviewees were purposefully sampled to ensure a range of experiences was represented. Interviews were conducted with 11 participants. Key themes influencing uptake of the quality improvement in colonoscopy evidence bundle included time, study promotion, training, engagement, positive outcomes and modifications. Areas within themes were increased awareness of quality in colonoscopy (QIC), emphasis on withdrawal time and empowerment of endoscopy nurses to encourage the use of quality measures were positive outcomes of the study. The simple, visible study posters were reported as useful in aiding study promotion. Feedback sessions improved engagement. Challenges included difficulty arranging set-up meetings and engaging certain speciality groups. This evaluation suggests that methods to implement evidence into clinical practice should include identification and empowerment of team members who can positively influence engagement, simple, visible reminders and feedback. Emphasis on timing of meetings and strategies to engage speciality groups should also be given consideration. Qualitative evaluations can provide important insights into why quality improvement initiatives are successful or not, across different sites.

  10. Exploring factors affecting undergraduate medical students' study strategies in the clinical years: a qualitative study.

    NARCIS (Netherlands)

    Al Kadri, H.M.; Al-Moamary, M.S.; Elzubair, M.; Magzoub, M.E.; AlMutairi, A.; Roberts, C.; Vleuten, C.P.M. van der

    2011-01-01

    The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health

  11. Exploring Factors Affecting Undergraduate Medical Students' Study Strategies in the Clinical Years: A Qualitative Study

    Science.gov (United States)

    Al Kadri, Hanan M. F.; Al-Moamary, Mohamed S.; Elzubair, Margaret; Magzoub, Mohi Eldien; AlMutairi, Abdulrahman; Roberts, Christopher; van der Vleuten, Cees

    2011-01-01

    The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi…

  12. A clinical and histopatholgical study of nevus sebaceus

    Directory of Open Access Journals (Sweden)

    Neerja Puri

    2013-08-01

    Full Text Available Background Nevus sebaceus (NS, otherwise designated as 'organoid nevus', involves proliferative changes of the sebaceous glands, sweat glands, and the hair follicles. It displays a range of appearances, depending on the lesion's age. Aims To study the clinical features along with histopathological study of 20 cases of nevus sebaceus. Methods We selected 20 cases of nevus sebaceous for the study. Results Clinically,verrucous plaques were seen in 60% patients, papules were seen in 25% patients and patches were seen in 15% patients. All of them showed abortive/immature hair follicles characterized by cords of undifferentiated, basaloid cells resembling the embryonic stages of hair follicle. Conclusions To conclude, NS is an organoid nevus, i.e a hamartoma consisting of various elements indigenous to the organ and not merely the sebaceous units.

  13. A clinical and histolopathological study of pityriasis lichenoides

    Directory of Open Access Journals (Sweden)

    Nair Pradeep

    2007-01-01

    Full Text Available Background: Pityriasis lichenoides is a papulosquamous disorder of unknown etiology with remissions and exacerbations. Histopathology helps greatly in the diagnosis of this condition. Aim: We studied clinical and histopathological features of pityriasis lichenoides in our patients. Methods: This is a 3-year retrospective and prospective, descriptive study of all patients clinically diagnosed as pityriasis lichenoides and confirmed by histopathology. All patients were studied clinically and histopathologically. Results: There were 51 (30 males and 21 females cases of pityriasis lichenoides in the study period. The maximum number of cases, 14 (27.45% were in their second decade of life. Pityriasis lichenoides chronica was diagnosed in 39 cases (76.47% and pityriasis lichenoides et varioliformis acuta (PLEVA in 12 cases (23.53%. Histopathologically, basal cell vacuolation and perivascular infiltrate were seen in all the cases. Exocytosis was seen in 45.1% of the cases. All the cases of PLEVA showed lymphocytic vasculitis albeit without fibrinoid deposition in the vessel walls. Conclusion: Pityriasis lichenoides is not a rare disorder. and is not a true lymphocytic vasculitis as blood vessel damage and fibrinoid deposition in the blood vessel walls were not seen in this study.

  14. Clinical, radiological and imunogenectical study in patients with Reiter's Syndrome

    International Nuclear Information System (INIS)

    Souza Meirelles, E. de.

    1987-01-01

    This study puspose was to investigate the clinical, radiological and immunogenetical parameters from a brazilian Reiter's Syndrome population. Twenty Reiter's Syndrome patients from ''Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo'' were prospectivelly studied in their demographical (sex, race, age at study, age at disease onset and disease duration), epidemiological (family history), clinical (general, articular, mucocutaneous, genitourinary, ocular and intestinal manifestations besides functional capacity at study), radiological (sacro-iliitis, spondylitis and calcaneal spur) and immunogenetical (HLA loci A, B and DR typing). The technique employed in the 61 aloantigens from loci HLA A (17), B (34) and DR (10) typing was Terasaki microlymphocitotoxicity modified by Danilovs, had being performed in the ''Laboratorio de Imunogenetica da Faculdade de Medicina da Universidade de Sao Paulo''. We concluded that the clinical, radiological and immunogenetical Reiter's Syndrome expression in the brazilian population is similar to the others north american or european already studied populations and that the probability of one brazilian HLA B27 positie individual to develop Reiter's Syndrome is 19 fold larger when compared to one brazilian HLA B27 negative individual. (author) [pt

  15. The Henri Mondor Procedure of Morbidity and Mortality Review Meetings: Prospective Registration of Clinical, Dosimetric, and Individual Radiosensitivity Data of Patients With Severe Radiation Toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Belkacemi, Yazid, E-mail: yazid.belkacemi@aphp.fr [AP-HP, Department of Radiation Oncology, University of Paris-Est, Créteil (France); AP-HP, Henri Mondor Breast Center, University of Paris-Est, Créteil (France); INSERM U955 Eq 07, University of Paris-Est, Créteil (France); Colson-Durand, Laurianne [AP-HP, Department of Radiation Oncology, University of Paris-Est, Créteil (France); AP-HP, Henri Mondor Breast Center, University of Paris-Est, Créteil (France); Granzotto, Adeline [INSERM, UMR1052, Radiobiology Group, Cancer Research Centre of Lyon, Lyon (France); Husheng, Shan; To, Nhu Hanh; Majdoul, Soufya; Guet, Saada; Hervé, Marie-Laure; Fonteneau, Gloria; Diana, Christian; Le Bret, Cindy; Dominique, Claude [AP-HP, Department of Radiation Oncology, University of Paris-Est, Créteil (France); Fayolle, Maryse [AP-HP, Department of Radiation Oncology, University of Paris-Est, Créteil (France); AP-HP, Henri Mondor Breast Center, University of Paris-Est, Créteil (France); Foray, Nicolas [INSERM, UMR1052, Radiobiology Group, Cancer Research Centre of Lyon, Lyon (France)

    2016-11-01

    Purpose: After radiation therapy (RT), various radiation-induced toxicities can develop in about one-fourth of patients. An international interest in using morbidity and mortality rates to monitor the quality of care and integrate morbidity and mortality review (MMR) meetings into organizations' governance processes has arisen. We report the first results of patients included in our MMR procedure that included biological assays for individual intrinsic radiosensitivity (IIRS). Methods and Materials: Twenty-three patients were prospectively included in the MMR database. Twenty-two were evaluable for IIRS. Prostate (n=10) and breast (n=8) cancers were the most frequent disease types. The total dose delivered, determined according to the type of disease, ranged from 30 to 74 Gy. Our MMR procedure requires strict criteria: patients with unresolved toxicity of grade 3 or higher with availability of clinical (photographic) data, IIRS results obtained from skin biopsy assays, treatment modalities, and follow-up data. The RT technique and dosimetry were reviewed. Results: Our prospective registration of toxicities showed mainly rectitis, occurring in 7 cases, and skin toxicities, occurring in 9. Of the 7 patients with rectitis, 5 received 66 Gy of post-prostatectomy RT with V50 (rectum volume receiving 50 Gy) ranging from 45% to 75% and a mean maximal dose of 66.5 Gy. For dermatitis and cystitis, the mean maximal doses were in the range of classical constraints without any overdosage or dose heterogeneity. No errors were found in the review of treatment planning and positioning. Conversely, all the patients were considered biologically as radiosensitive with genomic instability and ATM (ataxia telangiectasia mutated)-dependent DNA double-strand break repair impairments. Conclusions: The MMR review of files allowed clear answers for patients on the relationship between clinical events and their IIRS. Our procedure has allowed education of all our staff to monitor

  16. The Henri Mondor Procedure of Morbidity and Mortality Review Meetings: Prospective Registration of Clinical, Dosimetric, and Individual Radiosensitivity Data of Patients With Severe Radiation Toxicity

    International Nuclear Information System (INIS)

    Belkacemi, Yazid; Colson-Durand, Laurianne; Granzotto, Adeline; Husheng, Shan; To, Nhu Hanh; Majdoul, Soufya; Guet, Saada; Hervé, Marie-Laure; Fonteneau, Gloria; Diana, Christian; Le Bret, Cindy; Dominique, Claude; Fayolle, Maryse; Foray, Nicolas

    2016-01-01

    Purpose: After radiation therapy (RT), various radiation-induced toxicities can develop in about one-fourth of patients. An international interest in using morbidity and mortality rates to monitor the quality of care and integrate morbidity and mortality review (MMR) meetings into organizations' governance processes has arisen. We report the first results of patients included in our MMR procedure that included biological assays for individual intrinsic radiosensitivity (IIRS). Methods and Materials: Twenty-three patients were prospectively included in the MMR database. Twenty-two were evaluable for IIRS. Prostate (n=10) and breast (n=8) cancers were the most frequent disease types. The total dose delivered, determined according to the type of disease, ranged from 30 to 74 Gy. Our MMR procedure requires strict criteria: patients with unresolved toxicity of grade 3 or higher with availability of clinical (photographic) data, IIRS results obtained from skin biopsy assays, treatment modalities, and follow-up data. The RT technique and dosimetry were reviewed. Results: Our prospective registration of toxicities showed mainly rectitis, occurring in 7 cases, and skin toxicities, occurring in 9. Of the 7 patients with rectitis, 5 received 66 Gy of post-prostatectomy RT with V50 (rectum volume receiving 50 Gy) ranging from 45% to 75% and a mean maximal dose of 66.5 Gy. For dermatitis and cystitis, the mean maximal doses were in the range of classical constraints without any overdosage or dose heterogeneity. No errors were found in the review of treatment planning and positioning. Conversely, all the patients were considered biologically as radiosensitive with genomic instability and ATM (ataxia telangiectasia mutated)-dependent DNA double-strand break repair impairments. Conclusions: The MMR review of files allowed clear answers for patients on the relationship between clinical events and their IIRS. Our procedure has allowed education of all our staff to monitor

  17. Logic Meeting

    CERN Document Server

    Tugué, Tosiyuki; Slaman, Theodore

    1989-01-01

    These proceedings include the papers presented at the logic meeting held at the Research Institute for Mathematical Sciences, Kyoto University, in the summer of 1987. The meeting mainly covered the current research in various areas of mathematical logic and its applications in Japan. Several lectures were also presented by logicians from other countries, who visited Japan in the summer of 1987.

  18. Education of Disadvantaged Groups and Multiple Class Teaching: Studies and Innovative Approaches. Report of a Study Group Meeting (Jakarta, November 17-26, 1980).

    Science.gov (United States)

    United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and the Pacific.

    Participants from India, Korea, Maldives, Nepal, Thailand, the Philippines, Sri Lanka, and Indonesia met to formulate strategies and develop alternative methods of teaching multiple classes and educating disadvantaged groups. Activities of the Study Group Meeting included four phases: presentation and discussion of country experiences relating to…

  19. Effects of Normobaric Hyperoxia in Severe Acute Stroke: a Randomized Controlled Clinical Trial Study.

    Science.gov (United States)

    Mazdeh, Mehrdokht; Taher, Abbas; Torabian, Saadat; Seifirad, Soroush

    2015-11-01

    Oxygen therapy might increase damaged tissue oxygenation, turn on the aerobic pathway, and save neurons from death and could improve clinical outcome of the patients with stroke and head trauma. Hyperbaric oxygen therapy is accompanied by some unfavorable effects. Results of normobaric oxygen therapy on clinical outcomes of patients with stroke were controversial up till now.  This study was therefore designed to evaluate effects of normobaric hyperoxia on clinical outcomes of patients with severe acute stroke. A total of 52 consecutive patients with stroke who meet the inclusion criteria of the study were entered into this randomized controlled clinical trial. The patients in the case group underwent oxygen therapy with Venturi mask for first 12 hours of admission. The patients were examined for neurologic defects at the time of discharge and after six months using both Barthel and modified Rankin Scale (mRS) neurologic disability scoring systems. There was no significant sex difference between the two groups (P=0.5). There was no statistically significant difference between ischemic-hemorrhagic stroke constitutions of two groups (P=0.2). There were no significant difference in Barthel index scores of both groups at the time of discharge as well as the follow-up examination (P=0.7) According to the mRS scoring system, there was no difference between the patients of both groups at the time of admission (P= 0.8), however after treatment there was a significant difference between mRS scores of the treated group compared to the controls (P=0.04). According to the results of this study, normobaric oxygen therapy in the first 12 hours of accident could improve long time outcome of the patients with either ischemic or hemorrhagic stroke.

  20. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    DEFF Research Database (Denmark)

    Chalmers, J. R.; Simpson, Elizabeth M; Apfelbacher, C. J.

    2016-01-01

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmö, Sweden on 23–24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and q...

  1. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    NARCIS (Netherlands)

    Chalmers, J. R.; Simpson, E.; Apfelbacher, C. J.; Thomas, K. S.; von Kobyletzki, L.; Schmitt, J.; Singh, J. A.; Svensson, A.; Williams, H. C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T. L.; Block, J.; Bragg, A.; Burton, T.; Clemmensen, K. K. Bjerring; Creswell-Melville, A.; Dinesen, M.; Drucker, A.; Eckert, L.; Flohr, C.; Garg, M.; Gerbens, L. A. A.; Graff, A. L. B.; Hanifin, J.; Heinl, D.; Humphreys, R.; Ishii, H. A.; Kataoka, Y.; Leshem, Y. A.; Marquort, B.; Massuel, M. -A.; Merhand, S.; Mizutani, H.; Murota, H.; Murrell, D. F.; Nakahara, T.; Nasr, I.; Nograles, K.; Ohya, Y.; Osterloh, I.; Pander, Jan; Prinsen, C.; Purkins, L.; Ridd, M.; Sach, T.; Schuttelaar, M. -L. A.; Shindo, S.; Smirnova, J.; Sulzer, A.; Gjerde, E. Synnove; Takaoka, R.; Talmo, H. Vestby; Tauber, M.; Torchet, F.; Volke, A.; Wahlgren, C. -F.; Weidinger, S.; Weisshaar, E.; Wollenberg, A.; Yamaga, K.; Zhao, C. Y.; Spuls, P. I.

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmo, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and

  2. Report on the inaugural meeting of the international consortium on hallucination research : a clinical and research update and 16 consensus-set goals for future research

    NARCIS (Netherlands)

    Waters, F.; Aleman, A.; Fernyhough, C.; Allen, P.

    This article presents a report on the first meeting of the International Consortium on Hallucination Research, which took place on September 13-14, 2011 at the Institute of Psychiatry, London. The first day of the meeting served to reflect on the current state of knowledge regarding auditory

  3. A CLINICAL STUDY OF GASTRIC OUTLET OBSTRUCTION IN ADULT POPULATION

    Directory of Open Access Journals (Sweden)

    Manju Singh

    2017-02-01

    Full Text Available BACKGROUND Gastric outlet obstruction (GOO also known as pyloric obstruction is not a single entity. It is the clinical & pathophysiological consequence of any disease process that produces a mechanical impediment to gastric emptying. MATERIALS AND METHODS 37 patients attending surgical out-patient department of Pt. J. N. M. Medical College, Raipur during the period of March 2015 to September 2016 of GOO with chief complaints of projectile vomiting, visible gastric peristalsis or palpable distended stomach were included in this study. Cases of functional non-mechanical cause of GOO were excluded. Only patients of 20 years & above were included in this study. Saline load test, upper gastro-intestinal endoscopy and routine laboratory investigations done in all cases. RESULTS Age group of 40-59 was maximum sufferer 27%, followed by age group 60-69 years (21.9%. Male-Female ratio was 1.2:1. Antral carcinoma (75.7% cases topped the list followed by cicatrised duodenal ulcer which was seen in 18.9% cases; only two case was due to duodenal adenoma. CONCLUSION This study is a clinical observational study of gastric outlet obstruction, but in vast majority of cases diagnosis can be established clinically. Males are more sufferers and antral carcinoma seems to be main causes of GOO, Proliferative lesion is common finding in UGI.

  4. Impact of regulatory assessment on clinical studies in Brazil.

    Science.gov (United States)

    Russo, Luis Augusto Tavares; Eliaschewitz, Freddy Goldberg; Harada, Vitor; Trefiglio, Roberta Pereira; Picciotti, Raffaella; Machado, Paula Goulart Pinheiro; Kesselring, Gustavo Luiz Ferreira

    2016-01-01

    Despite the recent expansion of clinical studies allocated to Brazil, the delay of local regulatory deadlines directly impacts their completion. This article examines the allocation process of clinical studies to Brazil in comparison with other countries, as well as the financial impact of studies not completed due to interruption caused by the delay in the regulatory process. The allocation processes of studies were compared in nine countries with similar stages of economic development and countries in Latin America using the websites http://data.worldbank.org/data-catalog/GDP-rankings-table and http://worldpopulationreview.com and clinicaltrials.gov, comprising 185 countries. The 46 studies sponsored by the pharmaceutical industry underwent an analysis of the regulatory review process. 46 studies sponsored by the industry and submitted in the country between June 2007 and June 2013 were analyzed; 18 (39%) were discontinued due to the delay in obtaining the necessary approvals. For the approved studies, patient recruitment began an average of 11 months after the other countries. It is estimated that 530 Brazilians patients did not have the opportunity to participate in these studies. Financial losses were to the order of 14.6 million dollars for the country, including patient, medication and supplies costs, and expenses. Brazil has enormous potential for the realization of clinical studies. Researchers, associations of disabled people and patients with chronic diseases, sponsors and the authorities must work together to develop an approval process that is efficient, predictable and, most of all, transparent. The current regulatory environment must and can be improved and optimized in order to result in tangible benefits for patients, society and the country's scientific development.

  5. Report on the first WHO integrated meeting on development and clinical trials of influenza vaccines that induce broadly protective and long-lasting immune responses: Hong Kong SAR, China, 24-26 January 2013.

    Science.gov (United States)

    Girard, Marc P; Tam, John S; Pervikov, Yuri; Katz, Jacqueline M

    2013-08-20

    On January 24-26, 2013, the World Health Organization convened the first integrated meeting on "The development and clinical trials of vaccines that induce broadly protective and long-lasting immune responses" to review the current status of development and clinical evaluation of novel influenza vaccines as well as strategies to produce and deliver vaccines in novel ways. Special attention was given to the development of possible universal influenza vaccines. Other topics that were addressed included an update on clinical trials of pandemic and seasonal influenza vaccines in high-risk groups and vaccine safety, as well as regulatory issues. Copyright © 2013. Published by Elsevier Ltd.. All rights reserved.

  6. Standardized Representation of Clinical Study Data Dictionaries with CIMI Archetypes.

    Science.gov (United States)

    Sharma, Deepak K; Solbrig, Harold R; Prud'hommeaux, Eric; Pathak, Jyotishman; Jiang, Guoqian

    2016-01-01

    Researchers commonly use a tabular format to describe and represent clinical study data. The lack of standardization of data dictionary's metadata elements presents challenges for their harmonization for similar studies and impedes interoperability outside the local context. We propose that representing data dictionaries in the form of standardized archetypes can help to overcome this problem. The Archetype Modeling Language (AML) as developed by the Clinical Information Modeling Initiative (CIMI) can serve as a common format for the representation of data dictionary models. We mapped three different data dictionaries (identified from dbGAP, PheKB and TCGA) onto AML archetypes by aligning dictionary variable definitions with the AML archetype elements. The near complete alignment of data dictionaries helped map them into valid AML models that captured all data dictionary model metadata. The outcome of the work would help subject matter experts harmonize data models for quality, semantic interoperability and better downstream data integration.

  7. Pituitary apoplexy: clinical features, management and outcome. Clinical study and review of the literature

    Directory of Open Access Journals (Sweden)

    Solomon Adriana Elena

    2015-03-01

    Full Text Available Background: Pituitary apoplexy is a clinical syndrome secondary to rapid expansion of the content of the sella and extension to suprasellar region, cavernous sinus, sphenoid sinus secondary to a bleeding, ischemic or mixed episode taking place in a pituitary adenoma. This episode will determine a significant compression of the optic nerves, optic chiasm, cavernous sinus and hypothalamus, which translates clinically most often by headache, visual disturbances, deceased level of consciousness and ophthalmoplegia. Material and methods: This paper presents a retrospective study over a period of five years, from January 2009 to December 2013 and includes 98 patients diagnosed with pituitary apoplexy and treated in the Third Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni. Of the 98 patients, 62 were females (63.3 % and 36 were males (36.7 % with a ratio of female to male of 1.7:1. The patients were aged between 17 and 75 years old, average age being approximately 50 years. Follow-up period ranged from 2 months to 5 years. The main symptomsat presentation was sudden, intense headache, this symptom was encountered in 90 patients (91.83%, vomiting showed by 76 patients (77.55%, decreased visual acuity observed in 57 patients (58.16%, visual field deficits in 74 patients (75.51%, cranial nerves palsy (III, IV, VI observed in 14 patients (14.28 %. Conclusions: Pituitary apoplexy is a disease that can endanger patients' lives. The clinical presentation may vary from minor symptoms to major neurological deficits and even death so early diagnosis and treatment are vital.

  8. Enhancing clinical learning in the workplace: a qualitative study.

    Science.gov (United States)

    Magnier, K; Wang, R; Dale, V H M; Murphy, R; Hammond, R A; Mossop, L; Freeman, S L; Anderson, C; Pead, M J

    Workplace learning (WPL) is seen as an essential component of clinical veterinary education by the veterinary profession. This study sought to understand this type of learning experience more deeply. This was done utilising observations of students on intramural rotations (IMR) and interviews with students and clinical staff. WPL was seen as an opportunity for students to apply knowledge and develop clinical and professional skills in what is generally regarded as a safe, authentic environment. Clinical staff had clear ideas of what they expected from students in terms of interest, engagement, professionalism, and active participation, where this was appropriate. In contrast, students often did not know what to expect and sometimes felt under-prepared when entering the workplace, particularly in a new species area. With the support of staff acting as mentors, students learned to identify gaps in their knowledge and skills, which could then be addressed during specific IMR work placements. Findings such as these illustrate both the complexities of WPL and the diversity of different workplace settings encountered by the students.

  9. Myopathies of endocrine disorders: A prospective clinical and biochemical study

    Directory of Open Access Journals (Sweden)

    Vikas Sharma

    2014-01-01

    Full Text Available Introduction: Major categories of endocrine myopathy include those associated with: Adrenal dysfunction (as in Cushing′s disease or steroid myopathy; thyroid dysfunction (as in myxedema coma or thyrotoxic myopathy; vitamin D deficiency; parathyroid dysfunction; and pituitary dysfunction. Steroid myopathy is the most common endocrine myopathy. Objective: To study the etiology, varied presentations, and outcome after therapy of patients with endocrine myopathies. Materials and Methods: Myopathy was evaluated by the standard clinical procedures: Detailed clinical history, manual muscle strength testing, and creatine phosphokinase (CPK. Endocrine disorders were diagnosed as per clinical features and biochemical parameters. The treatment was given to patients as per underlying endocrine disease. Myopathy was assessed before and after treatment. Results: Out of the 37 patients who were diagnosed with endocrine myopathies, thyroid dysfunction was the most common cause (17 cases, followed by vitamin D deficiency in nine, adrenal dysfunction in six, parathyroid dysfunction in three, and pituitary dysfunction in two. Some patients had atypical presentation (repeated falls in one, tongue fasciculations in one, neck weakness in five, one with ptosis and facial weakness, asymmetrical onset in one, and calf hypertrophy in one. The serum creatine kinase (CK concentration did not correlate with muscle weakness. Following the treatment regimen which was specific for a given myopathy, 26 patients recovered fully. Conclusion: We found varied clinical presentations of endocrine myopathies. All the patients with neuromuscular complaints should be investigated for endocrine causes because significant number of them recovers fully with specific treatment.

  10. Digital breast tomosynthesis versus digital mammography: a clinical performance study

    Energy Technology Data Exchange (ETDEWEB)

    Gennaro, Gisella; Baldan, Enrica; Bezzon, Elisabetta; Polico, Ilaria; Proietti, Alessandro; Toffoli, Aida [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Toledano, Alicia [Statistics Collaborative Inc., Washington, DC (United States); Di Maggio, Cosimo [Padua University, Department of Oncological and Surgical Sciences, Padua (Italy); La Grassa, Manuela [Aviano Oncological Reference Center (CRO), IRCCS, Department of Radiology, Aviano (Pordenone) (Italy); Pescarini, Luigi [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Padua University, Department of Oncological and Surgical Sciences, Padua (Italy); Muzzio, Pier Carlo [Venetian Oncological Institute (IOV), IRCCS, Department of Radiology, Padua (Italy); Padua University, Department of Medical Diagnostic Sciences, Padua (Italy)

    2010-07-15

    To compare the clinical performance of digital breast tomosynthesis (DBT) with that of full-field digital mammography (FFDM) in a diagnostic population. The study enrolled 200 consenting women who had at least one breast lesion discovered by mammography and/or ultrasound classified as doubtful or suspicious or probably malignant. They underwent tomosynthesis in one view [mediolateral oblique (MLO)] of both breasts at a dose comparable to that of standard screen-film mammography in two views [craniocaudal (CC) and MLO]. Images were rated by six breast radiologists using the BIRADS score. Ratings were compared with the truth established according to the standard of care and a multiple-reader multiple-case (MRMC) receiver-operating characteristic (ROC) analysis was performed. Clinical performance of DBT compared with that of FFDM was evaluated in terms of the difference between areas under ROC curves (AUCs) for BIRADS scores. Overall clinical performance with DBT and FFDM for malignant versus all other cases was not significantly different (AUCs 0.851 vs 0.836, p = 0.645). The lower limit of the 95% CI or the difference between DBT and FFDM AUCs was -4.9%. Clinical performance of tomosynthesis in one view at the same total dose as standard screen-film mammography is not inferior to digital mammography in two views. (orig.)

  11. Chronic actinic dermatitis - A study of clinical features

    Directory of Open Access Journals (Sweden)

    Somani Vijay

    2005-01-01

    Full Text Available Background: Chronic actinic dermatitis (CAD, one of the immune mediated photo-dermatoses, comprises a spectrum of conditions including persistent light reactivity, photosensitive eczema and actinic reticuloid. Diagnostic criteria were laid down about 20 years back, but clinical features are the mainstay in diagnosis. In addition to extreme sensitivity to UVB, UVA and/or visible light, about three quarters of patients exhibit contact sensitivity to several allergens, which may contribute to the etiopathogenesis of CAD. This study was undertaken to examine the clinical features of CAD in India and to evaluate the relevance of patch testing and photo-aggravation testing in the diagnosis of CAD. Methods: The clinical data of nine patients with CAD were analyzed. Histopathology, patch testing and photo-aggravation testing were also performed. Results: All the patients were males. The average age of onset was 57 years. The first episode was usually noticed in the beginning of summer. Later the disease gradually tended to be perennial, without any seasonal variations. The areas affected were mainly the photo-exposed areas in all patients, and the back in three patients. Erythroderma was the presenting feature in two patients. The palms and soles were involved in five patients. Patch testing was positive in seven of nine patients. Conclusions: The diagnosis of CAD mainly depended upon the history and clinical features. The incidence of erythroderma and palmoplantar eczema was high in our series. Occupation seems to play a role in the etiopathogenesis of CAD.

  12. Study of the operation and maintenance of computer systems to meet the requirements of 10 CFR 73.55

    International Nuclear Information System (INIS)

    Lewis, J.R.; Byers, K.R.; Fluckiger, J.D.; McBride, K.C.

    1986-01-01

    The Pacific Northwest Laboratory has studied the operation and maintenance of computer-managed systems that can help nuclear power plant licensees to meet the physical security requirements of 10 CFR 73.55 (for access control, alarm monitoring, and alarm recording). This report of that study describes a computer system quality assurance program that is based on a system of related internal controls. A discussion of computer system evaluation includes verification and validation mechanisms for assuring that requirements are stated and that the product fulfills these requirements. Finally, the report describes operator and security awareness training and a computer system preventive maintenance program. 24 refs

  13. Study of the operation and maintenance of computer systems to meet the requirements of 10 CFR 73. 55

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, J.R.; Byers, K.R.; Fluckiger, J.D.; McBride, K.C.

    1986-01-01

    The Pacific Northwest Laboratory has studied the operation and maintenance of computer-managed systems that can help nuclear power plant licensees to meet the physical security requirements of 10 CFR 73.55 (for access control, alarm monitoring, and alarm recording). This report of that study describes a computer system quality assurance program that is based on a system of related internal controls. A discussion of computer system evaluation includes verification and validation mechanisms for assuring that requirements are stated and that the product fulfills these requirements. Finally, the report describes operator and security awareness training and a computer system preventive maintenance program. 24 refs.

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

    OpenAIRE

    Adem Köşlü; İlknur Kıvanç Altunay; Hilal Kaya Erdoğan

    2009-01-01

    Background and Design: The definition of emergent diseases includes potentially risky diseases that need urgent medical intervention. Diagnostic and therapeutic processes are managed mostly at ourpatient setting in dermatology. Therefore, it is unclear that which diseases are real emergencies and which patients apply urgently. There are a few studies assessing this topic. Our aim was to evaluate patients referred to our clinic urgently, and to review the concept of ‘‘real dermatologic emergen...

  15. Neurophysiology versus clinical genetics in Rett syndrome: A multicenter study

    Science.gov (United States)

    Halbach, Nicky; Julu, Peter; Witt‐Engerström, Ingegerd; Pini, Giorgio; Bigoni, Stefania; Hansen, Stig; Apartopoulos, Flora; Delamont, Robert; van Roozendaal, Kees; Scusa, Maria F.; Borelli, Paolo; Candel, Math; Curfs, Leopold

    2016-01-01

    Many studies have attempted to establish the genotype–phenotype correlation in Rett syndrome (RTT). Cardiorespiratory measurements provide robust objective data, to correlate with each of the different clinical phenotypes. It has important implications for the management and treatment of this syndrome. The aim of this study was to correlate the genotype with the quantitative cardiorespiratory data obtained by neurophysiological measurement combined with a clinical severity score. This international multicenter study was conducted in four European countries from 1999 to 2012. The study cohort consisted of a group of 132 well‐defined RTT females aged between 2 and 43 years with extended clinical, molecular, and neurophysiological assessments. Diagnosis of RTT was based on the consensus criteria for RTT and molecular confirmation. Genotype–phenotype analyses of clinical features and cardiorespiratory data were performed after grouping mutations by the same type and localization or having the same putative biological effect on the MeCP2 protein, and subsequently on eight single recurrent mutations. A less severe phenotype was seen in females with CTS, p.R133C, and p.R294X mutations. Autonomic disturbances were present in all females, and not restricted to nor influenced by one specific group or any single recurrent mutation. The objective information from non‐invasive neurophysiological evaluation of the disturbed central autonomic control is of great importance in helping to organize the lifelong care for females with RTT. Further research is needed to provide insights into the pathogenesis of autonomic dysfunction, and to develop evidence‐based management in RTT. © 2016 The Authors. American Journal of Medical Genetics Part A published by Wiley Periodicals, Inc. PMID:27354166

  16. Best herbs for managing diabetes: a review of clinical studies

    Directory of Open Access Journals (Sweden)

    Ahmad Ghorbani

    2013-09-01

    Full Text Available Diabetes mellitus is a public health problem which leads to serious complications over time. Experimentally, many herbs have been recommended for treating diabetes. In most cases, however, the recommendations are based on animal studies and limited pieces of evidence exist about their clinical usefulness. This review focused on the herbs, the hypoglycemic actions of which have been supported by three or more clinical studies. The search was done in Google Scholar, Medline and Science Direct databases using the key terms diabetes, plants, herbs, glucose and patients. According to the clinical studies, Aegle marmelos, Allium cepa, Gymnema sylvestre, Momordica charantia, Ocimum sanctum, Nigella sativa, Ocimum sanctum, Panax quinquefolius, Salacia reticulate, Silybum marianum and Trigonella foenum-graecum have shown hypoglycemic and, in some cases, hypolipidemic activities in diabetic patients. Among them, Gymnema sylvestre, Momordica charantia, Silybum marianum and Trigonella foenum-graecum have acquired enough reputation for managing diabetes. Thus, it seems that physicians can rely on these herbs and advise for the patients to improve management of diabetes.

  17. Resveratrol and diabetes: A critical review of clinical studies.

    Science.gov (United States)

    Öztürk, Ebru; Arslan, Ayşe Kübra Karaboğa; Yerer, Mükerrem Betül; Bishayee, Anupam

    2017-11-01

    Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia. The disease results from the defects of insulin secretion and/or action. Resveratrol is a non-flavonoid polyphenol that naturally occurs as phytoalexin. The shell and stem of Vitis vinifera L. (Vitaceae) are the richest source of this compound. In addition to various in vitro and in vivo studies revealing the effectiveness of resveratrol in DM, there are many clinical trials indicating that resveratrol has the potential to benefit in DM patients. The therapeutic action of this compound in relation to diabetes is complex and involves in several beneficial roles. In view of this, clinical studies are necessary to elucidate these roles. In the near future, the use of resveratrol, alone or in combination with current anti-diabetic therapies, might be a conventional approach to effectively manage DM or its complications. This mini-review provides a critical overview of currently available clinical studies examining the effects of resveratrol in DM last decade. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics.

    Science.gov (United States)

    Coury, Jennifer; Schneider, Jennifer L; Rivelli, Jennifer S; Petrik, Amanda F; Seibel, Evelyn; D'Agostini, Brieshon; Taplin, Stephen H; Green, Beverly B; Coronado, Gloria D

    2017-06-19

    The Plan-Do-Study-Act (PDSA) cycle is a commonly used improvement process in health care settings, although its documented use in pragmatic clinical research is rare. A recent pragmatic clinical research study, called the Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), used this process to optimize the research implementation of an automated colon cancer screening outreach program in intervention clinics. We describe the process of using this PDSA approach, the selection of PDSA topics by clinic leaders, and project leaders' reactions to using PDSA in pragmatic research. STOP CRC is a cluster-randomized pragmatic study that aims to test the effectiveness of a direct-mail fecal immunochemical testing (FIT) program involving eight Federally Qualified Health Centers in Oregon and California. We and a practice improvement specialist trained in the PDSA process delivered structured presentations to leaders of these centers; the presentations addressed how to apply the PDSA process to improve implementation of a mailed outreach program offering colorectal cancer screening through FIT tests. Center leaders submitted PDSA plans and delivered reports via webinar at quarterly meetings of the project's advisory board. Project staff conducted one-on-one, 45-min interviews with project leads from each health center to assess the reaction to and value of the PDSA process in supporting the implementation of STOP CRC. Clinic-selected PDSA activities included refining the intervention staffing model, improving outreach materials, and changing workflow steps. Common benefits of using PDSA cycles in pragmatic research were that it provided a structure for staff to focus on improving the program and it allowed staff to test the change they wanted to see. A commonly reported challenge was measuring the success of the PDSA process with the available electronic medical record tools. Understanding how the PDSA process can be applied to pragmatic

  19. A Study on the Clinical Diagnosis of Hyperthyroidism

    International Nuclear Information System (INIS)

    Ku, In Soo; Koh, Chang Soon; Lee, Mun Ho

    1973-01-01

    To attain a simple and reliable method of evaluating the thyroid function the reliability of the clinical manifestation and the conventional thyroid function tests in diagnosing the hyperthyroidism was studied. The subjects included 184 patients with hyperthyroidism and 66 cases with euthyroidism, who were treated at the Thyroid Clinic, Seoul National University Hospital, from July 1971 through August 1972. The observed results were as follows: l. In the cases of hyperthyroidism, 19% of the patients were male and 81% female; in the cases of euthyroidism, 7. 6% of the patients were male and 92. 4% female. The majority of the patients were in 2nd to 4th decades of their lives. 2. There were objective signs clearly manifested in hyperthyroidism which were rare or absent in the euthyroid state. These clinical signs included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor, and warm skin. In the hyperthyroid state 91. 3% of the cases manifested two or more of the above signs, whereas in the euthyroid state no patients manifested any two of the above signs. 3. The most frequent complaints of the patients with thyroid disease were palpitation, weight low, increased appetite, heat intolerance, perspiration, hunger feeling; nervousness, exertional dyapnea, etc. There was no clear difference in the incidence of the symptoms between hyperthyroidism and euthyroidism. 4. In the diagnosis of hyperthyroidism, the reliability of thyroid function tests was as follows: T 7 was 92. 4% reliable, 125 IT 3 resin uptake rate 91. 6% reliable, 131 I thyroid uptake rate in 24 hrs. 89. 4% reliable, serum T 4 level 85. 9% reliable and BMR 75. 5% reliable. Therefore the careful observation of the clinical manifestation of the disease is a simple and reliable way of making a correct diagnosis of either hyperthyroidism or euthymidism. 5. In hyperthyroidism there shows no correlationship between the results of the thyroid function test and clinical signs but a high BMR was

  20. Epidemiology, etiology and study of clinical findings of headache

    Directory of Open Access Journals (Sweden)

    Ghaffarpoor M

    1998-09-01

    Full Text Available In a cross-sectional epidemiological study of headache disorders in neurology clinic of Fatemieh hospital of Semnan (August 22-November 20.1996, information on types of headaches, quality, severity, location, duration, frequency, precipitating factors, age of onset, influence of menstruation and pregnancy, positive familial history, use of oral contraceptive pills and other epidemiological factors including socioeconomic and age/sex composition was collected. The presence of any types of headaches was ascertained by a clinical interview and examination using the operational diagnostic criteria of the International Headaches Society. The prevalence of migraine and tension type headache was also analysed in relation to variables of life style (physical activity and sleep pattern and associated signs and symptoms (nausea, vomiting, photophobia and phonophobia. In this study migraine and tension headache were also compared in variable aspects with each other. 1 Headache was more prevalent in women than men (F/M=3/1. 2 The most common types of headache included: tension type headache (41.4%, migraine (31.2% and unclassified headaches (17.2%. 3 Migraine and T.T.H were more prevalent in early adult life and middle ages. 4 In both migraine and tension type headache the time profiles (duration, frequency, age of onset, quality and location were like that noted in textbook and previous studies. 5 In both migraine and tension type headache the most conspicuous precipitating factor was stress and mental tension and frequent headaches were accompanied with psychiatric problems (e.g depression and or anxiety. 6 Nausea, vomiting, phonophobia and photophobia were the most common associated symptoms in both of them. 7 Positive familial history and aggravation of headache in perimenstual period were more commonly seen in patients with migraine than tension type headache. In conclusion using the operational diagnostic criteria of International Headache Society in

  1. Comparisons of hypertension-related costs from multinational clinical studies.

    Science.gov (United States)

    Mullins, C Daniel; Sikirica, Mirko; Seneviratne, Viran; Ahn, Jeonghoon; Akhras, Kasem S

    2004-01-01

    This study identifies and compares the individual cost components of hospital and ambulatory services that manage the care of hypertensive patients in eight countries: the US, the UK, France, Spain, Germany, Italy, Canada and Australia. Hypertension-related costs are classified according to four major cardiovascular events: (i) acute myocardial infarction; (ii) congestive heart failure; (iii) stroke; and (iv) renal failure, which was subdivided into renal failure treated by dialysis and renal failure treated by kidney transplantation. To make cross-country costs comparisons, we used the DRG codes used in the US and DRG-like codes from each country. US cost information was obtained from hypertension data available from the literature and health economics researchers. For costs in other countries, we consulted with national health economics experts in each country, used analyses by the Research Triangle Institute, and performed Medline and international literature searches. When available, we obtained information from the countries' public and private nationally representative data sources. For cross-country currency adjustments, all currencies were converted using the Purchasing Power Parities from the Organisation for Economic Cooperation and Development, and then converted into inflation-adjusted year 2000 US dollars. There exists considerable variation in hypertension-related costs from multinational clinical studies. This study documents that costs are generally higher in the US than in other countries; however, this is not always true. In particular, costs of treating heart failure in France and the costs of renal failure without transplantation in Germany and the UK are relatively high. While analysing multinational hypertensive cost data, this study also addresses the impact of cross-country cost variations on cost analyses. During the last decade, drug-development researchers have drawn extensively upon multinational trials to resolve enrollment problems and

  2. Clinical profile of diabetic ketoacidosis in tertiary hospitals in China: a multicentre, clinic-based study.

    Science.gov (United States)

    Xu, Y; Bai, J; Wang, G; Zhong, S; Su, X; Huang, Z; Chen, G; Zhang, J; Hou, X; Yu, X; Lu, B; Wang, Y; Li, X; Hu, H; Zhang, C; Liang, Y; Shaw, J; Wu, X

    2016-02-01

    To evaluate the clinical profile of patients with diabetic ketoacidosis in tertiary hospitals in China. A retrospective study of patients hospitalized with diabetic ketoacidosis between 2010 and 2012 was carried out in 15 tertiary hospitals around China. Clinical and laboratory data were collected. Patients were classified based on clinical diagnosis and treatment history. Groups were compared for differences in vital statistics and biochemical profiles at presentation. The study comprised 643 patients with diabetic ketoacidosis: 308 patients (47.9%) with Type 1 diabetes, 294 patients (45.7%) with Type 2 diabetes and 41 patients (6.4%) with atypical diabetes. Three hundred and eighty-eight diabetic ketoacidosis episodes (60.3%) were in patients with known diabetes. The most common precipitating factor was infection (40.1%), followed by unknown causes (36.9%) and non-compliance with anti-diabetes treatment (16.8%). At presentation, gastrointestinal symptoms and dehydration were more common in the Type 1 diabetes group. For new-onset diabetes, only 74.4% and 55.9% of patients were evaluated for β-cell function and autoantibodies for classification. Only 67% of patients with diabetic ketoacidosis received appropriate fluid therapy and 56% patients with severe acidosis received bicarbonate therapy. The length of hospital stay was 10.0 (7.0-14.0) days. The mortality rate was 1.7%, and was much higher in Type 2 diabetes than that in Type 1 diabetes (3.2% vs. 0.4%, P diabetes contribute to a similar proportion of cases presenting with diabetic ketoacidosis in China. Admissions with diabetic ketoacidosis are still associated with significant mortality and prolonged hospitalization. The efficiency of diabetic ketoacidosis management needs to be improved by implementing the updated guidelines. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  3. Patient advocacy from the clinical nurses' viewpoint: a qualitative study.

    Science.gov (United States)

    Davoodvand, Shirmohammad; Abbaszadeh, Abbas; Ahmadi, Fazlollah

    2016-01-01

    One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients' health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy.

  4. Clinical and neurological study of women with precatamenial epilepsy

    International Nuclear Information System (INIS)

    Hussain, Z.; Hasan, Z.; Aziz, H.; Qureshi, M.A.

    2007-01-01

    To describe clinical features and seizure dispersion in precatamenial/pericatamenial epilepsy patients. Present study included 33 untreated pericatamenial (n: 23, age: 12-40 years, menstrual cycles: 147) and precatamenial (n: 10, age: 13-32 years, menstrual cycles: 70) epileptics with tonic-clonic seizures. Clinical features and seizure dispersion were evaluated during premenstruation, menstruation, and postmenstruation phases. Women with precatamenial epilepsy had highly significant mean phase day seizures during premenstruation versus other phases, whereas women with pericatamenial epilepsy did not show any significant variations. Premenstrual seizures were found significantly more and others as significantly less in % number in precatamenials compared to those in pericatamenials. Furthermore, precatamenial epileptics with primary generalized seizures were significantly higher in % number and secondary generalized seizures as significantly lower against those in pericatamenial epileptics. All precatamenial epileptics under study had incontinence compared to 65% pericatamenial epileptics that had incontinence. Majority of the patients in both groups showed post-ictal headache. The present report describes the extent of exacerbation of premenstrual tonic-clonic seizures with clinical features. These investigations may help in understanding partly the complexity of catamenial/precatamenial/ pericatamenial/noncatamenial seizures, and similarities and dissimilarities between pericatamenial and precise precatamenial seizures. (author)

  5. Study Of Clinical Profile of Allergic Contact Dermatitis In Pune

    Directory of Open Access Journals (Sweden)

    Sayal S K

    1999-01-01

    Full Text Available One hundred and twenty five cases of clinically diagnosed allergic contact dermatitis were studied. All patients were subjected to patch test with standard test allergens and also with suspected test allergens based on history and clinical profile. Allergic contact dermatitis due to Parthenium hysterophorus was commonest and found in 64% cases, followed by wearing apparel and jewellery in 16.8%, topical medicaments in 8% and cosmetics and occupational contactants in 5.6% cases each. The common individual allergens other than parthenium, were nickel in 8.8%, leather, hair dye and cement in 3.2% each, nitrofurazone and petrol, oil, lubricant (POL in 2.4% each. Patch test with suspected allergens was positive in 72% of cases.

  6. Clinical and imaging characteristics of the vascular dementia. Preliminary studies

    International Nuclear Information System (INIS)

    Gomez Viera, Nelson; Rivero Arias, Edmundo; Perez Nellar, Jesus; Begueria Santos, Ramon; Arias Sifontes, William; Raiteris Flores, Juan

    1997-01-01

    A descriptive prospective study was carried out in 41 patients presenting with vascular dementia from Habana Vieja municipality, Havana City, in order to know some of the clinical and imaging characteristics of this disease. The main risk factors observed were the history of cerebrovascular disease and arterial hypertension. Depression, sleeping disorders and focal and pseudo bulbar neurologic signs were the most frequent clinical findings. Folstein neuropsychological test evidenced an important disorder of attention, calculation, the evocation memory and orientation. According to this test, 29 % of the patients had a severe dementia and nearly 50 % showed a severe handicap. The most frequent imaging findings observed in the computerized axial tomography of the cranium were cerebral atrophy, and single or multiple infarctions. Multiple cerebral infarctions, the lacunar status, subcortical encephalopathy of Binswanger, and single infarction located in cerebral areas related to cognition were considered as possible psychopathological mechanisms associated with the disease

  7. Clinical and microbiological study of otitis externa in sheep

    Directory of Open Access Journals (Sweden)

    M. I. Al-Farwachi

    2008-01-01

    Full Text Available In this study one hundred Awassi sheep were examined clinically and bacteriologically for isolation and identification of the bacterial agents of otitis externa in sheep. The main clinical signs appeared included weakness, pale mucus membrane, auricular discharge, cough, anorexia, emaciation, and nasal discharge. Results revealed isolation of bacteria from (45% examined swabs. The most being from right ear. Younger animals were more frequently infected than older animals. Pseudomonas aeruginosa, Staphylococcus aureus, Mannheimia haemolytica, Staph. epidermidis, Pasteurella multocida, Streptococcus spp., Acintobacter spp., Escherichia coli and Klebsiella pneumonia were isolated. The results revealed that the most bacterial isolates were resistance to the bactericidal effect of the normal serum included Streptococcus pneumonia, Staphylococcus aureus, Mannheimia haemolytica. While the most bacterial isolates were produced hydroxymate siderophore included Staphylococcus aureus, Mannheimia haemolytica, Streptococcus pneumonia. The obtained results indicated to the importance of determination of serum resistance as a bacterial virulence factor in otitis externa in sheep.

  8. Hamartomatous polyps - a clinical and molecular genetic study

    DEFF Research Database (Denmark)

    Jelsig, Anne Marie

    2016-01-01

    the knowledge on clinical course and molecular genetics in patients with HPs and HPS, and to investigate research participants' attitude towards the results of extensive genetic testing. Paper I: In the first paper we investigated the occurrence, anatomic distribution, and other demographics of juvenile polyps......-Jeghers syndrome, and the PTEN hamartoma tumour syndrome. Currently, the HPS diagnoses are based on clinical criteria and are often assisted with genetic testing as candidate genes have been described for each syndrome. This thesis is based on six scientific papers. The overall aim of the studies was to expand......% fulfilled to diagnostic criteria of JPS. The majority of patients had a single juvenile polyp. Paper II: In this paper we conducted a review of the HPS based on the current literature. Paper III: We investigated the hypothesis that patients with one or few HPs may have a HPS based on genetic screening. We...

  9. "I couldn't do this with opposition from my colleagues": A qualitative study of physicians' experiences as clinical tutors

    Directory of Open Access Journals (Sweden)

    Rödjer Stig

    2011-10-01

    Full Text Available Abstract Background Clinical contact in the early curriculum and workplace learning with active tutorship are important parts of modern medical education. In a previously published study, we found that medical students' tutors experienced a heavier workload, less reasonable demands and less encouragement, than students. The aim of this interview study was to further illuminate physicians' experiences as clinical tutors. Methods Twelve tutors in the Early Professional Contact course were interviewed. In the explorative interviews, they were asked to reflect upon their experiences of working as tutors in this course. Systematic text condensation was used as the analysis method. Results In the analysis, five main themes of physicians' experiences as clinical tutors in the medical education emerged: (a Pleasure and stimulation. Informants appreciated tutorship and meeting both students and fellow tutors, (b Disappointment and stagnation. Occasionally, tutors were frustrated and expressed negative feelings, (c Demands and duty. Informants articulated an ambition to give students their best; a desire to provide better medical education but also a duty to meet demands of the course management, (d Impact of workplace relations. Tutoring was made easier when the clinic's management provided active support and colleagues accepted students at the clinic, and (e Multitasking difficulties. Combining several duties with those of a tutorship was often reported as difficult. Conclusions It is important that tutors' tasks are given adequate time, support and preparation. Accordingly, it appears highly important to avoid multitasking and too heavy a workload among tutors in order to facilitate tutoring. A crucial factor is acceptance and active organizational support from the clinic's management. This implies that tutoring by workplace learning in medical education should play an integrated and accepted role in the healthcare system.

  10. A clinical and radiographic study of dentigerous cysts

    International Nuclear Information System (INIS)

    Lee, Kang Sook; Choi, Karp Shik

    1995-01-01

    The purpose of this study was to obtain information on the clinical and radiographic features of the dentigerous cysts in the jaws. For this study, the authors examined and analysed the clinical records and radiographs of 233 patients who had lesions of dentigerous cyst diagnosed by clinical and radiographic or histopathological examination. The following results were obtained: 1. Dentigerous cysts occurred the most frequently in the 2nd decade (38.2%) and occurred more frequently in males (67.4%) than in females (32.6%).2. The most common clinical symptom was swelling of the jaw (33.9%), and the lesions were treated by the method of surgical removal. 3. The type of lesions was mainly observed as central type (72.5%), and size of the lesion was most frequently observed 2-2.9 cm in the widest length. 4. The lesions were most frequently observed well-defined outline with hyperostotic border (49.8%), and smooth margin (73.4%), and homogeneous lesional radiolucency (79.4%). 5. Cortical thinning and expansion of the lesions (82.0%) were observed, and their direction were most frequently observed toward buccal side (64.0%). 6. The effect on the causative tooth were observed as tooth displacement (41.2%) and delayed root development (19.3%), and the distance between cemento-enamel junction and lesional wall attachment of the causative tooth was mainly observed as below 2 mm (79.6%). 7. The effect on the adjacent tooth were observed as loss of lamina dura (66.8%), root resorption (33.9%). and tooth displacement (31.5%). 8. The effect on the adjacent anatomic structure were observed as displacement of the mandibular canal (46.5%) and maxillary sinus or nasal cavity (72.2%).

  11. CLINICAL STUDY OF HASHIMOTO’S THYROIDITIS & ITS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Purnaiah

    2016-03-01

    Full Text Available INTRODUCTION Hashimoto’s Thyroiditis is a well-known clinical condition affecting the thyroid gland predominantly in women during 4 th decade & is often under diagnosed due its wide spectrum of clinical features. It could present as a multinodular goitre, diffuse goitre, or as a solitary nodule with features of Hypothyroidism, Hyperthyroidism or Euthyroid state. AIMS 1. To detect HT by FNAC, Antibody titers finally by Histopathology of excised Thyroid gland. 2. To know its various clinical features. 3. To study Sex ratio & Age it affects. 4. Management i.e. by conservative or surgical. 5. Complications & malignant transformation including Lymphomas. MATERIALS & METHODS 60 patients were taken for 2 years’ period from March 2014 to Feb 2016 attending Government General Hospital-Nizamabad; Telangana State. OBSERVATIONS  56 case are females, 4 cases are males; common age is 30-39 yrs., >50 yrs.-2 cases.  All cases presented with swelling in front of neck, only 5 had toxicity, 2 had obstructive symptoms. None had voice change.  36 Cases- 60% had MNG, 18 Cases- 30% diffuse goitre and 6 cases- 10%- solitary nodule.  The Hypothyroid, Euthyroid & Hyperthyroid state here are 48%, 44% & 8% comparative to Fenn et al -44%, 47% and 7%,  FNAC- was positive 90% here where as Lakshman Rao et al study has 77%.  We had 80% Anti Thyroid Antibodies positivity, others shown 63% and 84%. MANAGEMENT All are put on Hormone-Thyroxine replacement or suppression therapy and all patients found to be clinically Euthyroid during follow up. All patients showed decrease in size of gland except those with MNG. 8 patients underwent surgery- Subtotal Thyroidectomy. Of these 6 were Colloid goiters, later on diagnosed as HT by final HPE. One case was operated for cosmetic reason and the other for obstructive symptoms which was noticed to be lymphoma after HPE.

  12. Summary of the Update Session of Clinical Studies

    Science.gov (United States)

    Pinyavat, Teeda; Warner, David O.; Flick, Randall P.; McCann, Mary Ellen; Andropoulos, Dean B.; Hu, Danquig; Sall, Jeffrey W.; Spann, Marisa N.; Ing, Caleb

    2016-01-01

    During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment (PANDA) Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes following exposure to anesthetic drugs in infants and children. This article summarizes the update of five ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia (GAS), Toxicity of Remifentanil and Dexmedetomidine (T-Rex), Mayo Anesthesia Safety in Kids (MASK), the UCSF (University of California San Francisco) human cohort study, and Columbia University Medical Center (CUMC) Neonatal Magnetic Resonance Imaging (MRI) study. The purpose of this summary is to discuss the contributions and limitations of these studies, how they fit into the published literature, and what questions remain to be answered. PMID:27768673

  13. Clinical studies in orthodontics--an overview of NIDR-sponsored clinical orthodontic studies in the US.

    Science.gov (United States)

    Baumrind, S

    1998-11-01

    A number of clinical trials sponsored by the National Institutes of Health (NIH) use rigorous methods of data acquisition and analysis previously developed in fundamental biology and the physical sciences. The naive expectation that these trials would lead relatively rapidly to definitive answers concerning the therapeutic strategies and techniques under study is dispelled. This presentation focuses on delineating differences between the study of central tendencies and individual variation, more specifically on the strategy to study this variation: measure additional sources of variance within each patient at more timepoints and perhaps with greater precision. As rigorous orthodontic research is still in its infancy, the problem of defining the proper mix between prospective and retrospective trials is discussed. In view of the high costs of prospective clinical trials, many of the questions germane to orthodontics can be answered by well-conducted retrospective trials, assuming that properly randomized sampling procedures are employed. Definitive clinical trials are likely to require better theoretical constructs, better instrumentation, and better measures than now available. Reasons for concern are the restricted resources available and the fact that current mensurational approaches may not detect many of the individual differences. The task of constructing sharable databases and record bases stored in digital form and available either remotely from servers, or locally from CD-ROMs or optical disks, is crucial to the optimization of future investigations.

  14. Public meetings

    CERN Multimedia

    Staff Association

    2014-01-01

    You were hundreds of persons to participate in our information meetings of October 3 and 6 2014, and we thank you for your participation! The full presentation is available here. A summary of the topics is available here (in french).

  15. Disorganization at the stage of schizophrenia clinical outcome: Clinical-biological study.

    Science.gov (United States)

    Nestsiarovich, A; Obyedkov, V; Kandratsenka, H; Siniauskaya, M; Goloenko, I; Waszkiewicz, N

    2017-05-01

    According to the multidimensional model of schizophrenia, three basic psychopathological dimensions constitute its clinical structure: positive symptoms, negative symptoms and disorganization. The latter one is the newest and the least studied. Our aim was to discriminate disorganization in schizophrenia clinical picture and to identify its distinctive biological and socio-psychological particularities and associated genetic and environmental factors. We used SAPS/SANS psychometrical scales, scales for the assessment of patient's compliance, insight, social functioning, life quality. Neuropsychological tests included Wisconsin Card Sorting Test (WCST), Stroop Color-Word test. Neurophysiological examination included registration of P300 wave of the evoked cognitive auditory potentials. Environmental factors related to patient's education, family, surrounding and nicotine use, as well as subjectively significant traumatic events in childhood and adolescence were assessed. Using PCR we detected SNP of genes related to the systems of neurotransmission (COMT, SLC6A4 and DRD2), inflammatory response (IL6, TNF), cellular detoxification (GSTM1, GSTT1), DNA methylation (MTHFR, DNMT3b, DNMT1). Disorganization is associated with early schizophrenia onset and history of psychosis in family, low level of insight and compliance, high risk of committing delicts, distraction errors in WCST, lengthened P300 latency of evoked cognitive auditory potentials, low-functional alleles of genes MTHFR (rs1801133) and DNMT3b (rs2424913), high level of urbanicity and psychotraumatic events at early age. Severe disorganization at the stage of schizophrenia clinical outcome is associated with the set of specific biological and social-psychological characteristics that indicate its epigenetic nature and maladaptive social significance. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Public meetings

    CERN Multimedia

    Staff Association

    2017-01-01

    Do you have questions about the elections to the Staff Council, 2017 MERIT exercise, EVE and School, LD to IC exercise, CHIS, the Pension Fund… Come get informed and ask your questions at our public meetings. These public meetings are also an opportunity to get the more information on current issues. Benefit from this occasion to get the latest news and to discuss with the representatives of the statutory body that is the Staff Association!

  17. When Research Meets Reality–-Lessons Learned from a Pragmatic Multisite Group-Randomized Clinical Trial on Psychosocial Interventions in the Psychiatric and Addiction Field

    Directory of Open Access Journals (Sweden)

    Linda E. Wüsthoff

    2012-01-01

    Full Text Available Research on treatments for patients with co-occurring psychiatric and substance use disorders is of core importance and at the same time highly challenging as it includes patients that are normally excluded from clinical studies. Such research may require methodological adaptations which in turn create new challenges. However, the challenges that arise in such studies are insufficiently discussed in the literature. The aim of this methodology paper is, firstly, to discuss the methodological adaptations that may be required in such research; secondly, to describe how such adaptations created new challenges in a group-randomized clinical trial on Integrated Treatment amongst patients with co-occurring psychiatric and substance use disorders. We also discuss how these challenges might be understood and highlight lessons for future research in this field. Trial registration : NCT00447733.

  18. Therapeutic horticulture in clinical depression: a prospective study.

    Science.gov (United States)

    Gonzalez, Marianne Thorsen; Hartig, Terry; Patil, Grete Grindal; Martinsen, Egil W; Kirkevold, Marit

    2009-01-01

    Clinically depressed persons suffer from impaired mood and distortion of cognition. This study assessed changes in depression severity and perceived attentional capacity of clinically depressed adults (N=18) during a 12-week therapeutic horticulture program. The Beck Depression Inventory (BDI) and Attentional Function Index (AFI) were administered at baseline, twice during (4 and 8 weeks), and immediately after the intervention (12 weeks), and at a 3-month follow-up. Experiences of being away and fascination related to the intervention were measured at 4, 8, and 12 weeks. The mean BDI score declined 9.7 points from pretest (27.3) to posttest (p or =6) for 72% of the cases. The mean AFI score increased 10.2 points from pretest (68.8) to posttest (p = .06). The greatest change in BDI and AFI scores occurred in the initial weeks of the intervention. The reduction in BDI scores remained significant and clinically relevant at the 3-month follow-up (N=16). The decline in depression severity during the intervention correlated strongly with the degree to which the participants found that it captured their attention. Therapeutic horticulture may decrease depression severity and improve perceived attentional capacity by engaging effortless attention and interrupting rumination.

  19. Nasal polyps. A clinical radiological histopathological and mycological study

    International Nuclear Information System (INIS)

    Babiker, Babiker Eltayeb

    1997-12-01

    Forty patients with nasal polyposis were studied. This study included clinical, haematological and mycological aspects. There were 24 females (60% of patients) and 16 males (40%). We found that all patients presented with nasal obstruction and nasal tone and the majority of them had allergic nasal symptoms such as sneezing and watery discharge. Thirty five percent of the patients were recurrent cases, being operated before for nasal polyps. Radiological investigations showed high of sinusitis and that 10% of the patients had complicated disease with orbital or intracranial extensions. Mycological studies revealed the presence of fungal infection in 4 patient (10%) and it was caused by Aspergillus flavus. Histological studies identified the allergic nature of the polyps in all patients. Surgical treatment was carried out in all patients and operations varied from simple intranasal polypectomy, intranasal ethmiodectomy, external ethmoidectomy to Caldwell-Luc operation for patients with antrochanal polyps.(Author)

  20. The impact of short term clinical placement in a developing country on nursing students: A qualitative descriptive study.

    Science.gov (United States)

    Ulvund, Ingeborg; Mordal, Elin

    2017-08-01

    Offering nursing students' international clinical placement during the educational program is one response to meet the need of cultural competence among nurses. This paper provides insight into the impact of clinical placement, in a developing country, on third year nursing students. In the study we investigated how short term international clinical placement impacted Norwegian nursing students' development of cultural competency. In this study we utilised a qualitative descriptive design and used individual interviews with eighteen Norwegian nursing students who had all participated in an international clinical placement. The data were analysed using the principles of systematic text condensation. In spite the international clinical placement only was four weeks, the findings suggested that real life experience culturally awakened the students and forced an ongoing process developing cultural competence. However, it is important to give students time to reflection. Although increased cultural awareness and a growing cultural competence was identified by the students undertaking international clinical placement, further research is required. It is important to investigate the best methods to support the students' reflection such that the experiences lead to learning. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Human reporter genes: potential use in clinical studies

    Energy Technology Data Exchange (ETDEWEB)

    Serganova, Inna [Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Ponomarev, Vladimir [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Blasberg, Ronald [Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States)], E-mail: blasberg@neuro1.mskcc.org

    2007-10-15

    The clinical application of positron-emission-tomography-based reporter gene imaging will expand over the next several years. The translation of reporter gene imaging technology into clinical applications is the focus of this review, with emphasis on the development and use of human reporter genes. Human reporter genes will play an increasingly more important role in this development, and it is likely that one or more reporter systems (human gene and complimentary radiopharmaceutical) will take leading roles. Three classes of human reporter genes are discussed and compared: receptors, transporters and enzymes. Examples of highly expressed cell membrane receptors include specific membrane somatostatin receptors (hSSTrs). The transporter group includes the sodium iodide symporter (hNIS) and the norepinephrine transporter (hNET). The endogenous enzyme classification includes human mitochondrial thymidine kinase 2 (hTK2). In addition, we also discuss the nonhuman dopamine 2 receptor and two viral reporter genes, the wild-type herpes simplex virus 1 thymidine kinase (HSV1-tk) gene and the HSV1-tk mutant (HSV1-sr39tk). Initial applications of reporter gene imaging in patients will be developed within two different clinical disciplines: (a) gene therapy and (b) adoptive cell-based therapies. These studies will benefit from the availability of efficient human reporter systems that can provide critical monitoring information for adenoviral-based, retroviral-based and lenteviral-based gene therapies, oncolytic bacterial and viral therapies, and adoptive cell-based therapies. Translational applications of noninvasive in vivo reporter gene imaging are likely to include: (a) quantitative monitoring of gene therapy vectors for targeting and transduction efficacy in clinical protocols by imaging the location, extent and duration of transgene expression; (b) monitoring of cell trafficking, targeting, replication and activation in adoptive T-cell and stem/progenitor cell therapies

  2. Human reporter genes: potential use in clinical studies

    International Nuclear Information System (INIS)

    Serganova, Inna; Ponomarev, Vladimir; Blasberg, Ronald

    2007-01-01

    The clinical application of positron-emission-tomography-based reporter gene imaging will expand over the next several years. The translation of reporter gene imaging technology into clinical applications is the focus of this review, with emphasis on the development and use of human reporter genes. Human reporter genes will play an increasingly more important role in this development, and it is likely that one or more reporter systems (human gene and complimentary radiopharmaceutical) will take leading roles. Three classes of human reporter genes are discussed and compared: receptors, transporters and enzymes. Examples of highly expressed cell membrane receptors include specific membrane somatostatin receptors (hSSTrs). The transporter group includes the sodium iodide symporter (hNIS) and the norepinephrine transporter (hNET). The endogenous enzyme classification includes human mitochondrial thymidine kinase 2 (hTK2). In addition, we also discuss the nonhuman dopamine 2 receptor and two viral reporter genes, the wild-type herpes simplex virus 1 thymidine kinase (HSV1-tk) gene and the HSV1-tk mutant (HSV1-sr39tk). Initial applications of reporter gene imaging in patients will be developed within two different clinical disciplines: (a) gene therapy and (b) adoptive cell-based therapies. These studies will benefit from the availability of efficient human reporter systems that can provide critical monitoring information for adenoviral-based, retroviral-based and lenteviral-based gene therapies, oncolytic bacterial and viral therapies, and adoptive cell-based therapies. Translational applications of noninvasive in vivo reporter gene imaging are likely to include: (a) quantitative monitoring of gene therapy vectors for targeting and transduction efficacy in clinical protocols by imaging the location, extent and duration of transgene expression; (b) monitoring of cell trafficking, targeting, replication and activation in adoptive T-cell and stem/progenitor cell therapies

  3. Corticosteroid hypersensitivity studies in a skin allergy clinic.

    Science.gov (United States)

    Berbegal, L; DeLeon, F J; Silvestre, J F

    2015-12-01

    Corticosteroids can cause hypersensitivity reactions, particularly delayed-type allergic reactions. A new classification system for testing hypersensitivity to corticosteroids distributes the drugs into 3 groups according to molecular structure; patients are classified according to whether they are allergic to agents in 1 or more of the groups. We aimed to describe the clinical characteristics of corticosteroid-allergic patients treated at our clinic and apply the new classification system to them; we also compared these patients' characteristics to those of others treated at our clinic. Retrospective study of cases of delayed-type corticosteroid hypersensitivity treated in the skin allergy clinic of a tertiary level hospital over an 11-year period. We reviewed the records of 2857 patients, finding 33 with at least one positive patch test result showing corticosteroid hypersensitivity. Atopic dermatitis and hand involvement were less common in our corticosteroid-allergic patients. All were allergic to a group 1 corticosteroid (most often, budesonide, the culprit in 87.9%). Testing with a specific corticosteroid series revealed that 14 (42.4%) were also allergic to corticosteroids in group 2 and/or group 3. None were allergic exclusively to group 2 or group 3 agents. Twenty-one patients were exposed to a corticosteroid cream from a group their patch test results indicated allergy to; 13 of them (61.9%) did not develop a hypersensitivity reaction. The Spanish standard series only contains group 1 corticosteroids. In the interest of improving allergy management, we recommend testing with a specific corticosteroid series and a patient's own creams whenever patch testing with a standard series reveals a hypersensitivity reaction to corticosteroids. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

  4. A CLINICAL AND SURGICAL STUDY OF INCISIONAL HERNIAS

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    Kethavath Changa Thavarya Naik

    2017-02-01

    Full Text Available BACKGROUND Incisions through the abdominal wall are based on anatomical principles. The intra-abdominal pressure is considerable and the surgeon aims at leaving the abdominal wall as strong as possible after operation, otherwise there exists a very real fear that portions of the abdominal contents may leave the abdominal cavity through the weak area, which are caused by a badly placed incision resulting in a condition known as scar incisional or ventral hernia. This study is intended to understand the clinical and surgical factors that may have been a contributory factor for the formation of the incisional hernias and also the treatment modality that is commonly employed to correct the discontinuity. This study is intended to help the practicing surgeons and also the young budding surgeons to understand the disease in detail. MATERIALS AND METHODS This study was done in the Department of General Surgery, RIMS Medical College, Ongole. Sixty patients who returned after undergoing the surgical procedures were included in the study. The study included 15 males and 45 females. The study was done from January 2014 to December 2016. RESULTS In the present study, the mean age of the total population was found to be 48.23 years. The female counterpart was found to be three times higher than that when compared to the males. The symptoms that tend to increase the intra-abdominal pressure tends to increase the mishap. The condition is more common in the early stages post-surgery. CONCLUSION In this study, the demographic pattern and the most common clinical and surgical factors that is thought to be directly involved with the condition has been reported.

  5. Efficiency of Calatonia on clinical parameters in the immediate post-surgery period: a clinical study

    Directory of Open Access Journals (Sweden)

    Elaine Ferreira Lasaponari

    2013-09-01

    Full Text Available OBJECTIVE: to assess the efficiency of the Calatonia technique about clinical parameters and pain in the immediate post-surgical phase. METHOD: a randomised study was carried out with 116 patients subjected to a cholecystectomy, by laparoscopy, divided into an experimental group (58 patients and a placebo group (58 patients. The experimental group received the Calatonia technique, while the placebo was only subjected to non-intentional touches. RESULTS: The placebo group and the experimental group were considered homogeneous in terms of the variables: sex, age, physical status classification, duration of surgical procedures and also the time spent recovering in the Post-Anaesthetic Recovery Room. The only variable to show a statistically significant difference was the axillary temperature of the body. In relation to pain, the experimental group showed significant results, and hence it is possible to deduce that the relaxation caused by the Calatonia technique brought some relief of the general situation of pain. CONCLUSION: The application of Calatonia can take up the function of a resource complementary to assistance in the period immediately after surgery. Brazilian Register of Clinical Trials, UTN U1111-1129-9629.

  6. The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations: a nationwide register study.

    Science.gov (United States)

    Exarchou, Sofia; Lindström, Ulf; Askling, Johan; Eriksson, Jonas K; Forsblad-d'Elia, Helena; Neovius, Martin; Turesson, Carl; Kristensen, Lars Erik; Jacobsson, Lennart T H

    2015-05-09

    Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio-economic factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment. All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers. A total of 11,030 cases with an ankylosing spondylitis diagnosis (alive, living in Sweden, and 16 to 64 years old in December 2009) were identified in the National Patient Register, giving a point prevalence of 0.18% in 2009. The prevalence was higher in northern Sweden, and lower in those with a higher level of education. Men had a higher prevalence of ankylosing spondylitis (0.23% versus 0.14%, P ankylosing spondylitis of 0.18%. It revealed phenotypical and treatment differences between the sexes, as well as geographical and socio-economic differences in disease prevalence.

  7. Is Survival After Out-of-Hospital Cardiac Arrests Worse During Days of National Academic Meetings in Japan? A Population-Based Study.

    Science.gov (United States)

    Kitamura, Tetsuhisa; Kiyohara, Kosuke; Matsuyama, Tasuku; Hatakeyama, Toshihiro; Shimamoto, Tomonari; Izawa, Junichi; Nishiyama, Chika; Iwami, Taku

    2016-01-01

    Outcomes after out-of-hospital cardiac arrests (OHCAs) might be worse during academic meetings because many medical professionals attend them. This nationwide population-based observation of all consecutively enrolled Japanese adult OHCA patients with resuscitation attempts from 2005 to 2012. The primary outcome was 1-month survival with a neurologically favorable outcome. Calendar days at three national meetings (Japanese Society of Intensive Care Medicine, Japanese Association for Acute Medicine, and Japanese Circulation Society) were obtained for each year during the study period, because medical professionals who belong to these academic societies play an important role in treating OHCA patients after hospital admission, and we identified two groups: the exposure group included OHCAs that occurred on meeting days, and the control group included OHCAs that occurred on the same days of the week 1 week before and after meetings. Multiple logistic regression analysis was used to adjust for confounding variables. A total of 20 143 OHCAs that occurred during meeting days and 38 860 OHCAs that occurred during non-meeting days were eligible for our analyses. The proportion of patients with favorable neurologic outcomes after whole arrests did not differ during meeting and non-meeting days (1.6% [324/20 143] vs 1.5% [596/38 855]; adjusted odds ratio 1.02; 95% confidence interval, 0.88-1.19). Regarding bystander-witnessed ventricular fibrillation arrests of cardiac origin, the proportion of patients with favorable neurologic outcomes also did not differ between the groups. In this population, there were no significant differences in outcomes after OHCAs that occurred during national meetings of professional organizations related to OHCA care and those that occurred during non-meeting days.

  8. Lipoid proteinosis: A clinical and molecular study in Egyptian patients.

    Science.gov (United States)

    Afifi, Hanan H; Amr, Khalda S; Tosson, Angie M S; Hassan, Tarak A; Mehrez, Mennat I; El-Kamah, Ghada Y

    2017-09-10

    Lipoid proteinosis (LP) is an autosomal recessive disorder caused by the loss of function of ECM1 gene. Clinical features include varying degrees of skin thickening, hoarseness of voice and less frequently neuropsychiatric abnormalities. Twelve patients from ten unrelated families with a clinical diagnosis of lipoid proteinosis were enrolled in this study. Extraction of DNA samples of the 12 patients and their parents from peripheral blood by standard methods was performed. Polymerase chain reaction (PCR) amplification of the ECM1 gene was conducted using eight pairs of primers spanning over the 10 exons and splice junctions. Patients exhibited a variety of clinical manifestations with skin affection and hoarseness of voice being the consistent feature. We identified five novel homozygous insertion, small deletion, missense, and splice site mutations as well as two homozygous previously published splice site mutation c.70+1G>C in intron 1 and c.1305-2A>G in intron 8. The specific mutations were: c.10_11insC in exon 1, c.690_691delAG in exon 6, c.734G>A in exon 7, c.1286_1287delAA in exon 8 and c.1393-1G>T in intron 9. The novel mutations c.1393-1G>T and c.10_11insC occurred in three (30%) and two (20%) unrelated patients of the studied families, respectively. Further studies may designate an increased frequency of these mutations among Egyptian LP patients. Identification of pathogenic ECM1 mutations is important for accurate diagnosis and proper genetic counseling. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Predictors of clinical recovery from vestibular neuritis: a prospective study.

    Science.gov (United States)

    Cousins, Sian; Kaski, Diego; Cutfield, Nicholas; Arshad, Qadeer; Ahmad, Hena; Gresty, Michael A; Seemungal, Barry M; Golding, John; Bronstein, Adolfo M

    2017-05-01

    We sought to identify predictors of symptomatic recovery in vestibular neuritis. Forty VN patients were prospectively studied in the acute phase (median = 2 days) and 32 in the recovery phase (median = 10 weeks) with vestibulo-ocular reflex, vestibular-perceptual, and visual dependence tests and psychological questionnaires. Clinical outcome was Dizziness Handicap Inventory score at recovery phase. Acute visual dependency and autonomic arousal predicted outcome. Worse recovery was associated with a combination of increased visual dependence, autonomic arousal, anxiety/depression, and fear of bodily sensations, but not with vestibular variables. Findings highlight the importance of early identification of abnormal visual dependency and concurrent anxiety.

  10. MRI Diagnosis of Intracranial Hemorrhage : Experimental and Clinical Studies

    Energy Technology Data Exchange (ETDEWEB)

    Alemany Ripoll, Montserrat

    2003-02-01

    The purpose of this work was to improve the diagnosis of intracranial hemorrhage with MRI, and add knowledge about the newer sequences increasing in use to depict intra parenchymal bleeds, especially T2*-w GE sequences. We also compared the effect of magnetic field strengths. The sequences and field strengths were tested in animals. Then, the most effective technique was applied to patients with hematomas of different ages and with hematoma residuals. Occurrence of residuals of earlier, clinically silent, haemorrhages in patients with acute spontaneous hematoma or with suspected ischemic stroke were compared. Experimental studies: The MR detectability of small experimental haematomas in the brain and of blood in the cerebrospinal fluid (CSF) spaces of 30 rabbits was evaluated. MRI examinations were performed at determined intervals using different pulse sequences at two field strengths. The last MR images were compared to the formalin fixed brain sections and, in 16 rabbits, also to the histological findings. T2*-weighted GE sequences revealed all the intra parenchymal haematomas at 1.5 T: they were strongly hypointense. Their sizes became smaller but the signal patterns remained unchanged during the follow-up. The haematoma sizes and shapes corresponded well to gross pathology at acute and subacute stages. At chronic stage, the signal changes were larger than iron deposits. Blood in the CSF spaces was best detected at 1.5T with T2*-weighted GE sequences during the first 2 days. The FLAIR sequence often revealed blood in CSF spaces but not in the brain. SE sequences were rather insensitive. Imaging at 0.5 T was less effective than at 1.5 T. Clinical studies: All MR examinations on patients were performed at 1.5T, including T1- and T2-w SE, FLAIR, T2*-w GE sequences, and, occasionally, diffusion-w sequences. Sixty-six intra parenchymal hematomas were examined in the first clinical study. The hematomas were of different sizes and the ages varied from 8 hours to 3

  11. Redundant nerve roots of cauda equina in clinically neurologically asymptomatic patients. A clinical and radiographic study

    International Nuclear Information System (INIS)

    Otoshi, Ken-ichi; Kikuchi, Shin-ichi; Konno, Shin-ichi; Arai, Itaru

    2005-01-01

    A radiographic study was conducted to determine the incidence of redundant nerve roots of the cauda equina (RNR) in neurologically asymptomatic patients, and to clarify whether RNR has an impact on the clinical symptom. 50 patients who had spine disease such as spondylosis and compression fracture were examined by MRI. They didn't have neurological symptom such as sciatica, leg numbness, and motor weakness of lower extremities. There were 18 men and 32 women, and their mean age was 72.4 years (range: 32-87 years). RNR was found in 18 of the 50 patients (36.0%) and in a higher percentage of the patients who had lumber spinal canal stenosis. We concluded that RNR was only a morphological change of the cauda equine and had little effect on the neurological symptom. (author)

  12. Clinical study of CT discography for the lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Sakamoto, Tadashi (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1990-08-01

    The purpose of this clinical study was to introduce technique for correct positioning of the needle into the center of the disc for discography by means of CT analysis and also to clarify usefulness of CT discography for diagnosis of the lumbar disc herniation. We have taken CT analysis in order to determine correct place and the angle of inserting the needle. This measurement provides easy needle insertion. Unless the needle tip places center of disc, discogram false positive or negative will occur as a result. The materials of this study are 222 discs of 105 cases with the lumbar disc herniation. Comparative study of the findings among myelography, discography and CT discography was investigated. The results indicated that CT discography demonstrates the most clear findings and is useful in the diagnosis of lumbar disc herniation, especially in obtaining detailed observation of herniated discs. (author).

  13. Classification and clinical features of headache patients: an outpatient clinic study from China.

    Science.gov (United States)

    Wang, Yunfeng; Zhou, Jiying; Fan, Xiaoping; Li, Xuelian; Ran, Li; Tan, Ge; Chen, Lixue; Wang, Kuiyun; Liu, Bowen

    2011-10-01

    This study aimed to analyze and classify the clinical features of headache in neurological outpatients. A cross-sectional study was conducted consecutively from March to May 2010 for headache among general neurological outpatients attending the First Affiliated Hospital of Chongqing Medical University. Personal interviews were carried out and a questionnaire was used to collect medical records. Diagnosis of headache was according to the International classification of headache disorders, 2nd edition (ICHD-II). Headache patients accounted for 19.5% of the general neurology clinic outpatients. A total of 843 (50.1%) patients were defined as having primary headache, 454 (27%) secondary headache, and 386 (23%) headache not otherwise specified (headache NOS). For primary headache, 401 (23.8%) had migraine, 399 (23.7%) tension-type headache (TTH), 8 (0.5%) cluster headache and 35 (2.1%) other headache types. Overall, migraine patients suffered (1) more severe headache intensity, (2) longer than 6 years of headache history and (3) more common analgesic medications use than TTH ones (p headaches than migraine patients, and typically headache frequency exceeded 15 days/month (p headache patients were defined as chronic daily headache. Almost 20% of outpatient visits to the general neurology department were of headache patients, predominantly primary headache of migraine and TTH. In outpatient headaches, more attention should be given to headache intensity and duration of headache history for migraine patients, while more attention to headache frequency should be given for the TTH ones.

  14. THE STUDY OF CLINICAL PRESENTATION OF SOLITARY NODULE THYROID

    Directory of Open Access Journals (Sweden)

    Lakshmikanthan Premalatha

    2017-07-01

    Full Text Available BACKGROUND Thyroid disorders are the most common endocrine disorder seen in clinical practice and solitary thyroid nodule is one of the common presentations of thyroid disease. A discrete swelling in an otherwise impalpable gland is termed isolated or solitary nodule of thyroid.1 The prevalence of thyroid nodule increases from near zero at 15 years to 50% by about 60 to 65 years on sonography. At most 10% of these nodules are palpable even by experienced clinicians. This study is about the clinical presentation, histopathology and management of solitary nodule thyroid in MGM GH Tiruchirappalli. AIMS AND OBJECTIVES- To determine the age and sex incidence among the cases of solitary nodule thyroid. To study the percentage of euthyroid, hypothyroid or hyperthyroid state in patients presenting with solitary nodule thyroid. To study the proportion of malignant and benign cases among the solitary nodule thyroid at M.G.M. Govt. Hospital, Tiruchirappalli. MATERIALS AND METHODS This study includes 58 cases of solitary nodule of thyroid noted during the period Jan 2016-Dec 2016. Factors were tabulated and analysed statistically. RESULTS From the present study, the mean age at presentation found to be 42.5 years with preponderance to females. Because of periods of fluctuations in the demands of the hormonal requirement in female in their life cycle (puberty, menstrual cycles, pregnancy, menopause, the chances of thyroid nodule formation are very high as compared with male counterparts. From the study, distribution of malignancy is about 10.34. The incidence of malignancy found to be 12%, sensitivity is 87.5%, specificity is 100% for FNAC and HPE. CONCLUSION Majority of the patients are between 30-49 years of age. Incidence of solitary thyroid nodule is more common in female. Female: male ratio is almost about 15:1 Commonest symptom is swelling over anterior or lateral aspect of neck Among the benign lesion dominant nodule is most common and papillary and

  15. Isotope techniques in human studies of zinc nutrition. Report of an IAEA consultants' meeting

    International Nuclear Information System (INIS)

    1997-01-01

    A Consultants' Meeting was convened by the IAEA in November 1996 to review current knowledge of the role of zinc in human nutrition - with particular reference to (1) relevant public health issues in developing countries, and (2) the role that isotope techniques can play in increasing our understanding of some of these matters. More specifically, the Consultants Group was invited to advise the Agency on its future programmes in this area. It was concluded that there is now abundant scientific evidence that zinc deficiency of nutritional origin is a widespread phenomenon with important health consequences, particularly in developing countries. Even mild zinc deficiency is now thought to contribute to pregnancy complications, low birth weight, impaired immune competence, maternal and infant mortality and morbidity, and growth failure in infancy and childhood. Hence zinc deficiency may have far-reaching consequences for maternal, infant and child health in many developing countries. Isotope techniques - mainly using stable isotopes of zinc, but in some cases using radioisotopes - provide many possibilities 'for improving our understanding of the basic biochemical and metabolic functions of zinc, and for increasing our knowledge of the roles of this essential micronutrient in human nutrition. Through the use of isotope techniques, we may also expect to be better able to assess, and to increase, the efficacy of dietary and other intervention programmes designed to improve the nutritional status of developing country populations whose intakes are below the levels needed to achieve optimal health. This report briefly reviews some of these isotope techniques and makes recommendations on their use in IAEA research and technical co-operation programmes

  16. Clinical study of cutaneous leishmaniasis in the Kashmir Valley

    Directory of Open Access Journals (Sweden)

    Gh Mohiuddin Wani

    2015-01-01

    Full Text Available Background: Cutaneous leishmaniasis (CL is an infectious disease of tropical and semitropical areas of the world. The cold and harsh winter conditions of the Kashmir Valley do not favor the survival and growth of the Leishmania parasite or its vector, the sand fly, and the disease was until now practically unheard of in the Kashmir Valley. Aims: There has been a recent rise in the number of cases of CL in the Kashmir Valley. Against this background, the present study was taken up to describe the epidemiology, clinical features, and management outcomes of CL in the Kashmir Valley, where it represents a new phenomenon. Materials and Methods: Patients with direct smear-confirmed CL were evaluated. For each patient, we noted age, gender, geographical origin, stays in endemic areas, clinical aspects, number, site and size of lesions, treatment, and outcome. All the infected patients were treated with sodium stibogluconate. The dose, route of administration, adverse effects, and the clinical response in each patient was noted down. Results: Eighteen patients, 11 males (61.12% and 7 females (38.88% were studied. The age of the patients ranged from 3 to 60 years (mean age 29.8. The majority of our patients (16, 88.9% belonged to two hilly areas, Uri and Karnah. Duration of the disease ranged from a minimum of 1 month to a maximum of 18 months (mean duration 4.6 months. Lesions in most of our patients (16, 88.9% were located on the face including the lip and nose. The size of lesions varied from 4 to about 50 mm (average 2-3 cm. Most of our patients (13, 73.3% had only a single lesion and a few (5, 26.7% had two or three lesions. The clinical type of lesion in most of our patients (16, 88.9% was noduloulcerative, only two (11.1% had nodular (nonulcerative lesions. Sixteen patients; all with facial lesions were treated with intravenous sodium stibogluconate. A complete response was seen in 14 (87%, without any major adverse effect. Two adult patients with

  17. Clinical Research Informatics: Supporting the Research Study Lifecycle.

    Science.gov (United States)

    Johnson, S B

    2017-08-01

    Objectives: The primary goal of this review is to summarize significant developments in the field of Clinical Research Informatics (CRI) over the years 2015-2016. The secondary goal is to contribute to a deeper understanding of CRI as a field, through the development of a strategy for searching and classifying CRI publications. Methods: A search strategy was developed to query the PubMed database, using medical subject headings to both select and exclude articles, and filtering publications by date and other characteristics. A manual review classified publications using stages in the "research study lifecycle", with key stages that include study definition, participant enrollment, data management, data analysis, and results dissemination. Results: The search strategy generated 510 publications. The manual classification identified 125 publications as relevant to CRI, which were classified into seven different stages of the research lifecycle, and one additional class that pertained to multiple stages, referring to general infrastructure or standards. Important cross-cutting themes included new applications of electronic media (Internet, social media, mobile devices), standardization of data and procedures, and increased automation through the use of data mining and big data methods. Conclusions: The review revealed increased interest and support for CRI in large-scale projects across institutions, regionally, nationally, and internationally. A search strategy based on medical subject headings can find many relevant papers, but a large number of non-relevant papers need to be detected using text words which pertain to closely related fields such as computational statistics and clinical informatics. The research lifecycle was useful as a classification scheme by highlighting the relevance to the users of clinical research informatics solutions. Georg Thieme Verlag KG Stuttgart.

  18. [Psychometric approach of metacognition: Pilot study in clinical population].

    Science.gov (United States)

    Visinet, A; Soumet-Leman, C; Baptista, A; Bungener, C; Jouvent, R

    2017-04-01

    Metacognition describes the process of thinking about one's own thought processes. This concept was introduced by Flavell in 1979 and has since been widely developed in the cognitive approach to mood and anxiety disorders. As it happens, many recent studies have underlined the links between metacognition and anxio-depressive symptoms, pointing out the interest of assessing its various dimensions. The short form of the Metacognitions Questionnaire is a brief multidimensional measure of a range of metacognitive processes and metacognitive beliefs about worry and cognition relevant to the vulnerability to and the maintenance of emotional disorders. The aim of this study was twofold: firstly to adapt and validate a French version of the short form of the Metacognitions Questionnaire (MCQ-30) and to assess its psychometric properties in a clinical sample, and secondly to investigate metacognitive predictors of anxiety and depression in this sample. The sample included 55 clinical participants (24 men, 31 women, mean age=51.33±14.62) with DSM-IV-TR psychiatric disorders (major depression, bipolar disorder and obsessive-compulsive disorder). Instrument reliability (internal consistency), construct validity (confirmatory factor analysis), and convergent validity were measured. The total score and the five subscale scores were also compared with previous results in non-clinical samples. Reliability analyses indicated that the French version of the MCQ-30 possessed satisfactory internal consistency (Cronbach α=0.84), and confirmatory factor analysis supported the MCQ's original five-factor structure. Correlation with measurements of depression, anxiety and pathological worry demonstrated convergent validity (r=0.62, Pmetacognition, in relation to the anxio-depressive symptomatology and the subsequent management of patients. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  19. Clinical assessment of transthoracic echocardiography skills: a generalizability study.

    Science.gov (United States)

    Guldbrand Nielsen, Dorte; Jensen, Signe Lichtenstein; O'Neill, Lotte

    2015-02-01

    Transthoracic echocardiography (TTE) is a widely used cardiac imaging technique that all cardiologists should be able to perform competently. Traditionally, TTE competence has been assessed by unstructured observation or in test situations separated from daily clinical practice. An instrument for assessment of clinical TTE technical proficiency including a global rating score and a checklist score has previously shown reliability and validity in a standardised setting. As clinical test situations typically have several sources of error giving rise to variance in scores, a more thorough examination of the generalizability of the assessment instrument is needed. Nine physicians performed a TTE scan on the same three patients. Then, two raters rated all 27 TTE scans using the TTE technical assessment instrument in a fully crossed, all random generalizability study. Estimated variance components were calculated for both the global rating and checklist scores. Finally, dependability (phi) coefficients were also calculated for both outcomes in a decision study. For global rating scores, 66.6% of score variance can be ascribed to true differences in performance. For checklist scores this was 88.8%. The difference was primarily due to physician-rater interaction. Four random cases rated by one random rater resulted in a phi value of 0.81 for global ratings and two random cases rated by one random rater showed a phi value of 0.92 for checklist scores. Using the TTE checklist as opposed to the TTE global rating score had the effect of minimising the largest source of error variance in test scores. Two cases rated by one rater using the TTE checklist are sufficiently reliable for high stakes examinations. As global rating is less time consuming it could be considered performing four global rating assessments in addition to the checklist assessments to account for both reliability and content validity of the assessment.

  20. Clinical evaluations of cast gold alloy, machinable zirconia, and semiprecious alloy crowns: A multicenter study.

    Science.gov (United States)

    Park, Ji-Man; Hong, Yong-Shin; Park, Eun-Jin; Heo, Seong-Joo; Oh, Namsik

    2016-06-01

    Few studies have compared the marginal and internal fits of crowns fabricated from machinable palladium-silver-indium (Pd-Ag-In) semiprecious metal alloy. The purpose of this clinical study was to evaluate and compare the marginal and internal fits of machined Pd-Ag-In alloy, zirconia, and cast gold crowns. A prospective clinical trial was performed on 35 participants and 52 abutment teeth at 2 centers. Individuals requiring prosthetic restorations were treated with gold alloy or zirconia crowns (2 control groups) or Pd-Ag-In alloy crowns (experimental group). A replica technique was used to evaluate the marginal and internal fits. The buccolingual and mesiodistal cross-sections were measured, and a noninferiority comparison was conducted. The mean marginal gaps were 68.2 μm for the gold crowns, 75.4 μm for the zirconia crowns, and 76.9 μm for the Pd-Ag-In alloy crowns. In the 5 cross-sections other than the distal cross-section, the 2-sided 95% confidence limits for the differences between the Pd-Ag-In alloy crowns and the 2 control groups were not larger than the 25-μm noninferiority margin. The control groups displayed smaller internal gaps in the line angle and occlusal spaces compared with the Pd-Ag-In crown group. The marginal gaps of machinable Pd-Ag-In alloy crowns did not meet the noninferiority criterion in the distal margin compared with zirconia and gold alloy crowns. Nonetheless, all 3 crowns had clinically applicable precision. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  1. Are neurocognitive, clinical and social dysfunctions in schizotaxia reversible pharmacologically?: Results from the Changsha study.

    Science.gov (United States)

    Stone, William S; Hsi, Xiaolu; Giuliano, Anthony J; Tan, Liwen; Zhu, Shaochun; Li, Lingjiang; Seidman, Larry J; Tsuang, Ming T

    2012-03-01

    The Changsha study identifies adult, non-psychotic relatives of patients with schizophrenia who show deficits in neurocognitive, social, clinical and other dimensions, and who meet provisional criteria for a liability syndrome for schizophrenia ('schizotaxia'). In this study, we investigated whether negative symptoms, neurocognitive deficits, or other measures of clinical and social function in subjects who met our research criteria for schizotaxia were amenable to pharmacological remediation with a low dose (2.0 mg) of risperidone, a second generation antipsychotic medication. One hundred eighty nine relatives were assessed at the Mental Health Institute, Second Xiangya Hospital of Central South University, Changsha (Hunan Province, China), between 12/06 - 12/08. Eighty six of these individuals met modified criteria for schizotaxia, and 36 agreed to enter a 6-week, double-blind, placebo-controlled protocol. ANCOVAs using age and gender as covariates showed significant improvement in the risperidone group (n=20) on neurocognitive function (Wisconsin Card Sorting Test Total Errors and Perseverative Errors) and on a self-report measure of social function (Social Adjustment Scale), compared to the placebo-control group (n=16). Effect sizes were small to medium. Notably, risperidone effect sizes were larger (medium to large) in a subset of subjects (risperidone=15; placebo=10) whose membership in the schizotaxic group was supported empirically by cluster analysis. Negative symptoms did not change significantly in either analysis. The results are generally consistent with previous open-label investigations of risperidone administration in subjects with schizotaxia, and provide evidence that some neurocognitive and clinical problems are amenable to remediation in non-psychotic relatives of people with schizophrenia.

  2. Proceedings of the Twenty-First NASA Propagation Experimenters Meeting (NAPEX XXI) and the Advanced Communications Technology Satellite (ACTS) Propagation Studies Miniworkshop

    Science.gov (United States)

    Golshan, Nasser (Editor)

    1997-01-01

    The NASA Propagation Experimenters (NAPEX) meeting is convened each year to discuss studies supported by the NASA Propagation Program. Representatives from the satellite communications industry, academia and government who have an interest in space-ground radio wave propagation are invited to NAPEX meetings for discussions and exchange of information. The reports delivered at this meeting by program managers and investigators present recent activities and future plans. This forum provides an opportunity for peer discussion of work in progress, timely dissemination of propagation results, and close interaction with the satellite communications industry.

  3. A study on the perception of students in the radiologic technology study on the clinical practices

    International Nuclear Information System (INIS)

    Lee, Byung Ryul; Kim, Hyun Gil; Yoon, Myeong Kwan; Lee, Gi Jong; Cha, Sang Young; Lim, Cheong Hwan

    2014-01-01

    The clinical practices provide the students with a good opportunity to study the practical experiences in their field through the clinical training education in hospital. Now, in this study, comparing the perceptions of the clinic teachers with those of students at the clinical site. The study was conducted to the students attending universities located in Seoul and who finished the clinical practices in 2013. The questionnaires were distributed to the student and collected from them. The study were conducted to 275 questionnaires with frequency analysis, crosstabs, chi-square test and McNemar test. The major motivation was of the select radiography course was high employment rate(44.0%) and the satisfaction of radiography course was general(53.1%). 51.3% of the study answered 8 weeks current duration of clinical practices is proper. The 3-year course students answered that the period of clinical practices would be proper if it is performed in the winter vacation in their second year in college(47.3%). The 4-year course students answered that the first semester in their third years is proper for clinical practices(27.7%). The students answered that they felt the lack in their knowledge on the professional field(32.4%) during the clinical practices and some of the practical training is different from the education performed at school(68.4%). Most of answered that they were satisfied with the clinical practices and among them they recognized the importance of the clinical practices (3.94 ± 0.89). After the clinical practices, their desire for getting job as a radiography has changed from 84.1% to 82.9%. The reason why they want the job related to the radiation is because the job is stable (changed from 49.0% to 46.0% after the clinical practice) while the reason why they do not want be a radigrapher because that job is not proper for them (changed from 37.0% to 40.7% after the clinical practice) The effort should be made to enhance the position of radiation

  4. A study on the perception of students in the radiologic technology study on the clinical practices

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Ryul; Kim, Hyun Gil; Yoon, Myeong Kwan; Lee, Gi Jong; Cha, Sang Young [Dept. of Diagnostic Radiology, Inha University Hospital, Incheon (Korea, Republic of); Lim, Cheong Hwan [Dept. of Radiological Science, Hanseo University, Seosan (Korea, Republic of)

    2014-09-15

    The clinical practices provide the students with a good opportunity to study the practical experiences in their field through the clinical training education in hospital. Now, in this study, comparing the perceptions of the clinic teachers with those of students at the clinical site. The study was conducted to the students attending universities located in Seoul and who finished the clinical practices in 2013. The questionnaires were distributed to the student and collected from them. The study were conducted to 275 questionnaires with frequency analysis, crosstabs, chi-square test and McNemar test. The major motivation was of the select radiography course was high employment rate(44.0%) and the satisfaction of radiography course was general(53.1%). 51.3% of the study answered 8 weeks current duration of clinical practices is proper. The 3-year course students answered that the period of clinical practices would be proper if it is performed in the winter vacation in their second year in college(47.3%). The 4-year course students answered that the first semester in their third years is proper for clinical practices(27.7%). The students answered that they felt the lack in their knowledge on the professional field(32.4%) during the clinical practices and some of the practical training is different from the education performed at school(68.4%). Most of answered that they were satisfied with the clinical practices and among them they recognized the importance of the clinical practices (3.94 ± 0.89). After the clinical practices, their desire for getting job as a radiography has changed from 84.1% to 82.9%. The reason why they want the job related to the radiation is because the job is stable (changed from 49.0% to 46.0% after the clinical practice) while the reason why they do not want be a radigrapher because that job is not proper for them (changed from 37.0% to 40.7% after the clinical practice) The effort should be made to enhance the position of radiation

  5. improving clinical practice through simulation: a case study of ...

    African Journals Online (AJOL)

    PROF. BARTH EKWEME

    Seeples, 2006). Donovan and Forster (2015) report that effective communication and teamwork skills can easily be gained with practice simulation. Simulation in the area of medicine and nursing has become an important part of the education of students and practicing healthcare providers. To ensure that nurses meet the.

  6. Patient engagement in clinical communication: an exploratory study.

    Science.gov (United States)

    Chaboyer, Wendy; McMurray, Anne; Marshall, Andrea; Gillespie, Brigid; Roberts, Shelley; Hutchinson, Alison M; Botti, Mari; McTier, Lauren; Rawson, Helen; Bucknall, Tracey

    2016-09-01

    Existing practice strategies for actively involving patients in care during hospitalisation are poorly understood. The aim of this study was to explore how healthcare professionals engaged patients in communication associated with care transitions. An instrumental, collective case study approach was used to generate empirical data about patient transitions in care. A purposive sample of key stakeholders representing (i) patients and their families; (ii) hospital discharge planning team members; and (iii) healthcare professionals was recruited in five Australian health services. Individual and group semi-structured interviews were conducted to elicit detailed explanations of patient engagement in transition planning. Interviews lasted between 30 and 60 minutes and were digitally recorded and transcribed verbatim. Data collection and analysis were conducted simultaneously and continued until saturation was achieved. Thematic analysis was undertaken. Five themes emerged as follows: (i) organisational commitment to patient engagement; (ii) the influence of hierarchical culture and professional norms on patient engagement; (iii) condoning individual healthcare professionals' orientations and actions; (iv) understanding and negotiating patient preferences; and (v) enacting information sharing and communication strategies. Most themes illustrated how patient engagement was enabled; however, barriers also existed. Our findings show that strong organisational and professional commitment to patient-centred care throughout the organisation was a consistent feature of health services that actively engaged patients in clinical communication. Understanding patients' needs and preferences and having both formal and informal strategies to engage patients in clinical communication were important in how this involvement occurred. © 2016 Nordic College of Caring Science.

  7. Prospective randomized clinical studies involving reirradiation. Lessons learned

    International Nuclear Information System (INIS)

    Nieder, Carsten; Langendijk, Johannes A.; Guckenberger, Matthias; Grosu, Anca L.

    2016-01-01

    Reirradiation is a potentially useful option for many patients with recurrent cancer. The purpose of this study was to review all recently published randomized trials in order to identify methodological strengths and weaknesses, comment on the results, clinical implications and open questions, and give advice for the planning of future trials. Systematic review of trials published between 2000 and 2015 (databases searched were PubMed, Scopus and Web of Science). We reviewed 9 trials, most of which addressed reirradiation of head and neck tumours. The median number of patients was 69. Trial design, primary endpoint and statistical hypotheses varied widely. The results contribute mainly to decision making for reirradiation of nasopharynx cancer and bone metastases. The trials with relatively long median follow-up confirm that serious toxicity remains a concern after high cumulative total doses. Multi-institutional collaboration is encouraged to complete sufficiently large trials. Despite a paucity of large randomized studies, reirradiation has been adopted in different clinical scenarios by many institutions. Typically, the patients have been assessed by multidisciplinary tumour boards and advanced technologies are used to create highly conformal dose distributions. (orig.) [de

  8. Herpes zoster: A clinical study in 205 patients

    Directory of Open Access Journals (Sweden)

    E N Abdul Latheef

    2011-01-01

    Full Text Available Background: Even though herpes zoster is a common condition its incidence and pattern of occurrence in the era of HIV disease is significant. Aim: To analyze the incidence, pattern of occurrence and evolution of herpes zoster with special attention to provocative factors if any. Materials and Method s: This was an analytical study conducted for 2 years based on a preformed proforma containing preliminary information, a detailed clinical evaluation regarding the segment of involvement, morphology, pattern of lesions, complications, disseminations etc. and investigations to establish provocative factors if any. Results: Incidence of herpes zoster was mainly in the fourth and third decades of life. A definite history of chicken pox was present in only 63.4% cases. In the majority (70% herpes zoster occurred spontaneously. In 30% cases, immunosuppression due to chemotherapy, malignancy, HIV infection, diabetes mellitus were observed. The commonest segment affected was thoracic (42.4% followed by cranial (28.2% and cervical (12.1%. Majority resolved in 7-14 days except immunosuppressed. 34.6% of the patients had complications such as secondary bacterial infection, post herpetic neuralgia, and motor weakness. Ten patients had HIV infection as a provocative factor. Conclusion: The results of incidence and clinical pattern of herpes zoster is almost parallel to the previous studies. Any factors of immunosuppression should be checked, especially HIV, particularly in disseminated and long-lasting cases.

  9. [Clinical experience with lacosamide in Galicia: the GALACO study].

    Science.gov (United States)

    Rodriguez-Osorio, Xiana; Lopez-Gonzalez, Francisco J; Pato-Pato, Antonio; Cebrian-Perez, Ernesto; Marey-Lopez, José; Corredera-Garcia, Enrique; Rubio-Nazabal, Eduardo; Castro-Vilanova, M Dolores; Abella-Corral, Javier; Rodriguez-Regal, Ana; Amigo-Jorrin, M Campo; Pego-Reigosa, Robustiano

    2015-12-16

    Lacosamide is a sodium channel blocker antiepileptic drug authorized as an adjunctive therapy for focal seizures in adolescents and adults. To analyze the efficacy and safety of lacosamide in Galicia according to its use in daily clinical practice. Retrospective observational study in patients who started treatment with lacosamide between January 2014 and June 2013 in 10 hospitals in Galicia, Spain. Its efficacy and safety at 3, 6 and 12 months after starting lacosamide was assessed. We included 184 patients with a mean age of 44.2 ± 17.4 years old; 56.5% (n = 104) were male; 173 patients constituted the efficacy population. Mean duration of epilepsy was 18.8 ± 15.5 years. Seizure frequency was 2.5 ± 1.6 episodes/month. After 12 months, 68.2% of patients (n = 118) had >= 50% improvement (responders) and among them, 54 (45.8% of responder patients) were seizure free. Twenty-three percent (n = 43) suffered from adverse events after 12 months, being dizziness (10.3%) and instability (3.3%) the most frequently reported. After the 12 month visit, 87.5% of patients (n = 161) continued treatment with lacosamide. Lacosamide provides a very good efficacy and safety profile for patients with focal refractory epilepsy. High percentage of responders may be related to a less refractory population compared to other daily clinical practice studies. It constitutes an attractive therapeutic option for the treatment of focal epilepsies.

  10. A clinical study of temporomandibular joint disorders by using arthrography

    International Nuclear Information System (INIS)

    Lee, Seung Hyun; Hwang, Eui Hwan; Lee, Sang Rae

    1998-01-01

    The purpose of this study was to prove the relationship between arthrographic and clinical features in temporomandibular joint disorders. In order to carry out this study, ninety-eight arthrographic examinations of temporomandibular joints were performed in eighty-two patients who had the temporomandibular joint disorders. As the arthrographic examination, the cases were classified in three groups, disk displacement with reduction, disk displacement without reduction, within normal limit. After this, the cases were clinically examined, and the results were compared and analyzed in each other group. The obtained results were as follows ; 1. As the classification by arthrographic examination, three groups (disc displacement with reduction, disc displacement without reduction, within normal limit) were 41%, 54%, 5% of total cases in this study, respectively. 2. The third decade (65%) was most frequent in this study. The average age of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 24, 28, 21, and disc displacement without reduction group was higher than any other group. 3. In the chief complaint, pain was the most frequent in all three groups. Joint sound was also frequent in disc displacement with reduction group, but in disc displacement without reduction group, limitation of mouth opening was more frequent. 4. Of the various pain, the movement pain was most frequent (61%) in this study. In joint sound, click (63%) was the most frequent in disc displacement with reduction group, but sound history (42%) and no sound (31%) were more frequent in disc displacement without reduction group. 5. The average maximum opening of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 44 mm, 32.9 mm, 44 mm, and disc displacement without reduction group was less than any other group. 6. The masticatory disturbance of each group (disc displacement with reduction, disc

  11. A clinical study of temporomandibular joint disorders by using arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Hyun; Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kyunghee University, (Korea, Republic of)

    1998-02-15

    The purpose of this study was to prove the relationship between arthrographic and clinical features in temporomandibular joint disorders. In order to carry out this study, ninety-eight arthrographic examinations of temporomandibular joints were performed in eighty-two patients who had the temporomandibular joint disorders. As the arthrographic examination, the cases were classified in three groups, disk displacement with reduction, disk displacement without reduction, within normal limit. After this, the cases were clinically examined, and the results were compared and analyzed in each other group. The obtained results were as follows: 1. As the classification by arthrographic examination, three groups (disc displacement with reduction, disc displacement without reduction, within normal limit) were 41%, 54%, 5% of total cases in this study, respectively. 2. The third decade (65%) was most frequent in this study. The average age of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 24, 28, 21, and disc displacement without reduction group was higher than any other group. 3. In the chief complaint, pain was the most frequent in all three groups. Joint sound was also frequent in disc displacement with reduction group, but in disc displacement without reduction group, limitation of mouth opening was more frequent. 4. Of the various pain, the movement pain was most frequent (61%) in this study. In joint sound, click (63%) was the most frequent in disc displacement with reduction group, but sound history (42%) and no sound (31%) were more frequent in disc displacement without reduction group. 5. The average maximum opening of each group (disc displacement with reduction, disc displacement without reduction, within normal limit) was 44 mm, 32.9 mm, 44 mm, and disc displacement without reduction group was less than any other group. 6. The masticatory disturbance of each group (disc displacement with reduction, disc

  12. Input of Psychosocial Information During Multidisciplinary Team Meetings at Medical Oncology Departments: Protocol for an Observational Study.

    Science.gov (United States)

    Horlait, Melissa; Van Belle, Simon; Leys, Mark

    2018-02-26

    Multidisciplinary team meetings (MDTMs) have become standard practice in oncology and gained the status of the key decision-making forum for cancer patient management. The current literature provides evidence that MDTMs are achieving their intended objectives but there are also indications to question the positive impact of MDTMs in oncology settings. For cancer management to be patient-centered, it is crucial that medical information as well as psychosocial aspects-such as the patients' living situation, possible family problems, patients' mental state, and patients' perceptions and values or preferences towards treatment or care-are considered and discussed during MDTMs. Previous studies demonstrate that failure to account for patients' psychosocial information has a negative impact on the implementation of the treatment recommendations formulated during MDTMs. Few empirical studies have demonstrated the predominant role of physicians during MDTMs, leading to the phenomenon that medical information is shared almost exclusively at the expense of psychosocial information. However, more in-depth insight on the underlying reasons why MDTMs fail to take into account psychosocial information of cancer patients is needed. This paper presents a research protocol for a cross-sectional observational study that will focus on exploring the barriers to considering psychosocial information during MDTMs at medical oncology departments. This protocol encompasses a cross-sectional comparative case study of MDTMs at medical oncology departments in Flanders, Belgium. MDTMs from various oncology subspecialties at inpatient medical oncology departments in multiple hospitals (academic as well as general hospitals) are compared. The observations focus on the "multidisciplinary oncology consultation" (MOC), a formally regulated and financed type of MDTM in Belgian oncology since 2003. Data are collected through nonparticipant observations of MOC-meetings. Observational data are

  13. Use of a National Continuing Medical Education Meeting to Provide Simulation-Based Training in Temporary Hemodialysis Catheter Insertion Skills: A Pre-Test Post-Test Study

    Directory of Open Access Journals (Sweden)

    Edward G Clark

    2014-10-01

    Full Text Available Background: Simulation-based-mastery-learning (SBML is an effective method to train nephrology fellows to competently insert temporary, non-tunneled hemodialysis catheters (NTHCs. Previous studies of SBML for NTHC-insertion have been conducted at a local level. Objectives: Determine if SBML for NTHC-insertion can be effective when provided at a national continuing medical education (CME meeting. Describe the correlation of demographic factors, prior experience with NTHC-insertion and procedural self-confidence with simulated performance of the procedure. Design: Pre-test – post-test study. Setting: 2014 Canadian Society of Nephrology annual meeting. Participants: Nephrology fellows, internal medicine residents and medical students. Measurements: Participants were surveyed regarding demographics, prior NTHC-insertion experience, procedural self-confidence and attitudes regarding the training they received. NTHC-insertion skills were assessed using a 28-item checklist. Methods: Participants underwent a pre-test of their NTHC-insertion skills at the internal jugular site using a realistic patient simulator and ultrasound machine. Participants then had a training session that included a didactic presentation and 2 hours of deliberate practice using the simulator. On the following day, trainees completed a post-test of their NTHC-insertion skills. All participants were required to meet or exceed a minimum passing score (MPS previously set at 79%. Trainees who did not reach the MPS were required to perform more deliberate practice until the MPS was achieved. Results: Twenty-two individuals participated in SBML training. None met or exceeded the MPS at baseline with a median checklist score of 20 (IQR, 7.25 to 21. Seventeen of 22 participants (77% completed post-testing and improved their scores to a median of 27 (IQR, 26 to 28; p < 0.001. All met or exceeded the MPS on their first attempt. There were no significant correlations between demographics

  14. Use of a national continuing medical education meeting to provide simulation-based training in temporary hemodialysis catheter insertion skills: a pre-test post-test study.

    Science.gov (United States)

    Clark, Edward G; Paparello, James J; Wayne, Diane B; Edwards, Cedric; Hoar, Stephanie; McQuillan, Rory; Schachter, Michael E; Barsuk, Jeffrey H

    2014-01-01

    Simulation-based-mastery-learning (SBML) is an effective method to train nephrology fellows to competently insert temporary, non-tunneled hemodialysis catheters (NTHCs). Previous studies of SBML for NTHC-insertion have been conducted at a local level. Determine if SBML for NTHC-insertion can be effective when provided at a national continuing medical education (CME) meeting. Describe the correlation of demographic factors, prior experience with NTHC-insertion and procedural self-confidence with simulated performance of the procedure. Pre-test - post-test study. 2014 Canadian Society of Nephrology annual meeting. Nephrology fellows, internal medicine residents and medical students. Participants were surveyed regarding demographics, prior NTHC-insertion experience, procedural self-confidence and attitudes regarding the training they received. NTHC-insertion skills were assessed using a 28-item checklist. Participants underwent a pre-test of their NTHC-insertion skills at the internal jugular site using a realistic patient simulator and ultrasound machine. Participants then had a training session that included a didactic presentation and 2 hours of deliberate practice using the simulator. On the following day, trainees completed a post-test of their NTHC-insertion skills. All participants were required to meet or exceed a minimum passing score (MPS) previously set at 79%. Trainees who did not reach the MPS were required to perform more deliberate practice until the MPS was achieved. Twenty-two individuals participated in SBML training. None met or exceeded the MPS at baseline with a median checklist score of 20 (IQR, 7.25 to 21). Seventeen of 22 participants (77%) completed post-testing and improved their scores to a median of 27 (IQR, 26 to 28; p < 0.001). All met or exceeded the MPS on their first attempt. There were no significant correlations between demographics, prior experience or procedural self-confidence with pre-test performance. Small sample-size and

  15. AN ANALYTICAL STUDY OF GALLSTONES AND ITS CLINICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Vimal Venkatachalam

    2017-08-01

    Full Text Available BACKGROUND Gallstones occur when there is an imbalance in the chemical constituents of bile that result in precipitation of one or more of the components. This disease is, however, a worldwide medical problem, even though there are geographical variations in gallstone prevalence. In most cases, they do not cause symptoms and only 10% and 20% will eventually become symptomatic within 5 years and 20 years of diagnosis. Thus, the average risk of developing symptomatic disease is low and approaches 2.0- 2.6% year in all populations of the world regardless of overall gallstone prevalence. Women during their fertile years are almost twice as likely as men to experience cholelithiasis. Treatment of gallstones depends partly on whether they are causing symptoms or not. This study was conducted at government KAPV Medical College Hospital in patients who had undergone cholecystectomy to delineate their age and sex distribution, symptomatology and to find out the fraction of patients with incidental malignancy in the gallbladder. The aim of the study is to- 1. Study the clinical presentation of gallstone diseases - symptomatology and acuteness of presentation. 2. Study the gender and age, distribution of patients presenting with gallstone diseases and compare with given standards. 3. Study the prevalence of concomitant CBD stones in patients with gallstone diseases. 4. Study the prevalence of gallbladder carcinoma in patients with gallstone diseases. 5. Study the surgical management of patients with gallstone diseases/CBD stone and outcome. MATERIALS AND METHODS An analysis of patients presenting with gallstone diseases at Government KAPV Medical College Hospital between 2014-2016 was made with regard to the prevalence, age distribution, clinical presentation and the surgical management and outcome. RESULTS In our study, the male-to-female ratio is 1:1.61. The prevalence of symptomatic gallstone diseases in our study is highest in the 40-49 years age group

  16. Visuomotor ataxia. Clinical and CT scan studies in three cases

    Energy Technology Data Exchange (ETDEWEB)

    Hirose, Genjiro; Kawada, Junya; Oda, Rokuhei; Kitagawa, Yoshinobu; Kosoegawa, Hiroshi

    1985-03-01

    Three patients with visuomotor ataxia, a disorder of hand movement to grasp objects located in the periphery of the visual field, were studied clinically and neuroradiologically with conventional and reformatted CT scans. Visuomotor ataxia was noted in the hemifield contralateral to the parieto-occipital lesion with both hands regardless the side of the lesion in this study. No dominant hemisphere for visuomotor ataxia was noted. The responsible lesions for this disorder were overlapped at Broadmann's area 7, 18, 19 and their surrounded white matter including the connecting fibers to the contralateral hemisphere via the splenium of corpus callosum. No direct lesion was found in the angular gyrus (Broadmann area 39). Visuomotor ataxia was seen with both hands in our series and it can be explained by the disconnection of either or both of the direct and crossed long association fibers between visual association areas and motor association areas at the parieto-occipital junction. (author).

  17. Nd:YAG laser in caries prevention: a clinical study

    International Nuclear Information System (INIS)

    Boari, Heloisa Gomes Dimiranda

    2000-01-01

    The caries prevention by using laser irradiation has been investigated during the last 30 years. The Nd: YAG laser associated with acidulated phosphate fluoride has been shown as a very promising technique for enamel caries prevention. The aim of this work was to clinically evaluate the efficiency of Nd: YAG laser associated with acidulated phosphate fluoride in pit and fissure caries prevention of children and adolescents. In this work it was determined the dye that enhance the effect of Nd: YAG laser in enamel. It was selected 242 pre-molar and molar teeth from 33 children and adolescents, aged from 7 to 15 years old. The selected teeth were free from caries or decalcification marks (active white marks) to the clinical and radiographic exams. The teeth were divided into two groups: the first group was laser irradiated and their homologous remained as a control. The right side teeth were dye-assisted Nd:YAG laser irradiated. The dye solution was a moisture of dust coal and equal parts of water and alcohol. The irradiation conditions were 60 mJ/10 Hz, optical fiber in contact mode, with diameter of 300 μm, resulting in an energy density of 84,9 J/cm 2 . The oclusal surface of the teeth was completely irradiated, specially on the slopes and in the deepest part of the pits and fissures. This procedure was repeated three times. In the sequence it was applied the acidulated phosphate fluoride for 4 minutes. On the left side teeth - control group- only acidulated phosphate fluoride was applied for the same time. The final examination considered the presence of caries and active white marks after a period of one year. There were statistical significant differences (p < 0.01) between the lased + fluoride group and the non irradiated group. The present study concluded that the technique used in this work can be an alternative clinical method for caries prevention. (author)

  18. Effect of hyaluronan on periodontitis: A clinical and histological study

    Directory of Open Access Journals (Sweden)

    Gauri Gontiya

    2012-01-01

    Full Text Available Background: Conventional, non-surgical periodontal therapy consists of supra- and subgingival tooth debridement. However, it is a technically demanding procedure and is not always efficient at eradicating all periodontal pathogens and in reducing inflammation. Therefore, local subgingival application of other chemotherapeutic agents may be used as an adjunct to non-surgical therapy. The aim of this study was to investigate the clinical and histological outcomes of local subgingival application of 0.2% hyaluronic acid gel (GENGIGEL® as an adjunct to scaling and root planing (SRP in chronic periodontitis patients. Materials and Methods: One hundred and twenty sites were chosen from 26 patients with chronic periodontitis (criteria being periodontal pockets ≥5mm. Experimental sites additionally received HA gel subgingivally at baseline, 1 st , 2 nd , and 3 rd week. Clinical parameters were re-assessed at 4 th , 6 th , and 12 th week. At 4 th week recall, a gingival biopsy was obtained from test and control site for histologic examination. Results: Intra-group analysis of all the clinical parameters at all sites from baseline to 4 th , 6 th , and 12 th week showed statistically significant changes. Experimental sites showed statistically significant improvement in Gingival index and Bleeding index at 6 th and 12 th week when compared with control sites. However, no statistically significant differences were observed in the PPD and RAL between control and experimental sites at 4 th , 6 th , and 12 th week time interval. No statistically significant association was found between the histological grading of the sites that received HA treatment. Conclusion: Subgingival placement of 0.2% HA gel along with SRP provided a significant improvement in gingival parameters. However, no additional benefit was found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrate, but it was not statistically significant.

  19. Friedreich's ataxia: clinical and molecular study of 25 Brazilian cases

    Directory of Open Access Journals (Sweden)

    Albano Lilian M. J.

    2001-01-01

    Full Text Available INTRODUCTION: Friedreich's ataxia is a neurodegenerative disorder whose clinical diagnostic criteria for typical cases basically include: a early age of onset (< 20 or 25 years, b autosomal recessive inheritance, c progressive ataxia of limbs and gait, and d absence of lower limb tendon reflexes. METHODS: We studied the frequency and the size of expanded GAA and their influence on neurologic findings, age at onset, and disease progression in 25 Brazilian patients with clinical diagnosis of Friedreich's ataxia - 19 typical and 6 atypical - using a long-range PCR test. RESULTS: Abnormalities in cerebellar signs, in electrocardiography, and pes cavus occurred more frequently in typical cases; however, plantar response and speech were more frequently normal in this group when the both typical and atypical cases were compared. Homozygous GAA expansion repeats were detected in 17 cases (68% - all typical cases. In 8 patients (32% (6 atypical and 2 typical, no expansion was observed, ruling out the diagnosis of Friedreich's ataxia. In cases with GAA expansions, foot deformity, cardiac abnormalities, and some neurologic findings occurred more frequently; however, abnormalities in cranial nerves and in tomographic findings were detected less frequently than in patients without GAA expansions. DISCUSSION: Molecular analysis was imperative for the diagnosis of Friedreich's ataxia, not only for typical cases but also for atypical ones. There was no genotype-phenotype correlation. Diagnosis based only on clinical findings is limited; however, it aids in better screening for suspected cases that should be tested. Evaluation for vitamin E deficiency is recommended, especially in cases without GAA expansion.

  20. Meeting Indigenous peoples' objectives in environmental flow assessments: Case studies from an Australian multi-jurisdictional water sharing initiative

    Science.gov (United States)

    Jackson, Sue; Pollino, Carmel; Maclean, Kirsten; Bark, Rosalind; Moggridge, Bradley

    2015-03-01

    The multi-dimensional relationships that Indigenous peoples have with water are only recently gaining recognition in water policy and management activities. Although Australian water policy stipulates that the native title interests of Indigenous peoples and their social, cultural and spiritual objectives be included in water plans, improved rates of Indigenous access to water have been slow to eventuate, particularly in those regions where the water resource is fully developed or allocated. Experimentation in techniques and approaches to both identify and determine Indigenous water requirements will be needed if environmental assessment processes and water sharing plans are to explicitly account for Indigenous water values. Drawing on two multidisciplinary case studies conducted in Australia's Murray-Darling Basin, we engage Indigenous communities to (i) understand their values and explore the application of methods to derive water requirements to meet those values; (ii) assess the impact of alternative water planning scenarios designed to address over-allocation to irrigation; and (iii) define additional volumes of water and potential works needed to meet identified Indigenous requirements. We provide a framework where Indigenous values can be identified and certain water needs quantified and advance a methodology to integrate Indigenous social, cultural and environmental objectives into environmental flow assessments.

  1. ACCU Meeting

    CERN Multimedia

    PH Department

    2010-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 9 June 2010 At 9:15 a.m. in room 60-6-002 Chairperson’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS department CERN Global Network An update on Safety at CERN Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 11 is invited to send them to the Chairperson in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel (76592) ...

  2. ACCU Meeting

    CERN Multimedia

    PH Department

    2011-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 9 March 2011 At 9:15 a.m. in room 60-6-002   Chairperson's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS department Update on Safety at CERN The new account management system Users’ Office news Any Other Business Agenda for the next meeting   Anyone wishing to raise any points under item 10 is invited to send them to the Chairperson in writing or by e-mail to Michael.Hauschild@cern.ch Michael Hauschild (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria G. Walzel (76592) Belgium ...

  3. ACCU Meeting

    CERN Multimedia

    PH Department

    2010-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 8 December 2010 at 9:15 a.m. in room 60-6-002 Chairperson's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS department The CERN Ombuds The new account management system Crèche progress + Restaurants Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairperson in writing or by e-mail to Michael.Hauschild@cern.ch   Michael Hauschild (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): ...

  4. ACCU MEETING

    CERN Multimedia

    PH Department

    2010-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 8 September 2010 at 9:15 a.m. in Room 60-6-002 Chairperson’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS Department An update on Safety at CERN The CERN Summer Student program Bringing Library services to users Reports from ACCU representatives on other committees Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairperson in writing or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): ...

  5. Public meeting

    CERN Multimedia

    HR Department

    2010-01-01

    Dear Colleagues, I am pleased to invite you to a public meeting which will be held on Thursday 11 November 2010 at 2:30 p.m., in the Main Auditorium (welcome coffee from 2 p.m.) In this meeting Sigurd Lettow, Director for Administration and General Infrastructure will present the Management’s proposals towards restoring full funding of the Pension Fund. The meeting will follow discussions which took place with the Staff Association, at the Standing Concertation Committee (CCP) of 1 November 2010 and will be held with the Members States, at the Tripartite Employment Conditions Forum (TREF) of 4 November 2010. You will be able to attend this presentation in the Main Auditorium or via the webcast. The Management will also be available to reply to your questions on this subject. Best regards, Anne-Sylvie Catherin

  6. Study of the leakage current of clinical dosimeters for teletherapy

    International Nuclear Information System (INIS)

    Damatto, Willian B.; Santos, Gelson P.; Potiens, Maria da Penha A.; Caldas, Linda V.E.; Vivolo, Vitor

    2009-01-01

    This work demonstrates the importance of quality control of clinical dosemeters and therefore the equipment for radiotherapy treatment, exhibiting the necessary care related to answers and sensibilities and the possible defects of the clinical assembly

  7. From clinical data records to research: a database system for the study of clinical and functional indicators of chronic heart failure.

    Science.gov (United States)

    Pinna, G D; Opasich, C; Massimo, S; Perinati, L; Cobelli, F; Tavazzi, L

    1997-01-01

    The identification of reliable clinical and functional indicators of Chronic Heart Failure (CHF) is currently a major research challenge for physicians dealing with this pathology. With the aim of providing an adequate infrastructure for this research, we have developed a Database System where all relevant information concerning CHF patients during follow-up can be efficiently recorded, monitored, extracted and easily transferred to commercial packages for data processing and statistical analysis. Patient clinical status is recorded every 6 months, whereas data from several laboratory investigations are recorded every 12 months. All complications or events between two successive controls are recorded too. Patients needing cardiac transplantation are entered in a transplantation waiting list. The Database is fully integrated into the Hospital Information System and meets the standards of the national database of CHF patients. It grows with the concurrent activity of several independent teams, all of which have access to complete and structured information for research purposes. A user-friendly procedure allows the export in a standard format (Microsoft Excel) of all patients' data pertaining to a selected set of controls and variables of interest. These data are used directly for analysis or sub-selections are performed by the investigator through a simple query language. Depending on the objectives and complexity of the research, different commercial statistical analysis packages are available, which are used by clinical investigators autonomously or with the aid of a statistician. This overall approach allows great autonomy of each user in extracting, manipulating and statistically analyzing data. The Database has been in use at the Heart Failure Unit of our Rehabilitation Center since October 1992 and 595 patients have been enrolled since then. Several studies based on these data have been performed and more than 120 scientific communications and 30 articles in

  8. Public meetings

    CERN Multimedia

    Staff Association

    2014-01-01

      Public meetings : Come and talk about your future employment conditions !   The Staff Association will come and present the results of our survey on the 2015 five-yearly review. Following the survey, the topics discussed, will be contract policy, recognition of merit (MARS), working time arrangements and family policy. After each meeting and around a cup of coffee or tea you will be able to continue the discussions. Do not hesitate to join us, the five-yearly review, it is with YOU!

  9. STAFF MEETING

    CERN Multimedia

    Robert Aymar

    2005-01-01

    I would like to invite all members of the CERN Personnel to a meeting on Thursday 12 January 2006 at 4:00 p.m. - Main Auditorium (bldg. 500) to convey my best wishes for the new year, to review CERN's activities during 2005 and to present the perspectives for this coming year. Closed-circuit transmission of the meeting will be available in the Council Chamber and in the AB Auditorium (Meyrin), the AB Auditorium (Prévessin), the IT Auditorium (bldg. 31) and the AT Auditorium (bldg. 30). A simultaneous translation into English will be available in the main Auditorium. Best wishes for the festive season Robert AYMAR

  10. Staff meeting

    CERN Multimedia

    2006-01-01

    I would like to invite all members of the CERN Personnel to a meeting on Thursday 18 January 2007 at 3:00 p.m. Main Auditorium (bldg.. 500) to convey my best wishes for the new year, to review CERN's activities during 2006 and to present the perspectives for this special year of the LHC start-up. Closed-circuit transmission of the meeting will be available in the Council Chamber and in the AB Auditorium (Meyrin), the AB Auditorium (Prévessin), the IT Auditorium (bldg.. 31) and the AT Auditorium (bldg.. 30). Simultaneous translation into English will be available in the main Auditorium. Robert AYMAR

  11. STAFF MEETING

    CERN Multimedia

    2003-01-01

    I would like to invite all members of the CERN Personnel to a meeting on Tuesday 13 January 2004 at 4:00 p.m. - Main Auditorium (bldg. 500) to convey my best wishes for the new year and to present a perspective of CERN's future activities. Closed-circuit transmission of the meeting will be available in the Council Chamber and in the AB Auditorium (Meyrin), the AB Auditorium (Prévessin), the IT Auditorium (bldg. 31) and the AT Auditorium (bldg. 30). A simultaneous translation into English will be available in the main Auditorium. Robert AYMAR

  12. STAFF MEETING

    CERN Multimedia

    2004-01-01

    I would like to invite all members of the CERN Personnel to a meeting on Tuesday 13 January 2004 at 4:00 p.m. - Main Auditorium (bldg. 500) to convey my best wishes for the new year and to present a perspective of CERN's future activities. Closed-circuit transmission of the meeting will be available in the Council Chamber and in the AB Auditorium (Meyrin), the AB Auditorium (Prévessin), the IT Auditorium (bldg. 31) and the AT Auditorium (bldg. 30). A simultaneous translation into English will be available in the main Auditorium. Robert AYMAR

  13. Clinical TVA-based studies: a general review

    Directory of Open Access Journals (Sweden)

    Thomas eHabekost

    2015-03-01

    Full Text Available In combination with whole report and partial report tasks, the Theory of Visual Attention (TVA can be used to estimate individual differences in five basic attentional parameters: The visual processing speed, the storage capacity of visual short-term memory, the perceptual threshold, the efficiency of top-down selectivity, and the spatial bias of attentional weighting. TVA-based assessment has been used in about 30 studies to investigate attentional deficits in a range of neurological and psychiatric conditions: (a neglect and simultanagnosia, (b reading disturbances, (c aging and neurodegenerative diseases, and most recently (d neurodevelopmental disorders. The article introduces TVA based assessment, discusses its methodology and psychometric properties, and reviews the progress made in each of the four research fields. The empirical results demonstrate the general usefulness of TVA-based assessment for many types of clinical neuropsychological research. The method’s most important qualities are cognitive specificity and theoretical grounding, but it is also characterized by good reliability and sensitivity to minor deficits. The review concludes by pointing to promising new areas for clinical TVA-based research.

  14. Onchomycosis – a clinical and mycological study of 75 cases

    Directory of Open Access Journals (Sweden)

    Neerja Puri

    2012-07-01

    Full Text Available Onychomycosis or fungal infection of the nails is a common disease, especially in older persons. A mycological study of onchomycosis was undertaken in 75 patients. The nails were judged to be infected by their clinical appearance. There were a total of 75 suspected cases of onychomycosis. Of these 75 cases 22.6% were positive by direct microscopy and 33.3% were culture positive. Of these 75 cases, 18 were males (24% and 57 (76 % were females, male to female ratio being. The commonest age group was 31-40 years followed by 21-30 years. The finger nails were more frequently involved. i.e. 45 (60 %, followed by toe nails 30 (40 % and both in 18 (24% cases. Ratio of finger nail to toe nail infection was 1.5:1. Distal and lateral subungual onychomycosis (DLSO was the commonest clinical pattern (76% followed by total dystrophic onychomycosis (18.66% and then superficial white onychomycosis (4% and proximal subungual onychomycosis (1.33%. The most common fungal isolates were dermatophytes of which 44% were Trytophyton rubrum, 4% were Trytophyton mentagrophytes. Non dermatophyte moulds constituted 16% of the fungus isolates. Onychomycosis was found to be the commonest in housewives (52%, followed by serviceman / businessman (32% followed by farmers (8% and labourer and student 4% each.

  15. Study on waste from hospital and clinics in Phitsanulok

    Directory of Open Access Journals (Sweden)

    Suwannee Adsavakulchai

    2002-10-01

    Full Text Available Waste generation depends on numerous factors such as established waste management methods, type of hospital establishment, hospital specialization, proportion of reusable items employed in hospital, and proportion of patients treated on a day-care basis. This study surveyed the waste from hospital and clinics in Phitsanulok and found the average daily waste generated as general, medical and hazardous waste from all hospitals in Phitsanulok Province at 1.751, 0.284 and 0.013 kg/bed respectively and at 0.323, 0.041 and 0.002 kg/bed respectively from all clinics in Phitsanulok Province. Medical waste from all hospitals consisted of needles, gloves, drain tubes, cottons and gauze, napkins, plastic syringes, swap and body parts with total daily generation at 0.452, 0.480, 0.390, 0.404, 0.018, 0.355, 0.004 and 0.382 kg/bed respectively. Information about proper waste management process is needed to improve hospital waste management. Hospital waste management is an important and necessary component of environmental health protection.

  16. Black tea: Phytochemicals, cancer chemoprevention, and clinical studies.

    Science.gov (United States)

    Singh, Brahma N; Rawat, A K S; Bhagat, R M; Singh, B R

    2017-05-03

    Tea (Camellia sinensis L.) is the most popular, flavored, functional, and therapeutic non-alcoholic drink consumed by two-thirds of the world's population. Black tea leaves are reported to contain thousands of bioactive constituents such as polyphenols, amino acids, volatile compounds, and alkaloids that exhibit a range of promising pharmacological properties. Due to strong antioxidant property, black tea inhibits the development of various cancers by regulating oxidative damage of biomolecules, endogenous antioxidants, and pathways of mutagen and transcription of antioxidant gene pool. Regular drinking of phytochemicals-rich black tea is linked to regulate several molecular targets, including COX-2, 5-LOX, AP-1, JNK, STAT, EGFR, AKT, Bcl2, NF-κB, Bcl-xL, caspases, p53, FOXO1, TNFα, PARP, and MAPK, which may be the basis of how dose of black tea prevents and cures cancer. In vitro and preclinical studies support the anti-cancer activity of black tea; however, its effect in human trails is uncertain, although more clinical experiments are needed at molecular levels to understand its anti-cancer property. This review discusses the current knowledge on phytochemistry, chemopreventive activity, and clinical applications of black tea to reveal its anti-cancer effect.

  17. Clinical study on antibody-associated limbic encephalitis

    Directory of Open Access Journals (Sweden)

    WANG Jia-wei

    2013-01-01

    Full Text Available In recent years, the antibody-associated limbic encephalitis (LE has attracted attentions of more and more clinicians. The associated antibodies mainly act on neuronal cell surface antigens, including the N-methyl-D-aspartate (NMDA receptor, the α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA receptor, the γ-aminobutyric acid B (GABAB receptor, leucine-rich glioma-inactivated 1 (LGI1 and contactin-associated protein-like 2 (Caspr2 and so on. The clinical manifestation is primarily defined by the subacute onset of short-term memory loss, seizures, confusion and psychiatric symptoms suggesting the involvement of the limbic system. These severe and protracted disorders can affect children and young adults, occurring with or without tumor association. Routine detection of serum and cerebrospinal fluid (CSF and imaging tests show no specificity, but associated antibodies can be detected in serum and (or CSF. The patients respond well to tumor resection and immunotherapies, including corticosteroids, intravenous immunoglobulin (IVIg, plasma exchange or combination of them, but may relapse. This article aims to study the clinical features and treatment of antibody-associated limbic encephalitis and to improve the diagnosis and prognosis of these diseases.

  18. Multimodality molecular imaging - from target description to clinical studies

    International Nuclear Information System (INIS)

    Schober, O.; Rahbar, K.; Riemann, B.

    2009-01-01

    This highlight lecture was presented at the closing session of the Annual Congress of the European Association of Nuclear Medicine (EANM) in Munich on 15 October 2008. The Congress was a great success: there were more than 4,000 participants, and 1,597 abstracts were submitted. Of these, 1,387 were accepted for oral or poster presentation, with a rejection rate of 14%. In this article a choice was made from 100 of the 500 lectures which received the highest scores by the scientific review panel. This article outlines the major findings and trends at the EANM 2008, and is only a brief summary of the large number of outstanding abstracts presented. Among the great number of oral and poster presentations covering nearly all fields of nuclear medicine some headlines have to be defined highlighting the development of nuclear medicine in the 21st century. This review focuses on the increasing impact of molecular and multimodality imaging in the field of nuclear medicine. In addition, the question may be asked as to whether the whole spectrum of nuclear medicine is nothing other than molecular imaging and therapy. Furthermore, molecular imaging will and has to go ahead to multimodality imaging. In view of this background the review was structured according to the single steps of molecular imaging, i.e. from target description to clinical studies. The following topics are addressed: targets, radiochemistry and radiopharmacy, devices and computer science, animals and preclinical evaluations, and patients and clinical evaluations. (orig.)

  19. Clinical, Chromosomal and Endocrine Studies for Congenital Adrenal Hyperplasia

    International Nuclear Information System (INIS)

    Shousha, M.A.; Somaya, E.T.; Attia, M.

    2007-01-01

    Several forms of congenital adrenal hyperplasia are potentially fatal if unrecognized and untreated. The aim of this study is to throw light on the clinical presentation together with chromosomal and laboratory associations in this syndrome. Twenty four patients diagnosed as congenital adrenal hyperplasia were referred from the Diabetic Endocrine Metabolic Pediatric Unit [DEMPU], Children's Hospital, Cairo University for hormonal and chromosomal workup. Twenty two patients were diagnosed as classic congenital adrenal hyperplasia (CAH) syndrome. Sever salt wasting form was present in ten patients whereas simple virilization was the presenting manifestation in twelve patients. Two patients presented as late onset congenital adrenal hyperplasia (LOCAH). The mean age was 3.18 years, ranging from eight months to 19 years. The sex of rearing was Female in 18 cases and male in six cases. Genitography and sonography confirmed the presence of female internal organs in all cases. Advanced bone age was evident by radiographic studies. Although the karyotyping was (46,XX) in all cases, the correct sex diagnosis was delayed in 6 cases. Serum concentrations of 17-hydroxyprogesterone (17.OH.P); Dehydroepiandrosterone sulfate (DHEAS); Delta,4-androstenedione (D 4 A); Testosterone and 11-deoxycortisol were all elevated in relation to controls. We found that the adrenal androgens DHEAS, delta 4A, and T were more elevated in salt losers when compared to simple virilizing patients. However, this difference was not of statistical significance. The present study demonstrates that clinical examination and laboratory investigations are necessary for early detection and treatment of hese cases to avoid major medical and psychological problems for the patients and their parents.

  20. Electromagnetictherapy for Treatment of Insomnia: A clinical Trial Study

    Directory of Open Access Journals (Sweden)

    Fariba Sadeghi movahhed

    2012-04-01

    Full Text Available Background & Objectives: Insomnia is one of the most common sleep disorders in the world. It causes disruption in daily activities and increases the risk of major depression. Hence, clinically the appropriate and persistent treatment of insomnia is very important. Using of hypnotic drugs such as benzodiazepines is the common treatment for insomnia but they show several side effects and it seems that new medications should be used for treatment of sleep disorders. The aim of this study was comparison between the effects of electromagnetic therapy and conventional drug usage in the treatment of insomnia.   Methods: In a blind randomized clinical trial study, 60 people referred to the private office of the psychiatrist and experienced more than 3 months extended primary insomnia were selected. They were diagnosed by DSM-IV criteria and had no other underlying problems. The subjects were divided in two groups: 30 people in each and treated electromagnetically or with Alprazolam for 3 weeks. Before treatment, immediately and one month after treatment, quality of sleep and severity of the insomnia were evaluated by using the standard questionnaires and finally, the results were analyzed statistically.   Results : In this study, 60 individuals participated from whom 28 were male (46.7% and 32 patients were female (53.3%.The mean age was 37.3 years old in a range of 17- 65. The mean point of each questionnaire, before and immediately after treatment significantly didn't show any difference but one month after treatment, there was a significant difference in both groups.   Conclusion : To treat insomnia, electromagnetic therapy appears to be used as a replacement for sedative medicines. It also has more stability in comparison with other sedative medicines and no side effects have been reported yet.

  1. Clinical trials update from the Heart Failure Society of America Meeting 2009: FAST, IMPROVE-HF, COACH galectin-3 substudy, HF-ACTION nuclear substudy, DAD-HF, and MARVEL-1.

    Science.gov (United States)

    Lainscak, Mitja; Coletta, Alison P; Sherwi, Nasser; Cleland, John G F

    2010-02-01

    This article presents findings and a commentary on late-breaking trials presented during the meeting of the Heart Failure Society of America in September 2009. Unpublished reports should be considered as preliminary, since analyses may change in the final publication. The FAST trial showed somewhat better performance of intrathoracic impedance for prediction of deterioration in patients with heart failure (HF) when compared with daily weighing. The IMPROVE-HF study reported the benefits of education on the management of patients with systolic HF. Galectin-3 appeared a useful method for improving risk stratification of patients with chronic HF in a substudy of the COACH trial. A nuclear substudy of the HF-ACTION trial failed to demonstrate that resting myocardial perfusion imaging, a measure of myocardial scar and viability, was clinically useful. A small randomized controlled trial (DAD-HF) suggested that the use of low-dose dopamine in patients with acutely decompensated HF was associated with less deterioration in renal function and less hypokalaemia. The MARVEL-1 trial raises further concerns about the safety of myoblast transplantation in ischaemic HF.

  2. Is there a need for biomedical CBIR systems in clinical practice? Outcomes from a usability study

    Science.gov (United States)

    Antani, Sameer; Xue, Zhiyun; Long, L. Rodney; Bennett, Deborah; Ward, Sarah; Thoma, George R.

    2011-03-01

    Articles in the literature routinely describe advances in Content Based Image Retrieval (CBIR) and its potential for improving clinical practice, biomedical research and education. Several systems have been developed to address particular needs, however, surprisingly few are found to be in routine practical use. Our collaboration with the National Cancer Institute (NCI) has identified a need to develop tools to annotate and search a collection of over 100,000 cervigrams and related, anonymized patient data. One such tool developed for a projected need for retrieving similar patient images is the prototype CBIR system, called CervigramFinder, which retrieves images based on the visual similarity of particular regions on the cervix. In this article we report the outcomes from a usability study conducted at a primary meeting of practicing experts. We used the study to not only evaluate the system for software errors and ease of use, but also to explore its "user readiness", and to identify obstacles that hamper practical use of such systems, in general. Overall, the participants in the study found the technology interesting and bearing great potential; however, several challenges need to be addressed before the technology can be adopted.

  3. Clinical analysis of hypertension in children: An urban Indian study

    Directory of Open Access Journals (Sweden)

    Sunil K Kota

    2013-01-01

    Full Text Available Hypertension in children, although an uncommon entity, is associated with end-organ damage. We tried to study the clinical profile of hypertension in children presented to our hospital. The medical records from January 1990 to December 2010 of all children aged 18 years and younger with hypertension were studied. The patients were divided into four age groups (infants, pre-school age, school age and adolescents Presenting symptoms and other clinical parameters were thoroughly evaluated. The results were compared with previous studies on hypertension in children. A total of 135 patients were selected (male:female 103:32, with mean age of 0.4 ± 2.1 years (range: six months to 17 years. The most common age group affected was the adolescents group (42.9%. The most common clinical feature at presentation was dizziness (30.3%, followed by headache and chest discomfort (22.9%. Transient hypertension was detected in 34 patients (25.2%, and was most common in the adolescent age group, whereas sustained hypertension was noticed in 101 patients (74.8% and was the most common in the school age group (36/45, 80%. Forty-two patients (31.1% presented with hypertensive crisis. Nine patients were considered to have essential hypertension. The chief causes included chronic glomerulonephritis in 56 (41.5%, endocrine disorders in 21 (15.5%, obstructive uropathy in 16 (11.8%, reflux nephropathy in 12 (8.8% and renovascular disease in 5 (3.7%. Takayasu′s disease was the most common cause of renovascular hypertension. Coarctation of aorta was the most common cause of hypertension in infancy, being present in 40% of the cases. Hypertension in children may be easily underestimated but is a potentially life-threatening problem. Most of them are asymptomatic and a large chunk has an underlying etiology. Primary care clinicians should promptly identify patients with hypertension and treat them immediately and appropriately to prevent damage to the cardiovascular organs.

  4. Plaque removal efficacy of Colgate 360 toothbrush: A clinical study.

    Science.gov (United States)

    Iyer, Nageshwar; Chandna, Shalu; Dhindsa, Abhishek; Damle, Dhanashree; Loomba, Ashish

    2016-01-01

    The aim of this clinical study was to confirm the plaque removal efficacy of the Colgate 360 Whole Mouth Clean Toothbrush. This was a single-center, monadic, case-controlled study with the 7 days duration. A total of eighty participants (56 male and 24 female) aged between 18 and 45 years with a minimum of 20 permanent teeth (excluding the third molars) without any prosthetic crowns and an initial plaque score of minimum 1.5 as determined by Modified Quigley-Hein Plaque Index (1970) participated in the study. There were two dropouts during the study duration, one male and one female. The participants were instructed to brush for 1 min, after which plaque index was recorded again. They were then instructed to brush their teeth twice a day for 1 min with the assigned toothbrush (Colgate 360 Whole Mouth Clean Toothbrush) and a commercially available fluoride toothpaste for the next 7 days. On the 7(th) day, all the participants were recalled for follow-up and plaque examination. The plaque index scores (pre- and post-brushing) were recorded, tabulated, and analyzed statistically. The mean plaque indices reduced after brushing both on day 1 and day 7. There was also a reduction in mean plaque indices from day 1 to day 7. All these reductions were statistically significant (P Toothbrush throughout the study period. Continued use resulted in a further significant reduction in plaque scores irrespective of the gender of participants.

  5. Effectiveness of spirometry as a motivational tool for smoking cessation: a clinical trial, the ESPIMOAT study.

    Science.gov (United States)

    Irizar-Aramburu, María Isabel; Martínez-Eizaguirre, Jose Manuel; Pacheco-Bravo, Petra; Diaz-Atienza, Maria; Aguirre-Arratibel, Iñigo; Peña-Peña, Maria Isabel; Alba-Latorre, Mercedes; Galparsoro-Goikoetxea, Mikel

    2013-12-05

    Smoking is the main preventable cause of morbidity and mortality in our region, it being the main causative agent of chronic obstructive pulmonary disease. There still is no consensus on the use of spirometry as a strategy for smoking cessation, given that there is insufficient scientific evidence from high quality studies to recommend the use of this technique. This is to be a randomized, multicentre, open-label clinical trial. A total of 444 smokers over 40 years of age will be recruited by 39 general practitioners from 22 health centers. Primary objective of this study is to assess the effectiveness of spirometry together with information regarding the test for smoking cessation after 1 year in smokers over 40 years of age with a more than 10 pack-year history and no previous diagnosis of chronic obstructive pulmonary disease. Groups of 45 patients who smoke will be randomly selected from the lists of the participating doctors. The names will be sent to the corresponding doctors who will contact candidate patients and assess whether they meet the selection criteria. Patients who meet these criteria will be randomly allocated to an intervention or control group. For patients in both groups, a nurse will conduct an interview and perform a spirometry test to measure forced vital capacity. Then, all patients will be referred for an appointment with their doctor for brief anti-smoking intervention, patients from the intervention group additionally being informed about the result of the spirometry test. After 1 year, smoking status will be assessed and, in those who report that they have quit smoking, abstinence will be confirmed by co-oximetry. Data will be analyzed on an intention-to-treat basis using the chi-squared test for outcomes and binary logistic regression if it is considered to be necessary to adjust for confounding variables. Performing a spirometry test and providing information on pulmonary function may increase awareness of the effect of smoking among

  6. Cardiovascular biomarkers in clinical studies of type 2 diabetes

    DEFF Research Database (Denmark)

    Baldassarre, M P A; Andersen, A; Consoli, A

    2018-01-01

    When planning cardiovascular studies in type 2 diabetes, selection of cardiovascular biomarkers is a complex issue. Since the pathophysiology of cardiovascular disease in type 2 diabetes is multifactorial, ideally, the selected cardiovascular biomarkers should cover all aspects of the known...... biomarkers and 3) novel biomarkers (oxidative stress and endothelial dysfunction biomarkers). Within each category we present the currently best validated biomarkers with special focus on the population of interest (type 2 diabetes). For each individual biomarker, the physiological role, the validation...... in the general population and in type 2 diabetes, analytical methodology, the modifying factors, the effects of glucose-lowering drugs, and the interpretation are discussed. This approach will provide clinical researchers with all information necessary for planning, conducting and interpreting results from...

  7. Anaerobic orbital cellulitis: a clinical and experimental study.

    Science.gov (United States)

    Jedrzynski, M S; Bullock, J D; McGuire, T W; Elder, B L; Bullock, J D

    1991-01-01

    In this article we have reviewed the clinical and bacteriologic aspects of anaerobic orbital cellulitis and have presented six patients to illustrate these points. Physicians who treat patients with orbital cellulitis should have a high index of suspicion for possible instances involving anaerobes, so that appropriate management can be started early. To investigate this problem further, we created an animal model of anaerobic orbital cellulitis. This model may be useful in future studies of the pathogenesis and treatment of this serious and often devastating disease. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 8 FIGURE 9 FIGURE 10 FIGURE 11 FIGURE 12 FIGURE 13 FIGURE 14 FIGURE 15 FIGURE 16 FIGURE 17 FIGURE 18 FIGURE 19 PMID:1808813

  8. Clinicians’ experiences of becoming a clinical manager: a qualitative study

    Directory of Open Access Journals (Sweden)

    Spehar Ivan

    2012-11-01

    Full Text Available Abstract Background There has been an increased interest in recruiting health professionals with a clinical background to management positions in health care. We know little about the factors that influence individuals’ decisions to engage in management. The aim of this study is to explore clinicians’ journeys towards management positions in hospitals, in order to identify potential drivers and barriers to management recruitment and development. Methods We did a qualitative study which included in-depth interviews with 30 clinicians in middle and first-line management positions in Norwegian hospitals. In addition, participant observation was conducted with 20 of the participants. The informants were recruited from medical and surgical departments, and most had professional backgrounds as medical doctors or nurses. Interviews were analyzed by systemic text condensation. Results We found that there were three phases in clinicians’ journey into management; the development of leadership awareness, taking on the manager role and the experience of entering management. Participants’ experiences suggest that there are different journeys into management, in which both external and internal pressure emerged as a recurrent theme. They had not anticipated a career in clinical management, and experienced that they had been persuaded to take the position. Being thrown into the position, without being sufficiently prepared for the task, was a common experience among participants. Being left to themselves, they had to learn management “on the fly”. Some were frustrated in their role due to increasing administrative workloads, without being able to delegate work effectively. Conclusions Path dependency and social pressure seems to influence clinicians’ decisions to enter into management positions. Hospital organizations should formalize pathways into management, in order to identify, attract, and retain the most qualified talents. Top managers

  9. Clinical Study on 136 Children with Sudden Sensorineural Hearing Loss.

    Science.gov (United States)

    Li, Feng-Jiao; Wang, Da-Yong; Wang, Hong-Yang; Wang, Li; Yang, Feng-Bo; Lan, Lan; Guan, Jing; Yin, Zi-Fang; Rosenhall, Ulf; Yu, Lan; Hellstrom, Sten; Xue, Xi-Jun; Duan, Mao-Li; Wang, Qiu-Ju

    2016-04-20

    The prevalence of sudden sensorineural hearing loss in children (CSSNHL) is consistently increasing. However, the pathology and prognosis of CSSNHL are still poorly understood. This retrospective study evaluated clinical characteristics and possible associated factors of CSSNHL. One hundred and thirty-six CSSNHL patients treated in Department of Otolaryngology-Head and Neck Surgery and Institute of Otolaryngology at Chinese PLA General Hospital between July 2008 and August 2015 were included in this study. These patients were analyzed for clinical characteristics, audiological characteristics, laboratory examinations, and prognostic factors. Among the 136 patients (151 ears), 121 patients (121 ears, 80.1%) were diagnosed with unilaterally CSSNHL, and 15 patients (30 ears, 19.9%) with bilateral CSSNHL. The complete recovery rate of CSSNHL was 9.3%, and the overall recovery rate was 37.7%. We found that initial degree of hearing loss, onset of treatment, tinnitus, the ascending type audiogram, gender, side of hearing loss, the recorded auditory brainstem response (ABR), and distortion product otoacoustic emissions (DPOAEs) had prognostic significance. Age, ear fullness, and vertigo had no significant correlation with recovery. Furthermore, the relevant blood tests showed 30.8% of the children had abnormal white blood cell (WBC) counts, 22.1% had elevated homocysteine levels, 65.8% had high alkaline phosphatase (ALP), 33.8% had high IgE antibody levels, and 86.1% had positive cytomegalovirus (CMV) IgG antibodies. CSSNHL commonly occurs unilaterally and results in severe hearing loss. Initial severe hearing loss and bilateral hearing loss are negative prognostic factors for hearing recovery, while positive prognostic factors include tinnitus, gender, the ascending type audiogram, early treatment, identifiable ABR waves, and DPOAEs. Age, vertigo, and ear fullness are not correlated with the recovery. Some serologic indicators, including the level of WBC, platelet

  10. Clinical Study on 136 Children with Sudden Sensorineural Hearing Loss

    Science.gov (United States)

    Li, Feng-Jiao; Wang, Da-Yong; Wang, Hong-Yang; Wang, Li; Yang, Feng-Bo; Lan, Lan; Guan, Jing; Yin, Zi-Fang; Rosenhall, Ulf; Yu, Lan; Hellstrom, Sten; Xue, Xi-Jun; Duan, Mao-Li; Wang, Qiu-Ju

    2016-01-01

    Background: The prevalence of sudden sensorineural hearing loss in children (CSSNHL) is consistently increasing. However, the pathology and prognosis of CSSNHL are still poorly understood. This retrospective study evaluated clinical characteristics and possible associated factors of CSSNHL. Methods: One hundred and thirty-six CSSNHL patients treated in Department of Otolaryngology-Head and Neck Surgery and Institute of Otolaryngology at Chinese PLA General Hospital between July 2008 and August 2015 were included in this study. These patients were analyzed for clinical characteristics, audiological characteristics, laboratory examinations, and prognostic factors. Results: Among the 136 patients (151 ears), 121 patients (121 ears, 80.1%) were diagnosed with unilaterally CSSNHL, and 15 patients (30 ears, 19.9%) with bilateral CSSNHL. The complete recovery rate of CSSNHL was 9.3%, and the overall recovery rate was 37.7%. We found that initial degree of hearing loss, onset of treatment, tinnitus, the ascending type audiogram, gender, side of hearing loss, the recorded auditory brainstem response (ABR), and distortion product otoacoustic emissions (DPOAEs) had prognostic significance. Age, ear fullness, and vertigo had no significant correlation with recovery. Furthermore, the relevant blood tests showed 30.8% of the children had abnormal white blood cell (WBC) counts, 22.1% had elevated homocysteine levels, 65.8% had high alkaline phosphatase (ALP), 33.8% had high IgE antibody levels, and 86.1% had positive cytomegalovirus (CMV) IgG antibodies. Conclusions: CSSNHL commonly occurs unilaterally and results in severe hearing loss. Initial severe hearing loss and bilateral hearing loss are negative prognostic factors for hearing recovery, while positive prognostic factors include tinnitus, gender, the ascending type audiogram, early treatment, identifiable ABR waves, and DPOAEs. Age, vertigo, and ear fullness are not correlated with the recovery. Some serologic indicators

  11. ACCU Meeting

    CERN Multimedia

    PH Department

    2011-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 15 June 2011 At 9:15 a.m. in room 60-6-002 Chairperson’s remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Report on services from GS department Update on Safety at CERN Reports from ACCU representatives on other Committees a. Scientific Information Policy Board (SIPB) b. IT Service Review Meeting (ITSRM) c. GS User Commission Users’ Office news Any Other Business Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairperson in writing or by e-mail to Michael.Hauschild@cern.ch Michael Hauschild (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in bra...

  12. Crisis meeting

    CERN Multimedia

    Staff Association

    2015-01-01

    To all CERN staff: your rights are at risk! We invite you to come to a crisis meeting on Thursday 7th May 2015 at 9 a.m., Auditorium, Main Building, Meyrin site. Your presence is crucial, we are ALL concerned!

  13. Crisis meeting

    CERN Multimedia

    Staff Association

    2014-01-01

      To all CERN staff: your rights are at risk ! We invite you to come to a crisis meeting on Wednesday 2nd April at 10:30 a.m., Auditorium, Main Building, Meyrin site. Your presence is crucial, we are ALL concerned !

  14. ACCU MEETING

    CERN Multimedia

    Chris Onions (Secretary)

    2000-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 December 2000 At 10 a.m. in the 6th floor Conference Room, Main Building Chairman's remarks Adoption of the agenda News from the CERN Management Minutes of the previous meeting Matters arising Equal Opportunities at CERN The Summer Student programme CERN Programme for Physics High School Teachers Users' Office News Any Other Business Dates for Meetings in 2001 Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets) : Austria G. Neuhofer (74094) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Re...

  15. ACCU MEETING

    CERN Multimedia

    2000-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 6 December 2000 At 10 a.m. in the 6th floor Conference Room, Main Building Chairman's remarks Adoption of the agenda News from the CERN Management Minutes of the previous meeting Matters arising Equal Opportunities at CERN The Summer Student programme CERN Programme for Physics High School Teachers Users' Office News Any Other Business Dates for Meetings in 2001 Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Secretary in writing via the CERN Users' Office or by e-mail to Christopher.Onions@cern.ch Chris Onions (Secretary) ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets) :   Austria G. Neuhofer (74094) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958)...

  16. August Meeting

    African Journals Online (AJOL)

    chifaou.amzat

    2011-10-19

    Oct 19, 2011 ... exists on this new trend of Igbo women (re)venturing into the public sphere is, one would suggest or argue, ... section looks at the history, structure and dynamics of the 'August Meeting' assembly among Igbo ..... authority were divided between the sexes in a complementary fashion, was operational. In the ...

  17. ACCU MEETING

    CERN Multimedia

    Chris Onions

    2002-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 4 December 2002 At 9:15 a.m. in room 60-6-002 Chairman's remarks Adoption of the agenda Minutes of the previous meeting Matters arising News from the CERN Management Fellows, Associates and Summer Student Programmes Particle Data Book distribution Revoking Computer accounts Equipment insurance on site Reports from ACCU representatives on other committees Users' Office news Any Other Business Dates for meetings in 2003 Agenda for the next meeting Anyone wishing to raise any points under item 12 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch   ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (74837...

  18. ACCU MEETING

    CERN Multimedia

    Chris Onions (Secretary)

    2001-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 5 December 2001 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 2. Adoption of the agenda 3. Minutes of the previous meeting 4. Matters arising 5. News from the CERN Management 6. Housing 7. Restaurant Surveillance Committee 8. Users' Office news 9. Election of ACCU chairman 10. Any Other Business 11. Dates for meetings in 2002 12. Agenda for the next meeting Anyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria  W. Adam  (71661) Belgium  G. Wilquet  (74664) Bulgaria  R. Tzenov  (77958) Czech Republic  P. Závada&am...

  19. ACCU MEETING

    CERN Multimedia

    Chris Onions (Secretary)

    2001-01-01

    DRAFT Agenda for the meeting to be held on Wednesday 5 December 2001 At 9:15 a.m. in room 60-6-002 1. Chairman's remarks 2. Adoption of the agenda 3. Minutes of the previous meeting 4. Matters arising 5. News from the CERN Management 6. Housing 7. Restaurant Surveillance Committee 8. Users' Office news 9. Election of ACCU chairman 10. Any Other Business 11. Dates for meetings in 2002 12. Agenda for the next meetingAnyone wishing to raise any points under item 10 is invited to send them to the Chairman in writing or by e-mail to Christopher.Onions@cern.ch ACCU is the forum for discussion between the CERN Management and the representatives of CERN Users to review the practical means taken by CERN for the work of Users of the Laboratory. The User Representatives to ACCU are (CERN internal telephone numbers in brackets): Austria W. Adam (71661) Belgium G. Wilquet (74664) Bulgaria R. Tzenov (77958) Czech Republic P. Závada (75877) Denmark A. Waananen (75941) Finland A. Kiiskinen (79387) Fr...

  20. Plaque removal efficacy of Colgate 360 toothbrush: A clinical study

    Directory of Open Access Journals (Sweden)

    Nageshwar Iyer

    2016-01-01

    Full Text Available Aim: The aim of this clinical study was to confirm the plaque removal efficacy of the Colgate 360 Whole Mouth Clean Toothbrush. Study Design: This was a single-center, monadic, case-controlled study with the 7 days duration. Materials and Methods: A total of eighty participants (56 male and 24 female aged between 18 and 45 years with a minimum of 20 permanent teeth (excluding the third molars without any prosthetic crowns and an initial plaque score of minimum 1.5 as determined by Modified Quigley-Hein Plaque Index (1970 participated in the study. There were two dropouts during the study duration, one male and one female. The participants were instructed to brush for 1 min, after which plaque index was recorded again. They were then instructed to brush their teeth twice a day for 1 min with the assigned toothbrush (Colgate 360 Whole Mouth Clean Toothbrush and a commercially available fluoride toothpaste for the next 7 days. On the 7 th day, all the participants were recalled for follow-up and plaque examination. The plaque index scores (pre- and post-brushing were recorded, tabulated, and analyzed statistically. Results: The mean plaque indices reduced after brushing both on day 1 and day 7. There was also a reduction in mean plaque indices from day 1 to day 7. All these reductions were statistically significant (P < 0.001. The reduction in plaque scores was independent of the gender of the participants however female participants showed lower scores as compared to male participants (P < 0.001. Conclusion: The present study demonstrated a significant reduction in plaque scores with the use of Colgate 360 Whole Mouth Clean Soft Toothbrush throughout the study period. Continued use resulted in a further significant reduction in plaque scores irrespective of the gender of participants.