Quantitative Risk Assessment of Patient Manual Handling in Wards of One of the Hospitals of Tehran using MAPO Method, Iran

Directory of Open Access Journals (Sweden)

Sajad Ataei

2017-05-01

Full Text Available Background and Objectives: Manual handling of disabled patients is one of the important and effective factors in acute low back pain among exposed nurses. The present study was conducted with the objective of quantitative risk assessment of patient manual handling among nurses in wards of one of the hospitals in Tehran using MAPO method. Methods: The present study was conducted as an analytical-cross-sectional study in 26 wards of one of the hospitals in Tehran city. Samples were selected by census method from nurses and paramedics of different wards of hospital. Data collection was performed using demographic information and MAPO checklist. Results: The highest score of MAPO were, respectively, related to wards of DI clinic (score, 14.7, men orthopedic (score, 6.3, and general operating room (score, 57. 53.8% of hospital wards were at the level 2 corrective action, which indicated that the risk of musculoskeletal disorder is 2.4 times higher than level 1 corrective action. Conclusion: Given that the proportion of disabled patient in cooperation and/or partial cooperation, lifting tools, auxiliary, wheelchair, and training have the most role among risk factors for above-mentioned wards, increasing the number of human resources and wheelchair, use of lifting and auxiliary tools and training reduce MAPO score and consequently the risk of musculoskeletal disorders.

History, Archaeology and the Bible Forty Years after "Historicity"

DEFF Research Database (Denmark)

In History, Archaeology and the Bible Forty Years after “Historicity”, Hjelm and Thompson argue that a ‘crisis’ broke in the 1970s, when several new studies of biblical history and archaeology were published, questioning the historical-critical method of biblical scholarship. The crisis formed...... articles from some of the field’s best scholars with comprehensive discussion of historical, archaeological, anthropological, cultural and literary approaches to the Hebrew Bible and Palestine’s history. The essays question: “How does biblical history relate to the archaeological history of Israel...

Nurses`knowledge of and attitude towards exercise as a treatment method for hypertensive patients

OpenAIRE

L. Grobler; L. Roets

2005-01-01

Aerobic exercise is used in treating hypertension. Eventhough physiotherapists are the first choice in presenting exercise treatment, few are available to do so in primary health clinics. Nurses arepatients’ first contact and may be able to fulfil this role. Nurses’knowledge and attitude towards exercise as a treatment method for hypertensive patients was determined. This descriptive study included all nurses (n=67) working in 23 Bloemfontein clinics. Forty-three nursescompleted structured qu...

Risoe National Laboratory - Forty years of research in a changing society

International Nuclear Information System (INIS)

Nielsen, H.; Nielsen, K.; Petersen, F.; Siggaard Jensen, H.

1998-01-01

The creation of Risoe forty years ago was one of the largest, single investments in Danish research. The intention was to realise Niels Bohr's visions of the peaceful use in Denmark og nuclear energy for electricity production and other purposes. Risoe decided to take the opportunity of its 40th anniversary in 1998 to have its history written in a form that would contribute to the history of modern Denmark. The result was a book in Danish entitled Til samfundets tarv - Forskningscenter Risoes historie. The present text is a slightly reworked translation of the last chapter of that book. It contains a summary of Risoe's history and some reflections on forty years of change. Change in Danish society at large, in research policy, in energy policy, in technological expectations. Changes at Risoe, in leadership, in organisational structure, in strategy and in fields of research. Some of Risoe's largest projects are briefly characterised. (LN)

The preventive effect of granisetron on digestive tract symptoms induced by arterial infusion of anticancer and hypertensive agents in combination with radiotherapy. A study of forty patients with bladder cancer

Energy Technology Data Exchange (ETDEWEB)

Hayashida, Shigeaki; Hirasawa, Teruyuki; Uchiyama, Kouichi; Mitsui, Hiroshi; Nasu, Takahito; Shinohara, Youichi [Tokuyama Central Hospital (Japan)

1995-04-01

Forty patients with bladder cancer who underwent radiotherapy with angiotensin II, a hypertensor, and two cycles of arterial infusion of anticancer chemotherapies, including cisplatin 100 mg/body, were randomly assigned to a granisetron group and a non-granisetron group for comparative study of its prophylactic effect on nausea, vomiting and anorexia. Granisetron proved significantly effective in preventing nausea, as 75% of granisetron-administered patients experienced either only slight nausea or none at all, against only 22.5% in the non-granisetron group. The number of vomiting episodes was zero during the three-day observation period in 28 out of 40 (70%) granisetron-administered patients compared with 6 patients (15%) in the non-granisetron group. A significant difference in prophylactic effect on anorexia was demonstrated between the granisetron and non-granisetron group, indicating that control of alimentary symptoms such as nausea and vomiting influences the severity of anorexia. As to the safety, nausea was lengthened and deteriorated in one patient. Though the physician in charge judged it to be an adverse event too minor to question the safety of granisetron. Thus, granisetron proved to be highly effective and safe in preventing nausea, vomiting and anorexia in patients under concomitant administration of radiotherapy with hypertensor and arterial infusion of anticancer chemotherapies. (author).

The preventive effect of granisetron on digestive tract symptoms induced by arterial infusion of anticancer and hypertensive agents in combination with radiotherapy. A study of forty patients with bladder cancer

International Nuclear Information System (INIS)

Hayashida, Shigeaki; Hirasawa, Teruyuki; Uchiyama, Kouichi; Mitsui, Hiroshi; Nasu, Takahito; Shinohara, Youichi

1995-01-01

Forty patients with bladder cancer who underwent radiotherapy with angiotensin II, a hypertensor, and two cycles of arterial infusion of anticancer chemotherapies, including cisplatin 100 mg/body, were randomly assigned to a granisetron group and a non-granisetron group for comparative study of its prophylactic effect on nausea, vomiting and anorexia. Granisetron proved significantly effective in preventing nausea, as 75% of granisetron-administered patients experienced either only slight nausea or none at all, against only 22.5% in the non-granisetron group. The number of vomiting episodes was zero during the three-day observation period in 28 out of 40 (70%) granisetron-administered patients compared with 6 patients (15%) in the non-granisetron group. A significant difference in prophylactic effect on anorexia was demonstrated between the granisetron and non-granisetron group, indicating that control of alimentary symptoms such as nausea and vomiting influences the severity of anorexia. As to the safety, nausea was lengthened and deteriorated in one patient. Though the physician in charge judged it to be an adverse event too minor to question the safety of granisetron. Thus, granisetron proved to be highly effective and safe in preventing nausea, vomiting and anorexia in patients under concomitant administration of radiotherapy with hypertensor and arterial infusion of anticancer chemotherapies. (author)

ABO-Rh blood groups distribution in cardiac syndrome X patients

OpenAIRE

Kheradmand, Fatemeh; Rasmi, Yousef; Nemati, Mohaddeseh; Mohammadzad, Mir Hossein Seyed

2012-01-01

Background: Data on frequency distribution of ABO-Rh blood groups in cardiac syndrome X (CSX) patients are not available. We aimed to investigate the distribution of ABO-Rh blood groups in these patients. Materials and Methods: A total of 247 CSX patients’ records were reviewed in a cross-sectional study from 2006 to 2010. One hundred forty six patients (59.1%) were female, and the mean patient age was 52 ± 11 years. The frequency of ABO-Rh blood groups was compared to the frequency of these ...

The first forty years, 1947-1987

International Nuclear Information System (INIS)

Rowe, M.S.; Cohen, A.; Petersen, B.

1987-01-01

This report commemorates the fortieth anniversary of Brookhaven National Laboratory by representing a historical overview of research at the facility. The chapters of the report are entitled: The First Forty Years, Brookhaven: A National Resource, Fulfilling a Mission - Brookhaven's Mighty Machines, Marketing the Milestones in Basic Research, Meeting National Needs, Making a Difference in Everyday Life, and Looking Forward

Restaurant Forty One Dinner Menu 2017

OpenAIRE

Restaurant Forty One

2017-01-01

This is fine-dining without the stuffiness. The restaurant can host up to 52 guests in the front and main room, with an additional two private dining rooms (with both catering for up to 10 guests each). Tasting menus and special requests are willingly accommodated, and wine tastings and dinner evenings are always available. Our welcoming team are proud to have recently hosted US Secretary of State Hillary Clinton on her visit to Dublin. They now await your visit. “Exquisite works of art, and ...

Results of lateral ankle ligament repair surgery in one hundred and nineteen patients: do surgical method and arthroscopy timing matter?

Science.gov (United States)

Araoye, Ibukunoluwa; De Cesar Netto, Cesar; Cone, Brent; Hudson, Parke; Sahranavard, Bahman; Shah, Ashish

2017-11-01

Ankle sprains are the most common athletic injury. One of five chronic lateral ankle instability patients will require surgery, making operative outcomes crucial. The purpose of this study is to determine if operative method influences failure and complication rates in chronic lateral ankle ligament repair surgery. We retrospectively reviewed 119 cases (118 patients) of lateral ankle ligament surgery between 2006 and 2016. Patient charts and operative reports were examined for demographics, use and timing of ankle arthroscopy, ligament fixation method, type of surgical incision, presence of calcaneofibular ligament repair, and operative technique. Impact of operative methods on failure (one-year minimum follow-up) and complication outcomes was explored using Chi-square test of independence (or Fisher's exact test). Statistical significance was set at p less than .05. Mean age at surgery was 40 (range, 18-73) years. Mean follow-up was 51 (range, 12-260) weeks. Failure rate was 8.4% (10/89 cases) while complication rate was 17.6% (21/119). Failure rate did not differ significantly between any data subgroups (p > .05). Single stage arthroscopy was associated with a significantly lower complication rate (11%, 4/37) than double-stage arthroscopy (47%, 9/19) (p anchor ligament fixation (9%, 6/67) compared to direct suture ligament fixation (29%, 15/52) (p anchors and concurrent ankle arthroscopy may be favourable options to achieve fewer complications in chronic lateral ankle instability repair surgery.

The first forty years, 1947-1987

Energy Technology Data Exchange (ETDEWEB)

Rowe, M.S. (ed.); Cohen, A.; Petersen, B.

1987-01-01

This report commemorates the fortieth anniversary of Brookhaven National Laboratory by representing a historical overview of research at the facility. The chapters of the report are entitled: The First Forty Years, Brookhaven: A National Resource, Fulfilling a Mission - Brookhaven's Mighty Machines, Marketing the Milestones in Basic Research, Meeting National Needs, Making a Difference in Everyday Life, and Looking Forward.

Extracorporeal shock waves lithotripsy of urinary organs in patients with one kidney

Directory of Open Access Journals (Sweden)

Zogović Jezdimir

2002-01-01

Full Text Available Extracorporeal Shock Waves Lithotripsy (ESWL is a method of choice in the treatment of lithiasis. Surgical treatment is reduced to minimum, which in our case means 1-2%. Contraindications for using this method are: blood coagulation disorders, manifest tuberculosis, pregnancy, over obesity. Thanks to appropriate indications and technique which is used in an adequate way as well as to various endurological manipulations, removal of a stone by this method is safe, trauma is minimised, which is very important for patients with one kidney. During the last three years, usually in hospital conditions, 57 patients were treated in this way. Removal of a stone was performed by Extracorporeal Shock Waves Lithotripsy as mono therapy in 30 (53% patients; Extracorporeal Shock Waves Lithotripsy by using Double-J catheter in 16 (28% patients; Extracorporeal Lithotripsy with urine derivation by percutaneous nephrostome in 11 (19% patients. Endurological methods were used in 27 patients. Disintegration of stone was performed in the proper way. Full success was reached. Two patients had incrustation of ureteral catheter which had to be removed by surgery. In two other patients with inferior function of one kidney, after brief obstruction, hemodialisis was performed. Our results confirm that this method is nonaggressive, tech nically perfect for disintegration of urineorgans stone on all levels followed by small complications which are often solved by endoscopie manipulations.

Application of measuring 99mTc-MAG3 plasma clearance based on one-compartment model (MPC method) to pediatric patients

International Nuclear Information System (INIS)

Koizumi, Kiyoshi; Higashida, Kousuke; Arbab, A.S.; Toyama, Keiji; Arai, Takao; Yoshitomi, Tatsuya.

1997-01-01

Measurement of 99m Tc-MAG3 plasma clearance based on 1-compartment model (MPC method) were applied to 12 pediatric patients and evaluated for the factors which might affect the calculated results. Depth correction is a critical factor for the measurement of renal uptake. Three different equations for estimating renal depth were compared with the real depth measured by ultrasonography. The equation proposed by K. Itoh was suitable though the equations by T. Ito and Raynaud were insufficient. Estimation of distribution volume, which is regarded as circulating plasma volume (CPV), is also critical for the calculation of MAG3 clearance by MPC method. Precisely, hematocrit measured by venous sampling and circulating blood volume (CBV) calculated as 7.5% of body weight are used for estimation of CPV. However, assumed CPV as 5% of body weight was acceptable if the hematocrit was not severely deviated from the normal value. Simplified MPC method utilizing two factors mentioned above gave a positive correlation with Russell's one point sampling method. In conclusion, MPC method is applicable for pediatric patients. (author)

Weight changes and their predictors amongst 11 140 patients with type 2 diabetes in the ADVANCE trial.

NARCIS (Netherlands)

Dieren, S. van; Czernichow, S.; Chalmers, J.; Kengne, A.P.; Galan, B.E. de; Poulter, N.; Woodward, M.; Beulens, J.W.; Grobbee, D.E.; Schouw, Y.T. van der; Zoungas, S.

2012-01-01

AIMS: To determine the baseline characteristics and glucose-lowering therapies associated with weight change among patients with type 2 diabetes. METHODS: Eleven thousand one hundred and forty participants in the ADVANCE trial were randomly assigned to an intensive [aiming for a haemoglobin A1c

Clinical experience of intra-arterial therapy in patients with acute ischemic stroke from a single institute

International Nuclear Information System (INIS)

Park, So Young; Lee, Han Bin; Kim, Jong Guk; Oh, Seung Hun; Kim, Jin Kwon; Kim, Sang Heum; Kim, Ok Joon; Kim, Nam Keun

2016-01-01

To compare the efficacy and safety between intra-arterial therapy (IAT) and intra-venous and intra-arterial combined therapy (IVIACT) in patients with acute ischemic stroke in the anterior circulation territory. Forty-one patients treated with IAT using Solitaire were retrospectively reviewed. Nineteen patients were treated with IAT, twenty-two patients were treated with IVIACT, and ten patients of the forty-one patients were managed with multimodal treatment like stent, balloon angioplasty etc. We investigated the rate of recanalization and hemorrhage, NIH stroke scale and 3-month modified Rankin Scale. The overall recanalization rate was 93% and symptomatic ICH occurred in 10% of the patients. There was no difference in hemorrhage, recanalization rate, and early improvement between IAT and IVIACT. Good outcome was more frequently observed in 59% of the patients with IVIACT than 36% of the patients treated with IAT without any significant difference. The patients managed with multimodal treatment did not show any significant hemorrhage outcome. IAT using Solitaire is a useful treatment method without high risk in patients with acute ischemic stroke in the anterior circulation territory. Also, IVIACT and multimodal treatment might be considered as reasonable therapeutic options in these patients

Clinical experience of intra-arterial therapy in patients with acute ischemic stroke from a single institute

Energy Technology Data Exchange (ETDEWEB)

Park, So Young [Dept. Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul (Korea, Republic of); Lee, Han Bin; Kim, Jong Guk; Oh, Seung Hun; Kim, Jin Kwon; Kim, Sang Heum; Kim, Ok Joon [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of); Kim, Nam Keun [Institute for Clinical Research, School of Medicine, CHA University, Seongnam (Korea, Republic of)

2016-11-15

To compare the efficacy and safety between intra-arterial therapy (IAT) and intra-venous and intra-arterial combined therapy (IVIACT) in patients with acute ischemic stroke in the anterior circulation territory. Forty-one patients treated with IAT using Solitaire were retrospectively reviewed. Nineteen patients were treated with IAT, twenty-two patients were treated with IVIACT, and ten patients of the forty-one patients were managed with multimodal treatment like stent, balloon angioplasty etc. We investigated the rate of recanalization and hemorrhage, NIH stroke scale and 3-month modified Rankin Scale. The overall recanalization rate was 93% and symptomatic ICH occurred in 10% of the patients. There was no difference in hemorrhage, recanalization rate, and early improvement between IAT and IVIACT. Good outcome was more frequently observed in 59% of the patients with IVIACT than 36% of the patients treated with IAT without any significant difference. The patients managed with multimodal treatment did not show any significant hemorrhage outcome. IAT using Solitaire is a useful treatment method without high risk in patients with acute ischemic stroke in the anterior circulation territory. Also, IVIACT and multimodal treatment might be considered as reasonable therapeutic options in these patients.

Adjunctive naturopathic care for type 2 diabetes: patient-reported and clinical outcomes after one year

Directory of Open Access Journals (Sweden)

Bradley Ryan

2012-04-01

Full Text Available Abstract Background Several small, uncontrolled studies have found improvements in self-care behaviors and reductions in clinical risk in persons with type 2 diabetes who received care from licensed naturopathic physicians. To extend these findings and determine the feasibility and promise of a randomized clinical trial, we conducted a prospective study to measure the effects of adjunctive naturopathic care (ANC in primary care patients with inadequately controlled type 2 diabetes. Methods Forty patients with type 2 diabetes were invited from a large integrated health care system to receive up to eight ANC visits for up to one year. Participants were required to have hemoglobin A1c (HbA1c values between 7.5-9.5 % and at least one additional cardiovascular risk factor (i.e., hypertension, hyperlipidemia or overweight. Standardized instruments were administered by telephone to collect outcome data on self-care, self-efficacy, diabetes problem areas, perceived stress, motivation, and mood. Changes from baseline scores were calculated at 6- and 12-months after entry into the study. Six and 12-month changes in clinical risk factors (i.e., HbA1c, lipid and blood pressure were calculated for the ANC cohort, and compared to changes in a cohort of 329 eligible, non-participating patients constructed using electronic medical records data. Between-cohort comparisons were adjusted for age, gender, baseline HbA1c, and diabetes medications. Six months was pre-specified as the primary endpoint for outcome assessment. Results Participants made 3.9 ANC visits on average during the year, 78 % of which occurred within six months of entry into the study. At 6-months, significant improvements were found in most patient-reported measures, including glucose testing (P = 0.001, diet (P = 0.001, physical activity (P = 0.02, mood (P = 0.001, self-efficacy (P = 0.0001 and motivation to change lifestyle (P = 0.003. Improvements in glucose testing, mood, self-efficacy and

Modes of failure of Osteonics constrained tripolar implants: a retrospective analysis of forty-three failed implants.

Science.gov (United States)

Guyen, Olivier; Lewallen, David G; Cabanela, Miguel E

2008-07-01

The Osteonics constrained tripolar implant has been one of the most commonly used options to manage recurrent instability after total hip arthroplasty. Mechanical failures were expected and have been reported. The purpose of this retrospective review was to identify the observed modes of failure of this device. Forty-three failed Osteonics constrained tripolar implants were revised at our institution between September 1997 and April 2005. All revisions related to the constrained acetabular component only were considered as failures. All of the devices had been inserted for recurrent or intraoperative instability during revision procedures. Seven different methods of implantation were used. Operative reports and radiographs were reviewed to identify the modes of failure. The average time to failure of the forty-three implants was 28.4 months. A total of five modes of failure were observed: failure at the bone-implant interface (type I), which occurred in eleven hips; failure at the mechanisms holding the constrained liner to the metal shell (type II), in six hips; failure of the retaining mechanism of the bipolar component (type III), in ten hips; dislocation of the prosthetic head at the inner bearing of the bipolar component (type IV), in three hips; and infection (type V), in twelve hips. The mode of failure remained unknown in one hip that had been revised at another institution. The Osteonics constrained tripolar total hip arthroplasty implant is a complex device involving many parts. We showed that failure of this device can occur at most of its interfaces. It would therefore appear logical to limit its application to salvage situations.

Maxillary distraction osteogenesis at Le Fort-I level induces bone apposition at infraorbital rim.

Science.gov (United States)

Rattan, Vidya; Jena, Ashok Kumar; Singh, Satinder Pal; Utreja, Ashok Kumar

2014-09-01

The aim of this study is to evaluate whether there is any remodeling of bone at infraorbital rim following maxillary distraction osteogenesis (DO) at Le Fort-I level. Twelve adult subjects in the age range of 17-21 years with complete unilateral cleft lip and palate underwent advancement of the maxilla by DO. The effect of maxillary DO on the infraorbital rim remodeling was evaluated from lateral cephalograms recorded prior to the DO (T0), at the end of DO (T1), and at least 2-years after the DO (T2) by Walker's analysis. The ANOVA and two-tailed t test were used and probability value (P value) 0.05 was considered as statistically significant level. There was anterior movement of maxilla by 9.22 ± 3.27 mm and 7.67 ± 3.99 mm at the end of immediate (T1) and long-term (T2) follow-up of maxillary DO, respectively. The Walker's analysis showed 1.49 ± 1.22 mm and 2.31 ± 1.81 mm anterior movement of the infraorbital margin (Orbitale point) at the end of T1 and T2, respectively (P distraction osteogenesis at Le Fort-I level induced significant bone apposition at infraorbital rim. Patients with mild midface hypoplasia who would otherwise may be candidates for osteotomy at Le Fort-II or Le Fort-III level may benefit from maxillary distraction at Le Fort-I level.

Pulmonary function and autoantibodies in a long-term follow-up of juvenile dermatomyositis patients

DEFF Research Database (Denmark)

Mathiesen, Pernille Raasthøj; Buchvald, Frederik Fouirnaies; Nielsen, Kim G

2014-01-01

outcome, and (iii) identify possible associations between pulmonary impairment and myositis-specific autoantibodies (MSAs).Methods. Fifty-one JDM patients performed conventional spirometry in a cross-sectional follow-up study. The scores of the Myositis Damage Index (MDI), Myositis Damage by visual...... analogue scale (MYODAM-VAS) and physician's global damage assessment were used to estimate JDM outcome. ANAs, MSAs and myositis-associated autoantibodies were analysed in all patients.Results. Forty-two patients (82%) (mean follow-up time 14.3 years) had normal lung function. Four patients (8%) were...

Transit-time flow measurement as a predictor of coronary bypass graft failure at one year angiographic follow-up

DEFF Research Database (Denmark)

Lehnert, Per; Møller, Christian H; Damgaard, Sune

2015-01-01

on graft vessel type, anastomatic configuration, and coronary artery size. RESULTS: Nine hundred eighty-two coronary anastomoses were performed of which 12% had signs of graft failure at one year angiographic follow-up. In internal mammary arteries (IMAs), analysis showed a 4% decrease in graft failure......BACKGROUND: Transit-time flow measurement (TTFM) is a commonly used intraoperative method for evaluation of coronary artery bypass graft (CABG) anastomoses. This study was undertaken to determine whether TTFM can also be used to predict graft patency at one year postsurgery. METHODS: Three hundred...... forty-five CABG patients with intraoperative graft flow measurements and one year angiographic follow-up were analyzed. Graft failure was defined as more than 50% stenosis including the "string sign." Logistic regression analysis was used to analyze the risk of graft failure after one year based...

Characteristics of patients presenting with erythema nodosum and sarcoidosis.

LENUS (Irish Health Repository)

O'Connor, T M

2012-01-31

We explored the relationship between erythema nodosum (EN) and sex, age, serum angiotensin converting enzyme (ACE), bronchoalveolar lavage lymphocytosis (BAL-I), interstitial granulomas and radiological stage in patients presenting with pulmonary sarcoidosis in Ireland. Sixty-nine patients diagnosed with sarcoidosis between 2003 and 2006 were studied. Forty one patients (59%) were male. Sixteen patients (23%) presented with EN. Forty one patients of 65 (63%) had transbronchial biopsies demonstrating non-caseating granulomas. Patients with sarcoidosis presenting with EN were more likely to be female (p=0.042), younger (p=0.012) and have earlier stage pulmonary disease (p=0.02). There were no correlations between serum ACE, interstitial granulomas and disease stage. BAL-I did however predict increasing disease radiological stage (p=0.042). In this study, one quarter of patients with sarcoidosis presented with EN among their presenting features. These patients were more likely to be young females with early stage radiological disease.

Identification of forty-five gene-derived polymorphic microsatellite ...

Indian Academy of Sciences (India)

[Chen M., Gao L., Zhang W., You H., Sun Q. and Chang Y. 2013 Identification of forty-five ... including Japan, China, Korea and fareastern Russia (Chang et al. 2009). Because of ... tory using the Illumina HiSeq 2000 Sequencing Technology.

The association between submaximal quadriceps force steadiness and the knee adduction moment during walking in patients with knee osteoarthritis

DEFF Research Database (Denmark)

Sørensen, Tina Juul; Langberg, Henning; Aaboe, Jens

2011-01-01

in this population. METHODS: Forty-one patients with knee OA (34 females and 7 males) were included in the study. Submaximal isometric quadriceps force steadiness was measured during a force target-tracking task. Peak knee adduction moments during ambulation were measured using a 3-dimensional gait analysis system...

Determination of glycated hemoglobin in patients with advanced liver disease

Science.gov (United States)

Lahousen, Theresa; Hegenbarth, Karin; Ille, Rottraut; Lipp, Rainer W.; Krause, Robert; Little, Randie R.; Schnedl, Wolfgang J.

2004-01-01

AIM: To evaluate the glycated hemoglobin (HbA 1c) determination methods and to determine fructosamine in patients with chronic hepatitis, compensated cirrhosis and in patients with chronic hepatitis treated with ribavirin. METHODS: HbA1c values were determined in 15 patients with compensated liver cirrhosis and in 20 patients with chronic hepatitis using the ion-exchange high performance liquid chromatography and the immunoassay methods. Fructosamine was determined using nitroblue tetrazolium. RESULTS: Forty percent of patients with liver cirrhosis had HbA1c results below the non-diabetic reference range by at least one HbA1c method, while fructosamine results were either within the reference range or elevated. Twenty percent of patients with chronic hepatitis (hepatic fibrosis) had HbA1c results below the non -diabetic reference range by at least one HbA1c method. In patients with chronic hepatitis treated with ribavirin, 50% of HbA1c results were below the non-diabetic reference using at least one of the HbA1c methods. CONCLUSION: Only evaluated in context with all liver function parameters as well as a red blood count including reticulocytes, HbA 1c results should be used in patients with advanced liver disease. HbA 1c and fructosamine measurements should be used with caution when evaluating long-term glucose control in patients with hepatic cirrhosis or in patients with chronic hepatitis and ribavirin treatment. PMID:15259084

Institute of fundamental research: forty years of research

International Nuclear Information System (INIS)

1986-01-01

This document is aimed at illustration of forty years of fundamental research at CEA. It has not been conceived to give an exhaustive view of current research at IRF, but to give an illustration of these researches to non-specialists, and even to non-scientifists [fr

Hydrogeological characterization of Back Forty area, Albany Research Center, Albany, Oregon

International Nuclear Information System (INIS)

Tsai, S.Y.; Smith, W.H.

1983-12-01

Radiological surveys were conducted to determine the potential migration of radionuclides from the waste area to the area commonly referred to as the Back Forty, located in the southern portion of the ARC site. The survey results indicated that parts of the Back Forty contain soils contaminated with uranium, thorium, and their associated decay products. A hydrogeologic characterization study was conducted at the Back Forty as part of an effort to more thoroughly assess radionuclide migration in the area. The objectives of the study were: (1) to define the soil characteristics and stratigraphy at the site, (2) to describe the general conditions of each geologic unit, and (3) to determine the direction and hydraulic gradient of areal groundwater flow. The site investigation activities included literature review of existing hydrogeological data for the Albany area, onsite borehold drilling, and measurement of groundwater levels. 7 references, 9 figures, 2 tables

Analysis of the new code stroke protocol in Asturias after one year. Experience at one hospital.

Science.gov (United States)

García-Cabo, C; Benavente, L; Martínez-Ramos, J; Pérez-Álvarez, Á; Trigo, A; Calleja, S

2018-03-01

Prehospital code stroke (CS) systems have been proved effective for improving access to specialised medical care in acute stroke cases. They also improve the prognosis of this disease, which is one of the leading causes of death and disability in our setting. The aim of this study is to analyse results one year after implementation of the new code stroke protocol at one hospital in Asturias. We prospectively included patients who were admitted to our tertiary care centre as per the code stroke protocol for the period of one year. We analysed 363 patients. Mean age was 69 years and 54% of the cases were men. During the same period in the previous year, there were 236 non-hospital CS activations. One hundred forty-seven recanalisation treatments were performed (66 fibrinolysis and 81 mechanical thrombectomies or combined treatments), representing a 25% increase with regard to the previous year. Recent advances in the management of acute stroke call for coordinated code stroke protocols that are adapted to the needs of each specific region. This may result in an increased number of patients receiving early care, as well as revascularisation treatments. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Assessment of jeopardized myocardium in patients with one-vessel disease

International Nuclear Information System (INIS)

Iskandrian, A.S.; Lichtenberg, R.; Segal, B.L.; Mintz, G.S.; Mundth, E.D.; Hakki, A.-H.; Kimbiris, D.; Bemis, C.E.; Croll, M.N.; Kane, S.A.

1982-01-01

The size of the perfusion defect was assessed from a quantitative analysis of exercise thallium-201 images. Quantitative analysis was determined by measuring the area and the perimeter of the perfusion defect and expressing it as a percentage of the total left ventricular area or perimeter in three projections. Using this technique, we studied 50 patients with one-vessel disease of 50% or greater diameter narrowing. The planimetric and the perimetric methods correlated well (p<0.001, r=0.97). Of the 11 patients with less than 70% diameter narrowing, only one patient had abnormal exercise thallium-201 images. Of the remaining 39 patients with 70% or greater diameter narrowing, 35 had abnormal exercise images. The defects were larger in patients with left anterior descending coronary artery disease (33 +/- 10%; mean +/- SD by perimetry) than in patients with left circumflex coronary artery disease (19 +/- 14%, p<0.01) or right coronary artery disease (17 +/- 11%, p<0.01). There was also significant variation in the sizes of the defects in the three projections in patients with left circumflex and right coronary artery disease, but not in patients with left anterior descending coronary artery disease. Patients with left anterior descending coronary artery disease with collaterals had smaller defects than their counterparts without collaterals

Forty Years of Excellence, 1946 to 1986. Volume XXXVIII

National Research Council Canada - National Science Library

1986-01-01

... at providing the base for future technology. But, of more lasting importance, ONR developed policies and procedures forty years ago which became the organizational models for the National Science Foundation and other research agencies involving...

Teachers' Perceptions about School Violence in One Turkish City

Science.gov (United States)

Yavuzer, Yasemin; Gundogdu, Rezzan; Dikici, Ayhan

2009-01-01

The aim of this study is to determine the types and frequencies of violence encountered by teachers in primary and high schools in Nide province in Turkey, and, in addition, to determine the perceptions of teachers regarding the reasons for and methods of prevention of violent actions at schools. One hundred forty-two teachers were chosen for this…

[Infertility over forty: Pros and cons of IVF].

Science.gov (United States)

Belaisch-Allart, J; Maget, V; Mayenga, J-M; Grefenstette, I; Chouraqui, A; Belaid, Y; Kulski, O

2015-09-01

The population attempting pregnancy and having babies is ageing. The declining fertility potential and the late age of motherhood are increasing significantly the number of patients over forty consulting infertility specialists. Assisted reproductive technologies (ART) cannot compensate the natural decline in fertility with age. In France, in public hospital, ART is free of charge for women until 43 years, over 43, social insurance does not reimburse ART. Hence, 43 years is the usual limit, but between 40 and 42 is ART useful? The answer varies according to physicians, couples or society. On medical level, the etiology of the infertility must be taken into account. If there is an explanation to infertility (male or tubal infertility) ART is better than abstention. If the infertility is only due to age the question is raised. In France, the reimbursement by the society of a technique with very low results is discussed. However efficacy is not absolutely compulsory in Medicine. On the opposite to give false hopes may be discussed too. To obtain a reasonable consensus is rather difficult. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

French in Lesotho schools forty years after independence ...

African Journals Online (AJOL)

Most independent African states are now, like Lesotho, about forty years old. What has become of foreign languages such as French that once thrived under colonial rule albeit mostly in schools targeting non-indigenous learners? In Lesotho French seems to be the preserve of private or “international” schools. Can African ...

Frequency of anti thyroid peroxidase antibody in patients of vitiligo

International Nuclear Information System (INIS)

Zhokhar, A.; Shaikh, Z.I.

2013-01-01

Objective: The objective of this study was to compare the frequency of anti thyroid peroxidase antibody in patients suffering from vitiligo with healthy control group. Type of Study: Case control study. Settings: Dermatology Department, Military Hospital, Rawalpindi, from 20th March 2010 to 20th July 2011. Material and Methods: Fifty clinically diagnosed patients of vitiligo, age = 18 yrs and both genders with no history of thyroid disease, past or current use of drugs for thyroid disorder or thyroid surgery were included as cases (Group A). Fifty healthy individuals with no evidence of vitiligo or thyroid disorder on history and physical examination and with no family history of vitiligo, matched for age and gender with cases, were included as control (Group B). Serum anti thyroid peroxidase (anti TPO) antibodies were measured using enzyme linked immunosorbent assay (ELISA) in both cases and control. Results: Eight (16%) patients in Group A were anti-thyroid peroxidase antibody positive and forty two (84%) patients were negative while one (2%) patient was anti-thyroid peroxidase antibody positive in Group B and forty nine (98%) patients were negative (p = 0.001). Conclusion: Anti TPO antibody is significantly more common in patients of vitiligo as compared to general population. (author)

Taekwondo training improves balance in volunteers over forty.

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Gaby ePons Van Dijk

2013-03-01

Full Text Available AbstractBalance deteriorates with age, and may eventually lead to falling accidents which may threaten independent living. As Taekwondo contains various highly dynamic movement patterns, taekwondo practice may sustain or improve balance. Therefore, in 24 middle-aged healthy volunteers (40-71 year we investigated effects of age-adapted taekwondo training of one hour a week during one year on various balance parameters, such as: motor orientation ability (primary outcome measure, postural and static balance test, single leg stance, one leg hop test, and a questionnaire.Motor orientation ability significantly increased in favor of the antero-posterior direction with a difference of 0.62 degrees towards anterior compared to pre-training measurement, when participants corrected the tilted platform rather towards the posterior direction; female gender being an independent outcome predictor. On postural balance measurements sway path improved in all 19 participants, with a median of 9.3 mm/sec (range 0.71-45.86, and sway area in 15 participants with 4.2 mm²/sec (range 17.39-1.22. Static balance improved with an average of 5.34 seconds for the right leg, and with almost 4 seconds for the left. Median single leg stance duration increased in 17 participants with 5 seconds (range 1-16, and in 13 participants with 8 seconds (range 1-18. The average one leg hop test distance increased (not statistically significant with 9.5 cm. The questionnaire reported a better ‘ability to maintain balance’ in sixteen.In conclusion, our data suggest that age-adapted Taekwondo training improves various aspects of balance control in healthy people over the age of forty.

The Americleft Project: A Modification of Asher-McDade Method for Rating Nasolabial Esthetics in Patients With Unilateral Cleft Lip and Palate Using Q-sort.

Science.gov (United States)

Stoutland, Alicia; Long, Ross E; Mercado, Ana; Daskalogiannakis, John; Hathaway, Ronald R; Russell, Kathleen A; Singer, Emily; Semb, Gunvor; Shaw, William C

2017-11-01

The purpose of this study was to investigate ways to improve rater reliability and satisfaction in nasolabial esthetic evaluations of patients with complete unilateral cleft lip and palate (UCLP), by modifying the Asher-McDade method with use of Q-sort methodology. Blinded ratings of cropped photographs of one hundred forty-nine 5- to 7-year-old consecutively treated patients with complete UCLP from 4 different centers were used in a rating of frontal and profile nasolabial esthetic outcomes by 6 judges involved in the Americleft Project's intercenter outcome comparisons. Four judges rated in previous studies using the original Asher-McDade approach. For the Q-sort modification, rather than projection of images, each judge had cards with frontal and profile photographs of each patient and rated them on a scale of 1 to 5 for vermillion border, nasolabial frontal, and profile, using the Q-sort method with placement of cards into categories 1 to 5. Inter- and intrarater reliabilities were calculated using the Weighted Kappa (95% confidence interval). For 4 raters, the reliabilities were compared with those in previous studies. There was no significant improvement in inter-rater reliabilities using the new method. Intrarater reliability consistently improved. All raters preferred the Q-sort method with rating cards rather than a PowerPoint of photos, which improved internal consistency in rating compared to previous studies using the original Asher-McDade method. All raters preferred this method because of the ability to continuously compare photos and adjust relative ratings between patients.

Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction.

Science.gov (United States)

Patak, Lance S; Tait, Alan R; Mirafzali, Leela; Morris, Michelle; Dasgupta, Sunavo; Brummett, Chad M

2013-01-01

This study aimed to (1) identify patient-controlled analgesia (PCA) attributes that negatively impact patient satisfaction and ability to control pain while using PCA and (2) obtain data on patient perceptions of new PCA design features. We conducted a prospective survey study of postoperative pain control among patients using a PCA device. The survey was designed to evaluate patient satisfaction with pain control, understanding of PCA, difficulties using PCA, lockout-period management, and evaluation of new PCA design features. A total of 350 eligible patients completed the survey (91%). Patients who had difficulties using PCA were less satisfied (P PCA. Forty-nine percent of patients reported not knowing if they would receive medicine when they pushed the PCA button, and of these, 22% believed that this uncertainty made their pain worse. The majority of patients preferred the proposed PCA design features for easier use, including a light on the button, making it easier to find (57%), and a PCA button that vibrates (55%) or lights up (70%), alerting the patient that the PCA pump is able to deliver more medicine. A majority of patients, irrespective of their satisfaction with PCA, preferred a new PCA design. Certain attributes of current PCA technology may negatively impact patient experience, and modifications could potentially address these concerns and improve patient outcomes.

Spirometric assessment of lung transplant patients: one year follow-up

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Paulo M. Pêgo-Fernandes

2009-06-01

Full Text Available OBJECTIVE: The purpose of this study was to compare spirometry data between patients who underwent single-lung or double-lung transplantation the first year after transplantation. INTRODUCTION: Lung transplantation, which was initially described as an experimental method in 1963, has become a therapeutic option for patients with advanced pulmonary diseases due to improvements in organ conservation, surgical technique, immunosuppressive therapy and treatment of post-operative infections. METHODS: We retrospectively reviewed the records of the 39 patients who received lung transplantation in our institution between August 2003 and August 2006. Twenty-nine patients survived one year post-transplantation, and all of them were followed. RESULTS: The increase in lung function in the double-lung transplant group was more substantial than that of the single-lung transplant group, exhibiting a statistical difference from the 1st month in both the forced expiratory volume in one second (FEV1 and the forced vital capacity (FVC in comparison to the pre-transplant values (p <0.05. Comparison between double-lung transplant and single lung-transplant groups of emphysema patients demonstrated a significant difference in lung function beginning in the 3rd month after transplantation. DISCUSSION: The analyses of the whole group of transplant recipients and the sub-group of emphysema patients suggest the superiority of bilateral transplant over the unilateral alternative. Although the pre-transplant values of lung function were worse in the double-lung group, this difference was no longer significant in the subsequent months after surgery. CONCLUSION: Although both groups demonstrated functional improvement after transplantation, there was a clear tendency to greater improvement in FVC and FEV1 in the bilateral transplant group. Among our subjects, double-lung transplantation improved lung function.

Clinical outcome of pneumatic dilatation in patients with achalasia cardia: A single-center prospective study

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Amit Hanmant Shejal

2017-01-01

Full Text Available Background and Aim: Pneumatic balloon dilation is one of the most commonly used and effective methods for treating patients with achalasia cardia. This study was performed to assess immediate and long-term response of pneumatic dilatation (PD in these patients. Materials and Methods: Forty-four achalasia cardia patients, who underwent PD in our center from January 2013 to December 2015, were prospectively studied. Data from these patients were analyzed for clinical improvement in symptoms after dilatation procedure over this period as per Eckardt score. Patients who required repeated procedure and factors influencing remission of symptoms were analyzed. Results: A total of 44 patients underwent PD, among which three lost to follow up. Of the 41 patients, 21 were male (51.22% and 20 were females (48.78%. Mean age was 38.68 (13–64 years. Median symptom duration before first dilatation was 18 months (2–240. Major symptoms at presentation were dysphagia (n = 41, 100%, regurgitation (n = 38 92.68%, chest pain (n = 31, 75.6%, and weight loss (n = 20, 48.78%. Mean follow-up period was 22.22 months (9–38. Forty (97.56% patients had immediate clinical improvement after 1 dilatation, of which 38 (92.68% patients did not require any further treatment. Mean Eckardt score was 6.82 (4–11 at the time of first dilatation which improved to 0.66 during follow-up. Two patients required second dilatation (one 5 months and other 18 months after the first procedure. Conclusion: PD is a safe and effective long-term therapy for achalasia cardia and has a good long-term clinical remission.

Apoptosis Governs the Elimination of Schistosoma japonicum from the Non-Permissive Host Microtus fortis

Science.gov (United States)

Peng, Jinbiao; Gobert, Geoffrey N.; Hong, Yang; Jiang, Weibin; Han, Hongxiao; McManus, Donald P.; Wang, Xinzhi; Liu, Jinming; Fu, Zhiqiang; Shi, Yaojun; Lin, Jiaojiao

2011-01-01

The reed vole, Microtus fortis, is the only known mammalian host in which schistosomes of Schistosoma japonicum are unable to mature and cause significant pathogenesis. However, little is known about how Schistosoma japonicum maturation (and, therefore, the development of schistosomiasis) is prevented in M. fortis. In the present study, the ultrastructure of 10 days post infection schistosomula from BALB/c mice and M. fortis were first compared using scanning electron microscopy and transmission electron microscopy. Electron microscopic investigations showed growth retardation and ultrastructural differences in the tegument and sub-tegumental tissues as well as in the parenchymal cells of schistosomula from M. fortis compared with those in BALB/c mice. Then, microarray analysis revealed significant differential expression between the schistosomula from the two rodents, with 3,293 down-regulated (by ≥2-fold) and 71 up-regulated (≥2 fold) genes in schistosomula from the former. The up-regulated genes included a proliferation-related gene encoding granulin (Grn) and tropomyosin. Genes that were down-regulated in schistosomula from M. fortis included apoptosis-inhibited genes encoding a baculoviral IAP repeat-containing protein (SjIAP) and cytokine-induced apoptosis inhibitor (SjCIAP), genes encoding molecules involved in insulin metabolism, long-chain fatty acid metabolism, signal transduction, the transforming growth factor (TGF) pathway, the Wnt pathway and in development. TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) and PI/Annexin V-FITC assays, caspase 3/7 activity analysis, and flow cytometry revealed that the percentages of early apoptotic and late apoptotic and/or necrotic cells, as well as the level of caspase activity, in schistosomula from M. fortis were all significantly higher than in those from BALB/c mice. PMID:21731652

Functional Outcome With Percutaneous Ilio-sacral Screw Fixation For Posterior Pelvic Ring Injuries In Patients Involved In Heavy Manual Laboring

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Abhishek SM

2015-11-01

Full Text Available Introduction: Unstable posterior pelvic ring injuries are best treated with operative methods due to better post-op functional score. Our patient cohort was involved in heavy manual laboring frequently required ground level work in their activities of daily living. There are very few outcome studies dealing exclusively with such patients. Materials & Methods: Forty one patients who were treated with percutaneous sacroiliac screw fixation under fluoroscopic guidance and were followed-up for at least one year were analyzed retrospectively for functional outcome using the Majeed score. Results: Twenty one (51.22% and thirteen (31.70% patients were found to be in excellent and good categories respectively and majority of the patients (thirty/73.17% were able to return to their original occupation with or without minor adjustments. Conclusion: Percutaneous ilio-sacral screw fixation for posterior pelvic unstable injuries is an acceptable mode of treatment in patients involved in heavy manual laboring.

Enteric Duplication Cysts in Children: A Single-Institution Series with Forty Patients in Twenty-Six Years.

Science.gov (United States)

Erginel, Basak; Soysal, Feryal Gun; Ozbey, Huseyin; Keskin, Erbug; Celik, Alaattin; Karadag, Aslıhan; Salman, Tansu

2017-02-01

The purpose of the study was to evaluate our experience with enteric duplication cysts in 40 children during the past 26 years, while assessing the variability of their presentations and to propose an algorithm for surgical management. We retrospectively analysed sex, age, clinical presentations, duplication site, surgical treatment, presence of ectopic tissue, complications, associated anomalies, and prognosis of 40 patients with gastrointestinal tract duplications who were surgically treated in our clinic. Overall, there was a predominance of boys (28 males, 70 %; 12 females, 30 %). The presenting symptom was vomiting in 23 patients, rectal bleeding in 11 patients, abdominal mass in 10 patients, abdominal pain in 9 patients, constipation in 6 patients, cough in 2 patients, and respiratory distress in 2 patients. In 30 patients, a complete excision of the cyst with additional segmental intestinal resection and anastomosis was performed. Cystectomy was performed in seven patients, while complete excision of the cyst with additional wedge resection was performed in two. A Wrenn procedure (mucosectomy) was performed in one patient. Due to the variability in the site of enteric duplications, a wide range of presenting symptoms can exist, which is challenging for diagnosis. In children with a diagnosis of acute abdomen, enteric duplication cysts should be considered, and these children should be further investigated for additional skeletal, urogenital, and gastrointestinal system pathologies. Surgical treatment depends on the site and type of the cyst.

Muhammed b. Mahmud Jamal al-Din al-Halwatî and His Manuscript Titled The annotation of forty hadith qudsy

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Harun Reşit DEMİREL

2017-12-01

Full Text Available We don’t unfortunately have information about the birth and education of Jamal al-Din Aksarayī who lived in the XV century in the Ottoman State. However, the works shows that he was a very knowledgeable person. Al Aksarayi, who worked as a mudarris in Zinciriyye Madrasah, was capable of hadith, interpretation, jurisprudence, Arabic language and medicine. He has some works as: Risâle fî Hadiths “Innallāha Taālā khalaka âdama alā suretihi”, Risāletu’r-Rahīmiyye, Sharh Forty Hadīths, Forthy Hadīth. Aksarayi’s work titled Forty Hadīth and interpreted by him with a mystical method and currently located as a manuscript in libraries will be studied in this article. And we will try to demonstrate his scientific personality by showing the sources of hadiths which he used and examining his method.

Scattered light characterization of FORTIS

Science.gov (United States)

McCandliss, Stephan R.; Carter, Anna; Redwine, Keith; Teste, Stephane; Pelton, Russell; Hagopian, John; Kutyrev, Alexander; Li, Mary J.; Moseley, S. Harvey

2017-08-01

We describe our efforts to build a Wide-Field Lyman alpha Geocoronal simulator (WFLaGs) for characterizing the end-to-end sensitivity of FORTIS (Far-UV Off Rowland-circle Telescope for Imaging and Spectroscopy) to scattered Lyman α emission from outside of the nominal (1/2 degree)2 field-of-view. WFLaGs is a 50 mm diameter F/1 aluminum parabolic collimator fed by a hollow cathode discharge lamp with a 80 mm clear MgF2 window housed in a vacuum skin. It creates emission over a 10 degree FOV. WFLaGS will allow us to validate and refine a recently developed scattered light model and verify our scatter light mitigation strategies, which will incorporate low scatter baffle materials, and possibly 3-d printed light traps, covering exposed scatter centers. We present measurements of scattering intensity of Lyman alpha as a function of angle with respect to the specular reflectance direction for several candidate baffle materials. Initial testing of WFLaGs will be described.

Patients' Contexts and Their Effects on Clinicians' Impressions of Conduct Disorder Symptoms

Science.gov (United States)

De Los Reyes, Andres; Marsh, Jessecae K.

2011-01-01

The purpose of this study was to examine whether contextual information about patients' clinical presentations affected clinicians' judgments of conduct disorder symptoms. Forty-five clinicians read vignettes describing hypothetical patients who displayed one conduct disorder symptom alongside information about the patients' home, school, and peer…

Oropharyngeal Dysphagia in Acute Stroke Patients

OpenAIRE

Faezeh Asadollahpour; Kowsar Baghban; Mojgan Asadi; Ehsan Naderifar; Maryam Dehghani

2015-01-01

Background: The objective of this study was to investigate the prevalence of different kinds of swallowing disorder and it’s severity in patients after stroke. Patients and Methods: In this cross sectional study, 91 consecutive stroke patients were screened by the Northwestern Dysphagia Patient Check Sheet (NDPCS) and the Gugging Swallowing Screen (GUSS). Results: Forty seven percent of those assessed demonstrated signs of oropharyngeal dysphagia. Mild dysphagia was seen in (10.98%) pat...

Application of the "see one, do one, teach one" concept in surgical training.

Science.gov (United States)

Kotsis, Sandra V; Chung, Kevin C

2013-05-01

The traditional method of teaching in surgery is known as "see one, do one, teach one." However, many have argued that this method is no longer applicable, mainly because of concerns for patient safety. The purpose of this article is to show that the basis of the traditional teaching method is still valid in surgical training if it is combined with various adult learning principles. The authors reviewed literature regarding the history of the formation of the surgical residency program, adult learning principles, mentoring, and medical simulation. The authors provide examples for how these learning techniques can be incorporated into a surgical resident training program. The surgical residency program created by Dr. William Halsted remained virtually unchanged until recently with reductions in resident work hours and changes to a competency-based training system. Such changes have reduced the teaching time between attending physicians and residents. Learning principles such as experience, observation, thinking, and action and deliberate practice can be used to train residents. Mentoring is also an important aspect in teaching surgical technique. The authors review the different types of simulators-standardized patients, virtual reality applications, and high-fidelity mannequin simulators-and the advantages and disadvantages of using them. The traditional teaching method of "see one, do one, teach one" in surgical residency programs is simple but still applicable. It needs to evolve with current changes in the medical system to adequately train surgical residents and also provide patients with safe, evidence-based care.

Impact of different treatment methods on survival in advanced pancreatic cancer

International Nuclear Information System (INIS)

Brasiuniene, B.; Juozaityte, E.; Barauskas, G.

2005-01-01

The aim of the study was to evaluate the impact of different treatment methods on survival of patients treated for advanced pancreatic cancer at Kaunas University of Medicine Hospital from 1987 to 2003. Data on 262 patients with advanced pancreatic cancer treated from 1987 to 2003 were analyzed retrospectively. Four groups of patients were analyzed. One hundred eighty patients underwent palliative bypass or endoscopic bile duct stenting or observation alone. Forty three patients in addition to surgery were treated by radiotherapy. Twenty five patients received gemcitabine in standard doses and schedules. Fourteen patients received concomitant chemoradiotherapy (with gemcitabine or 5-fluorouracil). All patients were grouped by treatment method and median survival was analyzed. Median survival of patients treated by palliative surgery only or observation alone was 1.9 month, and for patients treated by palliative surgery and radiotherapy was 6.1 months (p=0.00007). Median survival of patients treated with gemcitabine was 9.5 months (p<0.001), and median survival of patients treated with concomitant chemoradiotherapy was 8.5 months (p=0.00003). Patients diagnosed with advanced pancreatic cancer in addition to surgical treatment should be treated by chemotherapy, concomitant chemoradiotherapy or radiotherapy. (author)

Effects of one year treatment of sibutramine on insulin resistance parameters in type 2 diabetic patients.

Science.gov (United States)

Derosa, Giuseppe; Maffioli, Pamela; Ferrari, Ilaria; Palumbo, Ilaria; Randazzo, Sabrina; D'Angelo, Angela; Cicero, Arrigo F G

2010-01-01

Comparison of the effects of one year treatment with sibutramine compared to placebo on insulin resistance parameters, body weight, glycemic control, and lipid profile, in type 2 diabetic patients. Two hundred and forty-six patients with uncontrolled type 2 diabetes mellitus in therapy with different oral hypoglycemic agents or insulin were enrolled in this study and randomised to take sibutramine 10 mg or placebo for one year. We evaluated at baseline, and after 3, 6, 9, and 12 months these parameters: homeostasis model assessment insulin resistance index (HOMA-IR), retinol binding protein-4 (RBP-4), resistin, visfatin, and high sensitivity-C reactive protein (Hs-CRP), body weight, body mass index (BMI), glycated hemoglobin (HbA(₁c)), fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), fasting plasma insulin (FPI), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and triglycerides (T(g)). A faster decrease of HOMA-IR, resistin, and RBP-4 was recorded with sibutramine compared to the control group. We observed a significant decrease of Hs-CRP in both groups, and a faster improvement of HbA(₁c), FPG and PPG with sibutramine compared to the control group; furthermore we recorded a decrease of FPI, TC, LDL-C, body weight, and BMI in the sibutramine group, but not in the control group. Sibutramine gave a faster improvement of insulin resistance parameters and glycemic control compared to placebo; furthermore sibutramine gave also an improvement of lipid profile, and body weight.

Rheumatic manifestations at presentation of Hodgkin's disease and non-Hodgkin's malignant lymphoma. A national survey of one hundred forty-six patients

International Nuclear Information System (INIS)

Gaudin, P.; Rozand, Y.; Fauconnier, J.; Phelip, X.

1995-01-01

The authors report the findings of a national survey conducted at the request for the French Society for Rheumatology to list the rheumatic manifestations that can be inaugural in Hodgkin's disease on non-Hodgkin's malignant lymphoma. This was an exploratory, retrospective, descriptive study of 146 patients from 22 rheumatology departments. A number of clinical features (young male, nocturnal sweats, generalized pruritus, protracted fever, central or peripheral lymphadenopathy) and laboratory test abnormalities (evidence of severe inflammation) considerably increased the likelihood of Hodgkin's disease rather than malignant lymphoma. The diagnosis of bony involvement requires multidisciplinary studies of tumor specimens. (authors). 4 figs., 7 tabs., 71 refs

Multiple aetiologies of secondary hypertension in one patient

OpenAIRE

Golan, Eliezer; Nabriski, Danny; Sharabi, Yehonatan; Werner, Miryam; Griton, Yigal; Moshkovich, Evgeny; Korzets, Ze?ev

2008-01-01

Apart from seeking target organ damage, the investigation of hypertension is primarily aimed at finding a treatable cause of the hypertension. The finding of one such cause is usually construed as being the sole culprit responsible for the patient's elevated blood pressure. The existence of multiple aetiologies of secondary hypertension in one patient is infrequent. In this report, we describe such a patient in whom secondary hypertension due to Cushing's disease, renovascular and finally bar...

EuReCa ONE-27 Nations, ONE Europe, ONE Registry

DEFF Research Database (Denmark)

Gräsner, Jan-Thorsten; Lefering, Rolf; Koster, Rudolph W

2016-01-01

INTRODUCTION: The aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe. METHODS: This was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were...

One size fits all? Mixed methods evaluation of the impact of 100% single-room accommodation on staff and patient experience, safety and costs

Science.gov (United States)

Maben, Jill; Penfold, Clarissa; Simon, Michael; Anderson, Janet E; Robert, Glenn; Pizzo, Elena; Hughes, Jane; Murrells, Trevor; Barlow, James

2016-01-01

Background and objectives There is little strong evidence relating to the impact of single-room accommodation on healthcare quality and safety. We explore the impact of all single rooms on staff and patient experience; safety outcomes; and costs. Methods Mixed methods pre/post ‘move’ comparison within four nested case study wards in a single acute hospital with 100% single rooms; quasi-experimental before-and-after study with two control hospitals; analysis of capital and operational costs associated with single rooms. Results Two-thirds of patients expressed a preference for single rooms with comfort and control outweighing any disadvantages (sense of isolation) felt by some. Patients appreciated privacy, confidentiality and flexibility for visitors afforded by single rooms. Staff perceived improvements (patient comfort and confidentiality), but single rooms were worse for visibility, surveillance, teamwork, monitoring and keeping patients safe. Staff walking distances increased significantly post move. A temporary increase of falls and medication errors in one ward was likely to be associated with the need to adjust work patterns rather than associated with single rooms per se. We found no evidence that single rooms reduced infection rates. Building an all single-room hospital can cost 5% more with higher housekeeping and cleaning costs but the difference is marginal over time. Conclusions Staff needed to adapt their working practices significantly and felt unprepared for new ways of working with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms. PMID:26408568

FORTY PLUS CLUBS AND WHITE-COLLAR MANHOOD DURING THE GREAT DEPRESSION

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Gregory Wood

2008-01-01

Full Text Available As scholars of gender and labor have argued, chronic unemployment during the Great Depression precipitated a “crisis” of masculinity, compelling men to turn towards new industrial unions and the New Deal as ways to affirm work, breadwinning, and patriarchy as bases for manhood. But did all men experience this crisis? During the late 1930s, white-collar men organized groups called “Forty Plus Clubs” in response to their worries about joblessness and manhood. The clubs made it possible for unemployed executives to find new jobs, while at the same time recreating the male-dominated culture of the white-collar office. For male executives, Forty Plus Clubs precluded the Depression-era crisis of manhood, challenging the idea that the absence ofpaid employment was synonymous with the loss of masculinity.

Community Energy Systems and the Law of Public Utilities. Volume Forty-one. Rhode Island

Energy Technology Data Exchange (ETDEWEB)

Feurer, D.A.; Weaver, C.L.

1981-01-01

A detailed description is presented of the laws and programs of the State of Rhode Island governing the regulation of public energy utilities, the siting of energy generating and transmission facilities, the municipal franchising of public energy utilities, and the prescription of rates to be charged by utilities including attendant problems of cost allocations, rate base and operating expense determinations, and rate of return allowances. These laws and programs are analyzed to identify impediments which they may present to the implementation of Integrated Community Energy Systems (ICES). This report is one of fifty-one separate volumes which describe such regulatory programs at the Federal level and in each state as background to the report entitled Community Energy Systems and the Law of Public Utilities - Volume One: An Overview. This report also contains a summary of a strategy described in Volume One - An Overview for overcoming these impediments by working within the existing regulatory framework and by making changes in the regulatory programs to enhance the likelihood of ICES implementation.

76 FR 58812 - Patient Safety Organizations: Delisting for Cause of Patient Safety Organization One, Inc.

Science.gov (United States)

2011-09-22

... Organizations: Delisting for Cause of Patient Safety Organization One, Inc. AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice of Delisting. SUMMARY: Patient Safety Organization One, Inc.: AHRQ has delisted Patient Safety Organization One, Inc. as a Patient Safety Organization (PSO...

Comparison of liver volumetry on contrast-enhanced CT images: one semiautomatic and two automatic approaches.

Science.gov (United States)

Cai, Wei; He, Baochun; Fan, Yingfang; Fang, Chihua; Jia, Fucang

2016-11-08

This study was to evaluate the accuracy, consistency, and efficiency of three liver volumetry methods- one interactive method, an in-house-developed 3D medical Image Analysis (3DMIA) system, one automatic active shape model (ASM)-based segmentation, and one automatic probabilistic atlas (PA)-guided segmentation method on clinical contrast-enhanced CT images. Forty-two datasets, including 27 normal liver and 15 space-occupying liver lesion patients, were retrospectively included in this study. The three methods - one semiautomatic 3DMIA, one automatic ASM-based, and one automatic PA-based liver volumetry - achieved an accuracy with VD (volume difference) of -1.69%, -2.75%, and 3.06% in the normal group, respectively, and with VD of -3.20%, -3.35%, and 4.14% in the space-occupying lesion group, respectively. However, the three methods achieved an efficiency of 27.63 mins, 1.26 mins, 1.18 mins on average, respectively, compared with the manual volumetry, which took 43.98 mins. The high intraclass correlation coefficient between the three methods and the manual method indicated an excel-lent agreement on liver volumetry. Significant differences in segmentation time were observed between the three methods (3DMIA, ASM, and PA) and the manual volumetry (p volumetries (ASM and PA) and the semiautomatic volumetry (3DMIA) (p < 0.001). The semiautomatic interactive 3DMIA, automatic ASM-based, and automatic PA-based liver volum-etry agreed well with manual gold standard in both the normal liver group and the space-occupying lesion group. The ASM- and PA-based automatic segmentation have better efficiency in clinical use. © 2016 The Authors.

Effect of Keishibukuryogan on Endothelial Function in Patients with at Least One Component of the Diagnostic Criteria for Metabolic Syndrome: A Controlled Clinical Trial with Crossover Design

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Yutaka Nagata

2012-01-01

Full Text Available We evaluated the effect of keishibukuryogan (KBG; Guizhi-Fuling-Wan, a traditional Japanese (Kampo formula, on endothelial function assessed by reactive hyperemia peripheral arterial tonometry (Endo-PAT2000 in patients with metabolic syndrome-related factors by controlled clinical trial with crossover design. Ninety-two patients were assigned to group A (first KBG-treatment period, then control period; each lasting 4 weeks, with about one-year interval or group B (first control, then KBG-treatment. In forty-nine (27, group A; 22, group B patients completing all tests, the mean value of the natural logarithmic-scaled reactive hyperemia index (L_RHI increased and those of serum nonesterified fatty acid (NEFA, malondialdehyde, and soluble vascular cell adhesion molecule 1 decreased significantly during the KBG-treatment period, but not during the control period, and 4-week changes of L_RHI, NEFA, and malondialdehyde between the 2 periods showed significance. These results suggest that KBG has beneficial effect on endothelial function in patients with metabolic syndrome-related factors.

Forty years of the Department of Nuclear Physics, 1961-2001

International Nuclear Information System (INIS)

Anon

2001-01-01

A brief report of activities of the Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Informatics, Comenius University, Bratislava during forty years of history is given. A review o personnel, research programmes, graduates and master thesis, curriculum of the master study, as well as of important scientific projects is given

Target of Opportunity - Far-UV Observations of Comet ISON with FORTIS

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McCandliss, Stephan

The goal of this one year program is to acquire spectra and imagery of the sungrazing Oort cloud comet known as ISON in the far-UV bandpass between 800 -- 1950 Angstroms over a 1/2 degree field-of-view (FOV), during its ingress and egress from the sun. This bandpass and FOV provides access to a particularly rich set of spectral diagnostics for determining the volatile production rates of CO, H, C, C+, O and S, and to search for previously undetected atomic and molecular species such as Ar, N, N+, N2, O+ and O5+. We are particularly interested in searching for compositional changes associated with the intense heating episode at the comet's perihelion to address an outstanding question in cometary research; do Oort cloud comets carry a chemical composition similar to the proto-stellar molecular cloud from which the Solar System formed? Sounding rockets are uniquely suited to observing cometary emissions in the far-UV as they can point to within 25 degrees of the sun, whereas HST is limited to observations at angles greater than 50 degrees. The projected ephemeris of this comet shows that on ingress it is expected to reach ~ +4 mag at 25 degrees from the sun on 21 November 2013 and, should it survive its trip to within 2.7 Rsun from the sun, it is expected to reach a similar magnitude during egress at 25 degrees on 08 December 2013. This will be a reflight of the JHU sounding rocket borne spectro-telescope called FORTIS, currently scheduled to fly in May of 2013 on NASA sounding rocket 36.268 UG. The instrumental configuration of FORTIS is uniquely suited to accomplishing the goals of this task.

The Effects of Viewing and Preferences for Online Cancer Information Among Patients' Loved Ones.

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Lauckner, Carolyn

2016-01-01

Emotional and psychological distress is common among loved ones of cancer patients, who sometimes report more severe mental health issues than the patients themselves. In addition, many loved ones feel as though their information needs are not being met, which can lead them to seek out additional information online. This survey research examined the experiences of cancer patients' loved ones in viewing online content about the disease and the emotional outcomes of such browsing sessions. Participants (N = 191) were recruited from cancer- and caregiver-related nonprofits and online discussion boards. Results indicated that patients' loved ones were active users of online cancer Web sites. They primarily viewed and expressed a desire for information-based, rather than support-based, content. Many individuals desired in-depth treatment information, and those who viewed it had significantly more hope. Interestingly, multiple regression analysis revealed that viewing user-generated content was associated only with negative emotions, illustrating the potential dangers of social media spaces. Overall, this study shows the need for supporting patients' loved ones during their almost inevitable viewings of online cancer information. More research is needed in order to determine the best methods of mitigating potential negative effects of cancer Web sites and developing a useful online resource for this population.

One digit interruption: the altered force patterns during functionally cylindrical grasping tasks in patients with trigger digits.

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Po-Tsun Chen

Full Text Available Most trigger digit (TD patients complain that they have problems using their hand in daily or occupational tasks due to single or multiple digits being affected. Unfortunately, clinicians do not know much about how this disease affects the subtle force coordination among digits during manipulation. Thus, this study examined the differences in force patterns during cylindrical grasp between TD and healthy subjects. Forty-two TD patients with single digit involvement were included and sorted into four groups based on the involved digits, including thumb, index, middle and ring fingers. Twelve healthy subjects volunteered as healthy controls. Two testing tasks, holding and drinking, were performed by natural grasping with minimal forces. The relations between the force of the thumb and each finger were examined by Pearson correlation coefficients. The force amount and contribution of each digit were compared between healthy controls and each TD group by the independent t test. The results showed all TD groups demonstrated altered correlation patterns of the thumb relative to each finger. Larger forces and higher contributions of the index finger were found during holding by patients with index finger involved, and also during drinking by patients with affected thumb and with affected middle finger. Although no triggering symptom occurred during grasping, the patients showed altered force patterns which may be related to the role of the affected digit in natural grasping function. In conclusion, even if only one digit was affected, the subtle force coordination of all the digits was altered during simple tasks among the TD patients. This study provides the information for the future studies to further comprehend the possible injuries secondary to the altered finger coordination and also to adopt suitable treatment strategies.

One digit interruption: the altered force patterns during functionally cylindrical grasping tasks in patients with trigger digits.

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Chen, Po-Tsun; Lin, Chien-Ju; Jou, I-Ming; Chieh, Hsiao-Feng; Su, Fong-Chin; Kuo, Li-Chieh

2013-01-01

Most trigger digit (TD) patients complain that they have problems using their hand in daily or occupational tasks due to single or multiple digits being affected. Unfortunately, clinicians do not know much about how this disease affects the subtle force coordination among digits during manipulation. Thus, this study examined the differences in force patterns during cylindrical grasp between TD and healthy subjects. Forty-two TD patients with single digit involvement were included and sorted into four groups based on the involved digits, including thumb, index, middle and ring fingers. Twelve healthy subjects volunteered as healthy controls. Two testing tasks, holding and drinking, were performed by natural grasping with minimal forces. The relations between the force of the thumb and each finger were examined by Pearson correlation coefficients. The force amount and contribution of each digit were compared between healthy controls and each TD group by the independent t test. The results showed all TD groups demonstrated altered correlation patterns of the thumb relative to each finger. Larger forces and higher contributions of the index finger were found during holding by patients with index finger involved, and also during drinking by patients with affected thumb and with affected middle finger. Although no triggering symptom occurred during grasping, the patients showed altered force patterns which may be related to the role of the affected digit in natural grasping function. In conclusion, even if only one digit was affected, the subtle force coordination of all the digits was altered during simple tasks among the TD patients. This study provides the information for the future studies to further comprehend the possible injuries secondary to the altered finger coordination and also to adopt suitable treatment strategies.

Frequency of Fimbrial Virulence Genes (fim, pap, sfa in Escherichia Coli Isolated from the Patients with Urinary Tract Infections from selective hospitals of Tehran, Boroujerd and Sanandej City in 2015-2016

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mohsen mirzaee

2017-02-01

Full Text Available Introduction: Urinary tract infection (UTI caused by E coli is one of the most common diseases in community. Colonization of E. coli and its attachment to the uroepithelium are mediated by adhesions such as P, Fim and S fimbriae. The present study was aimed to evaluate the prevalence of fimbrial virulence genes in Escherichia coli (E. coli isolates from the patients with urinary tract infection in Tehran, Boroujerd and Sanandaj cities, Iran. Methods: In this descriptive cross sectional study, 150 clinical isolates of uropathogenic E.coli were collected from the patients with urinary tract infection. All bacterial isolates were identified by standard biochemical laboratory methods; the fim, pap and sfa genes were detected using the PCR and Multiplex-PCR methods. Results: One hundred forty-five (96.66% isolates were positive for fim gene, one hundred forty (93.33% isolates were positive for pap gene and seven (4.66 isolates were positive for sfa gene. Whole of the isolates were possessed at least one of the three virulence genes. Six (4% isolates were positive for all genes. Conclusion: The findings of this study showed the high frequency of fim and P fimbriae among uropathogenic E.coli isolates from the patients with urinary tract infection. Because of the higher prevalence of UTI in the presence of these genes, detection of the genes in urine samples may help in more suspicious and rapid management of UTI.

Oromandibular Dystonia: Demographics and Clinical Data from 240 Patients

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Linda Slaim

2018-05-01

Full Text Available Objective To report demographic data from a large cohort of patients with oromandibular dystonia (OMD. Methods This is a retrospective review of patients with OMD referred to our institution between 1989 and 2015. Demographic (age of onset, gender, and familial history of dystonia and clinical (type of OMD, associated dystonia, and etiology of dystonia data were collected from a cohort of 240 individuals. Results The mean age of onset of OMD was 51.6 years old, with a female predominance (2:1. A family history of dystonia was found in 6 patients (2.5%. One hundred and forty-nine patients (62.1% had the jaw-opening type of OMD, 48 patients (20.0% had the jaw-closing type, and 43 patients (17.9% had a mixed form of OMD. Lingual dystonia was also present in 64 (26.7% of these patients. Eighty-two patients (34.2% had a focal dystonia, 131 patients (54.6% had a segmental dystonia, and 27 patients (11.3% had a generalized dystonia. One hundred and seventy-one patients (71.3% had idiopathic OMD. Conclusion OMD is a chronic and disabling focal dystonia. Our study found a prevalence of female patients, an onset in middle age and a predominantly idiopathic etiology. Unlike other studies, jaw-opening was found to be the most frequent clinical type of OMD.

Impact of one-dose package dispensing with patient counseling on medication adherence in geriatrics suffering from chronic disorders

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Narayana Goruntla

2018-01-01

Full Text Available Introduction: Medication nonadherence in elderly patients could result in a waste of medical expenses in a long-time span as well as deterioration of the patient's medical condition. Aim: The aim of this study is to evaluate the impact of one-dose package dispensing with patient counseling on medication adherence among elderly patients suffering from chronic disorders. Settings and Design: This is prospective, open-labeled, randomized trial carried out at dispensing pharmacy of the secondary care referral hospital, located in resource-limited settings of Anantapur District, Andhra Pradesh, India. Subjects and Methods: A total of 330 (aged ≥60 years patients were randomly assigned to one of three study groups: Group A (n = 110, no change in dosing and packing; Group B (n = 110, one-dose package dispensing; Group C (n = 110, One-dose package dispensing with patient counseling. Medication adherence levels were measured using a pill count and visual analog scale (VAS method at baseline and follow-up (after 1 month. Statistical Analysis: Descriptive statistics were used to represent the sociodemographic, clinical, and medication adherence profile of study participants. One-way ANOVA test is used to assess significant differences between three groups with a P 60 years who are on multiple medications can benefit from one-dose package dispensing and appropriate counseling. This will improve medication adherence hence better outcomes.

Forty years of uranium resources, production and demand in perspective

International Nuclear Information System (INIS)

Price, R.; Barthel, F.; Blaise, J.R.; McMurray, J.

2006-01-01

The NEA has been collecting and analysing data on uranium for forty years. The data and experience provide a number of answers to the questions being asked today, as many countries begin to look at nuclear energy with renewed interest. In terms of uranium resources, the lessons of the past give confidence that uranium supply will remain adequate to meet demand. (authors)

One-year mortality of HIV-positive patients treated for rifampicin- and isoniazid-susceptible tuberculosis in Eastern Europe, Western Europe, and Latin America.

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2017-01-28

The high mortality among HIV/tuberculosis (TB) coinfected patients in Eastern Europe is partly explained by the high prevalence of drug-resistant TB. It remains unclear whether outcomes of HIV/TB patients with rifampicin/isoniazid-susceptible TB in Eastern Europe differ from those in Western Europe or Latin America. One-year mortality of HIV-positive patients with rifampicin/isoniazid-susceptible TB in Eastern Europe, Western Europe, and Latin America was analysed and compared in a prospective observational cohort study. Factors associated with death were analysed using Cox regression modelsRESULTS:: Three hundred and forty-one patients were included (Eastern Europe 127, Western Europe 165, Latin America 49). Proportions of patients with disseminated TB (50, 58, 59%) and initiating rifampicin + isoniazid + pyrazinamide-based treatment (93, 94, 94%) were similar in Eastern Europe, Western Europe, and Latin America respectively, whereas receipt of antiretroviral therapy at baseline and after 12 months was lower in Eastern Europe (17, 39, 39%, and 69, 94, 89%). The 1-year probability of death was 16% (95% confidence interval 11-24%) in Eastern Europe, vs. 4% (2-9%) in Western Europe and 9% (3-21%) in Latin America; P Eastern Europe were at nearly 3-fold increased risk of death compared with those in Western Europe/Latin America (aHR 2.79 (1.15-6.76); P = 0.023). Despite comparable use of recommended anti-TB treatment, mortality of patients with rifampicin/isoniazid-susceptible TB remained higher in Eastern Europe when compared with Western Europe/Latin America. The high mortality in Eastern Europe was only partially explained by IDU, use of ART and CD4 cell count. These results call for improvement of care for TB/HIV patients in Eastern Europe.

Preoperative nuclear scans in patients with melanoma

International Nuclear Information System (INIS)

Au, F.C.; Maier, W.P.; Malmud, L.S.; Goldman, L.I.; Clark, W.H. Jr.

1984-01-01

One hundred forty-one liver scans, 137 brain scans, and 112 bone scans were performed in 192 patients with clinical Stage 1 melanoma. One liver scan was interpreted as abnormal; liver biopsy of that patient showed no metastasis. There were 11 suggestive liver scans; three of the patients with suggestive liver scans had negative liver biopsies. The remaining eight patients were followed from 4 to 6 years and none of those patients developed clinical evidence of hepatic metastases. All of the brain scans were normal. Five patients had suggestive bone scans and none of those patients had manifested symptoms of osseous metastases with a follow-up of 2 to 4.5 years. This study demonstrates that the use of preoperative liver, brain and bone scan in the evaluation of patients with clinical Stage 1 melanoma is virtually unproductive

Serum homocystein level in patients with scleroderma.

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Nazarinia, Mohammadali; Shams, Mesbah; Kamali Sarvestani, Eskandar; Shenavande, Saeede; Khademalhosseini, Maryam; Khademalhosseini, Zeinab

2013-01-01

Systemic Sclerosis (SSc) is a systemic connective tissue disease. In this study, we compared the serum Homocystein (Hcy) level between patients with SSc and normal control group. The current study was conducted to determine whether serum Hcy levels are elevated in SSc patients and whether there is any correlation between Hcy levels and RP, Gastro intestinal and lung involvement. Forty one patients who fulfilled the diagnostic criteria for SSc (39 females and 5 males) and Forty four community-based healthy individuals (sex and age matched) were enrolled in to the study. Serum Hcy, vitamin B12, and folate levels were determined. Thirty three patients (70.45%) had GI involvement, twenty two patients (50%) had lung involvement and twenty seven patients (61.36%) had Raynaud's phenomena. Mean serum Hcy level in control group was 22.78 ± 6.018 μmol/L and in case group was 19.43 ± 7.205 μmol/L, shows that the serum Hcy level in control group was significantly higher than patients (P = 0.020). Serum Hcy level is significantly lower in SSc patients than in control group. There is no statistically significant correlation between serum Hcy level and organ involvements.

Project Method, as One of the Basic Methods of Environmental Education

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Szállassy, Noémi

2008-01-01

Our aim was to present in this paper the one of the most important methods of environmental education, the project method. We present here the steps and phases of project method and we give an example of how to use these elements in planning an activity for celebrating the World Day for Water.

Detection of Chlamydia pneumoniae in Ankylosing Spondylitis Patients

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Dunya Fareed Salloom

2018-03-01

Full Text Available Ankylosing spondylitis is a complex debilitating disease because its pathogenesis is not clear. This study aims at detecting some pathogenesis factors that lead to induce the disease. Chlamydia pneumoniae is one of these pathogenesis factors which acts as a triggering factor for the disease. The study groups included forty Iraqi Ankylosing spondylitis patients and forty healthy persons as a control group. Immunological and molecular examinations were done to detect Chlamydia. pneumoniae in AS group. The immunological results were performed by Enzyme-Linked Immunosorbent Assay (ELISA to detect anti-IgG and anti-IgM antibodies of C. pneumoniae revealed that five of forty AS patients' samples (12.5% were positive for anti-IgG and IgM C. pneumoniae antibodies compared to controls which revealed seronegative. Molecular detection included 16srRNA and HSP-70 genes were to ensure the serological examination for detection of bacteria in the five blood samples which were positive; therefore, these results improved that C. pneumoniae played a role in the pathogenesis of the disease.

One Year Study of Chest X-Ray Changes in Opiate -poisoned Patients in Hamadan

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Jafari M.R.

2010-06-01

Full Text Available Background and Objectives: Intoxication with opiates is one of the most common causes of referring to emergency departments in Iran. Because respiratory signs are one of the most common and important signs in these patients, this study was designed to evaluate the chest x-ray changes of the patients.Methods: The present study was a cross-sectional one. The changes noted in the Chest X-Ray (CXR of the patients having been intoxicated with opiates and referred with respiratory signs of intoxication during the one year period between July 2007 till July 2008 to Farshchian Hospital in Hamadan were studied. The data, then, were gathered and analyzed using T and chi-square statistical tests.Results: Out of 1698 patients having referred due to poisoning with drugs and chemical agents, 318(18.72% patients were admitted due to opiates intoxication. Among them, 214 (67.29% had respiratory signs. 84.1% were male and 15.9% were female. Their average age was 35.6. The most important substance used was opium (57.5%.Most of the cases (84.1% were due to abuse. The most common physical signs were: miosis (83.6%, respiratory distress (74.8%, rales & wheezing (67.3%. The most common radiographic abnormality was pulmonary edema (14.5%. And the most common substance causing pulmonary edema was crack (59.4% revealing a significant statistical difference (p=0.001. Conclusion: As expected, one of the most important complications and common causes of death in opiate-poisoned patients was respiratory problems; we suggest that physicians and staffs working in the emergency department be well-trained in management of such patients.Keywords: Radiography, Thoracic; Analgesics, Opioid; Poisoning; Pulmonary Edema.

Characteristics, outcome and predictors of one year mortality rate in patients with acute heart failure

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Banović Marko

2011-01-01

Full Text Available Background/Aim. Acute heart failure (AHF is one of the most common diseases in emergency medicine, associated with poor prognosis and high in-hospital and longterm mortality. The aim of this study was to investigate characteristics, outcomes and one year mortality of patients with AHF in the local population. Methods. This prospective study consisted of 64 consecutive unselected patients treated in the Coronary Care Unit of the Emergency Centre (Clinical Center of Serbia, Belgrade and were followed for one year after the discharge. Results. Mean age of the patients was 63.6 ± 12.6 years and 59.4% were males. Acute congestion (43.8% and pulmonary edema (39.1% were the most common presentations of AHF. Mean left ventricular ejection fraction (LVEF was 39.7% ± 9.25%, while 44.4% of the patients had LVEF ≥ 50%. At discharge, 55.9% of the patients received therapy with β-blockers, 94.9% diuretics, out of which 47.7% spironolactone, 94.9% patients were given ACE-inhibitors or angiotensin receptor blokcers (ARB. The 12-month all-cause mortality was 26.5%. Independent predictors of one year mortality were previous hospitalization due to heart disease, reduced LVEF, reduced fraction of shortening (FS and a higher tricuspid velocity. Conclusion. One year mortality of our patients with AHF was high, similar to the known European studies. Independent predictors of one year mortality were previous hospitalization due to heart disease, reduced LVEF and LVFS and a higher tricuspid velocity.

Comparing the Recognition of Emotional Facial Expressions in Patients with

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Abdollah Ghasempour

2014-05-01

Full Text Available Background: Recognition of emotional facial expressions is one of the psychological factors which involve in obsessive-compulsive disorder (OCD and major depressive disorder (MDD. The aim of present study was to compare the ability of recognizing emotional facial expressions in patients with Obsessive-Compulsive Disorder and major depressive disorder. Materials and Methods: The present study is a cross-sectional and ex-post facto investigation (causal-comparative method. Forty participants (20 patients with OCD, 20 patients with MDD were selected through available sampling method from the clients referred to Tabriz Bozorgmehr clinic. Data were collected through Structured Clinical Interview and Recognition of Emotional Facial States test. The data were analyzed utilizing MANOVA. Results: The obtained results showed that there is no significant difference between groups in the mean score of recognition emotional states of surprise, sadness, happiness and fear; but groups had a significant difference in the mean score of diagnosing disgust and anger states (p<0.05. Conclusion: Patients suffering from both OCD and MDD show equal ability to recognize surprise, sadness, happiness and fear. However, the former are less competent in recognizing disgust and anger than the latter.

Automated patient and medication payment method for clinical trials

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Yawn BP

2013-01-01

Full Text Available Barbara P Yawn,1 Suzanne Madison,1 Susan Bertram,1 Wilson D Pace,2 Anne Fuhlbrigge,3 Elliot Israel,3 Dawn Littlefield,1 Margary Kurland,1 Michael E Wechsler41Olmsted Medical Center, Department of Research, Rochester, MN, 2UCDHSC, Department of Family Medicine, University of Colorado Health Science Centre, Aurora, CO, 3Brigham and Women's Hospital, Pulmonary and Critical Care Division, Boston, MA, 4National Jewish Medical Center, Division of Pulmonology, Denver, CO, USABackground: Published reports and studies related to patient compensation for clinical trials focus primarily on the ethical issues related to appropriate amounts to reimburse for patient's time and risk burden. Little has been published regarding the method of payment for patient participation. As clinical trials move into widely dispersed community practices and more complex designs, the method of payment also becomes more complex. Here we review the decision process and payment method selected for a primary care-based randomized clinical trial of asthma management in Black Americans.Methods: The method selected is a credit card system designed specifically for clinical trials that allows both fixed and variable real-time payments. We operationalized the study design by providing each patient with two cards, one for reimbursement for study visits and one for payment of medication costs directly to the pharmacies.Results: Of the 1015 patients enrolled, only two refused use of the ClinCard, requesting cash payments for visits and only rarely a weekend or fill-in pharmacist refused to use the card system for payment directly to the pharmacy. Overall, the system has been well accepted by patients and local study teams. The ClinCard administrative system facilitates the fiscal accounting and medication adherence record-keeping by the central teams. Monthly fees are modest, and all 12 study institutional review boards approved use of the system without concern for patient

Surgical management of cervical spine instability in Rheumatoid Arthritis patients

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Pedro Miguel Marques

2015-01-01

Full Text Available Aim: Cross-sectional study that aims to evaluate the results of cervical spine surgeries due to rheumatoid arthritis (RA instability, between January of 2000 and of 2012 in a main Portuguese centre Methods: Patients followed on Rheumatology submitted to cervical spine fusion due to atlantoaxial (AAI, sub-axial (SAI or cranio-cervical (CCI instabilities between 2000-2012 were included. Information about the surgical procedure and associated complications was gathered and imagiologic and clinical indexes before and after surgery (as anterior and posterior atlanto-axial interval and Ranawat index were evaluated and compared using adequate statistics. Results: Forty-five patients with RA were included: 25 with AAI, 13 with CCI and 7 with SAI. Ten AAI and 4 CCI patients were submitted to wiring stabilization techniques; 15 AAI and 9 CCI patients to rigid ones; and in all patients with SAI an anterior cervical arthrodesis was chosen. There is a significant increase in PADI and a decrease in AADI in the postoperative evaluation (p

An configuration method of patient service cloud for the home patient with multi sensor network

International Nuclear Information System (INIS)

Noji, Tamotsu; Arino, Masashi; Saito, Mayuko; Horii, Minoru; Ogino, Tadashi; Suto, Yasuzo; Sasaki, Hitoshi; Mansei, Kouiti

2010-01-01

We are advancing the research of patient service cloud in the global medical collaboration network system based on 3D electronic referral letters. In this paper it proposes one configuration method of private cloud that aims at the home care patient's health care and independence support based on voice navigation system (VONAVS). We evaluate 3D image compression rate, try image compositing Cloud's configuration by the multi sensor network, and search for the configuration method of the remote image diagnosis. The proposed configuration method expands the possibility to the global medical collaboration network system for new large areas such as a telemedicine, an emergency care, and home medical care. (author)

The effect of chronic lymphocytic thyroiditis on patients with thyroid cancer.

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Zhang, Yi; Ma, Xiao-Peng; Deng, Fu-Sheng; Liu, Zheng-Rong; Wei, Hou-Qing; Wang, Xi-Hong; Chen, Hao

2014-09-01

The purpose of this study was to investigate the association between chronic lymphocytic thyroiditis (CLT) and malignant tumors of the thyroid. A retrospective review of 647 patients who underwent thyroid surgery at the Department of Breast and Thyroid Surgery in Anhui Provincial Hospital, China in 2012 was performed. The clinicopathological characteristics of patients with thyroid malignancies and CLT were collected. CLT was diagnosed by histopathological method. Among 647 patients, 144 patients had thyroid malignancies and 108 patients had been diagnosed with CLT. Moreover, in total, 44 patients had thyroid malignancies coexistent with CLT: forty-one (93.2%) patients had been diagnosed with the papillary thyroid cancer (PTC); two (4.5%) patients suffered from medullary carcinoma; and one (2.3%) patient suffered from lymphoma. The morbidity of thyroid malignancies in patients with CLT was significantly higher than that in patients without CLT (40.7% versus 18.6%; P CLT compared with those without CLT (P CLT and without CLT. Female predominance was observed in patients with CLT. CLT may have no effect on the progression of thyroid malignant tumor. Nevertheless, the influences of CLT on the prognosis of the thyroid carcinoma still need to be investigated with a larger sample size.

One method for financing America's uninsured.

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Liberman, Aaron; Rotarius, Timothy

2009-01-01

The United States has 45 million individuals who lack health insurance, causing them to experience higher morbidity and mortality rates. One method for funding the uninsured includes creating an annuity (federally funded at $1,000 per year for the first 5 years of one's life) for each newborn. When the annuity matures, at the age of 45 years, the individual will have a large health care fund. When coupled with options such as familial vesting, within a few generations, these annuities have the capacity to ultimately provide health care coverage from birth through old age.

Computer assisted strain-gauge plethysmography is a practical method of excluding deep venous thrombosis

International Nuclear Information System (INIS)

Goddard, A.J.P.; Chakraverty, S.; Wright, J.

2001-01-01

AIM: To evaluate a computed strain-gauge plethysmograph (CSGP) as a screening tool to exclude above knee deep venous thrombosis (DVT). METHODS: The first phase took place in the Radiology department. One hundred and forty-nine patients had both Doppler ultrasound and CSGP performed. Discordant results were resolved by venography where possible. The second phase took place in an acute medical admissions ward using a modified protocol. A further 173 patients had both studies performed. The results were collated and analysed. RESULTS: Phase 1. The predictive value of a negative CSGP study was 98%. There were two false-negative CSGP results (false-negative rate 5%), including one equivocal CSGP study which had deep venous thrombosis on ultrasound examination. Two patients thought to have thrombus on ultrasound proved not to have acute thrombus on venography. Phase 2. The negative predictive value of CSGP using a modified protocol was 97%. There were two definite and one possible false-negative studies (false-negative rate 4-7%). CONCLUSION: Computer strain-gauge plethysmograph can provide a simple, cheap and effective method of excluding lower limb DVT. However, its use should be rigorously assessed in each hospital in which it is used. Goddard, A.J.P., Chakraverty, S. and Wright, J. (2001)

A randomized clinical trial comparing fitness and biofeedback training versus basic treatment in patients with fibromyalgia

NARCIS (Netherlands)

van Santen, Marijke; Bolwijn, Paulien; Verstappen, Frans; Bakker, Carla; Hidding, Alita; Houben, Harry; van der Heijde, Desiree; Landewé, Robert; van der Linden, Sjef

2002-01-01

To compare the therapeutic effects of physical fitness training or biofeedback training with the results of usual care in patients with fibromyalgia (FM). One hundred forty-three female patients with FM (American College of Rheumatology criteria) were randomized into 3 groups: a fitness program (n =

Forty Years Abuse of Baking Soda, Rhabdomyolysis, Glomerulonephritis, Hypertension Leading to Renal Failure: A Case Report

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Terje Forslund M.D., Ph.D.

2008-01-01

Full Text Available We present a patient who had ingested sodium bicarbonate for treatment of alcoholic dyspepsia during forty years at increasing doses. During the last year he had used more than 50 grams daily. He presented with metabolic alkalosis, epileptic convulsions, subdural hematoma, hypertension and rhabdomyolysis with end stage renal failure, for which he had to be given regular intermittent hemodialysis treatment. Untreated hypertension and glomerulonephritis was probably present prior to all these acute incidents. Examination of the kidney biopsy revealed mesangial proliferative glomerulonephritis and arterial wall thickening causing nephrosclerosis together with interstitial calcinosis. The combination of all these pathologic changes might be responsible for the development of progressive chronic renal failure ending up with the need for continuous intermittent hemodialysis treatment.

Forty years abuse of baking soda, rhabdomyolysis, glomerulonephritis, hypertension leading to renal failure: a case report.

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Forslund, Terje; Koistinen, Arvo; Anttinen, Jorma; Wagner, Bodo; Miettinen, Marja

2008-01-01

We present a patient who had ingested sodium bicarbonate for treatment of alcoholic dyspepsia during forty years at increasing doses. During the last year he had used more than 50 grams daily. He presented with metabolic alkalosis, epileptic convulsions, subdural hematoma, hypertension and rhabdomyolysis with end stage renal failure, for which he had to be given regular intermittent hemodialysis treatment. Untreated hypertension and glomerulonephritis was probably present prior to all these acute incidents. Examination of the kidney biopsy revealed mesangial proliferative glomerulonephritis and arterial wall thickening causing nephrosclerosis together with interstitial calcinosis. The combination of all these pathologic changes might be responsible for the development of progressive chronic renal failure ending up with the need for continuous intermittent hemodialysis treatment.

Locking plates in distal humerus fractures: study of 43 patients

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Gupta Rakesh Kumar

2013-08-01

Full Text Available 【Abstract】Objective: The treatment of multi-fragmentary, intraarticular fractures of the distal humerus is difficult, even in young patients with bone of good quality. Small distal fragment, diminished bone mineral quality and increased trauma-associated joint destruction make stable joint reconstruction more problematic. The anatomically preshaped locking plates allow angular stable fixation for these complex fractures. We evaluated functional results of patients treated with open reduction and internal fixation with distal humerus locking plates for complex distal hu-merus fractures. Methods: Forty-three consecutive patients with ar-ticular fractures of the distal humerus were treated by open reduction and internal fixation with AO distal humerus plate system and locking reconstruction plates. Forty patients were available for the final outcome analysis. According to AO/ASIF classification, there were 2 cases of type A2, 4 cases of type A3, 1 case of type B1, 1 case of type B2, 14 cases of type C1, 7 cases of type C2 and 11 cases of type C3. Open reduction with triceps splitting technique was used in all patients. The clinical and radiographic follow-up was performed and outcome measures included pain assessment, range of motion, and Mayo elbow performance score. Results: Forty patients were available for the final outcome analysis. There were 29 males and 11 females with an average age of 38.4 years (18-73 years. Clinical and ra-diological consolidation of the fracture was observed in all cases at an average of 11.6 weeks (9-14 weeks. The average follow-up was 12 months (10-18 months. Using the Mayo elbow performance score the results obtained were graded as excellent or good results in 33 patients (82.5%. One pa-tient had superficial infection, and 4 had myositis ossificans. There were no cases of primary malposition or secondary displacement, implant failure or ulnar neuropathy. Conclusion: Anatomically preshaped distal humerus locking

Patient's perception, compliance to treatment and health education of antiretroviral therapy among HIV patients at a tertiary healthcare setting

International Nuclear Information System (INIS)

Hussain, A.R.; Abbas, S.M.; Reza, T.E

2013-01-01

Objective: To illustrate perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy among HIV and AIDS patients. Methods: The cross-sectional survey was carried out at the HIV Treatment Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 2009 to February 2010 in which patients were interviewed separately regarding their perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy. All data collected was entered into SPSS version 15.0. The data was re-validated and analysed. Results: One hundred and forty patients were interviewed; there were 99 (70.7%) males.. Of the total, 28 (20%) had no knowledge about the beneficial effects of the therapy, and 45 (32 %) ranked health education services extremely beneficial in understanding the anti-retrovival therapy. Conclusion: While a significant proportion of patients considered ART either somewhat beneficial or beneficial in treating their ailment, they were unclear about the impact of health education provided at the treatment centre and different forms of print media. (author)

Variational iteration method for one dimensional nonlinear thermoelasticity

International Nuclear Information System (INIS)

Sweilam, N.H.; Khader, M.M.

2007-01-01

This paper applies the variational iteration method to solve the Cauchy problem arising in one dimensional nonlinear thermoelasticity. The advantage of this method is to overcome the difficulty of calculation of Adomian's polynomials in the Adomian's decomposition method. The numerical results of this method are compared with the exact solution of an artificial model to show the efficiency of the method. The approximate solutions show that the variational iteration method is a powerful mathematical tool for solving nonlinear problems

Proportion of sexually transmitted infections in patients attending the ...

African Journals Online (AJOL)

... at Umdurman Military Hospital in the period August, 2000 to March, 2001. Forty patients were selected. The results showed four cases (10 %) of gonorrhoea, three cases (7.5%) of chlamydia, two cases (5%) of candida and one case (2.5%) of Trichomonas vaginalis. Five cases of syphilis were associated with gonorrhea.

The one-stop clinic as the standard of out-patient care in a hospital urology department

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Alvaro Páez

2011-10-01

Full Text Available PURPOSE: To evaluate the performance of a 'one-stop' clinic in terms of proportion of discharges or inclusion in surgical waiting lists. MATERIALS AND METHODS: All patients were referred from primary care facilities (population 220.646 and from different departments in the hospital. Eight senior urologists, two registered nurses and two nurse attendants participated in the experience. Prior to the start of the project, referral protocols had been agreed with the primary care physicians involved. Compliance with the protocols was periodically tested. Eventually 5537 first visits (January-December 2009 where evaluable. RESULTS: Overall, the 'one-stop' format proved feasible in 74.2% of the patients (4108/5537. Patients, who successfully used the 'one-stop' format, were significantly younger than those who required additional consultations (43 vs 50 years old, respectively, Student's t test < 0.001. For obvious reasons the 'one-stop' format was universally possible in male sterilization and penile phimosis patients. Similarly, the 'one-stop' policy was applied in most consultations due to male sexual dysfunction (75% and urinary tract infection (73%. Other health problems, such as haematuria (62% and renal colic (46%, required more than one visit so that care of the patient reverted to the traditional, outpatient care model. CONCLUSION: A 'one-stop' philosophy is feasible for a number of procedures in a urological outpatient clinic. The costs to implement such an approach would be limited to managerial expenditure.

Image quality and patient acceptance of four regimens with different amounts of mild laxatives for CT colonography

NARCIS (Netherlands)

Jensch, Sebastiaan; de Vries, Ayso H.; Pot, Dennis; Peringa, Jan; Bipat, Shandra; Florie, Jasper; van Gelder, Rogier E.; Stoker, Jaap

2008-01-01

OBJECTIVE: The purpose of our study was to prospectively evaluate image quality and patient acceptance of CT colonography (CTC) with fecal tagging using different levels of catharsis. SUBJECTS AND METHODS: Forty consecutive increased-risk patients were randomized. Group 1 received orally 20 mg of

Work-related physical and psychosocial risk factors for sick leave in patients with neck or upper extremity complaints

NARCIS (Netherlands)

Bot, S.D.M.; Terwee, C.B.; Windt, D.A.W.M. van der; Beek, A.J. van der; Bouter, L.M.; Dekker, J.

2007-01-01

Objectives: To study work-related physical and psychosocial risk factors for sick leave among patients who have visited their general practitioner for neck or upper extremity complaints. Methods: Three hundred and forty two patients with neck or upper extremity complaints completed self-report

Validity and reliability of short form-12 questionnaire in Iranian hemodialysis patients

DEFF Research Database (Denmark)

Pakpour, Amir H.; Nourozi, Saeedeh; Mølsted, Stig

2011-01-01

INTRODUCTION: The aim of the study was to assess the validity and reliability of the SF-12 questionnaire in a sample of Iranian patients undergoing hemodialysis. MATERIALS AND METHODS: One hundred and forty-four hemodialysis patients were included from dialysis centers in Zanjan, Iran, and were...... asked to complete the SF-12 and SF-36 questionnaires. An initial test-retest reliability evaluation was performed on a sample of 70 patients from the total group, with a retest interval of 14 days. Reliability was estimated by internal consistency and validity was assessed using known-group comparisons...... and construct validity on the patient group as a whole. A linear regression analysis was used to assess any variation in the physical component summary and mental component summary scores of the SF-36 with the respective component summary scores of the SF-12. In addition, the factor structure...

Correlations between cutaneous malignant melanoma and other cancers: An ecological study in forty European countries

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Pablo Fernandez-Crehuet Serrano

2016-01-01

Full Text Available Background: The presence of noncutaneous neoplasms does not seem to increase the risk of cutaneous malignant melanoma; however, it seems to be associated with the development of other hematological, brain, breast, uterine, and prostatic neoplasms. An ecological transversal study was conducted to study the geographic association between cutaneous malignant melanoma and 24 localizations of cancer in forty European countries. Methods: Cancer incidence rates were extracted from GLOBOCAN database of the International Agency for Research on Cancer. We analyzed the age-adjusted and gender-stratified incidence rates for different localizations of cancer in forty European countries and calculated their correlation using Pearson′s correlation test. Results: In males, significant correlations were found between cutaneous malignant melanoma with testicular cancer (r = 0.83 [95% confidence interval (CI: 0.68-0.89], myeloma (r = 0.68 [95% CI: 0.46-0.81], prostatic carcinoma (r = 0.66 [95% CI: 0.43-0.80], and non-Hodgkin lymphoma (NHL (r = 0.63 [95% CI: 0.39-0.78]. In females, significant correlations were found between cutaneous malignant melanoma with breast cancer (r = 0.80 [95% CI: 0.64-0.88], colorectal cancer (r = 0.72 [95% CI: 0.52-0.83], and NHL (r = 0.71 [95% CI: 0.50-0.83]. Conclusions: These correlations call to conduct new studies about the epidemiology of cancer in general and cutaneous malignant melanoma risk factors in particular.

Where Anthropology Meets History—A Review of "Tracing China: A Forty-Year Ethnographic Journey," by Helen F. Siu

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May Bo Ching

2017-09-01

Full Text Available Helen F. Siu. Tracing China: A Forty-Year Ethnographic Journey. Hong Kong: Hong Kong University Press, 2016. ISBN: 9789888083732. For years, Helen Siu tangoed with history and trekked the fields of South China. "Tracing China: A Forty-Year Ethnographic Journey"(Hong Kong University Press, 2016—a collection of Siu’s work published over the last twenty years—is not a grandiose showpiece splotched with a lot of paint and colors. Instead, she uses a 2B pencil to leave fine marks on wafer-thin parchment and smudges them ever so slightly, gradually letting the image emerge through the back of the page. If I have understood correctly, though plurality exists in the meanings of “trace,” Siu’s intention with the title Tracing China is less to track the history of China, and more to scrupulously examine every footstep she comes across, no matter how indistinct—to “look for plum blossoms in the snow,” as the Chinese saying goes. This saying might have inspired the Chinese version of the title of the collection, one that preserves a sense of graceful subtlety...

Evaluation of micronutrient (Zinc, Magnesium, and Copper levels in serum and glycemic status after nonsurgical periodontal therapy in type 2 diabetic patients with chronic periodontitis

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Gopalakrishnan Sundaram

2017-01-01

Full Text Available Aims and Objectives: To find out the effect of nonsurgical periodontal therapy on serum zinc (Zn, magnesium (Mg, and copper (Cu concentration and glycemic status in type 2 diabetes with chronic periodontitis (CP. Materials and Methods: One hundred and twenty patients were included in this study, which was further divided into three groups. Group 1 consisted of forty patients with CP, Group 2 consisted of forty patients of CP with controlled diabetes, and Group 3 consisted of forty patients of CP with uncontrolled diabetes. Periodontal parameters such as plaque index, gingival index, bleeding on probing, pocket depth, and clinical attachment levels (CALs were evaluated. Blood samples were collected to assess the levels of fasting blood sugar, glycosylated hemoglobin, Zn, Mg, and Cu. All parameters were evaluated at baseline and 3 months after nonsurgical periodontal therapy. Results: The results showed statistically significant reduction in all the clinical parameters within the groups except for the CAL in group 1 patients (P = 0.05. The glycemic status also showed a statistically significant reduction after treatment (P < 0.001. The intragroup comparison was taken between the values of micronutrients, showed substantial increase in the levels of both Zn and Mg and decrease in the level of Cu after nonsurgical periodontal treatment (P < 0.001. Conclusion: Patients with diabetes and periodontitis had altered metabolism of Zn, Mg, and Cu contributing to the progression and complication of diabetes mellitus and periodontitis. Nonsurgical periodontal treatment improved the variation and concentration of plasma micronutrients and also the periodontal status and glycemic level.

Caring touch as a bodily anchor for patients after sustaining a motor vehicle accident with minor or no physical injuries - a mixed methods study.

Science.gov (United States)

Airosa, Fanny; Arman, Maria; Sundberg, Tobias; Öhlén, Gunnar; Falkenberg, Torkel

2016-03-22

Patients who sustain a motor vehicle accident may experience long-term distress, even if they are uninjured or only slightly injured. There is a risk of neglecting patients with minor or no physical injuries, which might impact future health problems. The aim of this study was to explore patients' subjective experiences and perspectives on pain and other factors of importance after an early nursing intervention consisting of "caring touch" (tactile massage and healing touch) for patients subjected to a motor vehicle accident with minor or no physical injuries. A mixed method approach was used. The qualitative outcomes were themes derived from individual interviews. The quantitative outcomes were measured by visual analogue scale for pain (VAS, 0-100), sense of coherence (SOC), post-traumatic stress (IES-R) and health status (EQ-5D index and EQ-5D self-rated health). Forty-one patients of in total 124 eligible patients accepted the invitation to participate in the study. Twenty-seven patients completed follow-up after 6 months whereby they had received up to eight treatments with either tactile massage or healing touch. Patients reported that caring touch may assist in trauma recovery by functioning as a physical "anchor" on the patient's way of suffering, facilitating the transition of patients from feeling as though their body is "turned off" to becoming "awake". By caring touch the patients enjoyed a compassionate care and experience moments of pain alleviation. The VAS pain ratings significantly decreased both immediately after the caring touch treatment sessions and over the follow-up period. The median scores for VAS (p touch intervention is associated with patients' report of decreased pain and improved wellbeing up to 6 months after the accident. ClinicalTrials.gov Id: NCT02610205 . Date 25 November 2015.

Evaluation of Salivary Glucose, IgA and Flow Rate in Diabetic Patients: A Case-Control Study

OpenAIRE

Bakianian Vaziri, P.; Vahedi, M.; Mortazavi, H.; Abdollahzadeh, Sh.; Hajilooi, M.

2010-01-01

Objective: An association between diabetes mellitus and alterations in the oral cavity has been noted. In this study, we evaluated differences between salivary IgA, glucose and flow rate in diabetic patients compared with healthy controls. Materials and Methods: Forty patients with type 1 diabetes, 40 patients with type 2 diabetes and 40 healthy controls were selected. Whole unstimulated saliva samples were collected by the standard method and the salivary flow rate was determined. Nephelomet...

Microscopy outperformed in a comparison of five methods for detecting Trichomonas vaginalis in symptomatic women.

Science.gov (United States)

Nathan, B; Appiah, J; Saunders, P; Heron, D; Nichols, T; Brum, R; Alexander, S; Baraitser, P; Ison, C

2015-03-01

In the UK, despite its low sensitivity, wet mount microscopy is often the only method of detecting Trichomonas vaginalis infection. A study was conducted in symptomatic women to compare the performance of five methods for detecting T. vaginalis: an in-house polymerase chain reaction (PCR); Aptima T. vaginalis kit; OSOM ®Trichomonas Rapid Test; culture and microscopy. Symptomatic women underwent routine testing; microscopy and further swabs were taken for molecular testing, OSOM and culture. A true positive was defined as a sample that was positive for T. vaginalis by two or more different methods. Two hundred and forty-six women were recruited: 24 patients were positive for T. vaginalis by two or more different methods. Of these 24 patients, 21 patients were detected by real-time PCR (sensitivity 88%); 22 patients were detected by the Aptima T. vaginalis kit (sensitivity 92%); 22 patients were detected by OSOM (sensitivity 92%); nine were detected by wet mount microscopy (sensitivity 38%); and 21 were detected by culture (sensitivity 88%). Two patients were positive by just one method and were not considered true positives. All the other detection methods had a sensitivity to detect T. vaginalis that was significantly greater than wet mount microscopy, highlighting the number of cases that are routinely missed even in symptomatic women if microscopy is the only diagnostic method available. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Value of Multidetector Computed Tomography in Assessing Blunt Multitrauma Patients

Energy Technology Data Exchange (ETDEWEB)

Ahvenjaervi, L.; Mattila, L.; Ojala, R.; Tervonen, O. [Oulu Univ. Hospital (Finland). Dept. of Diagnostic Radiology

2005-04-01

Purpose: To find out if multidetector computed tomography (MDCT), using a dedicated trauma protocol, provides sufficient diagnostic information of the injuries of blunt multitrauma patients to enable the planning of treatment for all body compartments. Material and Methods: One-hundred-and-thirty-three patients exposed to high-energy trauma were referred and scanned with the standardized MDCT multitrauma protocol. The imaging protocol consisted of axial scanning of the head and helical scanning of the facial bones, cervical spine, thorax, abdomen, and pelvis. The scanning times were 12 s for the head, 19-21 s for the facial bones and cervical spine (1 mm collimation), and 32-50 s for the thorax, abdomen, and pelvis (2 mm collimation). One-hundred-and-forty milliliters of non-iodinated contrast material (300 mg I/ml) was administered intravenously at 3 ml/s. Results: Ninety-nine of the patients (74%) had at least one finding consistent with trauma. The most frequent findings were in the thorax in 58 patients (44%). Nineteen false-negative findings and two false-positive findings were made. The overall sensitivity of MDCT was 94%, specificity 100%, and accuracy 97%. Conclusion: MDCT is accurate in the assessment of blunt multitrauma patients. The decision to treat the patient can be made on the basis of MDCT with a reasonable level of certainty.

A case study of systemic curricular reform: A forty-year history

Science.gov (United States)

Laubach, Timothy Alan

What follows is a description of the development of a particular inquiry-based elementary school science curriculum program and how its theoretical underpinnings positively influenced a school district's (K-12) science program and also impacted district- and state-wide curriculum reform initiatives. The district's science program has evolved since the inception of the inquiry-based elementary school science curriculum reform forty years ago. Therefore, a historical case study, which incorporated grounded theory methodology, was used to convey the forty-year development of a science curriculum reform effort and its systemic influences. Data for this study were collected primarily through artifacts, such as technical and non-technical documents, and supported and augmented with interviews. Fifteen people comprised the interview consortium with professional responsibilities including (a) administrative roles, such as superintendents, assistant superintendents, principals, and curriculum consultants/coordinators; (b) classroom roles, such as elementary and secondary school teachers who taught science; (c) partnership roles, such as university faculty who collaborated with those in administrative and classroom positions within the district; and (d) the co-director of SCIS who worked with the SCIS trial center director. Data were analyzed and coded using the constant comparative method. The analysis of data uncovered five categories or levels in which the curriculum reform evolved throughout its duration. These themes are Initiation, Education, Implementation, Confirmation, and Continuation. These five categories lead to several working hypotheses that supported the sustaining and continuing of a K-12 science curriculum reform effort. These components are a committed visionary; a theory base of education; forums promoting the education of the theory base components; shared-decision making; a university-school partnership; a core group of committed educators and teachers

From Forty-to-One to One-to-One: Eliminating the Digital Divide and Making Equity Actionable

Science.gov (United States)

Mucetti, Rosanna

2017-01-01

This article shows how the adoption of technology may serve as a catalyst for deeper, systemic reforms. This article shares a local case of organizational learning in which a midsize California urban school district faithfully acted on a technology goal nested in its strategic plan. Through this experience, the school district demonstrated various…

Increased diagnostic yield of capsule endoscopy in patients with chronic abdominal pain.

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Liping Yang

Full Text Available BACKGROUND AND STUDY AIMS: Chronic abdominal pain is one of the most common chief complaints, but the underlying pathophysiology often remains unknown after routine clinical evaluation. Capsule endoscopy (CE is a new technique for the visualization of the entire small bowel. The aim of this study was to evaluate the diagnostic efficacy of CE in patients with chronic abdominal pain of obscure origin. PATIENTS AND METHODS: Two hundred forty three patients with chronic abdominal pain with no significant lesions were enrolled in this study. CE was performed in all patients. RESULTS: A diagnosis was made in 23.0% of patients screened with CE. Of the 243 patients, 19 (7.8% were diagnosed with Crohn's disease, 15 (6.2% with enteritis, 11 (4.5% with idiopathic intestinal lymphangiectasia, 5 (2.1% with uncinariasis, and a number of other diagnoses including small bowel tumor, ascariasis, and anaphylactoid purpura. Five patients had abnormal transit time, and capsule retention occurred in two patients. CONCLUSIONS: In contrast to other previous studies, we found that CE is an effective diagnostic tool for patients with abdominal pain.

Estimation of throium deposited in thorotrast patients by whole body counter

International Nuclear Information System (INIS)

Tatsumi-Miyajima, Junko; Okajima, Shunzo; Takao, Hideaki; Norimura, Toshiyuki.

1986-01-01

Thorotrast, a colloidal solution of thorium dioxide was injected to wounded soldiers, for angiography from 1930 to 1945. The patients who received Thorotrast are interesting objects for finding a biological effect due to the internal irradiation by 232 Th. To determine a distribution and body burden of 232 Th, forty-one Thorotrast patients were measured their gamma-rays with a pair of NaI(T1) scintillation detectors coaxially positioned above and below the coach in the whole body counter of Nagasaki University. The comparison between the usual method using constant values and the method using individual values depend on the organ positions determined with CT (Computed Tomography) scanner for patients was performed to estimate the errors due to the individual differences in the detection efficiency of 232 Th. From the results, the estimates by the whole body counter of the amounts of 232 Th deposits in abdominal region were obtained within the uncertainties of 16 %. And the absorbed dose in the liver and the spleen was also estimated from the amounts of 232 Th. (author)

Canada's uranium future, based on forty years of development

International Nuclear Information System (INIS)

Aspin, N.; Dakers, R.G.

1982-09-01

Canada's role as a major supplier of uranium has matured through the cyclical markets of the past forty years. Present resource estimates would support a potential production capability by the late 1980s 50 per cent greater than the peak production of 12 200 tonnes uranium in 1959. New and improved exploration techniques are being developed as uranium deposits become more difficult to discover. Radiometric prospecting of glacial boulder fields and the use of improved airborne and ground geophysical methods have contributed significantly to recent discoveries in Saskatchewan. Advances have also been made in the use of airborne radiometric reconnaissance, borehole logging, emanometry (radon and helium gas) and multi-element regional geochemistry techniques. Higher productivity in uranium mining has been achieved through automation and mechanization, while improved ventilation systems in conjunction with underground environmental monitoring have contributed to worker health and safety. Improved efficiency is being achieved in all phases of ore processing. Factors contributing to the increased time required to develop uranium mines and mills from a minimum of three years in the 1950s to the ten years typical of today, are discussed. The ability of Canada's uranium refinery to manufacture ceramic grade UO 2 powder to consistent standards has been a major factor in the successful development of high density natural uranium fuel for the CANDU (CANada Deuterium Uranium) reactor. Over 400 000 fuel assemblies have been manufactured by three companies. The refinery is undertaking a major expansion of its capacity

Prevalence of lung abnormalities in 55 patients with esophageal cancer

International Nuclear Information System (INIS)

Zan, Tiago Alves de Brito; Cordeiro, Jose Antonio; Franca, Fabricio Correa de; Muniz, Marcos Pontes; Borim, Aldenis Albenese; Cury, Patricia Maluf

2001-01-01

The objective was to identify lung abnormalities in patients with esophageal cancer, to compare the obtained data and to demonstrate its relationship with smoking. This was a series of cases type of cross-sectional study. We studied 55 patients with esophageal carcinoma diagnosed between 1998 and 2001 at Hospital de Base de Sao Jose do Rio Preto, SP, Brazil. Chest plain films and computed tomography scans were analyzed. The frequency of the tumors and other lung abnormalities in two groups of patients were compared: smokers and non-smokers. The results showed that forty-six (83%) patients had spinous cell carcinoma, seven (13%) adenocarcinomas, one (2%) carcinoma of small cells and one (2%) non-Hodgkin lymphoma. Forty-eight (87%) patients were smokers and seven (13%) were non-smokers. In the smokers group, 89% had spinous cell carcinoma, 9% adenocarcinoma and 2% small cells carcinoma. In the non-smokers group, 57% had adenocarcinoma, 28% spinous cell carcinoma and 15% non-Hodgkin lymphoma. Metastases were identified in four smokers and in two non-smokers. The prevalence of the lung abnormalities (interstitial infiltration, emphysema and pneumonia) was higher in the smokers group (73%) than in the non-smokers group (27%) (p = 0.03). We concluded that this fact reinforces the importance of evaluation of the lungs in patients with esophageal neoplasms. (author)

What is an acceptable outcome of treatment before it begins? Methodological considerations and implications for patients with chronic low back pain

DEFF Research Database (Denmark)

Lauridsen, Henrik; Manniche, Claus; Korsholm, Lars

2009-01-01

(LBP) patients' view of an acceptable change (MCID(pre)) before treatment begins. One-hundred and forty-seven patients with chronic LBP were recruited from an out-patient hospital back pain unit and followed over an 8-week period. Original and modified versions of the Oswestry disability index (ODI...

Neurological and functional outcomes of subdural hematoma evacuation in patients over 70 years of age

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Patrick Mulligan

2013-01-01

Full Text Available Background: Subdural hematoma (SDH is a common disease entity treated by neurosurgical intervention. Although the incidence increases in the elderly population, there is a paucity of studies examining their surgical outcomes. Objectives: To determine the neurological and functional outcomes of patients over 70 years of age undergoing surgical decompression for subdural hematoma. Materials and Methods: We retrospectively reviewed data on 45 patients above 70 years who underwent craniotomy or burr holes for acute, chronic or mixed subdural hematomas. We analyzed both neurological and functional status before and after surgery. Results: Forty-five patients 70 years of age or older were treated in our department during the study period. There was a significant improvement in the neurological status of patients from admission to follow up as assessed using the Markwalder grading scale (1.98 vs. 1.39; P =0.005, yet no improvement in functional outcome was observed as assessed by Glasgow Outcome Score. Forty-one patients were admitted from home, however only 20 patients (44% were discharged home, 16 (36% discharged to nursing home or rehab, 6 (13% to hospice and 3 (7% died in the postoperative period. Neurological function improved in patients who were older, had a worse pre-operative neurological status, were on anticoagulation and had chronic or mixed acute and chronic hematoma. However, no improvement in functional status was observed. Conclusion: Surgical management of SDH in patients over 70 years of age provides significant improvement in neurological status, but does not change functional status.

Cognition improvement in Taekwondo novices over forty. Results from the SEKWONDO Study.

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Gaby ePons Van Dijk

2013-11-01

Full Text Available AbstractAge-related cognitive decline is associated with increased risk of disability, dementia and death. Recent studies suggest improvement in cognitive speed, attention and executive functioning with physical activity. However, whether such improvements are activity specific is unclear.Therefore, we aimed to study the effect of one year age-adapted Taekwondo training on several cognitive functions, including reaction/ motor time, information processing speed, and working and executive memory, in 24 healthy volunteers over forty.Reaction and motor time decreased with 41.2 seconds and 18.4 seconds (p=0.004, p=0.015, respectively. Digit symbol coding task improved with a mean of 3.7 digits (p=0.017. Digit span, letter fluency, and trail making test task-completion-time all improved, but not statistically significant. The questionnaire reported better reaction time in 10 and unchanged in 9 of the nineteen study compliers. In conclusion, our data suggest that age-adapted Taekwondo training improves various aspects of cognitive function in people over 40, which may, therefore, offer a cheap, safe and enjoyable way to mitigate age-related cognitive decline.

Observations of pretreatment prostate-specific antigen doubling time in 107 patients referred for definitive radiotherapy

International Nuclear Information System (INIS)

Lee, W. Robert; Hanks, Gerald E.; Corn, Benjamin W.; Schultheiss, Timothy E.

1995-01-01

Purpose: To determine pretreatment prostate-specific antigen doubling times (PSADT) in patients referred for definitive radiotherapy. Methods and Materials: One hundred and seven patients with histologically proven nonmetastatic prostate cancer and an elevated prostate-specific antigen (PSA) who were referred for radiation therapy had three serum PSA values obtained prior to the start of definitive therapy. Prostate-specific antigen doubling times were calculated by linear regression. Results: Prostate-specific antigen values increased during the period of observation in 78 patients (73%). Forty-three patients (40%) had calculated PSADT of less than 2 years and of those patients with pretreatment serum PSA values of greater than 10 ng/mL more than 50% has calculated PSADT of less than 2 years. Conclusions: A significant minority of patients referred for radiotherapy have calculated PSADT of less than 2 years. The significance of this relatively fast growth rate is as yet undetermined, but suggests that patients referred for radiotherapy may have aggressive disease prior to treatment

Improving patient care trajectories: an innovative quasi-experimental research method for health services.

Science.gov (United States)

Campos, Eneida Rached; Moreira-Filho, Djalma de Carvalho; Silva, Marcos Tadeu Nolasco da

2018-05-01

Scores to predict treatment outcomes have earned a well-deserved place in healthcare practice. However, when used to help achieve excellence in the care of a given disease, scores should also take into account organizational and social aspects. This article aims to create scores to obtain key variables and its application in the management of care of a given disease. We present a method called Epidemiological Planning for Patient Care Trajectory (PELC) and its application in a research of HIV pediatric patients. This case study is presented by means of two studies. The first study deals with the development of the method PELC. The second is HIV Pediatric case-control study based on PELC method. HIV pediatric research - the first practical PELC application - found these four key variables to the individual quality level care trajectories: adherence to ART, attending at least one appointment with the otolaryngologist, attending at least one appointment with social services, and having missed one or more routine appointments. We believe PELC method can be used in researches about any kind of care trajectories, contributing to quality level advancements in health services, with emphasis on patient safety and equity in healthcare.

Radiation exposure estimation from patient treated by I-131

International Nuclear Information System (INIS)

Lahfi, Y.; Anjak, O.

2012-09-01

Radioactive iodine is the main radiopharmaceutical substance in the nuclear medicine field which used in diagnosis and treatment of patients suffering from thyroid cancer; thus it can be considered as the main source of the public and patient relative exposure. In this study, 192 patients were selected randomly and their radiation dose rate was measured at different levels of the patient's body (thyroid, knee, bladder) after one, twenty four and forty eight hours from availing the prescript quantity of the I-131. The collected data may serve in estimating the worker and public exposure related to the patient treated by I-131. (authors)

Who Produces Ianthelline? The Arctic Sponge Stryphnus fortis or its Sponge Epibiont Hexadella dedritifera: a Probable Case of Sponge-Sponge Contamination.

Science.gov (United States)

Cárdenas, Paco

2016-04-01

The bromotyrosine derivative ianthelline was isolated recently from the Atlantic boreo-arctic deep-sea sponge Stryphnus fortis, and shown to have clear antitumor and antifouling effects. However, chemosystematics, field observations, and targeted metabolic analyses (using UPLC-MS) suggest that ianthelline is not produced by S. fortis but by Hexadella dedritifera, a sponge that commonly grows on S. fortis. This case highlights the importance of combining taxonomic and ecological knowledge to the field of sponge natural products research.

Forty years of training program in the JAERI

International Nuclear Information System (INIS)

1998-03-01

This report is to compile the past training program of researchers, engineers and regulatory members at the NuTEC (Nuclear Technology and Education Center) of Japan Atomic Energy Research Institute and the past basic seminars for the public, in addition to advice and perspective on the future program from relevant experts, in commemoration of the forty years of the NuTEC. It covers the past five years of educational courses and seminars in utilization of radioisotopes and nuclear energy for domestic and for international training provided at Tokyo and Tokai Education Centers and covers the activity of the Asia-Pacific nuclear technology transfer, including the activity of various committees and meetings. Especially, fifty six experts and authorities have contributed to the report with positive advice and perspective on the training program in the 21st century based on their reminiscences. (author)

Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction

NARCIS (Netherlands)

Wismeijer, D.; Tawse-Smith, A.; Payne, A.G.T.

2013-01-01

Objective To compare the levels of patient satisfaction with either conventional mandibular bilateral distal extension partial dentures or those assisted by bilateral distal implants. Materials and methods Forty-eight participants who were dissatisfied with their existing conventional mandibular

Cleft sidedness and congenitally missing teeth in patients with cleft lip and palate patients

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Abdolreza Jamilian

2016-05-01

Full Text Available Abstract Background The aim of this study was to investigate the prevalence of cleft sidedness, and the number of congenitally missing teeth in regard to cleft type and gender. Methods The charts, models, radiographs, and intraoral photographs of 201 cleft patients including 131 males with the mean age of 12.3 ± 4 years and 70 females with the mean age of 12.6 ± 3.9 years were used for the study. T test, Chi-square, and binomial tests were used for assessment of the data. Results and conclusions One hundred forty-eight of the subjects suffered from cleft lip and palate followed by 41 subjects who suffered from cleft lip and alveolus. Chi-square test did not show any significant difference between the genders. Binomial test showed that left-sided cleft was more predominant in unilateral cleft lip and palate patients (P < 0.001. This study also showed that the upper lateral incisors were the most commonly missing teeth in the cleft area.

Percutaneous Gastrostomy in Patients Who Fail or Are Unsuitable for Endoscopic Gastrostomy

International Nuclear Information System (INIS)

Thornton, Frank J.; Varghese, Jose C.; Haslam, Philip J.; McGrath, Frank P.; Keeling, Frank; Lee, Michael J.

2000-01-01

Purpose: Percutaneous endoscopic gastrostomy (PEG) is not possible or fails in some patients. We aimed to categorize the reasons for PEG failure, to study the success of percutaneous radiologic gastrostomy (PRG) in these patients, and to highlight the associated technical difficulties and complications.Methods: Forty-two patients (28 men, 14 women; mean age 60 years, range 18-93 years) in whom PEG failed or was not possible, underwent PRG. PEG failure or unsuitability was due to upper gastrointestinal tract obstruction or other pathology precluding PEG in 15 of the 42 patients, suboptimal transillumination in 22 of 42 patients, and advanced cardiorespiratory decompensation precluding endoscopy in five of 42 patients. T-fastener gastropexy was used in all patients and 14-18 Fr catheters were inserted.Results: PRG was successful in 41 of 42 patients (98%). CT guidance was required in four patients with altered upper gastrointestinal anatomy. PRG failed in one patient despite CT guidance. In the 16 patients with high subcostal stomachs who failed PEG because of inadequate transillumination, intercostal tube placement was required in three and cephalad angulation under the costal margin in six patients. Major complications included inadvertent placement of the tube in the peritoneal cavity. There was one case of hemorrhage at the gastrostomy site requiring transfusion and one case of superficial gastrostomy site infection requiring tube removal. Minor complications included superficial wound infection in six patients, successfully treated with routine wound toilette.Conclusion: We conclude that PRG is a safe, well-tolerated and successful method of gastrostomy and gastrojejunostomy insertion in the technically difficult group of patients who have undergone an unsuccessful PEG. In many such cases optimal clinical evaluation will suggest primary referral for PRG as the preferred option

Placing wireless tablets in clinical settings for patient education

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Judy C. Stribling, MA, MLS

2016-11-01

Full Text Available Objective: The authors explored the feasibility and possible benefit of tablet-based educational materials for patients in clinic waiting areas. Methods: We distributed eight tablets preloaded with diagnosis-relevant information in two clinic waiting areas. Patients were surveyed about satisfaction, usability, and effects on learning. Technical issues were resolved. Results: Thirty-seven of forty patients completed the survey. On average, the patients were satisfied in all categories. Conclusions: Placing tablet-based educational materials in clinic waiting areas is relatively easy to implement. Patients using tablets reported satisfaction across three domains: usability, education, and satisfaction.

The transmission probability method in one-dimensional cylindrical geometry

International Nuclear Information System (INIS)

Rubin, I.E.

1983-01-01

The collision probability method widely used in solving the problems of neutron transpopt in a reactor cell is reliable for simple cells with small number of zones. The increase of the number of zones and also taking into account the anisotropy of scattering greatly increase the scope of calculations. In order to reduce the time of calculation the transmission probability method is suggested to be used for flux calculation in one-dimensional cylindrical geometry taking into account the scattering anisotropy. The efficiency of the suggested method is verified using the one-group calculations for cylindrical cells. The use of the transmission probability method allows to present completely angular and spatial dependences is neutrons distributions without the increase in the scope of calculations. The method is especially effective in solving the multi-group problems

Positive end expiratory pressure during one-lung ventilation: Selecting ideal patients and ventilator settings with the aim of improving arterial oxygenation

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Hoftman Nir

2011-01-01

Full Text Available The efficacy of positive end-expiratory pressure (PEEP in treating intraoperative hypoxemia during one-lung ventilation (OLV remains in question given conflicting results of prior studies. This study aims to (1 evaluate the efficacy of PEEP during OLV, (2 assess the utility of preoperative predictors of response to PEEP, and (3 explore optimal intraoperative settings that would maximize the effects of PEEP on oxygenation. Forty-one thoracic surgery patients from a single tertiary care university center were prospectively enrolled in this observational study. After induction of general anesthesia, a double-lumen endotracheal tube was fiberoptically positioned and OLV initiated. Intraoperatively, PEEP = 5 and 10 cmH 2 O were sequentially applied to the ventilated lung during OLV. Arterial oxygenation, cardiovascular performance parameters, and proposed perioperative variables that could predict or enhance response to PEEP were analysed. T-test and c2 tests were utilized for continuous and categorical variables, respectively. Multivariate analyses were carried out using a classification tree model of binary recursive partitioning. PEEP improved arterial oxygenation by ≥20% in 29% of patients (n = 12 and failed to do so in 71% (n = 29; however, no cardiovascular impact was noted. Among the proposed clinical predictors, only intraoperative tidal volume per kilogram differed significantly between responders to PEEP and non-responders (mean 6.6 vs. 5.7 ml/kg, P = 0.013; no preoperative variable predicted response to PEEP. A multivariate analysis did not yield a clinically significant model for predicting PEEP responsiveness. PEEP improved oxygenation in a subset of patients; larger, although still protective tidal volumes favored a positive response to PEEP. No preoperative variables, however, could be identified as reliable predictors for PEEP responders.

Methods of patient warming during abdominal surgery.

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Li Shao

Full Text Available BACKGROUND: Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. METHODS: Patients (n = 160 scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients' nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. RESULTS: When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. DISCUSSION: The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed.

Geriatric Conditions in Acutely Hospitalized Older Patients: Prevalence and One-Year Survival and Functional Decline

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Buurman, Bianca M.; Hoogerduijn, Jita G.; de Haan, Rob J.; Abu-Hanna, Ameen; Lagaay, A. Margot; Verhaar, Harald J.; Schuurmans, Marieke J.; Levi, Marcel; de Rooij, Sophia E.

2011-01-01

Background To study the prevalence of eighteen geriatric conditions in older patients at admission, their reporting rate in discharge summaries and the impact of these conditions on mortality and functional decline one year after admission. Method A prospective multicenter cohort study conducted between 2006 and 2008 in two tertiary university teaching hospitals and one regional teaching hospital in the Netherlands. Patients of 65 years and older, acutely admitted and hospitalized for at least 48 hours, were invited to participate. Eighteen geriatric conditions were assessed at hospital admission, and outcomes (mortality, functional decline) were assessed one year after admission. Results 639 patients were included, with a mean age of 78 years. IADL impairment (83%), polypharmacy (61%), mobility difficulty (59%), high levels of primary caregiver burden (53%), and malnutrition (52%) were most prevalent. Except for polypharmacy and cognitive impairment, the reporting rate of the geriatric conditions in discharge summaries was less than 50%. One year after admission, 35% had died and 33% suffered from functional decline. A high Charlson comorbidity index score, presence of malnutrition, high fall risk, presence of delirium and premorbid IADL impairment were associated with mortality and overall poor outcome (mortality or functional decline). Obesity lowered the risk for mortality. Conclusion Geriatric conditions were highly prevalent and associated with poor health outcomes after admission. Early recognition of these conditions in acutely hospitalized older patients and improving the handover to the general practitioner could lead to better health outcomes and reduce the burden of hospital admission for older patients. PMID:22110598

Evaluating resective surgery targets in epilepsy patients: A comparison of quantitative EEG methods.

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Müller, Michael; Schindler, Kaspar; Goodfellow, Marc; Pollo, Claudio; Rummel, Christian; Steimer, Andreas

2018-05-18

Quantitative analysis of intracranial EEG is a promising tool to assist clinicians in the planning of resective brain surgery in patients suffering from pharmacoresistant epilepsies. Quantifying the accuracy of such tools, however, is nontrivial as a ground truth to verify predictions about hypothetical resections is missing. As one possibility to address this, we use customized hypotheses tests to examine the agreement of the methods on a common set of patients. One method uses machine learning techniques to enable the predictive modeling of EEG time series. The other estimates nonlinear interrelation between EEG channels. Both methods were independently shown to distinguish patients with excellent post-surgical outcome (Engel class I) from those without improvement (Engel class IV) when assessing the electrodes associated with the tissue that was actually resected during brain surgery. Using the AND and OR conjunction of both methods we evaluate the performance gain that can be expected when combining them. Both methods' assessments correlate strongly positively with the similarity between a hypothetical resection and the corresponding actual resection in class I patients. Moreover, the Spearman rank correlation between the methods' patient rankings is significantly positive. To our best knowledge, this is the first study comparing surgery target assessments from fundamentally differing techniques. Although conceptually completely independent, there is a relation between the predictions obtained from both methods. Their broad consensus supports their application in clinical practice to provide physicians additional information in the process of presurgical evaluation. Copyright © 2018 Elsevier B.V. All rights reserved.

Management and outcome of patients with pancreatic trauma

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Ravinder Pal Singh

2017-01-01

Full Text Available Introduction: Pancreatic trauma is a rare entity occurring in 0.2% of patients with blunt trauma abdomen. Once the diagnosis is made, the management of patients is dependent on multiple variables. Conservative management, suture repair, drainage, and resection have been utilized with varying degree of success. This study is aimed to evaluate the management of patients with pancreatic trauma. Materials and Methods: This was a prospective study done in the Department of Surgery in Dayanand Medical College and Hospital where forty hemodynamically stable patients diagnosed to have pancreatic trauma on contrast-enhanced computed tomography abdomen were included in the study. Results: Out of forty patients taken in this study, 38 were male and two were female with age ranging from 3 to 50 years. Road traffic accident was the most common cause of pancreatic injury. Pancreatic injuries were graded according to the American Association for Surgery in Trauma scale. Twelve patients had Grade I and II injuries. Grade III was the most common injury occurring in 14 patients. Twenty-four patients underwent surgical management. Mortality rate was 45% and it was in direct correlation with the severity of injury. Conclusion: Grade I and II pancreatic injury can be managed conservatively depending upon the hemodynamic status of the patient. Grade III and IV injuries have a better prognosis if managed surgically.

Urodynamic Bladder Patterns in Spinal Cord Injury Patients

International Nuclear Information System (INIS)

Aziz, T.; Khan, A. A.; Iqbal, S.; Aziz, U.; Jilani, S.; Ayyub, A.

2017-01-01

Objective: To determine the frequency of various neurogenic bladder patterns in patients with traumatic spinal cord injury presenting at Armed Forces Institute of Rehabilitation Medicine Rawalpindi based on urodynamic studies. Study Design: Descriptive cross sectional study. Place and Duration of Study: Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi, from Jul 2014 to Jun 2016. Material and Methods: One hundred and forty traumatic spinal cord injury patients fulfilling the inclusion criteria were included both from indoor and outdoor departments through non-probability purposive sampling. Urodynamic studies were performed using the urodynamic equipment at urodynamic laboratory. Data were collected and recorded on specialized proforma by the principal investigator. Results: Among 140 study participants detrusor overactivity was found in 100 patients out of which 76 (76 percent) had thoracic level of injury, 20 (20 percent) had cervical level and 4 (4 percent) had lumbar level of injury. Detrusor areflexia was the bladder pattern in 40 patients out of which 26 (65 percent) had thoracic level of injury, 10 (25 percent) had cervical level, and 4 (10 percent) had lumbar level of injury. Conclusion: Detrusor overactivity was the commonest neurogenic bladder pattern among the traumatic spinal cord injury patients. (author)

One-Year Outcome of Geriatric Hip-Fracture Patients following Prolonged ICU Treatment

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Daphne Eschbach

2016-01-01

Full Text Available Purpose. Incidence of geriatric fractures is increasing. Knowledge of outcome data for hip-fracture patients undergoing intensive-care unit (ICU treatment, including invasive ventilatory management (IVM and hemodiafiltration (CVVHDF, is sparse. Methods. Single-center prospective observational study including 402 geriatric hip-fracture patients. Age, gender, the American Society of Anesthesiologists (ASA classification, and the Barthel index (BI were documented. Underlying reasons for prolonged ICU stay were registered, as well as assessed procedures like IVM and CVVHDF. Outcome parameters were in-hospital, 6-month, and 1-year mortality and need for nursing care. Results. 15% were treated > 3 days and 68% 3d cohort were significantly increased (p=0.001. Most frequent indications were cardiocirculatory pathology followed by respiratory failure, renal impairment, and infection. 18% of patients needed CVVHDF and 41% IVM. In these cohorts, 6-month mortality ranged > 80% and 12-month mortality > 90%. 100% needed nursing care after 6 and 12 months. Conclusions. ICU treatment > 3 days showed considerable difference in mortality and nursing care needed after 6 and 12 months. Particularly, patients requiring CVVHDF or IVM had disastrous long-term results. Our study may add one further element in complex decision making serving this vulnerable patient cohort.

Use of exact albedo conditions in numerical methods for one-dimensional one-speed discrete ordinates eigenvalue problems

International Nuclear Information System (INIS)

Abreu, M.P. de

1994-01-01

The use of exact albedo boundary conditions in numerical methods applied to one-dimensional one-speed discrete ordinates (S n ) eigenvalue problems for nuclear reactor global calculations is described. An albedo operator that treats the reflector region around a nuclear reactor core implicitly is described and exactly was derived. To illustrate the method's efficiency and accuracy, it was used conventional linear diamond method with the albedo option to solve typical model problems. (author)

One-year abstinence improves ADHD symptoms among patients with polysubstance use disorder

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Egon Hagen

2017-12-01

Full Text Available Introduction: Attention-deficit/hyperactivity disorder (ADHD is a common comorbid disorder in patients suffering from substance use disorder (SUD. Individuals with co-occurring SUD and ADHD are more likely than SUD patients without ADHD to have developed SUD at a younger age, be polysubstance users, and need inpatient treatment more often. The present study investigates whether individuals with polysubstance use disorder who remain abstinent for a year after entering treatment have a more substantial reduction in ADHD symptoms than those who relapsed and controls. Material and methods: Subjects were SUD patients (N=115 and healthy controls (N=34. ADHD symptoms were assessed using the adult ADHD Self-Report Scale (ASRS. Substance use was assessed by self-reports on the Alcohol Use Disorders Identification Test (AUDIT and the Drug Use Disorders Identification Test (DUDIT. Participants were defined as having relapsed if they had an AUDIT score≥8 or a DUDIT score≥2 for women and≥6 for men. Results: Patients who remained abstinent for one year reported a substantial reduction of ADHD symptoms compared to patients who relapsed and controls. Conclusions: Abstinence alleviates ADHD symptoms among patients with polysubstance use disorder. We suggest that confirmation of an ADHD diagnosis should follow a period of abstinence to avoid identification of false-positive cases. Keywords: Polysubstance, Recovery, ADHD, Substance use disorder

Newly identified psychiatric illness in one general practice: 12-month outcome and the influence of patients' personality.

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Wright, A F; Anderson, A J

1995-01-01

BACKGROUND. Relatively little is known about the natural history and outcome of psychological problems in patients who present to general practitioners. Only a small proportion of such patients are seen by specialists. Clinical experience suggests that patient personality is one of the factors influencing outcome in patients diagnosed as having psychiatric illness. AIM. This study set out to examine prospectively the progress and 12-month outcome of patients with newly identified psychiatric illness, and the association of patients' personality with outcome. METHOD. One hundred and seventy one patients with clinically significant psychiatric illness attending one practice in a Scottish new town were followed up prospectively (96 presented with psychological symptoms and 75 with somatic symptoms), and were compared with a group of 127 patients with chronic physical illness. Patients were assessed in terms of psychiatric state, social problems and personality using both computer-based and pencil and paper tests in addition to clinical assessments at each consultation during the follow-up year and structured interview one year after recruitment. RESULTS. Most of the improvement in psychiatric state scores on the 28-item general health questionnaire occurred in the first six months of the illness. Of the 171 patients with psychiatric illness 34% improved quickly and remained well, 54% had an intermittent course but had improved at 12-month follow up while 12% pursued a chronic course without improvement. The mean number of consultations in the follow-up year was 8.4 for patients presenting with psychological symptoms, 7.2 for those presenting with somatic symptoms and 6.6 for patients with chronic physical illness. The Eysenck N score proved a strong predictor of the outcome of new psychiatric illness. CONCLUSION. Only one in three patients with newly identified psychiatric illness improved quickly and and remained well, reflecting the importance of continuing care of

A method for safely resecting anterior butterfly gliomas: the surgical anatomy of the default mode network and the relevance of its preservation.

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Burks, Joshua D; Bonney, Phillip A; Conner, Andrew K; Glenn, Chad A; Briggs, Robert G; Battiste, James D; McCoy, Tressie; O'Donoghue, Daniel L; Wu, Dee H; Sughrue, Michael E

2017-06-01

OBJECTIVE Gliomas invading the anterior corpus callosum are commonly deemed unresectable due to an unacceptable risk/benefit ratio, including the risk of abulia. In this study, the authors investigated the anatomy of the cingulum and its connectivity within the default mode network (DMN). A technique is described involving awake subcortical mapping with higher attention tasks to preserve the cingulum and reduce the incidence of postoperative abulia for patients with so-called butterfly gliomas. METHODS The authors reviewed clinical data on all patients undergoing glioma surgery performed by the senior author during a 4-year period at the University of Oklahoma Health Sciences Center. Forty patients were identified who underwent surgery for butterfly gliomas. Each patient was designated as having undergone surgery either with or without the use of awake subcortical mapping and preservation of the cingulum. Data recorded on these patients included the incidence of abulia/akinetic mutism. In the context of the study findings, the authors conducted a detailed anatomical study of the cingulum and its role within the DMN using postmortem fiber tract dissections of 10 cerebral hemispheres and in vivo diffusion tractography of 10 healthy subjects. RESULTS Forty patients with butterfly gliomas were treated, 25 (62%) with standard surgical methods and 15 (38%) with awake subcortical mapping and preservation of the cingulum. One patient (1/15, 7%) experienced postoperative abulia following surgery with the cingulum-sparing technique. Greater than 90% resection was achieved in 13/15 (87%) of these patients. CONCLUSIONS This study presents evidence that anterior butterfly gliomas can be safely removed using a novel, attention-task based, awake brain surgery technique that focuses on preserving the anatomical connectivity of the cingulum and relevant aspects of the cingulate gyrus.

Systematization of types and methods of radiation therapy methods and techniques of irradiation of patients

International Nuclear Information System (INIS)

Vajnberg, M.Sh.

1991-01-01

The paper is concerned with the principles of systematization and classification of types and methods of radiation therapy, approaches to the regulation of its terminology. They are based on the distinction of the concepts of radiation therapy and irradiation of patients. The author gives a consice historical review of improvement of the methodology of radiation therapy in the course of developing of its methods and facilities. Problems of terminology are under discussion. There is a table of types and methods of radiation therapy, methods and techniques of irradiation. In the appendices one can find a table of typical legends and examples of graphic signs to denote methods of irradiation. Potentialities of a practical use of the system are described

Forty-two

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John Dumay

2015-01-01

Full Text Available This article explores the meaning and context of intellectual capital (IC numbers to help break free from the domination of IC “accountingisation” . Offering a personal and reflective narrative about IC numbers, I first discuss what numbers mean by exploring the way we think about the number 42. This discussion is followed by two empirical sections examining the meaning and context of a common IC measure, employee turnover rates. Measuring any IC element is problematic from an IC accounting perspective because of the unique context in which each organization operates. The comparability of a number from one organization and one period with another is nearly impossible. The article is original because it takes a thought-provoking narrative journey into the use and meaning of applying IC numbers. It is a personal reflection on the implications of considering the meaning of numbers for IC practice, IC education and research, and IC’s future. It is particularly topical in light of the inclusion of IC in the recent Integrated Reporting ( Guidelines.

Evaluation of OneTouch Verio, a new blood glucose self-monitoring system for patients with diabetes

DEFF Research Database (Denmark)

Littman, Karin; Petersen, Eva R.B.; Pussinen, Christel

2013-01-01

(ADA) quality goals. Blood samples were collected and measured on the OneTouch Verio® by laboratory personnel and patients with diabetes (n = 91, randomized into groups receiving personal training or mail instructions for the OneTouch Verio® system). Results were compared to a validated routine method......, imprecision and bias were calculated. User-friendliness was evaluated with a questionnaire. Results. Quality specifications for blood glucose concentration monitoring systems according to ISO 15197 were fulfilled. The mean coefficients of variation (CV%) of repeatability was 3.4% when tested by laboratory...... personnel and within the goal of imprecision suggested by ADA. Mean CV% of repeatability for patient self-monitoring was 5.0% and 5.1% in the training- and the mail group, respectively. Total error was 6.4-10.0%. The OneTouch Verio® showed no hematocrit interference or variation between strip lots...

Detection of primary tumor by 18F-FDG-TEP in patients with cup syndrome

International Nuclear Information System (INIS)

Alberini, J.L.; Belhocine, T.; Daenen, F.; Hustinx, R.; Rigo, P.

2000-01-01

To study the performance of whole body 18 F-FDG-PET in the detection of the primary tumor in patients with unknown primary carcinoma in comparison with conventional imaging. Patients and methods: Forty-one patients, without previous history of known cancer, (18 women and 23 men; average age 64,1 years) with bone, brain, lymph node, liver, cutaneous, pleural and epidural metastases were included in a retrospective study. Results of PET (UGM Penn PET 240 H) were compared with those of techniques used in the current conventional procedure. There were 26 true positives, 2 false negatives (1 renal carcinoma and 1 myeloma) and one false positive results. Origins were lung [16], gut [6], breast [3] and head and neck [1] but stayed undetermined in 8 patients. Results of PET were superior to conventional diagnostic procedure in 12 patients and led to modify the therapy management in 11 patients. All known metastatic lesions were detected by PET. FDG-PET can be useful to determine the origin of metastasis. It allows detection of the primary tumor (26/33 patients) and allows evaluation of the spread of the disease. These results have to be confirmed and particularly in patients with highly treatable unknown primary carcinoma. (author)

Evaluation of risk factors for thrombophilia in patients with cerebral venous thrombosis

OpenAIRE

Osman Yokuş; Özlem Şahin Balçık; Murat Albayrak; Funda Ceran; Simten Dağdaş; Mesude Yılmaz; Gülsüm Özet

2010-01-01

Objective: The increased risk for thrombosis is known as hypercoagulability or thrombophilia. In our study, we aimed to determine the frequency of the identified defects for thrombophilia in patients with central venous thrombosis aged under 50 years and to compare results with the findings in the current literature. Materials and Methods: Forty-three patients (16-50 years old) were retrospectively evaluated. Thrombophilia investigation included determinations of protein C, protein S, antithr...

Touch cytology in diagnosing Helicobacter pylori: comparison of four staining methods.

Science.gov (United States)

Hashemi, M R; Rahnavardi, M; Bikdeli, B; Dehghani Zahedani, M; Iranmanesh, F

2008-06-01

Helicobacter pylori (Hp), a major cause of peptic ulcer disease and an important risk factor for gastric malignancy, can be diagnosed by several methods. Touch cytology (TC) of the gastric mucosa has been noted to give good results and has been found to be very simple, inexpensive and rapid. However, evidence regarding the accuracy of different staining methods of TC is lacking. The present study aims at defining the diagnostic accuracy of four different staining methods of TC. Biopsy specimens were taken from the antral mucosa of one hundred consecutive patients referred for upper gastrointestinal endoscopy (UGIE) for various indications. TC slides were processed by four staining methods: Wright, Giemsa, Papanicolaou and Gram. Rapid urease test (RUT) and histological examination of specimens were also performed. The same experienced pathologist evaluated the coded samples. A patient's Hp status was established by minimum concordance of the three tests, including histology, RUT, and 'Touch mean'. The latter was defined positive when at least three of the four TC staining methods were positive. Forty-six patients (46%) were positive for Hp according to Hp status. TC stained by Wright had excellent agreement with both histology (kappa = 0.80, P stained TC (88.89%) was significantly more specific than both Giemsa- (74.07%; P stained (70.37%; P stained TC can safely substitute for histology. However, when assessment for severity of mucosal damage or cell atypias is meant, histology cannot be neglected.

Stereotactic body radiotherapy of primary and metastatic renal lesions for patients with only one functioning kidney

International Nuclear Information System (INIS)

Svedman, Christer; Sandstroem, P.; Wersaell, Peter; Karlsson, Kristin; Rutkowska, Eva; Lax, Ingmar; Blomgren, H.

2008-01-01

Background. About 2% of patients with a carcinoma in one kidney develop either metastases or a new primary tumor in the contralateral kidney. Often, renal cancers progress rapidly at peripheral sites and a metastasis to the second kidney may not be the patient's main problem. However, when an initial renal cancer is more indolent yet spreads to the formerly unaffected kidney or a new primary tumor forms there, local treatment may be needed. Stereotactic body radiotherapy (SBRT) has been demonstrated as a valuable treatment option for tumors that cause local symptoms. Presented here is a retrospective analysis of patients in whom SBRT was used to control primary or metastatic renal disease. Patients and methods. Seven patients with a mean age of 64 (44-76) were treated for metastases from a malignant kidney to its contralateral counterpart. Dose/fractionation schedules varied between 10 Gyx3 and 10 Gyx4 depending on target location and size, given within one week. Follow-up times for patients who remained alive were 12, 52 and 66 months and for those who subsequently died were 10, 16, 49 and 70 months. Results. Local control, defined as radiologically stable disease or partial/complete response, was obtained in six of these seven patients and regained after retreatment in the one patient whose lesion progressed. Side effects were generally mild, and in five of the seven patients, kidney function remained unaffected after treatment. In two patients, the creatinine levels remained moderately elevated at approximately 160 μmol/L post treatment. At no time was dialysis required. Conclusion. These results indicate that SBRT is a valuable alternative to surgery and other options for patients with metastases from a cancer-bearing kidney to the remaining kidney and provides local tumor control with satisfactory kidney function

Routine one-stage exchange for chronic infection after total hip replacement.

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Jenny, Jean-Yves; Lengert, Régis; Diesinger, Yann; Gaudias, Jeannot; Boeri, Cyril; Kempf, Jean-François

2014-12-01

We hypothesized that a routine one-stage exchange for treatment of chronically infected total hip replacement (THR) will lead to (1) a higher rate of infection recurrence and (2) a poorer hip outcome than the published rates after two-stage exchange. Sixty-five cases have been treated consecutively with one-stage exchange. All patients have been followed for a period of three to six years or until death or infection recurrence. The five-year rate for infection recurrence was 16%. The five-year survival rate for recurrence of the index infection was 8%. Forty-two percent of the hips had a good or excellent PMA score, and 46% a good or excellent OH score. Routine one-stage exchange was not associated with a higher recurrence rate and a poorer hip function than previously published series of two-stage exchange. Therefore, there is little support to choose two-stage exchange as the routine treatment for management of chronically infected THR.

Analysis of corneal esthesia in patients undergoing photorefractive keratectomy

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Elmar Torres Neto

2015-12-01

Full Text Available ABSTRACT Purpose: To quantitatively analyze corneal esthesia in patients undergoing photorefractive keratectomy (PRK surgery. Methods: Forty-five patients selected for PRK in one eye underwent corneal esthesia using a Cochet-Bonnet esthesiometer preoperatively and 30 and 90 days postoperatively. Patients with a refractive diopter error of 4 or greater received intraoperative 0.02% mitomycin C for 20 s. Results: Twenty-four (53.3% of the 45 eyes received intraoperative 0.02% mitomycin. Decreased sensitivity was observed on postoperative day 30. By postoperative day 90, corneal esthesia had normalized but remained 14.9% lower than preoperative levels. In the mitomycin group, no recovery of corneal esthesia to normal sensitivity levels was observed. The mean esthesiometer level was 39.2 mm on postoperative day 90 (P<0.001. Conclusions: The results of the present study demonstrate recovery of corneal esthesia to normal levels at 90 days postoperatively in patients who did not receive mitomycin C. In patients administered mitomycin C, a 23.59% reduction in the corneal touch threshold was observed compared with preoperative levels indicating a failure of recovery to normal levels.

In-depth study of personality disorders in first-admission patients with substance use disorders

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Langås Anne-Marit

2012-10-01

Full Text Available Abstract Background Assessment of comorbid personality disorders (PDs in patients with substance use disorders (SUDs is challenging due to symptom overlap, additional mental and physical disorders, and limitations of the assessment methods. Our in-depth study applied methods to overcome these difficulties. Method A complete catchment area sample of 61 consecutively admitted patients with SUDs, with no previous history of specialized treatment (addiction clinics, psychiatry were studied, addressing PDs and associated clinical and demographic variables. The thorough assessments included the Psychiatric Research Interview for Substance and Mental Disorders and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Results Forty-six percent of the SUD patients had at least one PD (16% antisocial [males only]; 13% borderline; and 8% paranoid, avoidant, and obsessive-compulsive, respectively. Cluster C disorders were as prevalent as Cluster B disorders. SUD patients with PDs were younger at the onset of their first SUD and at admission; used more illicit drugs; had more anxiety disorders, particularly social phobia; had more severe depressive symptoms; were more distressed; and less often attended work or school. Conclusion The psychiatric comorbidity and symptom load of SUD patients with PDs differed from those of SUD patients without PDs, suggesting different treatment needs, and stressing the value of the assessment of PDs in SUD patients.

One-step radiolabelled biotin scintigraphy in patients with suspected vertebral infections

International Nuclear Information System (INIS)

Lazzeri, E.; Erba, P.; Chinol, M.; Tascini, C.; Menichetti, F.; Paganelli, G.; Mariani, G.

2003-01-01

Full text: Biotin (B), or vitamin H, belonging to the B-complex group is utilized by bacteria for acid synthesis by acetyl-CoA carboxylase. We evaluated the diagnostic potential per se of radiolabeled biotin without avidin pre-targeting, in patients with suspected vertebral bacterial infections. We evaluated 31 patients for suspected spine infection. All patients were selected on clinical ground, blood chemistry findings, back pain and fever. Patients were injected i.v. with 500 μg of DTPA-conjugated Biotin labelled with 111In (110-130 MBq); planar and SPECT scans were recorded starting 90 min post-injection. All patients underwent MR, or CT and some patients were imaged with either 99mTc-HMPAO-WBC and/or 67Ga-citrate. Diagnostic-quality imaging was obtained at 90 min and 4 hr after 111In-DTPA-Biotin injection. We observed only 2 false-negative results, while 24 studies were true-positive (4 performed during follow-up) and 10 true-negative (1 during follow-up) (91% sensitivity, 100% specificity). Either MR, CT or 99mTc-HMPAO-WBC had high proportions of either false-negative, false-positive or equivocal results (sensitivity/specificity around 50%). These preliminary results outline the high diagnostic potential of one-step 111In-DTPA-Biotin scintigraphy without avidin pre-targeting) in patients with suspected vertebral infection. The high true-positive and true-negative rate suggests that this system displays some specificity for bacterial infections. The high diagnostic accuracy of 111In-Biotin scintigraphy seems to be independent from antibiotic therapy, thus making this method very helpful relative to other imaging modalities in the clinical decision on starting proper therapy and for monitoring the efficacy of treatment. (author)

Peripheral nervous system assessment in acromegaly patients under somatostatin analogue therapy.

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Alibas, H; Gogas Yavuz, D; Kahraman Koytak, P; Uygur, M; Tanridag, T; Uluc, K

2017-01-01

Acromegaly is known to affect peripheral nervous system (PNS) causing carpal tunnel syndrome (CTS) and polyneuropathy. The frequency of these disorders and the evaluation methods vary among studies. In the present study, we aimed to examine PNS of acromegaly patients under somatostatin analogue (SSA) therapy. Forty-eight acromegaly patients (26 F/22 M, 45.58 ± 11.6 years) under SSA treatment and 44 healthy controls (25 F/19 M, 47.46 ± 8.7 years) were assessed by symptom questionnaires, neurologic examination and electrophysiological studies. 87.5 % of the acromegaly patients had at least one abnormal finding regarding PNS. With the incorporation of palm-wrist median nerve conduction velocity method, we detected CTS in 50 % of patients. Polyneuropathy was less frequent (29.2 %). Both conditions were independent from the coexisting diabetes mellitus (p = 0.22 for CTS, p = 0.71 for polyneuropathy). Polyneuropathy but not CTS was more common among biochemically uncontrolled acromegaly patients rather than those under control (p = 0.03; p = 0.68, respectively). Our findings emphasize the high prevalence of peripheral nervous system involvement in acromegaly patients under SSA therapy and importance of neurological evaluation of these patients. Early diagnosis and treatment of the disease may reduce the PNS involvement.

A one-dimensional, one-group absorption-production nodal method for neutron flux and power distributions calculations

International Nuclear Information System (INIS)

Ferreira, C.R.

1984-01-01

It is presented the absorption-production nodal method for steady and dynamical calculations in one-dimension and one group energy. It was elaborated the NOD1D computer code (in FORTRAN-IV language). Calculations of neutron flux and power distributions, burnup, effective multiplication factors and critical boron concentration were made with the NOD1D code and compared with results obtained through the CITATION code, which uses the finite difference method. The nuclear constants were produced by the LEOPARD code. (M.C.K.) [pt

A phantom based method for deriving typical patient doses from measurements of dose-area product on populations of patients

International Nuclear Information System (INIS)

Chapple, C.-L.; Broadhead, D.A.

1995-01-01

One of the chief sources of uncertainty in the comparison of patient dosimetry data is the influence of patient size on dose. Dose has been shown to relate closely to the equivalent diameter of the patient. This concept has been used to derive a prospective, phantom based method for determining size correction factors for measurements of dose-area product. The derivation of the size correction factor has been demonstrated mathematically, and the appropriate factor determined for a number of different X-ray sets. The use of phantom measurements enables the effect of patient size to be isolated from other factors influencing patient dose. The derived factors agree well with those determined retrospectively from patient dose survey data. Size correction factors have been applied to the results of a large scale patient dose survey, and this approach has been compared with the method of selecting patients according to their weight. For large samples of data, mean dose-area product values are independent of the analysis method used. The chief advantage of using size correction factors is that it allows all patient data to be included in a survey, whereas patient selection has been shown to exclude approximately half of all patients. (author)

Role of RENAL nephrometry scoring system in planning surgical intervention in patients with localized renal mas

OpenAIRE

Mohamed Samir Shaaban; Tamer Mohammed Abou Youssif; Ahmed Mostafa; Hossam Eldin Hegazy; Mohammed Adel Atta

2015-01-01

Purpose: The study was designed to validate the value of preoperative planning using RENAL nephrometry scoring system in patients having organ confined renal tumors and undergoing surgical intervention and to assess its correlation with the surgical technique. Patient and methods: Forty patients with organ-confined renal masses underwent RENAL nephrometry scoring which was correlated with the surgical technique either radical or nephron-sparing surgery. Result: RENAL nephrometry scoring...

Abnormal Gas Diffusing Capacity and Portosystemic Shunt in Patients With Chronic Liver Disease

OpenAIRE

Park, Moon-Seung; Lee, Min-Ho; Park, Yoo-Sin; Kim, Shin-Hee; Kwak, Min-Jung; Kang, Ju-Seop

2012-01-01

Background Pulmonary dysfunctions including the hepatopulmonary syndrome and portosystemic shunt are important complications of hepatic cirrhosis. To investigate the severity and nature of abnormal gas diffusing capacity and its correlation to portosystemic shunt in patients with chronic liver disease. Methods Forty-four patients with chronic liver disease (15 chronic active hepatitis (CAH), 16 Child-Pugh class A, and 13 Child-Pugh class B) without other diseases history were enrolled in the ...

Analysis of patients presenting to the emergency department with carbon monoxide intoxication

Directory of Open Access Journals (Sweden)

Selim Yurtseven

2015-12-01

Full Text Available Objectives: Carbon monoxide is a potentially fatal form of poisoning. The exact incidence is unclear, due to cases being undiagnosed or reported as fewer than the real number. Hyperbaric oxygen therapy (HBOT is of proven efficacy in the treatment of CO intoxication.The purpose of this study was to describe the general characteristics of carbon monoxide (CO intoxications presenting to the emergency department and to investigate troponin I values and the effectiveness of hyperbaric oxygen therapy (HBOT in these patients. Material and methods: Patients presenting to the emergency department with CO intoxication over one year and patients with such intoxications receiving HBOT were examined retrospectively. Results: One hundred seventy-one patients were included; 140 (81.9% were poisoned by stoves, 18 (10.5% by hot water boilers and 10 in (5.8% by fires. COHb levels were normal in 49 of the 163 patients whose values were investigated, and were elevated in 114 patients. Mean COHb value was 16.6. Troponin I values were investigated in 112 patients. These were normal in 86 patients and elevated in 26. Mean troponin I value was 0.38 ng/ml. One hundred twenty-three of the 171 patients in the study were discharged in a healthy condition after receiving normobaric oxygen therapy, while 48 patients received HBOT. Forty-two (87.5% of the patients receiving HBOT were discharged in a healthy condition while sequelae persisted in five (10.4%. One patient died after 15 session of HBOT. Conclusion: Although elevated carboxyhemoglobin confirms diagnosis of CO intoxication, normal levels do not exclude it. Troponin I levels may rise in CO intoxication. No significant relation was observed between carboxyhemoglobin and receipt of HBOT. A significant correlation was seen, however, between troponin I levels and receipt of HBOT. Keywords: Carbon monoxide intoxication, Hyperbaric oxygen, Troponin I, Echocardiography

A SWIFT Method for Handing Off Obstetrical Patients on the Labor Floor.

Science.gov (United States)

Sheen, Jean-Ju; Reimers, Laura; Govindappagari, Shravya; Ngai, Ivan M; Garretto, Diana; Donepudi, Roopali; Tropper, Pamela; Goffman, Dena; Dayal, Ashlesha K; Bernstein, Peter S

2017-07-06

The aim of this study was to improve patient handoffs on the labor floor. A prospective cohort study of obstetrics residents at Montefiore Medical Center was performed between 2012 and 2014. Labor-floor handoffs were recorded before and after didactic sessions as well as after installation of whiteboards formatted with the mnemonic SWIFT (Subject, Why?, Issues, Fetus, Tasks). Handoff transcripts were evaluated by obstetricians blinded to timing and speaker identity. An intraclass correlation coefficient accounted for evaluator differences. Data analysis was by ordinal logistic regression, the generalized estimating equations method (correlated data), and Bonferroni adjustment (multiple comparisons). Forty-five handoffs were evaluated (15 each predidactics, postdidactics, and postwhiteboard revision). Higher completeness scores over time were noted for admission reason, labor concerns, and task list (not statistically significant). Comprehensive score increases prelecture to postwhiteboard were seen in handoff clarity (2.81 versus 2.91) and overall quality (2.77 versus 2.81) (not statistically significant). A subanalysis of four residents who gave multiple handoffs over different periods revealed few significant changes over time. Greater interevaluator consistency was noted with more objective elements. The mnemonic SWIFT, with formalized curricula for obstetrical resident training focusing on new learners and increased faculty involvement and reinforcement, may result in improvement of handoffs on the labor floor.

An evidence-based patient-centered method makes the biopsychosocial model scientific.

Science.gov (United States)

Smith, Robert C; Fortin, Auguste H; Dwamena, Francesca; Frankel, Richard M

2013-06-01

To review the scientific status of the biopsychosocial (BPS) model and to propose a way to improve it. Engel's BPS model added patients' psychological and social health concerns to the highly successful biomedical model. He proposed that the BPS model could make medicine more scientific, but its use in education, clinical care, and, especially, research remains minimal. Many aver correctly that the present model cannot be defined in a consistent way for the individual patient, making it untestable and non-scientific. This stems from not obtaining relevant BPS data systematically, where one interviewer obtains the same information another would. Recent research by two of the authors has produced similar patient-centered interviewing methods that are repeatable and elicit just the relevant patient information needed to define the model at each visit. We propose that the field adopt these evidence-based methods as the standard for identifying the BPS model. Identifying a scientific BPS model in each patient with an agreed-upon, evidence-based patient-centered interviewing method can produce a quantum leap ahead in both research and teaching. A scientific BPS model can give us more confidence in being humanistic. In research, we can conduct more rigorous studies to inform better practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Brooks–Corey Modeling by One-Dimensional Vertical Infiltration Method

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Xuguang Xing

2018-05-01

Full Text Available The laboratory methods used for the soil water retention curve (SWRC construction and parameter estimation is time-consuming. A vertical infiltration method was proposed to estimate parameters α and n and to further construct the SWRC. In the present study, the relationships describing the cumulative infiltration and infiltration rate with the depth of the wetting front were established, and simplified expressions for estimating α and n parameters were proposed. The one-dimensional vertical infiltration experiments of four soils were conducted to verify if the proposed method would accurately estimate α and n. The fitted values of α and n, obtained from the RETC software, were consistent with the calculated values obtained from the infiltration method. The comparison between the measured SWRCs obtained from the centrifuge method and the calculated SWRCs that were based on the infiltration method displayed small values of root mean square error (RMSE, mean absolute percentage error (MAPE, and mean absolute error. SWMS_2D-based simulations of cumulative infiltration, based on the calculated α and n, remained consistent with the measured values due to small RMSE and MAPE values. The experiments verified the proposed one-dimensional vertical infiltration method, which has applications in field hydraulic parameter estimation.

Pressure Ulcer Surveillance in Neurotrauma Patients at a Level One Trauma Centre in India

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Annu Babu

2015-11-01

Full Text Available Objectives: Pressure ulcers are a multifactorial, prevalent, and preventable morbidity. They cause a burden both financially and emotionally, to the individual, their family and doctor, and to society as a whole. Pressure ulcers are extremely difficult to treat; therefore, prevention is key. Methods: We started a Wound Care Surveillance Program in 2012 involving nurses, physiotherapists, and doctors. We intended to prevent the occurrence of pressure ulcers, ensure early detection, and facilitate the healing process. The Braden scale was used to stratify patients’ risk. The number of patients observed in our study was 2,974 over a one-year period. Results: The pressure sore prevalence was 3.1%. Younger and middle-aged patients were most commonly affected; 27% of these patients did not survive. Mortality was not attributed to the pressure ulcer directly. The most common mode of injury was road traffic accidents. Most of our patients had just a single pressure area affected, most commonly the sacrum. Most patients were managed with debridement and dressings while 12% received surgical treatment. Of those with stage one ulcers, 29% healed completely at two months. In stage two and three patients, 17% and 6% healed in two months, respectively, and this number was zero in stage four patients. Conclusion: The Wound Care Surveillance Program has been a very effective strategy for the prevention and management of pressure ulcers. Stage two ulcers were the most common in our setup. Braden scoring, traditionally used to screen these ulcers, can be used as a predictive and prognostic tool to predict healing of pressure ulcers. Poor healing is expected in higher staged ulcers and patients with spinal injury and major solid organ injury and those who need a tracheostomy. Home-based care is not up to mark in our society and accounts for most of the cases in the follow-up.

A 7-year follow-up of multidisciplinary rehabilitation among chronic neck and back pain patients. Is sick leave outcome dependent on psychologically derived patient groups?

Science.gov (United States)

Bergström, Gunnar; Bergström, Cecilia; Hagberg, Jan; Bodin, Lennart; Jensen, Irene

2010-04-01

A valid method for classifying chronic pain patients into more homogenous groups could be useful for treatment planning, that is, which treatment is effective for which patient, and as a marker when evaluating treatment outcome. One instrument that has been used to derive subgroups of patients is the Multidimensional Pain Inventory (MPI). The primary aim of this study was to evaluate a classification method based on the Swedish version of the MPI, the MPI-S, to predict sick leave among chronic neck and back pain patients for a period of 7 years after vocational rehabilitation. As hypothesized, dysfunctional patients (DYS), according to the MPI-S, showed a higher amount of sickness absence and disability pension expressed in days than adaptive copers (AC) during the 7-years follow-up period, even when adjusting for sickness absence prior to rehabilitation (355.8days, 95% confidence interval, 71.7; 639.9). Forty percent of DYS patients and 26.7% of AC patients received disability pension during the follow-up period. However, this difference was not statistically significant. Further analyses showed that the difference between patient groups was most pronounced among patients with more than 60days of sickness absence prior to rehabilitation. Cost-effectiveness calculations indicated that the DYS patients showed an increase in production loss compared to AC patients. The present study yields support for the prognostic value of this subgroup classification method concerning long-term outcome on sick leave following this type of vocational rehabilitation. Copyright (c) 2009 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

Prostatic disorders in acromegalic patients experience of a Brazilian center

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Livia L. Correa

2013-06-01

Full Text Available Introduction Published data suggest that patients with acromegaly have an increased prevalence of prostate disorders. Objective To evaluate prostatic disorders in acromegalic patients comparing these results after one year of treatment of acromegaly and with a group of healthy men. Materials and Methods This study was composed of two parts: sectional study comparing patients with healthy controls (baseline and prospective, longitudinal study (at baseline and after one year of treatment. Forty acromegalic patients were enrolled and evaluated at baseline and after one year with the application of international prostatic symptoms score (IPSS, digital rectal examination, measurements of growth hormone (GH, insulin-like growth factor-I (IGF-I, insulin-like growth factor-binding protein-3 (IGFBP-3, sex hormone-binding globulin (SHBG, prolactin, luteinizing hormone (LH, follicle-stimulating hormone (FSH, total testosterone, total and free prostate-specific antigen (PSA levels and prostate ultrasonography (US. Thirty healthy men were selected as control group. Results We stratified patients and controls according to age, considering 40 years-old as cut off. Healthy controls under 40 had IPSS values lower than acromegalic patients. When considering only older patients and controls prostate hyperplasia and structural abnormalities were more frequent in acromegalics. After one year of treatment there was significant decrease in GH, IGF-I and prostate volume in acromegalics over 40 years-old. Conclusions Acromegalics under 40 have more urinary symptoms according to IPSS and above 40 years-old higher frequency of structural changes and increased prostate volume than healthy men. Significant reduction of GH and IGF-I levels during treatment of acromegaly leads to decrease in the prostate volume.

Post-operative telephone review is cost-effective and acceptable to patients.

LENUS (Irish Health Repository)

Gray, R T

2012-02-01

INTRODUCTION: Patients undergoing selective minor emergency and elective procedures are followed up by a nurse-led structured telephone review six weeks post-operatively in our hospital. Our study objectives were to review patients\\' satisfaction, assess cost-effectiveness and compare our practice with other surgical units in Northern Ireland (NI). PATIENTS AND METHODS: Completed telephone follow-up forms were reviewed retrospectively for a three-year period and cost savings calculated. Fifty patients were contacted prospectively by telephone using a questionnaire to assess satisfaction of this follow-up. A postal questionnaire was sent to 68 general and vascular surgeons in NI, assessing individual preferences for patient follow-up. RESULTS: A total of 1378 patients received a telephone review from September 2005 to September 2008. One thousand one hundred and seventy-seven (85.4%) were successfully contacted, while 201 (14.6%) did not respond despite multiple attempts. One hundred and forty-seven respondents (10.7%) required further outpatient follow-up, thereby saving 1231 outpatient reviews, equivalent to pound41,509 per annum. Thirty-nine (78%) patients expected post-operative follow-up, with 29 (58%) expecting this in the outpatient department. However, all patients were satisfied with the nurse-led telephone review. Fifty-three (78%) consultants responded. Those who always, or occasionally, review patients post-operatively varies according to the operation performed, ranging from 2.2% appendicectomy patients to 40.0% for varicose vein surgery. CONCLUSION: Current practice in NI varies, but a significant proportion of patients are not routinely reviewed. This study confirmed that patients expect post-operative follow-up. A nurse-led telephone review service is acceptable to patients, cost-effective and reduces the number of unnecessary outpatient reviews.

Black and blue gas, the Gaz de France story during the last forty years

International Nuclear Information System (INIS)

Beltran, A.; Williot, J.P.

1992-01-01

This book narrates Gaz de France story during the last forty years. The author describes the great events such change from coal gas to methane (black and blue gas), building of a national distribution network, natural gas promoting, negotiating on great supply contracts, research programs. 61 refs., 12 figs., 29 photos

Patients with chronic headache tend to have more psychological symptoms than those with sporadic episodes of pain

Directory of Open Access Journals (Sweden)

Maria Aparecida Junqueira Zampieri

2014-08-01

Full Text Available There are controversial associations between headaches and psychological symptoms. Objective To design a profile of neuroticism, a term that groups variables related to negative personality traits, in patients with chronic daily headache (CDH when compared to episodic migraine (EM patients, applying the Factorial Scale of Emotional Adjustment/Neuroticism (NFS. Method One hundred adult patients with CDH and forty with EM answered the NFS. Results Comorbidities of subtypes of neuroticism (p=0.006 were more common in chronic daily headache patients, with three or more disorders (p=0.0002: dependent personality disorder (p=0.0001, anxiety, reduced concentration and production (p=0.0008, depression (p<0.0001, suicidal ideation (p=0.0008 and hopelessness even without depression (p<0.0001. Conclusion Patients with CDH tend to have dependent personality disorder, low production and concentration, anxiety, depression, suicidal ideation and hopelessness, superimposing two or more psychological disorders. These factors should be pondered for a better resolution in the treatment of CDH.

One fourth of acutely admitted patients use over-the-counter-drugs 24 hours prior to hospitalisation

DEFF Research Database (Denmark)

Pedersen, Magnus; Brabrand, Mikkel

2014-01-01

to hospitalisation and the effects of this intake. MATERIAL AND METHODS: Junior physicians on call interviewed patients admitted to the medical admission unit at South-West Jutland Hospital in Esbjerg using a modified chart template. Adult patients aged 15 and older admitted during a two-week period in August 2012...... were included. Patients were asked about consumed OTC drugs, dosage, indication and effect. RESULTS: From a total of 349 admissions, 188 usable chart templates were registered (54%), and information on OTC usage was registered on 165 of these (88%). The patients where elderly (median: 70 years) and 43......, 60% felt an effect of the intake and the majority felt an effect on pain symptoms. CONCLUSION: One in four patients used OTC drugs 24 hours prior to hospitalisation and primarily analgesics were used. Most patients used OTC drugs relevantly and half with a positive effect. The intake is poorly...

Demographic characteristics of patients using a fully integrated psychosocial support service for cancer patients

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Hope Teresa

2009-12-01

Full Text Available Abstract Background Psychosocial support services are an important component of modern cancer treatment. A major challenge for all psychosocial services is the achievement of equity of use. Previous studies in the UK have found that women of higher socio-economic status with breast cancer were over-represented amongst those accessing support services. People with other cancer diagnoses, those from socio-economically deprived areas, and men, were under-represented. Findings The Oncology Health Service, Kingston Upon Hull, UK, delivers fully integrated psychosocial support and interventions. To assess equity of access in this service, a cross-sectional study of all patients with cancer accessing the service during a 5 day period was carried out. One hundred and forty-five patients attended. Forty four percent were male, and the types of cancer were broadly in the proportions expected on the basis of population prevalence (breast cancer 22%, colorectal cancer 21%, lung cancer 16%. Sixty six percent came from the three most deprived quintiles of the Townsend deprivation Index. Conclusions The fully integrated Oncology Health Service in Hull is accessed by a more diverse range of patients than previously reported for other services, and is an example of a model of service by which socially equitable use of psychosocial support in the National Health Service might be achieved.

See one, do one, teach one: advanced technology in medical education.

Science.gov (United States)

Vozenilek, John; Huff, J Stephen; Reznek, Martin; Gordon, James A

2004-11-01

The concept of "learning by doing" has become less acceptable, particularly when invasive procedures and high-risk care are required. Restrictions on medical educators have prompted them to seek alternative methods to teach medical knowledge and gain procedural experience. Fortunately, the last decade has seen an explosion of the number of tools available to enhance medical education: web-based education, virtual reality, and high fidelity patient simulation. This paper presents some of the consensus statements in regard to these tools agreed upon by members of the Educational Technology Section of the 2004 AEM Consensus Conference for Informatics and Technology in Emergency Department Health Care, held in Orlando, Florida. Web-based teaching: 1) Every ED should have access to medical educational materials via the Internet, computer-based training, and other effective education methods for point-of-service information, continuing medical education, and training. 2) Real-time automated tools should be integrated into Emergency Department Information Systems [EDIS] for contemporaneous education. Virtual reality [VR]: 1) Emergency physicians and emergency medicine societies should become more involved in VR development and assessment. 2) Nationally accepted protocols for the proper assessment of VR applications should be adopted and large multi-center groups should be formed to perform these studies. High-fidelity simulation: Emergency medicine residency programs should consider the use of high-fidelity patient simulators to enhance the teaching and evaluation of core competencies among trainees. Across specialties, patient simulation, virtual reality, and the Web will soon enable medical students and residents to... see one, simulate many, do one competently, and teach everyone.

Serum transforming growth factor beta 1 in hepatitis c virus related chronic liver disease and hepatocellular carcinoma patients

International Nuclear Information System (INIS)

El-fouly, N.F.

2007-01-01

hepatocellular carcinoma (HCC) is a major type of primary liver cancer and one of the most frequent human malignant neoplasms. it is estimated to cause more than a quarter of a million deaths each year throughout the world. the aim of the present work was to assess the value of serum level of TGF-betal in patients with HCV related CLD and its level in patients with HCC and to evaluate its sensitivity and specificity in comparison to AFP in early diagnosis of HCC. the study was performed on two groups of egyptian patients, from the tropical medicine department and outpatient,s clinic for early detection of hepatocellular carcinoma (HCC), Ain Shams university hospitals; croup 1 consisted of forty patients with chronic liver disease, their ages ranged between 85 and 35 years (mean 51.8+ 9.2 years) included 23 male patients (57.5%) and 17 female patients (42.5%), group 11 consisted of forty patients with HCC, their age ranged between 72 and 42 years (mean 54.0+ 7.5 years) included 30 male patients (75%) and 10 female patients (25%)

[An easy, safe and affective method for the treatment of intussusception: ultrasound-guided hydrostatic reduction].

Science.gov (United States)

Ülger, Fatma Esra Bahadır; Ülger, Aykut; Karakaya, Ali Erdal; Tüten, Fatih; Katı, Ömer; Çolak, Mustafa

2014-03-01

Intussusception is one of the important causes of intestinal obstruction in children. Hydrostatic reduction under ultrasound guidance is a popular treatment method for intussusception. In the present study, we aimed to explain the demographic characteristics of and treatment approaches in patients diagnosed with intussusception by ultrasound. Forty-one patients diagnosed with intussusception by ultrasound between August 2011 and May 2013 were retrospectively analyzed. Twenty-four of these patients who had no contraindications had been treated with ultrasound-guided hydrostatic reduction. Twenty-four of the patients were male and 17 were female, a 1.4/1 male-to-female ratio. The majority of the patients were between the ages of 6-24 months and 2-5 years. The mean age was 31.12±26.32 months (range 3-125). Patients were more frequently diagnosed in April and May. Seventeen patients who had clinical contraindications enrolled directly for surgery. In 20 of the 24 patients who underwent ultrasound-guided hydrostatic reduction, reduction was achieved. Three experienced recurrence. In two of these patients, successful reduction was achieved with the second attempt. The remaining patient was enrolled for surgery. Hydrostatic reduction was performed 26 times on these 24 patients, and in 22, success was achieved (84.6%). No procedure-related complications occurred in the patients. Ultrasound-guided hydrostatic reduction, with its high success rates and lack of radiation risk, should be the first choice therapeutic approach for children diagnosed with intussusception.

Clinical Evaluation of OneTouch Diabetes Management Software System in Patients with Type 2 Diabetes Mellitus

Directory of Open Access Journals (Sweden)

Jung Min Kim

2016-04-01

Full Text Available BackgroundOneTouch Diabetes Management Software (OTDMS is an efficient way to track and monitor the blood glucose level. It is possible to download data from the OneTouch Ultra via the meter's data port, and to transform the numbers of the blood glucose level into a graph, a chart, or statistics. The objectives of this study were to evaluate whether the use of OTDMS in consultation hours would improve patients' knowledge of diabetes mellitus (DM, compliance, satisfaction with doctor and medical treatment, doctor-patient reliability, and glucose control.MethodsAll patients were randomized into either the OTDMS group using OneTouch Ultra or the control groups not using it. Both groups had conventional DM education and only the OTDMS group used data from OTDMS as explanation materials during consultation hours. At enrollment and after 6 months, we performed a questionnaire survey consisting of the diabetes knowledge test, items for compliance of treatment, patient's satisfaction, doctor-patient reliability, and glycosylated hemoglobin (HbA1c.ResultsWe analyzed 6-month follow-up data from 92 patients (OTDMS 42 vs. control 50. Both groups showed significant improvements in HbA1c, diabetes knowledge, compliance, reliability, and satisfaction after 6 months. However, there were no significant differences between OTDMS and control groups overall. Only "weekly frequency of checking blood glucose level" of compliance and "trying to follow doctor's order" of reliability showed better results in the OTDMS group.ConclusionUsing the OTDMS system for explanation during consultation hours seems to be more helpful to improve patient's compliance and reliability, especially for checking blood glucose level and trying to follow the doctor's order.

Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

OpenAIRE

Mohammadreza Moshari; Bahman Malek; Mohammadreza Minator-Sajjadi; Maryam Vosoghian; Mastaneh Dahi; Mahshid Ghasemi; Razieh Shekari

2018-01-01

AbstractBackground: So far, many studies have been performed to determine the optimal dose and regimen of tranexamic acid to reduce preoperative and postoperative blood loss in primary total knee arthroplasty. In the present study, two different methods of administration (bolus and infusion), were compared.Materials and Methods: Forty patients were randomized in the two groups (A and B) of 20 patients each. All patients received 500 mg tranexamic acid before inflation of tourniquet. Group A (...

Azathioprine Intolerance in Japanese Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis

Science.gov (United States)

Morishita, Michiko; Watanabe, Haruki; Yan, Minglu; Zeggar, Sonia; Hiramatsu, Sumie; Ohashi, Keiji; Miyawaki, Yoshia; Katsuyama, Eri; Katsuyama, Takayuki; Takano Narazaki, Mariko; Toyota Tatebe, Noriko; Sunahori Watanabe, Katsue; Kawabata, Tomoko; Sada, Ken-Ei; Wada, Jun

2017-01-01

Objective To assess the safety of azathioprine (AZA) in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods We retrospectively enrolled 67 consecutive AAV patients who had initiated AZA treatment from January 2006 to August 2014 at Okayama University Hospital. We evaluated the development of severe adverse events (AEs), AZA discontinuation due to total AEs (severe AEs included) within 1 year, and AZA-associated risk factors. Results The patients' median age was 70 years old. Forty-nine women and 18 men participated at the initiation of the study. Fifty-eight (87%) patients experienced AEs, and 36 experienced severe AEs (21 hepatic and 11 cytopenic severe AEs). Thirty-one (46%) patients discontinued treatment because of AEs. Abnormal hepatic laboratory test results at the treatment initiation were more frequent in patients with hepatic severe AEs and were associated with treatment discontinuation. The leukocyte and neutrophil counts at the treatment initiation were lower in the patients who discontinued treatment because of cytopenic AEs than in those who continued treatment. Only two patients experienced flare-ups during treatment. Conclusion The AE-associated AZA discontinuation rate in Japanese AAV patients was relatively high. AZA use warrants caution in patients with abnormal hepatic laboratory test results or low leukocyte or neutrophil counts. PMID:28674351

Cognitive impairments in former patients with work-related stress complaints - one year later.

Science.gov (United States)

Eskildsen, Anita; Andersen, Lars Peter; Pedersen, Anders Degn; Andersen, Johan Hviid

2016-11-01

Patients on sick leave due to work-related stress often present with cognitive impairments. The aim of this prospective cohort study was to examine the long-term consequences of prolonged work-related stress in terms of cognitive functioning one year after initial professional care seeking. We tested a group of patients with work-related stress with a comprehensive neuropsychological test battery at two occasions, one year apart. At both time points, we compared the performance of patients with healthy controls matched pairwise on sex, age and length of education. This paper presents the results from the one-year follow-up. When adjusting for practice effects, patients improved on measures of prospective memory and processing speed. However, patients continued to perform worse than controls on all tests, though only half of the comparisons reached statistical significance. The effect sizes of the differences between the two groups at one-year follow-up were small to medium. In conclusion, former patients with prolonged work-related stress improved, but they continued to perform worse than controls after one year. In the acute phase, the largest impairments were related to executive function and mental speed but at follow-up memory impairments also became apparent.

Rapid methods for jugular bleeding of dogs requiring one technician.

Science.gov (United States)

Frisk, C S; Richardson, M R

1979-06-01

Two methods were used to collect blood from the jugular vein of dogs. In both techniques, only one technician was required. A rope with a slip knot was placed around the base of the neck to assist in restraint and act as a tourniquet for the vein. The technician used one hand to restrain the dog by the muzzle and position the head. The other hand was used for collecting the sample. One of the methods could be accomplished with the dog in its cage. The bleeding techniques were rapid, requiring approximately 1 minute per dog.

Shoulder complaints in patients with reflex sympathetic dystrophy of the upper extremity.

Science.gov (United States)

Veldman, P H; Goris, R J

1995-03-01

Five hundred forty-one patients with reflex sympathetic dystrophy (RSD) of the upper extremity were prospectively studied. One hundred fifteen patients complained of pain and/or limited range of motion in the shoulder. Shoulder complaints more often occurred in women (p = .01); age and etiology were not different from patients with RSD without shoulder complaints. Physical examination showed a tendinitis of one or both tendons of the biceps muscle in 109 patients. Seventy one patients were treated with local injection of bupivacaine followed by methylprednisolone. This resulted in permanent relief of complaints in 34 patients, temporary or moderate relief in 31, no difference in 3, increase of complaints in 1 patient, and in 2 patients results were not documented. We conclude that shoulder complaints in RSD occur in a minority of patients and more often in female patients. There are no predisposing factors. The pathophysiologic mechanism for developing shoulder complaints remains unknown. In most cases complaints can be attributed to a bicipital tendinitis for which local injection of bupivacaine followed by prednisolone are both diagnostic and therapeutic.

The effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc lactate on the microflora of oral halitosis patients : a dual-centre, double-blind placebo-controlled study

NARCIS (Netherlands)

Roldan, S; Winkel, EG; Herrera, D; Sanz, M; Van Winkelhoff, AJ

Aim: This study evaluated the microbial effects of a newly formulated mouthwash (Halita((R)) ) on oral halitosis patients. Methods: Forty subjects were included in this dual-centre, double-blind, placebo-controlled parallel study. Inclusion and exclusion criteria were used to select patients. At

Longer epilepsy duration and multiple lobe involvement predict worse seizure outcomes for patients with refractory temporal lobe epilepsy associated with neurocysticercosis

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Lucas Crociati Meguins

2015-12-01

Full Text Available ABSTRACT Objective To investigate the surgical outcomes of temporal lobe epilepsy associated with hippocampal sclerosis (TLE-HS and neurocysticercosis (NCC. Methods A retrospective investigation of patients with TLE-HS was conducted in a tertiary center. Results Seventy-nine (62.2%, 37 (29.1%, 6 (4.7%, and 5 (3.9% patients were Engel class I, II, III, and IV, respectively. Fifty-two (71.2% patients with epilepsy durations ≤ 10 years prior to surgery were seizure-free 1 year after the operation compared to 27 (50.0% patients with epilepsy durations > 10 years (p = 0.0121. Forty-three (72.9% patients with three or fewer lobes affected by NCC were seizure-free one year after the operation, and 36 (52.9% patients with more than three involved lobes were seizure-free after surgery (p = 0.0163. Conclusions Longer epilepsy durations and multiple lobe involvement predicted worse seizure outcomes in TLE-HS plus NCC patients.

Ultrasonographic Evaluation of Acupuncture Effect on Common Extensor Tendon Thickness in Patients with Lateral Epicondylitis: A Randomized Controlled Study.

Science.gov (United States)

Ural, Fatma Gülçin; Öztürk, Gökhan Tuna; Bölük, Hüma; Akkuş, Selami

2017-10-01

To explore the effect of acupuncture on common extensor tendon (CET) thickness in patients with lateral epicondylitis (LE). Additionally, to identify whether clinical and ultrasonographic changes showed any correlation. Forty-one patients were randomly assigned to acupuncture and control groups. Conventional treatment (rest, NSAİİ, bracing, exercise) methods for LE were applied to all patients. In addition to this, the acupuncture treatment was applied to the acupuncture group. The visual analog scale (VAS) for pain, the Duruoz Hand Index (DHI) for functioning of the affected limb, the pressure pain threshold, and CET thickness (via ultrasound imaging) were assessed before and end of the treatment in both groups. The VAS and DHI scores in both groups decreased. The pressure pain threshold and CET thickness only demonstrated improvement in the acupuncture group. These findings show that the CET thickness was reduced after 10 sessions of acupuncture treatment in LE patients.

What Do Patients Want? Survey of Patient Desires for Education in an Urban University Hospital

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Thomas Seibert

2014-11-01

Full Text Available Introduction: This study examines the emergency department (ED waiting room (WR population’s knowledge about the ED process and hospital function and explores the types of educational materials that might appeal to patients and their companions in an ED waiting room. Our goal was to identify potential high-impact opportunities for patient education. Methods: A 32-question survey about demographics, usage of primary care physicians (PCP, understanding of the ED and triage process, desire to know about delays, health education and understanding of teaching hospitals was offered to all qualified individuals. Results: Five hundred and forty-four surveys were returned. Fifty-five percent reported having a PCP, of which 53% (29% of all WR patients called a PCP prior to coming to the ED. It was found that 51.2% can define triage; 51% as an acuity assessment and 17% as a vital signs check. Sixty-nine percent knew why patients were seen according to triage priority. Seventy-two percent wanted to know about delays, yet only 25% wanted to know others’ wait times. People wanted updates every 41 minutes and only three percent wanted a physician to do this. Forty-one percent wanted information on how the ED functions, 60% via handouts and 43% via video. Information on updates and common medical emergencies is significantly more important than material on common illnesses, finding a PCP, or ED function (p<0.05. Median estimated time for medical workup ranged from 35 minutes for radiographs, to one hour for lab results, computed tomography, specialist consult, and admission. Sixty-nine percent knew the definition of a teaching hospital and of those, 87% knew they were at a teaching hospital. Subgroup analysis between racial groups showed significantly reduced knowledge of the definitions of triage and teaching hospitals and significantly increased desire for information on ED function in minority groups (p<0.05. Conclusion: The major findings in this study

Changing practice: red blood cell typing by molecular methods for patients with sickle cell disease.

Science.gov (United States)

Casas, Jessica; Friedman, David F; Jackson, Tannoa; Vege, Sunitha; Westhoff, Connie M; Chou, Stella T

2015-06-01

Extended red blood cell (RBC) antigen matching is recommended to limit alloimmunization in patients with sickle cell disease (SCD). DNA-based testing to predict blood group phenotypes has enhanced availability of antigen-negative donor units and improved typing of transfused patients, but replacement of routine serologic typing for non-ABO antigens with molecular typing for patients has not been reported. This study compared the historical RBC antigen phenotypes obtained by hemagglutination methods with genotype predictions in 494 patients with SCD. For discrepant results, repeat serologic testing was performed and/or investigated by gene sequencing for silent or variant alleles. Seventy-one typing discrepancies were identified among 6360 antigen comparisons (1.1%). New specimens for repeat serologic testing were obtained for 66 discrepancies and retyping agreed with the genotype in 64 cases. One repeat Jk(b-) serologic phenotype, predicted Jk(b+) by genotype, was found by direct sequencing of JK to be a silenced allele, and one N typing discrepancy remains under investigation. Fifteen false-negative serologic results were associated with alleles encoding weak antigens or single-dose Fy(b) expression. DNA-based RBC typing provided improved accuracy and expanded information on RBC antigens compared to hemagglutination methods, leading to its implementation as the primary method for extended RBC typing for patients with SCD at our institution. © 2015 AABB.

Utility of screening ultrasound after first febrile UTI among patients with clinically significant vesicoureteral reflux.

Science.gov (United States)

Massanyi, Eric Z; Preece, Janae; Gupta, Angela; Lin, Susan M; Wang, Ming-Hsien

2013-10-01

To assess the sensitivity and negative predictive value (NPV) of screening renal and bladder ultrasound (RBUS) after initial febrile urinary tract infection (UTI) among patients with clinically significant vesicoureteral reflux (VUR). A retrospective review was performed of all children UTI between 2004 and 2011. The sensitivity and NPV of initial RBUS was calculated among patients who were found to have high-grade (IV-V) VUR. Additionally, initial RBUS among patients with evidence of photopenia on dimercaptosuccinic acid (DMSA) scan or who underwent surgical intervention were reviewed. One hundred forty-four patients with febrile UTI were identified; available RBUS, voiding cystourethrogram (VCUG), and DMSA results for each kidney were reviewed. One hundred fifty-eight kidneys had evidence of VUR on VCUG, and initial RBUS demonstrated abnormality in 25 (sensitivity 0.17). Forty-five kidneys had high-grade VUR and RBUS revealed abnormality in 16 (sensitivity 0.36). One hundred seventy-eight kidneys had no evidence of abnormality on initial RBUS, and 136 (76%) were found to have VUR (NPV 0.24), of which 31 had high-grade VUR (NPV 0.83). Seven kidneys had scarring on DMSA and initial RBUS was normal in 4 (57%). Twelve of 19 patients (63%) who eventually underwent surgical intervention had a normal initial RBUS. RBUS has poor sensitivity and NPV for detecting high-grade VUR in patients UTI. A significant number of patients who were diagnosed with high-grade VUR, renal scarring, or underwent surgical correction of VUR had a negative screening RBUS. Copyright © 2013 Elsevier Inc. All rights reserved.

Idarucizumab in Three Patients Needing Urgent Surgical Intervention and One Case of Intravenous Thrombolysis in Ischaemic Stroke

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Fredrik Andreas von Wowern

2017-05-01

Full Text Available Objective: To describe the benefits of reversal of the anticoagulation effects of dabigatran etexilate in patients requiring urgent surgery or thrombolysis for ischaemic stroke. Materials and methods: Four patients, treated with dabigatran etexilate and presenting with cholecystitis, tibial fracture, lower limb ischaemia and ischaemic stroke, respectively. Results: Administration of idarucizumab normalized bleeding parameters and provided safe conditions for surgery and, in one case, successful thrombolysis of an ischaemic stroke. Conclusion: The introduction of an effective reversal agent for dabigatran etexilate allows physicians perform surgery under conditions of normal coagulation and permits thrombolysis in patients with ischaemic stroke despite being treated with dabigatran etexilate.

Safety and Efficacy of Fingolimod and Natalizumab in Multiple Sclerosis After the Failure of First-Line Therapy: Single Center Experience Based on the Treatment of Forty-Four Patients.

Science.gov (United States)

Puz, Przemysław; Lasek-Bal, Anetta

2016-11-10

BACKGROUND In Poland, natalizumab or fingolimod treatment can be delivered as a second-line therapy to those patients with relapsing-remitting multiple sclerosis (RRMS) who demonstrated no response to interferon or glatiramer acetate treatment for a minimum of one year. MATERIAL AND METHODS Analysis covered 44 RRMS patients switched from first- to second-line therapy. The annualized relapse rate, disability progression (assessed with Expanded Disability Status Scale, EDSS) and MRI results (new or enlarged T2 lesions and new Gd-positive lesions) before and after switching were compared. The occurrence of adverse events was also assessed. RESULTS The annualized relapse rate for second-line therapy was significantly lower than for first-line therapy (0.35±0.74 vs. 2.13±0.87, p=0.00005). Median of EDSS progression with first-line therapy was significantly higher than that with natalizumab or fingolimod treatment (p=0.00002). The mean number of new or enlarged T2 and Gd+ lesions in MRI after one-year second-line treatment was significantly lower in comparison to lesions in MRI performed at the end of the first-line therapy (for T2: 0.61 vs. 4.56, p=0.0004; for Gd+: 0.13 vs. 1.98, p=0.0009). No significant differences in the clinical data, MRI results, and side effects between fingolimod and natalizumab patients have been observed. CONCLUSIONS Treatment with natalizumab or fingolimod as a second-line therapy in RRMS patients is safe and effective. Less restrictive criteria for switching should be considered.

Communication about sexual health with breast cancer survivors: Variation among patient and provider perspectives.

Science.gov (United States)

Canzona, Mollie Rose; Garcia, David; Fisher, Carla L; Raleigh, Meghan; Kalish, Virginia; Ledford, Christy J W

2016-11-01

Breast cancer survivors experience a range of sexual health (SH) issues. Communication problems between patient and provider can prevent survivors from pursuing SH goals and can negatively influence biopsychosocial outcomes. The primary aims of this study were to identify provider communication behaviors that facilitate or impede clinical interactions regarding SH (according to survivors and providers) and to highlight discrepancies that affect care. Forty breast cancer survivors and forty health care providers from a variety of specialties participated in semi-structured interviews informed by the Critical Incident Technique. Transcripts were thematically analyzed using the constant comparative method. Survivors and providers discussed the importance of honoring individual patient needs and conveying compassionate messages. However, accounts varied significantly regarding the appropriate timing and method of initiating SH discussions and the helpfulness of certain support behaviors and linguistic devices. Provider and survivor accounts of what constitutes helpful and unhelpful provider communication behaviors when discussing SH concerns are misaligned in nuanced and meaningful ways. These discrepancies reveal potential areas for educational intervention. SH discussions require providers to examine assumptions about patients' communication preferences and information needs. Patients may benefit from frank yet sensitive discussions earlier in the cancer continuum. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The portfolio method as management support for patients with major depression.

Science.gov (United States)

Nunstedt, Håkan; Nilsson, Kerstin; Skärsäter, Ingela

2014-06-01

To describe how patients with major depression in psychiatric outpatient care use the portfolio method and whether the method helps the patients to understand their depression. Major depressive disorder is an increasing problem in society. Learning about one's depression has been demonstrated to be important for recovery. If the goal is better understanding and management of depression, learning must proceed on the patient's own terms, based on the patient's previous understanding of their depression. Learning must be aligned with patient needs if it is to result in meaningful and useful understanding. Each patient's portfolio consisted of a binder. Inside the binder, there was a register with predetermined flaps and questions. The patients were asked to work with the questions in the sections that built the content in the portfolio. Individual interviews with patients (n = 5) suffering from major depression according to Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) (American Psychiatric Association 1994) were repeatedly conducted between April 2008 and August 2009 in two psychiatric outpatient clinics in western Sweden. Data were analysed using latent content analysis. The results showed that the portfolio was used by patients as a management strategy for processing and analysis of their situation and that a portfolio's structure affects its usability. The patients use the portfolio for reflection on and confirmation of their progress, to create structure in their situation, as a management strategy for remembering situations and providing reminders of upcoming activities. Using a clearly structured care portfolio can enable participation and patient learning and help patients understand their depression. The portfolio method could provide a tool in psychiatric nursing that may facilitate patient understanding and increase self-efficacy. © 2013 John Wiley & Sons Ltd.

Assessing caries increments in elderly patients with and without dementia A one-year follow-up study

DEFF Research Database (Denmark)

Ellefsen, B.; Holm-Pedersen, P.; Morse, D.E.

2009-01-01

for all participants, and the number was highest for the OD group. The one-year adjusted caries and filling increments (ADJCIs) were high for participants with and without dementia but were highest for participants in the AD and OD groups. Baseline risk factors for developing elevated coronal and root......Background The authors conducted. a study to determine one-year, coronal and root caries increments in patients newly diagnosed as having Alzheimer disease (AD), other dementia (OD) or no dementia. Methods. The authors recruited patients from two hospital memory clinics in Copenhagen. The oral...... ADJCIs included having caries, having many teeth and being older than 80 years. onclusions. Elderly people referred to a memory clinic were at an elevated risk of developing high levels of coronal and root-surface caries during the first year after referral, and those with a dementia diagnosis other than...

Use of healthcare, patient satisfaction and burden of care in Guillain-Barre syndrome.

Science.gov (United States)

Forsberg, Anette; de Pedro-Cuesta, Jesús; Widén Holmqvist, Lotta

2006-07-01

The aim of this study was to investigate, in an unselected sample of patients with Guillain-Barré syndrome in Sweden, the utilization of healthcare resources, satisfaction with these resources, informal help and the burden of care on family caregivers during the first 2 years after onset. Forty-four patients were enrolled from 8 hospitals, and 42 of them were followed for 2 years. Data on the utilization of hospital inpatient and outpatient care, primary care and community-based services were collected via computerized registry information, medical records and a specific protocol. Patient satisfaction and the burden on family caregivers were studied using questionnaires. Forty-one patients required inpatient hospitalization for a mean of 82 days. Patients with persistent dependency during activities of daily living had significantly longer hospital stays and more days of outpatient rehabilitation. The majority of patients were satisfied with their care, but dissatisfaction was found regarding information and finances. At 2 years after onset, 26% of patients still depended on informal help. The spouses expressed increased concern and responsibility for household and family. Patients with persistent disability due to Guillain-Barré syndrome were found to have long-term need for services from the healthcare system and informal help.

The association between WNT10A variants and dental development in patients with isolated oligodontia

NARCIS (Netherlands)

Dhamo, Brunilda; Fennis, Willem; Creton, Marijn; Vucic, Strahinja; Cune, Marco; van Amstel, Hans Kristian Ploos; Wolvius, Eppo B; van den Boogaard, Marie-Jose; Ongkosuwito, Edwin M.

2017-01-01

In this study we aimed to determine the effect of WNT10A variants on dental development in patients with oligodontia. Forty-three (25 boys and 18 girls) individuals were eligible for this study. Stage of development for each present tooth was assessed using the Demirjian method. In case no

Patient information and patient preparation in orthognathic surgery : A medical audit study

NARCIS (Netherlands)

Rittersma, J.; Casparie, A.F.; Reerink, E.

1980-01-01

In 110 patients who had undergone various kinds of orthognathic surgery, patient satisfaction was measured by means of a written questionnaire. Ninety-four percent expressed satisfaction, both with regard to total preparation and the final outcome of the surgical procedure itself. Twenty to forty

Evaluation of Blood Pressure Control Levels and Treatment Compliances of Hypertensive Patients

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Cenk Aypak

2013-04-01

Full Text Available Purpose: The aim of the study is to evaluate the knowledge of patients about hypertension (HT, compliance with lifestyle changes and to determine their blood pressure levels under antihypertensive therapy. Method: Hypertensive patients that applied to Family medicine outpatient clinics of Diskapi Yildirim Beyazit Education and Research Hospital for the first time, in 2012 (between February 1 to April 30, were included in our cross-sectional study. Patients are evaluated primarily for the control and the factors that can affect high blood pressure and the rate on achieving treatment goals. Results: Three hundred and forty patients were included in the study. The mean age of the patients was 60.5±10.7 years and 222 of them (65.3% were female. The blood pressure was not under control in 108 (31.8% patients. The mean body weight of male patients was statistically higher than females (p=0.015. The number of the patients that knew the normal blood pressure value was 249 (73.2%. Among those 155 (62.2% were women and 179 (71.9% were younger than 65 years of age (p=0.0001. Forty one patients (12.1% were still smoking, 46 (13.5% patients were exercising regularly and 32 (9.4% were consuming regular diet. Blood pressure was better controlled in the group that was exercising regularly (p=0.001. The rate of male patients that were on regular exercise and diet, were higher than females (p=0.09. Only 86 patients (25.3% knew the name of their antihypertensive medication and 65 of patients (19.1% knew the dose of their medication. Female patients knew the name of their medication better than males (p=0.002. 156 patients (45.9% were using two kinds of antihypertensive medication. 58 patients (17.1% were skipping doses a few times a week. Conclusion: The knowledge of hypertensive patients on their illness and their compliance on non-drug treatments were inadequate. The compliance of patients should be improved by development of patient-doctor should be improved

Display methods of electronic patient record screens: patient privacy concerns.

Science.gov (United States)

Niimi, Yukari; Ota, Katsumasa

2013-01-01

To provide adequate care, medical professionals have to collect not only medical information but also information that may be related to private aspects of the patient's life. With patients' increasing awareness of information privacy, healthcare providers have to pay attention to the patients' right of privacy. This study aimed to clarify the requirements of the display method of electronic patient record (EPR) screens in consideration of both patients' information privacy concerns and health professionals' information needs. For this purpose, semi-structured group interviews were conducted of 78 medical professionals. They pointed out that partial concealment of information to meet patients' requests for privacy could result in challenges in (1) safety in healthcare, (2) information sharing, (3) collaboration, (4) hospital management, and (5) communication. They believed that EPRs should (1) meet the requirements of the therapeutic process, (2) have restricted access, (3) provide convenient access to necessary information, and (4) facilitate interprofessional collaboration. This study provides direction for the development of display methods that balance the sharing of vital information and protection of patient privacy.

Application of transcatheter arterial embolization in the intractable epistaxis

International Nuclear Information System (INIS)

Huang Zhaodong; Li Mingjun; Zhang Chuanwen

2005-01-01

Objective: To evaluate the value of transcatheter arterial embolization (TAE) in the treatment of intractable epistaxis. Methods: TAE using gel form or polyvinyl alcohol (PVA) particles of forty-one patients with intractable epistaxis were undertaken by the femoral artery approach, through selective catheterization of involved maxillary artery or the bleeding arteries for the stoppage of bleeding. Results: Of the forty-one patient, 39 cases were cured by once TAE and the other 2 with recurrent bleeding on the next day after the TAE, to whom a second interventional treatment full filled the requirement. Conclusions: Transcatheter arterial embolization is a simple, safe and effective treatment for the intractable epistaxis. (authors)

CT findings of pulmonary tuberculosis in diabetic and immunocompromised patients

Energy Technology Data Exchange (ETDEWEB)

Takeuchi, Noriyuki; Ikezoe, Junpei; Johkoh, Tsuyoshi (Osaka Univ. (Japan). Faculty of Medicine) (and others)

1992-01-01

To evaluate the CT features of pulmonary tuberculosis in diabetic or immunocompromised patients, we reviewed CT of the chest in 42 adult patients with active pulmonary tuberculosis. Forty-two had some underlying diseases or immunocompromised conditions (31 diabetes mellitus, 6 malignancies, 2 long-term steroid therapy, 2 pneumoconiosis, and one anorexia nervosa). In diabetic or immunocompromised patients, a high incidence of non-segmental distribution (27%) and multiple small cavities in a cavitary lesion (45%) was observed. Unusual localization of the lesions such as lower lung field disease was observed in 18% of cases (the incidence of unusual localization in patients with no underlying disease was equal to diabetic or immunocompromised patients). (author).

CT findings of pulmonary tuberculosis in diabetic and immunocompromised patients

International Nuclear Information System (INIS)

Takeuchi, Noriyuki; Ikezoe, Junpei; Johkoh, Tsuyoshi

1992-01-01

To evaluate the CT features of pulmonary tuberculosis in diabetic or immunocompromised patients, we reviewed CT of the chest in 42 adult patients with active pulmonary tuberculosis. Forty-two had some underlying diseases or immunocompromised conditions (31 diabetes mellitus, 6 malignancies, 2 long-term steroid therapy, 2 pneumoconiosis, and one anorexia nervosa). In diabetic or immunocompromised patients, a high incidence of non-segmental distribution (27%) and multiple small cavities in a cavitary lesion (45%) was observed. Unusual localization of the lesions such as lower lung field disease was observed in 18% of cases (the incidence of unusual localization in patients with no underlying disease was equal to diabetic or immunocompromised patients). (author)

Magnetic resonance imaging, radiography, and scintigraphy of the finger joints: one year follow up of patients with early arthritis

Science.gov (United States)

Klarlund, M; Ostergaard, M; Jensen, K; Madsen, J; Skjodt, H; Lorenzen, I; the, T

2000-01-01

OBJECTIVES—To evaluate synovial membrane hypertrophy, tenosynovitis, and erosion development of the 2nd to 5th metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints by magnetic resonance imaging in a group of patients with rheumatoid arthritis (RA) or suspected RA followed up for one year. Additionally, to compare the results with radiography, bone scintigraphy, and clinical findings.
PATIENTS AND METHODS—Fifty five patients were examined at baseline, of whom 34 were followed up for one year. Twenty one patients already fulfilled the American College of Rheumatology (ACR) criteria for RA at baseline, five fulfilled the criteria only after one year's follow up, whereas eight maintained the original diagnosis of early unclassified polyarthritis. The following MRI variables were assessed at baseline and one year: synovial membrane hypertrophy score, number of erosions, and tenosynovitis score.
RESULTS—MRI detected progression of erosions earlier and more often than did radiography of the same joints; at baseline the MRI to radiography ratio was 28:4. Erosions were exclusively found in patients with RA at baseline or fulfilling the ACR criteria at one year. At one year follow up, scores of MR synovial membrane hypertrophy, tenosynovitis, and scintigraphic tracer accumulation had not changed significantly from baseline; in contrast, swollen and tender joint counts had declined significantly (pthe changes seen over time in clinically assessed swollen and tender joint counts. Although joint disease activity may be assessed as quiescent by conventional clinical methods, a more detailed evaluation by MRI may show that a pathological condition is still present within the synovium.

 PMID:10873961

Dynamic scintigraphy of salivary glands in patients suffering from Sycca Syndrome

International Nuclear Information System (INIS)

Mijatovic, J.M.; Rajkovaca Zvezdana, Z.R.

2002-01-01

Aim: The objective of the study was to analyse the obtained results and evaluate the dynamic scintigraphy value in appraising the functional condition of salivary glands in patient suffering from Sycca Syndrome. Materials: Fifty-three patients (5 men and 48 women), aged l8-80, were referred to specialist for rheumatic diseases in the period March 2000 - March 2002. The patients had some of the following symptoms: dryness of oral cavity, dryness of conjunctivas with or without a chronic polyarthritis symptom. Methodology: Upon intravenous injection of 142-222MBq 99mTc pertechnetate, acquisition (matrix 64x64, 25 frems of 60 seconds, l5 minutes, vitamin C tablet under tongue). Generating of dynamic curves above both parotid and both submandibular salivary glands and semi-quantitative analysis of curves. Results: Four (4) out fifty-three (53) patients had a normal (regular) finding. Forty-nine (49) out of 53 patients had deviating dynamic curvec generated above the mentioned glands. Nineteen (19) out of those 49 patients had deviated all 4 dynamic curves, 22 out of 49 patients had deviated curves only above submandibular salivary glands, 1 patient had deviated curves only above parotid glands, 1 patient had deviated curves above both parotid and one submandibular salivary glands and the other 6 out of 49 patients had deviated curve only above one of the mentioned glands. Conclusion: In the diagnosis of Sycca syndrome, simple and non-invasive method for observing functional condition of parotid and submandibular salivary glands may help in clinical management of patients for diagnosing of heterogenic group of immunosialoadenitis

Diagnostic value of diuretic-enhanced excretory MR urography in patients with obstructive uropathy

Energy Technology Data Exchange (ETDEWEB)

Karabacakoglu, Aydin E-mail: radaydin@hotmail.com; Karakose, Serdar; Ince, Ozlem; Cobankara, Osman Ege; Karalezli, Giray

2004-12-01

Purpose: Ultrasonography and conventional intravenous urography are most common methods in diagnosis of obstructive uropathies. The disadvantage of ultrasonography is inability of visualizing middle and lower one thirds of ureter, while intravenous urography is using radiation, also functionally extra loading effect on kidneys. In this study, the diagnostic value of MR urography on obstructive uropathy were investigated. Materials and methods: Forty five patients who were suffered from obstructive uropathy examined by ultrasonography, intravenous urography and diuretic-enhanced excretory MR urography by using MR-contrast-agent. Results: MR urography established accuracy rate of 92.8% for stone diseases which formed the largest group in this study, however, in other causes of obstructive uropathy, MR urography provide 100% correct diagnosis. Conclusion: MR urography provide high quality images for diagnosing and determining causes of urinary obstruction defining position and severity of dilatations as well as showing localization of the pathology. We think that MR urography should be a primary investigation in patients with obstructive uropathy who have contrast agent and X-ray contrindication.

Diagnostic value of diuretic-enhanced excretory MR urography in patients with obstructive uropathy

International Nuclear Information System (INIS)

Karabacakoglu, Aydin; Karakose, Serdar; Ince, Ozlem; Cobankara, Osman Ege; Karalezli, Giray

2004-01-01

Purpose: Ultrasonography and conventional intravenous urography are most common methods in diagnosis of obstructive uropathies. The disadvantage of ultrasonography is inability of visualizing middle and lower one thirds of ureter, while intravenous urography is using radiation, also functionally extra loading effect on kidneys. In this study, the diagnostic value of MR urography on obstructive uropathy were investigated. Materials and methods: Forty five patients who were suffered from obstructive uropathy examined by ultrasonography, intravenous urography and diuretic-enhanced excretory MR urography by using MR-contrast-agent. Results: MR urography established accuracy rate of 92.8% for stone diseases which formed the largest group in this study, however, in other causes of obstructive uropathy, MR urography provide 100% correct diagnosis. Conclusion: MR urography provide high quality images for diagnosing and determining causes of urinary obstruction defining position and severity of dilatations as well as showing localization of the pathology. We think that MR urography should be a primary investigation in patients with obstructive uropathy who have contrast agent and X-ray contrindication

Sentinel lymph nodes in cancer of the oral cavity

DEFF Research Database (Denmark)

Thomsen, Jørn Bo; Christensen, Rikke Kølby; Sørensen, Jens Ahm

2007-01-01

when compared with (B) step-sectioning and immunostaining of the entire sentinel lymph node at 250 microM levels. METHODS: Forty patients with T1/T2 cN0 oral cancer were enrolled. Three patients were excluded. In one patient no sentinel lymph node was identified. The remaining two had unidentified...

Effect of Educational Program on Quality of Life of Patients with Heart Failure: A Randomized Clinical Trial

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Mohammad Khajegodary

2013-02-01

Full Text Available Introduction: Heart failure is one of the most common cardiovascular diseases which decrease the quality of life. Most of the factors influencing the quality of life can be modified with educational interventions. Therefore, this study examined the impact of a continuous training program on quality of life of patients with heart failure. Methods: This randomized clinical trial study was conducted during May to August 2011. Forty four participants with heart failure referred to Shahid Madani's polyclinics of Tabriz were selected through convenient sampling method and were randomly allocated to two groups. The intervention group (n = 22 received ongoing training including one-to-one teaching, counseling sessions and phone calls over 3 months. The control group (n = 22 received routine care program. Data on quality of life was collected using the Minnesota Living with Heart Failure Questionnaire at baseline as well as three months later. Results: The statistical tests showed significant differences in the physical, emotional dimensions and total quality of life in intervention group. But in control group, no significant differences were obtained. There was not any significant association in demographic characteristics and quality of life. Conclusion: Ongoing training programs can be effective in improving quality of life of patients with heart failure. Hence applying ongoing educational program as a non-pharmacological intervention can help to improve the quality of life of these patients.

Value of stereotactic radiosurgery in patients with multiple brain metastases

International Nuclear Information System (INIS)

Chen Jie; Lin Zhiguo; Li Qingguo; Shen Hong

2002-01-01

Objective: To analyze the prognostic factors and evaluate the effect of stereotactic radiosurgery for patients with multiple brain metastases. Methods: Comparison was made in 53 such patients treated by stereotactic radiosurgery plus radiotherapy and 53 treated by radiotherapy alone. Patients were matched-paired according to the following criteria: age, Karnofsky performance scale (KPS) before treatment, extent of systemic cancer and number of brain metastasis. Forty patients had stereotactic radiosurgery, 13 patients stereotactic fractionated radiosurgery. In the stereotactic radiosurgery group, the patients were given a mean marginal dose of 20 Gy. Methods of stereotactic fractionated radiosurgery was 4-12 Gy per fraction , twice a week to a total dose of 15-30 Gy. Whole brain radiotherapy was given immediately after stereotactic radiosurgery. For patients treated by radiotherapy alone, the entire brain was treated by 30-40 Gy in 3-4 weeks. Results: The median survival was 11.6 months in stereotactic radiosurgery plus radiotherapy and 6.7 months in radiotherapy alone. The one year survival rate and one year local control rate were 44.3%, 17.1% and 50.9%, 13. 2%. Those with KPS increased after treatment gave 1-year survivals of 69.8% and 30.2%, respectively. The validity rates in CT or MRI three months after treatment were 82.0% and 55.0%. The difference in the two groups was found to be statistically significant (P < 0.01). 23.3% of death in the stereotactic radiosurgery plus radiotherapy group was due to brain metastasis vs 51.0% in the radiotherapy alone group (P < 0.05). Complication of the two groups was similar. Conclusion: Stereotactic radiosurgery plus radiotherapy is superior to radiotherapy alone for multiple brain metastases in improving the local control and ultimate outcome

Prevalence of hereditary factors predisposing to thrombosis in 260 patients diagnosed as thrombosis and investigated at Hospital Israelita Albert Einstein, São Paulo, Brazil

Directory of Open Access Journals (Sweden)

João Carlos de Campos Guerra

2005-06-01

Full Text Available Objective: To evaluate the prevalence of genetic polymorphism incoagulation factors in thromboembolic disease in patients withclinical suspicion of thrombosis. Methods: A retrospective casecollection was performed searching all patients with clinicalsuspicion of thrombosis who were submitted to coagulation factoranalysis at the Hospital Israelita Albert Einstein from November2003 to April 2004. We included 260 patients, 118 male and 142female, mean age of 46 years. Prothrombin mutation and Leiden Vfactor were evaluated with multiplex PCR. Protein C, S and lupusanticoagulant were studied in coagulation assays. AntithrombinIII was studied by chromogenic assay. Anticardiolipin was evaluatedthrough an immunoenzymatic method and homocysteine by animmunometric method. Results: Factor V Leiden was found in 22cases (8.3 %, one homozygote and 21 heterozygotes. Prothrombinmutation was found in 18 cases (6.8%, one homozygote and 17heterozygotes. Forty cases with genetic alteration showed 34 caseswith thrombosis (85%, 29 venous thrombosis and 4 arterialthrombosis. One hundred and seven patients were tested foranticardiolipin antibodies: 21 were anticardiolipin antibody positives(19.6%, and 15 of them had IgG antibodies, 3 IgM and 3 IgA. Sixteenof the 21 patients had thrombosis, 11 venous thrombosis and 5arterial thrombosis. Lupus anticoagulant was found in two patients,both with thrombosis. There was only one case ofhyperhomocystinemia, with thrombosis. Protein C, protein S andantithrombin III deficiencies were found in 63 cases (12%. Out of31 cases with thrombosis (49,2 %, 26 cases had venous thrombosisand 5 had arterial thrombosis. Conclusion: Thromboembolicdisease is clearly associated with genetic factors but there isconsensus its cause is multifactorial. Genetic alterations, however,should be studied when there is clinical evidence of thrombosis,at least in young patients.

Pyometra caused by carrying of an intrauterine device for a period of forty years and chronic endometritis

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Todorović Nada 1

2002-01-01

Full Text Available Pyometra is the accumulation of pus in the uterine cavity, thus streaching its walls and thinning and enlarging the uterus. This change is characteristic of the senium period of life, when the uterus is atrophie with a stenotic cervical canal. It most frequently occurs as a result of secondary infection of the cancerogenic tissue of the uterus and additional stenosation and clogging up of cervical canal by a malignant process. Apart from carcinomas of the body and uterus cervix, pyometra less often can occur in other illnesses such as senile endometritis and senile colpitis. As pyometra most frequently occurs in uterine carcinomas, in detection of this state, we must think of malignancy and direct our examination to this direction. In this paper we present a patient in whom pyometra developed because she carried an intrauterine device for forty years that resulted in chronic endometritis. The main symptoms for which the patient was admited to hospital were abdominal pain and intensive suppurative vaginal excretion a month after removal of intrauterine device. The diagnosis of pyometra was made by gynaecological and ultrasound examinations, and also on the basis of gynecological and ultrasound examinations one month after chronic endometritis was confirmed. On the basis of this finding we suspected that chronic endometritis was caused by this state. By cytological, PAP and histopathological examinations of samples obtained by explorative curettage and biopsy of the uterine cervix, malignant changes were eliminated a possible cause. By laboratory analysis and bacteriological examination of the uterine cavity and vaginal excretion, inflammatory changes of the uterine mocous membrane were confirmed as a cause of the pyometra. This conditions was due to carrying the intrauterine device for more decades. The therapy consisted of dilatation of the cervical canal and evacuation of accumulated suppurative contents and irrigation of uterine cavity with 3

Application of a modified collocation method to the one dimensional, one group neutron transport equation

International Nuclear Information System (INIS)

Maschek, W.

1976-07-01

A modified collocation method is used for solving the one group criticality problem for a uniform multiplying slab. The critical parameters and the angular fluxes for a number of slabs are displayed and compared with previously published values. (orig.) [de

MRI assessment of early response to certolizumab pegol in rheumatoid arthritis

DEFF Research Database (Denmark)

Østergaard, Mikkel; Jacobsson, L T H; Schaufelberger, C

2015-01-01

OBJECTIVES: To identify the first time point of an MRI-verified response to certolizumab pegol (CZP) therapy in patients with rheumatoid arthritis (RA). METHODS: Forty-one patients with active RA despite disease-modifying antirheumatic drug therapy were randomised 2:1 to CZP (CZP loading dose 400...

Risk Prediction of One-Year Mortality in Patients with Cardiac Arrhythmias Using Random Survival Forest

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Fen Miao

2015-01-01

Full Text Available Existing models for predicting mortality based on traditional Cox proportional hazard approach (CPH often have low prediction accuracy. This paper aims to develop a clinical risk model with good accuracy for predicting 1-year mortality in cardiac arrhythmias patients using random survival forest (RSF, a robust approach for survival analysis. 10,488 cardiac arrhythmias patients available in the public MIMIC II clinical database were investigated, with 3,452 deaths occurring within 1-year followups. Forty risk factors including demographics and clinical and laboratory information and antiarrhythmic agents were analyzed as potential predictors of all-cause mortality. RSF was adopted to build a comprehensive survival model and a simplified risk model composed of 14 top risk factors. The built comprehensive model achieved a prediction accuracy of 0.81 measured by c-statistic with 10-fold cross validation. The simplified risk model also achieved a good accuracy of 0.799. Both results outperformed traditional CPH (which achieved a c-statistic of 0.733 for the comprehensive model and 0.718 for the simplified model. Moreover, various factors are observed to have nonlinear impact on cardiac arrhythmias prognosis. As a result, RSF based model which took nonlinearity into account significantly outperformed traditional Cox proportional hazard model and has great potential to be a more effective approach for survival analysis.

Neuropeptides in the desert ant Cataglyphis fortis: Mass spectrometric analysis, localization, and age-related changes.

Science.gov (United States)

Schmitt, Franziska; Vanselow, Jens T; Schlosser, Andreas; Wegener, Christian; Rössler, Wolfgang

2017-03-01

Cataglyphis desert ants exhibit an age-related polyethism, with ants performing tasks in the dark nest for the first ∼4 weeks of their adult life before they switch to visually based long-distance navigation to forage. Although behavioral and sensory aspects of this transition have been studied, the internal factors triggering the behavioral changes are largely unknown. We suggest the neuropeptide families allatostatin A (AstA), allatotropin (AT), short neuropeptide F (sNPF), and tachykinin (TK) as potential candidates. Based on a neuropeptidomic analysis in Camponotus floridanus, nano-LC-ESI MS/MS was used to identify these neuropeptides biochemically in Cataglyphis fortis. Furthermore, we show that all identified peptide families are present in the central brain and ventral ganglia of C. fortis whereas in the retrocerebral complex only sNPF could be detected. Immunofluorescence staining against AstA, AT, and TK in the brain revealed arborizations of AstA- and TK-positive neurons in primary sensory processing centers and higher order integration centers, whereas AT immunoreactivity was restricted to the central complex, the antennal mechanosensory and motor center, and the protocerebrum. For artificially dark-kept ants, we found that TK distribution changed markedly in the central complex from days 1 and 7 to day 14 after eclosion. Based on functional studies in Drosophila, this age-related variation of TK is suggestive of a modulatory role in locomotion behavior in C. fortis. We conclude that the general distribution and age-related changes in neuropeptides indicate a modulatory role in sensory input regions and higher order processing centers in the desert ant brain. J. Comp. Neurol. 525:901-918, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

CT in the evaluation of patients on ECMO due to acute respiratory failure

International Nuclear Information System (INIS)

Lidegran, Marika; Jorulf, Haakan; Palmer, Kenneth; Linden, Viveka

2002-01-01

Heading AbstractBackground. In patients with acute severe respiratory failure (ARF) treated with extracorporeal membrane oxygenation (ECMO) the radiological evaluation has until now almost exclusively relied on bedside radiography and US. At St. Goeran/Karolinska ECMO centre CT has become a routine complement to bedside examinations.Objective. To review retrospectively the frequency, indications and findings on CT of patients with ARF on ECMO and to evaluate the risk of complications associated with transportation for CT examinations.Materials and methods. One hundred twelve neonates, children and adults were treated with ECMO from May 1994 to January 2001. Forty-six per cent of these patients had CT examinations on one or more occasions during ECMO, giving a total number of 238 examination sites on 104 occasions. All CT examinations were performed in the Paediatric Radiology Department and included a 10-min transport using a mobile ECMO system.Results. CT was more often performed in older patients and in patients with long ECMO runs. The main indications were suspected complications of ECMO and/or the underlying disease or a delay in clinical improvement. In 57% of the CT occasions, significant findings affecting treatment were revealed. There were no complications associated with the examinations or transport.Conclusions. CT is safe and useful in evaluation of patients with ARF during ECMO. (orig.)

Patient perceptions of integrated care: confused by the term, clear on the concept

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Kara Odom Walker

2013-03-01

Full Text Available Purpose: Health care reform in the United States has introduced terms such as “the patient-centered medical home” and “integrated care” that are often unclear and unfamiliar to patients. This study explored patient experiences with the functional domains of integrated care. Theory and methods: Patients first wrote their definitions of integrated care and then participated in focus group discussions about their experiences with the health care system. Transcripts were analyzed for thematic content. Results: Forty-four patients participated in one of seven focus groups in San Francisco, CA in English and Spanish. Many patients were not clear about the meaning of the term integrated care. However, patients described experiences largely reflected in an existing conceptual model of integrated care and the importance of coordination within and across teams and with community resources, continuity and sharing of information, and patient engagement. Patients with high medical needs described the ubiquitous challenges they faced in experiencing coordinated care. Conclusions: Patients may not understand the term integrated care but are relatively clear on what the concept of integrated care entails and support its successful implementation. Patients and their families are at the center of integrated care, and health systems need to support and empower them to successfully navigate the medical neighborhood.

Effect of computerized cognitive rehabilitation program on cognitive function and activities of living in stroke patients

OpenAIRE

Yoo, Chanuk; Yong, Mi-hyun; Chung, Jaeyeop; Yang, Yeongae

2015-01-01

[Purpose] The objective of this study was to examine the effect of cognitive rehabilitation using a computer on cognitive function and activities of daily living in stroke patients presenting impairment of cognitive function. [Subjects] Forty-six stroke patients were divided into two groups (a training group and control group) through random assignment. [Methods] The training group received rehabilitation therapy and an additional computerized cognitive rehabilitation program using The RehaCo...

Measures of 'exposure needed for one additional patient to be harmed' in population-based case-control studies

DEFF Research Database (Denmark)

Hallas, J.; Christensen, R. D.; Sturmer, T.

2014-01-01

Purpose The magnitude of risk for adverse drug reactions may be communicated by a measure of 'exposure needed for one additional patient to be harmed' (ENH). We present four ENH measures, based on four different counterfactual contrasts, as illustrated by the known effects of NSAID use on peptic ...... bleeding. The ultimate choice of ENH measure will depend on epidemiological or clinical considerations and on availability of data. Copyright (C) 2014 John Wiley & Sons, Ltd.......Purpose The magnitude of risk for adverse drug reactions may be communicated by a measure of 'exposure needed for one additional patient to be harmed' (ENH). We present four ENH measures, based on four different counterfactual contrasts, as illustrated by the known effects of NSAID use on peptic...... ulcer bleeding. Methods The four measures were basic ENH (estimating the excess risk when treating the entire source population versus treating no one), age-restricted ENH (the entire source population above, e. g. 50 years old treated versus no one above 50 years old treated), standardised ENH (a...

Selecting the patients for morning report sessions: case-based vs. conventional method.

Science.gov (United States)

Rabiei, Mehdi; Saeidi, Masumeh; Kiani, Mohammad Ali; Amin, Sakineh Mohebi; Ahanchian, Hamid; Jafari, Seyed Ali; Kianifar, Hamidreza

2015-08-01

One of the most important issues in morning report sessions is the number of patients. The aim of this study was to investigate and compare the number of cases reported in the morning report sessions in terms of case-based and conventional methods from the perspective of pediatric residents of Mashhad University of Medical Sciences. The present study was conducted on 24 pediatric residents of Mashhad University of Medical Sciences in the academic year 2014-2015. In this survey, the residents replied to a 20-question researcher-made questionnaire that had been designed to measure the views of residents regarding the number of patients in the morning report sessions using case-based and conventional methods. The validity of the questionnaire was confirmed by experts' views and its reliability by calculating Cronbach's alpha coefficients. Data were analyzed by t-test analysis. The mean age of the residents was 30.852 ± 2.506, and 66.6% of them were female. The results showed that there was no significant relationship among the variables of academic year, gender, and residents' perspective to choosing the number of patients in the morning report sessions (P > 0.05). T-test analysis showed a significant relationship among the average scores of residents in the selection of the case-based method in comparison to the conventional method (P case-based morning report was preferred compared to the conventional method. This method makes residents pay more attention to the details of patients' issues and therefore helps them to better plan how to address patient problems and improve their differential diagnosis skills.

The influence of lymphangiography on the development of hypothyroidism in patients irradiated for Hodgkin's disease

International Nuclear Information System (INIS)

Fein, Douglas A.; Hanlon, Alexandra L.; Corn, Benjamin W.; Curran, Walter J.; Coia, Lawrence R.

1996-01-01

Purpose: There is no consensus in the literature regarding the role of lymphangiography in promoting hypothyroidism in individuals with Hodgkin's disease irradiated with a mantle field. We sought to analyze the onset and rate of developing clinical or chemical hypothyroidism as well as possible factors related to its development in patients who received irradiation to the thyroid gland during treatment of Hodgkin's disease. Methods and Materials: One hundred and forty-two patients with Hodgkin's disease were treated at the Fox Chase Cancer Center between June 1967 and October 1993. All patients were treated with curative intent with radiation therapy using a mantle field. After exclusion of patients without available thyroid function tests, < 200 days of follow-up, or no radiation to the thyroid, 104 patients were eligible for analysis. Follow-up ranged from 7-170 months (median: 43 months). Sixty-seven patients had a lymph angiogram. Seventy-three patients were treated with radiation alone and 31 with radiation plus chemotherapy. Results: The actuarial 2-, and 5-year rates of biochemical hypothyroidism for all 104 patients were 18 and 37%, respectively. Forty patients developed hypothyroidism: 9 (23%) at ≤ 1 year, 18 (45%) at ≤ 2 years, and 33 (83%) at ≤ 5 years. The actuarial 2-, and 5-year rates of biochemical hypothyroidism for patients who underwent a lymph angiogram were 23 and 42%, respectively, compared to 9 and 28%, respectively, for patients who received mantle irradiation without a lymph angiogram (p = 0.05). The effects of lymph angiogram, total thyroid dose, stage, chemotherapy, dose per fraction, energy, and age were evaluated for all patients by Cox proportional hazards regression analysis. The use of a lymph angiogram (p = 0.05) was the only variable that significantly influenced hypothyroidism. Conclusions: This paper demonstrates in a multivariate analysis accounting for other potentially important variables the significant effect of

Effect of joint traction on functional improvement and quality of life in patients with severe knee osteoarthritis

OpenAIRE

Sedigheh Sadat Naeimee; Abbas Rahimi; Mehdi Rezaee; Alireza Akbarzadeh Baghban; Khosro Khademi Kalantari; ُSomayeh Mahmoudi Aghdam

2012-01-01

Background and aim: Osteoarthritis (OA) is the most prevalent joint disease in adults around the world and its incidence rises with age. Patients with severe knee osteoarthritis often complain of pain and severe functional disability. Most of conservative treatments used in this group of patients induce poor improvements. This study evaluated the effect of joint traction on quality of life of patients with severe knee osteoarthritis.Materials and Methods: In this clinical trial study, forty f...

Direct intramyocardial mesenchymal stromal cell injections in patients with severe refractory angina - one year follow-up

DEFF Research Database (Denmark)

Haack-Sørensen, Mandana; Friis, Tina; Mathiasen, Anders B

2013-01-01

Aims: In patients with stable coronary artery disease (CAD) and refractory angina we performed direct intra-myocardial injections of autologous mesenchymal stromal cells (MSCs) and followed the safety and efficacy of the treatment for 12 months. Methods and Results: A total of 31 patients...... with stable CAD, moderate to severe angina, normal left ventricular ejection fraction and no further revascularization options, were included. Bone marrow MSCs were isolated and culture expanded for 6 - 8 weeks and then stimulated with vascular endothelial growth factor (VEGF) for one week.The 12 months...... follow-up demonstrated, that it was safe to culture expand MSCs and use the cells for clinical treatment. The patients maximal metabolic equivalent (MET) during exercise increased from 4.23 MET at baseline to 4.72 MET at 12 months follow-up (p...

Empathy in One-Shot Prisoner Dilemma

OpenAIRE

Rossi, Giulia; Tcheukam, Alain; Tembine, Hamidou

2017-01-01

Strategic decision making involves affective and cognitive functions like reasoning, cognitive and emotional empathy which may be subject to age and gender differences. However, empathy-related changes in strategic decision-making and their relation to age, gender and neuropsychological functions have not been studied widely. In this article, we study a one-shot prisoner dilemma from a psychological game theory viewpoint. Forty seven participants (28 women and 19 men), aged 18 to 42 years, we...

Relationship Between Plasma Homocystein Levels and Polyneuropaty in Patients Using Levodopa For Idiopathic Parkinson’s Disease

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Mithat Bedir

2012-06-01

Full Text Available Objective: Recent studies showed high plasma homocysteine levels in patients treated with Levodopa for Parkinson’s disease (PD. Homocysteine, due to its exotoxic effect, might be the cause of polyneuropathy seen in PD. In this study, our aim was to show the correlation between high concentration of plasma homocysteine levels and polyneuropathy associated with PD.. Material and Methods: Forty-one patients with PD receiving levodopa treatment (patient group and 30 healthy subjects (control group were included in this study. We compared the two groups in terms of electrophysiological findings. Twelve patients had high plasma homocysteine levels and 29 of them had low plasma homocysteine levels. Results: Six of the 41 patients had sensorial polyneuropathy and decreased compound muscle action potantiel amplitude compared to controls. Two patients had high plasma homocysteine levels, two patients had nearly high plasma homocysteine levels, two patients had low plasma homocysteine levels who had sensorial polyneuropathy. Conclusion: Although in our study, we did not show any correlation between polyneuropathy and high plasma homocysteine levels, further studies including homogeneous groups of younger patients with PD are needed. (The Me di cal Bul - le tin of Ha se ki 2012; 50: 53-8

Investigation of FANCA gene in Fanconi anaemia patients in Iran

Science.gov (United States)

Saffar Moghadam, Ali Akbar; Mahjoubi, Frouzandeh; Reisi, Nahid; Vosough, Parvaneh

2016-01-01

Background & objectives: Fanconi anaemia (FA) is a syndrome with a predisposition to bone marrow failure, congenital anomalies and malignancies. It is characterized by cellular hypersensitivity to cross-linking agents such as mitomycin C (MMC). In the present study, a new approach was selected to investigate FANCA (Fanconi anaemia complementation group A) gene in patients clinically diagnosed with cellular hypersensitivity to DNA cross-linking agent MMC. Methods: Chromosomal breakage analysis was performed to prove the diagnosis of Fanconi anaemia in 318 families. Of these, 70 families had a positive result. Forty families agreed to molecular genetic testing. In total, there were 27 patients with unknown complementary types. Genomic DNA was extracted and total RNA was isolated from fresh whole blood of the patients. The first-strand cDNA was synthesized and the cDNA of each patient was then tested with 21 pairs of overlapping primers. High resolution melting curve analysis was used to screen FANCA, and LinReg software version 1.7 was utilized for analysis of expression. Results: In total, six sequence alterations were identified, which included two stop codons, two frames-shift mutations, one large deletion and one amino acid exchange. FANCA expression was downregulated in patients who had sequence alterations. Interpretation & conclusions: The results of the present study show that high resolution melting (HRM) curve analysis may be useful in the detection of sequence alteration. It is simpler and more costeffective than the multiplex ligation-dependent probe amplification (MLPA) procedure. PMID:27121516

Identifying patient preferences for communicating risk estimates: A descriptive pilot study

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O'Connor Annette M

2001-08-01

Full Text Available Abstract Background Patients increasingly seek more active involvement in health care decisions, but little is known about how to communicate complex risk information to patients. The objective of this study was to elicit patient preferences for the presentation and framing of complex risk information. Method To accomplish this, eight focus group discussions and 15 one-on-one interviews were conducted, where women were presented with risk data in a variety of different graphical formats, metrics, and time horizons. Risk data were based on a hypothetical woman's risk for coronary heart disease, hip fracture, and breast cancer, with and without hormone replacement therapy. Participants' preferences were assessed using likert scales, ranking, and abstractions of focus group discussions. Results Forty peri- and postmenopausal women were recruited through hospital fliers (n = 25 and a community health fair (n = 15. Mean age was 51 years, 50% were non-Caucasian, and all had completed high school. Bar graphs were preferred by 83% of participants over line graphs, thermometer graphs, 100 representative faces, and survival curves. Lifetime risk estimates were preferred over 10 or 20-year horizons, and absolute risks were preferred over relative risks and number needed to treat. Conclusion Although there are many different formats for presenting and framing risk information, simple bar charts depicting absolute lifetime risk were rated and ranked highest overall for patient preferences for format.

Comparison of boundedness and monotonicity properties of one-leg and linear multistep methods

KAUST Repository

Mozartova, A.; Savostianov, I.; Hundsdorfer, W.

2015-01-01

© 2014 Elsevier B.V. All rights reserved. One-leg multistep methods have some advantage over linear multistep methods with respect to storage of the past results. In this paper boundedness and monotonicity properties with arbitrary (semi-)norms or convex functionals are analyzed for such multistep methods. The maximal stepsize coefficient for boundedness and monotonicity of a one-leg method is the same as for the associated linear multistep method when arbitrary starting values are considered. It will be shown, however, that combinations of one-leg methods and Runge-Kutta starting procedures may give very different stepsize coefficients for monotonicity than the linear multistep methods with the same starting procedures. Detailed results are presented for explicit two-step methods.

Comparison of boundedness and monotonicity properties of one-leg and linear multistep methods

KAUST Repository

Mozartova, A.

2015-05-01

© 2014 Elsevier B.V. All rights reserved. One-leg multistep methods have some advantage over linear multistep methods with respect to storage of the past results. In this paper boundedness and monotonicity properties with arbitrary (semi-)norms or convex functionals are analyzed for such multistep methods. The maximal stepsize coefficient for boundedness and monotonicity of a one-leg method is the same as for the associated linear multistep method when arbitrary starting values are considered. It will be shown, however, that combinations of one-leg methods and Runge-Kutta starting procedures may give very different stepsize coefficients for monotonicity than the linear multistep methods with the same starting procedures. Detailed results are presented for explicit two-step methods.

Validation and results of a questionnaire for functional bowel disease in out-patients

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Skordilis Panagiotis

2002-05-01

Full Text Available Abstract Background The aim was to evaluate and validate a bowel disease questionnaire in patients attending an out-patient gastroenterology clinic in Greece. Methods This was a prospective study. Diagnosis was based on detailed clinical and laboratory evaluation. The questionnaire was tested on a pilot group of patients. Interviewer-administration technique was used. One-hundred-and-forty consecutive patients attending the out-patient clinic for the first time and fifty healthy controls selected randomly participated in the study. Reliability (kappa statistics and validity of the questionnaire were tested. We used logistic regression models and binary recursive partitioning for assessing distinguishing ability among irritable bowel syndrome (IBS, functional dyspepsia and organic disease patients. Results Mean time for questionnaire completion was 18 min. In test-retest procedure a good agreement was obtained (kappa statistics 0.82. There were 55 patients diagnosed as having IBS, 18 with functional dyspepsia (Rome I criteria, 38 with organic disease. Location of pain was a significant distinguishing factor, patients with functional dyspepsia having no lower abdominal pain (p Conclusions This questionnaire for functional bowel disease is a valid and reliable instrument that can distinguish satisfactorily between organic and functional disease in an out-patient setting.

Routine Urine Culture at the Time of Percutaneous Urinary Drainage: Does Every Patient Need One?

International Nuclear Information System (INIS)

Brody, L.A.; Brown, K.T.; Covey, A.M.; Brown, A.E.; Getrajdman, G.I.

2006-01-01

Purpose. To determine the clinical variables associated with bacteriuria in patients undergoing primary percutaneous antegrade urinary drainage procedures in order to predict the utility of routinely obtaining urine cultures at the time of the procedure. Methods. Between October 1995 and March 1998 urine cultures were prospectively obtained in all patients undergoing a primary percutaneous antegrade urinary drainage procedure. One hundred and eighty-seven patients underwent 264 procedures. Results were available in 252 cases. Culture results were correlated with clinical, laboratory, and demographic variables. Anaerobic cultures were not uniformly performed. Results. Urine cultures were positive in 24 of 252 (9.5%) cases. An indwelling or recently removed ipsilateral device (catheter or stent) and a history of previous cystectomy with urinary diversion were significant predictors of a positive culture. Patients without either of these predictors, and without clinical or laboratory evidence of infection, were rarely found to have positive cultures. Conclusion. The likelihood of a positive urine culture can be predicted on the basis of the aforementioned clinical variables. In the absence of these clinical indicators routine urine cultures are neither useful nor cost-effective

Heart Rate Variability Correlates to Functional Aerobic Impairment in Hemodialysis Patients

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Maria Angela Magalhães de Queiroz Carreira

2015-06-01

Full Text Available Background: Autonomic dysfunction (AD is highly prevalent in hemodialysis (HD patients and has been implicated in their increased risk of cardiovascular mortality. Objective: To correlate heart rate variability (HRV during exercise treadmill test (ETT with the values obtained when measuring functional aerobic impairment (FAI in HD patients and controls. Methods: Cross-sectional study involving HD patients and a control group. Clinical examination, blood sampling, transthoracic echocardiogram, 24-hour Holter, and ETT were performed. A symptom-limited ramp treadmill protocol with active recovery was employed. Heart rate variability was evaluated in time domain at exercise and recovery periods. Results: Forty-one HD patients and 41 controls concluded the study. HD patients had higher FAI and lower HRV than controls (p<0.001 for both. A correlation was found between exercise HRV (SDNN and FAI in both groups. This association was independent of age, sex, smoking, body mass index, diabetes, and clonidine or beta-blocker use, but not of hemoglobin levels. Conclusion: No association was found between FAI and HRV on 24-hour Holter or at the recovery period of ETT. Of note, exercise HRV was inversely correlated with FAI in HD patients and controls. (Arq Bras Cardiol. 2015; [online]. ahead print, PP.0-0

Deteksi Penyakit Dengue Hemorrhagic Fever dengan Pendekatan One Class Classification

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Zida Ziyan Azkiya

2017-10-01

Full Text Available Two class classification problem maps input into two target classes. In certain cases, training data is available only in the form of a single class, as in the case of Dengue Hemorrhagic Fever (DHF patients, where only data of positive patients is available. In this paper, we report our experiment in building a classification model for detecting DHF infection using One Class Classification (OCC approach. Data from this study is sourced from laboratory tests of patients with dengue fever. The OCC methods compared are One-Class Support Vector Machine and One-Class K-Means. The result shows SVM method obtained precision value = 1.0, recall = 0.993, f-1 score = 0.997, and accuracy of 99.7% while the K-Means method obtained precision value = 0.901, recall = 0.973, f- 1 score = 0.936, and accuracy of 93.3%. This indicates that the SVM method is slightly superior to K-Means for One-Class Classification of DHF patients.

Changes of gait parameters following constrained-weight shift training in patients with stroke

OpenAIRE

Nam, Seok Hyun; Son, Sung Min; Kim, Kyoung

2017-01-01

[Purpose] This study aimed to investigate the effects of training involving compelled weight shift on the paretic lower limb on gait parameters and plantar pressure distribution in patients with stroke. [Subjects and Methods] Forty-five stroke patients participated in the study and were randomly divided into: group with a 5-mm lift on the non-paretic side for constrained weight shift training (5: constrained weight shift training) (n=15); group with a 10-mm lift on the non-paretic side for co...

Treatment of Patients With Complex Regional Pain Syndrome Type I With Mannitol: A Prospective, Randomized, Placebo-Controlled, Double-Blinded Study

NARCIS (Netherlands)

Perez, R.S.G.M.; Pragt, E.; Geurts, J.J.G.; Zuurmond, W.W.A.; Patijn, J.; van Kleef, M.

2008-01-01

To assess the effects of intravenous administration of the free radical scavenger mannitol 10% on complaints associated with complex regional pain syndrome Type I (CRPS I), a randomized, placebo-controlled, double-blinded trial was performed. Forty-one CRPS I patients according to the Bruehl et al

Pulsatile Stress in Middle-Aged Patients With Type 1 or Type 2 Diabetes Compared With Nondiabetic Control Subjects

OpenAIRE

Philips, Jean-Christophe; Marchand, Monique; Scheen, Andr? J.

2010-01-01

OBJECTIVE Arterial pulse pressure is considered to be an independent cardiovascular risk factor. We compared pulse pressure during an active orthostatic test in middle-aged patients with type 1 diabetes and with type 2 diabetes and corresponding nondiabetic control subjects. RESEARCH DESIGN AND METHODS Forty patients with type 1 diabetes (mean age 50 years, diabetes duration 23 years, and BMI 23.0 kg/m2) were compared with 40 nonhypertensive patients with type 2 diabetes (respectively, 50 yea...

Weight changes and their predictors amongst 11 140 patients with type 2 diabetes in the ADVANCE trial

NARCIS (Netherlands)

van Dieren, S.; Czernichow, S.; Chalmers, J.; Kengne, A. P.; de Galan, B. E.; Poulter, N.; Woodward, M.; Beulens, J. W. J.; Grobbee, D. E.; van der Schouw, Y. T.; Zoungas, S.

2012-01-01

To determine the baseline characteristics and glucose-lowering therapies associated with weight change among patients with type 2 diabetes. Eleven thousand one hundred and forty participants in the ADVANCE trial were randomly assigned to an intensive [aiming for a haemoglobin A1c (HbA1c) ≤6.5%] or a

One-year progression of diabetic subclinical macular edema in eyes with mild nonproliferative diabetic retinopathy

DEFF Research Database (Denmark)

Tejerina, Amparo Navea; Vujosevic, Stela; Varano, Monica

2015-01-01

PURPOSE: To characterize the 1-year progression of retinal thickness (RT) increase occurring in eyes with subclinical macular edema in type 2 diabetes. METHODS: Forty-eight type 2 diabetic eyes/patients with mild nonproliferative diabetic retinopathy (NPDR; levels 20 and 35 in the Early Treatment...... Diabetic Retinopathy Study) classified as presenting subclinical macular edema at baseline completed the 1-year follow-up period, from a sample of 194 followed in a 12-month observational and prospective study (ClinicalTrials.gov identifier: NCT01145599). Automated segmentation of the retinal layers...... in these eyes was performed, followed by verification and correction by a human grader. RESULTS: The highest increase in RT over the 1-year follow-up period for the 48 eyes/patients with subclinical macular edema was found in the inner nuclear layer (INL). Progression to clinical macular edema was also...

The one-leg standing radiograph

OpenAIRE

Pinsornsak, P.; Naratrikun, K.; Kanitnate, S.; Sangkomkamhang, T.

2016-01-01

Objectives The purpose of this study was to compare the joint space width between one-leg and both-legs standing radiographs in order to diagnose a primary osteoarthritis of the knee. Methods Digital radiographs of 100 medial osteoarthritic knees in 50 patients were performed. The patients had undergone one-leg standing anteroposterior (AP) views by standing on the affected leg while a both-legs standing AP view was undertaken while standing on both legs. The severity of the osteoarthritis wa...

Frequency and predictors of renal artery stenosis in patients with coronary artery disease

International Nuclear Information System (INIS)

Shah, S.S.; Hafeezullah, M.

2010-01-01

Background: Renal artery stenosis (RAS) is a common finding in patients undergoing coronary angiography. We designed this study to look for the frequency and any predictors of renal artery stenosis in patients with coronary artery disease (CAD). Methods: A total of 201 consecutive patients with CAD confirmed by coronary angiography underwent an abdominal aortogram in the same sitting to screen for RAS. Patient demographics and co-morbidities were analysed for any association with RAS. Results: Forty-one of the patients were female (20.4%); ninety patients were hypertensive (44.8%); 49 patients (24.4%) were smokers; 19 patients (9.5%) had renal insufficiency; 88 patients (43.8%) had high cholesterol levels; 44 patients (21.9%) were diabetic. Thirty-two patients (15.9%) had single coronary artery disease, 59 patients (29.4%) had two vessel disease, and 110 patients (54.7%) had three vessel disease. Significant renal artery stenosis (less or equal to 50% stenosis) was present in 26 patients (12.9%). Among the variables studied, only female gender was found to be associated with a higher frequency of renal artery stenosis (24.39% vs 10.0%, p=0.01). Conclusions: The frequency of renal artery stenosis in patients with coronary artery disease is 12.9%. Female gender is associated with a higher frequency of renal artery stenosis in patients with CAD. (author)

Circulating Endothelial-Derived Activated Microparticle: A Useful Biomarker for Predicting One-Year Mortality in Patients with Advanced Non-Small Cell Lung Cancer

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Chin-Chou Wang

2014-01-01

Full Text Available Background. This study tested the hypothesis that circulating microparticles (MPs are useful biomarkers for predicting one-year mortality in patients with end-stage non-small cell lung cancer (ES-NSCLC. Methods and Results. One hundred seven patients were prospectively enrolled into the study between April 2011 and February 2012, and each patient received regular follow-up after enrollment. Levels of four MPs in circulation, (1 platelet-derived activated MPs (PDAc-MPs, (2 platelet-derived apoptotic MPs (PDAp-MPs, (3 endothelial-derived activated MPs (EDAc-MPs, and (4 endothelial-derived apoptotic MPs (EDAp-MPs, were measured just after the patient was enrolled into the study using flow cytometry. Patients who survived for more than one year were categorized into group 1 (n=56 (one-year survivors and patients who survived less than one year were categorized into group 2 (n=51 (one-year nonsurvivors. Male gender, incidence of liver metastasis, progression of disease after first-line treatment, poor performance status, and the Charlson comorbidity index were significantly higher in group 2 than in group 1 (all P<0.05. Additionally, as measured by flow cytometry, only the circulating level of EDAc-MPs was found to be significantly higher in group 2 than in group 1 (P=0.006. Multivariate analysis demonstrated that circulating level of EDAc-MPs along with brain metastasis and male gender significantly and independently predictive of one-year mortality (all P<0.035. Conclusion. Circulating EDAc-MPs may be a useful biomarker predictive of one-year morality in ES-NSCLC patients.

Forty Years with Emerging Viruses.

Science.gov (United States)

Peters, C J

2014-11-01

I was raised in a middle-class family in West Texas and was lucky in my preparation through high school faculty, short government programs arising from the politics of Sputnik, inspiring high school mentors, and university training at a first-rate institution. My educational background led me to apply to medical school. With some financial aid, I managed to graduate and then obtain a first-class internal medicine residency at Parkland Hospital, where I acquired skills in discerning evaluation and treatment of patients with complicated diseases. In spite of a liking for and ability in clinical medicine, I entered the Public Health Service and worked for 5 years at the National Institutes of Health laboratory in Panama; there, I began to see the fascination of ecological impacts on virus transmission in nature and its spillover into human populations. I shifted my interests to these themes and their interaction with viral pathogenesis. At each stage of my career, I picked an institution to work where there were strong leaders and other inspiring scientists. I think the young scientist should choose the best available institution and one that offers a career direction that leads to a life where he or she awakens and cannot wait to arrive at his or her job-regardless of the details of each choice, the outcome will be a satisfied person who will contribute greatly to his or her chosen field.

Mutagenicity evaluation of forty-one metal salts by the umu test.

Science.gov (United States)

Yamamoto, Akiko; Kohyama, Yuko; Hanawa, Takao

2002-01-01

Metallic biomaterials implanted in a human body may corrode and wear, releasing metal ions and debris which may induce adverse reactions such as inflammation, allergy, neoplastic formation, developmental malformation, etc. Mutagenicity is a very fundamental and important toxicity related to carcinogenicity and reproductive/developmental toxicity because the damages to genes or DNA can be a cause of carcinogenesis and developmental abnormalities. However, available mutagenic data on metallic ions and compounds are restricted to the number of elements. Therefore, to obtain the systematic data necessary for metal ion mutagenicity, 41 metal salts encompassing 36 metals and 5 metallic elements tested with different valences, were evaluated on their mutagenicity by a microbial test, the umu test. As a result, K(2)Cr(2)O(7), RhCl(3), IrCl(4), and MgCl(2) are positive without metabolic activation. Concentrations having the maximum mutagenic effect (C(max)) are 9.65 x 10(-5), 1.00 x 10(-4), 3.11 x 10(-3), 4.12 x 10(-3) mol. L(-1), respectively. CuCl(2), VCl(3), CuCl, RhCl(3), K(2)Cr(2)O(7), and IrCl(4) are positive with metabolic activation by S-9 mix with C(max) of 1.60 x 10(-5), 3.91 x 10(-5), 1.57 x 10(-4), 2.00 x 10(-4), 3.86 x 10(-4), 1.56 x 10(-2) mol. L(-1), respectively. Thirty-five metal salts were negative for tests performed both with and without metabolic activation, whereas it was impossible to evaluate the mutagenicity of MoCl(5) and ZrCl(4) by the umu test because of their colorimetric reaction to testing reagents. Copyright 2001 John Wiley & Sons, Inc.

Preventing patient-to-worker violence in hospitals: outcome of a randomized controlled intervention

Science.gov (United States)

Arnetz, Judith E.; Hamblin, Lydia; Russell, Jim; Upfal, Mark J.; Luborsky, Mark; Janisse, James; Essenmacher, Lynnette

2016-01-01

Objective To evaluate the effects of a randomized controlled intervention on the incidence of patient-to-worker (Type II) violence and related injury in hospitals. Methods Forty-one units across 7 hospitals were randomized into intervention (n=21) and control (n=20) groups. Intervention units received unit-level violence data to facilitate development of an action plan for violence prevention; no data were presented to control units. Main outcomes were rates of violent events and injuries across study groups over time. Results Six months post-intervention, incident rate ratios of violent events were significantly lower on intervention units compared to controls (IRR 0.48, 95% CI 0.29-0.80). At 24 months, the risk for violence-related injury was lower on intervention units, compared to controls (IRR 0.37, 95% CI 0.17-0.83). Conclusion This data-driven, worksite-based intervention was effective in decreasing risks of patient-to-worker violence and related injury. PMID:28045793

Costs and difficulties of recruiting patients to provide e-health support: pilot study in one primary care trust.

Science.gov (United States)

Jones, Ray B; O'Connor, Anita; Brelsford, Jade; Parsons, Neil; Skirton, Heather

2012-03-29

Better use of e-health services by patients could improve outcomes and reduce costs but there are concerns about inequalities of access. Previous research in outpatients suggested that anonymous personal email support may help patients with long term conditions to use e-health, but recruiting earlier in their 'journey' may benefit patients more. This pilot study explored the feasibility and cost of recruiting patients for an e-health intervention in one primary care trust. The sample comprised 46 practices with total patient population of 250,000. We approached all practices using various methods, seeking collaboration to recruit patients via methods agreed with each practice. A detailed research diary was kept of time spent recruiting practices and patients. Researcher time was used to estimate costs. Patients who consented to participate were offered email support for their use of the Internet for health. Eighteen practices agreed to take part; we recruited 27 patients, most (23/27) from five practices. Practices agreed to recruit patients for an e-health intervention via waiting room leaflets (16), posters (16), practice nurses (15), doctors giving patients leaflets (5), a study website link (7), inclusion in planned mailshots (2), and a special mailshot to patients selected from practice computers (1). After low recruitment response we also recruited directly in five practices through research assistants giving leaflets to patients in waiting rooms. Ten practices recruited no patients. Those practices that were more difficult to recruit were less likely to recruit patients. Leaving leaflets for practice staff to distribute and placing posters in the practice were not effective in recruiting patients. Leaflets handed out by practice nurses and website links were more successful. The practice with lowest costs per patient recruited (£70) used a special mailshot to selected patients. Recruitment via general practice was not successful and was therefore expensive

Forty years of experience on closed-cycle gas turbines

International Nuclear Information System (INIS)

Keller, C.

1978-01-01

Forty years of experience on closed-cycle gas turbines (CCGT) is emphasized to substantiate the claim that this prime-mover technology is well established. European fossil-fired plants with air as the working fluid have been individually operated over 100,000 hours, have demonstrated very high availability and reliability, and have been economically successful. Following the initial success of the small air closed cycle gas turbine plants, the next step was the exploitation of helium as the working fluid for plants above 50 MWe. The first fossil fired combined power and heat plant at Oberhausen, using a helium turbine, plays an important role for future nuclear systems and this is briefly discussed. The combining of an HTGR and an advanced proven power conversion system (CCGT) represents the most interesting and challenging project. The key to acceptance of the CCGT in the near term is the introduction of a small nuclear cogeneration plant (100 to 300 MWe) that utilizes the waste heat, demonstrating a very high fuel utilization efficiency: aspects of such a plant are outlined. (author)

BIOFEEDBACK: A NEW METHOD FOR CORRECTION OF MOTOR DISORDERS IN PATIENTS WITH MULTIPLE SCLEROSIS

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Ya. S. Pekker

2014-01-01

Full Text Available Major disabling factors in multiple sclerosis is motor disorders. Rehabilitation of such violations is one of the most important medical and social problems. Currently, most of the role given to the development of methods for correction of motor disorders based on accessing natural resources of the human body. One of these methods is the adaptive control with biofeedback (BFB. The aim of our study was the correction of motor disorders in multiple sclerosis patients using biofeedback training. In the study, we have developed scenarios for training rehabilitation program computer EMG biofeedback aimed at correction of motor disorders in patients with multiple sclerosis (MS. The method was tested in the neurological clinic of SSMU. The study included 9 patients with definite diagnosis of MS with the presence of the clinical picture of combined pyramidal and cerebellar symptoms. Assessed the effectiveness of rehabilitation procedures biofeedback training using specialized scales (rating scale functional systems Kurtzke; questionnaire research quality of life – SF-36, evaluation of disease impact Profile – SIP and score on a scale fatigue – FSS. In the studied group of patients decreased score on a scale of fatigue (FSS, increased motor control (SIP2, the physical and mental components of health (SF-36. The tendency to reduce the amount of neurological deficit by reducing the points on the pyramidal Kurtske violations. Analysis of the exchange rate dynamics of biofeedback training on EMG for trained muscles indicates an increase in the recorded signal OEMG from session to session. Proved a tendency to increase strength and coordination trained muscles of patients studied.Positive results of biofeedback therapy in patients with MS can be recommended to use this method in the complex rehabilitation measures to correct motor and psycho-emotional disorders.

adverse effects of low dose methotrexate in rheumatoid arthritis patients

International Nuclear Information System (INIS)

Gilani, S.T.; Khan, D.A.; Khan, F.A.; Ahmed, M.

2012-01-01

To determine the frequency of adverse effects attributed to Methotrexate (MTX) toxicity and serum minimum toxic concentration with low dose MTX in Rheumatoid Arthritis (RA) patients. Study Design: Cross-sectional observational study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi, from March 2010 to March 2011. Methodology: One hundred and forty adult patients of RA receiving low dose MTX (10 mg/week) for at least 3 months, ere included by consecutive sampling. Blood samples were collected 2 hours after the oral dose of MTX. Serum alanine transaminase and creatinine were analyzed on Hitachi and blood counts on Sysmex analyzer. Serum MTX concentration was measured on TDX analyzer. Results: Out of one hundred and forty patients; 68 males (49%) and 72 females (51%), 38 developed MTX toxicity (27%), comprising of hepatotoxicity in 12 (8.6%), nephrotoxicity in 3 (2.1%), anaemia in 8 (5.7%), leucopenia in 2 (1.4%), thrombocytopenia in 3 (2.1%), pancytopenia in 2 (1.4%), gastrointestinal adverse effects in 5 (3.6%) and mucocutaneous problems in 3 (2.1%). Receiver operating characteristic curve revealed serum minimum toxic concentration of MTX at cutoff value of 0.71 mu mol/l with a sensitivity of 71% and specificity of 76%. Conclusion: Adverse effects of low dose MTX were found in 27% of RA patients, mainly comprising of hepatotoxicity and haematological problems. MTX toxicity can be detected by therapeutic drug monitoring of serum concentration of 0.71 mu mol/l with sensitivity of 71% and specificity of 76% in the patients on low dose MTX maintenance therapy. (author)

Characterization of liver lesions with mangafodipir trisodium-enhanced MR imaging: multicenter study comparing MR and dual-phase spiral CT

NARCIS (Netherlands)

M. Oudkerk (Matthijs); C.G. Torres; B. Song; M. Konig; J. Grimm; J. Fernandez-Cuadrado; B. op de Beeck; M. Marquardt; P. van Dijk (Pieter); J.C. de Groot (Jan Cees)

2002-01-01

textabstractPURPOSE: To evaluate whether mangafodipir trisodium (Mn-DPDP)-enhanced magnetic resonance (MR) imaging surpasses dual-phase spiral computed tomography (CT) in differentiating focal liver lesions. MATERIALS AND METHODS: One hundred forty-five patients who had or were

Patient-Clinician Communication About End-of-Life Care in Patients With Advanced Chronic Organ Failure During One Year.

Science.gov (United States)

Houben, Carmen H M; Spruit, Martijn A; Schols, Jos M G A; Wouters, Emiel F M; Janssen, Daisy J A

2015-06-01

Patient-clinician communication is an important prerequisite to delivering high-quality end-of-life care. However, discussions about end-of-life care are uncommon in patients with advanced chronic organ failure. The aim was to examine the quality of end-of-life care communication during one year follow-up of patients with advanced chronic organ failure. In addition, we aimed to explore whether and to what extent quality of communication about end-of-life care changes toward the end of life and whether end-of-life care communication is related to patient-perceived quality of medical care. Clinically stable outpatients (n = 265) with advanced chronic obstructive pulmonary disease, chronic heart failure, or chronic renal failure were visited at home at baseline and four, eight, and 12 months after baseline to assess quality of end-of-life care communication (Quality of Communication questionnaire). Two years after baseline, survival status was assessed, and if patients died during the study period, a bereavement interview was done with the closest relative. One year follow-up was completed by 77.7% of the patients. Quality of end-of-life care communication was rated low at baseline and did not change over one year. Quality of end-of-life care communication was comparable for patients who completed two year follow-up and patients who died during the study. The correlation between quality of end-of-life care communication and satisfaction with medical treatment was weak. End-of-life care communication is poor in patients with chronic organ failure and does not change toward the end of life. Future studies should develop an intervention aiming at initiating high-quality end-of-life care communication between patients with advanced chronic organ failure and their clinicians. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Intra-observer and interobserver reliability ofOne Leg Stand Test as a measure of posturalbalance in low back pain patients

DEFF Research Database (Denmark)

Maribo, Thomas; Iversen, Elena; Andersen, Niels Trolle

2009-01-01

Objective: To determine the absolute and relative reliability of intra-observer and interobserver To determine the absolute and relative reliability of intra-observer and interobserver measurements of postural balance using the One Leg Stand Test in patients with low back pain. Patients and methods...... to stand for the maximum time, and no further analysis was done. Eyes closed: intra-observer reliability was tested in 21 patients; absolute reliability showed a standard error of the measurement (SEM) of 2.48 s and a minimal detectable change (MDC) of 6.88. The relative reliability was acceptable...... with an intra class correlation coefficient (ICC) of 0.86. Interobserver reliability was tested in 27 patients; absolute reliability showed a SEM of 1.42 s and a MDC of 3.95. The relative reliability was acceptable with an ICC of 0.91. Conclusions: The One Leg Stand Test can be used to test postural balance...

Prognostic impact of hs-CRP and IL-6 in patients undergoing radiofrequency catheter ablation for atrial fibrillation

DEFF Research Database (Denmark)

Henningsen, Kristoffer Mads Aaris; Nilsson, Brian; Bruunsgaard, Helle

2008-01-01

Aim. The aim of this study was to assess the predictive value of inflammatory markers in patients with paroxysmal/ persistent atrial fibrillation (AF) treated with radiofrequency (RF) catheter ablation. Methods. Forty-six consecutive patients, mean age 55 years (range 31 - 81 yrs), with paroxysmal...... >10 minutes was considered failure and patients were offered a second ablation session. Interleukin-6 and high-sensitivity C-reactive protein were measured prior to ablation and at follow-up visits. Results. After a maximum of two ablations, 19 patients (41%) had SR without recurrence of AF after 12...

Mobile, one stage, bilateral ear surgery for chronic otitis media patients in remote areas

DEFF Research Database (Denmark)

Homøe, P; Sørensen, H C Florian; Tos, M

2009-01-01

OBJECTIVES: We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas....... MATERIALS AND METHODS: The study was longitudinal and prospective, with a two-year follow up. Seventeen East Greenlandic patients with bilateral chronic suppurative otitis media or chronic otitis media were selected. Their median age was 16 years; 53 per cent were female and 47 per cent male. Hearing...... were satisfied. There were no hearing hazards. CONCLUSIONS: The results of mobile, one stage, bilateral ear surgery conducted in Greenland for long-lasting chronic suppurative otitis media and chronic otitis media were acceptable and safe, and more ears underwent surgery at reduced cost compared...

Enrichment methods to detect bone marrow micrometastases in breast carcinoma patients: clinical relevance

International Nuclear Information System (INIS)

Choesmel, Valérie; Pierga, Jean-Yves; Nos, Claude; Vincent-Salomon, Anne; Sigal-Zafrani, Brigitte; Thiery, Jean-Paul; Blin, Nathalie

2004-01-01

Improving technologies for the detection and purification of bone marrow (BM) micrometastatic cells in breast cancer patients should lead to earlier prognosis of the risk of relapse and should make it possible to design more appropriate therapies. The technique used has to overcome the challenges resulting from the small number of target cells (one per million hematopoietic cells) and the heterogeneous expression of micrometastatic cell markers. In the present study, we have assessed the clinical relevance of current methods aimed at detecting rare disseminated carcinoma cells. BM aspirates from 32 carcinoma patients were screened for the presence of micrometastatic cells positive for epithelial cell adhesion molecule and positive for cytokeratins, using optimized immunodetection methods. A comparison with data obtained for 46 control BM aspirates and a correlation with the clinical status of patients were performed. We developed a sensitive and efficient immunomagnetic protocol for the enrichment of BM micrometastases. This method was used to divide 32 breast carcinoma patients into three categories according to their epithelial cell adhesion molecule status. These categories were highly correlated with the recently revised American Joint Committee on Cancer staging system for breast cancer, demonstrating the clinical relevance of this simple and reliable immunomagnetic technique. We also evaluated immunocytochemical detection of cytokeratin-positive cells and cytomorphological parameters. Immunocytochemistry-based methods for the detection of BM micrometastases did not provide any information about the clinical status of patients, but helped to refine the immunomagnetic data by confirming the presence of micrometastases in some cases. We also tested a new density gradient centrifugation system, able to enrich the tumor fraction of BM specimens by twofold to threefold as compared with standard Ficoll methods. These improved methods for the detection of

Long-Term Outcome in Patients With Ductal Carcinoma In Situ Treated With Breast-Conserving Therapy: Implications for Optimal Follow-up Strategies

International Nuclear Information System (INIS)

Shaitelman, Simona F.; Wilkinson, J. Ben; Kestin, Larry L.; Ye Hong; Goldstein, Neal S.; Martinez, Alvaro A.; Vicini, Frank A.

2012-01-01

Purpose: To determine 20-year rates of local control and outcome-associated factors for ductal carcinoma in situ (DCIS) after breast-conserving therapy (BCT). Methods and Materials: All DCIS cases receiving BCT between 1980 and 1993 were reviewed. Patient demographics and pathologic factors were analyzed for effect on outcomes, including ipsilateral breast tumor recurrence (IBTR) and survival. Results: One hundred forty-five cases were evaluated; the median follow-up time was 19.3 years. IBTR developed in 25 patients, for 5-, 10-, 15-, and 20-year actuarial rates of 9.9%, 12.2%, 13.7%, and 17.5%, respectively. One third of IBTRs were elsewhere failures, and 68% of IBTRs occurred <10 years after diagnosis. Young age and cancerization of lobules predicted for IBTR at <10 years, and increased slide involvement and atypical ductal hyperplasia were associated with IBTR at later time points. Conclusions: Patients with DCIS treated with BCT have excellent long-term rates of local control. Predictors of IBTR vary over time, and the risk of recurrence seems highest within 10 to 12 years after diagnosis.

Long-Term Outcome in Patients With Ductal Carcinoma In Situ Treated With Breast-Conserving Therapy: Implications for Optimal Follow-up Strategies

Energy Technology Data Exchange (ETDEWEB)

Shaitelman, Simona F. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wilkinson, J. Ben [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Kestin, Larry L. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ye Hong [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Goldstein, Neal S. [Advanced Diagnostics Laboratory, Redford, Michigan (United States); Martinez, Alvaro A. [Michigan HealthCare Professionals, Pontiac, Michigan (United States); Vicini, Frank A., E-mail: fvicini@pol.net [Michigan HealthCare Professionals, Pontiac, Michigan (United States)

2012-07-01

Purpose: To determine 20-year rates of local control and outcome-associated factors for ductal carcinoma in situ (DCIS) after breast-conserving therapy (BCT). Methods and Materials: All DCIS cases receiving BCT between 1980 and 1993 were reviewed. Patient demographics and pathologic factors were analyzed for effect on outcomes, including ipsilateral breast tumor recurrence (IBTR) and survival. Results: One hundred forty-five cases were evaluated; the median follow-up time was 19.3 years. IBTR developed in 25 patients, for 5-, 10-, 15-, and 20-year actuarial rates of 9.9%, 12.2%, 13.7%, and 17.5%, respectively. One third of IBTRs were elsewhere failures, and 68% of IBTRs occurred <10 years after diagnosis. Young age and cancerization of lobules predicted for IBTR at <10 years, and increased slide involvement and atypical ductal hyperplasia were associated with IBTR at later time points. Conclusions: Patients with DCIS treated with BCT have excellent long-term rates of local control. Predictors of IBTR vary over time, and the risk of recurrence seems highest within 10 to 12 years after diagnosis.

INTRAPERITONEAL AEROSOL CHEMOTHERAPY UNDER PRESSURE (IACUP – AN INNOVATIVE METHOD OF TREATMENT OF PATIENTS WITH PERITONEAL CARCINOMATOSIS

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A. D. Kaprin

2016-01-01

Full Text Available Widespread peritoneal carcinomatosis in gastric cancer, in fact, is the end-stage of the disease. The survival median of patients is no more than 3–6 months. Development of various methods of intraperitoneal chemotherapy can improve the prognosis of this category of patients.Objective. To evaluate the efficacy and safety of intraperitoneal aerosol chemotherapy under pressure (IACUP in patients with gastric cancer with peritoneal carcinomatosis.Materials and methods. The treatment Protocol consisted of a laparotomy or laparoscopy for the staging of the tumor process, 3–4 courses of systemic chemotherapy scheme XELOX followed by conducting at least 3 sessions of intraperitoneal aerosol chemotherapy under pressure (IACUP with an interval of 6 weeks on the background of chemotherapy. In the case of progression the patient was excluded from the study. Currently, the study included 27 patients with disseminated gastric cancer who underwent 46 procedures of IACUP. There were 8 men and 19 women. The average age of patients was 50.6 years.Results. In the framework of the safety assessment of IACUP there were 3 cases of adverse effects. Two patients (7,4% noted nausea for the first 2 days after running the session of IACUP. In one patient the iatrogenic perforation of the diaphragm during biopsy of the peritoneum with the development of carbonetworks occurred. The survival median was 11 months. One-year survival rate (by KaplanMeier was 50.7%. 14 patients are alive and continue to participate in the study during the first year of observation.Conclusion. Intraperitoneal aerosol chemotherapy under pressure (IACUP is a simple, minimally invasive and safe method for the palliative treatment of patients with disseminated carcinomatosis of gastric cancer. We developed the treatment Protocol that allows us to achieve one-year survival of more than half of patients.

Detailed Joint Region Analysis of the 7-Joint Ultrasound Score: Evaluation of an Arthritis Patient Cohort over One Year

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S. Ohrndorf

2013-01-01

Full Text Available Objective. The main objective of this study was to evaluate the 7-joint ultrasound (US7 score by detailed joint region analysis of an arthritis patient cohort. Methods. The US7 score examines the clinically most affected wrist, MCP and PIP II, III, MTP II, and V joints for synovitis, tenosynovitis/paratenonitis, and erosions. Forty-five patients with rheumatoid arthritis (RA (84.4% and spondyloarthritis with polyarticular peripheral arthritis (PsA 13.3%; AS 2.2% with a median disease duration of 6.5 yrs (range 7.5 mths–47.6 yrs were included and examined at baseline and 3, 6, and 12 months after starting or changing therapy (DMARD/biologic. In this study, detailed US7 score joint region analysis was firstly performed. Results. The joint region analysis performed at baseline disclosed synovitis in 95.6% of affected wrists in the dorsal aspect by greyscale (GS US where Grade 2 (moderate was most often (48.9% detected. Palmar wrist regions presented Grade 1 (minor capsule elevation in 40% and Grade 2 (moderate synovitis in 37.8%. Tenosynovitis of the extensor carpi ulnaris (ECU tendon was found in 40%, with PD activity in 6.6%. Most of the erosions in MCP II were detected in the radial (68.9%, followed by the dorsal (48.9% and palmar (44.4% aspects. In MTP V, erosions were seen in 75.6% from lateral. Conclusions. Synovitis in GSUS was more often detected in the wrist in the dorsal than in the palmar aspect. ECU tendon involvement was frequent. Most erosions were found in the lateral scan of MTP V and the medial (radial scan of MCP II.

A zero-one programming approach to Gulliksen's matched random subtests method

NARCIS (Netherlands)

van der Linden, Willem J.; Boekkooi-Timminga, Ellen

1988-01-01

Gulliksen’s matched random subtests method is a graphical method to split a test into parallel test halves. The method has practical relevance because it maximizes coefficient α as a lower bound to the classical test reliability coefficient. In this paper the same problem is formulated as a zero-one

Erlotinib in the Second/Third Line Treatment of Patients with Advanced Non-small Cell Lung Cancer

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Yilong WU

2009-05-01

Full Text Available Background and objective Erlotinib is a targeted drug for non-small cell lung cancer (NSCLC. The aim of this study is to evaluate the efficacy, influencing factors and toxicity of erlotinib in patients with NSCLC. Methods Patients with NSCLC who had been previously treated with at least one course of platinum based chemotherapyreceived 150 mg oral doses of erlotinib once daily until disease progression. Response rate, progression free survival, overall survival and toxicity profile were analyzed. Kaplan-Meier methods was used to analyze the survival rate. Cox regression was used to define the predictive factors. Results Forty-eight patients were enrolled into the study from Dec, 2005 to Sep, 2006. We followed up these patients until 08.Dec.2008. Median follow up time was 30 months. The compliance rate was 100%. The median symptom improving time was 7 days. Partial response 33.4% (16/48, stable disease 22.9% (11/48, and progressive disease 43.7% (21/48. Response rate was 33.4% (16/48. Disease control rate was 56.3% (27/48. One and two-year progression-free survival rates and overall survival rates were 25％(events 36, 8.3％ (events 40 and 43.8％ (death 27, 20.8％ (death 38; three-year overall survival 5.6％. The median progression-free survival time and median overall survival time was 5 months and 8 months, respectively. Performance status was the only predictor for overall survival in the Cox model (P <0.001. Skin toxicity(grade 1 to 3 was found in 93.7% patients. One patient discontinued erlotinib because of perianal abscess. Conclusion Erlotinib is another effective drug for patients with previously chemotherapy advanced NSCLC and accepted toxicity profile.

Economic evaluation in patient safety: a literature review of methods.

Science.gov (United States)

de Rezende, Bruna Alves; Or, Zeynep; Com-Ruelle, Laure; Michel, Philippe

2012-06-01

Patient safety practices, targeting organisational changes for improving patient safety, are implemented worldwide but their costs are rarely evaluated. This paper provides a review of the methods used in economic evaluation of such practices. International medical and economics databases were searched for peer-reviewed publications on economic evaluations of patient safety between 2000 and 2010 in English and French. This was complemented by a manual search of the reference lists of relevant papers. Grey literature was excluded. Studies were described using a standardised template and assessed independently by two researchers according to six quality criteria. 33 articles were reviewed that were representative of different patient safety domains, data types and evaluation methods. 18 estimated the economic burden of adverse events, 3 measured the costs of patient safety practices and 12 provided complete economic evaluations. Healthcare-associated infections were the most common subject of evaluation, followed by medication-related errors and all types of adverse events. Of these, 10 were selected that had adequately fulfilled one or several key quality criteria for illustration. This review shows that full cost-benefit/utility evaluations are rarely completed as they are resource intensive and often require unavailable data; some overcome these difficulties by performing stochastic modelling and by using secondary sources. Low methodological transparency can be a problem for building evidence from available economic evaluations. Investing in the economic design and reporting of studies with more emphasis on defining study perspectives, data collection and methodological choices could be helpful for strengthening our knowledge base on practices for improving patient safety.

Mindfulness training in a heterogeneous psychiatric sample : Outcome evaluation and comparison of different diagnostic groups

NARCIS (Netherlands)

Bos, Elisabeth H.; Merea, Ria; van den Brink, Erik; Sanderman, Robbert; Bartels-Velthuis, Agna A.

ObjectivesTo examine outcome after mindfulness training in a heterogeneous psychiatric outpatient population and to compare outcome in different diagnostic groups. MethodOne hundred and forty-three patients in 5 diagnostic categories completed questionnaires about psychological symptoms, quality of

Targeted methods for measuring patient satisfaction in a radiological center

International Nuclear Information System (INIS)

Maurer, M.H.; Stein, E.; Schreiter, N.F.; Renz, D.M.; Poellinger, A.

2010-01-01

Purpose: To investigate two event-oriented methods for evaluating patient satisfaction with radiological services like outpatient computed tomography (CT) examinations. Materials and Methods: 159 patients (55 % men, 45 % women) were asked to complete a questionnaire to provide information about their satisfaction with their examination. At first, patients were asked to spontaneously recall notably positive and negative aspects (so-called 'critical incidents', critical incident technique = CIT) of the examination. Subsequently a flow chart containing all single steps of the examination procedure was shown to all patients. They were asked to point out the positive and negative aspects they perceived at each step (so-called sequential incident technique = SIT). Results: The CIT-based part of the questionnaire yielded 356 comments (183 positive and 173 negative), which were assigned to one of four categories: interaction of staff with patient, procedure and organization, CT examination, and overall setting of the examination. Significantly more detailed comments regarding individual aspects of the CT examination were elicited in the second part of the survey, which was based on the SIT. There were 1413 statements with a significantly higher number of positive comments (n = 939, 66 %) versus negative comments (n = 474, 34 %; p < 0.001). Conclusion: The critical and sequential incident techniques are suitable to measure the subjective satisfaction with the delivery of radiological services such as CT examinations. Positive comments confirm the adequacy of the existing procedures, while negative comments provide direct information about how service quality can be improved. (orig.)

Personality traits in aesthetic surgery patients

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S. Visal Buturak

2016-09-01

Full Text Available Purpose: It has been known that psychological factors have an important effect on the decision to undergo aesthetic surgery. In this study, we aimed to test the hypothesis that the personality traits of people admitted for aesthetic surgery differ from those of people who have never planned to undergo aesthetic surgery in their lives. Material and Methods: Forty-seven patients who were referred to the outpatient clinic of the Faculty of Medicine, Department of Plastic, Reconstructive, and Aesthetic Surgery, Kirikkale University to undergo aesthetic surgery were enrolled in the study. Forty-three subjects who neither underwent nor planned to undergo aesthetic surgery at any time in their lives were included in the study as a control group. Psychometric evaluation of the patients and the control group was conducted using the Turkish version of the Minnesota Multiphasic Personality Inventory (MMPI. Results: Taking 65 as a cut-off point, the ratio of patients who scored and #8805;65 on the hysteria subscale of the MMPI was found to be significantly higher in the sugery group than in the control group and the ratio on social introversion subscale was also higher in the patient group than in the control group, very closely approaching significance. Conclusion: It should be kept in mind that people who have personality traits that can be partially improved with psyachiatric treatment, such as social introverted, lonely, timid, shy, and hysterical and feel the need for validation by others, may be more often admitted for aesthetic surgery. [Cukurova Med J 2016; 41(3.000: 554-558

One-dimensional treatment of polyatomic crystals by the Laplace transform method

International Nuclear Information System (INIS)

Rosato, A.; Santana, P.H.A.

1976-01-01

The one dimensional periodic potential problem is solved using the Laplace transform method and a condensed expression for the relation E x k and effective mass for one electron in a polyatomic structure is determined. Applications related to the effect of the asymmetry of the potential upon the one dimensional band structure are discussed [pt

The comparison between proton pump inhibitors and sucralfate in incidence of ventilator associated pneumonia in critically ill patients

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Farzin Khorvash

2014-01-01

Full Text Available Background: Ventilator associated pneumonia (VAP are one of the most common nosocomial infections in intensive care unit (ICU. The ICU patients are at risk of stress ulcer and gastrointestinal bleeding for different reasons. In order to prevent this complication, anti acids are used for patients. This study compared pantoprazole with sucralfate in incidence of ventilator associated pneumonia. Materials and Methods: This randomized clinical trial was carried out on ICU patients with mechanical ventilation in Alzahra university hospital in Isfahan from 2010 to 2011. One hundred forty eight ventilated patients were randomly allocated in two groups. The first group was treated with sucralfate and the second group was treated with pantoprazole for stress ulcer prophylaxis and followed up during hospitalization in ICU for nosocomial pneumonia. Data analyzed by SPSS software. Results: One hundred thirty seven patients were selected for study. During the study period, 34 cases (24.8% acquired pneumonia, of which 10 were in the sucralfate group and 24 were in the pantoprazole group (14.1% vs. 36.4%. According to Chi-square test, rate of pneumonia was significantly lower in patients receiving sucralfate than the pantoprazole group ( P < 0.001. Conclusion: On the basis of the results, there is a significant relationship between the kind of drug used for stress ulcer and ventilator associated pneumonia. According to this article, rate of pneumonia was significantly lower in patients receiving sucralfate than the pantoprazole group.

Risk Factors for Regional Nodal Relapse in Breast Cancer Patients With One to Three Positive Axillary Nodes

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Yates, Lucy, E-mail: lucy.yates@gstt.nhs.uk [Guy' s, King' s, St Thomas' Cancer Centre, Guy' s Hospital, London (United Kingdom); Kirby, Anna [Guy' s, King' s, St Thomas' Cancer Centre, Guy' s Hospital, London (United Kingdom); Department of Clinical Oncology, Royal Marsden Hospital, Sutton (United Kingdom); Crichton, Siobhan [Department of Statistics, Kings College London (United Kingdom); Gillett, Cheryl [Breast Pathology, Kings College London (United Kingdom); Cane, Paul [Department of Histopathology, Guy' s and St Thomas' Foundation Trust, London (United Kingdom); Fentiman, Ian; Sawyer, Elinor [Guy' s, King' s, St Thomas' Cancer Centre, Guy' s Hospital, London (United Kingdom)

2012-04-01

Purpose: In many centers, supraclavicular fossa radiotherapy (SCF RT) is not routinely offered to breast cancer patients with one to three positive lymph nodes. We aimed to identify a subgroup of these patients who are at high risk of supra or infraclavicular fossa relapse (SCFR) such that they can be offered SCFRT at the time of diagnosis to improve long term locoregional control. Methods and Materials: We performed a retrospective analysis of the pathological features of 1,065 cases of invasive breast cancer with one to three positive axillary lymph nodes. Patients underwent radical breast conserving surgery or mastectomy. A total of 45% of patients received adjuvant chest wall/breast RT. No patients received adjuvant SCFRT. The primary outcome was SCFR. Secondary outcomes were chest wall/breast recurrence, distant metastasis, all death, and breast-cancer specific death. Kaplan-Meier estimates were used to calculate actuarial event rates and survival functions compared using log-rank tests. Multivariate analyses (MVA) of factors associated with outcome were conducted using Cox proportional hazards models. Results: Median follow-up was 9.7 years. SCFR rate was 9.2%. Median time from primary diagnosis to SCFR was 3.4 years (range, 0.7-14.4 years). SCFR was associated with significantly lower 10-year survival (18% vs. 65%; p < 0.001). Higher grade and number of positive lymph nodes were the most significant predictors of SCFR on MVA (p < 0.001). 10 year SCFR rates were less than 1% in all patients with Grade 1 cancers compared with 30% in those having Grade 3 cancers with three positive lymph nodes. Additional factors associated with SCFR on univariate analysis but not on MVA included larger nodal deposits (p = 0.002) and proportion of positive nodes (p = 0.003). Conclusions: Breast cancer patients with one to three positive lymph nodes have a heterogenous risk of SCFR. Patients with two to three positive axillary nodes and/or high-grade disease may warrant

One New Method to Generate 3-Dimensional Virtual Mannequin

Science.gov (United States)

Xiu-jin, Shi; Zhi-jun, Wang; Jia-jin, Le

The personal virtual mannequin is very important in electronic made to measure (eMTM) system. There is one new easy method to generate personal virtual mannequin. First, the characteristic information of customer's body is got from two photos. Secondly, some human body part templates corresponding with the customer are selected from the templates library. Thirdly, these templates are modified and assembled according to certain rules to generate a personalized 3-dimensional human, and then the virtual mannequin is realized. Experimental result shows that the method is easy and feasible.

TRREMS procedure (transanal repair of rectocele and rectal mucosectomy with one circular stapler: a prospective multicenter trial

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José Vinicius Cruz

2011-03-01

Full Text Available CONTEXT: Since anorectocele is usually associated with mucosa prolapse and/or rectal intussusceptions, it was developed a stapled surgical technique using one circular stapler. OBJECTIVE: To report the results of Transanal Repair of Rectocele and Rectal Mucosectomy with one Circular Stapler (TRREMS procedure in the treatment of anorectocele with mucosa prolapse in a prospective multicenter trial. METHODS: It was conducted by 14 surgeons and included 75 female patients, mean aged 49.6 years, with symptoms of obstructed defecation due to grade 2 (26.7% and grade 3 (73.3% anorectocele associated with mucosa prolapse and/or rectal intussusception (52.0% and an average validated Wexner constipation score of 16. All patients were evaluated by a proctological examination, cinedefecography, anal manometry and colonic transit time. The TRREMS procedure consists of the manual removal of the rectocele wall with circumferential rectal mucosectomy performed with a circular stapler. The mean follow-up time was 21 months. RESULTS: All patients presented obstructed defecation and they persisted with symptoms despite conservative treatment. The mean operative time was 42 minutes. In 13 (17.3% patients, bleeding from the stapled line required hemostatic suture. Stapling was incomplete in 2 (2.6%. Forty-nine patients (65.3% required 1 hospitalization day, the remainder (34.7% 2 days. Postoperatively, 3 (4.0% patients complained of persistent rectal pain and 7 (9.3% developed stricture on the stapled suture subsequently treated by stricturectomy under anesthesia (n = 1, endoscopic stricturectomy with hot biopsy forceps (n = 3 and digital dilatation (n = 3. Postoperative cinedefecography showed residual grade I anorectoceles in 8 (10.6%. The mean Wexner constipation score decreased significantly from 16 to 4 (0-4: n = 68 (6: n = 6 (7: n = 1 (P<0.0001. CONCLUSION: Current trial results suggest that TRREMS procedure is a safe and effective technique for the treatment

One step linear reconstruction method for continuous wave diffuse optical tomography

Science.gov (United States)

Ukhrowiyah, N.; Yasin, M.

2017-09-01

The method one step linear reconstruction method for continuous wave diffuse optical tomography is proposed and demonstrated for polyvinyl chloride based material and breast phantom. Approximation which used in this method is selecting regulation coefficient and evaluating the difference between two states that corresponding to the data acquired without and with a change in optical properties. This method is used to recovery of optical parameters from measured boundary data of light propagation in the object. The research is demonstrated by simulation and experimental data. Numerical object is used to produce simulation data. Chloride based material and breast phantom sample is used to produce experimental data. Comparisons of results between experiment and simulation data are conducted to validate the proposed method. The results of the reconstruction image which is produced by the one step linear reconstruction method show that the image reconstruction almost same as the original object. This approach provides a means of imaging that is sensitive to changes in optical properties, which may be particularly useful for functional imaging used continuous wave diffuse optical tomography of early diagnosis of breast cancer.

Prognostic value of efficiently correcting nocturnal desaturations after one month of non-invasive ventilation in amyotrophic lateral sclerosis: a retrospective monocentre observational cohort study.

Science.gov (United States)

Gonzalez-Bermejo, Jésus; Morelot-Panzini, Capucine; Arnol, Nathalie; Meininger, Vincent; Kraoua, Salah; Salachas, François; Similowski, Thomas

2013-09-01

Abstract NIV adherence ('quantity' of ventilation) has a prognostic impact in amyotrophic lateral sclerosis (ALS). We hypothesized that NIV effectiveness ('quality') could also have a similar impact. NIV effectiveness was evaluated in 82 patients within the first month (M1) and every three months (symptoms, arterial blood bases, and nocturnal pulsed oxygen saturation - SpO2). Kaplan-Meier survival and risk factors for mortality one year after NIV initiation were evaluated. Forty patients were considered 'correctly ventilated' at M1 (Group 1, less than 5% of nocturnal oximetry time with an SpO2NIV effectiveness to correct nocturnal desaturations is an independent prognostic factor.

Bayesian methods for jointly estimating genomic breeding values of one continuous and one threshold trait.

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Chonglong Wang

Full Text Available Genomic selection has become a useful tool for animal and plant breeding. Currently, genomic evaluation is usually carried out using a single-trait model. However, a multi-trait model has the advantage of using information on the correlated traits, leading to more accurate genomic prediction. To date, joint genomic prediction for a continuous and a threshold trait using a multi-trait model is scarce and needs more attention. Based on the previously proposed methods BayesCπ for single continuous trait and BayesTCπ for single threshold trait, we developed a novel method based on a linear-threshold model, i.e., LT-BayesCπ, for joint genomic prediction of a continuous trait and a threshold trait. Computing procedures of LT-BayesCπ using Markov Chain Monte Carlo algorithm were derived. A simulation study was performed to investigate the advantages of LT-BayesCπ over BayesCπ and BayesTCπ with regard to the accuracy of genomic prediction on both traits. Factors affecting the performance of LT-BayesCπ were addressed. The results showed that, in all scenarios, the accuracy of genomic prediction obtained from LT-BayesCπ was significantly increased for the threshold trait compared to that from single trait prediction using BayesTCπ, while the accuracy for the continuous trait was comparable with that from single trait prediction using BayesCπ. The proposed LT-BayesCπ could be a method of choice for joint genomic prediction of one continuous and one threshold trait.

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

NARCIS (Netherlands)

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

2007-01-01

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

One-Stop Dispensing

DEFF Research Database (Denmark)

Houlind, Morten Baltzer; McNulty, Helle Bach Ølgaard; Treldal, Charlotte

2018-01-01

(1) Objective: To assess hospital medication costs and staff time between One-Stop Dispensing (OSD) and the Traditional Medication System (TMS), and to evaluate patient perspectives on OSD. (2) Methods: The study was conducted at Hvidovre Hospital, University of Copenhagen, Denmark in an elective...... gastric surgery and acute orthopedic surgery department. This study consists of three sub-studies including adult patients able to self-manage medication. In Sub-study 1, staff time used to dispense and administer medication in TMS was assessed. Medication cost and OSD staff time were collected in Sub......-study 2, while patient perspectives were assessed in Sub-study 3. Medication costs with two days of discharge medication were compared between measured OSD cost and simulated TMS cost for the same patients. Measured staff time in OSD was compared to simulated staff time in TMS for the same patients...

Bilateral sacrospinous vault fixation with tailored synthetic mesh arms: clinical outcomes at one year.

Science.gov (United States)

Geoffrion, Roxana; Hyakutake, Momoe T; Koenig, Nicole A; Lee, Terry; Cundiff, Geoffrey W

2015-02-01

Bilateral sacrospinous fixation with tailored mesh arms (bSSVF) uses polypropylene mesh to suspend the vault to the sacrospinous ligaments bilaterally with minimal tension, recreating nulliparous midline anatomy. It can be used with uterine conservation. Our primary objective was to determine objective cure rate at one year following bSSVF compared with a control group undergoing abdominal sacrocolpopexy (ASC). Secondary objectives were to compare symptoms, quality of life, sexual function, pain, and global satisfaction before and after surgery and between bSSVF and ASC groups at one year. This prospective cohort study enrolled patients with symptomatic prolapse who chose to undergo bSSVF or ASC. Baseline demographics were obtained. Prolapse quantification, validated symptom questionnaire scores, and McGill pain scores were obtained at baseline, six weeks, and one-year postoperatively. Global satisfaction was recorded. The primary outcome measure was the difference in cure rate (vault stage ≤ 1) between groups. Fifty patients were recruited: 30 underwent bSSVF and 17 ASC. Forty-three patients were available for one-year follow-up. Baseline data were similar. There was no difference in vault stage between bSSVF and ASC groups at one year. Five women who underwent bSSVF had cervical elongation, and four of these were classified as POP recurrence. Women who underwent bSSVF had more anterior recurrences but fewer postoperative complications, shorter hospital stay, and less use of narcotics than controls. Questionnaire scores were similar at one year. All respondents felt subjective improvement after either surgical procedure. Objective and subjective cure rates are comparable after bSSVF and ASC. Hysteropexy may cause cervical elongation that merits further research.

Image/patient registration from (partial) projection data by the Fourier phase matching method

International Nuclear Information System (INIS)

Weiguo Lu; You, J.

1999-01-01

A technique for 2D or 3D image/patient registration, PFPM (projection based Fourier phase matching method), is proposed. This technique provides image/patient registration directly from sequential tomographic projection data. The method can also deal with image files by generating 2D Radon transforms slice by slice. The registration in projection space is done by calculating a Fourier invariant (FI) descriptor for each one-dimensional projection datum, and then registering the FI descriptor by the Fourier phase matching (FPM) method. The algorithm has been tested on both synthetic and experimental data. When dealing with translated, rotated and uniformly scaled 2D image registration, the performance of the PFPM method is comparable to that of the IFPM (image based Fourier phase matching) method in robustness, efficiency, insensitivity to the offset between images, and registration time. The advantages of the former are that subpixel resolution is feasible, and it is more insensitive to image noise due to the averaging effect of the projection acquisition. Furthermore, the PFPM method offers the ability to generalize to 3D image/patient registration and to register partial projection data. By applying patient registration directly from tomographic projection data, image reconstruction is not needed in the therapy set-up verification, thus reducing computational time and artefacts. In addition, real time registration is feasible. Registration from partial projection data meets the geometry and dose requirements in many application cases and makes dynamic set-up verification possible in tomotherapy. (author)

Pretreatment PSA predicts for biochemical disease free survival in patients treated with post-prostatectomy external beam irradiation

International Nuclear Information System (INIS)

Crane, C.H.; Kelly, M.; Rich, T.A.

1996-01-01

Objective: To assess the outcome and determine prognostic factors for patients treated with external beam radiotherapy following radical prostatectomy. Methods and Materials: Forty-four patients were treated after prostatectomy with radiotherapy between March 1988 and October 1993. All patients were free from clinically or radiographically suspicious local or distant disease. One patient underwent neoadjuvant hormonal therapy, but no other patients received hormonal therapy prior to radiation. Pre-radiotherapy PSA and follow-up PSA data were available in all patients. Four patients had undetectable PSA ( 7, and 11% had nodal involvement. Survival was analyzed using the life table method. Actuarial freedom from biochemical (BCM) failure, defined as a rise of greater than 10% or an undetectable PSA becoming detectable, was the primary endpoint studied. Results: Fifty-nine percent of patients had a detectable PSA return to undetectable levels after XRT. The actuarial five year freedom from biochemical failure for all patients was 24%. A significant difference in BCM disease free survival was seen for patients irradiated with a pre-XRT PSA ≤2.7 versus a pre-XRT PSA >2.7 (p=0.0001). Sixty percent of the former group were BCM disease free versus 0% in the latter. Biochemical disease free survival was not affected by preoperative PSA level, presence of undetectable PSA after surgery, surgery to radiation interval, seminal vesicle invasion, clinical stage, pathologic stage, Gleasons grade, or total dose. There were no symptomatic or clinically suspicious local failures, and there were no grade 3, 4, or 5 acute or late complications. There were 69% grade 1 and 2 acute reactions and one grade 2 late complication. Conclusions: Pelvic radiotherapy for patients with a PSA of ≤2.7 after prostatectomy was effective in biochemically controlling 60% of the patients with four years median follow up. To our knowledge these data represent the longest follow-up for this patient

Impaired quality of life in patients with systemic sclerosis compared to the general population and chronic dermatoses

OpenAIRE

Bretterklieber, Agnes; Painsi, Clemens; Avian, Alexander; Wutte, Nora; Aberer, Elisabeth

2014-01-01

Background Systemic sclerosis (SSc) is a rare and potentially life threatening autoimmune disorder. The burden of disease compared to other dermatoses is unknown. The purpose of this study was to assess both the quality of life in patients with SSc and the variables that are associated with poor quality of life. Forty-one patients with systemic sclerosis (29 limited, 2 diffuse, 10 undifferentiated forms) were assessed with respect to their health status and compared to published data for the ...

Review of a single contemporary femoral neck fracture fixation method in young patients.

LENUS (Irish Health Repository)

Henari, Shwan

2011-03-01

An intracapsular femoral neck fracture in a young patient is a rare and difficult injury to manage. The occurrence of complications following fixation is multifactorial. Initial displacement and timing and accuracy of reduction are the key factors affecting outcome. The severities of the trauma to the hip and the impact of the intracapsular hematoma also play a role, the importance of which remains poorly understood. The purpose of this study was to evaluate the high incidence of femoral neck fractures treated in our institution over a 7-month period, to record the long-term outcome of these patients, all of whom were treated with contemporary methods of internal fixation, and to highlight the reasons for this injury being termed an "orthopedic emergency" and its differences from the same injury in the elderly population. We performed a retrospective analysis of 12 cases of intracapsular femur neck fracture in patients younger than 50 years treated over 7 months in a regional trauma center. All patients underwent satisfactory reduction and fixation. Nine of the 12 patients had a good outcome at a mean follow-up of 29 months. One patient developed a nonunion of the femoral head requiring total hip arthroplasty, one developed avascular necrosis of the femoral head, and one developed partial avascular necrosis. This compares favorably with other studies.

Forty-Seven DJs, Four Women: Meritocracy, Talent, and Postfeminist Politics

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Tami Gadir

2017-11-01

Full Text Available In 2016, only four of forty-seven DJs booked for Musikkfest, a festival in Oslo, Norway, were women. Following this, a local DJ published an objection to this imbalance in a local arts and entertainment magazine. Her editorial provoked booking agents to defend their position on the grounds that they prioritise skill and talent when booking DJs, and by implication, that they do not prioritise equality. The booking agents’ responses, on social media and in interviews I conducted, highlight their perpetuation of a status quo in dance music cultures where men disproportionately dominate the role of DJing. Labour laws do not align with this cultural attitude: gender equality legislation in Norway’s recent history contrasts the postfeminist attitudes expressed by dance music’s cultural intermediaries such as DJs and booking agents. The Musikkfest case ultimately shows that gender politics in dance music cultures do not necessarily correspond to dance music’s historical associations with egalitarianism.

Occurrence of allergic bronchopulmonary mycosis in patients with asthma: An Eastern India experience

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Sarkar Anirban

2010-01-01

Full Text Available Background: Allergic bronchopulmonary mycosis (ABPM is a clinical syndrome associated with immune sensitivity to various fungi notably Aspergillus spp. that colonize the airways of asthmatics. Early diagnosis and treatment with systemic corticosteroids is the key in preventing the progression of the disease to irreversible lung fibrosis. Aims: To study the occurrence of ABPM among asthma patients with fungal sensitization attending a chest clinic of a tertiary hospital of eastern India. The clinico-radiological and aetiological profiles are also described. Materials and Methods: All consecutive patients with asthma presenting to the chest clinic over a period of one year were screened for cutaneous hypersensitivity to 12 common fungal antigens. The skin test positive cases were further evaluated for ABPM using standard criteria. Results: One hundred and twenty-six asthma patients were screened using twelve common fungal antigens; forty patients (31.74% were found to be skin test positive, and ABPM was diagnosed in ten patients (7.93%. Of the 10 cases of ABPM, nine cases were those of allergic bronchopulmonary aspergillosis (ABPA and one case was identified as caused by sensitization to Penicillium spp. A majority of the cases of ABPM had advanced disease and had significantly lower FEV1 compared to non-ABPM skin test positive asthmatics. Central bronchiectasis on high resolution CT scan was the most sensitive and specific among the diagnostic parameters. Conclusion: There is a significant prevalence of ABPM in asthma patients attending our hospital and this reinforces the need to screen asthma patients for fungal sensitisation. This will help in early diagnosis and prevention of irreversible lung damage.

Fingolimod Treatment in Relapsing-Remitting Multiple Sclerosis Patients: A Prospective Observational Multicenter Postmarketing Study

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Rocco Totaro

2015-01-01

Full Text Available Objective. The aim of this prospective observational multicenter postmarketing study was to evaluate fingolimod efficacy in a real world clinical setting. Methods. One hundred forty-two subjects with relapsing-remitting multiple sclerosis (RRMS were enrolled in three multiple sclerosis centers throughout Central and Southern Italy between January 2011 and September 2013. After enrollment, regular visits and EDSS assessment were scheduled every 3 months, and MRI scan was obtained every 12 months. Patients were followed up from 1 to 33 months (mean 14.95 ± 9.15 months. The main efficacy endpoints included the proportion of patients free from clinical relapses, from disability progression, from magnetic resonance imaging activity, and from any disease activity. Results. Out of 142 patients enrolled in the study, 88.1% were free from clinical relapse and 69.0% were free from disability progression; 68.5% of patients remained free from new or newly enlarging T2 lesions and 81.7% of patients were free from gadolinium enhancing lesions. Overall the proportion of patients free from any disease activity was 41.9%. Conclusions. Our data in a real world cohort are consistent with previous findings that yield convincing evidence for the efficacy of fingolimod in patients with RRMS.

On the Evaluation of Outlier Detection and One-Class Classification Methods

DEFF Research Database (Denmark)

Swersky, Lorne; Marques, Henrique O.; Sander, Jörg

2016-01-01

It has been shown that unsupervised outlier detection methods can be adapted to the one-class classification problem. In this paper, we focus on the comparison of oneclass classification algorithms with such adapted unsupervised outlier detection methods, improving on previous comparison studies ...

Evaluation of photopatch test allergens for Indian patients of photodermatitis: Preliminary results

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Nidhi Jindal

2011-01-01

Full Text Available Background: There is a strong need to develop a photopatch test tray suitable for Indian patients of photodermatitis as European/Scandinavian photopatch test trays may not be wholly relevant for them. Aim: We carried out this study using photoallergens relevant in the Indian context to determine their relevance in patients of photodermatitis. Methods: Thirty patients (M:F, 23:7 between 19 and 76 years of age of photodermatitis and 10 controls were patch- and photopatch tested with 20 common photoallergens. In addition, the patients were also (photo patch tested with articles of daily use as and when these were suspected to be the cause. Results: Forty-three positive reactions to one or more antigens were seen in 22 (74% patients. Fourteen positive photopatch tests to seven allergens were observed in 10 (33% patients, and nine (30% of them had a definite relevance. The most common contact allergen was fragrance mix (FM (30%, followed by p-phenylenediamine (20% and Parthenium hysterophorous (17%. The definite relevance of the patch- and photopatch tests could be correlated in 47% of these patients. Conclusions: FM is the most common contact and photocontact allergen among the various photopatch test antigens. Although differences in technique and evaluation make direct comparison between different centers difficult, still photopatch testing remains an integral part and gold standard for the work-up of the photosensitive patients.

One-dimensional calculation of flow branching using the method of characteristics

International Nuclear Information System (INIS)

Meier, R.W.; Gido, R.G.

1978-05-01

In one-dimensional flow systems, the flow often branches, such as at a tee or manifold. The study develops a formulation for calculating the flow through branch points with one-dimensional method of characteristics equations. The resultant equations were verified by comparison with experimental measurements

Surgical complications of radical retropubic prostatectomy: A single institutional experience of seven years

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Neeraj K Goyal

2007-01-01

Full Text Available Aim: To determine the surgical complications of open retropubic radical prostatectomy. Materials and Methods: Fifty-nine cases of localized prostate cancer underwent retropubic radical prostatectomy in our department in the last seven years. Standard technique of open retropubic radical prostatectomy as described by Walsh was used. During follow-up cancer control and quality of life indices (potency and urinary continence were noted. Result: Postoperative recovery of all patients except one was excellent. This patient required cardio-respiratory support and nine units of blood transfusion. Forty-nine out of 52 patients were continent, two had stress incontinence and one was totally incontinent at one year. Bladder neck contracture was present in eight out of 52 patients at one year. Forty-five patients were impotent at one year with or without oral tablet sildenafil. Cancer control was present in 45 out of 52 cases. Seven cases had biochemical failure at one year. Conclusion: Though retropubic radical prostatectomy is the standard treatment for early prostate cancer it is not without complications. It has a steep learning curve. More number of cases and refinement in technique is required to achieve world-class results.

The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis

DEFF Research Database (Denmark)

Rosenlund, Signe; Holsgaard-Larsen, Anders; Overgaard, Søren

2016-01-01

) and with severe primary hip osteoarthritis underwent 3-dimensional gait analysis. Mean Gait Deviation Index, pain after walking and maximal isometric hip muscle strength (flexor, extensor, and abductor) were recorded. All patients completed the 'Physical Function Short-form of the Hip disability...... was to investigate associations between Gait Deviation Index as a measure of gait 'quality' and hip muscle strength and between Gait Deviation Index and patient-reported outcomes in patients with primary hip osteoarthritis. METHOD: Forty-seven patients (34 males), aged 61.1 ± 6.7 years, with BMI 27.3 ± 3.4 (kg/m2...... and Osteoarthritis Outcome Score (HOOS-Physical Function) and the Hip disability and Osteoarthritis Outcome Score subscales for pain (HOOS-Pain) and quality-of-life (HOOS-QOL). RESULTS: Mean Gait Deviation Index was positively associated with hip abduction strength (pstrength (p = 0...

Ambulatory orthopaedic surgery patients' emotions when using different patient education methods.

Science.gov (United States)

Heikkinen, Katja; Salanterä, Sanna; Leppänen, Tiina; Vahlberg, Tero; Leino-Kilpi, Helena

2012-07-01

A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.

Linear finite element method for one-dimensional diffusion problems

Energy Technology Data Exchange (ETDEWEB)

Brandao, Michele A.; Dominguez, Dany S.; Iglesias, Susana M., E-mail: micheleabrandao@gmail.com, E-mail: dany@labbi.uesc.br, E-mail: smiglesias@uesc.br [Universidade Estadual de Santa Cruz (LCC/DCET/UESC), Ilheus, BA (Brazil). Departamento de Ciencias Exatas e Tecnologicas. Laboratorio de Computacao Cientifica

2011-07-01

We describe in this paper the fundamentals of Linear Finite Element Method (LFEM) applied to one-speed diffusion problems in slab geometry. We present the mathematical formulation to solve eigenvalue and fixed source problems. First, we discretized a calculus domain using a finite set of elements. At this point, we obtain the spatial balance equations for zero order and first order spatial moments inside each element. Then, we introduce the linear auxiliary equations to approximate neutron flux and current inside the element and architect a numerical scheme to obtain the solution. We offer numerical results for fixed source typical model problems to illustrate the method's accuracy for coarse-mesh calculations in homogeneous and heterogeneous domains. Also, we compare the accuracy and computational performance of LFEM formulation with conventional Finite Difference Method (FDM). (author)

Homotopy decomposition method for solving one-dimensional time-fractional diffusion equation

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Abuasad, Salah; Hashim, Ishak

2018-04-01

In this paper, we present the homotopy decomposition method with a modified definition of beta fractional derivative for the first time to find exact solution of one-dimensional time-fractional diffusion equation. In this method, the solution takes the form of a convergent series with easily computable terms. The exact solution obtained by the proposed method is compared with the exact solution obtained by using fractional variational homotopy perturbation iteration method via a modified Riemann-Liouville derivative.

TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN PATIENTS WITH CEREBRAL ISCHEMIA

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Kavian Ghandehari

2010-12-01

Full Text Available Abstract INTRODUCTION: Transesophageal echocardiography (TEE is superior to Transthoracic echocardiography (TTE in detection of atrial septal defects and aneurysm, aortic atheroma, left atrial thrombus and mitral valve abnormalities. TEE is indicated in young adults with cryptogenic ischemic stroke who are suspected of having cardioembolic mechanism despite non-diagnostic TTE. METHODS: A prospective clinical study was conducted in patients with ischemic stroke or TIA who had TTE done in Ghaem hospital, Mashhad during 2006-2007. Ischemic cerebrovascular events were detected by stroke neurologist. TEE was performed with VIPI3/GE device, USA and a 7 MHz transesophageal probe by an echocardiologist. Patients who did not have TTE before TEE were excluded. Comparison of TEE to TTE results was performed by the echocardiologist and stroke neurologist in each patient. Influence of TEE on therapeutic decisions in each patient was evaluated. RESULTS: Forty-seven patients (20 females, 27 males with a mean age of 42.6±7.3 years were studied. Cardiac and aortic abnormalities were detected in TEE of 35 cases (35/47; 74% with ischemic cerebrovascular events. Cardiac abnormalities of 17 cases (36% were only detectable by TEE. These seventeen cases included 7 patients with PFO, 1 case with ASD, 6 cases with aortic atheroma and 2 patients with clot in the left atrium. Comparing the preventive stroke strategies before and after TEE revealed that it was changed only in two cases (2/47; 4.3% due to performing TEE. These included one patient with a small high-risk PFO and another case with dehicense of mechanical mitral valve. CONCLUSION: TEE revealed cardiac or aortic abnormalities in one-third of the patients with cerebral ischemia and has not been detected by TEE previously. The influence of TEE in therapeutic decisions of patients with ischemic cerebrovascular events is very low.         Keywords: Transesophageal echocardiography, Stroke, Transient Ischemic

Malignant gliomas (MG) in the elderly. A study of 85 consecutive patients in two institutions

International Nuclear Information System (INIS)

Villa, S.; Vinolas, N.; Verger, E.; Gil, M.; Caralt, L.; Moreno, V.; Graus, F.

1997-01-01

Purpose: The treatment of MG in old patients is controversial and not well established. Some authors consider that adjuvant radiotherapy (RT) is not useful to improve survival. Our aim was to identify which group of patients older than 65 years might benefit of adjuvant radiotherapy (RT). Patients and Methods: A total of 85 consecutive patients were analyzed from two Institutions diagnosed during the period 1987-1995. Forty six were male and 39 female. The median age was 70 (r 65-81). The extent of surgery (S) was analyzed by neurosurgeons reports or postoperative CT scan (32 p. underwent biopsy, 25 partial resection, 28 complete resection). Glioblastoma Multiforme was observed in 64 patients (75%) and anaplastic gliomas in 21 patients (25%). Postoperative Karnofsky Index (KI) was as follows: in 47 p 60% (for 2 p was unknown). Survival probability was estimated using Kaplan-Meier method and compared with log-rank test. Crude and adjusted hazard ratios (HR) were calculated using Cox's regression models. Results: Forty four patients were treated by adjuvant RT and 41 patients were not. Median survival time for all patients was 18.3 weeks. In multivariate analysis we found that the most powerful independent variable was not to receive RT with a hazard ratio of 8.5 (CI 4.55-16.06). Reasons for not RT were: in 7 p. postsurgical complications, in 17 p. KI 40%. Multivariate analysis showed that the most significant independent variable was age ( 71 y) with a HR of 2.85 (CI 1.31-6.19). Conclusions: 1- Patients who did not received RT, due to several reasons, had poorer evolution. 2-In patients who received adjuvant treatment, it was suggested that age is the first variable to consider, although patients older than 71 can benefit of RT (see table)

Scale Space Methods for Analysis of Type 2 Diabetes Patients' Blood Glucose Values

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Stein Olav Skrøvseth

2011-01-01

Full Text Available We describe how scale space methods can be used for quantitative analysis of blood glucose concentrations from type 2 diabetes patients. Blood glucose values were recorded voluntarily by the patients over one full year as part of a self-management process, where the time and frequency of the recordings are decided by the patients. This makes a unique dataset in its extent, though with a large variation in reliability of the recordings. Scale space and frequency space techniques are suited to reveal important features of unevenly sampled data, and useful for identifying medically relevant features for use both by patients as part of their self-management process, and provide useful information for physicians.

Forty years on and still going strong : the use of hominin-cercopithecid comparisons in palaeoanthropology.

OpenAIRE

Elton, S.

2006-01-01

Hominin-cercopithecid comparisons have been used in palaeoanthropology for over forty years. Fossil cercopithecids can be used as a ‘control group’ to contextualize the adaptations and evolutionary trends of hominins. Observations made on modern cercopithecids can also be applied to questions about human evolution. This article reviews the history of hominin-cercopithecid comparisons, assesses the strengths and weaknesses of cercopithecids as comparators in studies of human evolution, and use...

Using qualitative methods to understand factors contributing to patient satisfaction among dermatology patients: a systematic review.

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Gibbons, Caitlin; Singh, Sanminder; Gibbons, Brittany; Clark, Caitlin; Torres, Josefina; Cheng, Michelle Y; Wang, Elizabeth A; Armstrong, April W

2018-05-01

In this systematic review, we aimed to synthesize data that identify factors contributing to patient satisfaction in dermatology care using qualitative methods. We performed a comprehensive search of the literature using the PubMed database for articles published between January 1, 2000 and February 9, 2015. The initial search yielded 186 articles, of which 13 were included after applying inclusion and exclusion criteria. The systematic review of 13 articles included a total of 330 patients. Using in-field observations and semistructured interviews, studies found that qualitative methods and analysis increased the provider's sensitivity to patient needs and enhanced patient care. Analyses using qualitative methods found increased patient satisfaction in their healthcare provider is associated with (1) confidence in the provider's diagnosis, (2) perception of patient-centered, individualized recommendations and (3) quality of patient education and provider explanation during a visit. Patient satisfaction is measured using either quantitative or qualitative methods. Quantitative methods result in standardized data that often does not capture the nuances of patient experience. In contrast, qualitative methodology is integral to gathering patient perspectives on patient care and satisfaction and should be included in future research models.

The Effectiveness of Hard Martial Arts in People over Forty: An Attempted Systematic Review

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Gaby Pons van Dijk

2014-04-01

Full Text Available The objective was to assess the effect of hard martial arts on the physical fitness components such as balance, flexibility, gait, strength, cardiorespiratory function and several mental functions in people over forty. A computerized literature search was carried out. Studies were selected when they had an experimental design, the age of the study population was >40, one of the interventions was a hard martial art, and when at least balance and cardiorespiratory functions were used as an outcome measure. We included four studies, with, in total, 112 participants, aged between 51 and 93 years. The intervention consisted of Taekwondo or Karate. Total training duration varied from 17 to 234 h. All four studies reported beneficial effects, such as improvement in balance, in reaction tests, and in duration of single leg stance. We conclude that because of serious methodological shortcomings in all four studies, currently there is suggestive, but insufficient evidence, that hard martial arts practice improves physical fitness functions in healthy people over 40. However, considering the importance of such effects, and the low costs of the intervention, the potential of beneficial health effects of age-adapted, hard martial arts training, in people over 40, warrants further study.

High prevalence of heartburn and low acid sensitivity in patients with idiopathic achalasia.

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Ponce, Julio; Ortiz, Vicente; Maroto, Nuria; Ponce, Marta; Bustamante, Marco; Garrigues, Vicente

2011-03-01

Heartburn is frequently reported by patients with achalasia before treatment. However, the esophageal sensitivity to acid as a possible mediator of this symptom has not been previously evaluated. To evaluate the prevalence of gastroesophageal reflux symptoms and the esophageal sensitivity to acid perfusion in patients with untreated achalasia. Forty patients with achalasia were prospectively evaluated. Forty-three patients with gastroesophageal reflux disease comprised the control group (ten of them with Barrett's esophagus). Symptoms were evaluated by a structured clinical questionnaire. Objective assessment was performed by ambulatory 24-h esophageal pH monitoring and endoscopy. Esophageal sensitivity to acid was evaluated by esophageal perfusion of ClH 0.1 N. Fifteen (37%) of the 40 patients with achalasia presented heartburn, but only four of them had esophagitis and/or abnormal esophageal pH recording. Eight patients had abnormal pH recording. Three patients had esophagitis. The esophagus was sensitive to acid in seven (17%) patients with achalasia, three of them with heartburn and one with abnormal pH recording. In the control group, 40 of 43 (93%) presented heartburn. Acid perfusion was positive in 32 (74%). Sensitivity to acid was lower in patients with achalasia than in those with gastroesophageal reflux disease with or without Barrett's esophagus. The prevalence of heartburn in patients with achalasia is high, although its association with objective indicators of gastroesophageal reflux disease is weak. Patients with achalasia have lower esophageal sensitivity to acid than patients with GERD, suggesting that heartburn is does not arise from this condition.

The prevalence of antinuclear antibodies in patients with apparent polymorphic light eruption.

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Murphy, G M; Hawk, J L

1991-11-01

Polymorphic light eruption (PLE) is a very common photosensitive disorder, the most important differential diagnosis of which is lupus erythematosus (LE). One-hundred and forty-two patients with PLE were screened for circulating antinuclear (ANA), Ro and La antibodies over a 2-year period. Results were negative in 66 patients. Sixty-two patients had low-titre ANA of various patterns, ranging from trace to 1/80 without evidence of LE although one later developed subacute cutaneous LE. Fourteen had more significant findings, six with ANA ranging from 1/160 to 1/1280 but no anti-Ro antibodies, four with ANA ranging from 1/160 to 1/1280 and also with anti-Ro antibodies and four patients with anti-Ro antibodies but low-titre ANA, one of whom later developed discoid LE. Three of these 14 patients fulfilled the American Rheumatism Association criteria for the diagnosis of systemic LE, but it was not certain in any of the patients whether the PLE-like rash represented cutaneous LE or coincidental PLE. However the overall 10% incidence of definite or possible LE in patients with suspected PLE suggests that all PLE patients should be screened for LE.

Complex transformation method and resonances in one-body quantum systems

International Nuclear Information System (INIS)

Sigal, I.M.

1984-01-01

We develop a new spectral deformation method in order to treat the resonance problem in one-body systems. Our result on the meromorphic continuation of matrix elements of the resolvent across the continuous spectrum overlaps considerably with an earlier result of E. Balslev [B] but our method is much simpler and more convenient, we believe, in applications. It is inspired by the local distortion technique of Nuttall-Thomas-Babbitt-Balslev, further developed in [B] but patterned on the complex scaling method of Combes and Balslev. The method is applicable to the multicenter problems in which each potential can be represented, roughly speaking, as a sum of exponentially decaying and dilation-analytic, spherically symmetric parts

Fertility in cancer patients after cryopreservation of one ovary.

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Schmidt, K T; Nyboe Andersen, A; Greve, T; Ernst, E; Loft, A; Yding Andersen, C

2013-03-01

This questionnaire study describes the fertility and ovarian function in 143 adult female cancer survivors with only one ovary due to cryopreservation of the other. The women were asked about their ovarian function (as defined by the presence of a spontaneous menstrual cycle), pregnancies and their outcome. The mean follow-up time was 58months after cryopreservation (range 24-129months). The risk of premature ovarian failure was high in the group of patients with leukaemia (13/15; 87%) but low in the breast cancer group (5/54; 9%). Fifty-seven women had actively tried to become pregnant after end of treatment; of these, 41 women obtained a total of 68 pregnancies resulting in 45 live births and five ongoing pregnancies, 15 spontaneous abortions, one ectopic pregnancy and two elective abortions. In the remaining 86 women without a pregnancy wish, there had been five elective abortions. Ninety-three per cent of the pregnancies were after natural conception and only four cases were a result of fertility treatment. The overall risk of premature ovarian failure was low (22%). Patients who retain their ovarian function after treatment of a malignant disease have a good chance of becoming pregnant. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Dynamics of albumin in plasma and ascitic fluid in patients with cirrhosis

DEFF Research Database (Denmark)

Henriksen, Jens Henrik; Siemssen, O; Krintel, J J

2001-01-01

BACKGROUND/AIMS: To determine dynamics of albumin in plasma and ascitic fluid of patients with cirrhosis. METHODS: Forty-seven patients were classified in four groups: I--patients without fluid retention; II--patients with ascites not resistant to subsequent diuretic treatment; III......--recompensated patients during diuretic treatment; and IV--patients with diuretic-resistant ascites. Transvascular and transperitoneal albumin transports were quantified by 131I-/125I-labelled human albumin. RESULTS: TER(P) (i.e. the fraction of intravascular albumin (IVM) passing from plasma into the interstitial space...... per hour) was increased in all groups. In group IV patients the transport rate of albumin from plasma into the ascitic fluid (TER(PA)) was significantly higher than the transport rate from the ascitic fluid back into the plasma: TER(AP) (0.45 vs. 0.26% IVM/h, P

Case scheduling preferences of one Surgeon's cataract surgery patients.

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Dexter, Franklin; Birchansky, Lee; Bernstein, James M; Wachtel, Ruth E

2009-02-01

The increase in the number of operating rooms nationwide in the United States may reflect preferences of patients for scheduling of outpatient surgery. Yet, little is known of the importance that patients place on scheduling convenience and flexibility. Fifty cataract surgery patients seen by a surgeon at his main office during a 6-mo period responded to a marketing survey. All the patients had Medicare insurance and supplemental insurance permitting surgery at any facility. A telephone questionnaire included four vignettes describing different choices in the scheduling of cataract surgery. Respondents were asked how far they would be willing to travel for one option instead of another. For example, "Your surgery will be on Thursday in three weeks at 2 pm. You can drink water until 9 am. You arrive at 10 am, because your surgery might start early. If you travel farther, you would arrive at 8 am for 9 am surgery." The median (50th percentile) additional travel time was 60 min (lower 95% confidence bound >or=52 min) for each of four options: to receive care on a day chosen by the patient instead of assigned by the physician, to receive care at a single site instead of both the surgeon's office and a surgery center at a different location, to combine the examination and the surgery into a single visit instead of two visits, and to have surgery in the morning instead of the afternoon. The patients of this ophthalmologist placed a high value on convenience and flexibility in scheduling their surgery. In general, this would be achievable only if many operating rooms were available each morning.

Is one sputum specimen as good as two during follow-up cultures for monitoring multi drug resistant tuberculosis patients in India?

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Sharath Burugina Nagaraja

Full Text Available BACKGROUND: In India, the Revised National Tuberculosis Control Programme (RNTCP has adopted the strategy of examining two specimens during follow-up culture examinations to monitor the treatment response of multi-drug resistant tuberculosis (MDR-TB patients. OBJECTIVES: To determine the incremental yield of the second sputum specimen during follow-up culture examinations among patients with MDR-TB and the effect on case management on changing from two to one specimen follow-up strategy. METHODS: A cross sectional record review of MDR-TB patients registered during 2008-09 under RNTCP was undertaken in three MDR-TB treatment sites of India. RESULTS: Of 1721 pairs of follow-up sputum culture examinations done among 220 MDR-TB patients, 451(26% were positive with either of the two specimens; 29(1.7% were culture positive only on the second specimen indicating the incremental yield. To detect one additional culture positive result on the second specimen, 59 specimens needed to be processed. If we had examined only one specimen, we would have missed 29 culture-positive results. By current RNTCP guidelines, however, a single specimen policy would have altered case management in only 3(0.2% instances, where patients would have missed a one month extension of the intensive phase of MDR-TB treatment. There is no meaningful advantage in using two specimens for the monitoring of MDR-TB patients. A single specimen policy could be safely implemented with negligible clinical effect on MDR-TB patients and favourable resource implications for RNTCP.

Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted

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Cecilie Røe

2015-01-01

Full Text Available The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury model based prediction, from the Medical Research Council (MRC. Methods. Prospective, national multicenter study including patients with severe TBI ≥65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic (age, GCS score, and pupil reactivity to light, as well as with additional CT findings (CRASH CT. Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7 years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR for mortality was 2.65. Unfavorable outcome (GOSE < 5 was observed at one year follow-up in 72% of patients. The CRASH models predicted unfavorable outcome in all patients. Conclusion. The CRASH model overestimated mortality and unfavorable outcome in old and very old Norwegian patients with severe TBI.

Mortality and One-Year Functional Outcome in Elderly and Very Old Patients with Severe Traumatic Brain Injuries: Observed and Predicted

Science.gov (United States)

Røe, Cecilie; Skandsen, Toril; Manskow, Unn; Ader, Tiina; Anke, Audny

2015-01-01

The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based prediction, from the Medical Research Council (MRC). Methods. Prospective, national multicenter study including patients with severe TBI ≥65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic) (age, GCS score, and pupil reactivity to light), as well as with additional CT findings (CRASH CT). Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7) years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR) for mortality was 2.65. Unfavorable outcome (GOSE < 5) was observed at one year follow-up in 72% of patients. The CRASH models predicted unfavorable outcome in all patients. Conclusion. The CRASH model overestimated mortality and unfavorable outcome in old and very old Norwegian patients with severe TBI. PMID:26688614

Synthesis and characterization of copper nanofluid by a novel one-step method

International Nuclear Information System (INIS)

Kumar, S. Ananda; Meenakshi, K. Shree; Narashimhan, B.R.V.; Srikanth, S.; Arthanareeswaran, G.

2009-01-01

This paper presents a novel one-step method for the preparation of stable, non-agglomerated copper nanofluids by reducing copper sulphate pentahydrate with sodium hypophosphite as reducing agent in ethylene glycol as base fluid by means of conventional heating. This is an in situ, one-step method which gives high yield of product with less time consumption. The characterization of the nanofluid is done by particle size analyzer, X-ray diffraction topography, UV-vis analysis and Fourier transform infrared spectroscopy (FT-IR) followed by the study of thermal conductivity of nanofluid by the transient hot wire method

Frequency of anti-HCV antibodies in patients with lichen planus

International Nuclear Information System (INIS)

Mahboob, A.; Haroon, T.S.; Iqbal, Z.; Butt, A.K.

2003-01-01

Objective: To determine the frequency of anti-HCV antibodies, identify risk factors associated with HCV infection and to screen asymptomatic carries in patients with lichen planus. Subjects and Methods: A total of 184 clinically diagnosed cased of lichen (LP) were selected for the study. Blood samples of all the patients were tested for anti hepatitis C virus antibodies (anti-HCV-Ab). Polymerase chain reaction for hepatitis C virus was done in patients with positive anti-HCV-Ab. Trancutaneous liver biopsy was performed in 7 patients with positive HCV-RNA. The histopathological results were evaluated using validated Metavir and Knodell scoring systems. Results: Out of 184 LP patients, 43 (23.4%) were anti-HCV antibodies positive. Females were predominantly affected and male to female ratio was 1:5.1. Maximum positively for anti-HCV was observed in age group 31-40 years (39.53%) followed by 41-50 years (25.58%). Eighty-one percent patients had history of dental treatment and 63% had received multiple injections for various ailments. Forty percent patients had family history of jaundice while 26% had jaundice in the past. Ten out of 16 anti-HCV antibody positive patients, checked for HCV-RNA, had high levels of virus in blood. Transcutaneous liver biopsy done in 7 patients revealed underlying liver disease at various stages. Four patients treated with alpha-interferon and ribazole therapy for liver disease, showed marked improvement in their skin disease. Conclusion: A high prevalence of HCV infection was detected in patients with lichen planus. Patients with lichen planus should be screened for HCV carrier state. (author)

Detection of mutation in isoniazid-resistant Mycobacterium tuberculosis isolates from tuberculosis patients in Belarus

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Bostanabad S

2008-01-01

Full Text Available The aim of this study was to investigate the frequency, location and type of katG mutations in Mycobacterium tuberculosis strains isolated from patients in Belarus. Forty two isoniazid-resistant isolates were identified from sputum of 163 patients with active pulmonary tuberculosis. Drug susceptibility testing was determined by using CDC standard conventional proportional method and BACTEC system. Standard PCR method for detection of isoniazid resistance associated mutations was performed by katG gene amplification and DNA sequencing. Most mutations were found in katG gene codons 315, 316 and 309. Four types of mutations were identified in codon 315: AGC→ACC ( n = 36 85%, AGC→AGG ( n = 1 2.3%, AGC→AAC ( n = 2 4.7%, AGC→GGC ( n = 1 2.3%. One type of mutation was found in codon 316: GGC→AGC ( n = 1841.4%, four types of mutations were detected in codon 309: GGT→GGT ( n = 716.1%, GGT→GCT ( n = 49.2%, GGT→GTC ( n = 36.9%, GGT→GGG ( n = 12.7%. The highest frequency of mutations sharing between primary and secondary infections was found in codon 315.

The repeatability of interleukin-6, tumor necrosis factor-alpha, and C-reactive protein in COPD patients over one year

DEFF Research Database (Denmark)

Kolsum, Umme; Roy, Kay; Starkey, Cerys

2009-01-01

BACKGROUND: Many of the systemic manifestations of chronic obstructive pulmonary disease (COPD) are mediated through increased systemic levels of inflammatory proteins. We assessed the long term repeatability of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein......(i)) and the Bland-Altman method. Pearson correlations were used to determine the relationships between the systemic markers at both visits. RESULTS: There was moderate repeatability with a very high degree of statistical significance (p...... (CRP) over one year and examined the relationships between these systemic markers in COPD. METHODS: Fifty-eight stable COPD patients completed a baseline and one-year visit. Serum IL-6, plasma CRP, and plasma TNF-alpha were measured. Repeatability was expressed by intraclass correlation coefficient (R...

The repeatability of interleukin-6, tumor necrosis factor-alpha, and C-reactive protein in COPD patients over one year

DEFF Research Database (Denmark)

Kolsum, Umme; Roy, Kay; Starkey, Cerys

2009-01-01

BACKGROUND: Many of the systemic manifestations of chronic obstructive pulmonary disease (COPD) are mediated through increased systemic levels of inflammatory proteins. We assessed the long term repeatability of Interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein......(i)) and the Bland-Altman method. Pearson correlations were used to determine the relationships between the systemic markers at both visits. RESULTS: There was moderate repeatability with a very high degree of statistical significance (p...... (CRP) over one year and examined the relationships between these systemic markers in COPD. METHODS: Fifty-eight stable COPD patients completed a baseline and one-year visit. Serum IL-6, plasma CRP, and plasma TNF-alpha were measured. Repeatability was expressed by intraclass correlation coefficient (R...

[Clinical Trial to Test the iFuse Implant System® in Patients with Sacroiliac Joint Syndrome: One Year Results].

Science.gov (United States)

Bornemann, R; Pflugmacher, R; Webler, M; Koch, E M W; Dengler, J; Wirtz, D C; Frey, S P

2016-12-01

Background: This study reports one year post-operative monitoring of the efficacy and safety of iFuse Implant System® in patients with sacroiliac joint syndrome. Material and Methods: After 6 months of inadequate conservative treatment, patients with properly proven ISG syndrome were selected for surgery. The iFuse implants had a triangular profile and coating of porous titanium plasma spray and were used in the minimally invasive procedures. The procedure was performed under general anaesthesia and fluoroscopic control. In each case, three implants were placed. Results: 24 patients (22 f; 92 %; 54.9 ± 14 years) participated in the study. The operations were performed in 11 patients (46 %) on the left and in 13 patients (54 %) on the right. The mean operative time was 42.4 minutes (95 % CI: 35.6-49.3). The reduction in pain intensity on the VAS scale was 58 ± 11 mm (68 ± 7 %). The Oswestry score showed a median decrease of 44 percentage points (57 %). After 12 months, 15 patients (63 %) reported that they were taking no more painkillers. Conclusion: The minimally invasive treatment of patients with sacroiliac joint syndrome using the iFuse Implant System leads to significant analgesic effects over the period of one year; it also contributes significantly to improving the functioning of the patient. Georg Thieme Verlag KG Stuttgart · New York.

Using Four-Layer Sculpted Rib Cartilage Framework to Increase Transverse Height of the Reconstructive Ear in One Operative Stage for Microtia Patients.

Science.gov (United States)

Wan, Rui; Pang, Xingyuan; Ren, Jun

2018-02-01

This case study improves an operative method of ear reconstruction for microtia patients by using a four-layer rib cartilage framework to increase transverse height of the reconstructive ear to a natural level in one operative stage. The procedures of ear reconstruction were conducted from February 2014 to May 2016. The ear framework used in the procedures was fabricated from autologous rib cartilage into a four-layer spliced sculpture. Totally 23 patients with unilateral microtia were willing to be enrolled in this study. After the operation, 23 patients achieved 2.3-2.8 cm transverse height of reconstructed ears, which was basically the same as the normal side. Both patients and their families felt satisfied with the results. Follow-up was performed at 6-16 months after the procedures. Only one case showed significantly lowered transverse height of the reconstructed ear, compared to the normal one. It was due to the sleeping position of the patient (10-year-old boy), which put the reconstructed ear under pressure and reduced the transverse height of the ear. The method of four-layer sculpted autologous rib cartilage ear reconstruction has good clinical effect. It can provide a reconstructed ear that reaches normal transverse height and avoids a third operation to increase the transverse height by rib cartilage transplantation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Alpha-defensin DEFA1A3 gene copy number elevation in Danish Crohn's disease patients

DEFF Research Database (Denmark)

Jespersgaard, Cathrine; Fode, Peder; Dybdahl, Marianne

2011-01-01

BACKGROUND AND PURPOSE OF STUDY: Extensive copy number variation is observed for the DEFA1A3 gene encoding alpha-defensins 1-3. The objective of this study was to determine the involvement of alpha-defensins in colonic tissue from Crohn's disease (CD) patients and the possible genetic association...... of DEFA1A3 with CD. METHODS: Two-hundred and forty ethnic Danish CD patients were included in the study. Reverse transcriptase PCR assays determined DEFA1A3 expression in colonic tissue from a subset of patients. Immunohistochemical analysis identified alpha-defensin peptides in colonic tissue. Copy...

Stability of one-step methods in transient nonlinear heat conduction

International Nuclear Information System (INIS)

Hughes, J.R.

1977-01-01

The purpose of the present work is to ascertain practical stability conditions for one-step methods commonly used in transient nonlinear heat conduction analyses. The class of problems considered is governed by a temporally continuous, spatially discrete system involving the capacity matrix C, conductivity matrix K, heat supply vector, temperature vector and time differenciation. In the linear case, in which K and C are constant, the stability behavior of one-step methods is well known. But in this paper the concepts of stability, appropriate to the nonlinear problem, are thoroughly discussed. They of course reduce to the usual stability criterion for the linear, constant coefficient case. However, for nonlinear problems there are differences and these ideas are of key importance in obtaining practical stability conditions. Of particular importance is a recent result which indicates that, in a sense, the trapezoidal and midpoint families are quivalent. Thus, stability results for one family may be translated into a result for the other. The main results obtained are summarized as follows. The stability behavior of the explicit Euler method in the nonlinear regime is analogous to that for linear problems. In particular, an a priori step size restriction may be determined for each time step. The precise time step restriction on implicit conditionally stable members of the trapezoidal and midpoint families is shown not to be determinable a priori. Of considerable practical significance, unconditionally stable members of the trapezoidal and midpoint families are identified

Qualitative Methods in Patient-Centered Outcomes Research.

Science.gov (United States)

Vandermause, Roxanne; Barg, Frances K; Esmail, Laura; Edmundson, Lauren; Girard, Samantha; Perfetti, A Ross

2017-02-01

The Patient-Centered Outcomes Research Institute (PCORI), created to fund research guided by patients, caregivers, and the broader health care community, offers a new research venue. Many (41 of 50) first funded projects involved qualitative research methods. This study was completed to examine the current state of the science of qualitative methodologies used in PCORI-funded research. Principal investigators participated in phenomenological interviews to learn (a) how do researchers using qualitative methods experience seeking funding for, implementing and disseminating their work; and (b) how may qualitative methods advance the quality and relevance of evidence for patients? Results showed the experience of doing qualitative research in the current research climate as "Being a bona fide qualitative researcher: Staying true to research aims while negotiating challenges," with overlapping patterns: (a) researching the elemental, (b) expecting surprise, and (c) pushing boundaries. The nature of qualitative work today was explicitly described and is rendered in this article.

Magnetic resonance imaging of the hip in rheumatoid arthritis patients: a descriptive study

International Nuclear Information System (INIS)

Caldana, Wanda Chiyoko Iwakami; Fernandes, Artur da Rocha Correa; Juliano, Yara

2005-01-01

Objective: To assess the usefulness of MRI as a diagnostic method in patients with rheumatoid arthritis, and to evaluate the frequency of changes in the hip in symptomatic and asymptomatic patients. Materials and methods: Forty patients (17 symptomatic and 23 asymptomatic) were evaluated by 1.5 T magnetic resonance imaging (MRI) after intravenous contrast media injection. MRI findings were divided in inflammatory, degenerative, combined (inflammatory and degenerative) and extra-articular changes. Results: The most frequent findings seen were degenerative and extra-articular changes (22.5% each). Inflammatory changes were seen in only five (12.5%) symptomatic patients, four of them with degenerative findings associated (10%). Conclusion: The use of MRI of the hip allowed the evaluation of the main articular abnormalities seen in patients with rheumatoid arthritis. The most frequent findings were degenerative and extra-articular changes. Inflammatory findings were seen in only five patients, four of them with degenerative changes associated. (author)

Habitat evaluation for outbreak of Yangtze voles (Microtus fortis) and management implications.

Science.gov (United States)

Xu, Zhenggang; Zhao, Yunlin; Li, Bo; Zhang, Meiwen; Shen, Guo; Wang, Yong

2015-05-01

Rodent pests severely damage agricultural crops. Outbreak risk models of rodent pests often do not include sufficient information regarding geographic variation. Habitat plays an important role in rodent-pest outbreak risk, and more information about the relationship between habitat and crop protection is urgently needed. The goal of the present study was to provide an outbreak risk map for the Dongting Lake region and to understand the relationship between rodent-pest outbreak variation and habitat distribution. The main rodent pests in the Dongting Lake region are Yangtze voles (Microtus fortis). These pests cause massive damage in outbreak years, most notably in 2007. Habitat evaluation and ecological details were obtained by analyzing the correlation between habitat suitability and outbreak risk, as indicated by population density and historical events. For the source-sink population, 96.18% of Yangtze vole disaster regions were covered by a 10-km buffer zone of suitable habitat in 2007. Historical outbreak frequency and peak population density were significantly correlated with the proportion of land covered by suitable habitat (r = 0.68, P = 0.04 and r = 0.76, P = 0.03, respectively). The Yangtze vole population tends to migrate approximately 10 km in outbreak years. Here, we propose a practical method for habitat evaluation that can be used to create integrated pest management plans for rodent pests when combined with basic information on the biology, ecology and behavior of the target species. © 2014 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.

Diagnostic role of capsule endoscopy in patients of obscure gastrointestinal bleeding after negative CT enterography

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Jaswinder Singh Sodhi

2013-01-01

Full Text Available Background and Objectives: Computed tomographic enterography (CT-EG has emerged a useful tool for the evaluation of small bowel in patients of obscure gastrointestinal bleeding (OGIB. However, CT-EG may be negative in about 50-60% of patients. We aimed to see the efficacy of capsule endoscopy (CE in patients of OGIB, who had initial negative CT-EG. Materials and Methods: All consecutive patients of OGIB after initial hemodynamic stabilization were subjected to CT-EG. Those having negative CT-EG were further evaluated with CE. Results: Fifty-five patients of OGIB with mean standard deviation age, 52.7 (19.0, range 18-75 years, women 31/55 (56.4% were subjected to CT-EG. Nine (17.6% patients had positive findings on CT-EG, which included mass lesions in six, thickened wall of distal ileal loops, narrowing, and wall enhancement in two and jejunal wall thickening with wall hyperenhancement in one patient. Forty-two patients had negative CT-EG of which 25 underwent CE for further evaluation. CE detected positive findings in 11 of 25 (48% patients which included vascular malformations in three, ulcers in seven, and fresh blood without identifiable source in one. The diagnostic yield of CE in overt OGIB was more compared to occult OGIB ((7/14, 50% vs (4/11, 36.4% P = 0.2 and was higher if performed within 2 weeks of active gastrointestinal (GI bleed (P = 0.08. Conclusions: In conclusion, CE is an additional tool in the evaluation of obscure GI bleed, especially mucosal lesions which can be missed by CT-EG.

US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients

International Nuclear Information System (INIS)

Oguzkurt, Levent; Tercan, Fahri; Kara, Gulcan; Torun, Dilek; Kizilkilic, Osman; Yildirim, Tulin

2005-01-01

Objective: : To evaluate the technical success and immediate complication rates of temporary internal jugular vein (IJV) haemodialysis catheter placement in normal and high-risk patients. Methods and materials: Two-hundred and twenty temporary internal jugular vein catheters inserted under ultrasound guidance in 172 patients were prospectively analyzed. Of 172 patients, 93 (54%) were males and 79 (46%) were females (age range, 18-83; mean, 56.0 years). Of 220 catheters, 171 (78%) were placed in patients who had a risk factor for catheter placement like patients with disorder of haemostasis, poor compliance, and previous multiple catheter insertion in the same IJV. Forty-seven (21.3%) procedures were performed on bed-side. A catheter was inserted in the right IJV in 178 procedures (80.9%) and left IJV in 42 procedures. Of 172 patients, 112 (65%) had only one catheter placement and the rest had had more than one catheter placement (range, 1-5). Results: Technical success was achieved in all patients (100%). Average number of puncture was 1.24 (range, 1-3). One hundred and eighty-three insertions (83.1%) were single-wall punctures, whereas 37 punctures were double wall punctures. Nine (4%) minor complications were encountered. Inadvertent carotid artery puncture without a sequel in four procedures (1.8%), oozing of blood around the catheter in three procedures (1.4%), a small hematoma in one procedure (0.4%), and puncture through the pleura in one procedure (0.4%) without development of pneumothorax. Oozing of blood was seen only in patients with disorder of haemostasis. Conclusion: Ultrasound-guided placement of internal jugular vein catheters is very safe with very high success rate and few complications. It can safely be performed in high-risk patients, like patients with disorders of haemostasis and patients with previous multiple catheter insertion in the same vein

Cerebral perfusion changes in schizophrenia patients evaluated with Tc-99 HMPAO

International Nuclear Information System (INIS)

Sehweil, A.; El-Hilu, S.; Jahan, S.; Higazi, E.; Salhat, M.; Al-Mohannadi, S.; Abdel-Dayem, H.M.

1989-01-01

Tc-99m HMPAO has been used to image cerebral perfusion changes in 20 chronic schizophrenia patients (19 men and 1 woman), with an average age of 29 years (range, 22-48 years). All were receiving neuroleptic drugs. Twelve had received electroconvulsive therapy. All patients had abnormal studies (except one, which was normal) and poor response to treatment. Ventricular dilation and cerebral atrophy were seen in 11 patients. Seventy-seven focal lesions were detected. Forty-two lesions showed increased HMPAO retention: 26 in the basal ganglia in 14 patients (12, bilateral, two unilateral), 10 along the sylvian fissure in the parietotemporal region, three in the frontal region, and one in each of the temporal, parietal, and occipital regions. Thirty-five focal lesions showed decreased perfusion: 10 parietal, eight frontal, seven temporal, six cerebellar, and four occipital. This study demonstrates the potential value of Tc-99m HMPAO in the study of schizophrenia and other psychiatric disorders

The Role of Radiotherapy in the Treatment of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

OpenAIRE

Nam, Taek-Keun; Ahn, Jae-Sook; Choi, Yoo-Duk; Jeong, Jae-Uk; Kim, Yong-Hyeob; Yoon, Mee Sun; Song, Ju-Young; Ahn, Sung-Ja; Chung, Woong-Ki

2014-01-01

Purpose To assess radiotherapy for patients with early stage gastric mucosa-associated lymphoid tissue (MALT) lymphoma with respect to survival, treatment response, and complications. Materials and Methods Enrolled into this study were 48 patients diagnosed with gastric MALT lymphoma from January 2000 to September 2012. Forty-one patients had low grade and seven had mixed component with high grade. Helicobacter pylori eradication was performed in 33 patients. Thirty-four patients received rad...

The long-term effects of radiation therapy on patients with ovarian dysgerminoma

International Nuclear Information System (INIS)

Mitchell, M.F.; Gershenson, D.M.; Soeters, R.P.; Eifel, P.J.; Delclos, L.; Wharton, J.T.

1991-01-01

A retrospective chart review and questionnaire study was undertaken to look at the long-term effects of radiation therapy in ovarian dysgerminoma patients. Forty-three patients and 55 controls responded to a questionnaire that detailed bowel, bladder, thyroid, menstrual, reproductive, sexual, and growth function. Statistically significant differences in the number of bowel movements were noticed when comparing patients with controls. The authors noticed no significant differences between cases and controls in bladder function. No thyroid disorders were attributable to mediastinal radiation therapy. Most patients with intact uteri bleed monthly on hormonal replacement. Three patients with a remaining ovary and uterus resumed menstrual function after substantial doses of abdominopelvic radiation therapy. No patients have conceived. The authors noticed a slight increase in dyspareunia in the treated group, but most patients were satisfied with their sexual function. One premenarchal patient exhibited a growth disorder

Management of fertility preservation in young breast cancer patients in a large breast cancer centre.

Science.gov (United States)

Lawrenz, B; Neunhoeffer, E; Henes, M; Lessmann-Bechle, S; Krämer, B; Fehm, Tanja

2010-11-01

The increase of breast cancer in young women under 40 years and the increasing age of women at the time of the birth of their first child underlines the importance to implement counselling for fertility-preserving strategies in the management of breast cancer care. We present the fertility-preserving procedures performed after routine counselling for primary breast cancer patients in a large certified breast cancer centre. Since November 2006, patients aged below 40 years with histologically confirmed breast cancer are routinely counselled on fertility-preserving possibilities before breast surgery and chemotherapy in the fertility centre of the University Women's Hospital in Tuebingen. The recommendations are based on the treatment recommendations of the network FertiPROTEKT. During the last 40 months, 56 primary breast cancer patients were counselled. Forty-one of these patients were hormone receptor positive. Thirty-four patients (63%) underwent fertility-preserving strategies. The majority of the patients (n = 22) decided on ovarian tissue cryopreservation. GnRH protection was performed in 14 patients. In 12 patients an ovarian stimulation protocol was initiated to cryopreserve fertilized or unfertilized oocytes. A combination of different fertility-preserving methods was performed in 12 patients. The preservation of ovarian function and fertility are of great importance to young breast cancer patients. Counselling on fertility-preserving strategies is therefore critical in these patients and should be routinely performed.

Candida Prosthetic Joint Infection. A Review of Treatment Methods.

Science.gov (United States)

Cobo, Fernando; Rodríguez-Granger, Javier; Sampedro, Antonio; Aliaga-Martínez, Luis; Navarro-Marí, José María

2017-01-01

Fungal microorganisms are still a rare cause of bone and joint infections. We report a new case of knee prosthetic joint infection due to Candida albicans in a patient with a previous two-stage right knee arthroplasty for septic arthritis due to S. epidermidis occurred several months ago. Moreover, the treatment in 76 cases of Candida prosthetic joint infection has been discussed. Forty patients were female and mean age at diagnosis was 65.7 (± SD 18) yrs. No risk factors for candidal infection were found in 25 patients. Infection site was the knee in 38 patients and hip in 36; pain was present in 44 patients and swelling in 24. The most frequent species was C. albicans , followed by C. parapsilosis . Eleven patients were only treated with antifungal drugs being the outcome favourable in all of them. Two-stage exchange arthroplasty was performed in 30 patients, and resection arthroplasty in other 30; in three patients one-stage exchange arthroplasty was done. A favourable outcome was found in 58 patients after antifungal plus surgical treatment, in 11 after antifungal treatment alone and in one after surgery alone. The type of treatment is still not clearly defined and an algorithm for treatment in fungal PJI should be established, but various types of surgical procedures may be applied.

Music Appreciation after Cochlear Implantation in Adult Patients: A Systematic Review.

Science.gov (United States)

Riley, Phoebe E; Ruhl, Douglas S; Camacho, Macario; Tolisano, Anthony M

2018-06-01

Objective The cochlear implant (CI) improves quality of life for people who are severely and profoundly deafened, allowing implantees to perceive speech at levels similar to those of individuals with normal hearing. However, patients with CIs generally report a reduced appreciation of music after implantation. We aimed to systematically review the English-language literature for studies evaluating music enjoyment and perception among adult patients with CIs. Data Sources A systematic review of PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library. Review Methods The PRISMA statement was utilized to identify English-language studies reporting music appreciation among adults with CIs. Two independent reviewers performed searches through May 2017. Included studies investigated parameters related to music enjoyment and music perception, including (1) pitch and timbre perception, (2) noise-canceling algorithms, and (3) the presence of dissonant chords, lyrics, or visual cues. Results A total of 508 articles were screened for relevance. Forty-one full-text articles were evaluated, and 18 met final inclusion criteria. Studies used heterogeneous methods of outcome measurement for identifying music appreciation. The outcome measures suggest that rhythm and lyrics are important components of enjoyment. Patients with CIs had difficulty with pitch and timbre perception. Conclusion The heterogeneous outcome measures identified in this systematic review suggest that rhythm and lyrics are important components of enjoyment, while patients with CIs had difficulty with pitch and timbre perception. Because there is no standardized reporting metric for music appreciation among adult patients with CIs, a standardized validated outcome-measuring tool is warranted.

Worries and Concerns among Inflammatory Bowel Disease Patients Followed Prospectively over One Year

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Lars-Petter Jelsness-Jørgensen

2011-01-01

Full Text Available Disease-related worries are frequently reported in inflammatory bowel disease (IBD, but longitudinal assessments of these worries are scarce. In the present study, patients completed the rating form of IBD patient concerns (RFIPC at three occasions during one year. One-way analysis of variance (ANO VA, t-tests, bivariate correlation, and linear regression analyses were used to analyse data. The validity and reliability of the Norwegian RFIPC was tested. A total of 140 patients were included (V1, ulcerative colitis (UC n = 92, Crohn's disease (CD n = 48, mean age 46.9 and 40.0-year old, respectively. The highest rated worries included having an ostomy bag, loss of bowel control, and reduced energy levels. Symptoms were positively associated with more worries. A pattern of IBD-related worries was consistent over a period of one year. Worries about undergoing surgery or having an ostomy bag seemed to persist even when symptoms improved. The Norwegian RFIPC is valid and reliable.

Evaluation of Clinical and Laboratory Data in Patients with Recurrent Infections and Suspected Immunodeficiency

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Hamid Ahanchian

2014-09-01

Full Text Available Background: Frequent infections is among the most frequent clinical dilemmas for primary care physicians. Immunodeficiency disorders are a heterogeneous group of illnesses that predispose patients to the recurrent infections, autoimmunity and malignancies. The aim of this study was to evaluate the clinical and laboratory data collected for the final diagnosis of patients referred with recurrent infections and suspected immunodeficiency to a local immunodeficiency clinic.   Methods: This epidemiological study was carried out between April 2010 and September 2012 at the Immunodeficiency Clinic of Mashhad. All patients with clinical manifestations of immunodeficiency who were referred to our clinic during this period of time were included in this study. 41 patients aged from 10 months to 51 years, were evaluated. Results: Forty one patients, aged between 10 months and 51 years were evaluated. Eleven patients had a primary immunodeficiency, four cases had a secondary immunodeficiency, in three patients an underlying structural disease were found, eight patients were predisposed to recurrent infections as a result of allergies and finally, fifteen cases were found to be normal individuals.   Discussion: Most patients with recurrent infection have a normal immune system. Allergic disorders are the most common predisposing factor to recurrent infection. However, as immunodeficiency disorders are potentially serious, early diagnosis can improve the quality of life and outcome and prevent severe sequels in future.

Neurological symptoms, evaluation and treatment in Danish patients with achondroplasia and hypochondroplasia

DEFF Research Database (Denmark)

Doherty, Mia Aagaard; Hertel, Niels Thomas; Hove, Hanne Buciek

2017-01-01

Aim To investigate the prevalence of neurological symptoms and the types of complications in a cohort of Danish patients with mutation verified achondroplasia and hypochondroplasia and compare the results with previously reported findings. Methods Retrospective descriptive study by chart review...... of patients followed in three outpatients clinics in the period 1997-2014. Forty-eight patients with achondroplasia and a median age of 9,5 years old and 20 patients with hypochondroplasia and a median age of 12 years old were enrolled. Neurological manifestations, epidemiological variables and clinical data...... for referral to an MRI scan or neurosurgery. Conclusion Through investigation of phenotypes and genotypes in patients with achondroplasia and hypochondroplasia we report the frequencies of neurological symptoms, foramen magnum stenosis, spinal cord compression and neurosurgery in Danish patients. Variation...

Severity of Anxiety Disorders in Patients with Chronic Obstructive Pulmonary Disease

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Mitra Safa

2015-10-01

Full Text Available Objective: Patients with chronic physical diseases sometimes show increased loss of function; such patients need more care. Anxiety is a well-known symptom that is prevalent among chronic obstructive pulmonary disease patients that can prolong and increase the risk of hospitalization. The purpose of this study was to evaluate the severity of anxiety in the mentioned patients and to examine the presence of symptoms and appropriate treatment strategies to understand the role of psychological functions in physical patients.Methods: This was a cross sectional study conducted in Masih Daneshvari Hospital. One hundred forty- three patients entered into the project by accessible method and signed the informed consent; they filled demographic information and Hamilton anxiety and depression questionnaires. Data were analyzed by SPSS-16 .Results: Of the participants, 68% were above 60 years of age; 78% were male; 89% were married; and 38% were self-employed. Also, among the participants, 51% were illiterate; 72% had history of smoking; 46% had history of substance abuse; and 49% had moderate to severe anxiety disorder. Moreover, of the patients with severe anxiety, 41.3% had severe muscle spasms; and severe sleeplessness was found in 38.5% of those with severe anxiety disorder. Severe anxiety related symptoms were found in 20.3% of the patients with severe anxiety disorder. Depressed mood was found in 27.3% of the patients with severe anxiety disorder. Severe physical and muscular signs were found in 35.7% of those with severe anxiety disorder .Conclusion: According to our findings, many chronic diseases such as chronic obstructive pulmonary disease may contain anxiety and depression which result in vulnerability. Therefore, evaluation of anxiety in such patients is of importance for alleviating the disease.

Effect of joint traction on functional improvement and quality of life in patients with severe knee osteoarthritis

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Sedigheh Sadat Naeimee

2012-07-01

Full Text Available Background and aim: Osteoarthritis (OA is the most prevalent joint disease in adults around the world and its incidence rises with age. Patients with severe knee osteoarthritis often complain of pain and severe functional disability. Most of conservative treatments used in this group of patients induce poor improvements. This study evaluated the effect of joint traction on quality of life of patients with severe knee osteoarthritis.Materials and Methods: In this clinical trial study, forty female patients with severe knee OA were randomly assigned to two following groups; common physiotherapy treatment and common physiotherapy treatment accompanied by knee distraction. Quality of life was evaluated pre- and post-treatment and also one month follow-up using the Knee injury and Osteoarthritis Outcome Score (KOOS questionnaire.Results: Common physiotherapy treatment accompanied by knee distraction resulted in significantly better quality of life post-treatment and at 1month follow-up, compared to common physiotherapy treatment alone (P<0.01.Conclusion: Common physiotherapy treatment accompanied by knee distraction induces significant improvement in quality of life in patients with severe knee osteoarthritis compared to common physiotherapy treatment alone.

Enzymatic degradation of hybrid iota-/nu-carrageenan by Alteromonas fortis iota-carrageenase.

Science.gov (United States)

Jouanneau, Diane; Boulenguer, Patrick; Mazoyer, Jacques; Helbert, William

2010-05-07

Hybrid iota-/nu-carrageenan was water-extracted from Eucheuma denticulatum and incubated with Alteromonas fortis iota-carrageenase. The degradation products were then separated by anion-exchange chromatography. The three most abundant fractions of hybrid iota-/nu-carrageenan oligosaccharides were purified and their structures were analyzed by NMR. The smallest hybrid was an octasaccharide with a iota-iota-nu-iota structure. The second fraction was composed of two decasaccharides with iota-iota-iota-nu-iota and iota-[iota/nu]-iota-iota structures. The third fraction was a mixture of dodecasaccharides which contained at least a iota-iota-iota-iota-nu-iota oligosaccharide. The carbon and proton NMR spectra of the octasaccharides were completely assigned, thereby completely attributing the nu-carrabiose moiety for the first time.

Salvage liver transplantation for patients with recurrent hepatocellular carcinoma after curative resection.

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LinWei Wu

Full Text Available OBJECTIVE: To summarize the experience with salvage liver transplantation (SLT for patients with recurrent hepatocellular carcinoma (HCC after primary hepatic resection in a single center. METHODS: A total of 376 adult patients with HCC underwent orthotopic liver transplantation (OLT at Organ Transplantation Center, the First Affiliated Hospital of Sun Yat-sen University, between 2004 and 2008. Among these patients, 36 underwent SLT after primary liver curative resection due to intrahepatic recurrence. During the same period, one hundred and forty-seven patients with HCC within Milan criteria underwent primary OLT (PLTW group, the intra-operative and post-operative parameters were compared between these two groups. Furthermore, we compared tumor recurrence and patient survival of patients with SLT to 156 patients with HCC beyond Milan criteria (PLTB group. Cox Hazard regression was made to identify the risk factors for tumor recurrence. RESULTS: The median interval between initial liver resection and SLT was 35 months (1-63 months. The intraoperative blood loss (P0.05. When compared to those patients with HCC beyond Milan criteria undergoing primary OLT, patients undergoing SLT achieved a better survival and a lower tumor recurrence. Cox Proportional Hazards model showed that vascular invasion, including macrovascular and microvascular invasion, as well as AFP level >400 IU/L were risk factors for tumor recurrence after LT. CONCLUSIONS: In comparison with primary OLT, although SLT is associated with increased operation difficulties, it provides a good option for patients with HCC recurrence after curative resection.

Factors associated with management of cervical cancer patients at ...

African Journals Online (AJOL)

Forty-seven percent of the cervical cancer patients were referred to Ocean Road Cancer Institute for radiotherapy and or chemotherapy. Patients discharged home for palliative care were 30% and 17% patients died at the hospital. Known HIV positive patients were significantly associated with death and terminal care seen ...

Compiling a register of patients with moderate or severe learning disabilities: experience at one United Kingdom general practice

Science.gov (United States)

2011-01-01

Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks. Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice. Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed. Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap. Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities. PMID:22479290

Compiling a register of patients with moderate or severe learning disabilities: experience at one United Kingdom general practice.

Science.gov (United States)

Lodge, Keri-Michèle; Milnes, David; Gilbody, Simon M

2011-03-01

Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks.Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice.Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed.Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap.Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities.

Influence of Lymphatic Invasion on Locoregional Recurrence Following Mastectomy: Indication for Postmastectomy Radiotherapy for Breast Cancer Patients With One to Three Positive Nodes

International Nuclear Information System (INIS)

Matsunuma, Ryoichi; Oguchi, Masahiko; Fujikane, Tomoko; Matsuura, Masaaki; Sakai, Takehiko; Kimura, Kiyomi; Morizono, Hidetomo; Iijima, Kotaro; Izumori, Ayumi; Miyagi, Yumi; Nishimura, Seiichiro; Makita, Masujiro; Gomi, Naoya; Horii, Rie; Akiyama, Futoshi; Iwase, Takuji

2012-01-01

Purpose: The indication for postmastectomy radiotherapy (PMRT) in breast cancer patients with one to three positive lymph nodes has been in discussion. The purpose of this study was to identify patient groups for whom PMRT may be indicated, focusing on varied locoregional recurrence rates depending on lymphatic invasion (ly) status. Methods and Materials: Retrospective analysis of 1,994 node-positive patients who had undergone mastectomy without postoperative radiotherapy between January 1990 and December 2000 at our hospital was performed. Patient groups for whom PMRT should be indicated were assessed using statistical tests based on the relationship between locoregional recurrence rate and ly status. Results: Multivariate analysis showed that the ly status affected the locoregional recurrence rate to as great a degree as the number of positive lymph nodes (p < 0.001). Especially for patients with one to three positive nodes, extensive ly was a more significant factor than stage T3 in the TNM staging system for locoregional recurrence (p < 0.001 vs. p = 0.295). Conclusion: Among postmastectomy patients with one to three positive lymph nodes, patients with extensive ly seem to require local therapy regimens similar to those used for patients with four or more positive nodes and also seem to require consideration of the use of PMRT.

Patient empowerment--a strategy for pain management in endodontics.

Science.gov (United States)

Selden, H S

1993-10-01

In order to promote rapid resolution of symptoms associated with root canal treatment, a multifaceted program was implemented. One-visit endodontics was performed universally, antibiotics were prescribed when infection was detected within the root canal, and nonsteroidal anti-inflammatory drugs were widely used at the time of treatment. The centerpiece of the program was the integration of various behavioral strategies designed to strengthen the patient's inherent coping capacity. The combination of clinical, pharmacological, and psychological approaches was collectively called patient empowerment. Five hundred forty patients were asked to contact the office the day after treatment. Four hundred twenty (78%) called and 390 (93%) reported a reduction in symptoms. Twenty of the 30 (7%) who were not relieved within the first 24 h reported significant improvement 1 day later. No patients experienced a flare-up or a worsening of symptoms.

Prognostic Impact of Adjuvant Radiotherapy in Breast Cancer Patients with One to Three Positive Axillary Lymph Nodes

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Mansour Ansari

2018-01-01

Full Text Available Background: Radiotherapy, as an adjuvant treatment, plays a well-known role in prevention of locoregional recurrence in breast cancer patients. This study aims to investigate the impact of radiotherapy in patients with N1 disease. Methods: In this retrospective study, we reviewed the characteristics and treatment outcomes of 316 patients with a biopsy proven diagnosis of breast carcinoma and 1-3 positive axillary lymph nodes. The patients received treatment between 1995 and 2014. The patients had a median follow-up of 60 (range: 6-182 months. Results: This study was conducted on 316 patients with a median age of 48 (range: 26-86 years. Among patients, 215 underwent modified radical mastectomy and 101 had breast-conserving surgery before adjuvant treatment. Indeed, 259 patients received radiotherapy (radiation group and 57 did not (control group. There was locoregional recurrence in one control group patient and two patients in the radiation group. Multivariate analysis results indicated hormone receptor status as an independent prognostic factor for the 5-year disease-free survival rate. Estrogen and progesterone receptor negativity (HR = 1.80, 95% CI: 1.02-3.19, P=0.043 also had a negative influence on the 5-year disease-free survival rate. However, radiotherapy had no significant effect on disease-free survival (P=0.446 and overall survival (P=0.058 rates. Conclusion: The results showed that adjuvant radiotherapy had no prognostic impacts on locoregional and distant disease control in breast cancer patients with N1 disease.

Blame the Patient, Blame the Doctor or Blame the System? A Meta-Synthesis of Qualitative Studies of Patient Safety in Primary Care

Science.gov (United States)

Daker-White, Gavin; Hays, Rebecca; McSharry, Jennifer; Giles, Sally; Cheraghi-Sohi, Sudeh; Rhodes, Penny; Sanders, Caroline

2015-01-01

Objective Studies of patient safety in health care have traditionally focused on hospital medicine. However, recent years have seen more research located in primary care settings which have different features compared to secondary care. This study set out to synthesize published qualitative research concerning patient safety in primary care in order to build a conceptual model. Method Meta-ethnography, an interpretive synthesis method whereby third order interpretations are produced that best describe the groups of findings contained in the reports of primary studies. Results Forty-eight studies were included as 5 discrete subsets where the findings were translated into one another: patients’ perspectives of safety, staff perspectives of safety, medication safety, systems or organisational issues and the primary/secondary care interface. The studies were focused predominantly on issues seen to either improve or compromise patient safety. These issues related to the characteristics or behaviour of patients, staff or clinical systems and interactions between staff, patients and staff, or people and systems. Electronic health records, protocols and guidelines could be seen to both degrade and improve patient safety in different circumstances. A conceptual reading of the studies pointed to patient safety as a subjective feeling or judgement grounded in moral views and with potentially hidden psychological consequences affecting care processes and relationships. The main threats to safety appeared to derive from ‘grand’ systems issues, for example involving service accessibility, resources or working hours which may not be amenable to effective intervention by individual practices or health workers, especially in the context of a public health system. Conclusion Overall, the findings underline the human elements in patient safety primary health care. The key to patient safety lies in effective face-to-face communication between patients and health care staff or

Irisin is Associated with Urotensin II and Protein Energy Wasting in Hemodialysis Patients

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Wan-Yu He

2016-02-01

Full Text Available Aims/Introduction: Irisin is a newly identified myokine which can promote energy expenditure. Urotensin II (UII is identified as the most potent mammalian vasoconstrictor to date. Previous studies showed that UII can aggravate insulin resistance while irisin alleviate insulin resistance. Through this study, it is our aim to elucidate if UII can induce insulin resistance and also have an association with the irisin level in hemodialysis (HD patients. Materials and Methods: One hundred and twenty-eight patients on maintenance hemodialysis treatment and forty healthy subjects were enrolled in this study. Blood irisin concentrations and UII concentrations were measured by ELISA and RIA respectively. The body composition was analyzed by bioelectrical impedance. Results: The serum irisin levels and UII levels were both significantly lower in HD patients in comparison to that of the healthy subjects. The serum irisin levels were lower in HD patients with protein energy wasting than those of the patients without protein energy wasting. The independent determinants of circulating Ln (irisin (the natural logarithm of irisin were UII lean body mass and patients with protein energy wasting. Conclusions: Our results are the first to provide the clinical evidence of the association among irisin, UII, and protein energy wasting. Our results hint that UII and protein energy wasting might inhibit the release or synthesis of irisin from skeletal muscles in HD patients.

A Randomized Controlled Study of Fuzheng Huayu Capsule for Prevention of Esophageal Variceal Bleeding in Patients with Liver Cirrhosis

Directory of Open Access Journals (Sweden)

Jie Gu

2013-01-01

Full Text Available To elucidate the role of Fuzheng Huayu Capsule, a herbal formula, in the prevention of esophageal variceal bleeding in cirrhotic patients, a multicenter randomized and placebo-controlled trial was carried out. One hundred forty-six cirrhotic patients with esophageal varices were enrolled to compare the probability of upper gastrointestinal bleeding and survival between Fuzheng Huayu Capsule group and controlled group for the duration of 2 years. The results demonstrated that the FZHYC could effectively reduce the risk of variceal bleeding and improve survival rates for cirrhotic patients with varices, especially the combination of the capsule and Propranolol, which presented a better effect; FZHYC could reduce the varices size in patients with small ones. Its effect may be related to the amelioration of hepatic fibrosis.

Centering Ability of ProTaper Next and WaveOne Classic in J-Shape Simulated Root Canals.

Science.gov (United States)

Troiano, Giuseppe; Dioguardi, Mario; Cocco, Armando; Giuliani, Michele; Fabiani, Cristiano; D'Alessandro, Alfonso; Ciavarella, Domenico; Lo Muzio, Lorenzo

Introduction . The aim of this study was to evaluate and compare the shaping and centering ability of ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland) and WaveOne Classic systems (Dentsply Maillefer) in simulated root canals. Methods . Forty J-shaped canals in resin blocks were assigned to two groups ( n = 20 for each group). Photographic method was used to record pre- and postinstrumentation images. After superimposition, centering and shaping ability were recorded at 9 different levels from the apex using the software Autocad 2013 (Autodesk Inc., San Rafael, USA). Results . Shaping procedures with ProTaper Next resulted in a lower amount of resin removed at each reference point level. In addition, the pattern of centering ability improved after the use of ProTaper Next in 8 of 9 measurement points. Conclusions . Within the limitations of this study, shaping procedures with ProTaper Next instruments demonstrated a lower amount of resin removed and a better centering ability than WaveOne Classic system.

United nations scientific committee on the effects of atomic radiation (UNSCEAR) and its forty-ninth session

International Nuclear Information System (INIS)

Pan Ziqiang; Xiu Binglin

2000-01-01

The author describes the brief history of United Nations Scientific Committee on the Effects of Atomic Radiation and main issues under discussion at the Forty-ninth session of UNSCEAR. During the session UNSCEAR completed its 2000 Report and scientific Annexes to the General Assembly. The report with scientific Annexes will be published in this year. The author discusses noticeable aspects and make a suggestion for future work

Speech in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair.

Science.gov (United States)

Morén, Staffan; Mani, Maria; Lilian, Stålhammar; Lindestad, Per Åke; Holmström, Mats

2017-11-01

  To evaluate speech in adults treated for unilateral cleft lip and palate with one-stage or two-stage palate closure and compare the speech of the patients with that of a noncleft control group.   Cross-sectional study with long-term follow-up.   All unilateral cleft lip and palate patients born from 1960 to 1987 and treated at Uppsala University Hospital, Sweden, were invited (n = 109). Participation rate was 67% (n = 73) at a mean of 35 years after primary surgery. Forty-seven had been treated according to one-stage palate closure and 26 according to two-stage palate closure. Pharyngeal flap surgery had been performed in 11 of the 73 patients (15%). The noncleft control group consisted of 63 age-matched volunteers.   Speech-language pathologists rated perceptual speech characteristics from blinded audio recordings.   Among patients, seven (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one (2%) had reduced intelligibility. Controls had no audible signs of velopharyngeal insufficiency and no quantifiable problems with the other speech production variables. No significant differences were identified between patients treated with one-stage and two-stage palate closure for any of the variables.   The prevalence of speech outcome indicative of velopharyngeal insufficiency among adult patients treated for unilateral cleft lip and palate was low but higher compared with individuals without cleft. Whether palatal closure is performed in one or two stages does not seem to affect the speech outcome at a mean age of 35 years.

The Brimmond Reservoir extending the Forties Field into the millenium by maximizing profits without extensive rig upgrades

Energy Technology Data Exchange (ETDEWEB)

Smith, L.; Perras, L. [Noble Drilling (United Kingdom)

1998-12-31

Drilling a horizontal well with a minimum facilities workover rig in the Brimmond Field (North Sea) which overlies the Forties Reservoir, was described. Feasibility studies indicated that further development of the Brimmond Field would require extensive rig upgrade to be able to drill the horizontal well within recognized industry parameters. Since the upgrading of the drilling package would have delayed the project by several months, as well as making it uneconomical, a number of critical operations were identified and analyzed, which led to introducing `new technology` - premixed cement, leading edge LWD tools and hole cleanup techniques. The first horizontal sidetrack was successfully completed with the minimum facilities drilling package and production commenced at an initial rate of 2.4 mbd dry oil from a 13 ft cased hole gravel pack utilizing an existing Forties Field producing well. The original Paleocene interval was abandoned with cement plugs prior to milling a window on the 9-5/8 inch casing and installing a gravel pack. Steady production of this new well led to consideration of further development of the field. 4 figs.

Satisfaction and complications with the Titan® one-touch release penile implant

DEFF Research Database (Denmark)

Lindeborg, Lisa; Fode, Mikkel; Fahrenkrug, Lasse

2014-01-01

OBJECTIVE: The aim of this study was to assess complication rates and patient satisfaction with Coloplast Titan® one-touch release (OTR) inflatable penile implants inserted at one university hospital centre between November 2008 and April 2011. MATERIAL AND METHODS: Overall, 33 patients with orga......OBJECTIVE: The aim of this study was to assess complication rates and patient satisfaction with Coloplast Titan® one-touch release (OTR) inflatable penile implants inserted at one university hospital centre between November 2008 and April 2011. MATERIAL AND METHODS: Overall, 33 patients...... with organic erectile dysfunction underwent penile implant surgery during the study period. The Titan OTR inflatable penile implants were inserted using a penoscrotal approach. Patient and partner satisfaction was assessed with the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire...

High inter-tester reliability of the new mobility score in patients with hip fracture

DEFF Research Database (Denmark)

Kristensen, M.T.; Bandholm, T.; Foss, N.B.

2008-01-01

OBJECTIVE: To assess the inter-tester reliability of the New Mobility Score in patients with acute hip fracture. DESIGN: An inter-tester reliability study. SUBJECTS: Forty-eight consecutive patients with acute hip fracture at a median age of 84 (interquartile range, 76-89) years; 40 admitted from...... their own home and 8 from nursing homes to an acute orthopaedic hip fracture unit at a university hospital. METHODS: The New Mobility Score, which evaluates the prefracture functional level with a score from 0 (not able to walk at all) to 9 (fully independent), was assessed by 2 independent physiotherapists...... the prefracture functional level in patients with acute hip fracture Udgivelsesdato: 2008/7...

Breast imaging after dark: patient outcomes following evaluation for breast abscess in the emergency department after hours.

Science.gov (United States)

Bosma, Melissa S; Morden, Kasey L; Klein, Katherine A; Neal, Colleen H; Knoepp, Ursula S; Patterson, Stephanie K

2016-02-01

In our study, we sought to report the management, clinical outcomes, and follow-up rates of patients who presented for evaluation of breast abscess in the Emergency Department (ED) after hours. A retrospective search of ultrasound reports at our institution identified all patients from January 1, 2009 to June 30, 2013 who were scanned in the ED after hours to evaluate for breast abscess. Patient demographics, clinical information, imaging findings, follow-up rates, and outcomes were reviewed. One hundred eighty-five patients were included in the study. Forty-four percent (86/185) of the patients were diagnosed with abscess based on ultrasound findings in the ED. Twenty-seven percent (23/86) were recently post-operative, and 12 % (10/86) were postpartum/breastfeeding. Mastitis was the diagnosis in the remaining 54 % (99/185). Only 1/86 cases were associated with breast cancer. Seventy-seven percent (66/86) of patients were treated with an invasive procedure; 39 % (26/66) had surgical evacuation, 30 % (20/66) image-guided drainage, 23 % (15/66) bedside or clinic incision and drainage, and 8 % (5/66) palpation-guided fine needle aspiration (FNA). Seventy-seven percent (143/185) of patients had clinical and/or imaging follow-up. Forty-four percent (63/143) had long-term follow-up (≥ 3 months). Almost 50 % of the patients who presented to the ED for evaluation of abscess were diagnosed with abscess while the remaining patients were diagnosed with mastitis. Appropriate clinical and/or imaging follow-up occurred in 77 %. Long-term follow-up (≥ 3 months) occurred more frequently in patients older than 30 years of age. Appropriate follow-up does not occur in approximately one fourth of cases, suggesting that additional clinician and patient education is warranted.

One-year health and care costs after hip fracture for home-dwelling elderly patients in Norway: Results from the Trondheim Hip Fracture Trial

OpenAIRE

Hektoen, Liv Faksvåg; Saltvedt, Ingvild; Sletvold, Olav; Helbostad, Jorunn L.; Lurås, Hilde; Halsteinli, Vidar

2016-01-01

Aim: The aim of this study was to estimate the one-year health and care costs related to hip fracture for home-dwelling patients aged 70 years and older in Norway, paying specific attention to the status of the patients at the time of fracture and cost differences due to various patient pathways after fracture. Methods: Data on health and care service provision were extracted from hospital and municipal records and from national registries; data on unit costs were collected from the municipal...

The rise of quantitative methods in Psychology

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Denis Cousineau

2005-09-01

Full Text Available Quantitative methods have a long history in some scientific fields. Indeed, no one today would consider a qualitative data set in physics or a qualitative theory in chemistry. Quantitative methods are so central in these fields that they are often labelled “hard sciences”. Here, we examine the question whether psychology is ready to enter the “hard science club” like biology did in the forties. The facts that a over half of the statistical techniques used in psychology are less than 40 years old and that b the number of simulations in empirical papers has followed an exponential growth since the eighties, both suggests that the answer is yes. The purpose of Tutorials in Quantitative Methods for Psychology is to provide a concise and easy access to the currents methods.

Association between serum homocysteine concentration with coronary artery disease in Iranian patients

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Ahmad Mirdamadi

2011-07-01

Full Text Available BACKGROUND: The role of novel biomarkers like homocystein as a risk factor of coronary artery disease (CAD is being increasingly recognized. There is a marked geographical variation in plasma homocystein concentration. In spite of importance of hyperhomocysteinemia in CAD risk, there is a paucity of studies in Iran that evaluate it. Consequently, we evaluated the association between plasma total homocystein (tHcy concentration and CAD risk in an Iranian population.METHODS: In a case-control study, we compared the level of tHcy of forty five patients with angiographically proved CAD with forty five age and gender matched subjects without CAD as control group. The patients with diabetes, hypertension, thyroid dysfunction, chronic renal failure, hyperlipidemia and obesity and other conventional CAD risk factors were excluded from the study. Plasma tHcy was measured using immunoturbidimetry. RESULTS: Homocystein level was higher in men than women (16.7 ± 5.2 versus 14.3 ± 3.9 micromol/lit, P = 0.019. CAD patients had higher mean plasma tHcy than control group (17.1 ± 5.3 versus 14.2 ± 3.8 micromol/lit, P = 0.004. CONCLUSION: This study denoted that high plasma homocystein concentration is associated with CAD risk in Iranian people. Keywords: Coronary Artery Disease, Homocystein, Iran.

One column method to prepare 11C-labelled methyl iodide

International Nuclear Information System (INIS)

Kovacs, Z.; Priboczki, E.

1999-01-01

A new method in which the [ 11 C]methyl iodide is prepared on one alumina column is presented. A high specific surface alumina column, previously impregnated with lithium aluminium hydride solution, was used for direct trapping from the target gas and reduction into radiocomplex. The complex was then reacted on this column with HI to form [ 11 C]methyl iodide. The use of one alumina column, instead of a freezing trap, reaction vessel and separate unit for iodination, simplifies the apparatus, shortens the synthesis time and is well suitable for automation. (K.A.)

Effect of educational program on quality of life of patients with heart failure: a randomized clinical trial.

Science.gov (United States)

Lakdizaji, Sima; Hassankhni, Hadi; Mohajjel Agdam, Alireza; Khajegodary, Mohammad; Salehi, Rezvanieh

2013-03-01

Heart failure is one of the most common cardiovascular diseases which decrease the quality of life. Most of the factors influencing the quality of life can be modified with educational interventions. Therefore, this study examined the impact of a continuous training program on quality of life of patients with heart failure. This randomized clinical trial study was conducted during May to August 2011. Forty four participants with heart failure referred to Shahid Madani's polyclinics of Tabriz were selected through convenient sampling method and were randomly allocated to two groups. The intervention group (n = 22) received ongoing training including one-to-one teaching, counseling sessions and phone calls over 3 months. The control group (n = 22) received routine care program. Data on quality of life was collected using the Minnesota Living with Heart Failure Questionnaire at baseline as well as three months later. The statistical tests showed significant differences in the physical, emotional dimensions and total quality of life in intervention group. But in control group, no significant differences were obtained. There was not any significant association in demographic characteristics and quality of life. Ongoing training programs can be effective in improving quality of life of patients with heart failure. Hence applying ongoing educational program as a non-pharmacological intervention can help to improve the quality of life of these patients.

Management of coccidioidomycosis in patients receiving biologic response modifiers or disease-modifying antirheumatic drugs.

Science.gov (United States)

Taroumian, Sara; Knowles, Susan L; Lisse, Jeffrey R; Yanes, James; Ampel, Neil M; Vaz, Austin; Galgiani, John N; Hoover, Susan E

2012-12-01

Coccidioidomycosis (valley fever) is an endemic fungal infection of the American Southwest, an area with a large population of patients with rheumatic diseases. There are currently no guidelines for management of patients who develop coccidioidomycosis while under treatment with biologic response modifiers (BRMs) or disease-modifying antirheumatic drugs (DMARDs). We conducted a retrospective study of how both concurrent diseases were managed and the patient outcomes at 2 centers in Tucson, Arizona. A retrospective chart review identified patients who developed coccidioidomycosis during treatment with DMARDs or BRMs. Patients were seen at least once in a university-affiliated or Veterans Affairs outpatient rheumatology clinic in Tucson, Arizona, between 2007 and 2009. Forty-four patients were identified. Rheumatologic treatment included a BRM alone (n = 11), a DMARD alone (n = 8), or combination therapy (n = 25). Manifestations of coccidioidomycosis included pulmonary infection (n = 29), disseminated disease (n = 9), and asymptomatic positive coccidioidal serologies (n = 6). After the diagnosis of coccidioidomycosis, 26 patients had BRMs and DMARDs stopped, 8 patients had BRMs stopped but DMARD therapy continued, and 10 patients had no change in their immunosuppressive therapy. Forty-one patients had antifungal therapy initiated for 1 month or longer. Followup data were available for 38 patients. BRM and/or DMARD therapy was continued or resumed in 33 patients, only 16 of whom continued concurrent antifungal therapy. None of the patients have had subsequent dissemination or complications of coccidioidomycosis. Re-treating rheumatic disease patients with a BRM and/or a DMARD after coccidioidomycosis appears to be safe in some patients. We propose a management strategy based on coccidioidomycosis disease activity. Copyright © 2012 by the American College of Rheumatology.

A survey on psychiatric patients' use of non-medical alternative practitioners: incidence, methods, estimation, and satisfaction.

Science.gov (United States)

Demling, J H; Neubauer, S; Luderer, H-J; Wörthmüller, M

2002-12-01

We investigated to what extent psychiatric inpatients consult Heilpraktiker, i.e. non-academically trained providers of complementary and alternative medicine (CAM), which diagnostic and therapeutic methods Heilpraktiker employ, how patients assess Heilpraictikers' professional competence, CAM in general and issues of satisfaction for those who have had experience with Heilpraktiker. Four hundred and seventy three patients admitted to a psychiatric university department during a 9-month period filled out a questionnaire developed for this investigation. About one third of the patients had consulted a Heilpraktiker, a quarter of these for their current psychiatric illness. Women were in the majority. Patients with the highest secondary school education consulted Heilpraktiker less often. There was considerable 'customer loyalty' towards Heilpraktiker. Largely the same diagnostic and treatment methods were employed for mental illness as for somatic complaints. Except for iridology, exotic or dangerous methods played a secondary role. Patients generally revealed a very positive attitude toward Heilpraktiker and CAM, although methods were rated differently. CAM enjoyed greater appreciation among women and patients who had consulted Heilpraktiker. Patients with personal experience were, on the whole, very satisfied with the professional competence, with the atmosphere in the practice and staff concern for the patient's well-being. Degree of satisfaction correlated closely with frequency of consultation. More patients with neurotic disorders considered the cost unreasonable than others, despite comparatively frequent visits. Psychiatric patients seek out Heilpraktiker to a considerable degree. Especially those who have relevant experience rank Heilpraktiker highly, in particular due to their 'psychotherapeutic' attitude, but professional competence is also valued. Methods of CAM received mixed reviews from patients but are generally seen in a positive light. It is

The impact of lymph vascular space invasion on recurrence and survival in patients with early stage endometrial cancer.

Science.gov (United States)

Loizzi, V; Cormio, G; Lorusso, M; Latorre, D; Falagario, M; Demitri, P; Scardigno, D; Selvaggi, L E

2014-05-01

The aim of this study was to determine impact of lymph vascular space involvement (LVSI) on recurrence and survival in early stage of endometrial cancer. From 1991 through 2010, all endometrial cancer patients at University Hospital of Bari, Italy were identified. The Log-rank test and Kaplan-Meyer methods were used for time-to-event analysis to evaluate the effects of on lymph vascular space involvement recurrence rate and survival time. Of the 560 endometrial cancer patients, 525 underwent primary surgery. Of those, 399 had early stage disease. Three hundred and forty women were not found to have LVSI, whereas 59 were found to have lymph vascular space involvement. Forty-nine (12%) patients developed a recurrence and 20 of them showed lymph vascular space involvement. The statistical analysis demonstrated that LVSI was strongly associated with a poor survival (P < 0.0001). Lymph vascular space involvement is associated with a high risk of recurrence and poor overall survival in early stage of endometrial cancer; therefore, the clinical decision to decide whether or not a patient with early stage endometrial cancer should receive adjuvant therapy should be included the evaluation of lymph vascular space involvement. © 2013 John Wiley & Sons Ltd.

Improvement of C peptide zero BMI 24-34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA).

Science.gov (United States)

Garciacaballero, M; Martínez-Moreno, J M; Toval, J A; Miralles, F; Mínguez, A; Osorio, D; Mata, J M; Reyes-Ortiz, A

2013-03-01

Although bariatric surgery proved to be a very effective method in the treatment of patients in whose pancreas still produce insulin (type 2 diabetes), the accompanied metabolic syndrome and their diabetes complications, there is no information on the effect of this type of surgery in BMI24-34 patients when pancreas do not produce insulin at all (type 1, LADA and long term evolution type 2 diabetes among others). We report preliminary data of a serie of 11 patients all with a C-peptide values below 0.0 ng/ml. They were followed for 6 to 60 months (mean 19 months) after surgery. We studied the changes in glycemic control, evolution of the metabolic syndrome and diabetes complications after one anastomosis gastric bypass (BAGUA). All values relative to glycemic control were improved HbA1c (from 8.9 ± 0.6 to 6.7 ± 0.2%), FPG (Fasting Plasma Glucose) [from 222.36 ± 16.87 to 94 ± 5 (mg/dl)] as well as the daily insulin requirement of rapid (from 40.6 ± 12.8 to 0 (U/d) and long-lasting insulin (from 41.27 ± 7.3 U/day to 15.2 ± 3.3 U/day). It resolved 100% of the metabolic syndrome diseases as well as severe hypoglycaemia episodes present before surgery and improved some serious complications from diabetes like retinopathy, nephropathy, neuropathy, peripheral vasculopathy and cardiopathy. Tailored one anastomosis gastric bypass in BMI 24-34 C peptide zero diabetic patients eliminated the use of rapid insulin, reduced to only one injection per day long-lasting insulin and improved the glycemic control. After surgery disappear metabolic syndrome and severe hypoglycaemia episodes and improves significantly retinopathy, neuropathy, nephropathy, peripheral vasculopathy and cardiopathy. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

One-year mortality of HIV-positive patients treated for rifampicin- and isoniazid-susceptible tuberculosis in Eastern Europe, Western Europe, and Latin America

DEFF Research Database (Denmark)

Podlekareva, DN; Schultze, A; Panteleev, A

2017-01-01

in Western Europe or Latin America. METHODS: One-year mortality of HIV-positive patients with rifampicin/isoniazid-susceptible TB in Eastern Europe, Western Europe, and Latin America was analysed and compared in a prospective observational cohort study. Factors associated with death were analysed using Cox......OBJECTIVES: The high mortality among HIV/tuberculosis (TB) coinfected patients in Eastern Europe is partly explained by the high prevalence of drug-resistant TB. It remains unclear whether outcomes of HIV/TB patients with rifampicin/isoniazid-susceptible TB in Eastern Europe differ from those...... cell count. These results call for improvement of care for TB/HIV patients in Eastern Europe....

Influence of lateral decubitus positioning after combined use of hyperbaric and hypobaric ropivacaine on hemodynamic characteristics in spinal anesthesia for caesarean section

OpenAIRE

Quan, Zhe-Feng; He, Hai-Li; Tian, Ming; Chi, Ping; Li, Xin

2014-01-01

Purpose: Positioning of the patient during and after surgery can have significant implications on recovery. Therefore, the purpose of the present study was to determine the influence of placing patients in a lateral decubitus position for 15 min after combined use of hyperbaric and hypobaric ropivacaine and assess hemodynamic characteristics during spinal anesthesia for caesarean section. Methods: One hundred-forty patients undergoing elective cesarean delivery with combined use of hyperbaric...

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload.

Science.gov (United States)

Koehl, Bérengère; Missud, Florence; Holvoet, Laurent; Ithier, Ghislaine; Sakalian-Black, Oliver; Haouari, Zinedine; Lesprit, Emmanuelle; Baruchel, André; Benkerrou, Malika

2017-03-14

Children with sickle cell anemia (SCA) may be at risk of cerebral vasculopathy and strokes, which can be prevented by chronic transfusion programs. Repeated transfusions of packed red blood cells (PRBCs) is currently the simplest and most used technique for chronic transfusion programs. However, iron overload is one of the major side effects of this therapy. More developed methods exist, notably the apheresis of RBC (erythrapheresis), which is currently the safest and most efficient method. However, it is costly, complicated, and cannot be implemented everywhere, nor is it suitable for all patients. Manual exchange transfusions combine one or more manual phlebotomies with a PRBC transfusion. At the Reference Center of Sickle Cell Disease, we set up a continuous method of manual exchange transfusion that is feasible for all hospital settings, demands no specific equipment, and is widely applicable. In terms of HbS decrease, stroke prevention, and iron overload prevention, this method showed comparable efficiency to erythrapheresis. In cases where erythrapheresis is not available, this method can be a good alternative for patients and care centers.

Predictors of ischemic versus hemorrhagic strokes in hypertensive patients

International Nuclear Information System (INIS)

Khealani, B.A.; Syed, N.A.; Maken, S.; Mapari, U.U.; Hameed, B.; Ali, S.; Qureshi, R.; Akhter, N.; Hassan, A.; Sonawalla, A.B.; Baig, S.M.; Wasay, M.

2005-01-01

Objective: To identify the factors that predispose to ischemic versus hemorrhagic stroke in hypertensive patients. Materials and Methods: All the hypertensive patients, who were registered in AKUH acute stroke outcome data base, over a period of 22 months, were identified and from this cohort the patients with first ever stroke were selected. The data regarding demographics, stroke type (ischemic vs. hemorrhagic), pre-existing medical problems, laboratory and radiological investigations was recorded and analyzed. Results: Five hundred and nineteen patients with either ischemic stroke or parenchymal hemorrhage were registered over a period of 22 months. Three hundred and forty-eight patients (67%) had hypertension and of these, 250 had first ever stroke at the time of admission. Presence of diabetes mellitus (OR: 3.76; Cl:1.67-8.46) and ischemic heart disease (OR: 6.97; Cl:1.57-30.98) were found to be independent predictors of ischemic strokes. Conclusion: Presence of diabetes mellitus and ischemic heart disease predict ischemic stroke in a patient with hypertension. (author)

Sympathetic neuropathy in diabetes mellitus patients does not elicit Charcot osteoarthropathy

DEFF Research Database (Denmark)

Christensen, Tomas M; Simonsen, Lene; Holstein, Per E

2011-01-01

AIM: The aim of the study was to determine the degree of neuropathy (autonomic and somatic) in patients with diabetes mellitus with or without Charcot osteoarthropathy (CA). METHODS: Forty-nine patients with diabetes mellitus type 1 or 2 were investigated. The patient population of interest...... with first toe amputation (n=5), a high-risk group for development of CA, and two control groups consisting of diabetes patients with (n=9) or without somatic neuropathy (n=11) were investigated. Regional blood flow in the feet was measured by venous occlusion plethysmography. Quantitation of somatic...... neuropathy was done by the Neuropathy Disability Score and modified Neuropathy Symptom Score. Quantitation of autonomic neuropathy was done by measurements of local venoarteriolar sympathetic axon reflex in the feet and of heart rate variability during deep breathing and orthostatic challenge. RESULTS...

ABO-Rh blood groups distribution in cardiac syndrome X patients.

Science.gov (United States)

Kheradmand, Fatemeh; Rasmi, Yousef; Nemati, Mohaddeseh; Mohammadzad, Mir Hossein Seyed

2012-07-01

Data on frequency distribution of ABO-Rh blood groups in cardiac syndrome X (CSX) patients are not available. We aimed to investigate the distribution of ABO-Rh blood groups in these patients. A total of 247 CSX patients' records were reviewed in a cross-sectional study from 2006 to 2010. One hundred forty six patients (59.1%) were female, and the mean patient age was 52 ± 11 years. The frequency of ABO-Rh blood groups was compared to the frequency of these blood groups in the West-Azerbaijan province, Iran; general population. Blood groups distribution among CSX patients showed phenotypes A, B, AB, O and Rh negative as 33.1%, 21.9%, 9.3%, 35.8%, and 7.9%, respectively. According to our results, there were no differences in ABO-Rh blood groups distribution between CSX patients and normal population. These data suggest that ABO-Rh blood groups might be unassociated with CSX.

Moving Least Squares Method for a One-Dimensional Parabolic Inverse Problem

Directory of Open Access Journals (Sweden)

Baiyu Wang

2014-01-01

Full Text Available This paper investigates the numerical solution of a class of one-dimensional inverse parabolic problems using the moving least squares approximation; the inverse problem is the determination of an unknown source term depending on time. The collocation method is used for solving the equation; some numerical experiments are presented and discussed to illustrate the stability and high efficiency of the method.

[The comparison of different bronchial aspirate culturing methods in patients with ventilator-associated pneumonia (VAP)].

Science.gov (United States)

Kowalczyk, Wojciech; Rybicki, Zbigniew; Tomaszewski, Dariusz; Truszczyński, Andrzej; Guzek, Aneta

2011-01-01

Although broncho-alveolar lavage (BAL) culture and protected specimen brush (PSB) are regarded as the most effective methods in the diagnosis of VAP, a simple endotracheal aspiration (EA) is frequently performed during routine care, because of its simplicity and low cost. We compared the effectiveness of EA with BAL and PSB in VAP patients. Sixty-one adult VAP patients, ventilated for longer than 48 h, were cultured with all three methods. Positive cultures were obtained from 63.9% of patients, with Acinetobacter baumannii being the most common pathogen. There was a high positive correlation between simple aspirates and BAL (k 0.817, CI 0.664-0.840, p aspirates and PSB (k 0.667, CI 0.483-0.871, p aspirate culturing, compared to BAL and PSB, it can be used successfully in most cases.

Percutaneous Microwave Ablation in the Spleen for Treatment of Hypersplenism in Cirrhosis Patients.

Science.gov (United States)

Jiang, XiangWu; Gao, Fei; Ma, Yan; Feng, ShuFen; Liu, XueLian; Zhou, HongKe

2016-01-01

The aim of this study was to estimate the feasibility and therapeutic effectiveness of percutaneous microwave ablation in the treatment of hypersplenism in cirrhosis. Forty-one cirrhosis patients with hypersplenism were treated with ultrasonography-guided percutaneous microwave ablation between February 2007 and August 2011. Peripheral blood cell counts, portal vein diameter, splenic vein diameter, and blood flow of splenic vein were evaluated before and after the operation, and complications of the treatment were also investigated. All patients were followed up for 24 months. The levels of platelets and white blood cells were increased, while the splenic vein diameter narrowed gradually after the therapy and 24 months later. Moreover, patients received percutaneous microwave ablation had much lower splenic venous flow velocity. The portal vein diameter did not change significantly 6 months after the treatment, although it narrowed gradually within 3 months after the treatment. Furthermore, no complications such as uncontrollable bleeding, splenic abscess, spleen rupture, and damage in surrounding organ happened after the therapy. Graded percutaneous microwave ablation, as a minimally invasive therapy, could damage the spleen, increase the levels of platelets and white blood cells, and reduce portal hypertension effectively without serious complications. Percutaneous microwave ablation is an effective, safe, and feasible method for cirrhosis patients with hypersplenism.

Measuring quality of life in patients with head and neck cancer: Update of the EORTC QLQ-H&N Module, Phase III

DEFF Research Database (Denmark)

Singer, Susanne; Araújo, Cláudia; Arraras, Juan Ignacio

2015-01-01

BACKGROUND: The objective of this study was to pilot test an updated version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&N60). METHODS: Patients with head and neck cancer were asked to complete a list of 60 head...... and neck cancer-specific items comprising the updated EORTC head and neck module and the core questionnaire EORTC QLQ-C30. Debriefing interviews were conducted to identify any irrelevant items and confusing or upsetting wording. RESULTS: Interviews were performed with 330 patients from 17 countries......, representing different head and neck cancer sites and treatments. Forty-one of the 60 items were retained according to the predefined EORTC criteria for module development, for another 2 items the wording was refined, and 17 items were removed. CONCLUSION: The preliminary EORTC QLQ-H&N43 can now be used...

The diagnostic efficiency of ultrasound guided imaging algorithm in evaluation of patients with hematuria

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Unsal, Alparslan, E-mail: alparslanunsal@yahoo.com [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Caliskan, Eda Kazak [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey); Erol, Haluk [Adnan Menderes University, Faculty of Medicine, Department of Urology, 09100 Aydin (Turkey); Karaman, Can Zafer [Adnan Menderes University, Faculty of Medicine, Department of Radiology, 09100 Aydin (Turkey)

2011-07-15

Purpose: To assess the efficiency of the following imaging algorithm, including intravenous urography (IVU) or computed tomography urography (CTU) based on ultrasonographic (US) selection, in the radiological management of hematuria. Materials and methods: One hundred and forty-one patients with hematuria were prospectively evaluated. Group 1 included 106 cases with normal or nearly normal US result and then they were examined with IVU. Group 2 was composed of the remaining 35 cases which had any urinary tract abnormality, and they were directed to CTU. Radiological results were compared with clinical diagnosis. Results: Ultrasonography and IVU results of 97 cases were congruent in group 1. Eight simple cysts were detected with US and 1 non-obstructing ureter stone was detected with IVU in remaining 9 patients. The only discordant case in clinical comparison was found to have urinary bladder cancer on conventional cystoscopy. Ultrasonography and CTU results were congruent in 30 cases. Additional lesions were detected with CTU (3 ureter stones, 1 ureter TCC, 1 advanced RCC) in remaining 5 patients. Ultrasonography + CTU combination results were all concordant with clinical diagnosis. Except 1 case, radio-clinical agreement was achieved. Conclusion: Cross-sectional imaging modalities are preferred in evaluation of hematuria. CTU is the method of choice; however the limitations preclude using CTU as first line or screening test. Ultrasonography is now being accepted as a first line imaging modality with the increased sensitivity in mass detection compared to IVU. The US guided imaging algorithm can be used effectively in radiological approach to hematuria.

Stable isotope separation in calutrons: Forty years of production and distribution

International Nuclear Information System (INIS)

Bell, W.A.; Tracy, J.G.

1987-11-01

The stable isotope separation program, established in 1945, has operated continually to provide enriched stable isotopes and selected radioactive isotopes, including the actinides, for use in research, medicine, and industrial applications. This report summarizes the first forty years of effort in the production and distribution of stable isotopes. Evolution of the program along with the research and development, chemical processing, and production efforts are highlighted. A total of 3.86 million separator hours has been utilized to separate 235 isotopes of 56 elements. Relative effort expended toward processing each of these elements is shown. Collection rates (mg/separator h), which vary by a factor of 20,000 from the highest to the lowest ( 205 Tl to 46 Ca), and the attainable isotopic purity for each isotope are presented. Policies related to isotope pricing, isotope distribution, and support for the enrichment program are discussed. Changes in government funding, coupled with large variations in sales revenue, have resulted in 7-fold perturbations in production levels

My Forty-Year Adventure in the Wonderful World of Fiber Optics!

Science.gov (United States)

Hodara, Henri

2016-11-01

In the first part of this presentation, I review the key technology developments of the last century up to the present. These developments are what led us to the communication and information revolution. This is followed by a discussion of how the use of optical fibers brought about the fusion of these two elements and the resultant proliferation of smart phones and social networks. In the second part, I recollect some of my work in fiber optics over a period of forty years in the context of those key developments. In particular, I stress what it takes for a company small in comparison to the giants in the field to capture niche markets. I also discuss the criteria that are needed to justify the application of a new technology like optical fibers to existing communication and sensing systems, and make it cost effective. I end this presentation with a few personal considerations regarding technology developments and innovation.

Yankee Tank Creek Observatory Report No. 1: Forty-One Measures from 2012

Science.gov (United States)

Wiley, E. O.

2014-01-01

This report contains 41 measures of mostly STF pairs taken in 2012 and comprises those pairs not reported in other papers. All measures were taken with a 0.2M Dall-Kirkham and a DMK21 video camera working at F22.5. Both stacking and pixel correlation techniques were used to obtain measures using REDUC.

Quality of life assessment in asthmatic patients receiving fluticasone compared with equipotent doses of beclomethasone or budesonide

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Thomas Sabin

2005-01-01

Full Text Available Aims: To assess the quality of life in patients with asthma receiving either fluticasone or other inhaled steroids like beclomethasone or budesonide. To assess the effect of equipotent dosage of inhaled steroids at 3 months duration. Methods: Patients were randomised to receive either fluticasone or beclomethasone/budesonide. After spirometry, St. George′s Respiratory Questionnaire (SGRQ was administered at baseline and at 15 th , 30 th , 45 th , 60 th and 90 th day, to assess improvement in lung function and HRQoL. Results: Out of 96 patients who were enrolled, eighty patients completed three months duration of the study, while sixteen patients dropped out. Forty patients received fluticasone and forty received either beclomethasone or budesonide. No significant difference (p>0.05 was found in the baseline values of St. George′s Respiratory Questionnaire (SGRQ scores and Forced Expiratory Volume at first second (FEV 1 between the two groups. However, significant difference (p< 0.05 was noted between the above two groups, in Quality of Life (QoL but not in pulmonary functions, on 15th day favoring fluticasone. No significant difference (p>0.05 was noted either in QoL or in pulmonary function tests on subsequent follow-ups. Conclusion: Early response in terms of improved QoL was observed in fluticasone treated group in patients with moderate to severe asthma.

Evaluation of Salivary Glucose, IgA and Flow Rate in Diabetic Patients: A Case-Control Study

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P. Bakianian Vaziri

2010-03-01

Full Text Available Objective: An association between diabetes mellitus and alterations in the oral cavity has been noted. In this study, we evaluated differences between salivary IgA, glucose and flow rate in diabetic patients compared with healthy controls.Materials and Methods: Forty patients with type 1 diabetes, 40 patients with type 2 diabetes and 40 healthy controls were selected. Whole unstimulated saliva samples were collected by the standard method and the salivary flow rate was determined. Nephelometricand Pars method were used to measure salivary IgA and salivary glucose concentrations,respectively. Statistical analysis was performed by Chi-square and t test.Results: There were no significant differences in salivary IgA and glucose concentrations between type 1 and type 2 diabetic patients and their matched control subjects (P>0.05.Salivary flow rate was significantly lower in diabetic patients (P<0.05. In addition,DMFT was higher in diabetic patients than the controls.Conclusion: Determination of salivary constituents may be useful in the description and management of oral findings in diabetic patients.

Analysis of Hepatitis C Virus NS5A Region in Patients with Cirrhosis Using an Ultra-Deep Pyrosequencing Method.

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Keskin, Fahriye; Ciftci, Sevgi; Akyuz, Filiz; Abaci, Neslihan; Cakiris, Aris; Akyuz, Umit; Demir, Kadir; Besisik, Fatih; Ustek, Duran; Kaymakoglu, Sabahattin

2017-09-01

HCV (Hepatitis C Virus) is genetically more diverse than HBV and HIV (Human Immunodeficiency Virus) and exists as quasispecies within infected individuals. This is due to the lack of efficient proofreading of the viral RNA-dependent RNA polymerase. Consequently, quasispecies emerge depending on the mutation rate of the viral polymerase, which may display a high level of genetic variability in a population. In infected individuals, HCV replicates and circulates as quasispecies composed of a complex mixture of different but closely related genomes that undergoes continuous change due to competitive selection and cooperation between arising mutants. The aim of this study is to investigate mutations in the NS5A region as a whole, including ISDR, PKRBD, IRRDR, and V3 of HCV genotype 1b cirrhosis patients being naive and nonresponders, treated with IFN (interferon) + ribavirin (RBN) by using an ultra-deep pyrosequencing method (UDPS). During the study, five patients (four females, and one male, mean age 59.8 ± 11 years) with HCV related cirrhosis were analyzed. Three patients received IFN + RBN for six months, but two patients did not receive any therapy. HCV-RNA concentrations in patients' sera were determined using a COBAS AMPLICOR HCV MONITOR Test, Version 2.0. Genotyping was performed by using a commercial reverse hybridization method, Line Probe Assay. The quasispecies for the NS5A region were investigated using UDPS. All five patients were HCV genotype 1b (Mean Child-Pugh score 7.2 ± 1.9, 2 pts Child A, 2 pts Child B, and one pt Child C) but only one patient had hepatocellular carcinoma (HCC). A total of 19 different mutations were detected in each of the five patients (ranging from 3 to 6 mutations per patient). In all five patients, several mutations in the ISDR and PKR-BD regions were detected. On the other hand, mutations in the V3 and IRRDR regions were only detected in one patient. UDPS is a new sequencing technology and a very sensitive method in detection

Assessment of right liver graft perfusion effectiveness between one and two-catheter infusion methods.

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Jung, Bo-Hyun; Hwang, Shin; Ha, Tae-Yong; Song, Gi-Won; Jung, Dong-Hwan; Kim, Ki-Hun; Ahn, Chul-Soo; Moon, Deok-Bog; Park, Gil-Chun; Kang, Sung-Hwa; Yoon, Young-In; Lee, Sung-Gyu

2014-05-01

Conventional graft perfusion method using one small-caliber catheter takes a relatively long time for right liver graft perfusion, thus some modification is needed. In this study, we intended to assess the effectiveness of right liver graft perfusion methods through comparison of different infusion catheters. The study consisted of two parts including one bench experiment to obtain data of hydraulic infusion and one clinical trial of 40 cases on graft perfusion with one- versus two-catheter infusion methods. These two graft infusion methods were compared in terms of the perfusion time and washing-out efficiency. At bench experiment, the infusion flow rate and infusion pressure were 3.3 ml/sec and 1.9 cmH20 in one blood transfusion catheter group, and 11.7 ml/sec and 3.1 cmH20 in single transurethral resection of prostate irrigation catheter group, and 6.6 ml/sec and 2.0 cmH20 in two blood transfusion catheters group, respectively. In clinical trial with 40 right liver grafts, two-catheter group had a shorter graft portal perfusion time for the first 2 L of histidine-tryptophan-ketoglutarate (HTK) solution than the conventional one-catheter group (375±25 seconds vs. 662±34 seconds; p=0.001) and a lower rate of incomplete blood washing-out after the initial 2 L portal perfusion (40% vs. 85%; p=0.03). The two-catheter infusion method appears to be more effective than the conventional one-catheter infusion method for right liver graft perfusion at the back table. Large size of right liver grafts seems to be its good indication.

Development and evaluation of one step single tube multiplex RT-PCR for rapid detection and typing of dengue viruses

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Parida Manmohan

2008-01-01

Full Text Available Abstract Background Dengue is emerging as a major public health concern in many parts of the world. The development of a one-step, single tube, rapid, and multiplex reverse transcription polymerase chain reaction (M-RT-PCR for simultaneous detection and typing of dengue virus using serotype specific primers during acute phase of illness is reported. Results An optimal assay condition with zero background was established having no cross-reaction with closely related members of flavivirus (Japanese encephalitis, West Nile, Yellow fever and alphavirus (Chikungunya. The feasibility of M-RT-PCR assay for clinical diagnosis was validated with 620 acute phase dengue patient sera samples of recent epidemics in India. The comparative evaluation vis a vis conventional virus isolation revealed higher sensitivity. None of the forty healthy serum samples screened in the present study revealed any amplification, thereby establishing specificity of the reported assay for dengue virus only. Conclusion These findings clearly suggested that M-RT-PCR assay reported in the present study is the rapid and cost-effective method for simultaneous detection as well as typing of the dengue virus in acute phase patient serum samples. Thus, the M-RT-PCR assay developed in this study will serve as a very useful tool for rapid diagnosis and typing of dengue infections in endemic areas.

Influence of long-term colonoscopic surveillance on incidence of colorectal cancer and death from the disease in patients with precursors (adenomas)

DEFF Research Database (Denmark)

Jørgensen, Ole Dan; Kronborg, Ole; Fenger, Claus

2007-01-01

Case-control studies and short term prospective studies have suggested that selected groups of patients with precursors of colorectal cancer may benefit from colonoscopic surveillance after initial removal of adenomas. The aim of the present study was to demonstrate such a possible benefit from...... long term (1-24 years) colonoscopic surveillance in a population of patients with all types of adenomas regardless of size and way of removal. Two thousand and forty-one patients with a first time diagnosis of colorectal adenoma were included in prospective surveillance between year 1978 and 2002. All...

Nutritional assessment methods as predictors of postoperative mortality in gastric cancer patients submitted to gastrectomy

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Aline Kirjner Poziomyck

Full Text Available ABSTRACT Objectives: to determine the nutritional evaluation method that best predicts mortality in 90 days of patients submitted to gastrectomy for gastric cancer. Methods: we conducted a prospective study with 44 patients with gastric cancer, stages II to IIIa, of whom nine were submitted to partial gastrectomy, 34 to total gastrectomy, and one to esophago-gastrectomy. All patients were nutritionally evaluated through the same protocol, up to 72h after hospital admission. The parameters used were Patient-Generated Subjective Global Assessment (PGSGA, classical anthropometry, current weight and height, percentage of weight loss (%WL and body mass index (BMI. We also measured the thickness of the thumb adductor muscle (TAM in both hands, dominant hand (TAMD and non-dominant hand (TAMND, as well as the calculated the prognostic nutritional index (PNI. The laboratory profile included serum levels of albumin, erythrocytes, hemoglobin, hematocrit, leukocytes, and total lymphocytes count (TLC. Results: of the 44 patients studied, 29 (66% were malnourished by the subjective method, 15 being grade A, 18 grade B and 11 grade C. Cases with PGSGA grade B and TAMD 10.2±2.9 mm were significantly associated with higher mortality. The ROC curves (95% confidence interval of both PGSGA and TAMD thickness reliably predicted mortality at 30 and 90 days. No laboratory method allowed predicting mortality at 90 days. Conclusion: PGSGA and the TAMD thickness can be used as preoperative parameters for risk of death in patients undergoing gastrectomy for gastric cancer.

[Use of Patient Specific Instruments at Total Knee Arthroplasty. One-Year Results of a Prospective Randomised Study].

Science.gov (United States)

Musil, D; Stehlík, J; Abrman, K; Held, M; Sadovský, P

2016-01-01

PURPOSE OF THE STUDY The aim of this prospective study was to evaluate, at one year of follow-up, radiographic and clinical results of total knee arthroplasty (TKA) performed with use of Zimmer® Patient Specific Instruments (PSIs) which allow for planning and customising each patient's TKA. MATERIAL AND METHODS Of the patients with knee arthritis who were eligible for joint replacement, 23 were randomly selected and included in this study. There were 11 men and 12 women, with 11 right and 12 left knee joints. On the basis of pre-operative CT scans, PSI custom-made pin guides, which conformed to the individual patient's anatomy, were produced and then used in the THA surgery involving a NexGen (CR) system. All patients were examined before surgery and at 1 year after THA. The evaluation at a follow-up visit included standing full-length radiographs (antero-posterior and lateral), Knee Score results, range of motion (ROM), patient's satisfaction report, and post-operative complications. The X-ray views were examined for mechanical leg axis alignment, TKA alignment in antero-posterior and lateral projection and signs of potential loosening. RESULTS At 1 post-operative year, the average Knee Society Score (KSS) was 85.5 points and the average functional score was 82.6 point. The satisfaction rate was 94% and, on a school rating system, the average mark was 1.3. The average postoperative ROM value was 116°. All patients were willing to undergo the surgery again. The only complication was thrombosis in one patient. Radiographic findings of knee alignment were optimal in 18, correct (up to 3° deviation) in three and incorrect (above 3° deviation) in two patients. Radiographic signs of loosening were not recorded. DISCUSSION Correct knee alignment is one of the requirements for achieving a good TKA outcome. Various techniques are used to improve the total knee process (computer-aided surgery, customised guides). Zimmer Patient Specific Instruments provide advanced pre

Survey of sexual educational needs in radiation oncology patients

International Nuclear Information System (INIS)

Chen, L.; Sweeney, P.; Wallace, G.; Neish, P.; Vijayakumar, S.

1997-01-01

Purpose: To assess the knowledge of and need for education about sexuality in oncology patients treated with radiation therapy. Methods and Materials: Patients who received radiation therapy for any disease site were given a self-assessment survey to complete to determine their opinions on sexuality and needs for sexual education. The surveys were given to patients on follow-up visit seen approximately 6 months to 2 years after radiation therapy. All patients were diagnosed with a malignancy and asked to participate on a voluntary basis; confidentiality was ensured by excluding any identifying patient information on the survey form. Respondents were polled with a survey that consisted of 17 questions about their sexual activity. Questions were broadly categorized into the following: definition of sexual activity, frequency of sexual activity prior to and after diagnosis and treatment of cancer, perception of sexual attractiveness, sexual satisfaction in the relationship, patient perception of partner's sexual satisfaction in the relationship, educational needs with regard to sexuality after therapy for cancer, and demographic information. Results: All patients were over age 18, and received radiation therapy as part of the treatment. Patients with all disease sites were included in the survey, regardless of stage or diagnosis. A total of 28 patients completed the survey form, which was approved by our institutional review board. Forty-three percent of patients felt that the cancer diagnosis or treatment effect was the cause of not engaging in sexual intercourse. Fifty percent reported not having the same sexual desire as before the diagnosis of cancer, while 46% reported having the same sexual desire as prior to the diagnosis of cancer. Forty-six percent felt less attractive than before the diagnosis of cancer, while 43% felt the same as before diagnosis. Thirty-six percent of patients received no information with regards to sexuality and cancer, while 18% received

Evaluation of salivary glucose, IgA and flow rate in diabetic patients: a case-control study.

Science.gov (United States)

Bakianian Vaziri, P; Vahedi, M; Mortazavi, H; Abdollahzadeh, Sh; Hajilooi, M

2010-01-01

An association between diabetes mellitus and alterations in the oral cavity has been noted. In this study, we evaluated differences between salivary IgA, glucose and flow rate in diabetic patients compared with healthy controls. Forty patients with type 1 diabetes, 40 patients with type 2 diabetes and 40 healthy controls were selected. Whole unstimulated saliva samples were collected by the standard method and the salivary flow rate was determined. Nephelometric and Pars method were used to measure salivary IgA and salivary glucose concentrations, respectively. Statistical analysis was performed by Chi-square and t test. There were no significant differences in salivary IgA and glucose concentrations between type 1 and type 2 diabetic patients and their matched control subjects (P>0.05). Salivary flow rate was significantly lower in diabetic patients (Pdiabetic patients than the controls. Determination of salivary constituents may be useful in the description and management of oral findings in diabetic patients.

Impingement syndrome and rotator cuff tears: US findings in 140 patients

International Nuclear Information System (INIS)

Malvestiti, Oreste; Scorsolini, Alessandro; Ratti, Francesco; Ferraris, Giuseppe; Columbaro, Guido; Mariani, Claudio

1997-01-01

The authors investigated the role of rotator cuff impingement in causing tears of supraspinatus and biceps tendons and the comparative reliability of plain radiography and sonography (US). One hundred forty patients with symtoms referrable to the rotator cuff were examined with plain radiography and US of the shoulder. The differential diagnosis must distinguish all these common causes of shoulder dysfunction and cuff problems from other conditions. The authors conclude that US and plain radiography are accurate routine tests of rotator cuff integrity and rotator cuff impingement

Kansas City Cardiomyopathy Questionnaire Utility in Prediction of 30-Day Readmission Rate in Patients with Chronic Heart Failure

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Shengchuan Dai

2016-01-01

Full Text Available Background. Heart failure (HF is one of the most common diagnoses associated with hospital readmission. We designed this prospective study to evaluate whether Kansas City Cardiomyopathy Questionnaire (KCCQ score is associated with 30-day readmission in patients hospitalized with decompensated HF. Methods and Results. We enrolled 240 patients who met the study criteria. Forty-eight (20% patients were readmitted for decompensated HF within thirty days of hospital discharge, and 192 (80% patients were not readmitted. Compared to readmitted patients, nonreadmitted patients had a higher average KCCQ score (40.8 versus 32.6, P = 0.019 before discharge. Multivariate analyses showed that a high KCCQ score was associated with low HF readmission rate (adjusted OR = 0.566, P = 0.022. The c-statistic for the base model (age + gender was 0.617. The combination of home medication and lab tests on the base model resulted in an integrated discrimination improvement (IDI increase of 3.9%. On that basis, the KCQQ further increased IDI of 2.7%. Conclusions. The KCCQ score determined before hospital discharge was significantly associated with 30-day readmission rate in patients with HF, which may provide a clinically useful measure and could significantly improve readmission prediction reliability when combined with other clinical components.

Usefulness of transrectal ultrasound-guided 12 core biopsy method in patients with clinically suspected prostate cancer

International Nuclear Information System (INIS)

Kwon, Se Hwan; Lim, Joo Won; Park, Seong Jin; Ko, Young Tae; Kim, Yoon Wha

2000-01-01

To evaluate the improvement of prostate cancer detection provided by transrectal ultrasound (TRUS)-guided 12 core biopsy method compared with sextant biopsy method. Between June 1997 and February 1999, 29 patients with pathologically proven prostate cancer in 124 patients who underwent TRUS-guided 12 core biopsy method were evaluated. They had abnormal findings in prostate specific antigen (PSA), digital rectal examination (DRE) or TRUS findings. The prostate was diffusely enlarged in all patients on DRE findings and in 15 cases (15/29, 52%), hard nodule was palpated. The average of PSA and prostate specific antigen density (PSAD) is 229.33 ng/ml (1-2280) and 9.14 ng/ml/cm 3 (0.048-142.5), respectively, 12 transrectal biopsy, including 2 transition zones, was performed in both lobe, 6 biopsies were located in both base, middle and apex. Then 2 biopsies were inserted between 3 biopsies in both peripheral zone and 2 biopsies were performed in both transition zone. Each specimen was pathologically examined. The results of pathology were compared with method 1 and 2, respectively. We defined the method 1 and 2 as different sextant biopsy method. The method 1 is that cores are taken from both base, middle and apex and method 2 is that cores are taken from both base, apex and transition zone. TRUS findings were analyzed by two radiologists. Of the 29 patients with prostate cancer, 3 (10%) had carcinomas only in the additional regions as compared with method. When compared with method 2,2 (7.0%) had carcinomas only in the additional regions. 2 patients were same in both cases. TRUS findings were abnormal in 21 cases in all patients whose 12 biopsy method was not helpful. 12 biopsy method was helpful in 2/8 (25%) whose TRUS findings were non-specific and 1/21 (4.8%) whose TRUS findings were abnormal. Small low echoic lesion was seen in one patients whose 12 biopsy method was helpful, but cancer was found in other area. TRUS-guided 12 core biopsy method may be superior to

Assessment of physician and patient (child and adult) equivalent doses during renal angiography by Monte Carlo method

International Nuclear Information System (INIS)

Karimian, A.; Nikparvar, B.; Jabbari, I.

2014-01-01

Renal angiography is one of the medical imaging methods in which patient and physician receive high equivalent doses due to long duration of fluoroscopy. In this research, equivalent doses of some radiosensitive tissues of patient (adult and child) and physician during renal angiography have been calculated by using adult and child Oak Ridge National Laboratory phantoms and Monte Carlo method (MCNPX). The results showed, in angiography of right kidney in a child and adult patient, that gall bladder with the amounts of 2.32 and 0.35 mSv, respectively, has received the most equivalent dose. About the physician, left hand, left eye and thymus absorbed the most amounts of doses, means 0.020 mSv. In addition, equivalent doses of the physician's lens eye, thyroid and knees were 0.023, 0.007 and 7.9 - 4 mSv, respectively. Although these values are less than the reported thresholds by ICRP 103, it should be noted that these amounts are related to one examination. (authors)

Audit of new long-stay patients in Permai Mental Hospital, Johor.

Science.gov (United States)

Cheah, Y C; Nur Aiza, Z; Paramasivam, S; Kadir, A B; Jeyarajah, S

1997-06-01

We report a cross-sectional descriptive study of 90 new long-stay patients (NLS) (i.e. those who had been resident for six months to three years in Permai Mental Hospital, Johor) and studied from April to June, 1995. The age of this sample ranged from 18 to 85 years. Two subgroups were observed (i.e. younger NLS patients aged 18 to 34 years and older NLS patients aged 35 to 85 years). Among the younger NLS patients, the commonest diagnosis was schizophrenia (51.2%), followed by mental retardation with related problems (24.4%). Sixty-one percent of these younger patients had a history of serious violence or dangerous behaviour. Older NLS patients were likely to have a diagnosis of schizophrenia (79.6%), followed by mood disorder (6.1%) and dementia (4.1%). Forty seven percent of these older group had history of danger to others and 57.1% were at moderate or severe risk of non-deliberate self-harm. Focusing on the schizophrenic patients, all of them had some form of psychopathology, either positive, negative or general symptoms and about one-fourth were assessed to pose a risk for aggression.

An investigation on clinical radiological diagnosis of hereditary osteogenesis imperfect (a report of 42 patients in a family)

International Nuclear Information System (INIS)

He Junxiang; Jiang Xuzhou; Zhang Shunzhi; Huang Guomei; Mu Huinian; Li Yi; Li Meihe

1998-01-01

Purpose: To investigate the main points of diagnosing hereditary osteogenesis imperfect. Methods: Retrospective analysis of clinical and radiological diagnosis of hereditary osteogenesis imperfect was done in 35 surviving patients and 7 deaths in a family. Results: (1) A family was described in which hereditary osteogenesis imperfect occurred in 5 generations. Forty-two patients (18 males, 24 females) ranged in age from 10 months to 67 years. (2) Both modes of inheritance existed simultaneously (dominant in 35 patients, recessive in 7 patients). (3) Blue sclera of different shades was found in all 42 patients. (4) Radiological change of bone was recognised in 35 surviving patients. The conditions were as follows: in 29 patients, general decreased bone density, thin bone cortex and long slender tubular bones were observed; six patients were normal; twenty-two patients had fracture. (5) Twenty-four patients (including 3 deaths) suffered form progressive deafness. (6) Twenty-one patients (including 3 deaths) had the triad of blue sclera, osteopsathyrosis and progressive deafness. (7) An increase in alkaline phosphatase level (in 17 patients) was confirmed by the tests in our laboratory. Conclusion: The authors suggested that the triad of blue sclera, osteopsathyrosis and progressive deafness is the characteristic manifestations of the disease, especially blue sclera, which may be regarded as an initial and suggestible physical sign, and an essential criterion for diagnosis

Clinical characteristics differentiating bacteriologically positive pulmonary tuberculosis patients from negative ones in Mongolia.

Science.gov (United States)

Toyota, M; Yasuda, N; Koda, S; Ohara, H; Enkhbat, S; Tsogt, G

1998-06-01

The objective of this study is to clarify clinical characteristics which differentiate bacteriologically positive pulmonary tuberculosis patients from negative ones in Mongolia. The subjects include 338 patients aged 16 years and older who had undergone bacteriological examinations. Of them, 107 patients (31.7%) were confirmed bacteriologically. The proportion of bacteriological positive results increased significantly among patients who had cavities in the roentgenographic examination, cough at diagnosis and the family history of tuberculosis. Addressing these clinical characteristics will contribute to raising not only the sensitivity of the sputum examination, but also the specificity of the roentgenographic examination in the diagnostic process of tuberculosis.

Acute myocardial infarction after heart irradiation in young patients with Hodgkin's disease

International Nuclear Information System (INIS)

Joensuu, H.