Is there a role for TENS application in the control of diabetes mellitus in insulin-dependent patients?

Science.gov (United States)

Khan, Mueen Ullah

2012-11-01

An 80-year-old man with insulin-dependent diabetes mellitus presented to the hospital with low back pain. He was initially managed with non-steroidal anti-inflammatory drugs, tramadol and epidural steroid injection. Transcutaneous electrical nerve stimulation (TENS), applied on the back and buttocks, was subsequently advised. Initially, TENS was applied once every 24 hours. On improvement of pain symptoms, it was increased to thrice every 24 hours. The patient then complained of symptoms of hypoglycaemia (blood sugar level TENS resulted in raised blood sugar level. When TENS was restarted, the same hypoglycaemic response was noted. The insulin dosage was adjusted to half of the patient's routine daily requirement with continued application of TENS. This incidental finding has alerted us to hypoglycaemic episodes following TENS application, which may be due to effective pain control, decreased sympathetic stimulation, enhanced insulin sensitivity or altered muscle metabolism due to electrical stimulation.

Macroscopic, pathologic and immunologic investigations of ten patients with carcinoma of oral cavity treated by a single large dose irradiation

International Nuclear Information System (INIS)

Mikuriya, Shuichi; Saito, Tsutomu; Konoeda, Koichi; Igarashi, Seishi; Hirohashi, Hitoshi

1979-01-01

The immunosuppressive effect of radiation has been emphasized. Although the irradiated cancer cells die gradually during the treatment, it is understood that they keep cancer specific antigenecity in that process. Another words, we assume that the immunologic capacity participates in the dying process of cancer cells by radiotherapy. We have been preferring to treat carcinoma by a single large dose irradiation method because this method does not impair the patient's immunologic capacity. On this time, we treated ten patients with carcinoma of oral cavity by this method and could obtain favorable results. 1) Ten patients with carcinoma of oral cavity classified in T1N0M0-T3N0M0 were irradiated by 4 - 10 MeV betatron electron. In seven patients, 2,500 - 3,000 rads were given at once and other three patients were irradiated with fractionated dose of 1,000 rads three times within two weeks (total 3,000 rads per two weeks). 2) Effects of a single large dose irradiation were remarkable and almost all cancer cells in these patients disappeared both macroscopically and pathologically. 3) According to the results of cellular immunity tests, numbers of peripheral lymphocytes, absolute numbers of fractionated T and B cells, and blastoid formation rate of lymphocytes stimulated by PHA in vitro were all increased and values obtained by four kinds of skin tests were also elevated after the radiations. These results indicate that the single large dose irradiation for these patients does not impair the immunologic capacity of the patients. (author)

Etiologic Causes and Epidemiological Characteristics of Patients with Intraocular Foreign Bodies: Retrospective Analysis of 1340 Cases over Ten Years

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Lin Li

2018-01-01

Full Text Available Objective. Patients with intraocular foreign bodies were retrospectively analyzed. Population characteristics, pathogenic factors, and the outcomes during the past ten years were discussed. Design. Retrospective case series study. Method. Medical records of 1340 patients hospitalized in Beijing Tongren Hospital from January 1, 2004, to December 31, 2013, were collected. Results. Average age was 33.0 ± 13.8 (1–76 years old in 1340 patients. There were more males (1270, 94.8% than females (70, 5.2%. Patients from outside of Beijing (82.1%, n=1100 prevailed. Farmers (32.1%, n=430 and workers (22.3%, n=299 were the top two affected professions. Leading two causes were splashing of foreign bodies (SFB (58.6%, n=785 and explosives (31.8%, n=426. More males than females were injured by SFB (59.4% versus 44.3%, P=0.009. Firework injury was the commonest (41.6% versus 3.1%–15.3%, P<0.05 in patients under nine. The annual percentages in patients over 50 increased (P<0.001 and in patients by explosives decreased (P=0.027. Conclusion. Most patients in this study were young males from outside of Beijing and farmers. SFB accounted most for patients over 10 years old and fireworks for those under ten. Patients over 50 increased while those by explosives decreased annually over the period.

Basal Cell Carcinoma in Asians: A Retrospective Analysis of Ten Patients

International Nuclear Information System (INIS)

Moore, M. G.; Bennett, R. G.

2012-01-01

Background. Few studies have been done that characterize basal cell carcinoma (BCC) in Asians because this tumor is relatively uncommon in this population group. Objective. To characterize BCC in Asians. Methods. We retrospectively examined fifteen patient variables and eight tumor variables of ten Asian patients with BCC and compared these results to those of thirty matched Caucasian controls with BCC. Results. Asians developed their first BCC at an older age than the age of first BCC in Caucasian controls (68.9 years versus 58.3 years; ρ< 0 . 0 5 ). During their lifetime, Asians had fewer BCCs than the number of BCCs in Caucasian controls (1.11 versus 5.41;ρ< 0 . 0 2 ), despite a similar estimated lifetime daily sun exposure (hours/day) for both groups. Compared to BCCs in Caucasian controls, a higher percentage of BCCs in Asians were clinically pigmented (50.0% versus 3.3%; ρ< 0 . 0 1 ). Conclusion. Asians develop BCCs later in life and develop fewer BCCs over their lifetime than Caucasians, despite similar estimated lifetime daily sun exposure. This finding is probably due to skin pigmentation in Asians being more protective of ultraviolet light than skin pigmentation in Caucasians.

Evaluation of four methods for separation of lymphocytes from normal individuals and patients with cancer and tuberculosis.

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Patrick, C C; Graber, C D; Loadholt, C B

1976-01-01

An optimal technique was sought for lymphocyte recovery from normal and chronic diseased individuals. Lymphocytes were separated by four techniques: Plasmagel, Ficoll--Hypaque, a commercial semiautomatic method, and simple centrifugation using blood drawn from ten normal individuals, ten cancer patients, and ten tuberculosis patients. The lymphocyte mixture obtained after using each method was analyzed for percent recovery, amount if contamination by erythrocytes and neutrophils, and percent viability. The results show that the semiautomatic method yielded the best percent recovery of lymphocytes for normal individuals, while the simple centrifugation method contributed the highest percent recovery for cancer and tuberculosis patients. The Ficoll-Hypaque method gave the lowest erythrocyte contamination for all three types of individuals tested, while the Plasmagel method gave the lowest neutrophil contamination for all three types of individuals. The simple centrifugation method yielded all viable lymphocytes and thus gave the highest percent viability.

Transcutaneous electric nerve stimulation (TENS) in dentistry- A review.

Science.gov (United States)

Kasat, Vikrant; Gupta, Aditi; Ladda, Ruchi; Kathariya, Mitesh; Saluja, Harish; Farooqui, Anjum-Ara

2014-12-01

Transcutaneous electric nerve stimulation (TENS) is a non-pharmacological method which is widely used by medical and paramedical professionals for the management of acute and chronic pain in a variety of conditions. Similarly, it can be utilized for the management of pain during various dental procedures as well as pain due to various conditions affecting maxillofacial region. This review aims to provide an insight into clinical research evidence available for the analgesic and non analgesic uses of TENS in pediatric as well as adult patients related to the field of dentistry. Also, an attempt is made to briefly discuss history of therapeutic electricity, mechanism of action of TENS, components of TENs equipment, types, techniques of administration, advantages and contradictions of TENS. With this we hope to raise awareness among dental fraternity regarding its dental applications thereby increasing its use in dentistry. Key words:Dentistry, pain, TENS.

Feasibility study of Transcutaneous Electrical Nerve Stimulation (TENS) for cancer bone pain.

Science.gov (United States)

Bennett, Michael I; Johnson, Mark I; Brown, Sarah R; Radford, Helen; Brown, Julia M; Searle, Robert D

2010-04-01

This multicenter study assessed the feasibility of conducting a phase III trial of transcutaneous electrical nerve stimulation (TENS) in patients with cancer bone pain recruited from palliative care services. Eligible patients received active and placebo TENS for 1 hour at site of pain in a randomized crossover design; median interval between applications 3 days. Responses assessed at 30 and 60 minutes included numerical and verbal ratings of pain at rest and on movement, and pain relief. Recruitment, tolerability, adverse events, and effectiveness of blinding were also evaluated. Twenty-four patients were randomised and 19 completed both applications. The intervention was well tolerated. Five patients withdrew: 3 due to deteriorating performance status, and 2 due to increased pain (1 each following active and placebo TENS). Confidence interval estimation around the differences in outcomes between active and placebo TENS suggests that TENS has the potential to decrease pain on movement more than pain on rest. Nine patients did not consider that a placebo was used; the remaining 10 correctly identified placebo TENS. Feasibility studies are important in palliative care prior to undertaking clinical trials. Our findings suggest that further work is required on recruitment strategies and refining the control arm before evaluating TENS in cancer bone pain. Cancer bone pain is common and severe, and partly mediated by hyperexcitability. Animal studies suggest that Transcutaneous Electrical Nerve Stimulation can reduce hyperalgesia. This study examined the feasibility of evaluating TENS in patients with cancer bone pain in order to optimize methods before a phase III trial. Copyright 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.

Valuing companies by cash flow discounting: Ten methods and nine theories

OpenAIRE

Fernández , Pablo

2002-01-01

This paper is a summarized compendium of all the methods and theories on company valuation using cash flow discounting. The paper shows the ten most commonly used methods for valuing companies by cash flow discounting: 1) free cash flow discounted at the WACC; 2) equity cash flows discounted at the required return to equity; 3) capital cash flows discounted at the WACC before tax; 4) APV (Adjusted Present Value); 5) the business's risk-adjusted free cash flows discounted at the required retur...

Extraskeletal mesenchymal chondrosarcoma: an imaging review of ten new patients

Energy Technology Data Exchange (ETDEWEB)

Hashimoto, N.; Joyama, S.; Araki, N. [Osaka Medical Center for Cancer and Cardiovascular Disease, Department of Orthopedic Surgery, Osaka (Japan); Ueda, T.; Yoshikawa, H. [Osaka University Graduate School of Medicine, Department of Orthopedic Surgery, Osaka (Japan); Beppu, Y. [National Cancer Center Hospital, Department of Orthopedic Surgery, Tokyo (Japan); Tatezaki, S. [Chiba Cancer Center Hospital, Department of Orthopedic Surgery, Chiba (Japan); Matsumoto, S. [Cancer Institute Hospital, Japanese Foundation for Cancer Research Hospital, Department of Orthopedic Surgery, Tokyo (Japan); Nakanishi, K. [Osaka Seamen' s Insurance Hospital, Department of Radiology, Osaka (Japan); Tomita, Y. [Osaka University Graduate School of Medicine, Department of Pathology, Osaka (Japan)

2005-12-01

Extraskeletal mesenchymal chondrosarcoma (EMC) is a rare soft-tissue tumor that most arises in young adults. Because of its rarity, few imaging studies have been reported to date. The purpose of this study was to elucidate the imaging features of this tumor. We conducted a multi-institutional study in cooperation with five referral cancer centers in Japan. Imaging findings of ten new EMC cases, including conventional radiography, computed tomography (CT), and magnetic resonance imaging (MRI), performed at each institute, were reviewed along with clinical features. Ten patients with EMC, who had been treated at each hospital from 1990 to 2001, participated in this study. Soft-tissue masses with well-demarcated, dense and granular calcification were most frequently observed on plain radiographs and CT scans. T2-weighted MR images most clearly depicted a two-component structure composed of calcified and uncalcified areas, and enhanced MRI showed inhomogeneous enhancement in both areas. Although the sensitivity and specificity of these findings are unknown, they might be characteristic and have diagnostic value for this rare tumor. (orig.)

Ten years' of experience in patient education of families with a child/adolescent suffering from cystic fibrosis

DEFF Research Database (Denmark)

Bregnballe, Vibeke

2007-01-01

Aims: The patient education programme for families with children or adolescents with cystic fibrosis (the CF school) was established ten years ago to enable patients to make choices in their lives as CF patients. The CF school provides patients with knowledge about cystic fibrosis (CF), teaches...

Equivalence of ten different methods for valuing companies by cash flow discounting.

OpenAIRE

Fernandez, Pablo

2003-01-01

This paper shows that ten methods of company valuation using cash flow discounting (WACC; equity cash flow; capital cash flow; adjusted present value; residual income; EVA; business's risk-adjusted equity cash flow; business's risk-adjusted free cash flow; risk-free-adjusted equity cash flow; and risk-free-adjusted free cash flow) always give the same value when identical assumptions are used. This result is logical, since all the methods analyze the same reality based upon the same assumptio...

"Take ten minutes": a dedicated ten minute medication review reduces polypharmacy in the elderly.

LENUS (Irish Health Repository)

Walsh, E K

2012-02-01

Multiple and inappropriate medications are often the cause for poor health status in the elderly. Medication reviews can improve prescribing. This study aimed to determine if a ten minute medication review by a general practitioner could reduce polypharmacy and inappropriate prescribing in elderly patients. A prospective, randomised study was conducted. Patients over the age of 65 (n = 50) underwent a 10-minute medication review. Inappropriate medications, dosage errors, and discrepancies between prescribed versus actual medication being consumed were recorded. A questionnaire to assess satisfaction was completed following review. The mean number of medications taken by patients was reduced (p < 0.001). A medication was stopped in 35 (70%) patients. Inappropriate medications were detected in 27 (54%) patients and reduced (p < 0.001). Dose errors were detected in 16 (32%). A high level of patient satisfaction was reported. A ten minute medication review reduces polypharmacy, improves prescribing and is associated with high levels of patient satisfaction.

"Take ten minutes": a dedicated ten minute medication review reduces polypharmacy in the elderly.

LENUS (Irish Health Repository)

Walsh, E K

2010-09-01

Multiple and inappropriate medications are often the cause for poor health status in the elderly. Medication reviews can improve prescribing. This study aimed to determine if a ten minute medication review by a general practitioner could reduce polypharmacy and inappropriate prescribing in elderly patients. A prospective, randomised study was conducted. Patients over the age of 65 (n = 50) underwent a 10-minute medication review. Inappropriate medications, dosage errors, and discrepancies between prescribed versus actual medication being consumed were recorded. A questionnaire to assess satisfaction was completed following review. The mean number of medications taken by patients was reduced (p < 0.001). A medication was stopped in 35 (70%) patients. Inappropriate medications were detected in 27 (54%) patients and reduced (p < 0.001). Dose errors were detected in 16 (32%). A high level of patient satisfaction was reported. A ten minute medication review reduces polypharmacy, improves prescribing and is associated with high levels of patient satisfaction.

Efficacy of the use of two simultaneously TENS devices for fibromyalgia pain.

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Lauretti, Gabriela Rocha; Chubaci, Eliana Fazuoli; Mattos, Anita Leocadia

2013-08-01

Fibromyalgia is characterized by a range of symptoms that include muscle pain, fatigue and sleep disorders. Transcutaneous electrical nerve stimulation (TENS) is an established method for pain relief. The purpose of the study was to evaluate the effectiveness and safety of the use of two simultaneously new TENS devices for fibromyalgia pain. After Ethics approval and informed consent, 39 patients were prospectively divided into three groups to evaluate TENS device, applied simultaneously in each patient: (1) at the lower back (perpendicular to the vertebrae canal, at the level of the 5th lumbar vertebrae) and (2) centrally above and below the space between the C7 and T1 spinous processes. The devices were applied for 20 min at 12-h interval during 7 consecutive days. For the placebo group (PG), the devices did not transmitted electrical stimulus. The single-TENS group (STG) (n = 13) had one active and one placebo TENS. The DTG applied both active TENS devices at the low back and cervical areas. Diclofenac was used as rescue analgesic. The efficacy measures were pain relief, reduction in use of daily analgesic tablets, quality of sleep and fatigue. The evaluation within groups revealed that patients from DPG refereed no pain relief when compared to their previous VAS pain score (8 cm, p > 0.05), while patients from the STG refereed improvement of 2.5 cm in the pain VAS (previous 8.5 cm compared to 6 cm after treatment) (p pain (previous 8.5-4.3 cm) (p STG > PG (p TENS improved pain relief in fibromyalgia pain, pain and fatigue were further improved when two active devices were simultaneously applied at the low back and cervical area, with no side effects.

Point and interval forecasts of mortality rates and life expectancy: A comparison of ten principal component methods

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Han Lin Shang

2011-07-01

Full Text Available Using the age- and sex-specific data of 14 developed countries, we compare the point and interval forecast accuracy and bias of ten principal component methods for forecasting mortality rates and life expectancy. The ten methods are variants and extensions of the Lee-Carter method. Based on one-step forecast errors, the weighted Hyndman-Ullah method provides the most accurate point forecasts of mortality rates and the Lee-Miller method is the least biased. For the accuracy and bias of life expectancy, the weighted Hyndman-Ullah method performs the best for female mortality and the Lee-Miller method for male mortality. While all methods underestimate variability in mortality rates, the more complex Hyndman-Ullah methods are more accurate than the simpler methods. The weighted Hyndman-Ullah method provides the most accurate interval forecasts for mortality rates, while the robust Hyndman-Ullah method provides the best interval forecast accuracy for life expectancy.

Stevens Johnson syndrome, toxic epidermal necrolysis and SJS-TEN overlap: A retrospective study of causative drugs and clinical outcome

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Sharma Vinod

2008-01-01

Full Text Available Background and Aims: Stevens Johnson syndrome (SJS, toxic epidermal necrolysis (TEN and SJS-TEN overlap are serious adverse cutaneous drug reactions. Drugs are often implicated in these reactions. Methods: A retrospective analysis of inpatients′ data with these dermatological diagnoses were carried out for three years, to study the causative drugs, clinical outcome, and mortality in these conditions. Results: Thirty patients (15 TEN, nine SJS-TEN overlap, and six SJS were admitted. In 21 cases, multiple drugs were implicated whereas single drugs were responsible in nine. Anticonvulsants (35.08% were the most commonly implicated drugs followed by antibiotics (33.33% and NSAIDS (24.56%. Twenty-five patients recovered whereas five died (four TEN, one SJS-TEN overlap. Conclusion: Anticonvulsants, antibiotics and NSAIDs were the most frequently implicated drugs. TEN causes higher mortality than both SJS and SJS-TEN overlap.

Ten year experience with antiretroviral treatment in Cambodia: Trends in patient characteristics and treatment outcomes.

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Phirum Lay

Full Text Available Although HIV disease stage at ART initiation critically determines ART outcomes, few reports have longitudinally monitored this within Asia. Using prospectively collected data from a large ART program at Sihanouk Hospital Center of Hope in Cambodia, we report on the change in patient characteristics and outcomes over a ten-year period.We conducted a retrospective analysis including all adults (≥ 18 years old starting ART from March 2003-March 2013 in a non-governmental hospital in Phnom Penh, Cambodia. The cumulative incidence of death, lost to follow-up (LTFU, attrition (death or LTFU and first line treatment failure were calculated using Kaplan-Meier methods. Independent risk factors for these outcomes were determined using Cox regression modeling.Over the ten-year period, 3581 patients initiated ART with a median follow-up time of 4.8 years (IQR 2.8-7.2. The median age was 35 years (IQR 30-41, 54% were female. The median CD4 count at ART initiation increased from 22 cells/μL (IQR 4-129 in 2003 to 218 (IQR 57-302 in 2013. Over the 10 year period, a total of 282 (7.9% individuals died and 433 (12.1% were defined LTFU. Program attrition (died or LTFU was 11.1% (95% CI: 10.1%- 12.4% at one year, 16.3% (95% CI: 15.1%-17.6% at three years, 19.8% (95% CI: 18.5%-21.2% at five years and 23.3% (95% CI: 21.6-25.1 at ten years. Male sex and low baseline body mass index (BMI were associated with increased attrition. Factors independently associated with mortality included a low baseline CD4 count, older age, male sex, low baseline BMI and hepatitis B co-infection. Individuals aged above 40 years old had an increased risk of mortality but were less likely to LTFU. There were a total of 137 individuals with first line ART failure starting second line treatment. The probability of first line failure was estimated at 2.8% (95% CI: 2.3%-3.4% at 3 years, 4.6% (95% CI: 3.9%-5.5% at 5 years and 7.8% (95% CI 4.8%-12.5% at ten years of ART. The probability was

Ten Lessons from Ten Years PPP Experience in Belgium

NARCIS (Netherlands)

Willems, T.; Verhoest, K.; Voets, J.; Coppens, T.; van Dooren, W.; van den Hurk, M.

2017-01-01

In 2004 Flanders, the northern region of Belgium launched a range of large public–private partnership (PPP) projects for a total value of 6 billion euros. Ten years later, PPP has become a well-embedded procurement method for long-term public infrastructure projects. This article makes a critical

Different mechanisms for the short-term effects of real versus sham transcutaneous electrical nerve stimulation (TENS) in patients with chronic pain: a pilot study.

Science.gov (United States)

Oosterhof, Jan; Wilder-Smith, Oliver H; Oostendorp, Rob A; Crul, Ben J

2012-01-01

Transcutaneous electrical nerve stimulation (TENS) has existed since the early 1970s. However, randomized placebo controlled studies show inconclusive results in the treatment of chronic pain. These results could be explained by assuming that TENS elicits a placebo response. However, in animal research TENS has been found to decrease hyperalgesia, which contradicts this assumption. The aim of this study is to use quantitative sensory testing to explore changes in pain processing during sham versus real TENS in patients with chronic pain. Patients with chronic pain (N = 20) were randomly allocated to real TENS or sham TENS application. Electrical pain thresholds (EPTs) were determined inside and outside the segment stimulated, before and after the first 20 minutes of the intervention, and after a period of 10 days of daily real/sham TENS application. Pain relief did not differ significantly for real versus sham TENS. However, by comparing time courses of EPTs, it was found that EPT values outside the segment of stimulation increased for sham TENS, whereas for real TENS these values decreased. There were, however, no differences for EPT measurements inside the segment stimulated. These results illustrate the importance of including mechanism-reflecting parameters in addition to symptoms when conducting pain research.

Ten years of experience with transgastric necrosectomy for walled-off necrosis in acute pancreatitis

DEFF Research Database (Denmark)

Busse, Malene Just; Ainsworth, Alan Patrick

2015-01-01

: Acute pancreatitis with walled-off necrosis has a high mortality rate. Need for additional therapy following necrosectomy was associated with fatal outcome. Endocrine and exocrine insufficiency was often seen at follow-up. FUNDING: none. TRIAL REGISTRATION: The study was approved by the Danish Data....... Ten patients (20%) died during their admission to our department. In total, 18 (45%) patients developed late complications defined as endocrine and/or exocrine malfunction of the pancreas (diabetes (n = 10), exocrine insufficiency (n = 4), both diabetes and exocrine insufficiency (n = 4)). CONCLUSION......INTRODUCTION: The aim of this study was to report our results with open transgastric necrosectomy for walled-off necrosis in acute pancreatitis over a period of ten years. METHODS: Patients operated at the department from 2003 until 2012 were studied retrospectively. RESULTS: A total of 50 patients...

Preemptive Analgesic Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on Postoperative Pain: A Randomized, Double-Blind, Placebo-Controlled Trial.

Science.gov (United States)

Eidy, Mohammad; Fazel, Mohammad Reza; Janzamini, Monir; Haji Rezaei, Mostafa; Moravveji, Ali Reza

2016-04-01

Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological analgesic method used to control different types of pain. The aim of this study was to evaluate the effects of preoperative TENS on post inguinal hernia repair pain. This randomized, double-blind, placebo-controlled clinical trial was performed on 66 male patients with unilateral inguinal hernias who were admitted to the Shahid Beheshti hospital in Kashan, Iran, from April to October 2014. Participants were selected using a convenience sampling method and were assigned to intervention (n = 33) and control (n = 33) groups using permuted-block randomization. Patients in the intervention group were treated with TENS 1 hour before surgery, while the placebo was administered to patients in the control group. All of the patients underwent inguinal hernia repair by the Lichtenstein method, and pain intensity was evaluated at 2, 4, 6, and 12 hours after surgery using a visual analogue scale. Additionally, the amounts of analgesic administered by pump were calculated and compared between the two groups. The mean estimated postoperative pain intensity was 6.21 ± 1.63 in the intervention group and 5.45 ± 1.82 in the control group (P = 0.08). In the intervention group pain intensity at 2 and 4 hours after surgery were 3.54 ± 1.48 and 5.12 ± 1.41 (P TENS can reduce postoperative pain in the early hours after inguinal hernia repair surgery.

Commonly used severity scores are not good predictors of mortality in sepsis from severe leptospirosis: a series of ten patients.

Science.gov (United States)

Velissaris, Dimitrios; Karanikolas, Menelaos; Flaris, Nikolaos; Fligou, Fotini; Marangos, Markos; Filos, Kriton S

2012-01-01

Introduction. Severe leptospirosis, also known as Weil's disease, can cause multiorgan failure with high mortality. Scoring systems for disease severity have not been validated for leptospirosis, and there is no documented method to predict mortality. Methods. This is a case series on 10 patients admitted to ICU for multiorgan failure from severe leptospirosis. Data were collected retrospectively, with approval from the Institution Ethics Committee. Results. Ten patients with severe leptospirosis were admitted in the Patras University Hospital ICU in a four-year period. Although, based on SOFA scores, predicted mortality was over 80%, seven of 10 patients survived and were discharged from the hospital in good condition. There was no association between SAPS II or SOFA scores and mortality, but survivors had significantly lower APACHE II scores compared to nonsurvivors. Conclusion. Commonly used severity scores do not seem to be useful in predicting mortality in severe leptospirosis. Early ICU admission and resuscitation based on a goal-directed therapy protocol are recommended and may reduce mortality. However, this study is limited by retrospective data collection and small sample size. Data from large prospective studies are needed to validate our findings.

Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia.

Science.gov (United States)

Ferreira, Fabiana Cristina; Issy, Adriana Machado; Sakata, Rioko Kimiko

2011-01-01

Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat musculoskeletal pain, but it may also be indicated for postoperative analgesia. The objective of this study was to evaluate the analgesic effects of TENS on post-thoracotomy. Thirty patients between 18 and 60 years of age undergoing thoracotomy for lung cancer resection on the second postoperative day were included in this study. Patients were divided into two groups (G1 and G2). G1 patients were treated with TENS; and in G2 (without TENS) electrodes were placed but the equipment was not turned on. TENS was maintained for one hour. The visual analogue scale was used to evaluate the analgesic effects on three moments: before TENS (M0), immediately after TENS (M1), and one hour later (M2), with the patient at rest, elevation of the upper limbs, change in decubitus, and coughing. The intensity of pain at rest was higher in G2 immediately after TENS, but not one hour after the procedure. There was no difference between both groups with elevation of the upper limbs, decubitus change, and coughing. With the use of TENS for one hour on the second post-thoracotomy day in patients who received fentanyl (50 μg) associated with bupivacaine (5 mL), a reduction in pain intensity was observed at rest immediately after TENS; with elevation of the upper limbs, change in decubitus, and coughing, a reduction in pain severity was not observed. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

Transcutaneous electrical nerve stimulation (TENS) for chronic low-back pain.

Science.gov (United States)

Khadilkar, A; Milne, S; Brosseau, L; Robinson, V; Saginur, M; Shea, B; Tugwell, P; Wells, G

2005-07-20

Chronic low-back pain (LBP) affects a significant proportion of the population. Transcutaneous electrical nerve stimulation (TENS) was introduced more than 30 years ago as an adjunct to the pharmacological management of pain. However, despite its widespread use, the usefulness of TENS in chronic LBP is still controversial. The aim of this systematic review was to determine the effectiveness of TENS in the management of chronic LBP. We searched the Cochrane Central Register of Controlled Trials (Issue 2, 2005), MEDLINE, EMBASE and PEDro up to April 1, 2005. Only randomized controlled clinical trials (RCTs) evaluating the effect of TENS on chronic LBP were included. Abstracts were excluded unless further data could be obtained from the authors. Two reviewers independently selected trials and extracted data using predetermined forms. Heterogeneity was tested with Cochrane's Q test. A fixed effect model was used throughout for calculating continuous variables, except where heterogeneity existed, in which case, a random effects model was used. Results are presented as weighted mean differences (WMD) with 95% confidence intervals (95% CI), where the difference between the treated and control groups was weighted by the inverse of the variance. Standardized mean differences (SMD) were calculated by dividing the difference between the treated and control by the baseline variance. SMD were used when different scales were used to measure the same concept. Dichotomous outcomes were analyzed with odds ratios. The only two RCTs (175 patients) meeting eligibility criteria differed in study design, methodological quality, inclusion and exclusion criteria, type and method of TENS application, treatment schedule, co-interventions and final outcomes. In one RCT, TENS produced significantly greater pain relief than the placebo control. However, in the other RCT, no statistically significant differences between treatment and control groups were shown for multiple outcome measures. Pre

The use of transcutaneous electrical nerve stimulation (TENS) in a major cancer center for the treatment of severe cancer-related pain and associated disability.

Science.gov (United States)

Loh, Jeffrey; Gulati, Amitabh

2015-06-01

Cancer pain is difficult to treat, often requiring a multimodal approach. While medication management remains the mainstay for the treatment of cancer pain, medications are often associated with undesired side effects. Transcutaneous electrical nerve stimulation (TENS) provides a potential adjunctive method for treating cancer pain with minimal side effects. Few studies have been performed evaluating the efficacy of TENS on cancer pain. We sought to examine the usefulness of TENS on all cancer patients and to specifically look at the use of TENS as a goal-directed therapy to improve functionality. Retrospective cohort study. Since 2008, patients with chronic cancer pain and on multimodal pain regimens were trialed with TENS. Those patients who showed an improvement in pain symptoms or severity were educated about and provided with a TENS unit for use at home. Pain symptoms and scores were monitored with the visual analog scale (VAS), the numerical rating pain (NRP) scale, and Short-Form McGill Questionnaire at the start of TENS treatment and at 2 months follow-up. TENS proved beneficial in 69.7% of patients over the course of 2 months. In TENS responsive patients, VAS scores decreased by 9.8 on a 0-100 mm scale (P TENS provides a beneficial adjunct for the treatment of cancer pain, especially when utilized as a goal-directed therapy. Wiley Periodicals, Inc.

"How much will I get charged for this?" Patient charges for top ten diagnoses in the emergency department.

Directory of Open Access Journals (Sweden)

Nolan Caldwell

Full Text Available We examined the charges, their variability, and respective payer group for diagnosis and treatment of the ten most common outpatient conditions presenting to the Emergency department (ED.We conducted a cross-sectional study of the 2006-2008 Medical Expenditure Panel Survey. Analysis was limited to outpatient visits with non-elderly, adult (years 18-64 patients with a single discharge diagnosis.We studied 8,303 ED encounters, representing 76.6 million visits. Median charges ranged from $740 (95% CI $651-$817 for an upper respiratory infection to $3437 (95% CI $2917-$3877 for a kidney stone. The median charge for all ten outpatient conditions in the ED was $1233 (95% CI $1199- $1268, with a high degree of charge variability. All diagnoses had an interquartile range (IQR greater than $800 with 60% of IQRs greater than $1550.Emergency department charges for common conditions are expensive with high charge variability. Greater acute care charge transparency will at least allow patients and providers to be aware of the emergency department charges patients may face in the current health care system.

Radiation therapy of penile cancer: six to ten-year follow-up

International Nuclear Information System (INIS)

Grabstald, H.; Kelley, C.D.

1980-01-01

Ten patients with penile cancer were treated with radiation therapy between 1968 and 1973. Nine of ten remain free of disease though in 1 patient a new penile primary developed eight years after the radiation therapy and was treated by partial penectomy. One patient died following surgery for ''bleeding ulcer.'' He was free of penile cancer five years after radiation. The most common complication is urethral stricture and skin telangiectasia

COMPARATIVE STUDY BETWEEN TITANIUM ELASTIC NAILING (TENS AND DYNAMIC COMPRESSION PLATING (DCP IN THE TREATMENT OF FEMORAL DIAPHYSEAL FRACTURES IN CHILDREN

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Ramasubba Reddy

2015-08-01

Full Text Available BACKGROUND : Orthopaedic surgeons have long maintained that all children who have sustained a diaphyseal fracture of femur recover with c onservative treatment, given the excellent remodeling ability of immature bone in children. Angulations, shortenings and malrotations are not always corrected by conservative treatment. Of many surgical options, titanium elastic nailing has been the newer implant which is being used regularly. Although good results have been reported with elastic intramedullary nails, plate fixation continues to be a viable alternative in surgical treatment of femoral shaft fractures. However there are not many studies comp aring the efficiency of titanium elastic nailing and plating for femoral diaphyseal fractures in pediatric age group. AIM : The present study aims to compare the surgical management of diaphyseal fractures of femur in children with Dynamic Compression Plati ng versus Titanium Elastic Nailing. DESIGN : This is a prospective study . MATERIALS AND METHODS : This prospective study was conducted in a tertiary hospital. Patients who presented to the out - patient department and casualty of the hospital with femoral diap hyseal fractures during April 2012 to June 2014 were considered for the study. Subjects fulfilling the predetermined inclusion and exclusion criteria were included in the study. STATISTICAL METHODS : Fisher Exact test, Chi - Square Test, Student t test (Two t ailed, independent . RESULTS : Patients in the age group of 6 - 14 years were considered for the study, Patients were divided into two groups and treated with DCP/TENS. The duration of surgery, hospital stay, and, amount of blood loss was minimal in TENS grou p. Callus was seen early in TENS group. Radiological union was early in TENS group by 2 - 3 weeks. Outcome was better in patients treated with TENS (Excellent - 70%; Satisfactory – 30%; Poor - 0% in comparison to DCP (Excellent - 70%; Satisfactory - 25%; Poor - 5%. CO NCLUSION : TENS

Transcutaneous electrical nerve stimulation (TENS) for pain control after vaginal delivery and cesarean section.

Science.gov (United States)

Kayman-Kose, Seda; Arioz, Dagistan Tolga; Toktas, Hasan; Koken, Gulengul; Kanat-Pektas, Mine; Kose, Mesut; Yilmazer, Mehmet

2014-10-01

The present study aims to determine the efficiency and reliability of transcutaneous electrical nerve stimulation (TENS) in the management of pain related with uterine contractions after vaginal delivery and the pain related with both abdominal incision uterine contractions after cesarean section. A hundred healthy women who underwent cesarean section under general anesthesia were randomly assigned to the placebo group (Group 1) or the TENS group (Group 2), while 100 women who delivered by vaginal route without episiotomy were randomized into the placebo group (Group 3) or the TENS group (Group 4). The patients in Group 2 had statistically lower visual analog scale (VAS) and verbal numerical scale (VNS) scores than the patients in Group 1 (p TENS (p = 0.006). The need for analgesics at the eighth hour of vaginal delivery was statistically similar in the patients who were treated with TENS and the patients who received placebo (p = 0.830). TENS is an effective, reliable, practical and easily available modality of treatment for postpartum pain.

How did General Surgery Department of a Training Hospital Change in Ten Years?

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Zafer Ergül

2012-07-01

Full Text Available  Aim: To investigate the changes in a training hospital’s surgical patient profile in ten years. To delineate the effects of the transfer of Social Security Institution Hospitals to the Ministry of Health on this process. Material and Method: Ten-year apart, two-year periods were selected and all elective and emergency cases were retrospectively searched. In between periods, the hospital was transferred from Social Security Institution Hospital to the Ministry of Health and then became a trauma center. The indications, techniques, the number of performed surgeries, and the patient related factors were compared. The ratio of the number emergency cases and the number of cases performed by residents in training to the total number of cases were investigated. Results: The number of elective and emergent operations during the former and the latter periods were 2668 and 2041, respectively. The percentage of the decrease was 23.5%. After ten years, the patients were younger, more commonly male, emergency cases were more common, and operations performed primarily by the residents in training were less frequent than the former period (p<0,05. Oncological surgery of stomach, colon-rectum, breast, thyroid and primary-metastatic-malign carcinoma were more frequent during former period whereas urgent operations except peptic ulcer perforation and upper gastrointestinal bleeding and benign anorectal diseases were more common during later period (p<0,05. Discussion: The comparison revealed a significant decrease in the number of operations in ten years. The number of oncological patients increased whereas the number of emergency cases declined. The changes were thought to be related more to the transition in health and becoming a trauma center than to major developments in the country and the world.

Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.

Science.gov (United States)

Hurlow, Adam; Bennett, Michael I; Robb, Karen A; Johnson, Mark I; Simpson, Karen H; Oxberry, Stephen G

2012-03-14

cancer population. The initial review identified two RCTs (64 participants) therefore this review now includes a total of three RCTs (88 participants). These studies were heterogenous with respect to study population, sample size, study design, methodological quality, mode of TENS, treatment duration, method of administration and outcome measures used. In one RCT, there were no significant differences between TENS and placebo in women with chronic pain secondary to breast cancer treatment. In the other RCT, there were no significant differences between acupuncture-type TENS and sham in palliative care patients; this study was underpowered. Despite the one additional RCT, the results of this updated systematic review remain inconclusive due to a lack of suitable RCTs. Large multi-centre RCTs are required to assess the value of TENS in the management of cancer-related pain in adults.

The application of the 'ten-day rule' in radiopharmaceutical investigations

International Nuclear Information System (INIS)

Ellis, R.E.; Nordin, B.E.C.; Tothill, P.; Veall, N.

1977-01-01

The working party first classified subjects who are investigated using radiopharmaceuticals into three groups, being (a) patients and other subjects who are asked to volunteer as controls for research studies, (b) patients on whom research investigations are being conducted which are relevant to their clinical condition but which are not strictly necessary for their management, and (c) patients on whom investigations are required for their proper management. The application of the 'ten-day rule' in relation to the use of radiopharmaceuticals is complicated by the fact that the total radiation dose is received over a time given by the effective life of the radiopharmaceutical in the organ, which may be a substantial part or even longer of the menstrual cycle. The activities of the radiopharmaceuticals normally administered are tabulted together with their effective half-lives and resulting gonad doses, and those radiopharmaceuticals requiring consideration of the implementation of the 'ten-day rule' for patients in groups (b) and (c) are identified. When the administration of therapeutic quantities of radiopharmaceuticals is being contemplated it is particularly important to take into account the applicability or otherwise of the 'ten-day rule'. It is recommended that the 'ten-day rule' should be strictly applied to all radiopharmaceutical administrations to women of child-bearing age who are volunteers for research purposes (group(a)). (U.K.)

A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain.

Science.gov (United States)

Deyo, R A; Walsh, N E; Martin, D C; Schoenfeld, L S; Ramamurthy, S

1990-06-07

A number of treatments are widely prescribed for chronic back pain, but few have been rigorously evaluated. We examined the effectiveness of transcutaneous electrical nerve stimulation (TENS), a program of stretching exercises, or a combination of both for low back pain. Patients with chronic low back pain (median duration, 4.1 years) were randomly assigned to receive daily treatment with TENS (n = 36), sham TENS (n = 36), TENS plus a program of exercises (n = 37), or sham TENS plus exercises (n = 36). After one month no clinically or statistically significant treatment effect of TENS was found on any of 11 indicators of outcome measuring pain, function, and back flexion; there was no interactive effect of TENS with exercise. Overall improvement in pain indicators was 47 percent with TENS and 42 percent with sham TENS (P not significant). The 95 percent confidence intervals for group differences excluded a major clinical benefit of TENS for most outcomes. By contrast, after one month patients in the exercise groups had significant improvement in self-rated pain scores, reduction in the frequency of pain, and greater levels of activity as compared with patients in the groups that did not exercise. The mean reported improvement in pain scores was 52 percent in the exercise groups and 37 percent in the nonexercise groups (P = 0.02). Two months after the active intervention, however, most patients had discontinued the exercises, and the initial improvements were gone. We conclude that for patients with chronic low back pain, treatment with TENS is no more effective than treatment with a placebo, and TENS adds no apparent benefit to that of exercise alone.

Complete ten-year follow-up after endovascular abdominal aortic aneurysm repair: Survival and causes of death

International Nuclear Information System (INIS)

Wibmer, Andreas; Nolz, Richard; Teufelsbauer, Harald; Kretschmer, Georg; Prusa, Alexander M.; Funovics, Martin; Lammer, Johannes; Schoder, Maria

2012-01-01

Purpose: To analyze the hazard and causes of death after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms during a complete ten year follow-up. Methods: This is a retrospective clinical study of 130 consecutive patients undergoing EVAR between 1995 and 1998. One-hundred twenty-one patients (93.1%) were treated with first-generation stentgrafts and nine patients (6.9%) received second-generation devices. All patients completed a follow-up of at least 10 years, unless death occurred before then. Time and causes of death were provided by the Austrian central register of deaths. Results: The median follow-up was 7.6 years, and the 130 patients had 968.5 person-years of follow-up. The ten-year mortality rate was 62.3%. Cardiovascular events were the most frequent causes of death, with a 3.9 incidence rate per 100 person-years. Cancer death and death due to other causes occurred in 2.1 and 1.8 cases per 100 person-years, respectively. Lethal late aneurysm rupture happened in 4.6% (n = 6), which corresponds to an annual incidence rate of 0.6 per 100 person-years. All of those patients had been treated with first-generation devices. Conclusions: Cardiovascular events were the most frequent cause of death after EVAR, followed by malignancy and other diseases. The risk of dying from secondary rupture was clearly lower than that of death due to other reasons during ten years after EVAR, even in patients with first-generation stentgrafts.

Reverse shoulder arthroplasty in young patient with achondroplasia - Ten year follow up: Case report.

Science.gov (United States)

van den Broek, M; Verborgt, O; Declercq, G

2017-11-01

Skeletal dysplasia in achondroplasia can affect all body joints - including the glenohumeral joint - and is prone to develop to degenerative osteoarthritis (OA). This may cause pain and mobility problems at young age. Surgical treatment is challenging due to the dysplastic anatomy of the shoulder joint - with a dysplastic deformed short humerus, a small, hypoplastic medialized glenoid and lateralized acromion - and the long life expectancy of these patients. The indications for reverse shoulder arthroplasty (RSA) evolved during years with rotator cuff tears and rotator cuff arthropathy in combination with or without glenohumeral OA as the main indicator, with good short to mid-term results. Long term results of RSA are rarely found in literature, especially in young patients. The use of a RSA in glenohumeral OA with an intact rotator cuff has rarely been reported. In this case report we present the ten-year clinical and radiographic results of a RSA for the treatment of degenerative OA with glenohumeral dysplasia in a young patient with achondroplasia. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

[Why is cytology a profession (branch), not a method? Ten rules for success of the cytology profession].

Science.gov (United States)

Kardum-Skelin, Ika

2011-09-01

Clinical cytology is an interdisciplinary medical diagnostic profession that integrates clinical, laboratory and analytical fields along with final cytologist's expert opinion. Cytology involves nonaggressive, minimally invasive and simple for use procedures that are fully acceptable for the patient. Cytology offers rapid orientation, while in combination with additional technologies on cytologic smear analysis (cytochemistry, immunocytochemistry for cell marker analysis, computer image analysis) or sophisticated methods on cytologic samples (flow cytometry, molecular and cytogenetic analysis) it plays a major role in the diagnosis, subtyping and prognosis of malignant tumors. Ten rules for successful performance in cytology are as follows: 1) due knowledge of overall cytology (general cytologist); 2) inclusion in all stages of cytologic sample manipulation from sampling through reporting; 3) due knowledge of additional technologies to provide appropriate interpretation and/or rational advice in dubious cases; 4) to preserve dignity of the profession because every profession has its advantages, shortcomings and limitations; 5) to insist on quality control of the performance, individual cytologists and cytology team; 6) knowledge transfer to young professionals; 7) assisting fellow professionals in dubious cases irrespective of the time needed and fee because it implies helping the patient and the profession itself; 8) experience exchange with other related professionals to upgrade mutual understanding; 9) to prefer the interest of the profession over one's own interest; and 10) to love cytology.

Effect of conventional TENS on pain and electromyographic activity of masticatory muscles in TMD patients Efeito da TENS convencional sobre a dor e a atividade eletromiográfica dos músculos mastigatórios em pacientes com DTM

Directory of Open Access Journals (Sweden)

Delaine Rodrigues

2004-12-01

Full Text Available Temporomandibular disorders (TMD are characterized by several signs and symptoms, such as pain and changes in the electrical activity of masticatory muscles. Considering that transcutaneous electrical nerve stimulation (TENS is a resource indicated to promote analgesia, the objective of this study was to evaluate the effect of TENS on pain and electromyographic (EMG activity of the jaw elevator muscles in TMD patients. This study evaluated 35 female volunteers: 19 TMD patients (mean age = 23.04 ± 3.5 and 16 normal subjects (mean age = 23.3 ± 3.0. Transcutaneous electrical nerve stimulation (conventional mode, 150 Hz was applied once to each group for 45 minutes. Surface electromyography (gain of 100 times and 1 kHz sampling frequency and the visual analogue scale (VAS were applied before and immediately after TENS application. Both VAS data and root mean square (RMS values were analyzed using Student's t-test. The TMD group, compared to the control group, showed higher EMG activity of the jaw elevator muscles at rest. No difference was observed between the groups regarding maximum voluntary clenching (MVC. In TMD patients, TENS reduced both pain and EMG activity of the anterior portion of the temporal muscle, increasing the activity of the masseter muscles during MVC. It is possible to conclude that a single TENS application is effective in pain reduction. However, it does not act homogeneously on the features of the electric activity of the muscles evaluated.A desordem temporomandibular (DTM é caracterizada por diversos sinais e sintomas, como dor e alteração do sinal eletromiográfico dos músculos da mastigação. Considerando que a estimulação elétrica nervosa transcutânea (TENS é um recurso indicado para promover analgesia, o objetivo deste trabalho foi avaliar o efeito da TENS na dor e na atividade eletromiográfica (EMG dos músculos elevadores da mandíbula em indivíduos com DTM. Foram selecionados 35 voluntários do sexo

[Analysis of quality of life in patiens with low back pain after receiving transcutaneous electrical nerve stimulation (TENS)].

Science.gov (United States)

Zaniewska, Renata; Okurowska-Zawada, Bozena; Kułak, Wojciech; Domian, Karolina

2012-01-01

Low back pain (LBP) is one of the most common disorders affecting office employees working with a computer, which inevitably leads to lower quality of life. The aim of this study was to analyze the quality of life of patients with LBP after application of TENS (Transcutaneous Electrical Nervous Stimulation). The study group included 30 computer workers (26 females and 4 males) aged 30-60 years (45 +/- 12). The quality of life was assessed using the World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-Bref) before and after 10 applications of TENS. Outcomes were evaluated with a visual analog score (VAS) for pain and Schober's test to measure the ability of a patient to flex his or her lower back. The mean VAS value decreased significantly from 3.83 +/- 1.31 cm at baseline to 3.36 +/- 1.21 cm after treatment. Patients reported pain relief. The highest quality of life scores in terms of social relationships were found in the social category evaluating personal relationships, social support and sexual activity (15.91 +/- 2.07) and mental health (14.32 +/- 1.59). After treatment a significant increase in the flexion of lower back was observed in the majority of patients. No significant correlations between the quality of life and the intensity of pain and the flexion of lower back before and after treatment were found. TENS therapy is an effective technique for pain relief in patients with LBP. TENS can also be used with other methods of LBP treatment and may improve the patients' quality of life.

Ten-year study of postoperative complications following dental extractions in patients with inherited bleeding disorders.

Science.gov (United States)

Hsieh, J-T; Klein, K; Batstone, M

2017-09-01

Dental extractions challenge the body's haemostatic mechanism. Postoperative bleeding from dental extraction can be prolonged, or even life threatening in patients with inherited bleeding disorders. Pre- and postoperative clotting factor replacements or systemic desmopressin (ddAVP) have been advocated at our institution to prevent bleeding complications in these patients. This study aimed to assess the postoperative bleeding rate in patients with inherited bleeding disorders that underwent dental extractions at our institution between 2003 and 2012. Patients with inherited bleeding disorders such as haemophilia A, haemophilia B, and von Willebrand's disease were included. Retrospective chart review was conducted. The result showed 53 extraction events occurred in 45 patients over the 10-year period. Ten out of 53 extraction events (18.9%) had postoperative bleeding requiring further factor replacement or ddAVP. Postoperative bleeding in one patient with mild haemophilia A was complicated by the development of inhibitors. Type and severity of bleeding disorder, bone removal, and use of a local haemostatic agent did not have any significant effect on postoperative bleeding. Despite the use of perioperative factors and desmopressin, the postoperative bleeding rates remain high for patients with inherited bleeding disorders. More studies are required to assess the safety and effectiveness of using local haemostatic control to achieve haemostasis following extractions. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Eight to ten years follow-up after carotid endarterectomy

DEFF Research Database (Denmark)

Knudsen Rathenborg, Lisbet; Sillesen, H; Schroeder, T

1990-01-01

Follow-up information was obtained on 185 patients who consecutively underwent carotid endarterectomy eight to ten years previously. Doppler ultrasound examination was performed in 59 patients who were still alive and living within 100 miles of the hospital. Using lifetable analysis, the annual r...

Medical follow up of ten patients victims of the radiological accident occurred in Goiania, Goias State, Brazil 1988/1992

International Nuclear Information System (INIS)

Curado, M.P.; Morais, M.S.A.; Silva, J.F.; Assis, P.R.; Oliveira, A.R.; Santos, E.A.

1992-01-01

The author makes an update of the medical aspects of ten victims of the radiological accident occurred in Goiania in September 1987. These patients received specialized treatment during the critical phase at Marcilio Dias Naval Hospital in Rio de Janeiro. Actually these patients are under medical follow-up at Leide das Neves Ferreira Foundation since march 1988. The clinical, haematological and laboratorial results are presented and discussed. The importance of a close medical follow-up direct victims of a radiological accident is stressed. (author)

Transcutaneous electrical nerve stimulation (TENS) for pain management in labour

Science.gov (United States)

Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

2014-01-01

Background Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. TENS machines are frequently operated by women, which may increase a sense of control in labour. Objectives To assess the effects of TENS on pain in labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 April 2011) and reference lists of retrieved papers. Selection criteria Randomised controlled trials comparing women receiving TENS for pain management in labour versus routine care, alternative non-pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Data collection and analysis Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. Main results Seventeen trials with 1466 women contribute data to the review. Thirteen examined TENS applied to the back, two to acupuncture points, and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (average risk ratio 0.41, 95% confidence interval 0.31 to 0.54; measured in two studies). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No

Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain.

Science.gov (United States)

Khadilkar, Amole; Odebiyi, Daniel Oluwafemi; Brosseau, Lucie; Wells, George A

2008-10-08

Transcutaneous electrical nerve stimulation (TENS) was introduced more than 30 years ago as a therapeutic adjunct to the pharmacological management of pain. However, despite widespread use, its effectiveness in chronic low-back pain (LBP) is still controversial. To determine whether TENS is more effective than placebo for the management of chronic LBP. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PEDro and CINAHL were searched up to July 19, 2007. Only randomized controlled clinical trials (RCTs) comparing TENS to placebo in patients with chronic LBP were included. Two review authors independently selected the trials, assessed their methodological quality and extracted relevant data. If quantitative meta-analysis was not possible, a qualitative synthesis was performed, taking into consideration 5 levels of evidence as recommended by the Cochrane Collaboration Back Review Group. Four high-quality RCTs (585 patients) met the selection criteria. Clinical heterogeneity prevented the use of meta-analysis. Therefore, a qualitative synthesis was completed. There was conflicting evidence about whether TENS was beneficial in reducing back pain intensity and consistent evidence in two trials (410 patients) that it did not improve back-specific functional status. There was moderate evidence that work status and the use of medical services did not change with treatment. Conflicting results were obtained from two studies regarding generic health status, with one study showing no improvement on the modified Sickness Impact Profile and another study showing significant improvements on several, but not all subsections of the SF-36 questionnaire. Multiple physical outcome measures lacked statistically significant improvement relative to placebo. In general, patients treated with acupuncture-like TENS responded similarly to those treated with conventional TENS. However, in two of the trials, an inadequate stimulation intensity was used for acupuncture

Early Predictors of Ten-Year Course in First-Episode Psychosis

DEFF Research Database (Denmark)

Friis, Svein; Melle, Ingrid; Johannessen, Jan Olav

2016-01-01

, five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores ≥4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years......, patients were also evaluated by their clinicians at least biweekly. Baseline and early-course predictors of long-term course were identified with linear mixed-model analyses. RESULTS: Four variables provided significant, additive predictions of longer time in psychosis during the ten-year follow...

Frictional amyloidosis in Oman - A study of ten cases

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Mysore Venkataram

2002-01-01

Full Text Available Macular amyloidosis is an important cause for cutaneous pigmentation, the aetiology of which is poorly understood. Friction has recently been implicated the causation of early lesions, referred to as frictional amyloidosis. Confirmation of diagnosis by the detect on of amyloid using histochemical stains is inconsistent. Ten patients with pigmentation suggestive of macular amyloidosis were studied with detailed history, clinical examination, biopsy for histochemistry and electron microscopy. Nine out of ten patients had a history of prolonged friction with various objects such as bath sponges, brushes, towels, plant sticks and leaves. Amyloid was demonstrated by histochemical staining in only six out of ten cases. In the remaining four cases, amyloid was detected by electron microscopy. These consisted of aggregates of non-branching, extracellular, intertwining fibres measuring between 200-500 nm in length and between 20-25 nm in diameter. The study confirms the role of friction in the causation of this condition. Histochemical stains are not always successful in the detection of amyloid and electron microscopy is helpful for confirming its presence. The term frictional amyloidosis aptly describes the condition.

Ten cases of metastatic cervical cancer with the treatment of permanent 125I seeds interstitial implants

International Nuclear Information System (INIS)

Zhang Hongwei; Li Naibin; Li Qingxin; Liu Huiping; Meng Hui; Chao Dong

2011-01-01

Objective: To investigate the clinical effect of permanent 125 I seeds interstitial implants for metastatic cervical cancer. Methods: Under the guidance of the B-sonography, 125 I seeds were implanted into the eleven cervical lymph nodes of ten patients who had been given tumor resection. The pain relief and tumor size were observed in regular follow-up after one-month treatment. Results: All the patients were followed up for 6-14 months,and the postoperative recovery was good with no complication. One month after the implantation, the pain symptom was alleviated entirely in two nodes and partly in nine nodes. The tumor size shrank in ten nodes while there was no change in one node after one month. Conclusion: Permanent 125 I seeds interstitial implants for metastatic cervical cancer is a safe, minimally invasive and effective treatment. (authors)

CT findings in ten patients with failed renal allografts: comparison with findings in functional grafts

International Nuclear Information System (INIS)

Gayer, Gabriela; Apter, Sara; Katz, Rama; Ben-David, Aharon; Katzir, Ze'ev; Hertz, Marjorie

2000-01-01

Our aim is to report the computed tomography (CT) features of the long-term failed renal allograft. Ten patients with failed renal transplants in whom the graft was left in situ underwent CT for various unrelated indications. The majority of the failed grafts showed marked shrinkage and coarse punctate diffuse parenchymal calcifications. Small cysts were seen in four grafts. A long-term failed renal transplant appeared on CT as a small rounded soft tissue mass. The graft was almost always heavily calcified. Lack of awareness of the nature of such a mass may mislead the radiologist in interpreting it as a space-occupying lesion

Effects of transcutaneous electrical nerve stimulation (TENS) on cognition and behaviour in aging

NARCIS (Netherlands)

Scherder, E.J A; van Someren, E.W J; Bouma, J.M.; van der Berg, M

2000-01-01

In previous studies, transcutaneous electrical nerve stimulation (TENS) improved cognition and behaviour in patients with Alzheimer's disease (AD). The rationale underlying these studies was that TENS could activate, e.g. the septo-hippocampal region and the hypothalamus through direct and indirect

Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on cognition and behaviour in aging

NARCIS (Netherlands)

Scherder, E.J.A.; Bouma, A.; van den Berg, M.

2000-01-01

In previous studies, transcutaneous electrical nerve stimulation (TENS) improved cognition and behaviour in patients with Alzheimer's disease (AD). The rationale underlying these studies was that TENS could activate, e.g. the septo-hippocampal region and the hypothalamus through direct and indirect

Relationship between Processing Method and the Glycemic Indices of Ten Sweet Potato (Ipomoea batatas Cultivars Commonly Consumed in Jamaica

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Perceval S. Bahado-Singh

2011-01-01

Full Text Available This study investigated the effect of different traditional cooking methods on glycemic index (GI and glycemic response of ten Sweet potato (Ipomoea batatas cultivars commonly eaten in Jamaica. Matured tubers were cooked by roasting, baking, frying, or boiling then immediately consumed by the ten nondiabetic test subjects (5 males and 5 females; mean age of 27 ± 2 years. The GI varied between 41 ± 5–93 ± 5 for the tubers studied. Samples prepared by boiling had the lowest GI (41 ± 5–50 ± 3, while those processed by baking (82 ± 3–94 ± 3 and roasting (79 ± 4–93 ± 2 had the highest GI values. The study indicates that the glycemic index of Jamaican sweet potatoes varies significantly with the method of preparation and to a lesser extent on intravarietal differences. Consumption of boiled sweet potatoes could minimize postprandial blood glucose spikes and therefore, may prove to be more efficacious in the management of type 2 diabetes mellitus.

Critical Studies on Men in Ten European Countries

DEFF Research Database (Denmark)

Pringle, Keith; Hearn, Jeff (and 13 other network partners)

2002-01-01

This article is one the work of The European Research Network on Men in Europe project “The Social Problem and Societal Problematization of Men and Masculinities” (2000-2003), funded by the European Commission. The Network comprises women and men researchers with range of disciplinary backgrounds...... of statistical sources on men's practices in the ten countries, are presented. This is the second of four articles reviewing critical studies on men in the ten countries through different methods and approaches....

Does transcutaneous electrical nerve stimulation (TENS) alleviate the pain experienced during bone marrow sampling in addition to standard techniques? A randomised, double-blinded, controlled trial.

Science.gov (United States)

Tucker, David L; Rockett, Mark; Hasan, Mehedi; Poplar, Sarah; Rule, Simon A

2015-06-01

Bone marrow aspiration and trephine (BMAT) biopsies remain important tests in haematology. However, the procedures can be moderately to severely painful despite standard methods of pain relief. To test the efficacy of transcutaneous electrical nerve stimulation (TENS) in alleviating the pain from BMAT in addition to standard analgesia using a numerical pain rating scale (NRS). 70 patients requiring BMAT were randomised (1:1) in a double-blind, placebo-controlled trial. -35 patients received TENS impulses at a strong but comfortable amplitude (intervention group) and 35 patients received TENS impulses just above the sensory threshold (control group) (median pulse amplitude 20 and 7 mA, respectively). Patients and operators were blinded to group allocation. Pain assessments were made using a numerical pain scale completed after the procedure. No significant difference in NRS pain recalled after the procedure was detected (median pain score 5.7 (95% CI 4.8 to 6.6) in control vs 5.6 (95% CI 4.8 to 6.4) in the intervention group). However, 100% of patients who had previous experience of BMAT and >94% of participants overall felt they benefited from using TENS and would recommend it to others for this procedure. There were no side effects from the TENS device, and it was well tolerated. TENS is a safe, non-invasive adjunct to analgesia for reducing pain during bone marrow biopsy and provides a subjective benefit to most users; however, no objective difference in pain scores was detected when using TENS in this randomised controlled study. NCT02005354. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Ten patients with refractory status epilepticus in an intensive care department

NARCIS (Netherlands)

ter Maaten, JC; van Schijndel, RJM; Heimans, JJ; Schreuder, WO

1998-01-01

Status epilepticus (SE) is a serious disease, associated with a high morbidity and mortality, particularly if refractory to initial therapy. We describe the clinical manifestations and outcome in ten cases with refractory SE admitted to our medical intensive care unit. Three of these selected group

Closed Tibial shaft fractures treated with the Ilizarov method: A ten year case series.

Science.gov (United States)

May, Jonathan David; Paavana, Thumri; McGregor-Riley, Jonathan; Royston, Simon

2017-07-01

To review the outcomes of patients treated with the Ilizarov method for an isolated, closed, simple diaphyseal, Tibial fracture at our institution over the last decade. The Ilizarov frame database was used to identify 76 skeletally mature patients who sustained an isolated, closed, extra-articular, simple, diaphyseal Tibial fracture; the injury also known as a "nail-able Tibial fracture." The average age of the patient was 38 (17-70). All 76 patients progressed to union. The average time until union was 148 (55-398) days. The coronal and sagittal alignment was 3° (0-17°) and 4° (0-14°) respectively. No patient suffered from compartment syndrome. No patient developed septic arthritis. No patient had documented anterior knee pain or secondary knee specialist input post frame removal. On average, there were 9(4-29) follow up appointments and 10(5-26) radiographs post frame application. There is a 59% chance of a patient having a difficulty post frame application. The malunion rate was 5%. Persisting pinsite infection post frame removal occurred in 5 patients (6.5%). Drilling of the pinsite sequestrum resolved the infection in four of these patients, giving a deep infection rate of 1.3%. The Ilizarov method has a role to play in the treatment of simple closed Tibial shaft fractures in patients who need to kneel. Patient education is a priority however; the patient must be made aware of the difficulty rate associated with the Ilizarov method when compared to the complication profile of alternative treatments. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

The short-term effects of TENS plus therapeutic ultrasound combinations in chronic neck pain.

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Sayilir, Selcuk

2018-05-01

To investigate the effects of TENS plus therapeutic ultrasound combinations on symptom relief, physical functionality, perceived stress levels, daytime sleepiness and neck mobility in patients with chronic neck pain (CNP). A total of 64 patients were divided into two groups as the TENS plus ultrasound group (n = 39) and the control CNP group (n = 25). The therapy comprised TENS and therapeutic ultrasound applications for 10 sessions. The control subjects were discouraged from using analgesics but were allowed to use paracetamol daily, if necessary. The Neck Disability Index (NDI), Epworth Sleepiness Scale (ESS), Perceived Stress Scale (PSS), visual analog scale (VAS) and tragus-wall/chin-manubrium distances were recorded at the baseline and after therapy. Significant improvements were detected in the TENS plus ultrasound group compared to the control CNP subjects in respect of VAS, PSS and NDI scores after the TENS plus therapeutic ultrasound therapies (all p stress levels and improving functionality in the short-term of CNP. Copyright © 2018 Elsevier Ltd. All rights reserved.

A randomized trial to determine the duration of analgesia following a 15- and a 30-minute application of acupuncture-like TENS on patients with chronic low back pain.

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Tousignant-Laflamme, Yannick; Laroche, Claudia; Beaulieu, Christine; Bouchard, Ann-Julie; Boucher, Sabrina; Michaud-Létourneau, Mélanie

2017-05-01

Acupuncture-like TENS (AL-TENS) has been shown to produce prolonged pain relief, but no study has yet investigated its duration on a population suffering from chronic low back pain (CLPB). Our objective was to quantify the duration and magnitude of analgesia induced by a 15- or 30-minute application of AL-TENS. We recruited a sample of 11 participants presenting with CLBP and conducted a randomized, crossover study, where participants were given AL-TENS for 15 and 30 minutes on two separate occasions. The pain intensity of their CLBP was assessed with a visual analogue scale before, during, and after AL-TENS applications. Magnitude and duration of analgesia were determined for each subject and for both AL-TENS application times. The AL-TENS applications induced a clinically and statistically significant (p = 0.003) analgesia in all participants. Median duration of analgesia was 9 hours and 10 hours 30 minutes following the 15- and 30-minute AL-TENS applications, respectively; this 1.5-hour difference was not statistically significant (p = 0.55). Furthermore, we observed no significant difference in the magnitude of analgesia between both applications of AL-TENS (p > 0.56), suggesting that the duration of application of AL-TENS does not influence the magnitude of analgesia. Our results suggest that clinicians could use a 15-minute AL-TENS application to provide significant analgesia in patients presenting with low back pain since if provides a comparable analgesia versus a 30-minute application.

Quality of life in the late follow-up of ulcerative colitis patients submitted to restorative proctocolectomy with sphincter preservation over ten years ago

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Alberto Luiz Monteiro Meyer

2009-01-01

Full Text Available OBJECTIVE: To evaluate, by means of the Inflammatory Bowel Disease Questionnaire (IBDQ, the quality of life of ulcerative colitis patients submitted to proctocolectomy with sphincter preservation using J-pouch reconstruction over ten years ago. METHODS: The study consisted of 36 patients interviewed using the Inflammatory Bowel Disease Questionnaire. The score scale, resulting from the addition of each answer, ranged from 32 to 224, where the highest score indicates the best quality of life. The chi square test was used to verify the existence of meaningful differences between the results of the questionnaire and age, and gender proportion. For each section, as well as for all of them combined, the Kruskal-Wallis test was used to verify if there were differences in the Inflammatory Bowel Disease Questionnaire scores among the groups in relation to the proportions. RESULTS: After applying the Inflammatory Bowel Disease Questionnaire, it was determined that quality of life was considered excellent for 9 (25%, good for 11 (30.6%, regular for 13 (36.1%, and bad for 3 (8.3% patients. In our study, we determined that 85% of the patients were pleased with and thankful for the surgery that they underwent. CONCLUSION: We can conclude that the possibility of sphincter preservation should always be taken into account, since patients remain clinically stable and have a high quality of life even after long periods.

HIPs at Ten

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Kuh, George; O'Donnell, Ken; Schneider, Carol Geary

2017-01-01

2017 is the anniversary of the introduction of what are now commonly known as high-impact practices (HIPs). Many of the specific activities pursued under the HIPs acronym have been around in some form for decades, such as study abroad, internships, and student-faculty research. It was about ten years ago that, after conferring HIPs at Ten with…

Transcutaneous electrical nerve stimulation (TENS) for pain relief in labour.

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Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

2009-04-15

Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. The TENS unit is frequently operated by women, which may increase sense of control in labour. To assess the effects of TENS on pain in labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). Randomised controlled trials comparing women receiving TENS for pain relief in labour versus routine care, alternative pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. The search identified 25 studies; we excluded six and included 19 studies including 1671 women. Fifteen examined TENS applied to the back, two to acupuncture points and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (risk ratio 0.41, 95% confidence interval 0.32 to 0.55). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No adverse events were reported. There is only limited evidence that TENS reduces pain in labour and it does not seem to have any impact (either positive or

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

LENUS (Irish Health Repository)

Whitfield, Kate

2010-11-12

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

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

Science.gov (United States)

2010-01-01

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

Prognostic factors in children with acute lymphoblastic leukemia: a ten year study

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Oloomi yazdi Z.

2008-06-01

Full Text Available Background: Acute lymphoblastic leukemia (ALL is the most common cancer in the pediatric population. With modern treatments, the chance of the complete recovery is nearly 100%. The most important prognostic factors are appropriate treatment protocol and determination of patient risk factors based on clinical, morphological, immunological and cytological characteristics. In this study we reviewed frequency of these factors, like as age, gender, the primary white blood cell number, sub- group on the base of FAB classification, immunophenotype and the clinical progress. Methods: In this retrospective study, we reviewed 877 pediatric patients with the diagnosis of ALL between the years of 1994 and 2004. In these patients the age, gender, primary WBC count, sub-group based on the FAB classification, immunophenotype and the clinical progress in 177 patient with acute lymphoblastic leukemia at Imam Khomeini Hospital between the years of 1994 to 2004 were determined. Results: Of these patients, 1.6% was younger than one year, 24.8% more than ten years old and 73.6% were between the ages of one and ten years; 63.8% were male. WBC counts were above 50,000/ul in 28.8% of the patients. FAB classifications included L1 in 80.2%, L2 in 17.5% and L3 in 2.3% of the patients. Immunophenotypes included pre-B cell in 63.8%, early pre-B cell in 23.1%, T cell in 12.3% and mature B cell in 0.8% of the patients. Marker CD10+ was detected in 88.1% of the B cell cases. In this study group, 74% of the patients recovered, 16.3% died and 16.5% relapsed.Conclusions: The prevalence of FAB-L1 and pre-B cell cases in this study is greater than a previous study, while the prevalence of FAB-L2 and early pre-B cell cases is less than that of the previous study.

Choledochal cysts: our ten year experience.

LENUS (Irish Health Repository)

Cianci, F

2012-04-01

We present our experience in the management of choledochal cysts from 1999 to 2009. A retrospective review of all charts with a diagnosis of choledochal cysts in our institution in this ten-year period. Data was collated using Excel. A total of 17 patients were diagnosed with choledochal cyst: 9 females and 8 males. The average age at diagnosis was 28 months (range from 0 to 9 years). The most common presenting symptoms were obstructive jaundice 6 (35%) and abdominal pain and vomiting 4 (23%). Ultrasound (US) was the initial diagnostic test in all cases with 4 patients requiring further investigations. All patients underwent Roux-en-Y Hepaticojejunostomy. The average length of stay was 11 days. Patients were followed up with Liver Function Tests (LFTS) and US 4-6 weeks post-operatively. Three patients developed complications including post-op collection, high drain output requiring blood transfusion and adhesive bowel obstruction. Our overall experience with choledochal cyst patients has been a positive one with effective management and low complication rates.

Inducible displacement of cemented tibial components ten years after total knee arthroplasty.

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Lam Tin Cheung, K; Lanting, B A; McCalden, R W; Yuan, X; MacDonald, S J; Naudie, D D; Teeter, M G

2018-02-01

The aim of this study was to evaluate the long-term inducible displacement of cemented tibial components ten years after total knee arthroplasty (TKA). A total of 15 patients from a previously reported prospective trial of fixation using radiostereometric analysis (RSA) were examined at a mean of 11 years (10 to 11) postoperatively. Longitudinal supine RSA examinations were acquired at one week, one year, and two years postoperatively and at final follow-up. Weight-bearing RSA examinations were also undertaken with the operated lower limb in neutral and in maximum internal rotation positions. Maximum total point motion (MTPM) was calculated for the longitudinal and inducible displacement examinations (supine versus standing, standing versus internal rotation, and supine versus standing with internal rotation). All patients showed some inducible displacement. Two patients with radiolucent lines had greater mean standing-supine MTPM displacement (1.35; sd 0.38) compared with the remaining patients (0.68; sd 0.36). These two patients also had a greater mean longitudinal MTPM at ten years (0.64; sd 0.50) compared with the remaining patients (0.39; sd 0.13 mm). Small inducible displacements in well-fixed cemented tibial components were seen ten years postoperatively, of a similar magnitude to that which has been reported for well-fixed components one to two years postoperatively. Greater displacements were found in components with radiolucent lines. Cite this article: Bone Joint J 2018;100-B:170-5. ©2018 The British Editorial Society of Bone & Joint Surgery.

Higher percentage of in vitro apoptotic cells at time of diagnosis in patients with chronic lymphocytic leukemia indicate earlier treatment requirement: Ten years follow up

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Kravić-Stevović Tamara

2014-01-01

Full Text Available Introduction. Chronic lymphocytic leukemia (CLL has an extremely variable clinical course. Biological reasons for that wide variation in clinical course and survival rates in CLL patients are not fully understood. Objective. The aim of the study was to evaluate the value of spontaneous apoptosis of CLL cells in vitro determined at presentation of disease, in prediction of treatment requirements and evolution of the CLL. Methods. Malignant B cells were isolated from the whole blood of 30 newly diagnosed CLL patients and cultured for 24 hours in RPMI-1640 medium supplemented with 10% of serum obtained from the same CLL patient. Cells were later fixed and processed for embedding in Epon, or cell smears were prepared and stained with TUNEL technique. Results. Ten-year follow-up revealed that patients with lower percentage of cells in apoptosis at presentation of disease had significant longer time treatment initiation (log rank test p0.05. Conclusion. The results of this study emphasize the importance of apoptosis of CLL cells at the time of the initial diagnosis in pathobiology of this disease. [Projekat Ministarstva nauke Republike Srbije, br. 41025

NDT-Bobath method in normalization of muscle tone in post-stroke patients.

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Mikołajewska, Emilia

2012-01-01

Ischaemic stroke is responsible for 80-85% of strokes. There is great interest in finding effective methods of rehabilitation for post-stroke patients. The aim of this study was to assess the results of rehabilitation carried out in the normalization of upper limb muscle tonus in patients, estimated on the Ashworth Scale for Grading Spasticity. The examined group consisted of 60 patients after ischaemic stroke. 10 sessions of NDT-Bobath therapy were provided within 2 weeks (ten days of therapy). Patient examinations using the Ashworth Scale for Grading Spasticity were done twice: the first time on admission and the second after the last session of the therapy to assess rehabilitation effects. Among the patients involved in the study, the results measured on the Ashworth Scale (where possible) were as follows: recovery in 16 cases (26.67%), relapse in 1 case (1.67%), no measurable changes (or change within the same grade of the scale) in 8 cases (13.33%). Statistically significant changes were observed in the health status of the patients. These changes, in the area of muscle tone, were favorable and reflected in the outcomes of the assessment using the Ashworth Scale for Grading Spasticity.

Transcutaneous electrical nerve stimulation (TENS) for chronic low back pain.

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Milne, S; Welch, V; Brosseau, L; Saginur, M; Shea, B; Tugwell, P; Wells, G

2001-01-01

Low back pain (LBP) affects a large proportion of the population. Transcutaneous electrical nerve stimulation (TENS) was introduced more than 30 years ago as an alternative therapy to pharmacological treatments for chronic pain. However, despite its widespread use, the effectiveness of TENS is still controversial. The aim of this systematic review was to determine the efficacy of TENS in the treatment of chronic LBP. We searched MEDLINE, EMBASE, PEDro and the Cochrane Controlled Trials Register up to June 1, 2000. Only randomized controlled clinical trials of TENS for the treatment of patients with a clinical diagnosis of chronic LBP were included. Abstracts were excluded unless further data could be obtained from the authors. Two reviewers independently selected trials and extracted data using predetermined forms. Heterogeneity was tested with Cochran's Q test. A fixed effects model was used throughout for continuous variables, except where heterogeneity existed, in which case, a random effects model was used. Results are presented as weighted mean differences (WMD) with 95% confidence intervals (95% CI), where the difference between the treated and control groups was weighted by the inverse of the variance. Standardized mean differences (SMD) were calculated by dividing the difference between the treated and control by the baseline variance. SMD were used when different scales were used to measure the same concept. Dichotomous outcomes were analyzed with odds ratios. Five trials were included, with 170 subjects randomized to the placebo group receiving sham-TENS and 251 subjects receiving active TENS (153 for conventional mode, 98 for acupuncture-like TENS). The schedule of treatments varied greatly between studies ranging from one treatment/day for two consecutive days, to three treatments/day for four weeks. There were no statistically significant differences between the active TENS group when compared to the placebo TENS group for any outcome measures

Granulocyte colony-stimulating factor in toxic epidermal necrolysis (TEN) and Chelsea & Westminster TEN management protocol [corrected].

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de Sica-Chapman, A; Williams, G; Soni, N; Bunker, C B

2010-04-01

Toxic epidermal necrolysis (TEN) is a rare but life-threatening, allergic drug reaction. Skin blistering with epidermal and mucosal necrolysis with subsequent detachment from an inflamed underlying dermis is a hallmark of the condition. The pathogenesis of TEN is not well understood, accounting for controversies about its management and significant delay in initiating potentially beneficial therapy. There are no management protocols based on a robust evidence base. Prompt recognition of the diagnosis and consensus on early management initiatives are necessary in order to improve outcomes and survival in TEN. To date, TEN management has been directed at arresting the allergic reaction and treating the complications. We have identified a need for specific medical interventions to accelerate wound regeneration. This approach has not previously been adopted in the management of TEN. We observed that in two cases of severe TEN, dramatic re-epithelialization and recovery coincided with the introduction of granulocyte colony-stimulating factor (G-CSF) for neutropenia. We explain how addition of the G-CSF promotes recovery from TEN by enhanced bioregeneration of the damaged tissues through accelerated re-epithelialization. G-CSF has been used for severe neutropenia in TEN, but we recommend and explain why, as in our Chelsea and Westminster protocol, G-CSF should be considered in treating severe TEN irrespective of the severity of neutropenia.

Ten years after the IOM report: Engaging residents in quality and patient safety by creating a House Staff Quality Council.

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Fleischut, Peter M; Evans, Adam S; Nugent, William C; Faggiani, Susan L; Lazar, Eliot J; Liebowitz, Richard S; Forese, Laura L; Kerr, Gregory E

2011-01-01

Ten years after the 1999 Institute of Medicine report, it is clear that despite significant progress, much remains to be done to improve quality and patient safety (QPS). Recognizing the critical role of postgraduate trainees, an innovative approach was developed at New York-Presbyterian Hospital, Weill Cornell Medical Center to engage residents in QPS by creating a Housestaff Quality Council (HQC). HQC leaders and representatives from each clinical department communicate and partner regularly with hospital administration and other key departments to address interdisciplinary quality improvement (QI). In support of the mission to improve patient care and safety, QI initiatives included attaining greater than 90% compliance with medication reconciliation and reduction in the use of paper laboratory orders by more than 70%. A patient safety awareness campaign is expected to evolve into a transparent environment where house staff can openly discuss patient safety issues to improve the quality of care.

Nonresponse Error in Mail Surveys: Top Ten Problems

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Jeanette M. Daly

2011-01-01

Full Text Available Conducting mail surveys can result in nonresponse error, which occurs when the potential participant is unwilling to participate or impossible to contact. Nonresponse can result in a reduction in precision of the study and may bias results. The purpose of this paper is to describe and make readers aware of a top ten list of mailed survey problems affecting the response rate encountered over time with different research projects, while utilizing the Dillman Total Design Method. Ten nonresponse error problems were identified, such as inserter machine gets sequence out of order, capitalization in databases, and mailing discarded by postal service. These ten mishaps can potentiate nonresponse errors, but there are ways to minimize their frequency. Suggestions offered stem from our own experiences during research projects. Our goal is to increase researchers' knowledge of nonresponse error problems and to offer solutions which can decrease nonresponse error in future projects.

Pressure-assisted electrokinetic injection for on-line enrichment in capillary electrophoresis-mass spectrometry: a sensitive method for measurement of ten haloacetic acids in drinking water.

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Zhang, Huijuan; Zhu, Jiping; Aranda-Rodriguez, Rocio; Feng, Yong-Lai

2011-11-07

Haloacetic acids (HAAs) are by-products of the chlorination of drinking water containing natural organic matter and bromide. A simple and sensitive method has been developed for determination of ten HAAs in drinking water. The pressure-assisted electrokinetic injection (PAEKI), an on-line enrichment technique, was employed to introduce the sample into a capillary electrophoresis (CE)-electrospray ionization-tandem mass spectrometry system (ESI-MS/MS). HAAs were monitored in selected reaction monitoring mode. With 3 min of PAEKI time, the ten major HAAs (HAA10) in drinking water were enriched up to 20,000-fold into the capillary without compromising resolution. A simple solid phase clean-up method has been developed to eliminate the influence of ionic matrices from drinking water on PAEKI. Under conditions optimized for mass spectrometry, PAEKI and capillary electrophoresis, detection limits defined as three times ratio of signal to noise have been achieved in a range of 0.013-0.12 μg L(-1) for ten HAAs in water sample. The overall recoveries for all ten HAAs in drinking water samples were between 76 and 125%. Six HAAs including monochloro- (MCAA), dichloro- (DCAA), trichloro- (TCAA), monobromo- (MBAA), bromochloro- (BCAA), and bromodichloroacetic acids (BDCAA) were found in tap water samples collected. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Ten years of x-ray holography

International Nuclear Information System (INIS)

Faigel, G.; Bortel, G.; Tegze, M.; Fadley, C.S.; Simionovici, A.S.

2007-01-01

With the appearance of nano-science the role of local methods has become more and more important. Hard x-ray holography based on the inside reference point concept is a local probe of the atomic order in solids. It gives the 3D real space image of atoms without the phase ambiguity inherent to diffraction methods. In this paper a brief description of the basics of hard x-ray holography is given. The last ten years' experimental and evaluation-related developments are reviewed. We also introduce different variants of the method, such as Bremsstrahlung and gamma ray holography (GRH). The power of the method is illustrated by examples. We outline new directions and future possibilities. (authors)

Adult Klebsiella pneumoniae meningitis in Qatar:clinical pattern of ten cases

Institute of Scientific and Technical Information of China (English)

Fahmi Yousef Khan; Mohammed Abukhattab; Mohammed AbuKamar; Deshmukh Anand

2014-01-01

Objective: To describe the clinical presentation, underlying diseases, antimicrobial susceptibility, treatment and outcome of Klebsiella pneumoniae meningitis patients. Methods:This retrospective study involved all patients with 15 years of age or older who admitted to Hamad General Hospital with culture proven Klebsiella pneumoniae meningitis from January 1, 2007 to December 31, 2012. Results: A total of ten cases were identified (nine males and one female). Their mean age was (43.3±12.8) years. Eight patients (80%) had nosocomial meningitis with neurosurgery being the most frequent associated condition. Fever and altered consciousness were the most frequent symptom. Cerebrospinal fluid showed elevated protein and glucose levels. Gram stain showed Gram-negative rods in 50%of cases, while positive cerebrospinal fluid culture results were found in all patients. Multidrug resistance was observed in two cases, and all patients had received appropriate empirical and definitive antibiotic treatments. The mean duration of intravenous antimicrobial treatment was (19.3±7.0) d and all patients with external ventricular drains underwent removal of the device, while in-hospital mortality was 50%. Conclusions: The number of cases was too small to come up with therapeutic and prognostic conclusions. Further large-scale prospective study is needed.

Adult Klebsiella pneumoniae meningitis in Qatar:clinical pattern of ten cases

Institute of Scientific and Technical Information of China (English)

Fahmi; Yousef; Khan; Mohammed; Abukhattab; Mohanuned; Abukamar; Deshmukh; Anand

2014-01-01

Objective:To describe the clinical presentation,underlying diseases,antimicrobial susceptibility,treatment and outcome of Klebsiella pneumoniae meningitis patients.Methods:This retrospective study involved all patients with 15 years of age or older who admit ted to Hamad General Hospital with culture proven Klebsiella pneumoniae meningitis from January 1,2007 to December 31,2012.Results:A total of ten cases were identified mine males and one female).Their mean age was i43.3±12.8) years.Eight patients(80%) had nosocomial meningitis with neurosurgery being the most frequent associated condition.Fever and altered consciousness were the most frequent symptom.Cerebrospinal fluid showed elevated protein and glucose levels.Oram slain showed Gram—negative rods in 50%of cases,while positive cerebrospinal fluid culture results were found in all patients.Multidrug resistance was observed in two cases,and all patients had received appropriate empirical and definitive antibiotic treatments.The mean duration of intravenous antimicrobial treatment was(19.3±7.0) d and all patients with external ventricular drains underwent removal of the device,while in—hospital mortality was 50%.Conclusions:The number of cases was too small to come up with therapeutic and prognostic conclusions.Further large-scale prospective study is needed.

Effects of transcutaneous electrical nerve stimulation (TENS) on proinflammatory cytokines: protocol for systematic review.

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Almeida, Tábata Cristina do Carmo; Figueiredo, Francisco Winter Dos Santos; Barbosa Filho, Valter Cordeiro; de Abreu, Luiz Carlos; Fonseca, Fernando Luiz Affonso; Adami, Fernando

2017-07-11

Pain reduction can be achieved by lowering proinflammatory cytokine levels in the blood. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive physiotherapeutic resource for pain management, but evidence on the effectiveness of this device at reducing proinflammatory cytokines in the blood is unclear. This study systematically reviews the literature on the effect of TENS on proinflammatory cytokines. A systematic review protocol was developed based on searches of articles in six electronic databases and references of retrieved articles, contact with authors, and repositories of clinical trials. Eligibility criteria: publication in peer-reviewed journals, randomized clinical trials, use of TENS in the experimental group, and pre- and post-measurements of proinflammatory cytokines in the blood. Selection of the studies and extraction of the data will be carried out by two reviewers independently. Characteristics of the study, participants, interventions and outcomes were extracted and described. Assessments were performed on the risk of bias, level of evidence and the size of the intervention effect in the studies, according to GRADE guidelines and the Cochrane Handbook for Systematic Reviews. Clinical and statistical assessments compared the effects of the interventions (meta-analysis), taking into consideration any influencing characteristics of the studies (e.g., methods and application sites). We anticipate that this review will strengthen evidence-based knowledge of the effect of TENS on proinflammatory cytokines and, as a result, direct new studies to benefit patients with specific pathologies. PROSPERO, CRD42017060379 .

Value of TENS for relief of chronic low back pain with or without radicular pain.

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Buchmuller, A; Navez, M; Milletre-Bernardin, M; Pouplin, S; Presles, E; Lantéri-Minet, M; Tardy, B; Laurent, B; Camdessanché, J P

2012-05-01

To evaluate the efficacy of transcutaneous electrical neurostimulation (TENS) in patients with chronic low back pain (LBP). Prospective, randomized, multicentre, single-blind study. Twenty-one French pain centres. Two hundred thirty-six consecutive adult patients consulting for chronic LBP, with or without radicular pain (mean age ± standard deviation: 53 ± 13 years; range: 28-86 years). Patients were randomly assigned to receive either active (n = 117) or sham (n = 119) TENS in four 1-h daily treatment sessions for 3 months. The primary outcome measured was improvement of functional status at 6 weeks (Roland-Morris Disability Questionnaire). Secondary outcome measures were improvement of functional status at 3 months, pain relief (weekly visual analogue scale assessments), positive functional repercussions of pain levels on quality of life, a diminution of the use of analgesic and anti-inflammatory medication, satisfaction with the overall treatment strategy and compliance. Functional status did not differ between the groups, whether at 6 weeks or 3 months (p = 0.351 at 6 weeks). A significant improvement between the first and last visual analogue scale assessments was observed in patients with either lumbar pain alone or lumbar and radicular pain treated with active TENS. Other outcome measures did not differ significantly between the two groups. There was no functional benefit of TENS in the treatment of patients with chronic LBP. © 2011 European Federation of International Association for the Study of Pain Chapters.

SHORT TERM EFFECT OF ACUPUNCTURE-TENS ON LUNG FUNCTIONS AND DYSPNEA FOR SUBJECTS WITH MODERATE COPD

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Vinod Babu. K

2015-10-01

Full Text Available Background: Acupuncture TENS is used to improve pain instead of invasive acupuncture. Acupuncture shown to improve dyspnoea and lung functions in COPD (Chronic Obstructive Pulmonary Disease patients. The purpose of the study is to determine Short term effectiveness of Acupuncture-TENS in reducing dyspnea and improving lung functions for subjects with moderate COPD. Method: An experimental study design, selected 30 geriatric subjects with COPD randomized 15 subjects into each Study and Control group. Study group received Acu-TENS for 45 minutes for total 5 sessions, while control group received placebo TENS. Outcome measurements such as breathlessness using Modified Borg Scale (MBS, Lung functions using Pulmonary Function Test (PFT was measured before and after intervention. Results: Analysis from pre-intervention to post-intervention within study group found that there is statistically significant change in means of MBS, FEV1, FEV1/FVC ratio and within control group there is a statistically significant change in means of MBS, but there is no statistically significant change in means of FEV1, FVC and FEV1/FVC ratio. When post-intervention means were compared between the groups there is no statistically significant difference in means of MBS and FEV1, FVC and FEV1/FVC ratio. Conclusion: It is concluded that one week of Acu-TENS on EXL1 point found no significant effect on improving dyspnea and lung functions in subjects with moderate COPD in geriatric populations.

Is TENS purely a placebo effect? A controlled study on chronic low back pain.

Science.gov (United States)

Marchand, S; Charest, J; Li, J; Chenard, J R; Lavignolle, B; Laurencelle, L

1993-07-01

Although high-frequency low-intensity transcutaneous electric nerve stimulation (TENS) has been extensively used to relieve low back pain, experimental studies of its effectiveness have yielded contradictory findings mainly due to methodological problems in pain evaluation and placebo control. In the present study, separate visual analog scales (VAS) were used to measure the sensory-discriminative and motivational-affective components of low back pain. Forty-two subjects were randomly assigned to 1 of 3 groups: TENS, placebo-TENS, and no treatment (control). In order to measure the short-term effect of TENS, VAS pain ratings were taken before and after each treatment session. Also, to measure long-term effects, patients rated their pain at home every 2 h throughout a 3-day period before and 1 week, 3 months and 6 months after the treatment sessions. In comparing the pain evaluations made immediately before and after each treatment session, TENS and placebo-TENS significantly reduced both the intensity and unpleasantness of chronic low back pain. TENS was significantly more efficient than placebo-TENS in reducing pain intensity but not pain unpleasantness. TENS also produced a significant additive effect over repetitive treatment sessions for pain intensity and relative pain unpleasantness. This additive effect was not found for placebo-TENS. When evaluated at home, pain intensity was significantly reduced more by TENS than placebo-TENS 1 week after the end of treatment, but not 3 months and 6 months later. At home evaluation of pain unpleasantness in the TENS group was never different from the placebo-TENS group.(ABSTRACT TRUNCATED AT 250 WORDS)

Taste intensities of ten vegetables commonly consumed in the Netherlands.

Science.gov (United States)

van Stokkom, V L; Teo, P S; Mars, M; de Graaf, C; van Kooten, O; Stieger, M

2016-09-01

Bitterness has been suggested to be the main reason for the limited palatability of several vegetables. Vegetable acceptance has been associated with preparation method. However, the taste intensity of a variety of vegetables prepared by different methods has not been studied yet. The objective of this study is to assess the intensity of the five basic tastes and fattiness of ten vegetables commonly consumed in the Netherlands prepared by different methods using the modified Spectrum method. Intensities of sweetness, sourness, bitterness, umami, saltiness and fattiness were assessed for ten vegetables (cauliflower, broccoli, leek, carrot, onion, red bell pepper, French beans, tomato, cucumber and iceberg lettuce) by a panel (n=9) trained in a modified Spectrum method. Each vegetable was assessed prepared by different methods (raw, cooked, mashed and as a cold pressed juice). Spectrum based reference solutions were available with fixed reference points at 13.3mm (R1), 33.3mm (R2) and 66.7mm (R3) for each taste modality on a 100mm line scale. For saltiness, R1 and R3 differed (16.7mm and 56.7mm). Mean intensities of all taste modalities and fattiness for all vegetables were mostly below R1 (13.3mm). Significant differences (p<0.05) within vegetables between preparation methods were found. Sweetness was the most intensive taste, followed by sourness, bitterness, fattiness, umami and saltiness. In conclusion, all ten vegetables prepared by different methods showed low mean intensities of all taste modalities and fattiness. Preparation method affected taste and fattiness intensity and the effect differed by vegetable type. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reliability and validity of ten consumer activity trackers

NARCIS (Netherlands)

Kooiman, Thea; Dontje, Manon L.; Sprenger, Siska; Krijnen, Wim; van der Schans, Cees; de Groot, Martijn

2015-01-01

Background: Activity trackers can potentially stimulate users to increase their physical activity behavior. The aim of this study was to examine the reliability and validity of ten consumer activity trackers for measuring step count in both laboratory and free-living conditions. Method: Healthy

Rescue mastectomy in 192 breast cancer patients with T2 tumors larger than 3 cm or T3 tumors first treated by breast conservation protocols and followed-up for at least ten years

International Nuclear Information System (INIS)

Khayat, D.; Baillet, F.; Simon, J.M.; Sahraoui, S.; Voican, D.; Housset, M.

1997-01-01

Breast conservation therapy was used in 192 breast cancer patients treated between 1980 and 1986 for T2 tumors larger than 3 cm or T3 tumors. Primary chemotherapy was followed by external beam radiation therapy then by boost brachytherapy and adjuvant chemotherapy. Locoregional recurrences were treated whenever possible by tumor-ectomy and/or axillary node clearance. Median follow-up was 13 years. Of the three patients with local therapeutic failures at completion of the locoregional treatment, two were treated by tumor-ectomy and one by mastectomy. Subsequently, 21 mastectomies were performed, for oncological reasons in 20 cases. Overall survival was 55 % after five years, 60 % after ten years, and 56 % after 15 years. Local control rates were 82 %, 77 %, and 75 % after five, ten, and 15 years, respectively. After exclusion of the patients who required mastectomy, cosmetic results were satisfactory in 68 % of patients overall, 67 % of five-year survivors, and 73 % of ten-year survivors. These results show that the conventional approach involving routine initial mastectomy is no longer appropriate in patients with T3 or large T2 breast cancers. (authors)

The efficacy of transcutaneous electrical nerve stimulation on the improvement of walking distance in patients with peripheral arterial disease with intermittent claudication: study protocol for a randomised controlled trial: the TENS-PAD study.

Science.gov (United States)

Besnier, Florent; Sénard, Jean-Michel; Grémeaux, Vincent; Riédel, Mélanie; Garrigues, Damien; Guiraud, Thibaut; Labrunée, Marc

2017-08-10

In patients with peripheral arterial disease (PAD), walking improvements are often limited by early pain onset due to vascular claudication. It would thus appear interesting to develop noninvasive therapeutic strategies, such as transcutaneous electrical nerve stimulation (TENS), to improve the participation of PAD patients in rehabilitation programmes, and thus improve their quality of life. Our team recently tested the efficacy of a single 45-min session of 10-Hz TENS prior to walking. TENS significantly delayed pain onset and increased the pain-free walking distance in patients with class-II PAD. We now seek to assess the efficacy of a chronic intervention that includes the daily use of TENS for 3 weeks (5 days a week) on walking distance in Leriche-Fontaine stage-II PAD patients. This is a prospective, double-blind, multicentre, randomised, placebo-controlled trial. One hundred subjects with unilateral PAD (Leriche-Fontaine stage II) will be randomised into two groups (1:1). For the experimental group (TENS group): the treatment will consist of stimulation of the affected leg (at a biphasic frequency of 10 Hz, with a pulse width of 200 μs, maximal intensity below the motor threshold) for 45 min per day, in the morning before the exercise rehabilitation programme, for 3 weeks, 5 days per week. For the control group (SHAM group): the placebo stimulation will be delivered according to the same modalities as for the TENS group but with a voltage level automatically falling to zero after 10 s of stimulation. First outcome: walking distance without pain. transcutaneous oxygen pressure (TcPO 2 ) measured during a Strandness exercise test, peak oxygen uptake (VO 2 peak), endothelial function (EndoPAT®), Ankle-brachial Pressure Index, Body Mass Index, lipid profile (LDL-C, HDL-C, triglycerides), fasting glycaemia, HbA1c level, and the WELCH questionnaire. TENS-PAD is the first randomised controlled trial that uses transcutaneous electrical therapy as an

Effectiveness of transcutaneous electrical nerve stimulation on saliva production in post-radiated oral cancer patients

OpenAIRE

Sakshi Ojha; Thimmarasa V Bhovi; Prashant P Jaju; Manas Gupta; Neha Singh; Kriti Shrivastava

2016-01-01

Aims and Objectives: To determine the effectiveness of transcutaneous electrical nerve stimulation (TENS) in stimulating salivary flow in post-radiated oral cancer patients, and to compare the salivary flow rate between unstimulated saliva and saliva stimulated with TENS in post-radiated oral cancer patients. Materials and Methods: In 30 patients who underwent radiotherapy for oral cancer, unstimulated saliva was collected every minute for 5 min in a graduated test tube. The TENS unit was act...

Comparative Treatment Outcomes of Pre and Post-exercise TENS Application on Knee Osteoarthritis: A Preliminary Report

Directory of Open Access Journals (Sweden)

Ajediran I. Bello

2014-03-01

Full Text Available Objective The effects of TENS before exercise (TBE and TENS after exercise (TAE in the management of knee osteoarthritis (OA were compared. Methods Fifteen participants with knee OA were alternatively assigned to either TBE or TAE groups. Participants' pain, active knee flexibility, thigh girth, disability, and activity levels were assessed at baseline and at the end of eight-week study. Mixed design two-way analysis of variance (ANOVA at P < 0.05 was used to compare the two groups. Results The mean age of the participants was 58.1 ± 10.9 years. Post-intervention comparison showed that TAE had significantly lower scores (1.9 ± 0.9 than TBE (4.3 ± 1.5 on Disability Index Questionnaire (DIQ ( F -ratio = 10.5; P = 0.006, and significantly lower scores (0.8 ± 0.3 than TBE (1.4 ± 0.6 on Patient Assessment Scale (PAS ( F -ratio = 8.3; P = 0.013. However, both groups did not significantly differ on the selected impairment measures. Conclusion TAE was found to be more effective on the primary outcome measures in patients with knee OA.

Effect of burst TENS and conventional TENS combined with cryotherapy on pressure pain threshold: randomised, controlled, clinical trial.

Science.gov (United States)

Macedo, L B; Josué, A M; Maia, P H B; Câmara, A E; Brasileiro, J S

2015-06-01

To assess the immediate effect of conventional and burst transcutaneous electrical nerve stimulation (TENS) in combination with cryotherapy on pain threshold and tolerance in healthy individuals. Randomised, controlled trial. University laboratory. One hundred and twelve healthy women. Volunteers were allocated at random to seven groups (n=16): (1) control, (2) placebo TENS, (3) conventional TENS, (4) burst TENS, (5) cryotherapy, (6) cryotherapy in combination with burst TENS, and (7) cryotherapy in combination with conventional TENS. Pain threshold and tolerance were measured by applying a pressure algometer at the lateral epicondyle of the humerus, before and after each intervention. The primary outcome measure was pressure pain threshold. A significant increase in pain threshold and tolerance at the 5% level of significance was recorded as follows: burst TENS {pain threshold: mean difference 1.3 [95% confidence interval (CI) 1.4 to 1.2]; pain tolerance: mean difference 3.8 (95% CI 3.9 to 3.7)}, cryotherapy [pain threshold: mean difference 1.3 (95% CI 1.4 to 1.2); pain tolerance: mean difference 1.9 (95% CI 1.8 to 2.0)] and cryotherapy in combination with burst TENS [pain threshold: mean difference 2.6 (95% CI 2.4 to 2.8); pain tolerance: mean difference 4.9 (95% CI 5.0 to 4.8)]. Cryotherapy in combination with burst TENS provided greater analgesia compared with the other groups (Pcryotherapy in combination with burst TENS to reduce induced pain, and suggest a potentiating effect when these techniques are combined. No such association was found between cryotherapy and conventional TENS. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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

Directory of Open Access Journals (Sweden)

L. Grobler

2005-01-01

Full Text Available 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 questionnaires that determined their knowledge of exercise as a treatment method. All nurses prescribed medication forhypertensive patients. Most nurses prescribed weight control (72.1%, diet control (76.7%, patient education (74.4%, and life-style modification (72.1%. Most (83.7% nurses were aware of exercise as a treatment method for hypertension. Only seven nurses, prescribing a brisk walk, recommended the correct type of exercise. The nurses’attitude towards exercise as a treatment method was determined using focus group interviews (n=16. Nurses reflected a positive attitude towards exercise with 198 positive responses. Nurses could express more than one opinion, all of which were recorded. Twenty responses reflected little or no knowledge, and four responses reflected an unsure/neutral attitude towards exercise. Ten responses reflected disinterest in prescribing exercise. Nurses do not have adequate knowledge to enable them to confidently prescribe exercise to patients. The need for more information was mentioned and some nurses were willing to present exercise classes. A training program, containing pertinent information, so that nurses can prescribe exercise for hypertension, needs to be developed.

TENS (transcutaneous electrical nerve stimulation) for labour pain.

Science.gov (United States)

Francis, Richard

2012-05-01

Because TENS is applied inconsistently and not always in line with optimal TENS application theory, this may explain why TENS for labour pain appears to be effective in some individuals and not in others. This article reviews TENS theory, advises upon optimal TENS application for labour pain and discusses some of the limitations of TENS research on labour pain. TENS application for labour pain may include TENS applied to either side of the lower spine, set to 200 mus pulse duration and 100 pulses per second. As pain increases, TENS intensity should be increased and as pain decreases, TENS intensity should be reduced to maintain a strong but pain free intensity of stimulation. This application may particularly reduce back pain during labour.

Effects of tripolar TENS on slow and fast motoneurons: a preliminary study using H-reflex recovery curve method.

Science.gov (United States)

Simorgh, L; Torkaman, G; Firoozabadi, S M

2008-01-01

This study aimed at examining the effect of tripolar TENS of vertebral column on the activity of slow and fast motoneurons on 10 healthy non-athlete women aged 22.7 +/- 2.21 yrs. H-reflex recovery curve of soleus (slow) and gastrocnemius (fast) muscles were recorded before and after applying tripolar TENS. For recording of this curve, rectangular paired stimuli were applied on tibial nerve (with 40-520 ISI, frequency of 0.2 Hz and pulse width of 600 micros). Our findings showed that maximum H-reflex recovery in gastrocnemius muscle appeared in the shorter ISI, while in soleus muscle, it appeared in the longer ISI and its amplitude slightly decreased after applying tripolar TENS. It is suggested that tripolar TENS excites not only the skin but also Ia and Ib afferents in the dorsal column. A Synaptic interaction of these afferents in spinal cord causes the inhibition of type I MNs and facilitation of type II MNs. This effect can be used in muscle tone modulation.

Cost-effectiveness analysis of HLA-B*5801 testing in preventing allopurinol-induced SJS/TEN in Thai population.

Directory of Open Access Journals (Sweden)

Surasak Saokaew

Full Text Available BACKGROUND: Stevens-Johnson syndrome (SJS and Toxic Epidermal Necrolysis (TEN, caused by allopurinol therapy, are strongly associated with the human leukocyte antigen (HLA, HLA-B*5801. Identification of HLA-B*5801 genotype before prescribing allopurinol offers the possibility of avoiding allopurinol-induced SJS/TEN. As there is a paucity of evidence about economic value of such testing, this study aims to determine the cost-effectiveness of HLA-B*5801 testing compared with usual care (no genetic testing before allopurinol administration in Thailand. METHODS AND FINDING: A decision analytical and Markov model was used to estimate life time costs and outcomes represented as quality adjusted life years (QALYs gained. The model was populated with relevant information of the association between gene and allopurinol-induced SJS/TEN, test characteristics, costs, and epidemiologic data for Thailand from a societal perspective. Input data were obtained from the literature and a retrospective database analysis. The results were expressed as incremental cost per QALY gained. A base-case analysis was performed for patients at age 30. A series of sensitivity analyses including scenario, one-way, and probabilistic sensitivity analyses were constructed to explore the robustness of the findings. Based on a hypothetical cohort of 1,000 patients, the incremental total cost was 923,919 THB (USD 29,804 and incremental QALY was 5.89 with an ICER of 156,937.04 THB (USD 5,062 per QALY gained. The cost of gout management, incidence of SJS/TEN, case fatality rate of SJS/TEN, and cost of genetic testing are considered very influential parameters on the cost-effectiveness value of HLA-B*5801 testing. CONCLUSIONS: The genetic testing for HLA-B*5801 before allopurinol administration is considered a highly potential cost-effective intervention in Thailand. The findings are sensitive to a number of factors. In addition to cost-effectiveness findings, consideration of other

Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults.

Science.gov (United States)

Gibson, William; Wand, Benedict M; O'Connell, Neil E

2017-09-14

Neuropathic pain, which is due to nerve disease or damage, represents a significant burden on people and society. It can be particularly unpleasant and achieving adequate symptom control can be difficult. Non-pharmacological methods of treatment are often employed by people with neuropathic pain and may include transcutaneous electrical nerve stimulation (TENS). This review supersedes one Cochrane Review 'Transcutaneous electrical nerve stimulation (TENS) for chronic pain' (Nnoaham 2014) and one withdrawn protocol 'Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults' (Claydon 2014). This review replaces the original protocol for neuropathic pain that was withdrawn. To determine the analgesic effectiveness of TENS versus placebo (sham) TENS, TENS versus usual care, TENS versus no treatment and TENS in addition to usual care versus usual care alone in the management of neuropathic pain in adults. We searched CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, Web of Science, PEDro, LILACS (up to September 2016) and various clinical trials registries. We also searched bibliographies of included studies for further relevant studies. We included randomised controlled trials where TENS was evaluated in the treatment of central or peripheral neuropathic pain. We included studies if they investigated the following: TENS versus placebo (sham) TENS, TENS versus usual care, TENS versus no treatment and TENS in addition to usual care versus usual care alone in the management of neuropathic pain in adults. Two review authors independently screened all database search results and identified papers requiring full-text assessment. Subsequently, two review authors independently applied inclusion/exclusion criteria to these studies. The same review authors then independently extracted data, assessed for risk of bias using the Cochrane standard tool and rated the quality of evidence using GRADE. We included 15 studies with 724 participants. We found a

Powers of ten

CERN Document Server

1979-01-01

Powers of Ten is a 1977 short documentary film written and directed by Charles Eames and his wife, Ray. The film depicts the relative scale of the Universe in factors of ten (see also logarithmic scale and order of magnitude). The idea for the film appears to have come from the 1957 book Cosmic View by Kees Boeke. The film begins with an aerial image of a man reclining on a blanket; the view is that of one meter across. The viewpoint, accompanied by expository voiceover, then slowly zooms out to a view ten meters across ( or 101 m in standard form), revealing that the man is picnicking in a park with a female companion. The zoom-out continues, to a view of 100 meters (102 m), then 1 kilometer (103 m), and so on, increasing the perspective—the picnic is revealed to be taking place near Soldier Field on Chicago's waterfront—and continuing to zoom out to a field of view of 1024 meters, or the size of the observable universe. The camera then zooms back in to the picnic, and then to views of negative pow...

transverse patella fracture in a ten year old boy: case report

African Journals Online (AJOL)

report a case of a transverse patella fracture in a ten year old boy. He presented with ... fall, he reported that he had pain and swelling which resolved ... radiographs of the patient's right (normal) knee. Figure 1 ... the limb splinted in a back slab.

Impact of glutathione transferases genes polymorphisms in nevirapine adverse reactions: a possible role for GSTM1 in SJS/TEN susceptibility.

Science.gov (United States)

Ciccacci, Cinzia; Latini, Andrea; Politi, Cristina; Mancinelli, Sandro; Marazzi, Maria C; Novelli, Giuseppe; Palombi, Leonardo; Borgiani, Paola

2017-10-01

Nevirapine (NVP) is used in developing countries as first-line treatment of HIV infection. Unfortunately, its use is associated with common serious adverse drug reactions, such as liver toxicity and the most severe and rare Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). GSTT1 and GSTM1 genes code for enzymes involved in the metabolism of a wide range of drugs. We hypothesized that this gene variability could be implicated in NVP adverse reactions. We analyzed the GSTM1 and GSTT1 null genotypes by multiplex PCR in a population of 181 patients from Mozambique, treated with NVP. A case/control association study was performed. We also counted the number of risk alleles in SJS/TEN patients and in controls, including the GSTM1 null genotype and four previously identified risk alleles in CYP2B6, HCP5, and TRAF3IP2 genes. Among patients, 27 had developed SJS/TEN and 76 had developed hepatotoxicity during the treatment. The GSTM1 null genotype was more frequent in the cases with SJS/TEN than in the controls (OR = 2.94, P = 0.027). This association is also observed when other risk factors are taken into account, by a multivariate analysis (P = 0.024 and OR = 3.58). The risk allele counting analysis revealed a significantly higher risk for SJS/TEN in patients carrying three or four risk alleles. Moreover, all subjects with five or six risk alleles developed SJS/TEN, while subjects without any risk alleles were present only in the control group. We observed an association between GSTM1 and SJS/TEN susceptibility. Moreover, GSTM1 contributes to the definition of a genetic risk profile for SJS/TEN susceptibility.

Anti-stress effects of transcutaneous electrical nerve stimulation (TENS) on colonic motility in rats.

Science.gov (United States)

Yoshimoto, Sazu; Babygirija, Reji; Dobner, Anthony; Ludwig, Kirk; Takahashi, Toku

2012-05-01

Disorders of colonic motility may contribute to symptoms in patients with irritable bowel syndrome (IBS), and stress is widely believed to play a major role in developing IBS. Stress increases corticotropin releasing factor (CRF) of the hypothalamus, resulting in acceleration of colonic transit in rodents. In contrast, hypothalamic oxytocin (OXT) has an anti-stress effect via inhibiting CRF expression and hypothalamic-pituitary-adrenal axis activity. Although transcutaneous electrical nerve stimulation (TENS) and acupuncture have been shown to have anti-stress effects, the mechanism of the beneficial effects remains unknown. We tested the hypothesis that TENS upregulates hypothalamic OXT expression resulting in reduced CRF expression and restoration of colonic dysmotility in response to chronic stress. Male SD rats received different types of stressors for seven consecutive days (chronic heterotypic stress). TENS was applied to the bilateral hind limbs every other day before stress loading. Another group of rats did not receive TENS treatment. TENS significantly attenuated accelerated colonic transit induced by chronic heterotypic stress, which was antagonized by a central injection of an OXT antagonist. Immunohistochemical study showed that TENS increased OXT expression and decreased CRF expression at the paraventricular nucleus (PVN) following chronic heterotypic stress. It is suggested that TENS upregulates hypothalamic OXT expression which acts as an anti-stressor agent and mediates restored colonic dysmotility following chronic stress. TENS may be useful to treat gastrointestinal symptoms associated with stress.

Ten new withanolides from Physalis peruviana.

Science.gov (United States)

Fang, Sheng-Tao; Liu, Ji-Kai; Li, Bo

2012-01-01

Ten new withanolides, including four perulactone-type withanolides, perulactones E-H (1-4), three 28-hydroxy-withanolides, withaperuvins I-K (5-7), and three other withanolides, withaperuvins L-N (8-10), together with six known compounds (11-16) were isolated from the aerial parts of Physalis peruviana. The structures of these compounds were elucidated on the basis of extensive spectroscopic analyses (1D and 2D NMR, IR, HR-MS) and chemical methods. Copyright © 2011 Elsevier Inc. All rights reserved.

Sclerotherapy of Plummer's disease - A critical ten year review

International Nuclear Information System (INIS)

Sandrock, D.; Humplik, B.I.; Munz, D.L.

2002-01-01

Aim: Since ten years sclerotherapy with ethanol is proposed for the treatment of Plummer's disease (unifocal autonomy). Hence, it was the aim of this study to evaluate critically all the sclerotherapies performed in our institution. Special attention should be given to the long-term results. Material and Methods: In the study enrolled were 47 consecutive patients with Plummer's disease, who were referred to sclerotherapy with ethanol since 1991 (10 men, 37 women, aged 24-79 years). The diagnosis of unifocal autonomy was proven in all patients by scintigraphy under TSH-suppressed conditions. 31 patients had latent, 16 manifest hyperthyroidism, 12 of these under antithyroid medication. All patients received ultrasound guided infiltrations of 0.5-2 ml 96 % ethanol into the autonomy. The procedure was repeated at intervals (individually between 1 week and 3 months) until there was A) sufficient success, B) partial success or C) the patient refused further infiltrations. Results: Overall, 407 infiltrations were performed. The number of infiltrations per patient reached from 1 to 63 (mean 7). The side effects included 2 cases of a (transient) paresis of the recurrent nerve and pain/discomfort in 32 %. The therapy was finished successfully (group A; normal TSH, normalisation of the scintigraphic pattern) in 17 patients, partially successfully (group B; change from manifest to latent hyperthyroidism and/or TSH > 0.1 mU/l, scintigram not completely normalized) in 12 patients, and without success (group C) in 16 patients - 2 changed to surgery, 4 to radioiodine therapy, 3 continued antithyroid medication and 4 refused therapy without further comments. Excluding 2 patients from group B (with 35 and 61 infiltrations, respectively) there was no significant difference between A, B, and C in the parameters uptake under suppression, volume of the autonomy, laboratory values, number of infiltrations, age or sex. Conclusion: The sclerotherapy with ethanol, consequently performed, is

Antifungal susceptibility testing of Candida species isolated from the immunocompromised patients admitted to ten university hospitals in Iran: comparison of colonizing and infecting isolates

Directory of Open Access Journals (Sweden)

Parisa Badiee

2017-11-01

Full Text Available Abstract Background Antifungal susceptibility testing is a subject of interest in the field of medical mycology. The aim of the present study were the distributions and antifungal susceptibility patterns of various Candida species isolated from colonized and infected immunocompromised patients admitted to ten university hospitals in Iran. Methods In totally, 846 Candida species were isolated from more than 4000 clinical samples and identified by the API 20 C AUX system. Antifungal susceptibility testing was performed by broth microdilution method according to CLSI. Results The most frequent Candida species isolated from all patients was Candida albicans (510/846. The epidemiological cutoff value and percentage of wild-type species for amphotericin B and fluconazole in Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei were 0.5 μg/ml (95% and 4 μg/ml (96%; 1 μg/ml (95% and 8 μg/ml (95%; 0.5 μg/ml (99% and 19 μg/ml (98%; and 4 μg/ml (95% and 64 μg/ml (95%, respectively. The MIC90 and epidemiological cutoff values to posaconazole in Candida krusei were 0.5 μg/ml. There were significant differences between infecting and colonizing isolates of Candida tropicalis in MIC 90 values of amphotericin B, and isolates of Candida glabrata in values of amphotericin B, caspofungin, and voriconazole (P < 0.05. Conclusions Our findings suggest that the susceptibility patterns of Candida species (colonizing and infecting isolates in immunocompromised patients are not the same and acquired resistance was seen in some species.

Ganglion cysts at the gastrocnemius origin: a series of ten cases

International Nuclear Information System (INIS)

James, S.L.J.; Connell, D.A.; Saifuddin, A.; Bell, J.

2007-01-01

To describe ganglion cysts arising close to the origin of the medial and lateral head of gastrocnemius as identified on magnetic resonance (MR) imaging. We present a series of ten cases of ganglion cysts arising close to the gastrocnemius origin from the medial and lateral femoral condyles. These were collected over a 6-year period from our imaging database. All patients attended for routine MR imaging of the knee with a variety of clinical presentations. Data collected included patient demographics, ganglion size, ganglion site, clinical presentation and ancillary MR imaging findings. The ten patients in this series consisted of seven males and three females, five right and five left knees, age range 27-68 years, mean age 40.6 years. The mean maximal dimension of the ganglion cysts was 26 mm, range 15-40 mm. The medial gastrocnemius origin was involved in eight patients and the lateral origin in two patients. The MR imaging findings consisted of both uni- and multi-loculated cysts, often containing numerous septations with fluid signal characteristics. The cysts were extra-capsular with no clear communication with the joint. One patient presented with a popliteal soft tissue mass and none of the cases required surgical intervention for cyst removal. MR imaging may identify ganglion cysts arising in an intra- or extra-articular site around the knee. This series documents the MR imaging characteristics of ganglion cysts arising close to the gastrocnemius origin and discusses the relevance of this imaging finding. (orig.)

Efeitos da estimulação elétrica nervosa transcutânea (TENS) e da corrente interferencial (CI) em pacientes com lombalgia crônica não específica: ensaio clínico randomizado

OpenAIRE

Facci, Ligia Maria [UNIFESP; Nowotny, Jean Paulus; Tormem, Fabio; Trevisani, Virgínia Fernandes Moça [UNIFESP

2011-01-01

CONTEXT AND OBJECTIVE: Transcutaneous electrical nerve stimulation (TENS) and interferential current are the most used electrotherapy methods, although there is little scientific evidence to support their use. The aim of this study was to compare the effects of TENS and interferential current among patients with nonspecific chronic low back pain. DESIGN AND SETTING: Single-blind randomized controlled trial in the Department of Physiotherapy, Centro Universitário de Maringá. METHODS: One hundr...

Gardner's syndrome: a ten year follow up survey of 12 subjects in a family

International Nuclear Information System (INIS)

Lu Kaimin; Si Liya; Wu Zhiqiang; Lu Xuan; Meng Liancheng

1998-01-01

Purpose: To study the development of Gardner's syndrome by following up 12 subjects in a family for ten years. Methods: 12 subjects with Gardner's syndrome of 4 generations in a family were studied. Six were male and six female. The age of the patients was from 9 to 74 years, with average of 38 years. The examinations consisted of air-barium double contrast radiography of colon, fiber-optic colonoscopy, plain X-ray and body photography. Results: Triology was present in 8 cases (66.7%) and the double signs in 4 cases (33.3%). 4 patients (33.3%) died of malignant degeneration of colonic polyp in 10 years, all occurring in rectum and sigmoid colon, the oldest one was 74 years and the youngest 35 years. Conclusion: The incidence of malignant degeneration of colonic polyp is very high in patients with Gardner's syndrome and may occur in patients older than 30 years, with the peak incidence in the sixth decade. Preventive resection of colonic polyp is still the best treatment

Systemic adverse events following rituximab therapy in patients with Graves' disease

DEFF Research Database (Denmark)

El Fassi, D; Nielsen, C H; Junker, P

2010-01-01

had the third highest increase in immunoglobulin deposition on monocytes by day 14. The arthralgias persisted in two of the patients, despite glucocorticoid rescue therapy. Conclusions: We report articular adverse events in three and gastrointestinal symptoms in two out of ten GD patients who received...... methimazole only. Adverse events were recorded, and the presence of circulating immune complexes (CICs) was measured as IgG, IgM and complement component 3 (C3) depositing on normal monocytes following incubation with patient plasma. Results: Five patients had benign infusion-related adverse events at first......Background and aim: Rituximab (RTX) therapy has shown promising results in Graves´ disease (GD), with or without ophthalmopathy. We examined the occurrence of adverse events in GD patients treated with RTX. Subjects and methods: Ten patients received RTX and methimazole, while ten patients received...

The occurrence of osteoarthritis at a minimum of ten years after reconstruction of the anterior cruciate ligament

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Patt Thomas W

2008-06-01

Full Text Available Abstract Objective The objective of this study was to evaluate the incidence of radiographic osteoarthritis in the operated knee in comparison with the contralateral knee ten years after a bone-tendon bone patellar autograft ACL-reconstruction and to evaluate to which level patients regain activity ten years after reconstruction. Methods Fifty-three patients with ACL instability were operated arthroscopically using the central third of the patellar tendon as a bone-tendon-bone autograft. At a minimum of 10 year follow up 28/44 patients matched the inclusion criteria and could be reached for follow-up. Evaluation included a patient satisfaction evaluation using a Visual Analog Scale, physical examination (International Knee Documentation Committee score, Tegner score, Lysholm score, KT-1000 stabilometry and a radiological evaluation (Kellgren and Fairbanks classification. Results The patients' satisfaction, at a mean of 10,3 year follow-up, measured with a VAS score (0–10 was high with a mean of 8.5 (range 4 to 10. The KT 1000 arthrometer laxity measurements revealed in 55% of the patients an A rating (1–2 mm, in 29% a B rating (3–5 mm and in 16% a C rating (6–10 mm. According to the Tegner score 54% of the patients were able to perform at the same activity level as pre-operatively. The mean pre-operative Tegner score was 6.8 and the mean post-operative Tegner score was 6.0 at final follow up. The Lysholm score showed satisfactory results with a mean of 91 points (range 56 to 100. According to the Kellgren and Fairbank classifications, there is a significant difference (p Conclusion The patellar BTB ACL reconstruction does not prevent the occurrence of radiological OA after 10 years but does help the patient to regain the pre-operative level of activity.

Ten principles of good interdisciplinary team work.

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Nancarrow, Susan A; Booth, Andrew; Ariss, Steven; Smith, Tony; Enderby, Pam; Roots, Alison

2013-05-10

Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team work, and in some cases, outcomes. This study draws on two sources of knowledge to identify the attributes of a good interdisciplinary team; a published systematic review of the literature on interdisciplinary team work, and the perceptions of over 253 staff from 11 community rehabilitation and intermediate care teams in the UK. These data sources were merged using qualitative content analysis to arrive at a framework that identifies characteristics and proposes ten competencies that support effective interdisciplinary team work. Ten characteristics underpinning effective interdisciplinary team work were identified: positive leadership and management attributes; communication strategies and structures; personal rewards, training and development; appropriate resources and procedures; appropriate skill mix; supportive team climate; individual characteristics that support interdisciplinary team work; clarity of vision; quality and outcomes of care; and respecting and understanding roles. We propose competency statements that an effective interdisciplinary team functioning at a high level should demonstrate.

Problems, Solutions, and Strategies Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

Science.gov (United States)

Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

2016-07-01

Transcutaneous electrical nerve stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methods identified significant problems with low treatment fidelity. There is little information available to inform the development of a pragmatic implementation design for a TENS evaluation. The aim of this study was to explore the experiences of patients who were receiving secondary care in a pain clinic and who had expertise in using TENS to manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Semistructured interviews were conducted with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that patients learned to address a range of problems in order to optimize TENS use. Patients may need to personalize the positioning of electrodes and the TENS settings and to readjust them over time. Patients learned to use TENS in a strategic manner, and the outcomes of each strategy varied. The findings indicated that a pragmatic TENS evaluation may need to incorporate a learning phase to allow patients to optimize this complex pattern of TENS usage, and evaluation may need to be sensitive to the outcomes of strategic use. These findings also have implications for clinical practice. © 2016 American Physical Therapy Association.

Review of a community oral health programme in Nigeria after ten ...

African Journals Online (AJOL)

It comprises school health programmes, health education programmes for specific target groups, examination for early detection of diseases and provision of dental services at the clinic located on site. Within the first ten years under review (1988-1997), a total of 780 patients were seen at the dental clinic. Three hundred ...

Transcutaneous electrical nerve stimulation (TENS) accelerates cutaneous wound healing and inhibits pro-inflammatory cytokines.

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Gürgen, Seren Gülşen; Sayın, Oya; Cetin, Ferihan; Tuç Yücel, Ayşe

2014-06-01

The purpose of this study was to evaluate transcutaneous electrical nerve stimulation (TENS) and other common treatment methods used in the process of wound healing in terms of the expression levels of pro-inflammatory cytokines. In the study, 24 female and 24 male adult Wistar-Albino rats were divided into five groups: (1) the non-wounded group having no incision wounds, (2) the control group having incision wounds, (3) the TENS (2 Hz, 15 min) group, (4) the physiological saline (PS) group and (5) the povidone iodine (PI) group. In the skin sections, interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were assessed with enzyme-linked immunosorbent assay and immunohistochemical methods. In the non-wounded group, the expression of IL-1β, IL-6, and TNF-α signaling molecules was weaker in the whole tissue; however, in the control group, significant inflammatory response occurred, and strong cytokine expression was observed in the dermis, granulation tissue, hair follicles, and sebaceous glands (P TENS group, the decrease in TNF-α, IL-1β, and IL-6 immunoreaction in the skin was significant compared to the other forms of treatment (P TENS group suggest that TENS shortened the healing process by inhibating the inflammation phase.

Ten-year in vivo wear measurement of a fully congruent mobile bearing unicompartmental knee arthroplasty.

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Price, A J; Short, A; Kellett, C; Beard, D; Gill, H; Pandit, H; Dodd, C A F; Murray, D W

2005-11-01

Polyethylene particulate wear debris continues to be implicated in the aetiology of aseptic loosening following knee arthroplasty. The Oxford unicompartmental knee arthroplasty employs a spherical femoral component and a fully congruous meniscal bearing to increase contact area and theoretically reduce the potential for polyethylene wear. This study measures the in vivo ten-year linear wear of the device, using a roentgenstereophotogrammetric technique. In this in vivo study, seven medial Oxford unicompartmental prostheses, which had been implanted ten years previously were studied. Stereo pairs of radiographs were acquired for each patient and the films were analysed using a roentgen stereophotogrammetric analysis calibration and a computer-aided design model silhouette-fitting technique. Penetration of the femoral component into the original volume of the bearing was our estimate of linear wear. In addition, eight control patients were examined less than three weeks post-insertion of an Oxford prosthesis, where no wear would be expected. The control group showed no measured wear and suggested a system accuracy of 0.1 mm. At ten years, the mean linear wear rate was 0.02 mm/year. The results from this in vivo study confirm that the device has low ten-year linear wear in clinical practice. This may offer the device a survival advantage in the long term.

Ten Years Evidence-Based High-Tech Acupuncture—A Short Review of Peripherally Measured Effects

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Gerhard Litscher

2009-01-01

Full Text Available Since 1997, the Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine of Graz Medical University has been dealing with the demystification of acupuncture and examining, using non-invasive methods, how different stimulation modalities (manual needle acupuncture, laserneedle acupuncture and electro acupuncture affect peripheral and central functions. Laser is also an important instrument for acupuncture. One only needs to mention the treatment of children or of patients with needle phobia. The laserneedle acupuncture, which was examined scientifically for the first time in Graz, represents a new painless acupuncture method for which up to ten laserneedles are glued to the skin, but not stuck into it. This first part of the short review article summarizes some of the peripherally measured effects of acupuncture obtained at the Medical University of Graz within the last 10 years.

Building patient safety in intensive care nursing : Patient safety culture, team performance and simulation-based training

OpenAIRE

Ballangrud, Randi

2013-01-01

Aim: The overall aim of the thesis was to investigate patient safety culture, team performance and the use of simulation-based team training for building patient safety in intensive care nursing. Methods: Quantitative and qualitative methods were used. In Study I, 220 RNs from ten ICUs responded to a patient safety culture questionnaire analysed with statistics. Studies II-IV were based on an evaluation of a simulation-based team training programme. Studies II-III included 53 RNs from seven I...

A Retrospective Audit of Dental Treatment Provided to Special Needs Patients under General Anesthesia During a Ten-Year Period.

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Mallineni, Sreekanth Kumar; Yiu, Cynthia Kar Y

The purpose of this study was to perform a comprehensive audit of dental treatment provided to special needs patients (SNP) under general anesthesia (GA) over a ten-year period. Special needs patients who received dental treatment under GA as an in-patient at Queen Mary Hospital, Hong Kong SAR during the time period January 2002 and December 2011 were included in the study. The study population was divided into three groups, based on age (12 years). One-way ANOVA was used to evaluate the effect of "age group" on duration of treatment, post-recovery time, treatment procedures and utilization of different restorative materials. Kappa statistics were used for intra-examiner reliability. A total of 275 patients (174 males and 101 females) were included in the study. The mean age of the patients at the time they received GA was 12.37±10.18 years. Dental procedures performed were mostly restorative in nature (47%). The >12 years group had significantly shorter treatment duration (pdifference in post-operative recovery time was observed among the three age groups (p>0.05). The group received significantly less preventive, but more restorative procedures (pgroup (puse of composite restorations was significantly higher in the group; while amalgam restorations were more frequently used in the >12 years group (Page (page, had longer treatment time under GA. Composite restorations and stainless steel crowns were more frequently used in the primary dentition and amalgam restorations were more frequently employed in the permanent dentition.

Prevalence of oral squamous cell carcinoma cases for ten years in Qazvin province (2003-13

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F. Keshani

2017-06-01

Full Text Available Background: Human cancers comprise a large group of diseases that despite modern methods of diagnosis and advanced treatment techniques its mortality rate is high. Considering the role of environmental and cultural factors in the prevalence of oral cancer, epidemiological studies have a great importance. Objective: The aim of this research was to determine the prevalence of oral squamous cell carcinoma (OSCC in the province of Qazvin in a period of ten years. Methods: In this descriptive - analytical study, the documents of 88 patients with OSCC that were recorded by the Qazvin Cancer Registry Center during 2003-13, were used. Demographic data including age, sex and location of lesions were extracted from patient records. Data analysis were performed using chi-square, t-test and fisher exact test. Findings: Among the 88 patients, the average age was 64.3±17.7. The male to female ratio was 1 to 1.37 and the most involved area was tongue with 39 cases (63.9%, and the lowest was upper lip with 1 case (1.6%. The most of the patients were in the age between 70-80 years old. Conclusions: Pattern of OSCC in this study was similar to the other studies but the number of females and the mean age of patient had increased. Also, the mean age of patients was increased in eight decades and the most involved area tongue was reported.

Treatment of severe tracheobronchomalacia: Ten-year experience.

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de Trey, Lorraine A; Dudley, Julia; Ismail-Koch, Hasnaa; Durward, Andrew; Bellsham-Revell, Hannah; Blaney, Sean; Hore, Ian; Austin, Conal B; Morrison, Gavin A

2016-04-01

Paediatric tracheobronchomalacia is a rare but potentially serious condition. Severe tracheobronchomalacia requires intervention or operation. This is an evaluation of a ten-year experience at an institution. In this retrospective study all patients were included that required an intervention for severe tracheobronchomalacia from 2003 to 2012. Symptoms, aetiology, comorbidities, localisation of the malacia, age at diagnosis, therapeutic measures and associated complications were evaluated. Forty-four patients with severe tracheobronchomalacia underwent intervention/operation. The predominant aetiology was vascular compression in 48%. The majority of patients had complex comorbidities, most importantly cardiac pathology in 66%. The median age at diagnosis was 3 months. A total of 17 aortopexies, 21 tracheostomies and 25 stent placements were performed. The mean follow-up was 2.6 years. Severe complications occurred in 12 patients. The most common complications were stent obstruction/fracture and tracheostomy tube obstruction. The management of severe tracheobronchomalacia is complex and the population of patients is very heterogeneous. Therefore the treatment has to be adapted for each patient individually. The decision strategies are discussed in this article. The surgical techniques for placement and safe removal of expandable bare metallic stents employed in our institution are presented. A multidisciplinary team of ENT surgeons, Intensivists, Cardiologists and Cardiac surgeons is of great importance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Coronary angiography in Qatar: the first ten years.

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Chaikhouni, A; Gehani, A A; Horak, J; Hajar, H A

1998-08-01

Cardiac catheterization in Qatar was initiated in July 1982. In ten years, a total of 3900 procedures were performed at Hamad General Hospital. Computerized data registry has been maintained since 1982. Isolated coronary angiography was done in 2911 patients; of these, 2635 (90.5%) were men, and 276 (9.5%) were women, the average age of the patients was 47+/-9.2 years (range, twenty-five to eighty-eight). Patients' nationality was Qatari in 492 (17%), and other Arabs in 610 (21%), and 1512 (52%) were from the Asian subcontinent. Myocardial infarction was the most common indication (43%). Single-vessel disease was found in 638 (22%), two-vessel disease in 630 (22%), three-vessel disease in 950 (33%), and nonsignificant coronary artery disease in 693 (24%) patients. Morbidity related to the coronary angiography was reported in 147 (5%) patients, but there was no mortality related to the procedure. In 822 (28%) patients, the age was forty years or younger. The angiographic findings of these younger patients were compared with those of the older ones. Younger patients were usually men of Asian subcontinental origin with a recent myocardial infarction (MI). Often, they had normal coronary arteries or single-vessel disease. Patients of Asian subcontinent origin were usually young male patients with a recent MI, who receive streptokinase, and have single-vessel disease.

Pain relief by transcutaneous electric nerve stimulation with bidirectional modulated sine waves in patients with chronic back pain: a randomized, double-blind, sham-controlled study.

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Shimoji, Koki; Takahashi, Norio; Nishio, Yasuyuki; Koyanagi, Mika; Aida, Sumihisa

2007-01-01

Objectives.  Newly developed bidirectional modulated sine waves (BMW) might provide some derived benefit to patients with low back pain. Pain relief by transcutaneous electric nerve stimulation (TENS) with BMWs was tested. Materials and Methods.  Analgesic effects of BMWs and conventional bidirectional pulsed waves on chronic back pain in 28 patients were compared, and effects of repeated TENS using BMWs on chronic back pain were investigated in 21 patients by means of a randomized double-blind, sham-controlled, parallel-group method. Pain intensity was assessed using numerical rating scale (NRS). Results.  There was significant immediate reduction in NRS in patients receiving BMWs, and 60 min after treatment compared to sham TENS. Weekly repeated treatments using massage and TENS with BMWs for 5 weeks resulted in a decrease of NRS, but there were no significant differences between the TENS plus massage and sham TENS plus massage groups. Conclusions.  This study shows that TENS with BMWs significantly inhibits chronic back pain, and treatment effects are attained within a day. The results also suggest that there were no statistically significant long-term effects of TENS with BMW in the repeated treatment.

The Supersymmetric Top-Ten Lists

OpenAIRE

Haber, Howard E.

1993-01-01

Ten reasons are given why supersymmetry is the leading candidate for physics beyond the Standard Model. Ultimately, the experimental discovery of supersymmetric particles at future colliders will determine whether supersymmetry is relevant for TeV scale physics. The grand hope of supersymmetry enthusiasts is to connect TeV scale supersymmetry with Planck scale physics. The ten most pressing theoretical problems standing in the way of this goal are briefly described.

Prolonged treatment with transcutaneous electrical nerve stimulation (TENS) modulates neuro-gastric motility and plasma levels of vasoactive intestinal peptide (VIP), motilin and interleukin-6 (IL-6) in systemic sclerosis.

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McNearney, Terry A; Sallam, Hanaa S; Hunnicutt, Sonya E; Doshi, Dipti; Chen, Jiande D Z

2013-01-01

We assessed the effects of transcutaneous electrical nerve stimulation (TENS) on neurogastric functioning in scleroderma patients. Seventeen SSc patients underwent 30 min TENS treatment >10Hz at GI acupuncture points PC6 and ST36, once (acute TENS) and then after two weeks of TENS sessions for 30 min twice daily (prolonged TENS). Data collected at Visits 1 and 2 included gastric myoelectrical activity (GMA) by surface electrogastrography (EGG), heart rate variability (HRV) by surface electrocardiography (EKG), GI specific symptoms and health related SF-36 questionnaires. Plasma VIP, motilin and IL-6 levels were determined. Statistical analyses were performed by Student's t-test, Spearman Rank and p-values TENS, the percentages of normal slow waves and average slow wave coupling (especially channels 1, 2 reflecting gastric pacemaker and corpus regions) were significantly increased; 2. the percentage of normal slow waves was significantly correlated to sympathovagal balance; 3. Mean plasma VIP and motilin levels were significantly decreased after acute TENS, (vs. baseline), generally maintained in the prolonged TENS intervals. Compared to baseline, mean plasma IL-6 levels were significantly increased after acute TENS, but significantly decreased after prolonged TENS. 4. After prolonged TENS, the frequency of awakening due to abdominal pain and abdominal bloating were significantly and modestly decreased, respectively. In SSc patients, two weeks of daily TENS improved patient GMA scores, lowered plasma VIP, motilin and IL-6 levels and improved association between GMA and sympathovagal balance. This supports the therapeutic potential of prolonged TENS to enhance gastric myoelectrical functioning in SSc.

ALGORITHMS FOR TETRAHEDRAL NETWORK (TEN) GENERATION

Institute of Scientific and Technical Information of China (English)

无

2000-01-01

The Tetrahedral Network(TEN) is a powerful 3-D vector structure in GIS, which has a lot of advantages such as simple structure, fast topological relation processing and rapid visualization. The difficulty of TEN application is automatic creating data structure. Al though a raster algorithm has been introduced by some authors, the problems in accuracy, memory requirement, speed and integrity are still existent. In this paper, the raster algorithm is completed and a vector algorithm is presented after a 3-D data model and structure of TEN have been introducted. Finally, experiment, conclusion and future work are discussed.

Breast-conserving therapy with partial or whole breast irradiation: Ten-year results of the Budapest randomized trial

International Nuclear Information System (INIS)

Polgár, Csaba; Fodor, János; Major, Tibor; Sulyok, Zoltán; Kásler, Miklós

2013-01-01

Background and purpose: To report the long-term results of a single-institution randomized study comparing the results of breast-conserving treatment with partial breast irradiation (PBI) or conventional whole breast irradiation (WBI). Patients and methods: Between 1998 and 2004, 258 selected women with pT1 pN0-1mi M0, grade 1–2, non-lobular breast cancer without the presence of extensive intraductal component and resected with negative margins were randomized after BCS to receive 50 Gy WBI (n = 130) or PBI (n = 128). The latter consisted of either 7 × 5.2 Gy high-dose-rate (HDR) multi-catheter brachytherapy (BT; n = 88) or 50 Gy electron beam (EB) irradiation (n = 40). Primary endpoint was local recurrence (LR) as a first event. Secondary endpoints were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and cosmetic results. Results: After a median follow up of 10.2 years, the ten-year actuarial rate of LR was 5.9% and 5.1% in PBI and WBI arms, respectively (p = 0.77). There was no significant difference in the ten-year probability of OS (80% vs 82%), CSS (94% vs 92%), and DFS (85% vs 84%), either. The rate of excellent-good cosmetic result was 81% in the PBI, and 63% in the control group (p < 0.01). Conclusions: Partial breast irradiation delivered by interstitial HDR BT or EB for a selected group of early-stage breast cancer patients produces similar ten-year results to those achieved with conventional WBI. Significantly better cosmetic outcome can be achieved with HDR BT implants compared with the outcome after WBI

The five times ten things everyone should have had in their hands before they are ten and two years old.

Science.gov (United States)

Hut, R.; Poot, A.

2017-12-01

To train the young ones to become people that make stuff, I present the five times ten things we use a lot that everyone should have used before they are ten and two years old. I will bring at least two times ten of these things and show them live to you! And: I will bring a large paper for you to bring home with those five times ten things on it to put in the hands of your kids!

[A comparative study of blood culture conventional method vs. a modified lysis/centrifugation technique for the diagnosis of fungemias].

Science.gov (United States)

Santiago, Axel Rodolfo; Hernández, Betsy; Rodríguez, Marina; Romero, Hilda

2004-12-01

The purpose of this work was to compare the efficacy of blood culture conventional method vs. a modified lysis/centrifugation technique. Out of 450 blood specimens received in one year, 100 where chosen for this comparative study: 60 from patients with AIDS, 15 from leukemic patients, ten from febrile neutropenic patients, five from patients with respiratory infections, five from diabetics and five from septicemic patients. The specimens were processed, simultaneously, according to the above mentioned methodologies with daily inspections searching for fungal growth in order to obtain the final identification of the causative agent. The number (40) of isolates recovered was the same using both methods, which included; 18 Candida albicans (45%), ten Candida spp. (25%), ten Histoplasma capsulatum (25%), and two Cryptococcus neoformans (5%). When the fungal growth time was compared by both methods, growth was more rapid when using the modified lysis/centrifugation technique than when using the conventional method. Statistical analysis revealed a significant difference (pcentrifugation technique showed to be more efficacious than the conventional one, and therefore the implementation of this methodology is highly recommended for the isolation of fungi from blood.

Adjunct High Frequency Transcutaneous Electric Stimulation (TENS) for Postoperative Pain Management during Weaning from Epidural Analgesia Following Colon Surgery: Results from a Controlled Pilot Study.

Science.gov (United States)

Bjerså, Kristofer; Jildenstaal, Pether; Jakobsson, Jan; Egardt, Madelene; Fagevik Olsén, Monika

2015-12-01

The potential benefit of nonpharmacological adjunctive therapy is not well-studied following major abdominal surgery. The aim of the present study was to investigate transcutaneous electrical nerve stimulation (TENS) as a complementary nonpharmacological analgesia intervention during weaning from epidural analgesia (EDA) after open lower abdominal surgery. Patients were randomized to TENS and sham TENS during weaning from EDA. The effects on pain at rest, following short walk, and after deep breath were assessed by visual analog scale (VAS) grading. Number of patients assessed was lower than calculated because of change in clinical routine. Pain scores overall were low. A trend of lower pain scores was observed in the active TENS group of patients; a statistical significance between the groups was found for the pain lying prone in bed (p TENS use in postoperative pain management during weaning from EDA after open colon surgery. Further studies are warranted in order to verify the potential beneficial effects from TENS during weaning from EDA after open, lower abdominal surgery. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Comparison of the refractive error changes among young children in ten years interval

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Hai-Yan Li

2013-07-01

Full Text Available AIM: To compare the optometric examination results of myopic young children between those diagnosed in the period from 1998 to 2000 and those diagnosed in the period from 2008 to 2010; and to find out the causes of myopia and factors that worsen the condition, and suggest methods of its prevention and treatment.METHODS: This study was a retrospective case study. We randomly selected sample from out-patient department register of cases and divided them into two main groups, ‘ten year before group'(TYBG(1998/2000 year casesand ‘ten years later group'(2008/2010 year cases(TYLG. Each group was further subdivided into three sub-groups by age: under-six years old children group(CG, seven-twelve years old primary-school group(PSGand thirteen-eighteen years old middle-school group(MSG. The optometric examination results were statistically analyzed.RESULTS: The difference of the mean dioptre between the TYBG and TYLG was strongly statistically significant, also forward-lead trend of age when children suffered from myopia was found(P0.01. There was a significant increase of dioptre among PSG and MSG in TYLG compared to TYBG(PCONCLUSION: Our study shows that the age of getting myopia was forward lead, the dioptre increases by 1.00 degree and the prevalence of myopia is increasing gradually. This situation may due to the modern life style and changes of living standard of the population. Therefore, prevention of myopia should concentrate more on younger children at kindergarten and primary school stage students.

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.

Microwave Ablation of Lung Tumors Near the Heart: A Retrospective Review of Short-Term Procedural Safety in Ten Patients.

Science.gov (United States)

Maxwell, Aaron W P; Healey, Terrance T; Dupuy, Damian E

2017-09-01

To evaluate the rate of short-term complications associated with microwave ablation of lung tumors located near the heart. This HIPAA-compliant study was performed with a waiver for informed consent. Patients who underwent microwave ablation of lung tumors located 10 mm or less from the heart were identified by retrospective chart review. Both primary and metastatic tumors were included. Only tumors directly adjacent to one of the four cardiac chambers were included. All patients were treated in a single session using CT guidance with continuous electrocardiographic monitoring. Rates of new-onset arrhythmia and myocardial infarction (MI) within 90 days of the procedure were quantified, and evidence of cardiac or pericardiac injury was assessed for using post-ablation contrast-enhanced chest CT, electrocardiography (EKG), and-when available-echocardiography. Complications were graded using the Common Terminology Criteria for Adverse Events (CTCAE) system. Ten patients (four males, six females; mean age 73.1 ± 9.5 years) met all inclusion criteria. Mean tumor distance from the heart was 3 mm (range, 0-6 mm). New-onset arrhythmia was not observed during or following any of the microwave ablation treatments, and there were no documented 90-day MI events. CTCAE Grade 1 complications were observed by CT in eight patients, most commonly mild focal pericardial thickening. EKG and echocardiography were normal in all patients. No major complications (CTCAE Grade 3 or greater) were observed. Microwave ablation of lung tumors located 10 mm or less from the heart appears to have low associated short-term morbidity and may be appropriate in selected patients.

Tens bij bevallingen

NARCIS (Netherlands)

Tuin-Nuis, F.D.F.

2000-01-01

TENS (Transcutane Electrische Neuro Stimulatie) is een pijnverlichtingsmethode die berust op de Gate Control Theory van Melzack en Wall. Door middel van electrische pulsen via de huid zou de geleiding van nociceptieve signalen (pijnprikkels) worden beïnvloed en zou het lichaam endorfinen aanmaken:

Stevens-Johnson syndrome and toxic epidermal necrolysis in childhood-onset systemic lupus erythematosus patients: a multicenter study

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Ana Paula Sakamoto

2017-07-01

Full Text Available Objective: To assess Stevens-Johnson syndrome (SJS and toxic epidermal necrolysis (TEN in a large population of childhood-onset systemic lupus erythematosus (cSLE patients. Methods: Multicenter study including 852 cSLE patients followed in Pediatric Rheumatology centers in São Paulo, Brazil. SJS was defined as epidermal detachment below 10% of body surface area (BSA, overlap SJS-TEN 10-30% and TEN greater than 30% of BSA. Results: SJS and TEN was observed in 5/852 (0.6% cSLE female patients, three patients were classified as SJS and two patients were classified as overlap SJS-TEN; TEN was not observed. The mean duration of SJS and overlap SJS-TEN was 15 days (range 7-22 and antibiotics induced four cases. Regarding extra-cutaneous manifestations, hepatomegaly was observed in two cSLE patients, nephritis in two and neuropsychiatric involvement and conjunctivitis were observed respectively in one patient. Hematological involvement included lymphopenia in four, leucopenia in three and thrombocytopenia in two patients. The mean SLEDAI-2K score was 14.8 (range 6-30. Laboratory analysis showed low C3, C4 and/or CH50 in two patients and the presence of anti-dsDNA autoantibody in two patients. One patient had lupus anticoagulant and another one had anticardiolipin IgG. All patients were treated with steroids and four needed additional treatment such as intravenous immunoglobulin in two patients, hydroxychloroquine and azathioprine in two and intravenous cyclophosphamide in one patient. Sepsis was observed in three cSLE patients. Two patients required intensive care and death was observed in one patient. Conclusion: Our study identified SJS and overlap SJS-TEN as rare manifestations of active cSLE associated with severe multisystemic disease, with potentially lethal outcome.

Hippocampal volume measurement in patients with Meniere's disease : a pilot study

NARCIS (Netherlands)

van Cruijsen, Nynke; Hiemstra, Wilma M.; Meiners, Linda C.; Wit, Hero P.; Albers, Frans W. J.

2007-01-01

Conclusion. No signs of chronic stress as in hippocampal atrophy were present in patients with Meniere's disease. Objective. To evaluate the effect of chronic stress (allostatic load) by measuring hippocampal volume in patients with Meniere's disease. Subjects and methods. Ten patients with

Safety and efficacy of anti-tumor necrosis factor α therapy in ten patients with recent-onset refractory reactive arthritis.

Science.gov (United States)

Meyer, Alain; Chatelus, Emmanuel; Wendling, Daniel; Berthelot, Jean-Marie; Dernis, Emmanuelle; Houvenagel, Eric; Morel, Jacques; Richer, Olivier; Schaeverbeke, Thierry; Gottenberg, Jacques-Eric; Sibilia, Jean

2011-05-01

There are few treatments for reactive arthritis (ReA). Since concentrations of tumor necrosis factor α (TNFα) are high in the serum and joints of patients with persistent ReA, this cytokine could be targeted in patients who do not respond to nonsteroidal antiinflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs). We under-took this study to investigate the safety and efficacy of TNF antagonists in patients with recent-onset and refractory ReA. All French rheumatology and internal medicine practitioners registered on the Club Rhumatisme et Inflammation web site were asked to report on patients with ReA (defined by the criteria of the Third International Workshop on Reactive Arthritis) who had received anti-TNF therapy within the 12 months following the triggering infection. Tolerance and efficacy were retrospectively assessed using a standardized questionnaire. Ten patients with ReA previously refractory to NSAIDs and DMARDs, for which there was clinical and microbiologic evidence of a triggering bacterial infection, received anti-TNF therapy within a median of 6 months (range 2-12 months) between the beginning of ReA and the initiation of the treatment. The median followup was 20.6 months (range 6-50 months). We observed no severe adverse event and no infection related to the bacterium that triggered the ReA. Anti-TNF therapy was rapidly effective in 9 patients (90%), as shown by the rapid effect on a visual analog scale pain score, tender joint count, swollen joint count, and extraarticular manifestations, and by the corticosteroid-sparing effect. Anti-TNF therapy appears to be a safe and effective treatment of rheumatic and extraarticular manifestations in patients with recent-onset and refractory ReA, with a corticosteroid-sparing effect. Thus, TNFα could be a relevant target for ReA therapy.

Antifungal susceptibility testing of Candida species isolated from the immunocompromised patients admitted to ten university hospitals in Iran: comparison of colonizing and infecting isolates.

Science.gov (United States)

Badiee, Parisa; Badali, Hamid; Boekhout, Teun; Diba, Kambiz; Moghadam, Abdolkarim Ghadimi; Hossaini Nasab, Ali; Jafarian, Hadis; Mohammadi, Rasoul; Mirhendi, Hossein; Najafzadeh, Mohammad Javad; Shamsizadeh, Ahmad; Soltani, Jafar

2017-11-21

Antifungal susceptibility testing is a subject of interest in the field of medical mycology. The aim of the present study were the distributions and antifungal susceptibility patterns of various Candida species isolated from colonized and infected immunocompromised patients admitted to ten university hospitals in Iran. In totally, 846 Candida species were isolated from more than 4000 clinical samples and identified by the API 20 C AUX system. Antifungal susceptibility testing was performed by broth microdilution method according to CLSI. The most frequent Candida species isolated from all patients was Candida albicans (510/846). The epidemiological cutoff value and percentage of wild-type species for amphotericin B and fluconazole in Candida albicans, Candida tropicalis, Candida glabrata and Candida krusei were 0.5 μg/ml (95%) and 4 μg/ml (96%); 1 μg/ml (95%) and 8 μg/ml (95%); 0.5 μg/ml (99%) and 19 μg/ml (98%); and 4 μg/ml (95%) and 64 μg/ml (95%), respectively. The MIC90 and epidemiological cutoff values to posaconazole in Candida krusei were 0.5 μg/ml. There were significant differences between infecting and colonizing isolates of Candida tropicalis in MIC 90 values of amphotericin B, and isolates of Candida glabrata in values of amphotericin B, caspofungin, and voriconazole (P Candida species (colonizing and infecting isolates) in immunocompromised patients are not the same and acquired resistance was seen in some species.

Ultrasound combined transcutaneous electrical nerve stimulation (UltraTENS) versus phonophoresis of piroxicam (PhP) in symptomatic knee osteoarthritis: A randomized double-blind, controlled trial.

Science.gov (United States)

Boonhong, Jariya; Suntornpiyapan, Phitsanu; Piriyajarukul, Apatchanee

2018-02-02

Ultrasound combined with transcutaneous electrical nerve stimulation (UltraTENS) and phonophoresis of piroxicam (PhP) are combined modality therapy that frequently used in musculoskeletal pain including knee osteoarthritis (OA). But it is lack of a good clinical trial to prove and compare their effects. To compare the effects of UltraTENS with PhP on mild to moderate degree of symptomatic knee OA. Sixty-one patients (55 women), mean age of 63.4 ± 8.1 y, 50-90 mm VAS of knee pain and Kellgren-Lawrence score of grade I-III were randomly allocated into UltraTENS and PhP (N = 31 and 30, respectively). The UltraTENS group received a combined ultrasound with TENS program and a non-drug gel, whereas the PhP group got an ultrasound program with piroxicam gel and sham TENS. All patients were treated for a total of 10 sessions, consisting of five times per week and 10 min per session. Before and after treatment, patients were evaluated knee pain by using the 100-mm VAS and functional performance by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. The UltraTENS and PhP groups experienced considerable improvement in both VAS and total WOMAC scores post-treatment (PPhP had better VAS of pain and WOMAC scores but no statistical significance. Results show that UltraTENS and PhP were effective for relieving pain and improve functionality knee OA without significant differences between their effects.

Sequentially allocated clinical trial of rhythmic stabilization exercises and TENS in women with chronic low back pain.

Science.gov (United States)

Kofotolis, Nikolaos D; Vlachopoulos, Symeon P; Kellis, Eleftherios

2008-02-01

To examine the effectiveness of rhythmic stabilization exercises and transcutaneous electrical nerve stimulation (TENS) and their combination in treating women with chronic low back pain. Sequentially allocated, single-blinded and controlled study, with a two-month follow-up. The data were collected in a patient rehabilitation setting. A total of 92 women (34-46 years old) with chronic low back pain were studied. Sequential allocation was undertaken into four groups: ;rhythmic stabilization' (n=23), ;rhythmic stabilization - TENS' (n=23), TENS (n=23), and a placebo group (n = 23). Each programme lasted for four weeks. All outcome measures were assessed prior to, immediately after, four weeks and eight weeks post intervention. Data were obtained on functional disability, pain intensity, trunk extension range of motion, dynamic endurance of trunk flexion and static endurance of trunk extension. A total of 88 patients provided two-month follow-up data. The ;rhythmic stabilization' and the ;rhythmic stabilization - TENS' groups displayed statistically significant (Ppain intensity (ranging from 21.2 to 42.8%), trunk extension range of motion (ranging from 6.5 to 25.5%), dynamic endurance of trunk flexion and static endurance of trunk extension (ranging from 13.5 to 74.3%) compared with the remaining groups. The rhythmic stabilization programmes resulted in more gains in women with chronic low back pain regarding the present outcome variables compared with the other groups; therefore, its application in female chronic low back pain patients aged 34-46 years is recommended.

Increasing intensity of TENS prevents analgesic tolerance in rats

Science.gov (United States)

Sato, Karina L.; Sanada, Luciana S.; Rakel, Barbara A.; Sluka, Kathleen A.

2012-01-01

Transcutaneous electrical nerve stimulation (TENS) reduces hyperalgesia and pain. Both low frequency (LF) and high frequency (HF) TENS, delivered at the same intensity (90% motor threshold (MT)) daily, result in analgesic tolerance with repeated use by the 5th day of treatment. Thecurrentstudytestedif 1) increasingintensityby 10% per daypreventsthedevelopmentoftolerance to repeated TENS, and 2) iflowerintensity TENS (50 % MT) produces an equivalentreduction in hyperalgesia when compared to 90% MT TENS. Sprague-Dawley rats with unilateral knee joint inflammation (3% carrageenan) were separated according to the intensity of TENS used: Sham, 50% LF, 50% HF, 90% LF, 90% HF, and increased intensity by 10% per day (LF and HF). The reduced mechanical withdrawal threshold following the induction of inflammation was reversed by application of TENS applied at 90% MT and increasing intensity for the first 4 days. On the 5th day, the groups that received 90% MT intensity showed tolerance. Nevertheless, the group that received an increased intensity on each day still showed a reversal of the mechanical withdrawal threshold with TENS. These results show that the development of tolerance can be delayed by increasing intensity of TENS. PMID:22858165

Total knee arthroplasty with an oxidised zirconium femoral component: ten-year survivorship analysis.

Science.gov (United States)

Ahmed, I; Salmon, L J; Waller, A; Watanabe, H; Roe, J P; Pinczewski, L A

2016-01-01

Oxidised zirconium was introduced as a material for femoral components in total knee arthroplasty (TKA) as an attempt to reduce polyethylene wear. However, the long-term survival of this component is not known. We performed a retrospective review of a prospectively collected database to assess the ten year survival and clinical and radiological outcomes of an oxidised zirconium total knee arthroplasty with the Genesis II prosthesis. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and a patient satisfaction scale were used to assess outcome. A total of 303 consecutive TKAs were performed in 278 patients with a mean age of 68 years (45 to 89). The rate of survival ten years post-operatively as assessed using Kaplan-Meier analysis was 97% (95% confidence interval 94 to 99) with revision for any reason as the endpoint. There were no revisions for loosening, osteolysis or failure of the implant. There was a significant improvement in all components of the WOMAC score at final follow-up (p zirconium TKA gives comparable rates of survival with other implants and excellent functional outcomes ten years post-operatively. Total knee arthroplasty with an oxidised zirconium femoral component gives comparable long-term rates of survival and functional outcomes with conventional implants. ©2016 The British Editorial Society of Bone & Joint Surgery.

Effectiveness of Electrostimulation on Whole Salivary Flow Among Patients with Type 2 Diabetes Mellitus.

Science.gov (United States)

Dyasnoor, Sujatha; Kamath, Shwetha; Khader, Nishat Fatima Abdul

2017-01-01

Xerostomia and hyposalivation are associated with diabetes. Research is sparse regarding electrostimulation as a mainstream therapy for salivary gland hypofunction. To clinically evaluate the effectiveness of transcutaneous electric nerve stimulation (TENS) therapy in stimulating whole salivary flow among patients with xerostomia and hyposalivation caused by diabetes mellitus. Forty patients between age 30 to 75 years with diabetes mellitus categorized as controlled or uncontrolled who had subjective symptoms of xerostomia and an objective sign of hyposalivation were included in a prospective study. Unstimulated saliva through the "low forced spitting" method and stimulated saliva collection using TENS were assessed and compared. Longer-term effects of TENS application were evaluated by recalling the patient 24 hours later. A statistically significant increase in stimulated whole saliva after TENS application in continuous mode (p diabetes. Burst mode inferred a statistically significant decrease in salivary flow (p diabetes with xerostomia and hyposalivation, TENS was highly effective in stimulating whole salivary flow.

Impact of Health Care Provider's Training on Patients ...

African Journals Online (AJOL)

Material and Methods: A situation analysis was done before training to assess existing practice of providers' communication skills and patient's satisfaction. All care providers in labour ward were trained and their practice was assessed before and after training. A ten percent sample of patients delivered in hospital before ...

Skull Bone Defects Reconstruction with Custom-Made Titanium Graft shaped with Electron Beam Melting Technology: Preliminary Experience in a Series of Ten Patients.

Science.gov (United States)

Francaviglia, Natale; Maugeri, Rosario; Odierna Contino, Antonino; Meli, Francesco; Fiorenza, Vito; Costantino, Gabriele; Giammalva, Roberto Giuseppe; Iacopino, Domenico Gerardo

2017-01-01

Cranioplasty represents a challenge in neurosurgery. Its goal is not only plastic reconstruction of the skull but also to restore and preserve cranial function, to improve cerebral hemodynamics, and to provide mechanical protection of the neural structures. The ideal material for the reconstructive procedures and the surgical timing are still controversial. Many alloplastic materials are available for performing cranioplasty and among these, titanium still represents a widely proven and accepted choice. The aim of our study was to present our preliminary experience with a "custom-made" cranioplasty, using electron beam melting (EBM) technology, in a series of ten patients. EBM is a new sintering method for shaping titanium powder directly in three-dimensional (3D) implants. To the best of our knowledge this is the first report of a skull reconstruction performed by this technique. In a 1-year follow-up no postoperative complications have been observed and good clinical and esthetic outcomes were achieved. Costs higher than those for other types of titanium mesh, a longer production process, and the greater expertise needed for this technique are compensated by the achievement of most complex skull reconstructions with a shorter operative time.

Assessment of clinical residents' needs for ten educational subjects

Directory of Open Access Journals (Sweden)

Mansour Razavi

2002-04-01

Full Text Available Background Fulfilling the learners' "real needs" will improve medical education. There are subjects that are necessary for any clinical residents not considering their field of specialty. Among the subjects ten seems to be the most important: research methodology and data analysis, computer-based programs, medical recording, cardiopulmonary and cerebral resuscitation, clinical teaching programs, communication skills, clinical ethics, laboratory examinations, reporting special diseases and death certification, and prescription. Purpose This cross-sectional study assessed educational needs of clinical residents for ten educational subjects. Methods A questionnaire prepared by board faculty members consisted of 10 close-ended questions, and one open­ ended question was distributed among 1307 residents from 22 clinical disciplines, who registered for preboard or promotion exam in June 2000. Results Among the subjects three were the most needed: computer-based programs 149 (60%, data collecting system 606 (49%, and clinical ethics 643 (46%. The prescription standard was the least required 177(13%. Conclusion Complementary training courses on these subjects can be an answer to the clinical residents needs. Keywords : research methodology, computer in medicine, cpr, clinical teaching methods, communication in medicine, medical ethics, laboratory ordering, disease coding system, death certificate, prescription writing

Selective preservation of anterior pituitary functions in patients with Sheehan′s syndrome

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Bashir Ahmad Laway

2011-01-01

Full Text Available Background: Sheehan′s syndrome manifests as hypopituitarism following a child birth usually preceded by postpartum hemorrhage. The symptoms range from vague feelings of ill health to symptoms of a full blown panhypopituitarism. A large series of such patients is not described in the literature. Materials and Methods: We present the details of ten women with partial Sheehan′s syndrome. They presented with post-partum hemorrhage and lactation failure. Results: After delivery, seven out of ten patients had regular menstrual cycles indicating preservation of gonadotroph function. Lactotroph, thyrotroph, and somatotroph failure were present in all and corticotrophs preservation was documented in four out of ten patients. The hypophysial magnetic resonance imaging (MRI confirmed empty sella in all. Conclusion: lactotroph, somatotroph and thyrotroph failure are common in patients with Sheehan′s syndrome. In addition to known preservation of gonadotroph axis, corticotroph axis may be preserved in some of these patients arguing against the universal treatment of these patients with glucocorticoids.

Transcutaneous electrical nerve stimulation (TENS) improves the rest-activity rhythm in midstage Alzheimer's disease

NARCIS (Netherlands)

Scherder, E. J.; van Someren, E. J.; Swaab, D. F.

1999-01-01

Nightly restlessness in patients with Alzheimer's disease (AD) is probably due to a disorder of circadian rhythms. Transcutaneous electrical nerve stimulation (TENS) was previously reported to increase the strength of coupling of the circadian rest activity rhythm to Zeitgebers in early stage

Differential effect of opioids in patients with chronic pancreatitis

DEFF Research Database (Denmark)

Staahl, Camilla; Dimcevski, Georg; Andersen, Søren Due

2007-01-01

and morphine on experimental pain in patients with pain caused by chronic pancreatitis. MATERIAL AND METHODS: Ten patients took part in this blinded, cross-over study. The analgesic effects of morphine (30 mg, oral), oxycodone (15 mg, oral) and placebo were tested against multimodal (mechanical, thermal...

Prostate preservation by combined external beam and hdr brachytherapy at nodal negative prostate cancer patients - an intermediate analysis after ten years experience

International Nuclear Information System (INIS)

Kovacs, G.; Wirth, B.; Bertermann, H.; Galalae, R.; Kohr, P.; Wilhelm, R.; Kimmig, B.

1996-01-01

Purpose/Objective: The combined external beam (EBT) and HDR brachytherapy (HBT) boost treatment for localized prostate cancer was established in 1986. The aim of this analysis is to judge the results of this method after 10 years experience. Material and Methods: The treatment and follow-up data of 171 histologically proven, localized (N-staging by imaging) prostate cancer patients were analyzed. Average age of the patients was 68.2 years with a median of 69 years (44-84 years). Tumor stages (using transrectal ultrasound /TRUS/) ranged from A2 (T1b) in two, to B (T2) in 110 and C (T3) in 59 cases. Tumor grading: 27 highly differentiated (G1), 86 moderately differentiated (G2) as well as 57 poorly differentiated (G3) and one undifferentiated (G4) tumor. Follow-up lasted 13-114 months (mean: 53; median: 55 months). Forty-six patients had previous surgery on the bladder neck. Sixty-one patients had transitory androgen deprivation or antiandrogen treatment prior to radiation, which lasted for a max. of 6 months and was finished before radiation with the exception of 13 patients who continued the hormone deprivation after radiotherapy. Initial PSA was known in 126 cases, 86 of them had not received previous androgen deprivation. In 13% values under 4 ng/ml (Hybritech), as well as 46% not above 20 ng/ml and 40 % above 20 ng/ml, respectively. Those cases in which PSA began to rise without having been fallen under a level of 1 ng/ml were considered as PSA progression as well as those cases in which PSA rose to a value twice the PSA nadir we found be essential (2 ng/ml) after it had fallen to a minimum under 1 ng/ml. Ultrasound guided conformal HBT treatment planning was carried out. The 2x 15 Gy HBT boost was integrated into the EBT schedule, total dose was 50 Gy for subclinical disease and 70 Gy for the prostate in 6-7 weeks. Regular follow-up by clinical examination, TRUS + volumetry, PSA, bone scan and after 12 months biopsy. Results: Ten of 171 patients died of

Electronic structure and optical properties of (BeTen/(ZnSem superlattices

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Caid M.

2016-03-01

Full Text Available The structural, electronic and optical properties of (BeTen/(ZnSem superlattices have been computationally evaluated for different configurations with m = n and m≠n using the full-potential linear muffin-tin method. The exchange and correlation potentials are treated by the local density approximation (LDA. The ground state properties of (BeTen/(ZnSem binary compounds are determined and compared with the available data. It is found that the superlattice band gaps vary depending on the layers used. The optical constants, including the dielectric function ε(ω, the refractive index n(ω and the refractivity R(ω, are calculated for radiation energies up to 35 eV.

EORTC QLQ-COMU26: a questionnaire for the assessment of communication between patients and professionals. Phase III of the module development in ten countries.

Science.gov (United States)

Arraras, Juan Ignacio; Wintner, Lisa M; Sztankay, Monika; Tomaszewski, Krzysztof A; Hofmeister, Dirk; Costantini, Anna; Bredart, Anne; Young, Teresa; Kuljanic, Karin; Tomaszewska, Iwona M; Kontogianni, Meropi; Chie, Wei-Chu; Kulis, Dagmara; Greimel, Eva

2017-05-01

Communication between patients and professionals is one major aspect of the support offered to cancer patients. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group (QLG) has developed a cancer-specific instrument for the measurement of different issues related to the communication between cancer patients and their health care professionals. Questionnaire development followed the EORTC QLG Module Development Guidelines. A provisional questionnaire was pre-tested (phase III) in a multicenter study within ten countries from five cultural areas (Northern and South Europe, UK, Poland and Taiwan). Patients from seven subgroups (before, during and after treatment, for localized and advanced disease each, plus palliative patients) were recruited. Structured interviews were conducted. Qualitative and quantitative analyses have been performed. One hundred forty patients were interviewed. Nine items were deleted and one shortened. Patients' comments had a key role in item selection. No item was deleted due to just quantitative criteria. Consistency was observed in patients' answers across cultural areas. The revised version of the module EORTC QLQ-COMU26 has 26 items, organized in 6 scales and 4 individual items. The EORTC COMU26 questionnaire can be used in daily clinical practice and research, in various patient groups from different cultures. The next step will be an international field test with a large heterogeneous group of cancer patients.

Injuries to the upper extremities in polytrauma: limited effect on outcome more than ten years after injury - a cohort study in 629 patients.

Science.gov (United States)

Macke, C; Winkelmann, M; Mommsen, P; Probst, C; Zelle, B; Krettek, C; Zeckey, C

2017-02-01

To analyse the influence of upper extremity trauma on the long-term outcome of polytraumatised patients. A total of 629 multiply injured patients were included in a follow-up study at least ten years after injury (mean age 26.5 years, standard deviation 12.4). The extent of the patients' injury was classified using the Injury Severity Score. Outcome was measured using the Hannover Score for Polytrauma Outcome (HASPOC), Short Form (SF)-12, rehabilitation duration, and employment status. Outcomes for patients with and without a fracture of the upper extremity were compared and analysed with regard to specific fracture regions and any additional brachial plexus lesion. In all, 307 multiply-injured patients with and 322 without upper extremity injuries were included in the study. The groups with and without upper limb injuries were similar with respect to demographic data and injury pattern, except for midface trauma. There were no significant differences in the long-term outcome. In patients with brachial plexus lesions there were significantly more who were unemployed, required greater retraining and a worse HASPOC. Injuries to the upper extremities seem to have limited effect on long-term outcome in patients with polytrauma, as long as no injury was caused to the brachial plexus. Cite this article: Bone Joint J 2017;99-B:255-60. ©2017 The British Editorial Society of Bone & Joint Surgery.

The TEN-T core network and the Fehmarnbelt region

DEFF Research Database (Denmark)

Guasco, Clement Nicolas

This note is a snapshot picture, taken in early 2014, that places the Green STRING corridor project within the context of the TEN-T strategy and gives a summarized overview on the impact of this strategy in the region. Chapter 1 contains a summary of the TEN-T strategy today, chapter 2 presents...... the sources used for this note, chapter 3 presents all the relevant EU regulations with direct impact on the development of TEN-T corridors, chapter 4 gives practical examples of the challenges for the development of TEN-T corridors, chapter 5 pre-sents the national initiatives related to the TEN-T corridor...

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN): could retinoids play a causative role?

Science.gov (United States)

Mawson, Anthony R; Eriator, Ike; Karre, Sridhar

2015-01-12

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are overlapping manifestations on a spectrum of acute drug-induced conditions associated with severe blistering, skin peeling, and multi-organ damage. TEN is an eruption resembling severe scalding, with ≥30% skin detachment. SJS is a mild form of TEN, characterized histologically by epidermal keratinocyte apoptosis with dermo-epidermal separation and extensive small blisters with <10% body surface skin detachment. The syndrome can be induced by numerous medications and typically occurs 1-4 weeks after the initiation of therapy. Granulysin is found in the lesions of patients with SJS/TEN and plays a significant pathogenic role in the condition, but the overall mechanisms linking medications, granulysin, and disease manifestations remain obscure. This paper reviews evidence suggesting that the different medications implicated in SJS/TEN have the common property of interacting and synergizing with endogenous retinoids (vitamin A and its congeners), in many instances causing the latter to accumulate in and damage the liver, the main storage organ for vitamin A. It is hypothesized that liver damage leads to the spillage of toxic retinoid compounds into the circulation, resulting in an endogenous form of hypervitaminosis A and cytotoxicity with widespread apoptosis, mediated by granulysin and recognized as SJS/TEN. Subject to testing, the model suggests that symptom worsening could be arrested at onset by lowering the concentration of circulating retinoids and/or granulysin via phlebotomy or plasmapheresis or by pharmacological measures to limit their expression.

Effectiveness of transcutaneous electrical nerve stimulation on saliva production in post-radiated oral cancer patients

Directory of Open Access Journals (Sweden)

Sakshi Ojha

2016-01-01

Full Text Available Aims and Objectives: To determine the effectiveness of transcutaneous electrical nerve stimulation (TENS in stimulating salivary flow in post-radiated oral cancer patients, and to compare the salivary flow rate between unstimulated saliva and saliva stimulated with TENS in post-radiated oral cancer patients. Materials and Methods: In 30 patients who underwent radiotherapy for oral cancer, unstimulated saliva was collected every minute for 5 min in a graduated test tube. The TENS unit was activated and stimulated saliva was collected for 5 min in a separate graduated test tube, and the flow rate was compared with the unstimulated salivary flow rate. Results: A statistically significant improvement was seen in saliva production during stimulation (P < 0.001. In addition, statistically significant increase in TENS stimulated saliva was observed in patients aged ≥50 years compared to that in patients aged <50 years (P < 0.05. There was no significant difference in salivary flow rate between the two genders in both stimulated and unstimulated conditions, however, statistically significant increase in salivary flow rate was observed in males under stimulated condition (P < 0.01. Conclusion: TENS was highly effective in stimulating the whole salivary flow rate in post-radiated oral cancer patients. It is an effective supportive treatment modality in xerostomia patients caused by radiotherapy in oral cancer patients.

Problems, solutions, and strategies reported by users of TENS for chronic musculoskeletal pain: A qualitative exploration using patient interviews

OpenAIRE

Gladwell, P.; Badlan, K.; Cramp, F. A.; Palmer, S.

2016-01-01

BACKGROUND: Transcutaneous Electrical Nerve Stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to inform the development of a pragmatic implementation design for a TENS evaluation.\\ud OBJECTIVES: To explore the experiences of s...

The medium-term effects of diadynamic currents in chronic low back pain; TENS versus diadynamic currents: A randomised, follow-up study.

Science.gov (United States)

Sayilir, Selcuk; Yildizgoren, Mustafa Turgut

2017-11-01

The aims of the study were to evaluate the medium-term effects of diadynamic (DD) currents on relieving symptoms/improving physical functionality in patients with chronic low back pain (LBP) and to compare the efficacy of DD versus TENS. The patients were divided into two groups as the TENS group (n = 26) and the DD group (n = 29). Additional treatment of hot pack + therapeutic ultrasound was applied to all patients. The therapy programs were administered as a total of 10 sessions over a period of 2 weeks. Roland Morris Disability Questionnaire (RDQ), Oswestry Disability Index and Visual Analog Scale (VAS) values were recorded. Both groups showed significant improvements in VAS and RDQ scores after one month of the therapies (all p TENS and DD currents in chronic LBP can lead to reduced pain, and improved physical functions. Hence, DD currents can be used as an adjuvant therapy for rehabilitation of chronic LBP. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Dental care in pregnancy. Ten questions and answers].

Science.gov (United States)

Patcas, Raphael; Schmidlin, Patrick R; Zimmermann, Roland; Gnoinski, Wanda

2012-01-01

Dental care of pregnant patients is a demanding task. On one hand, clinicians are facing patients with an altered physiology that may cause a greater need for treatment. On the other hand, pregnancy in itself as well as the unborn child involves potential contraindications to dental interventions. It is therefore essential that dentists be knowledgeable of the ramifications pregnancy has on medical findings and therapy. Also, clinicians must be able to conduct their treatment based on well-grounded data to avoid any harm to the pregnant woman and her unborn child. This article focuses on facts specifically relevant to clinicians. Based on most current scientific data, we aim to answer the following ten questions: 1. What are the physiological changes during pregnancy? 2. What is the adequate lying position for a pregnant patient? 3. Is there a pregnancy-related gingivitis? 4. What is the association between periodontitis, pregnancy and preterm birth? 5. Are there oral manifestations of pregnancy-related therapies? 6. Are caries and erosions inevitable during pregnancy? 7. Should the intake of fluoride be advocated? 8. Is it permissible to x-ray pregnant patients? 9. Is orthodontics contraindicated during pregnancy and 10. Which medication should be administered with caution?

Ten-year survival of patients with oesophageal squamous cell ...

African Journals Online (AJOL)

patients with oesophageal SCC continues to be poor, with 5-year survival rates ranging from 26.2% to ... approach, and the cervico-thoraco-abdominal procedure. The .... abuse, a family history of any cancer, neo-adjuvant treatment, pathological ... Of the entire series, 72 patients (6.9%) underwent neo-adjuvant therapy, and.

Ten steps to successful software process improvement

Science.gov (United States)

Kandt, R. K.

2003-01-01

This paper identifies ten steps for managing change that address organizational and cultural issues. Four of these steps are critical, that if not done, will almost guarantee failure. This ten-step program emphasizes the alignment of business goals, change process goals, and the work performed by the employees of an organization.

Effects of transcutaneous electrical nerve stimulation (TENS) on memory in elderly with mild cognitive impairment.

NARCIS (Netherlands)

Luijpen, M.W.; Swaab, D.F.; Sergeant, J.A.; Dijk, K.R.A.; Scherder, E.J.

2005-01-01

In previous studies, transcutaneous electrical nerve stimulation (TENS) was shown to have a positive effect on memory in Alzheimer's disease (AD) patients. Moreover, the reported effects appeared to be more beneficial in early stages of Alzheimer's disease compared to later stage intervention. Based

Effects of transcutaneous electrical nerve stimulation (TENS) on memory in elderly with mild cognitive impairment

NARCIS (Netherlands)

Luijpen, MW; Swaab, DF; Sergeant, JA; van Dijk, KRA; Scherder, EJA

2005-01-01

In previous studies, transcutaneous electrical nerve stimulation (TENS) was shown to have a positive effect on memory in Alzheimer's disease (AD) patients. Moreover, the reported effects appeared to be more beneficial in early stages of Alzheimer's disease compared to later stage intervention. Based

Successful replantation in ten-digit amputation.

Science.gov (United States)

Kantarci, Umit; Cepel, Selim; Buldu, Halil

2010-01-01

Amputations involving ten digits are very rare because of different lengths of the digits. A 34-year-old man working in a printing house presented one hour after guillotine amputation involving all ten digits. Surgery was initiated 80 minutes after admission and took seven hours. Under axillary anesthesia, the operation was performed by two teams each consisting of two microsurgeons and two assistants. Replantation was completed without the use of any skin graft or flap. Fingertip examination showed poor arterial circulation in the second, third, and fourth digits of the left hand after 24 hours of replantation and surgical exploration was performed, during which anastomosis of the ulnar digital artery of the second digit was re-established and a Y-shaped vein graft was placed at the level of the third web to restore revascularization of the third and fourth digits. However, these interventions did not prevent the development of necrosis in the distal segment of the fourth digit which resulted in dry gangrene that required amputation. After 38 months of replantation, radiographic examination showed complete union in all fingers without malunion or damage to the joint surface and about 8 degrees of medial angulation in the proximal phalanx of the fourth digit of the right hand. The patient did not have difficulty in performing daily activities and had a considerably good pinching. Losses of active range of motion of the metacarpophalangeal and interphalangeal joints were within the rage of 10 to 30 degrees in both hands. In the assessment of sensation, static and dynamic two-point discrimination test results were 6.1 mm and 4.0 mm, respectively.

Comparing deep learning and concept extraction based methods for patient phenotyping from clinical narratives.

Science.gov (United States)

Gehrmann, Sebastian; Dernoncourt, Franck; Li, Yeran; Carlson, Eric T; Wu, Joy T; Welt, Jonathan; Foote, John; Moseley, Edward T; Grant, David W; Tyler, Patrick D; Celi, Leo A

2018-01-01

In secondary analysis of electronic health records, a crucial task consists in correctly identifying the patient cohort under investigation. In many cases, the most valuable and relevant information for an accurate classification of medical conditions exist only in clinical narratives. Therefore, it is necessary to use natural language processing (NLP) techniques to extract and evaluate these narratives. The most commonly used approach to this problem relies on extracting a number of clinician-defined medical concepts from text and using machine learning techniques to identify whether a particular patient has a certain condition. However, recent advances in deep learning and NLP enable models to learn a rich representation of (medical) language. Convolutional neural networks (CNN) for text classification can augment the existing techniques by leveraging the representation of language to learn which phrases in a text are relevant for a given medical condition. In this work, we compare concept extraction based methods with CNNs and other commonly used models in NLP in ten phenotyping tasks using 1,610 discharge summaries from the MIMIC-III database. We show that CNNs outperform concept extraction based methods in almost all of the tasks, with an improvement in F1-score of up to 26 and up to 7 percentage points in area under the ROC curve (AUC). We additionally assess the interpretability of both approaches by presenting and evaluating methods that calculate and extract the most salient phrases for a prediction. The results indicate that CNNs are a valid alternative to existing approaches in patient phenotyping and cohort identification, and should be further investigated. Moreover, the deep learning approach presented in this paper can be used to assist clinicians during chart review or support the extraction of billing codes from text by identifying and highlighting relevant phrases for various medical conditions.

The Land-Use and Land-Cover Change Analysis in Beijing Huairou in Last Ten Years

Science.gov (United States)

Zhao, Q.; Liu, G.; Tu, J.; Wang, Z.

2018-04-01

With eCognition software, the sample-based object-oriented classification method is used. Remote sensing images in Huairou district of Beijing had been classified using remote sensing images of last ten years. According to the results of image processing, the land use types in Huairou district of Beijing were analyzed in the past ten years, and the changes of land use types in Huairou district were obtained, and the reasons for its occurrence were analyzed.

Reliability and Validity of Ten Consumer Activity Trackers Depend on Walking Speed

NARCIS (Netherlands)

Fokkema, Tryntsje; Kooiman, Thea J. M.; Krijnen, Wim P.; Van der Schans, Cees P.; De Groot, Martijn

Purpose: To examine the test-retest reliability and validity of ten activity trackers for step counting at three different walking speeds. Methods: Thirty-one healthy participants walked twice on a treadmill for 30 min while wearing 10 activity trackers (Polar Loop, Garmin Vivosmart, Fitbit Charge

Reliability and validity of ten consumer activity trackers depend on walking speed

NARCIS (Netherlands)

Fokkema, Tryntsje; Kooiman, Thea; Krijnen, Wim; van der Schans, Cees; de Groot, Martijn

Purpose: To examine the test–retest reliability and validity of ten activity trackers for step counting at three different walking speeds. Methods: Thirty-one healthy participants walked twice on a treadmill for 30 min while wearing 10 activity trackers (Polar Loop, Garmin Vivosmart, Fitbit Charge

Withdrawal of corticosteroids in inflammatory bowel disease patients after dependency periods ranging from 2 to 45 years: a proposed method.

LENUS (Irish Health Repository)

Murphy, S J

2012-02-01

BACKGROUND: Even in the biologic era, corticosteroid dependency in IBD patients is common and causes a lot of morbidity, but methods of withdrawal are not well described. AIM: To assess the effectiveness of a corticosteroid withdrawal method. METHODS: Twelve patients (10 men, 2 women; 6 ulcerative colitis, 6 Crohn\\'s disease), median age 53.5 years (range 29-75) were included. IBD patients with quiescent disease refractory to conventional weaning were transitioned to oral dexamethasone, educated about symptoms of the corticosteroid withdrawal syndrome (CWS) and weaned under the supervision of an endocrinologist. When patients failed to wean despite a slow weaning pace and their IBD remaining quiescent, low dose synthetic ACTH stimulation testing was performed to assess for adrenal insufficiency. Multivariate analysis was performed to assess predictors of a slow wean. RESULTS: Median durations for disease and corticosteroid dependency were 21 (range 3-45) and 14 (range 2-45) years respectively. Ten patients (83%) were successfully weaned after a median follow-up from final wean of 38 months (range 5-73). Disease flares occurred in two patients, CWS in five and ACTH testing was performed in 10. Multivariate analysis showed that longer duration of corticosteroid use appeared to be associated with a slower wean (P = 0.056). CONCLUSIONS: Corticosteroid withdrawal using this protocol had a high success rate and durable effect and was effective in patients with long-standing (up to 45 years) dependency. As symptoms of CWS mimic symptoms of IBD disease flares, gastroenterologists may have difficulty distinguishing them, which may be a contributory factor to the frequency of corticosteroid dependency in IBD patients.

Application of the measurement-based Monte Carlo method in nasopharyngeal cancer patients for intensity modulated radiation therapy

International Nuclear Information System (INIS)

Yeh, C.Y.; Lee, C.C.; Chao, T.C.; Lin, M.H.; Lai, P.A.; Liu, F.H.; Tung, C.J.

2014-01-01

This study aims to utilize a measurement-based Monte Carlo (MBMC) method to evaluate the accuracy of dose distributions calculated using the Eclipse radiotherapy treatment planning system (TPS) based on the anisotropic analytical algorithm. Dose distributions were calculated for the nasopharyngeal carcinoma (NPC) patients treated with the intensity modulated radiotherapy (IMRT). Ten NPC IMRT plans were evaluated by comparing their dose distributions with those obtained from the in-house MBMC programs for the same CT images and beam geometry. To reconstruct the fluence distribution of the IMRT field, an efficiency map was obtained by dividing the energy fluence of the intensity modulated field by that of the open field, both acquired from an aS1000 electronic portal imaging device. The integrated image of the non-gated mode was used to acquire the full dose distribution delivered during the IMRT treatment. This efficiency map redistributed the particle weightings of the open field phase-space file for IMRT applications. Dose differences were observed in the tumor and air cavity boundary. The mean difference between MBMC and TPS in terms of the planning target volume coverage was 0.6% (range: 0.0–2.3%). The mean difference for the conformity index was 0.01 (range: 0.0–0.01). In conclusion, the MBMC method serves as an independent IMRT dose verification tool in a clinical setting. - Highlights: ► The patient-based Monte Carlo method serves as a reference standard to verify IMRT doses. ► 3D Dose distributions for NPC patients have been verified by the Monte Carlo method. ► Doses predicted by the Monte Carlo method matched closely with those by the TPS. ► The Monte Carlo method predicted a higher mean dose to the middle ears than the TPS. ► Critical organ doses should be confirmed to avoid overdose to normal organs

THE LAND-USE AND LAND-COVER CHANGE ANALYSIS IN BEIJING HUAIROU IN LAST TEN YEARS

Directory of Open Access Journals (Sweden)

Q. Zhao

2018-04-01

Full Text Available With eCognition software, the sample-based object-oriented classification method is used. Remote sensing images in Huairou district of Beijing had been classified using remote sensing images of last ten years. According to the results of image processing, the land use types in Huairou district of Beijing were analyzed in the past ten years, and the changes of land use types in Huairou district were obtained, and the reasons for its occurrence were analyzed.

Ten PM Note of Organophosphae Poisoning- Successful outcome of a Medical Audit with complete seven steps

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M D Bhattarai

2010-03-01

Full Text Available Medical audit in general consists of seven steps like choosing topic, setting criterion and standard, collecting first data, comparing data with standard, introducing change, collecting second data and reflecting. Its three basic premise are improvement of patient care by using existing knowledge, team work with ongoing educational process and change management and promotion of blame-free culture maintaining confidentiality. Audit mostly relates to a particular practice and is therefore not generalisable. An audit of residents' late evening routine notes of organophosphate poisoning patients is reported here, as the change introduced appears relevant to the situation of developing countries. Organophosphate poisoning patients should be managed in intensive care unit with close monitoring, as inadvertent stoppage or slowing of atropine infusion may occur, particularly at night, leading to reappearance of poisoning manifestations, which may cause respiratory failure and death. If they are managed in wards, residents-on-duty can check the clinical and intravenous drip status in the late evening and communicate with nurses and relatives to be particularly vigilant. In the audit done, such regular ten pm notes of organophosphate poisoning about the clinical and drip status and communication by residents were increased from 15.5% in the first to 81.7% in the second data collection (p < 0.01 after the introduction of the change. The ten pm note is being continued for about two years now. Implementation of ten pm note of organophosphate poisoning patients admitted in medical wards is feasible and appears useful to improve the quality of health care delivery and learning of residents. Keywords: atrophine, audit, audit steps, organophosphate mortality, organophosphate poisoning.

Przezskórna elektrostymulacja nerwów (TENS w leczeniu zespołów bólowych kręgosłupa lędźwiowo-krzyżowego = Transcutaneous electrical nerve stimulation (TENS in the treatment of low back pain

Directory of Open Access Journals (Sweden)

Magdalena Weber-Rajek

2016-03-01

gaining more recognition among physiotherapists, as well as among patients is the  transcutaneus electrical nerve stimulation (TENS. Aim of the study The aim of this study was to evaluate the effectiveness of TENS in the treatment of low back pain. Material and Methods Study included of forty patients aged 30 - 60 years (mean age 45 years. Immediately before and after therapy in all patients: assessment of pain using the VAS assessment of pain intensity and frequency, amount of applied analgesics, limiting physical activity using a questionnaire Laitinen, Schober test assessing the scope bending lumbosacral spine. Statistical analysis was performed using version 1.4.8 PQStat package. In order to compare the results obtained in the test prior to treatment with the results obtained after treatment  was Wilcoxon test at the significance level α = 0.05. Results Achieved a statistically significant reduction in the intensity and frequency of pain, reduction of applied analgesics, reduced physical activity limitations and increasing the range of flexion of low back pain. Conclusion TENS  is an effective treatment for both acute and chronic low back pain   Key words: transcutaneous electrical nerve stimulation, low back pain.

The origin of the future ten questions for the next ten years

CERN Document Server

Gribbin, John

2006-01-01

How did the universe begin? Where do galaxies come from? How do stars and planets form? Where do the material particles we are made of come from? How did life begin? Today we have only provisional answers to such questions. But scientific progress will improve these answers dramatically over the next ten years, predicts John Gribbin in this riveting book. He focuses on what we know—or think we know—about ten controversial, unanswered issues in the physical sciences and explains how current cutting-edge research may yield solutions in the very near future. With his trademark facility for engaging readers with or without a scientific background, the author explores ideas concerning the creation of the universe, the possibility of other forms of life, and the fate of the expanding cosmos. He examines “theories of everything,” including grand unified theories and string theory, and he discusses the Big Bang theory, the origin of structure and patterns of matter in the galaxies, and dark mass and dark ene...

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.

Impaired vascular function during short-term poor glycaemic control in Type 1 diabetic patients

DEFF Research Database (Denmark)

Sørensen, V.R.; Mathiassen, E.R.; Clausen, P.

2005-01-01

AIM: To study the effects of short-term poor glycaemic control on vascular function in Type 1 diabetic patients. METHODS: Ten Type 1 diabetic patients, with diabetes duration of less than 10 years and normal urinary albumin excretion and ophthalmoscopy, were studied. All patients were examined af...

Femoral shaft fractures in children, treaties with elastic nails of titanium - TENs

International Nuclear Information System (INIS)

Solano Urrutia, Antonio Luis; Gallon, Luis Alfonso; Echandia, Carlos

2003-01-01

Femoral shaft fractures are a common and temporarily disabling injury in children. Recent advances in orthopedic traumatology have led us at the Hospital Universitario del Valle, in Cali, Colombia, to perform a case series observational study with the use of a more aggressive approach with the new endomedullar titanium nails (TENs) in children suffering femur shaft fractures, in a closed procedure performed under image intensification. The main purpose of this study was to evaluate the outcome of 30 children treated with these nails. Pediatric femoral shaft fractures are more common in males with approximately a 2.75:1 male to female ratio. The age distribution is bimodal, with peaks in the younger than 5 years and mid-teenage groups (10-14 years) because of the increased incidence of high-energy trauma in teenage children (mean age: 9 years). Overall, TENs allowed rapid mobilization with few complications. The results were excellent or satisfactory in our cases. No child lost rotational alignment in the postoperative period. Irritation of the soft tissue near the knee by the nail tip occurred in one patient. As indications, implantation technique, and aftercare are refined, TENs may prove to be the ideal implant to stabilize most pediatric femur shaft fractures, avoiding the prolonged immobilization and complications of traction and spica cast

Ten-year survival and patient-reported outcomes of a medial unicompartmental knee arthroplasty incorporating an all-polyethylene tibial component.

Science.gov (United States)

Scott, Chloe E H; Wade, Frazer A; MacDonald, Deborah; Nutton, Richard W

2018-05-01

Biomechanical studies have suggested that proximal tibial strain is elevated in UKAs incorporating all-polyethylene tibial components with concern that this leads to premature failure. This study reports minimum 10-year outcomes for a UKA incorporating an all-polyethylene tibial component to determine whether these concerns were realised. 109 fixed bearing UKAs (97 patients, mean age 68 (range 48-87), 54/97 (56%) female) with all-polyethylene tibial components were followed up for ≥ 10 years with Oxford Knee Scores, Forgotten Joint Scores and Kaplan-Meier analysis. 106/109 implants were 7 mm, 3 were 9.5 mm. Ten-year survival was 85.5% (78.6-92.4 95% CI) with the end-point failure for any reason. Unexplained pain was the commonest mode of failure (6/17) followed by lateral compartment osteoarthritis (5/17) and tibial subsidence/loosening (4/17). Revision rate was highest at 2-5 years due to revisions for unexplained pain. Ten-year survival was worse in patients  30 (p = 0.017) and in those with postoperative increases in medial tibial sclerosis (p  30 was 2.9 (1.2-6.9 95% CI). In those with intact UKAs at 10 years, mean Oxford Knee Score was 34.8 ± 10.7, Forgotten Joint Score was 37.9 ± 26.7 and 96% were satisfied with their knee. The high rate of early failure between 2 and 5 years in this all-polyethylene tibial component UKA did not persist in the long term. Though medial proximal tibial metabolic changes appear to persist they are not necessarily symptomatic. BMI > 30 and age < 65 years were significant risk factors for revision.

Performance Analysis of Ten Common QRS Detectors on Different ECG Application Cases

Directory of Open Access Journals (Sweden)

Feifei Liu

2018-01-01

Full Text Available A systematical evaluation work was performed on ten widely used and high-efficient QRS detection algorithms in this study, aiming at verifying their performances and usefulness in different application situations. Four experiments were carried on six internationally recognized databases. Firstly, in the test of high-quality ECG database versus low-quality ECG database, for high signal quality database, all ten QRS detection algorithms had very high detection accuracy (F1 >99%, whereas the F1 results decrease significantly for the poor signal-quality ECG signals (all 95% except RS slope algorithm with 94.24% on normal ECG database and 94.44% on arrhythmia database. Thirdly, for the paced rhythm ECG database, all ten algorithms were immune to the paced beats (>94% except the RS slope method, which only output a low F1 result of 78.99%. At last, the detection accuracies had obvious decreases when dealing with the dynamic telehealth ECG signals (all <80% except OKB algorithm with 80.43%. Furthermore, the time costs from analyzing a 10 s ECG segment were given as the quantitative index of the computational complexity. All ten algorithms had high numerical efficiency (all <4 ms except RS slope (94.07 ms and sixth power algorithms (8.25 ms. And OKB algorithm had the highest numerical efficiency (1.54 ms.

Analyses of Genotypes and Phenotypes of Ten Chinese Patients with Wolf-Hirschhorn Syndrome by Multiplex Ligation-dependent Probe Amplification and Array Comparative Genomic Hybridization.

Science.gov (United States)

Yang, Wen-Xu; Pan, Hong; Li, Lin; Wu, Hai-Rong; Wang, Song-Tao; Bao, Xin-Hua; Jiang, Yu-Wu; Qi, Yu

2016-03-20

Wolf-Hirschhorn syndrome (WHS) is a contiguous gene syndrome that is typically caused by a deletion of the distal portion of the short arm of chromosome 4. However, there are few reports about the features of Chinese WHS patients. This study aimed to characterize the clinical and molecular cytogenetic features of Chinese WHS patients using the combination of multiplex ligation-dependent probe amplification (MLPA) and array comparative genomic hybridization (array CGH). Clinical information was collected from ten patients with WHS. Genomic DNA was extracted from the peripheral blood of the patients. The deletions were analyzed by MLPA and array CGH. All patients exhibited the core clinical symptoms of WHS, including severe growth delay, a Greek warrior helmet facial appearance, differing degrees of intellectual disability, and epilepsy or electroencephalogram anomalies. The 4p deletions ranged from 2.62 Mb to 17.25 Mb in size and included LETM1, WHSC1, and FGFR3. The combined use of MLPA and array CGH is an effective and specific means to diagnose WHS and allows for the precise identification of the breakpoints and sizes of deletions. The deletion of genes in the WHS candidate region is closely correlated with the core WHS phenotype.

A Ten-Year Reflection

Science.gov (United States)

Phillip, Cyndi

2016-01-01

Five initiatives launched during Cyndi Phillip's term as American Association of School Librarians (AASL) President (2006-2007) continue to have an impact on school librarians ten years later. They include the rewriting of AASL's learning standards, introduction of the SKILLS Act, the presentation of the Crystal Apple Award to Scholastic Library…

Music therapy in relief of pain in oncology patients

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Mariana Franco

2009-03-01

Full Text Available Objective: To evaluate the perception of oncology patients with chronic pain as to the effects of music in alleviating pain, to identify if there are changes in the vital signs of these patients before and after the musicotherapy session, and to identify whether the intensity of pain is diminished after the music session as per an analogic scale of pain. Methods: This level II, descriptive-exploratory and cross-sectional study used a quantitative and qualitative approach. The sample consisted of ten oncology patients with chronic pain. Rresults: There was a reduction in vital signs and in intensity of pain in ten patients of the sample; after the music sessions, the patients reported a sensation of relief of pain, relaxation, and a belief in the power of music as a supplementary therapy. Cconclusions: Music showed an influence in reducing vital signs and pain intensity, and the patients perceived a reduction of pain and anxiety, and began to believe in music as a form of therapy.

Supersymmetric gauged scale covariance in ten and lower dimensions

International Nuclear Information System (INIS)

Nishino, Hitoshi; Rajpoot, Subhash

2004-01-01

We present globally supersymmetric models of gauged scale covariance in ten, six, and four dimensions. This is an application of a recent similar gauging in three dimensions for a massive self-dual vector multiplet. In ten dimensions, we couple a single vector multiplet to another vector multiplet, where the latter gauges the scale covariance of the former. Due to scale covariance, the system does not have a Lagrangian formulation, but has only a set of field equations, like Type IIB supergravity in ten dimensions. As by-products, we construct similar models in six dimensions with N=(2,0) supersymmetry, and four dimensions with N=1 supersymmetry. We finally get a similar model with N=4 supersymmetry in four dimensions with consistent interactions that have never been known before. We expect a series of descendant theories in dimensions lower than ten by dimensional reductions. This result also indicates that similar mechanisms will work for other vector and scalar multiplets in space-time lower than ten dimensions

Randomised controlled trial comparing the effectiveness of electroacupuncture and TENS for low back pain: a preliminary study for a pragmatic trial.

Science.gov (United States)

Tsukayama, Hiroshi; Yamashita, Hitoshi; Amagai, Hitoshi; Tanno, Yasuo

2002-12-01

The objective of this study was to compare the effectiveness of electroacupuncture and TENS for low back pain when the electroacupuncture is applied in a clinically realistic manner. The study was designed as an evaluator-blinded randomised controlled trial (RCT). The study was performed at the Tsukuba College of Technology Clinic in Japan. Twenty subjects, who suffered from low back pain (LBP) without sciatica, were recruited, using leaflets in Tsukuba city. Subjects were allocated to either an electroacupuncture (EA) group (10 patients) or a transcutaneous electrical nerve stimulation (TENS) group (10 patients). The procedure for EA was in accordance with standard practice at our clinic. The main outcome measures were a pain relief scale (100 mm visual analogue scale: VAS) and a LBP score recommended by the Japanese Orthopaedic Association (JOA Score). Mean VAS value during the 2-weeks experimental period of the EA group was significantly smaller than that of the TENS group (65 mm vs 86 mm; 95% CI, 4.126 - 37.953). JOA Score in the EA group improved significantly while that in the TENS group showed no change. Although some placebo effect may be included, EA appeared more useful than TENS in the short-term effect on low back pain. We suggest that more realistic acupuncture interventions based on standard practice should be employed in pragmatic RCTs.

TOJDE: Electronic Publishing and a Review of Ten Years' Experience in Turkey

Science.gov (United States)

Ozarslan, Yasin; Balaban-Sali, Jale; Demiray, Ugur

2012-01-01

This review examines "The Turkish Online Journal of Distance Education" (TOJDE) over a ten years period from 2000-2010. The study provides an opportunity to examine publishing activities such as number of published articles, authors, research topics and methods, and analyses of TOJDE's website such as time users stay on site and user…

Laparoscopic adrenalectomy: Our clinical experiences with the first 10 patients

Directory of Open Access Journals (Sweden)

Alparslan Kemal Tuzcu

2012-12-01

Full Text Available Objectives: The aim of this study is to present the resultsof our first ten laparoscopic adrenalectomy cases whichwere performed in our clinic.Materials and methods: Between December 2010 andSeptember 2012 the standard transperitoneal laparoscopicadrenalectomy was performed on 10 patients.Data of patients such as age, weight, height, operationtime, hospitalization time, complications, size of adrenalmass and pathological diagnosis were retrospectively reviewedand recorded from the hospital records.Results: Three of ten patients were male and seven ofthem were female. The mean age of the patients was42.12±11.4 (21-55 years. Mean operation time was recordedas 136±23.6 (100-190 min. Mean tumor size was7.1±2.7 (5-12 cm. None of the patients required bloodtransfusion. Mean hospital stay was 2.3±1.2 (2-6 days.Pathological diagnoses of masses were pheocromacytomain two patients, adrenal adenoma in six, myelolipomain one and pseudocist in one.Conclusions: According to our experience with the limitednumber of the first ten cases, transperitoneal laparoscopicadrenalectomy is a safe and effective treatmentmodality, associated with minimal morbidity. To obtainmore reliable information larger series with long-term resultsof laparoscopic adrenalectomy is needed.Key words: Laparoscopy, adrenalectomy, experience,transperitoneal

Affordances: Ten Years On

Science.gov (United States)

Brown, Jill P.; Stillman, Gloria

2014-01-01

Ten years ago the construct, affordance, was rising in prominence in scholarly literature. A proliferation of different uses and meanings was evident. Beginning with its origin in the work of Gibson, we traced its development and use in various scholarly fields. This paper revisits our original question with respect to its utility in mathematics…

Determination of ten pyrethroids in various fruit juices: comparison of dispersive liquid-liquid microextraction sample preparation and QuEChERS method combined with dispersive liquid-liquid microextraction.

Science.gov (United States)

Zhang, Yaohai; Zhang, Xuelian; Jiao, Bining

2014-09-15

Dispersive liquid-liquid microextraction (DLLME) sample preparation and the quick, easy, cheap, effective, rugged and safe (QuEChERS) method combined with DLLME were developed and compared for the analysis of ten pyrethroids in various fruit juices using gas chromatography-electron capture detection (GC-ECD). QuEChERS-DLLME method has found its widespread applications to all the fruit juices including those samples with more complex matrices (orange, lemon, kiwi and mango) while DLLME was confined to the fruit juices with simpler matrices (apple, pear, grape and peach). The two methods provided acceptable recoveries and repeatability. In addition, the applicabilities of two methods were demonstrated with the real samples and further confirmed by gas chromatography-mass spectrometry (GC-MS). Copyright © 2014. Published by Elsevier Ltd.

Hypoalgesia in response to transcutaneous electrical nerve stimulation (TENS) depends on stimulation intensity.

Science.gov (United States)

Moran, Fidelma; Leonard, Tracey; Hawthorne, Stephanie; Hughes, Ciara M; McCrum-Gardner, Evie; Johnson, Mark I; Rakel, Barbara A; Sluka, Kathleen A; Walsh, Deirdre M

2011-08-01

Transcutaneous electrical nerve stimulation (TENS) is an electrophysical modality used for pain management. This study investigated the dose response of different TENS intensities on experimentally induced pressure pain. One hundred and thirty TENS naïve healthy individuals (18-64 years old; 65 males, 65 females) were randomly allocated to 5 groups (n = 26 per group): Strong Non Painful TENS; Sensory Threshold TENS; Below Sensory Threshold TENS; No Current Placebo TENS; and Transient Placebo TENS. Active TENS (80 Hz) was applied to the forearm for 30 minutes. Transient Placebo TENS was applied for 42 seconds after which the current amplitude automatically reset to 0 mA. Pressure pain thresholds (PPT) were recorded from 2 points on the hand and forearm before and after TENS to measure hypoalgesia. There were significant differences between groups at both the hand and forearm (ANOVA; P = .005 and .002). At 30 minutes, there was a significant hypoalgesic effect in the Strong Non Painful TENS group compared to: Below Sensory Threshold TENS, No Current Placebo TENS and Transient Placebo TENS groups (P TENS and No Current Placebo TENS groups at the hand (P = .001). There was no significant difference between Strong Non Painful TENS and Sensory Threshold TENS groups. The area under the curve for the changes in PPT significantly correlated with the current amplitude (r(2) = .33, P = .003). These data therefore show that there is a dose-response effect of TENS with the largest effect occurring with the highest current amplitudes. This study shows a dose response for the intensity of TENS for pain relief with the strongest intensities showing the greatest effect; thus, we suggest that TENS intensity should be titrated to achieve the strongest possible intensity to achieve maximum pain relief. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

Ten Things Every Professor Should Know about Assessment

Science.gov (United States)

Wolf, Kenneth; Dunlap, Joanna; Stevens, Ellen

2012-01-01

This article describes ten key assessment practices for advancing student learning that all professors should be familiar with and strategically incorporate in their classrooms and programs. Each practice or concept is explained with examples and guidance for putting it into practice. The ten are: learning outcomes, performance assessments,…

Long-term benefits of exercise training in patients with a systemic right ventricle

NARCIS (Netherlands)

van der Bom, Teun; Winter, Michiel M.; Knaake, Jennifer L.; Cervi, Elena; de Vries, Leonie S. C.; Balducci, Anna; Meregalli, Paola G.; Pieper, Petronella G.; van Dijk, Arie P. J.; Bonvicini, Marco; Mulder, Barbara J. M.; Bouma, Berto J.

2015-01-01

Objectives: The aim of the present study is to determine the long-term effects of a ten-week exercise training program in adult patients with a systemic right ventricle. Methods: All patients who participated in a 2009 randomized controlled trial were approached. At approximately three years of

TRANSCUTANEOUS ELECTRICAL NERVE-STIMULATION (TENS) IN RAYNAUDS-PHENOMENON

NARCIS (Netherlands)

MULDER, P; DOMPELING, EC; VANSLOCHTERENVANDERBOOR, JC; KUIPERS, WD; SMIT, AJ

Transcutaneous nerve stimulation (TENS) has been described as resulting in vasodilatation. The effect of 2 Hz TENS of the right hand during forty-five minutes on skin temperature and plethysmography of the third digit of both hands and feet and on transcutaneous oxygen tension (TcpO2) of the right

Direct and Indirect Benefits Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

Science.gov (United States)

Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

2015-11-01

There is no consensus regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for management of chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of patient-reported outcome measures appropriate for TENS evaluation. The purpose of this study was to explore the experiences of patients at a secondary care pain clinic who successfully used TENS to help manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. A mini focus group informed the development of a discussion guide for semistructured interviews with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that distraction from pain and a reduction in the sensations associated with muscle tension or spasm should be considered as separate outcomes from pain relief. These direct benefits led to a wide range of indirect benefits dependent on patient decision making, including medication reduction, enhanced function, psychological benefits, and enhanced ability to rest. The findings indicate that evaluating TENS using a unidimensional pain scale is likely to overlook potential benefits. The complex pattern of TENS usage, as well as multiple direct and indirect outcomes, indicates that TENS could be considered as a complex intervention. © 2015 American Physical Therapy Association.

ABACC ten years applying safeguards

International Nuclear Information System (INIS)

Palacios, Elias

2001-01-01

The Argentinian-Brazilian Agency for Accounting and Control of nuclear special materials has been in operations for ten years. The rational behind the creation and the work performed by the Agency during the last decade is described. (author)

Ten Challenges of the Amyloid Hypothesis of Alzheimer's Disease.

Science.gov (United States)

Kepp, Kasper Planeta

2017-01-01

The inability to effectively halt or cure Alzheimer's disease (AD), exacerbated by the recent failures of high-profile clinical trials, emphasizes the urgent need to understand the complex biochemistry of this major neurodegenerative disease. In this paper, ten central, current challenges of the major paradigm in the field, the amyloid hypothesis, are sharply formulated. These challenges together show that new approaches are necessary that address data heterogeneity, increase focus on the proteome level, use available human patient data more actively, account for the aging phenotype as a background model of the disease, unify our understanding of the interplay between genetic and non-genetic risk factors, and combine into one framework both the familial and sporadic forms of the disease.

EEG Correlates of Ten Positive Emotions.

Science.gov (United States)

Hu, Xin; Yu, Jianwen; Song, Mengdi; Yu, Chun; Wang, Fei; Sun, Pei; Wang, Daifa; Zhang, Dan

2017-01-01

Compared with the well documented neurophysiological findings on negative emotions, much less is known about positive emotions. In the present study, we explored the EEG correlates of ten different positive emotions (joy, gratitude, serenity, interest, hope, pride, amusement, inspiration, awe, and love). A group of 20 participants were invited to watch 30 short film clips with their EEGs simultaneously recorded. Distinct topographical patterns for different positive emotions were found for the correlation coefficients between the subjective ratings on the ten positive emotions per film clip and the corresponding EEG spectral powers in different frequency bands. Based on the similarities of the participants' ratings on the ten positive emotions, these emotions were further clustered into three representative clusters, as 'encouragement' for awe, gratitude, hope, inspiration, pride, 'playfulness' for amusement, joy, interest, and 'harmony' for love, serenity. Using the EEG spectral powers as features, both the binary classification on the higher and lower ratings on these positive emotions and the binary classification between the three positive emotion clusters, achieved accuracies of approximately 80% and above. To our knowledge, our study provides the first piece of evidence on the EEG correlates of different positive emotions.

Using TENS for pain control: the state of the evidence

Science.gov (United States)

Vance, Carol GT; Dailey, Dana L; Rakel, Barbara A; Sluka, Kathleen A

2014-01-01

Summary Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological intervention that activates a complex neuronal network to reduce pain by activating descending inhibitory systems in the central nervous system to reduce hyperalgesia. The evidence for TENS efficacy is conflicting and requires not only description but also critique. Population-specific systemic reviews and meta-analyses are emerging, indicating both HF and LF TENS being shown to provide analgesia, specifically when applied at a strong, nonpainful intensity. The purpose of this article is to provide a critical review of the latest basic science and clinical evidence for TENS. Additional research is necessary to determine if TENS has effects specific to mechanical stimuli and/or beyond reduction of pain and will improve activity levels, function and quality of life. PMID:24953072

Effect of the TNF-α inhibitor adalimumab in patients with recalcitrant sarcoidosis: a prospective observational study using FDG-PET

DEFF Research Database (Denmark)

Milman, Nils; Graudal, Niels; Loft, Annika

2012-01-01

-PET) in patients with recalcitrant sarcoidosis treated with adalimumab. Methods: Prospective 24-week observational study. Patients continued medication with steroids and antimetabolites and received adalimumab 40 mg subcutaneously every other week. Ten patients with biopsy-proven sarcoidosis (two men) were...

Effectiveness of complementary pain treatment for women with deep endometriosis through Transcutaneous Electrical Nerve Stimulation (TENS): randomized controlled trial.

Science.gov (United States)

Mira, Ticiana A A; Giraldo, Paulo C; Yela, Daniela A; Benetti-Pinto, Cristina L

2015-11-01

Evaluate TENS effectiveness as a complementary treatment of chronic pelvic pain and deep dyspareunia in women with deep endometriosis. This randomized controlled trial was performed in a tertiary health care center, including twenty-two women with deep endometriosis undergoing hormone therapy with persistent pelvic pain and/or deep dyspareunia. This study was registered in the Brazilian Record of Clinical Trials (ReBEC), under n RBR-3rndh6. TENS application for 8 weeks followed a randomized allocation into two groups: Group 1 - acupuncture-like TENS (Frequency: 8Hz, pulse duration: 250μs) - VIF (n=11) and Group 2 - self-applied TENS (Frequency: 85Hz, pulse duration: 75μs) (n=11). The intensity applied was "strong, but comfortable". We evaluated patients before and after treatment by the use of the Visual Analogue Scale, Deep Dyspareunia Scale and Endometriosis Quality of Life Questionnaire. We used the Wilcoxon and Mann-Whitney tests to compare before and after treatment conditions. Despite the use of hormone therapy for 1.65±2.08 years, the 22 women with deep endometriosis sustained pelvic pain complaints (VAS=5.95±2.13 and 2.45±2.42, pTENS. Both application types of TENS were effective for improving the evaluated types of pain. Both resources (acupuncture-like TENS and self-applied TENS) demonstrated effectiveness as a complementary treatment of pelvic pain and deep dyspareunia, improving quality of life in women with deep endometriosis regardless of the device used for treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Ten good reasons to practice ultrasound in critical care.

Science.gov (United States)

Lichtenstein, Daniel; van Hooland, Simon; Elbers, Paul; Malbrain, Manu L N G

2014-01-01

Over the past decade, critical care ultrasound has gained its place in the armamentarium of monitoring tools. A greater understanding of lung, abdominal, and vascular ultrasound plus easier access to portable machines have revolutionised the bedside assessment of our ICU patients. Because ultrasound is not only a diagnostic test, but can also be seen as a component of the physical exam, it has the potential to become the stethoscope of the 21st century. Critical care ultrasound is a combination of simple protocols, with lung ultrasound being a basic application, allowing assessment of urgent diagnoses in combination with therapeutic decisions. The LUCI (Lung Ultrasound in the Critically Ill) consists of the identification of ten signs: the bat sign (pleural line); lung sliding (seashore sign); the A-lines (horizontal artefact); the quad sign and sinusoid sign indicating pleural effusion; the fractal and tissue-like sign indicating lung consolidation; the B-lines and lung rockets indicating interstitial syndromes; abolished lung sliding with the stratosphere sign suggesting pneumothorax; and the lung point indicating pneumothorax. Two more signs, the lung pulse and the dynamic air bronchogram, are used to distinguish atelectasis from pneumonia. The BLUE protocol (Bedside Lung Ultrasound in Emergency) is a fast protocol (respiratory failure. With this protocol, it becomes possible to differentiate between pulmonary oedema, pulmonary embolism, pneumonia, chronic obstructive pulmonary disease, asthma, and pneumothorax, each showing specific ultrasound patterns and profiles. The FALLS protocol (Fluid Administration Limited by Lung Sonography) adapts the BLUE protocol to be used in patients with acute circulatory failure. It makes a sequential search for obstructive, cardiogenic, hypovolemic, and distributive shock using simple real-time echocardiography in combination with lung ultrasound, with the appearance of B-lines considered to be the endpoint for fluid therapy

The effects of Transcutaneous Electrical Nerve Stimulation on postural control in patients with chronic low back pain

OpenAIRE

Rojhani-Shirazi, Z; Rezaeian, T

2015-01-01

Objective: The effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with low back pain which is not well known. This study aimed to evaluate the effects of TENS on postural control in chronic low back pain. Methods: This study was an experimental research design. Twenty-eight patients with chronic LBP (25-45 Y/ O) participated and by using a random allocation, were divided to samples who participated in this study. The mean center of pressure (COP) vel...

Ten Tips for Parents to Help Their Children Avoid Teen Pregnancy

Science.gov (United States)

... we do » Resource library » Ten tips for parents Ten Tips for Parents to Help Their Children Avoid Teen Pregnancy Publication Created with Sketch. Ten Tips for Parents to Help Their Children Avoid ...

Medical follow up of ten patients victims of the radiological accident occurred in Goiania, Goias State, Brazil 1988/1992; Acompanhamento clinico de dez pacientes vitimas do acidente radiologico de Goiania - 1988/1992

Energy Technology Data Exchange (ETDEWEB)

Curado, M.P.; Morais, M.S.A.; Silva, J.F.; Assis, P.R.; Oliveira, A.R.; Santos, E.A

1992-12-31

The author makes an update of the medical aspects of ten victims of the radiological accident occurred in Goiania in September 1987. These patients received specialized treatment during the critical phase at Marcilio Dias Naval Hospital in Rio de Janeiro. Actually these patients are under medical follow-up at Leide das Neves Ferreira Foundation since march 1988. The clinical, haematological and laboratorial results are presented and discussed. The importance of a close medical follow-up direct victims of a radiological accident is stressed. (author) 13 refs., 5 tabs., 2 graphs.

Chernobyl ten years after

International Nuclear Information System (INIS)

1996-01-01

The accident in the fourth reactor plant in Chernobyl in Ukraine occurred ten years years ago, caused the death of 31 people while the health consequences have turned out to be difficult to assess. This review describes the accident, its consequences and effects to health, studies carried out at the present state as well as the comparison with the other accidents and disaster. (author)

A prospective randomized controlled study of VAX-D and TENS for the treatment of chronic low back pain.

Science.gov (United States)

Sherry, E; Kitchener, P; Smart, R

2001-10-01

Low back pain is one of the most significant medical and socioeconomic problems in modern society. International guidelines call for evidence-based management for the pain and disability associated with musculoskeletal disorders. The purpose of this randomized controlled trial is to address the question of efficacy and appropriateness of vertebral axial decompression (VAX-D) therapy, a new technology that has been shown in clinical research to create negative intradiscal pressures, and has been shown to be effective in treating patients presenting with chronic low back pain (> 3 months duration) with associated leg pain. Successful outcome was defined as a 50% reduction in pain utilizing a 10 cm Visual Analog Pain Scale and an improvement in the level of functioning as measured by patient-nominated disability ratings. Patients were randomly assigned to VAX-D or to TENS which was used as a control treatment or placebo. The TENS treatment demonstrated a success rate of 0%, while VAX-D demonstrated a success rate of 68.4% (p pain and improvement in functional outcome was obtained in patients with chronic low back pain treated with VAX-D.

ANALGETSKI UCINAK TRANSAKUTNE ELEKTRICNE NERVNE STIMULACIJE (TENS)

OpenAIRE

ĆURKOVIĆ, B.

1984-01-01

Transkutana električna nervna stimulacija. (TENS) danas je široko prihvaćen terapijski postupak za suzbijanje boli. Način njezina djelovanja nije još jasno definiran, premda se većina autora priklanja centralnom mehranizmu smanjenja boli. Rezultati, u literaturi, variraju od nesignifikantno boljeg učinka od placeba do 95°/o dobrog analgetskog djelovanja. U Zavodu za reumatske bolesti i rehabilitaciju Kliničkog bolničkog centra, Zagreb, evaluiran je učinak TENS-a u bolesnika s križ...

A prospective PET study of patients with glioblastoma multiforme

DEFF Research Database (Denmark)

Andersen, Preben B.; Blinkenberg, M; Lassen, U

2006-01-01

OBJECTIVE: To study the post-surgical metabolic and structural cerebral changes in patients with glioblastoma multiforme (GBM). MATERIALS AND METHODS: We examined ten patients prospectively with newly diagnosed GBM. All patients were primarily treated with surgery, followed by chemotherapy...... compared with structural imaging in the prospective evaluation of GBM. We found a difference in metabolic increase and tumor growth between the two treatment regimens, although this finding has limited relevance due to the design of the study....

Modulation of cerebral blood flow with transcutaneous electrical neurostimulation (TENS) in patients with cerebral vasospasm after subarachnoid hemorrhage

NARCIS (Netherlands)

ter Laan, Mark; van Dijk, J.M.C.; Stewart, Roy; Staal, Michiel J; Elting, Jan-Willem J.

ObjectivesTranscutaneous electrical neurostimulation (TENS) and spinal cord stimulation have been shown to increase peripheral and cerebral blood flow. We postulate that certain pathological conditions attenuate cerebral autoregulation, which may result in a relative increase of the importance of

Modulation of cerebral blood flow with transcutaneous electrical neurostimulation (TENS) in patients with cerebral vasospasm after subarachnoid hemorrhage

NARCIS (Netherlands)

Laan, M. ter; Dijk, J.M. van; Stewart, R.; Staal, M.J.; Elting, J.W.

2014-01-01

OBJECTIVES: Transcutaneous electrical neurostimulation (TENS) and spinal cord stimulation have been shown to increase peripheral and cerebral blood flow. We postulate that certain pathological conditions attenuate cerebral autoregulation, which may result in a relative increase of the importance of

The Effectiveness of MURDER Cooperative Model towards Students' Mathematics Reasoning Ability and Self Concept of Ten Grade

Directory of Open Access Journals (Sweden)

Sofan Tri Prasetiyo

2017-08-01

Full Text Available The purpose of this research was to know the effectiveness of MURDER cooperative model towards students’ mathematics reasoning ability and self concept of ten grade. Population of this research were students of MIA ten grade Senior High School 1 Kebumen in the academic year 2016/1017. Sampling technique using simple random sampling technique. The data collected by the method of documentation, test methods, observation methods, and questionnaire methods. The analyzed of data are used completeness test and average different test. The results showed that: (1 mathematics reasoning ability of students that following MURDER cooperative model have completed individual and classical study completeness; (2 mathematics reasoning ability of students that following MURDER cooperative model better than mathematics reasoning ability of students that following ekspository learning; (3 self concept of students that following MURDER cooperative model better than self concept of students that following ekspository learning.

The interventional treatment for recurrent jaundice after palliative bilio-intestinal anastomosis in patients with malignant obstructive jaundice due to cholangiocarcinoma

International Nuclear Information System (INIS)

Han Xinwei; Li Yongdong; Li Tianxiao; Ma Bo; Xing Gusheng; Wu Gang

2002-01-01

Objective: To explore the interventional methods to treat recurrent jaundice after palliative bilio-intestinal anastomosis in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods: Ten patients with recurrent jaundice after bilio-intestinal anastomosis were retrospectively evaluated. Nine of ten underwent PTCD with metallic stent placement, one underwent the inner-outer draining catheter procedure. The patients were evaluated with comparison in regard to preoperative conditions, TBIL, ALT, GTP and AKP values. Results: Stent placement was successful only once in all 10 cases with successful rate of 100%. TBIL, ALT, GTP and AKP values were significantly lower 7 days postoperative than that preoperation. Subsidence of jaundice was satisfactory for 100% in all patients after the treatment. Conclusions: Percutaneous placement of biliary metallic stents is a safety, simple, low complication method for managing recurrent jaundice after palliative bilio-intestinal anastomosis for the terminal stage of malignant obstructive jaundice

The value of cognitive interviewing for optimizing a patient experience survey.

NARCIS (Netherlands)

Buers, C.; Triemstra, M.; Bloemendal, E.; Zwijnenberg, N.C.; Hendriks, M.; Delnoij, D.M.J.

2014-01-01

This mixed-methods study uses both cognitive interviewing and a quantitative field test to provide empirical evidence on the value of cognitive interviewing for questionnaire development. Ten interviews were conducted with a questionnaire on patient experiences with cataract surgery (75-item

Limited results of group self-management education for rheumatoid arthritis patients and their partners: explanations from the patient perspective

NARCIS (Netherlands)

Bode, C.; Taal, E.; Emons, P.A.A.; Galetzka, M.; Rasker, J.J.; Laar, M.A.F.J. van de

2008-01-01

This study aimed to identify the reasons for limited results of group self-management for RA patients and their partners from the patient perspective. Semi-structured interviews with ten male and ten female patients who had participated in group self-management with or without their partner were

Limited results of group self-management education for rheumatoid arthritis patients and their partners: Explanations from the patient perspective.

NARCIS (Netherlands)

Bode, Christina; Taal, Erik; Emons, P.A.A.; Galetzka, Mirjam; Rasker, Johannes J.; van de Laar, Mart A F J

2008-01-01

This study aimed to identify the reasons for limited results of group self-management for RA patients and their partners from the patient perspective. Semi-structured interviews with ten male and ten female patients who had participated in group self-management with or without their partner were

Breath-hold two-dimensional MR angiography of coronary arteries. Comparison with conventional coronary angiography in ten cases

International Nuclear Information System (INIS)

Li Liwei; Zhang Wanshi; Liu Chaozhong; Lu Xiaoyan; Xu Jiaxing

1997-01-01

Purpose: To assess the diagnostic value of two-dimensional coronary magnetic resonance (MR) angiography in patients evaluated for ischemic heart disease. Materials and methods: Ten patients who underwent selective cardiac catheterization with coronary MR angiography were evaluated with two-dimensional coronary MR angiography. Coronary MR angiography was performed with breath-hold fat-suppressed ECG-gated Turbo-FLASH with K-space segmentation using a 1.5 T imager. Results: The left main coronary artery, proximal left anterior descending artery, circumflex artery and right coronary artery were demonstrated in all cases. Continuous segments (mean) of left anterior descending, circumflex and right coronary arteries visualized on MRA were 6.72 +- 3.16 cm, 3.67 +- 4.81 cm and 7.93 +- 3.12 cm respectively. The overall sensitivity for detection of hemodynamically significant coronary artery lesion (≥50%) was 62.5% respectively. Conclusion: Breath-hold two-dimensional coronary MR angiography was useful in showing relatively long segments of the main coronary arteries and also has potential in depicting hemodynamically significant coronary artery lesions

The Talar Body Prosthesis: Results at Ten to Thirty-six Years of Follow-up.

Science.gov (United States)

Harnroongroj, Thos; Harnroongroj, Thossart

2014-07-16

Satisfactory results of implantation of the talar body prosthesis were reported in 1997, although some complications associated with the initial design were noted. The present study evaluated outcomes of treatment with a modified talar body prosthesis. Of the thirty-six talar body prostheses implanted with use of a transmalleolar surgical approach from 1974 to 2011, thirty-three were available for follow-up at ten to thirty-six years or had failed prior to that time. The indication for implantation had been osteonecrosis in twenty-three patients, a comminuted talar fracture in eight, and a talar body tumor in two. Twenty-eight of the thirty-three prostheses were still in place at the time of final follow-up and five had failed prior to five years. The duration of follow-up was ten to twenty years in eight patients, twenty to thirty years in eleven, and thirty to thirty-six years in nine. The AOFAS (American Orthopaedic Foot & Ankle Society) ankle-hindfoot score did not differ significantly among these three groups. Patients over sixty-five years of age with underlying disease that impeded walking ability had lower AOFAS scores. Early prosthesis failure occurred as a result of size mismatch in two patients, tumor recurrence in one, infection in one, and osteonecrosis of the talar head and neck in one. These failures, which occurred at eight to fifty-seven months, were treated with tibiotalar arthrodesis in three patients, prosthesis revision in one, and below-the-knee amputation in one. Although early prosthesis failure may occur, survival of the talar body prosthesis can provide satisfactory ankle and foot function. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Effects of transcutaneous electrical nerve stimulation (TENS) on self-efficacy and mood in elderly with mild cognitive impairment

NARCIS (Netherlands)

Luijpen, Marijn W.; Swaab, Dick F.; Sergeant, Joseph A.; Scherder, Erik J. A.

2004-01-01

In previous studies, transcutaneous electrical nerve stimulation (TENS) has been applied to patients with either Alzheimer's disease (AD) or incipient dementia, resulting in an enhancement in memory and verbal fluency. Moreover, affective behavior was shown to improve. Based on the positive effects

How the Big Ten West Was Won: Football Recruiting

Directory of Open Access Journals (Sweden)

Diehl Kevin A.

2017-06-01

Full Text Available The paper analyses the 2017 Big Ten West Division football cycle models recruiting. The top ten recruit scores [(Rivals.com * 100 + [100 (outside surrounding; 75 (surrounding] + extra credit walk-ons (100; 75] allow proper ranking: Iowa, Nebraska, Wisconsin, Northwestern, Illinois, Minnesota, and Purdue.

2012 Ten-year scheme of network development

International Nuclear Information System (INIS)

2012-01-01

RTE, an independent subsidiary of EDF, is the French electricity transmission system operator. It is a public service company responsible for operating, maintaining and developing the high and extra high voltage network. It guarantees the reliability and proper operation of the power network. RTE transports electricity between electricity suppliers (French and European) and consumers, whether they are electricity distributors or industrial consumers directly connected to the transmission system. The mission of RTE is to balance the electricity supply and demand in real time. With the support of the government authorities, RTE prepares a ten-year scheme of network development in France; This document presents the main electricity transport infrastructures to foresee within the ten coming years and lists the network development investments which must be realised and implemented within 3 years. The document is updated each year and comes to complement at the national level the European ten year network development plan (TYNDP) and the European regional plans as provided for in the 2009/72/CE European directive

Ten-year scheme of network development - 2011

International Nuclear Information System (INIS)

2011-01-01

RTE, an independent subsidiary of EDF, is the French electricity transmission system operator. It is a public service company responsible for operating, maintaining and developing the high and extra high voltage network. It guarantees the reliability and proper operation of the power network. RTE transports electricity between electricity suppliers (French and European) and consumers, whether they are electricity distributors or industrial consumers directly connected to the transmission system. The mission of RTE is to balance the electricity supply and demand in real time. With the support of the government authorities, RTE prepares a ten-year scheme of network development in France; This document presents the main electricity transport infrastructures to foresee within the ten coming years and lists the network development investments which must be realised and implemented within 3 years. The document is updated each year and comes to complement at the national level the European ten year network development plan (TYNDP) and the European regional plans as provided for in the 2009/72/CE European directive

The Ross Procedure in Patients among the Pediatric Population, Post Ten Years of Experience

Directory of Open Access Journals (Sweden)

Andrey A. Ivanov

2013-09-01

Full Text Available The aim of the study was to analyze the results of the surgical treatment in pediatric patients who had undergone the Ross procedure.Material and Methods: The study involved 114 patients between 12 days to 18 years in age. The early and late (up to 5 years results of the treatment were studied. The examination included echocardiography, catheterization of the cardiac chambers and angiocardiography. The case distribution of patients based on diagnosis was as follows: isolated aortic valve stenosis (IAVS in 38 (33.3% patients, aortic valve insufficiency (AVI in 33 (28.9%, and combined heart defects in 56 patients (49.1%.Results: The death rate was 6.14% during the early postoperative period and 1.14% in the late postoperative period; the actuarial survival in the long-term was 98.86%. The complication rate was 51.5%. The most frequent complication was pericarditis (25.6%, whereas cardiac and respiratory failure occurred in 7.6% of the cases and cardiac arrhythmias in 6.1% of the cases. The average time spent in the intensive care unit was 3.48 ± 2.90 days; the hospitalization period on average was 24.70±10.87 days. After surgery, there was a tendency of the echocardiographic parameters to move toward normalization. The frequency of reoperation in the late period was 23.7%, the main reason for which being the conduit dysfunction in the position of the pulmonary artery (PA.Conclusion: The clinical efficacy of the Ross procedure in the treatment of aortic valve malformations in the pediatric group was confirmed. However, in some cases, the need to perform repeated operations due to the increase in the ring size and an increase in the neo-aortic insufficiency during the somatic growth process.

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.

The Ultrastructure Of Pollinia Of Ten Species Of Orchid In Substribe Aeridinae (ORCHIDACEAE)

International Nuclear Information System (INIS)

Sulistyono; Purbaningsih, Susiani; Pujoarianto, Agus

2000-01-01

Orchid taxonimy lags several decades behind the taxonomy of most other large interisting groups of plants. New methods and techiniques, like scanning and transmission electron microscope are rarely applied in orchid's taxonomy. It would be most benefical to orchid taxonomy if a better understanding of the pollinia could be obtained. The main purpose of this research is to study the ultrastructure pollinia of ten species of Aeridinae (Orchidaceae). The scanning electron microscope (SEM) has been used to study the pollinia of ten species of orchids in the substribe Aeridina. This work shows that the ultrastructure of the pollinias are different. Regarding at the number and the surface of pollinia in one flowe, the ten species of Aeridinae can be devided mto three main group: (1) the first group is the flowe with two pollinia with it surface porate : Ascocentrum miniatum; (2) the second group has the same number of pollinia, but with surface cleft : Phalaenopsis. Ph. amboinensis, Ph.cornu-cervi, Ph. Fuscata, Ph. Venosa, Rhychostylis retusa, Vanda limbota, and Vanda insignis: and the third (3)is the flower with four pollinia, unequel : Kingidium deliciosum

Top-Ten IT Issues: 2009

Science.gov (United States)

Agee, Anne Scrivener; Yang, Catherine

2009-01-01

This article presents the top-ten IT-related issues in terms of strategic importance to the institution, as revealed by the tenth annual EDUCAUSE Current Issues Survey. These IT-related issues include: (1) Funding IT; (2) Administrative/ERP Information Systems; (3) Security; (4) Infrastructure/Cyberinfrastructure; (5) Teaching and Learning with…

Different mechanisms for the short-term effects of real versus sham transcutaneous electrical nerve stimulation (TENS) in patients with chronic pain: a pilot study.

NARCIS (Netherlands)

Oosterhof, J.; Wilder-Smith, O.H.G.; Oostendorp, R.A.B.; Crul, B.J.P.

2012-01-01

Transcutaneous electrical nerve stimulation (TENS) has existed since the early 1970s. However, randomized placebo controlled studies show inconclusive results in the treatment of chronic pain. These results could be explained by assuming that TENS elicits a placebo response. However, in animal

Evaluation of perioperative nutritional status with subjective global assessment method in patients undergoing gastrointestinal cancer surgery.

Science.gov (United States)

Erdim, Aylin; Aktan, Ahmet Özdemir

2017-01-01

This study was designed to evaluate the perioperative nutritional status of patients undergoing surgery for gastrointestinal cancer using Subjective Global Assessment and surgeon behavior on nutritional support. We recruited 100 patients undergoing surgery for gastrointestinal cancer in one university and two state teaching hospitals. Subjective Global Assessment was administered to evaluate preoperative and postoperative nutritional status. Fifty-two patients in the state hospitals (Group 1) and 48 in the university hospital were assessed. Anthropometric and biochemical measurements were performed. Changes in preoperative Subjective Global Assessment scores and scores at the time of discharge and types of nutritional support were compared. Subjective Global Assessment-B was regarded as moderate and Subjective Global Assessment-C as heavy malnutrition. Ten patients had Subjective Global Assessment-B and 29 had Subjective Global Assessment-C malnutrition in Group 1 and nine had Subjective Global Assessment-B and 31 had Subjective Global Assessment-C malnutrition in Group 2 during preoperative assessment. Respective numbers in postoperative assessment were 12 for Subjective Global Assessment-B and 30 for Subjective Global Assessment-C in Group 1 and 14 for Subjective Global Assessment-B and 26 for Subjective Global Assessment-C in Group 2. There was no difference between two groups. Nutritional methods according to Subjective Global Assessment evaluation in pre- and postoperative periods were not different between the groups. This study demonstrated that the malnutrition rate is high among patients scheduled for gastrointestinal cancer surgery and the number of surgeons were inadequate to provide perioperative nutritional support. Both university and state hospitals had similar shortcomings. Subjective Global Assessment is an easy and reliable test and if utilized will be helpful to detect patients requiring nutritional support.

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

Science.gov (United States)

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.

Fabrication of ten-fold photonic quasicrystalline structures

Directory of Open Access Journals (Sweden)

XiaoHong Sun

2015-05-01

Full Text Available Compared to periodic crystals, quasicrystals have higher point group symmetry and are more favorable in achieving complete band-gaps. In this report, a top-cut prism interferometer is designed to fabricate ten-fold photonic quasicrystalline structures. By optimizing the exposing conditions and material characteristics, appropriate quasicrystals have been obtained in the SU8 photoresist films. Atomic Force Microscopy and laser diffraction are used to characterize the fabricated structures. The measurement results show the consistence between the theoretical design and experiments. This will provide guidance for the large-area and fast production of ten-fold quasicrystalline structures with high quality.

Ten-year survival of patients with oesophageal squamous cell ...

African Journals Online (AJOL)

Objectives. The standard predictive factors of actuarial survival such as T and N stage become less important as patients live for more than 10 years after treatment of cancer. Reports of actual 10-year survivors of oesophageal squamous cell carcinoma (SCC) are rare, and demographic and clinicopathological factors ...

Ten into four won't go

International Nuclear Information System (INIS)

Freedman, D.Z.; West, P.C.

1989-01-01

It is shown that nontrivial spontaneous compactification of ten-dimensional N = 1 supergravity with or without Yang-Mills matter is not possible unless maximal symmetry (i.e. Lorentz invariance) is violated in the four-dimensional spacetime

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.

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

DEFF Research Database (Denmark)

Whitfield, Kate; Huemer, Karl-Heinz; Winter, Diana

2010-01-01

'Compassionate use' programmes allow medicinal products that are not authorised, but are in the development process, to be made available to patients with a severe disease who have no other satisfactory treatment available to them. We sought to understand how such programmes are regulated in ten ...

Resource requirements of inclusive urban development in India: insights from ten cities

Science.gov (United States)

Singh Nagpure, Ajay; Reiner, Mark; Ramaswami, Anu

2018-02-01

This paper develops a methodology to assess the resource requirements of inclusive urban development in India and compares those requirements to current community-wide material and energy flows. Methods include: (a) identifying minimum service level benchmarks for the provision of infrastructure services including housing, electricity and clean cooking fuels; (b) assessing the percentage of homes that lack access to infrastructure or that consume infrastructure services below the identified benchmarks; (c) quantifying the material requirements to provide basic infrastructure services using India-specific design data; and (d) computing material and energy requirements for inclusive development and comparing it with current community-wide material and energy flows. Applying the method to ten Indian cities, we find that: 1%-6% of households do not have electricity, 14%-71% use electricity below the benchmark of 25 kWh capita-month-1 4%-16% lack structurally sound housing; 50%-75% live in floor area less than the benchmark of 8.75 m2 floor area/capita; 10%-65% lack clean cooking fuel; and 6%-60% lack connection to a sewerage system. Across the ten cities examined, to provide basic electricity (25 kWh capita-month-1) to all will require an addition of only 1%-10% in current community-wide electricity use. To provide basic clean LPG fuel (1.2 kg capita-month-1) to all requires an increase of 5%-40% in current community-wide LPG use. Providing permanent shelter (implemented over a ten year period) to populations living in non-permanent housing in Delhi and Chandigarh would require a 6%-14% increase over current annual community-wide cement use. Conversely, to provide permanent housing to all people living in structurally unsound housing and those living in overcrowded housing (social policies that seek to provide basic infrastructure provisioning for all residents would not dramatically increasing current community-wide resource flows.

Progeny Clustering: A Method to Identify Biological Phenotypes

Science.gov (United States)

Hu, Chenyue W.; Kornblau, Steven M.; Slater, John H.; Qutub, Amina A.

2015-01-01

Estimating the optimal number of clusters is a major challenge in applying cluster analysis to any type of dataset, especially to biomedical datasets, which are high-dimensional and complex. Here, we introduce an improved method, Progeny Clustering, which is stability-based and exceptionally efficient in computing, to find the ideal number of clusters. The algorithm employs a novel Progeny Sampling method to reconstruct cluster identity, a co-occurrence probability matrix to assess the clustering stability, and a set of reference datasets to overcome inherent biases in the algorithm and data space. Our method was shown successful and robust when applied to two synthetic datasets (datasets of two-dimensions and ten-dimensions containing eight dimensions of pure noise), two standard biological datasets (the Iris dataset and Rat CNS dataset) and two biological datasets (a cell phenotype dataset and an acute myeloid leukemia (AML) reverse phase protein array (RPPA) dataset). Progeny Clustering outperformed some popular clustering evaluation methods in the ten-dimensional synthetic dataset as well as in the cell phenotype dataset, and it was the only method that successfully discovered clinically meaningful patient groupings in the AML RPPA dataset. PMID:26267476

Design and Evaluation on the Mobile Application of Transcutaneous Electrical Nerve Stimulation (TENS).

Science.gov (United States)

Cheng, Ching-Lung; Lee, Li-Hui; Cheng, Yu-Ting

2017-01-01

This study aims to design a transcutaneous electrical nerve stimulation Application (TENS App) according to the suggestions from potential users. To the best of our knowledge, this is the first App including meridian and acupoints for TENS. After its development, there are eight participants recruited for evaluating the usability. Despite two out of eight users reporting that the typical TENS system requires lower cost and has better functionality than TENS App, the results show that almost seventy percent of participants have a better perception of TENS App on price, functionality, convenience, operational ability, and quality. However, participants still reported concerns about the safety issue of adopting TENS App. Therefore, for people who are the first time or unfamiliar with TENS App, instructions from occupational or physical therapists are recommended. We conclude that by using TENS App, users can not only use the portable electrotherapy devices at anyplace, but also reduce their outpatient visits.

Transcutaneous Electrical Nerve Stimulation (TENS) for the Control of Pain during Rehabilitation Following Total Knee Arthroplasty (TKA): A Randomized, Blinded, Placebo-Controlled Trial

Science.gov (United States)

Rakel, Barbara; Zimmerman, M. Bridget; Geasland, Katharine; Embree, Jennie; Clark, Charles R; Noiseux, Nicolas O; Callaghan, John J; Herr, Keela; Walsh, Deirdre; Sluka, Kathleen A

2014-01-01

This study evaluated the efficacy of TENS in reducing pain and hyperalgesia and increasing function following total knee arthroplasty (TKA). We hypothesized participants using TENS during rehabilitation exercises would: 1) report significantly lower pain during range-of-motion (ROM) and fast walking but not at rest; 2) have less hyperalgesia; and, 3) have better function than participants receiving Placebo-TENS or Standard Care. We also hypothesized that change in ROM pain would differ based on psychological characteristics (trait anxiety, pain catastrophizing and depression) and treatment group. This prospective, randomized study used intent-to-treat analyses on 317 subjects after primary, unilateral TKA. Assessors, blinded to treatment allocation, measured pain, function (ROM and gait speed), and hyperalgesia (quantitative sensory tests) postoperatively and 6 weeks after surgery. Analgesic intake, anxiety, depression, and pain catastrophizing were also assessed. TENS participants used it 1–2 times/day at 42 mA (on average) and had less pain postoperatively during active knee extension (p=0.019) and fast walking (p=0.006) than Standard Care participants. TENS and Placebo-TENS were not significantly different. TENS participants who scored low on anxiety and pain catastrophizing had a greater reduction in ROM pain at 6 weeks than those scoring high on these factors (p=0.002 and 0.03). Both TENS and Placebo-TENS participants had less postoperative mechanical hyperalgesia (p=0.03 – 0.01) than Standard Care participants. Supplementing pharmacologic analgesia with TENS during rehabilitation exercises reduces movement pain postoperatively but a placebo influence exists and the effect is gone by 6 weeks. Patients with low anxiety and pain catastrophizing may benefit most from TENS. PMID:25270585

Impact of quality control radiation doses received by patients undergoing abdomen x-ray examination in ten hospitals

International Nuclear Information System (INIS)

Aghahadi, B.; Zhang, Z.; Zareh, S.; Sarkar, S.; Tayebi, P. S.

2006-01-01

The X-ray machines used for radiodiagnosis should meet certain quality assurance programmes. These are necessary to have good quality radiographs at reasonably low exposure to patients. Materials and Methods: Dose reduction methods in abdomen X-ray examination were carried out in 10 hospitals in Tehran. This paper presents the work, which was implemented on 200 patients and evaluated using the entrance skin dose in the Anterior-Posterior abdomen projection measured directly at the center of the X-ray field. In addition, the machine room, and dark room parameters, as well as work practices and repeat rates were studied. Results: The quality control parameters and the entrance skin dose were evaluated utilizing an anthropologic phantom to define the optimal exposure condition at all hospitals before and after quality control . Results show that after using the quality control parameters and optimization of the exposure conditions, the mean of mAs and entrance skin dose can be decreased by 62% and 65% respectively. Conclusion: The quality of the radiographs generally increased. The reported method is easily implemented in any clinical situation where optimization of abdomen radiography is necessary

Familial hypercholesterolaemia reduces the quality of life of patients not reaching treatment targets

DEFF Research Database (Denmark)

Mortensen, Gitte Lee; Madsen, Ivan Bredbjerg; Kruse, Charlotte

2016-01-01

are only met in approximately 50% of patients. This comparative study examined the quality of life (QoL) impact of FH in patients who had and had not reached the target of treatment. METHODS: Two qualitative focus group interviews were carried out with a total of ten FH patients. A semi...... of treatment. FUNDING: The study was funded by a research grant from Amgen. TRIAL REGISTRATION: not relevant....

Patterns of Physician-Patient Communication Associated with Patient Satisfaction.

Science.gov (United States)

Williams, M. Lee; Clampitt, Phillip G.

Using data drawn from ten initial physician/patient interviews, an original category system was employed to analyze patterns of physician/patient communication. Static analysis, interaction analysis, and Markov chain analysis were used to discover the underlying communication patterns associated with patient satisfaction. Results revealed that…

Mid-term evaluation of ten National Research schools

DEFF Research Database (Denmark)

Gustafsson, Göran; Dahl, Hanne Marlene; Gustafsson, Christina

the scheme was launched, the Research Council has issued three calls for proposals and allocated grants to a total of 22 national research schools. Five were started up in 2009, ten in 2013 and seven in 2015. A Nordic scientific programme committee was appointed in 2013, with responsibility for assessing...... grant applications, monitoring the progress of the FORSKERSKOLER scheme and serving as the evaluation panel for the mid-term evaluation in 2013 and in 2016/2017. The task of the evaluation panel has been to: 1) evaluate the quality of and progress achieved by the ten research schools which were awarded...... funding in 2012 and launched in 2013; and 2) to provide recommendations as to whether funding should be continued to cover the full eight-year period or terminated after five years. Continued funding is recommended for all ten schools to cover the full eight-year period, according to the proposed budget...

Contributions of COPD, asthma, and ten comorbid conditions to health care utilization and patient-centered outcomes among US adults with obstructive airway disease

Directory of Open Access Journals (Sweden)

Murphy TE

2017-08-01

Full Text Available Terrence E Murphy,1 Gail J McAvay,1 Heather G Allore,1 Jason A Stamm,2 Paul F Simonelli2 1Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA; 2Department of Internal Medicine, Section of Thoracic Medicine, Geisinger Medical Center, Danville, PA, USA Background: Among persons with obstructive airway disease, the relative contributions of chronic obstructive pulmonary disease (COPD, asthma, and common comorbid conditions to health care utilization and patient-centered outcomes (PCOs have not been previously reported.Methods: We followed a total of 3,486 persons aged ≥40 years with COPD, asthma, or both at baseline, from the Medical Expenditure Panel Survey (MEPS cohorts enrolled annually from 2008 through 2012 for 1 year. MEPS is a prospective observational study of US households recording self-reported COPD, asthma, and ten medical conditions: angina, arthritis, cancer, coronary heart disease, cognitive impairment, diabetes, hypertension, lung cancer, myocardial infarction, and stroke/transient ischemic attack. We studied the separate contributions of these conditions to health care utilization (all-cause and respiratory disease hospitalization, any emergency department [ED] visit, and six or more outpatient visits and PCOs (seven or more days spent in bed due to illness, incident loss of mobility, and incident decline in self-perceived health.Results: COPD made the largest contributions to all-cause and respiratory disease hospitalization and ED visits, while arthritis made the largest contribution to outpatient health care. Arthritis and COPD, respectively, made the greatest contributions to the PCOs.Conclusion: COPD made the largest and second largest contributions to health care utilization and PCOs among US adults with obstructive airway disease. The twelve medical conditions collectively accounted for between 52% and 61% of the health care utilization outcomes and between 53

Ten out of ten for LHC decapole magnets

CERN Multimedia

2001-01-01

CERN's Albert Ijspeert (left) and Avinash Puntambekar of the Indian CAT laboratory with the ten Indian decapole magnets on the test bench. Tests will be carried out by the LHC-MTA group. A batch of 10 superconducting decapole magnets for the LHC has just arrived at CERN from India. These will be used to correct for slight imperfections in the dipole magnets that will steer proton beams around CERN's new accelerator. All magnets have slight imperfections in the fields they produce, and in the LHC dipoles these will be corrected for using sextupoles and decapoles. The sextupoles were the first LHC magnets to be given the production green-light following successful tests of pre-series magnets last year (Bulletin 21/2000, 22 May 2000). Now it is the turn of pre-series decapoles to go on trial at CERN. Of the LHC's 1232 dipole magnets, half will use sextupole correctors only and the other half will use both sextupoles and decapoles. That means that a total of 616 pairs of decapoles are needed. Like the sextupole...

Ten helical twist angles of B-DNA

Energy Technology Data Exchange (ETDEWEB)

Kabsch, W; Sander, C; Trifonov, E N

1982-01-01

On the assumption that the twist angles between adjacent base-pairs in the DNA molecule are additive a linear system of 40 equations was derived from experimental measurements of the total twist angles for different pieces of DNA of known sequences. This system of equations is found to be statistically consistent providing a solution for all ten possible twist angles of B-DNA by a least squares fitting procedure. Four of the calculated twist angles were not known before. The other six twist angles calculated are very close to the experimentally measured ones. The data used were obtained by the electrophoretic band-shift method, crystallography and nuclease digestion of DNA adsorbed to mica or Ca-phosphate surface. The validity of the principle of additivity of the twist angles implies that the angle between any particular two base-pairs is a function of only these base-pairs, independent of nearest neighbors.

Ten years after the Jali Commission

African Journals Online (AJOL)

Ten years have lapsed since the Jali Commission's final report became publicly available, and it is therefore an .... as the 'core business' of the department. This was seen as .... the 2009/10–2013/14 DCS Strategic Plan did the department ...

Ten-decimal tables of the logarithms of complex numbers and for the transformation from Cartesian to polar coordinates

CERN Document Server

Lyusternik, L A

1965-01-01

Ten-Decimal Tables of the Logarithms of Complex Numbers and for the Transformation from Cartesian to Polar Coordinates contains Tables of mathematical functions up to ten-decimal value. These tables are compiled in the Department for Approximate Computations of the Institute of Exact Mechanics and Computational Methods of the U.S.S.R. Academy of Sciences. The computations are carried out by this department in conjunction with the Computational-Experimental Laboratory of the Institute.This book will be of value to mathematicians and researchers.

Marked seasonality of Cyclospora cayetanensis infections: ten-year observation of hospital cases, Honduras.

Science.gov (United States)

Kaminsky, Rina Girard; Lagos, Javier; Raudales Santos, Gabriela; Urrutia, Samuel

2016-02-04

Document seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras. Retrospective non interventional hospital-based study analyzed laboratory results from the period 2002 to 2011 of fresh and Ziehl-Nielsen carbolfuchsin stained routine stool samples received for parasitologic examination. Sporadically a sample with numerous oocysts was allowed to sporulate in 2.5 % potassium dichromate confirming the presence of bi-cystic bi-zoic oocysts. A total of 35,157 fecal samples were examined during a ten-year span, of which a third (28.4 %) was stained by the Ziehl-Neelsen carbolfuchsin method diagnosing a total of 125 (1.3 %) C.cayetanensis infections. A statistically significant apparent seasonality was observed most years during May to August (range p < 0.036-0.001), with 83.3 % of 125 cases occurring in those rainy months. All C. cayetanensis cases came from urban poor neighborhoods; male/female relation was 1:1 except in 2006, when all patients were females (p = 0.05; r(2) = 22,448). Forty four point eight percent of the stool samples were diarrheic or liquid and 65.6 % infections were identified in children 10 years old or less. Enteric helminths and protozoa co-infected Cyclospora positive patients in 52 instances.: 8 % Ascaris lumbricoides, 8 % Giardia duodenalis, 23.2 % Blastocystis spp. and less frequently Entamoeba histolytica/E. dispar, Strongyloides stercoralis, and Trichuris trichiura. Results suggest a seasonal pattern for Cyclospora infections diagnosed in a clinical setting during the rainy months in Tegucigalpa and surrounding areas. Community studies should be conducted to support or dispute these observations.

Treatment of chronic back pain by sensory discrimination training. A Phase I RCT of a novel device (FairMed vs. TENS

Directory of Open Access Journals (Sweden)

Sackley Catherine M

2008-06-01

Full Text Available Abstract Background The causes of chronic low back pain (CLBP remain obscure and effective treatment of symptoms remains elusive. A mechanism of relieving chronic pain based on the consequences of conflicting unpleasant sensory inputs to the central nervous system has been hypothesised. As a result a device was generated to deliver sensory discrimination training (FairMed, and this randomised controlled trial compared therapeutic effects with a comparable treatment modality, TENS. Methods 60 patients with CLBP were recruited from physiotherapy referrals to a single-blinded, randomised controlled, non-inferiority trial. They were randomised to receive either FairMed or TENS and asked to use the allocated device for 30 minutes, twice a day, for 3 weeks. The primary outcome variable measured at 0 and 3 weeks was pain intensity measured using a visual analogue scale averaged over 7 days. Secondary outcome measures were Oswestry Disability Index, 3 timed physical tests, 4 questionnaires assessing different aspects of emotional coping and a global measure of patient rating of change. Data were analysed for the difference in change of scores between groups using one-way ANOVA. Results Baseline characteristics of the two groups were comparable. The primary outcome, change in pain intensity (VAS at 3 weeks showed a mean difference between groups of -0.1, (non significant p = 0.82. The mean difference in change in ODI scores was 0.4; (non significant p = 0.85. Differences in change of physical functioning showed that no significant difference in change of scores for any of these test (p = 0.58 – 0.90. Changes in scores of aspects of emotional coping also demonstrated no significant difference in change scores between the groups (p = 0.14 – 0.94. Conclusion FairMed was not inferior to TENS treatment. The findings have implications for further research on current chronic pain theories and treatments. Further work to explore these mechanisms is important

Upper gastrointestinal Kaposi's sarcoma in HIV-infected patients: ten years of endoscopy observation at a single Brazilian center

Directory of Open Access Journals (Sweden)

Rosamar Eulira Fontes Rezende

2015-10-01

Conclusions: GI KS is an infrequent finding in patients with HIV infection. Among those with GI KS, 80% had concomitant skin lesions. Immunohistochemical methods for CD31, CD34, and LNA-1 were important tools in the diagnostic assessment of lesions suggestive of KS in the GI tract. Further studies are required to confirm these data, and the need for routine endoscopic investigation of the GI tract in HIV-infected patients with cutaneous KS should be assessed.

Ten years of nuclear power

Energy Technology Data Exchange (ETDEWEB)

NONE

1964-08-15

Ten years have elapsed since the world's first nuclear power station began to supply electricity in Russia, and this in turn marked the end of a twelve year stage following the first controlled nuclear chain reaction at Chicago. These periods mark major stages in the development of atomic energy from the realm of abstract ideas to that of everyday industrial application. They followed a period of fundamental research and laboratory work, culminating in Enrico Fermi's demonstration of a system whereby the forces of the atom could be brought under control. Then it was necessary to find ways and means of using the chain reaction for practical purposes and on an industrial scale. And after this had been shown in 1954 to be technically possible, it had still to be developed into an economic process. The nuclear power station has proved itself from the technical and engineering standpoint. The third phase of development has been to bring it to the stage of being economically competitive with alternative sources of energy, and it would appear that we are now reaching that goal - though more slowly than had been envisaged ten years ago

The acute radiation syndrome: A study of ten cases and a review of the problem

Energy Technology Data Exchange (ETDEWEB)

Hempelmann, L.H.; Lisco, H.

1950-03-17

In this report ten cases of acute radiation syndrome are described resulting from two accidents occurring at the Los Alamos Scientific Laboratory of unique nature involving fissionable material. These cases are described in considerable detail. The report comprises ten sections. This volume, part II of the report, is comprised of sections entitled: (1) the Biological Basis for the Clinical Response seen in the Acute radiation Syndrome, (2) Clinical Signs and Symptoms, (3) Discussion of Hematological Findings, (4) Chemistry of the Blood and Urine, (5) Discussion of Pathological Findings, and (6) Reconsiderations of the Calculated Radiation Doses in Terms of the Observed Biological Response of the Patients. This report was prepared primarily for the clinician who is interested in radiation injuries and therefore emphasis has been placed on the correlation of clinical and pathological changes with the type of cytogenetic change known to be produced by ionizing radiation.

Von Blüten, Göttern und Gelehrten

OpenAIRE

Zotter, Astrid

2013-01-01

Der Sanskrittext Puṣpacintāmaṇi (PuCi) behandelt Blüten als Darbringungen (upacāra) im wichtigsten hinduistischen Verehrungsritual, der pūjā. In ca. 400 Strophen werden über 200 Namen von Blüten genannt und für verschiedene Gottheiten und pūjās als geeignete oder ungeeignete Gaben vorgeschrieben. Der Text ist eine Kompilation (Nibandha), in der die Inhalte aus 47 namentlich genannten Quellentexten referiert werden. Ziel der Dissertation ist es nicht nur, diesen Text, der 1966 zum ersten Ma...

The European General Practice Research Network Presents the Translations of Its Comprehensive Definition of Multimorbidity in Family Medicine in Ten European Languages

Science.gov (United States)

Le Reste, Jean Yves; Nabbe, Patrice; Rivet, Charles; Lygidakis, Charilaos; Doerr, Christa; Czachowski, Slawomir; Lingner, Heidrun; Argyriadou, Stella; Lazic, Djurdjica; Assenova, Radost; Hasaganic, Melida; Munoz, Miquel Angel; Thulesius, Hans; Le Floch, Bernard; Derriennic, Jeremy; Sowinska, Agnieska; Van Marwijk, Harm; Lietard, Claire; Van Royen, Paul

2015-01-01

Background Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. Objective To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. Method Forward translation of the EGPRN’s definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached Results 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. Conclusion A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care. PMID:25607642

Large scale exact quantum dynamics calculations: Ten thousand quantum states of acetonitrile

Science.gov (United States)

Halverson, Thomas; Poirier, Bill

2015-03-01

'Exact' quantum dynamics (EQD) calculations of the vibrational spectrum of acetonitrile (CH3CN) are performed, using two different methods: (1) phase-space-truncated momentum-symmetrized Gaussian basis and (2) correlated truncated harmonic oscillator basis. In both cases, a simple classical phase space picture is used to optimize the selection of individual basis functions-leading to drastic reductions in basis size, in comparison with existing methods. Massive parallelization is also employed. Together, these tools-implemented into a single, easy-to-use computer code-enable a calculation of tens of thousands of vibrational states of CH3CN to an accuracy of 0.001-10 cm-1.

Validation of ten-minute single sample carbon-14 urea breath test for diagnosis of Helicobacter pylori infection

International Nuclear Information System (INIS)

Prabakaran, K.; Fernandes, V.; McDonald, J.

1996-01-01

Helicobacter pylori infection is traditionally diagnosed by endoscopy followed by gastric biopsy and histologic demonstration of organisms, rapid urease test and culture. The non-invasive carbon-14-urea breath test has been widely accepted now for the diagnosis of this bacterium. This study was aimed to establish and validate normal and abnormal values for an Australian population, for a single sample carbon-14-urea breath test at ten minutes. A dose of 185 kBq was used in order to achieve reasonable counting statistics. The derived values were validated with the results of the rapid urease test. This method has a high sensitivity, specificity and greater patient acceptance, and could be used in many clinical settings as the first modality for the diagnosis of H. pylori infection and for documenting response or cure after antibiotic therapy for eradication. 11 refs., 1 tab., 4 figs

A ten-year study of penetrating injuries of the colon.

Science.gov (United States)

Adesanya, Adedoyin A; Ekanem, Ekanem E

2004-12-01

Colon injury has been associated with a high risk of septic complications and mortality. We prospectively studied the pattern, management, outcome, and prognostic factors in patients who sustained penetrating colon injuries. Sixty patients who presented to our hospital with penetrating colon injuries over a ten-year period (1992 to 2001) were studied. Colon wounds were caused by gunshots in 55 (91.7 percent) patients and knife stabs in 5 (8.3 percent). There was a delay of more than 12 hours before laparotomy in 30 (50 percent) patients. Moderate or major fecal contamination of the peritoneal cavity occurred in 58 (96.7 percent) patients. The average penetrating abdominal trauma index score was 25.9 and 20 (33.3 percent) patients sustained Flint Grade 3 colon injury. Associated intra-abdominal injuries occurred in the small bowel (73.3 percent), liver (25 percent), stomach (23.3 percent), and mesentery (16.7 percent). Right colon wounds (35) were managed by primary repair in 24 (68.6 percent) patients and proximal diverting colostomy in 11 (31.4 percent), whereas left colon wounds (25) were managed by diverting colostomy in 22 (88.0 percent) patients and primary repair in 3 (12.0 percent) patients. Common complications included wound infection (56.7 percent), septicemia (31.7 percent), and enterocutaneous fistula (16.7 percent). The overall mortality rate was 33.3 percent and colon injury-related mortality was 21.7 percent. Presence of destructive colon injury was associated with a greater than fourfold increased incidence of death. Other significant risk factors included shock on admission, major fecal contamination, duration of operation more than four hours, penetrating abdominal trauma index score >25, and more than two postoperative complications. There was no difference in outcome between patients who had primary repair and those undergoing diverting colostomy. Colostomy closure-related morbidity was 21 percent and mortality was 5.3 percent. A more liberal

Ten-Year Survival in Patients with Idiopathic Pulmonary Fibrosis After Lung Transplantation.

Science.gov (United States)

ten Klooster, Liesbeth; Nossent, George D; Kwakkel-van Erp, Johanna M; van Kessel, Diana A; Oudijk, Erik J; van de Graaf, Ed A; Luijk, Bart; Hoek, Rogier A; van den Blink, Bernt; van Hal, Peter Th; Verschuuren, Erik A; van der Bij, Wim; van Moorsel, Coline H; Grutters, Jan C

2015-12-01

Idiopathic pulmonary fibrosis (IPF) is a progressive and lethal fibrosing lung disease with a median survival of approximately 3 years after diagnosis. The only medical option to improve survival in IPF is lung transplantation (LTX). The purpose of this study was to evaluate trajectory data of IPF patients listed for LTX and to investigate the survival after LTX. Data were retrospectively collected from September 1989 until July 2011 of all IPF patients registered for LTX in the Netherlands. Patients were included after revision of the diagnosis based on the criteria set by the ATS/ERS/JRS/ALAT. Trajectory data, clinical data at time of screening, and donor data were collected. In total, 98 IPF patients were listed for LTX. During the waiting list period, 30 % of the patients died. Mean pulmonary artery pressure, 6-min walking distance, and the use of supplemental oxygen were significant predictors of mortality on the waiting list. Fifty-two patients received LTX with a median overall survival after transplantation of 10 years. This study demonstrated a 10-year survival time after LTX in IPF. Furthermore, our study demonstrated a significantly better survival after bilateral LTX in IPF compared to single LTX although bilateral LTX patients were significantly younger.

The effects of Transcutaneous Electrical Nerve Stimulation on postural control in patients with chronic low back pain.

Science.gov (United States)

Rojhani-Shirazi, Z; Rezaeian, T

2015-01-01

Objective: The effects of transcutaneous electrical nerve stimulation (TENS) on postural control in patients with low back pain which is not well known. This study aimed to evaluate the effects of TENS on postural control in chronic low back pain. Methods: This study was an experimental research design. Twenty-eight patients with chronic LBP (25-45 Y/ O) participated and by using a random allocation, were divided to samples who participated in this study. The mean center of pressure (COP) velocity and displacement were measured before, immediately and 30 min after the intervention. The tests were done with eyes open and closed on a force platform. Sensory electrical stimulation was applied through the TENS device. The descriptive statistics, independent sample T-test and ANOVA with repeated measurement on time were used for data analysis. Results: The results of the present study demonstrated that the application of the sensory electrical stimulation in chronic LBP patients showed a statistically significant improvement in postural control in Medio-lateral direction with no corresponding effect on the anterior-posterior direction immediately following the TENS application and 30 minutes after it in closed eyes conditions as compared to baseline. The application of TENS decreased the displacement and velocity of COP (p≤0.05), 30 minutes after the application of sensory electrical stimulation. The results showed that the mean displacement and velocity of COP decreased in eyes open position (p≤0.05). Also, immediately and 30 minutes after the application of sensory electrical stimulation, COP displacement and velocity in ML direction with eyes closed significantly decreased in the intervention group in comparison with control group (p≤0.05). Conclusion: The application of TENS in patients with chronic low back pain could improve postural control in these patients.

Kaluza-Klein supergravity in ten dimensions

International Nuclear Information System (INIS)

Huq, M.; Namazie, M.A.

1983-11-01

We construct a massive version of N=2 supergravity in ten dimensions by compactification of the eleven dimensional, N=1 theory. This theory describes the usual N=2 massless super-multiplet, in addition to which there is an infinite tower of massive, charged N=2 supermultiplets. (author)

Ten themes of viscous liquid dynamics

DEFF Research Database (Denmark)

Dyre, J. C.

2007-01-01

Ten ‘themes' of viscous liquid physics are discussed with a focus on how they point to a general description of equilibrium viscous liquid dynamics (i.e., fluctuations) at a given temperature. This description is based on standard time-dependent Ginzburg-Landau equations for the density fields...

Ten-year scheme of network development - 2013 edition

International Nuclear Information System (INIS)

2013-01-01

RTE, an independent subsidiary of EDF, is the French electricity transmission system operator. It is a public service company responsible for operating, maintaining and developing the high and extra high voltage network. It guarantees the reliability and proper operation of the power network. RTE transports electricity between electricity suppliers (French and European) and consumers, whether they are electricity distributors or industrial consumers directly connected to the transmission system. The mission of RTE is to balance the electricity supply and demand in real time. With the support of the government authorities, RTE prepares a ten-year scheme of network development in France; This document presents the main electricity transport infrastructures to foresee within the ten coming years and lists the network development investments which must be realised and implemented within 3 years. The document is updated each year and comes to complement at the national level the European ten year network development plan (TYNDP) and the European regional plans as provided for in the 2009/72/CE European directive

The ten successful elements of an ambulatory care center.

Science.gov (United States)

Watkins, G

1997-01-01

Experts in healthcare predict that in the future, over 80% of all care will be provided either in the home or ambulatory care centers. How radiology facilities position themselves for this shifting market is critical to their long-term success, even though it appears there are endless opportunities for providing care in this atmosphere. The ten most critical elements that healthcare providers must address to ensure their preparedness are discussed. Location is critical, particularly since patients no longer want to travel to regional medical centers. The most aggressive providers are building local care centers to serve specific populations. Ambulatory care centers should project a high tech, high touch atmosphere. Patient comfort and the appeal of the overall environment must be considered. Centers need to focus on their customers' needs in multiple areas of care. A quick and easy registration process, providing dressing gowns in patient areas, clear billing functions--these are all important areas that centers should develop. Physicians practicing in the ambulatory care center are key to its overall success and can set the tone for all staff members. Staff members must be friendly and professional in their work with patients. The hours offered by the center must meet the needs of its client base, perhaps by offering evening and weekend appointments. Keeping appointments on schedule is critical if a center wants satisfied customers. It's important to identify the target before developing your marketing plan. Where do your referrals come from? Look to such sources as referring physicians, managed care plans and patients themselves. Careful billing is critical for survival in the ambulatory care world. Costs are important and systems that can track cost per exam are useful. Know your bottom line. Service remains the central focus of all successful ambulatory care center functions.

Simultaneous Determination of Ten Constituents in Chaiqin Qingning Capsule by High-performance Liquid Chromatography Coupled with Triple-quadrupole Mass Spectrometry

Science.gov (United States)

Li, Ting Yu; Huo, Xiao Kui; Zheng, Lu; Wang, Chao; Cong, Hai Jian; Xiang, Ting; Zhang, Lin; Zhang, Bao Jing; Huang, Shan Shan; Wu, Bin; Li, Xin Yu

2017-01-01

Background: Chaiqin Qingning Capsule (CQQNC) was a prescription of Traditional Chinese Medicine with the effects of clearing away heat and removing toxin, harmonizing the exterior and interior, it was widely used in Asian, for example, China and Japan, different batches of the raws materials and different processing time may be the vital factor which raised a challenge to control the quality of the CQQNC. Experimental Methods: In this experiment, a high-performance liquid chromatography-mass spectrometry/MS (HPLC-MS/MS) method was developed to simultaneously determine ten bioactive components for the quality control of CQQNC. Chromatographic separation was achieved using an XBridge BEH C18 column (150 mm × 4.6 mm, 2.5 μm) with a mobile phase composed of 10 mm aqueous ammonium acetate and acetonitrile using a gradient elution in 20 min. This study was conducted by multiple reaction monitoring mode through electrospray ionization resource with a negative ionization mode. Results: The established method was validated with good performance of precision, accuracy, stability, and reproducibility and was utilized to simultaneously quantify ten constituents of CQQNC obtained from seven different batches. Conclusion: It is the first time to report the rapid and simultaneous analysis of the ten compounds in CQQNC by HPLC-MS/MS and apply to determine 10 constituents in 7 batches of CQQNC bought from drug store in china. This method could be considered as good quality criteria to control the quality of CQQNC. SUMMARY In this paper, a simple, specific, and rapid high-performance liquid chromatogram coupled with triple-quadrupole mass spectrometry method for simultaneous quantification of ten constituents in Chaiqin Qingning Capsule has been developed for the first time. This method could be considered as good quality criteria to control the quality of CQQNC. Abbreviations used: CHM: Chinese herbal medicine; TCM: Traditional Chinese Medicine; CQQNC: Triple-quadrupole mass

Vadose Zone Journal: The first ten years

NARCIS (Netherlands)

Vrugt, J.A.; Or, D.; Young, M.H.

2013-01-01

Celebrating ten years of publication, the authors introduce a special section commemorating the anniversary of Vadose Zone Journal and reviewing the journal’s role in an evolving understanding of vadose zone science.

Dosimetry results for Big Ten and related benchmarks

International Nuclear Information System (INIS)

Hansen, G.E.; Gilliam, D.M.

1980-01-01

Measured average reaction cross sections for the Big Ten central flux spectrum are given together with calculated values based on the U.S. Evaluated Nuclear Data File ENDF/B-IV. Central reactivity coefficients for 233 U, 235 U, 239 Pu, 6 Li and 10 B are given to check consistency of bias between measured and calculated reaction cross sections for these isotopes. Spectral indexes for the Los Alamos 233 U, 235 U and 239 Pu metal critical assemblies are updated, utilizing the Big Ten measurements and interassembly calibrations, and their implications for inelastic scattering are reiterated

A Ten Year Analysis of Fatal Peripheral Vascular Injuries Autopsy Study

Directory of Open Access Journals (Sweden)

Salim Tuncer

2016-04-01

Full Text Available Aim: Peripheral vascular injuries are usually associated with fatal injuries. Early diagnosis and intervention are so vital for improving a favorable outcome for traumatic vascular injuries. As a preventable cause of death, we aimed to evaluate peripheral vascular injuries in overall deaths in ten year period, 2003-2012. Material and Method: A retrospective evaluation was made of 2845 death cases which had post-mortem examination and autopsy from the 10-year period of 2003-2012 in Eskisehir, Turkey. The mean age of the cases included in the study was 32.5±7.9 years with the highest rate of cases occurring in the 30-39 years age group. Males constituted 89.2% of the victims. The most frequent manner of death was homicide 83.8%.The femoral artery was the most commonly injured vessel 29 cases (78.4%. In this study it was identified that, 33 patients (89.3% died before any medical intervention could be performed. Discussion: Our study shows that, peripheral vascular injuries most commonly caused by sharp objects. The injuries have a low mortality rate when early intervention is made. Autopsies are conducted is very important to explain not only the cause of death but also the treatment process, which would clear the cases of any potential malpractice or negligence claims.

Rapid and accurate liquid chromatography and tandem mass spectrometry method for the simultaneous quantification of ten metabolic reactions catalyzed by hepatic cytochrome P450 enzymes.

Science.gov (United States)

Shi, Rong; Ma, Bingliang; Wu, Jiasheng; Wang, Tianming; Ma, Yueming

2015-10-01

The hepatic cytochrome P450 enzymes play a central role in the biotransformation of endogenous and exogenous substances. A sensitive high-throughput liquid chromatography with tandem mass spectrometry assay was developed and validated for the simultaneous quantification of the products of ten metabolic reactions catalyzed by hepatic cytochrome P450 enzymes. After the substrates were incubated separately, the samples were pooled and analyzed by liquid chromatography with tandem mass spectrometry using an electrospray ionization source in the positive and negative ion modes. The method exhibited linearity over a broad concentration range, insensitivity to matrix effects, and high accuracy, precision, and stability. The novel method was successfully applied to study the kinetics of phenacetin-O deethylation, coumarin-7 hydroxylation, bupropion hydroxylation, taxol-6 hydroxylation, omeprazole-5 hydroxylation, dextromethorphan-O demethylation, tolbutamide-4 hydroxylation, chlorzoxazone-6 hydroxylation, testosterone-6β hydroxylation, and midazolam-1 hydroxylation in rat liver microsomes. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The Ten Years Survey on Clinical and Epidemiologic Features of Guillain-Barre Syndrome in Sina Hospital, Hamadan, Iran

Directory of Open Access Journals (Sweden)

Sh. Mazaheri

2007-07-01

Full Text Available Introduction & Objective: Since the elimination of poliomyelitis from Iran, Guillain–Barre Syndrome (GBS has been the leading cause of acute flaccid paralysis. There are a few studies concerning clinical and epidemiologic features of Guillain-Barré syndrome in our country, therefore we evaluated ten years clinical and epidemiologic features of GBS in Sina hospital, Hamadan, Iran.Materials & Methods: In a retrospective descriptive study, we reviewed 80 records of patients with GBS who were hospitalized in Sina Hospital (Hamadan, Iran during 1993-2003. Because of incomplete data we excluded 29 patients from the study. We evaluated clinical and epidemiologic features, risk factors, lab data and management protocols. Complete remission defined as complete improved patient four weeks after the GBS treatment and partial remission as the continuation of the symptom after that time. All the data extracted manually and analyzed with SPSS software.Results: From 51 patients, 36 (70.59% were men and 15 (29.41% women, with a proportion of 2.4 men to 1 woman. The age ranged from 3 to 85 years. The highest frequency was observed in patients aged 11 to 20 (35.28%. 13 patients were student, 11 were house keeper, 11 were farmer, 7 were worker. 29 patients (56.84% had risk factors like respiratory and gastrointestinal track infection, surgery and fever before the disease onset. Complete and partial remission occurred in 17 and 28 patients respectively and 5 patients did not improve. Management failure occurred in 3 (8.83%, 2 (22.23% and 5 (62.5% patients who underwent IVIG, plasmapheresis and corticosteroids respectively.Conclusion: Our data was not similar to other studies in term of male to female proportion, age distribution and management protocols, therefore geographical pattern of the disease should be concerned for better patients’ management.

Immediate effects of tongue trills associated with transcutaneous electrical nerve stimulation (TENS).

Science.gov (United States)

Fabron, Eliana Maria Gradim; Petrini, Andressa Schweitzer; Cardoso, Vanessa de Moraes; Batista, João Carlos Torgal; Motonaga, Suely Mayumi; Marino, Viviane Cristina de Castro

2017-06-08

To investigate vocal quality variability after applying tongue trills associated with transcutaneous electrical nerve stimulation (TENS) on the larynx of women with normal laryngeal function. Additionally, to verify the effect of this technique over time on voice quality. Participants were 40 women (average 23.4 years) without vocal complaints. The procedure involved tongue trills with or without TENS for 3 minutes, rest and repeating the technique for another 2 minutes. The participants' voices were recorded before (Pre), after three minutes (Post 3min) and after two additional minutes (Post 5min) applying the technique. TENS with two electrodes was used on the thyroid cartilage. Self-assessment, acoustic and perceptual analysis were performed. When comparing tongue trills in isolation and associated with TENS, a greater sense of stability in phonation (self-assessment) and improvement in voice quality (perceptual evaluation) was observed in the combination technique. There was no statistical difference in acoustics findings between tongue trills in isolation and associated with TENS. When comparing the time effect of tongue trills with TENS in self-assessment there was a perception of less muscle tension (3min) and greater comfort during phonation (5 min); in the acoustic analysis, there was an increase of F0 (3 and 5 min) and intensity (5 min) when compared to Pre-moment; in the perceptual evaluation, better voice quality (3min). Comparing tongue trills in isolation and associated with TENS, there were changes in the comfort and muscle tension perception, as well as in vocal quality. On the other hand, tongue trills associated with TENS performed in 3 or 5 minutes resulted in beneficial effects on the voice identified in the assessments.

Serum protein profile of Malaria patients through SDS-PAGE method ...

African Journals Online (AJOL)

Serum protein profile of Malaria patients through SDS-PAGE method. ... reliable method in the diagnosis of antibodies produced against Plasmodium spps. ... of malaria patients may be undertaken for study to develop possible future vaccine.

Optimal duration of ultra low frequency-transcutaneous electrical nerve stimulation (ULF-TENS) therapy for muscular relaxation in neuromuscular occlusion: A preliminary clinical study.

Science.gov (United States)

Esclassan, Rémi; Rumerio, Anaïs; Monsarrat, Paul; Combadazou, Jean Claude; Champion, Jean; Destruhaut, Florent; Ghrenassia, Christophe

2017-05-01

The primary aim of this work was to determine the duration of ultra-low-frequency transcutaneous electrical nerve stimulation (ULF-TENS) application necessary to achieve sufficient relaxation of the masticatory muscles. A secondary aim was to analyze the influence of stimulation on muscle relaxation in pathological subjects and determine whether ULF-TENS has a noteworthy impact on muscle relaxation. Sixteen adult subjects with temporomandibular disorders (TMD) and muscle pain and a group of four control subjects were included in this study. ULF-TENS was applied, and muscular activities of the masseter, temporal, and sternocleidomastoid muscles (SCM) were recorded for 60 min. Significant relaxation was achieved in the TMD group from 20, 40, and 60 min for the temporal, masseter, and SCM muscles (p TENS application would last 40 min to obtain sufficient muscle relaxation both in patients with masticatory system disorders and healthy subjects, a time constraint that is consistent with everyday clinical practice.

Effects of Saccharomyces boulardii on fecal short-chain fatty acids and microflora in patients on long-term total enteral nutrition

Science.gov (United States)

Schneider, Stéphane M; Girard-Pipau, Fernand; Filippi, Jérôme; Hébuterne, Xavier; Moyse, Dominique; Hinojosa, Gustavo Calle; Pompei, Anne; Rampal, Patrick

2005-01-01

AIM: To assess the effects of Sb on fecal flora and short-chain fatty acids (SCFA) in patients on long-term TEN. METHODS: Ten patients (3 females, 7 males, 59±5.5 years), on TEN for a median of 13 mo (1-125), and 15 healthy volunteers (4 females, 11 males, 32±2.0 years) received Sb (0.5 g bid PO) for 6 d. Two stool samples were taken before, on the last 2 d and 9-10 d after treatment, for SCFA measurement and for culture and bacterial identification. Values (mean±SE) were compared using sign tests and ANOVA. RESULTS: Fecal butyrate levels were lower in patients (10.1±2.9 mmol/kg) than in controls (19.2±2.9, P = 0.02). Treatment with Sb increased total fecal SCFA levels in patients (150.2±27.2vs 107.5?8.2 mmol/kg, P = 0.02) but not in controls (129.0±28.6 vs 113.0±15.2 mmol/kg, NS). At the end of treatment with Sb, patients had higher fecal butyrate (16.0±4.4 vs 10.1 [2.9] mmol/kg, P = 0.004). Total SCFAs remained high 9 d after treatment was discon-tinued. Before the treatment, the anaerobe to aerobe ratio was lower in patients compared to controls (2.4±2.3 vs 69.8±1.8, P = 0.003). There were no significant changes in the fecal flora of TEN patients. CONCLUSION: Sb-induced increase of fecal SCFA concentrations (especially butyrate) may explain the preventive effects of this yeast on TEN-induced diarrhea. PMID:16273644

Verhalen sprokkelen langs de frontlijn. Een kritische blik op Ten Oorlog

Directory of Open Access Journals (Sweden)

Hans Boers

2015-03-01

Full Text Available Gathering Stories along the Front: A Critical Look at Ten Oorlog [To War]This article reflects critically on the popular television programme Ten Oorlog, thereby examining the field of tension between history and entertainment, between historians and ‘the public’. History can be addressed via various television formats as an historical documentary or a travel programme. An analysis indicates the extent to which Ten Oorlog is inspired by these formats. However, the popular television programme from the outset was not conceived as a classic historical documentary and perhaps can best be described as a historical human interest programme as part of the large-scale commemoration of the First World War. How do history and entertainment relate to one another in this programme? Is there more emphasis on the historical context or on anecdotal stories? This analysis of Ten Oorlog illustrates the tense relation between historians and ‘the public’.Dit artikel werpt een kritische blik op het populaire televisieprogramma Ten Oorlog en gaat daarbij in op het spanningsveld tussen geschiedenis en entertainment, tussen historici en ‘het publiek’. Geschiedenis kan via verschillende formats zoals een historische documentaire of een reisprogramma aan bod komen op televisie. Een analyse van deze formats geeft aan in welke mate Ten Oorlog hierop geïnspireerd is. Het populaire televisieprogramma was echter van begin af aan niet als een klassieke historische documentaire bedoeld en kan misschien het bestomschreven worden als een historisch human interest programma, in het kader van de grootschalige herdenking van de Eerste Wereldoorlog. Hoe verhoudengeschiedenis en entertainment zich daarin? Helt de balans meer over naar historische omkadering of naar anekdotische verhalen? Deze analyse van Ten Oorlog illustreert de gespannen relatie tussen historici en het grote publiek.

AB115. Preliminary study on the immune status of patients with prostate cancer

OpenAIRE

He, Jingliang; He, Leye

2014-01-01

Objective To preliminarily assess the immune status of patients with prostate cancer through detecting various immune indexs and then analyse the relationship between immune status and clinical factors such as clinical stage, pathological classification and endocrine therapy. Methods Flow cytometry was used to detect the percentage of CD4, CD8and NK cells in peripheral blood lymphocyte (PBL) of 28 patients with PCa, 16 BPH patients and ten healthy men (HM). The expression of perforin and gran...

Hypoplastic thumb type IIIB: An alternative method for surgical repair

Directory of Open Access Journals (Sweden)

Salih Onur Basat

2014-08-01

Full Text Available Hypoplastic thumb is the second most common congenital deformity of the thumb. Thumb hypoplasia is characterized by diminished thumb size, metacarpal adduction, metacarpophalangeal joint instability, and thenar muscle hypoplasia. In the literature, different classification types of hypoplastic thumb have been used and different treatment methods described. In this case we presented an alternative palliative treatment method for a ten-year-old patient with modified Blauth's classification type IIIB hypoplastic thumb and one-year follow-up results. [Hand Microsurg 2014; 3(2.000: 59-61

Ten scenarios from early radiation to late time acceleration with a minimally coupled dark energy

Energy Technology Data Exchange (ETDEWEB)

Fay, Stéphane, E-mail: steph.fay@gmail.com [Palais de la Découverte, Astronomy Department, Avenue Franklin Roosevelt, 75008 Paris (France)

2013-09-01

We consider General Relativity with matter, radiation and a minimally coupled dark energy defined by an equation of state w. Using dynamical system method, we find the equilibrium points of such a theory assuming an expanding Universe and a positive dark energy density. Two of these points correspond to classical radiation and matter dominated epochs for the Universe. For the other points, dark energy mimics matter, radiation or accelerates Universe expansion. We then look for possible sequences of epochs describing a Universe starting with some radiation dominated epoch(s) (mimicked or not by dark energy), then matter dominated epoch(s) (mimicked or not by dark energy) and ending with an accelerated expansion. We find ten sequences able to follow this Universe history without singular behaviour of w at some saddle points. Most of them are new in dark energy literature. To get more than these ten sequences, w has to be singular at some specific saddle equilibrium points. This is an unusual mathematical property of the equation of state in dark energy literature, whose physical consequences tend to be discarded by observations. This thus distinguishes the ten above sequences from an infinity of ways to describe Universe expansion.

Ten scenarios from early radiation to late time acceleration with a minimally coupled dark energy

International Nuclear Information System (INIS)

Fay, Stéphane

2013-01-01

We consider General Relativity with matter, radiation and a minimally coupled dark energy defined by an equation of state w. Using dynamical system method, we find the equilibrium points of such a theory assuming an expanding Universe and a positive dark energy density. Two of these points correspond to classical radiation and matter dominated epochs for the Universe. For the other points, dark energy mimics matter, radiation or accelerates Universe expansion. We then look for possible sequences of epochs describing a Universe starting with some radiation dominated epoch(s) (mimicked or not by dark energy), then matter dominated epoch(s) (mimicked or not by dark energy) and ending with an accelerated expansion. We find ten sequences able to follow this Universe history without singular behaviour of w at some saddle points. Most of them are new in dark energy literature. To get more than these ten sequences, w has to be singular at some specific saddle equilibrium points. This is an unusual mathematical property of the equation of state in dark energy literature, whose physical consequences tend to be discarded by observations. This thus distinguishes the ten above sequences from an infinity of ways to describe Universe expansion

Analysis of Personal Dosimetry for Nuclear Medicine Staff in Ten-Year Period

International Nuclear Information System (INIS)

Poropat, M.; Dodig, D.; Ciglar, M.; Tezak, S.

2011-01-01

The aim of this study was to assess the value of personal dosimetry for nuclear medicine personnel in our department in a ten-year period. We have analyzed personal doses for 80 employees in nuclear medicine in a ten year period that we divided into two five year periods (from 2000 to 2004 and from 2005 to 2009). The personnel was dived into 8 groups according to their working assignments due to different radiation exposure from various radioisotopes in different wards in nuclear medicine: nuclear medicine specialists, technologists in scintigraphy ward, personnel of physics ward, ward for radiochemistry and radioimmunology, clinical ward and ultrasound ward, cleaning personnel, administrative personnel. We have compared average dose per person in particular ward in two five year periods. All doses for all personnel were in the permissible limits prescribed by the authorities. Higher average dose per person in a first five year period was detected in two wards, scintigraphy ward and ward for radiochemistry and radioimmunology due to the nature of their working assignments (preparation and application of radiopharmaceuticals, contact with patients who have received radiopharmaceutical). The decrease in the average dose per person was noticed in a second five-year period, especially in the wards with personnel that had no prior education in ionizing radiation protection. The decrease of dose was from 7.5 % to 84.2 %. We think that the decrease of average dose per person in a second five-year period was not only the result of the increased personal protection measures but also the result of continuing education of nuclear medicine personnel that is obligatory by the Law for ionizing radiation protection from year 1999, and the results from a ten-year period show its positive effect on radiation protection. (author)

42 CFR 414.232 - Special payment rules for transcutaneous electrical nerve stimulators (TENS).

Science.gov (United States)

2010-10-01

... nerve stimulators (TENS). 414.232 Section 414.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Special payment rules for transcutaneous electrical nerve stimulators (TENS). (a) General payment rule. Except as provided in paragraph (b) of this section, payment for TENS is made on a purchase basis with...

Survival of the Scandinavian total ankle replacement (STAR): results of ten to nineteen years follow-up.

Science.gov (United States)

Frigg, Arno; Germann, Ursula; Huber, Martin; Horisberger, Monika

2017-10-01

The purpose of this study was to evaluate survival and clinical outcome of the Scandinavian total ankle replacement (STAR) prosthesis after a minimum of ten years up to a maximum of 19 years. Fifty STAR prostheses in 46 patients with end stage ankle osteoarthritis operated between 1996 and 2006 by the same surgeon (MH) were included. Minimal follow-up was ten years (median 14.6 years, 95% confidence interval [CI] 12.9-16.4). Clinical (Kofoed score) and radiological assessments were taken before the operation and at one, ten (+2), and 16 (±3) years after implantation. The primary endpoint was defined as exchange of the whole prosthesis or conversion to arthrodesis (def. 1), exchange of at least one metallic component (def. 2), or exchange of any component including the inlay (due to breakage or wear) (def. 3). Survival was estimated according to Kaplan-Meier. Further reoperations related to STAR were also recorded. The ten year survival rate was (def. 1) 94% (CI 82-98%), (def. 2) 90% (CI, 77-96%), and (def. 3) 78% (CI 64-87%). The 19-year survival rate was (def. 1) 91% (CI 78-97%), (def. 2) 75% (CI 53-88%), and (def. 3) 55% (CI 34-71%). Considering any re-operations related to STAR, 52% (26/50) of prostheses were affected by re-operations. Mean pre-operative Kofoed score was 49, which improved to 84 after one year (n = 50), to 90 after ten years (n = 46), and to 89 after 16 years (n = 28). The survival rate for def. 1 and 2 was high. However, re-operations occurred in 52% of all STAR prosthesis. Retrospective cohort study, evidence Level 4.

Radioisotopic methods in the study of salivary glands

International Nuclear Information System (INIS)

Salvatori, M.; Valenza, V.; Focacci, C.

1986-01-01

The results achieved by dynamic and static salivary gland scintigraphy in 272 patients over a ten year time (January 1976-December 1985) are reported. On the basis of a semi-quantitative assessment of time/activity curves, dynamic studies prove to be the most suitable method for studying functional disorders (phlogosis, facial paralisis, etc.). Harmlesness, easy execution and functional results are the mains advantages of radioisotope techniques. Salivary gland scintigraphy has some limits in the study of space occupying lesions (SOL): however, ultrasounds, CT and sialography represent the methods of choice in this field of salivary gland pathology

Impact of concomitant laparoscopic sleeve gastrectomy and hiatal hernia repair on gastro-oesophageal reflux disease in morbidly obese patients

Directory of Open Access Journals (Sweden)

Harshit Garg

2017-01-01

Full Text Available Background: The aim of this study was to analyse the impact of hiatal hernia repair (HHR on gastro-oesophageal reflux disease (GERD in morbidly obese patients with hiatus hernia undergoing laparoscopic sleeve gastrectomy (LSG. Materials and Methods: It is a retrospective study involving ten morbidly obese patients with large hiatus hernia diagnosed on pre-operative endoscopy who underwent LSG and simultaneous HHR. The patients were assessed for symptoms of GERD using a Severity symptom score (SS questionnaire and anti-reflux medications. Results: Of the ten patients, five patients had GERD preoperatively. At the mean follow-up of 11.70 ± 6.07 months after surgery, four patients (80% showed complete resolution while one patient complained of persistence of symptoms. Endoscopy in this patient revealed resolution of esophagitis indicating that the persistent symptoms were not attributable to reflux. The other five patients without GERD remained free of any symptom attributable to GERD. Thus, in all ten patients, repair of hiatal hernia (HH during LSG led to either resolution of GERD or prevented any new onset symptom related to GER. Conclusion: In morbidly obese patients with HH with or without GERD undergoing LSG, repair of the hiatus hernia helps in amelioration of GERD and prevents any new onset GER. Thus, the presence of HH should not be considered as a contraindication for LSG.

Emission properties of Sm(III) complex having ten-coordination structure

International Nuclear Information System (INIS)

Hasegawa, Yasuchika; Tsuruoka, Shin-ichi; Yoshida, Takahiko; Kawai, Hideki; Kawai, Tsuyoshi

2008-01-01

Sammarium(III) complex having ten-coordination structure, bis-(1,10-phenanthroline)tris-(hexafluoroacetylacetonato)samarium(III) (Sm(hfa) 3 (phen) 2 ) was prepared by chelation of tris-(hexafluoroacetylacetonato) samarium(III) (Sm(hfa) 3 (H 2 O) 2 ) with 1,10-phenantroline (phen). The characteristic ten-coordination structure of Sm(hfa) 3 (phen) 2 was determined by 1 H NMR and elemental analyses. Strong deep-red emission (λ max =643 nm) and narrow emission band (FWHM=5 nm) of Sm(hfa) 3 (phen) 2 originated from electronic allowed transition from characteristics ten coordinate structure. The emission quantum yields Sm(hfa) 3 (phen) 2 excited at absorption bands of ligands and Sm(III) ion were found to be 0.36 and 1.4%, respectively

Different distribution patterns of ten virulence genes in Legionella reference strains and strains isolated from environmental water and patients.

Science.gov (United States)

Zhan, Xiao-Yong; Hu, Chao-Hui; Zhu, Qing-Yi

2016-04-01

Virulence genes are distinct regions of DNA which are present in the genome of pathogenic bacteria and absent in nonpathogenic strains of the same or related species. Virulence genes are frequently associated with bacterial pathogenicity in genus Legionella. In the present study, an assay was performed to detect ten virulence genes, including iraA, iraB, lvrA, lvrB, lvhD, cpxR, cpxA, dotA, icmC and icmD in different pathogenicity islands of 47 Legionella reference strains, 235 environmental strains isolated from water, and 4 clinical strains isolated from the lung tissue of pneumonia patients. The distribution frequencies of these genes in reference or/and environmental L. pneumophila strains were much higher than those in reference non-L. pneumophila or/and environmental non-L. pneumophila strains, respectively. L. pneumophila clinical strains also maintained higher frequencies of these genes compared to four other types of Legionella strains. Distribution frequencies of these genes in reference L. pneumophila strains were similar to those in environmental L. pneumophila strains. In contrast, environmental non-L. pneumophila maintained higher frequencies of these genes compared to those found in reference non-L. pneumophila strains. This study illustrates the association of virulence genes with Legionella pathogenicity and reveals the possible virulence evolution of non-L. pneumophia strains isolated from environmental water.

[TVT (transvaginal mesh) surgical method for complex resolution of pelvic floor defects].

Science.gov (United States)

Adamík, Z

2006-01-01

Assessment of the effects of a new surgical method for complex resolution of pelvic floor defects. Case study. Department of Obstetrics and Gynaecology, Bata Hospital, Zlín. We evaluated the procedures and results of the new TVM (transvaginal mesh) surgical method which we used in a group of 12 patients. Ten patients had vaginal prolapse following vaginal hysterectomy and in two cases there was uterine prolapse and vaginal prolapse. Only in one case there was a small protrusion in the range of 0.5 cm which we resolved by removal of the penetrated section. The resulting anatomic effect was very good in all the cases.

Prehospital trauma care reduces mortality. Ten-year results from a time-cohort and trauma audit study in Iraq

Directory of Open Access Journals (Sweden)

Murad Mudhafar K

2012-02-01

Full Text Available Abstract Background Blunt implementation of Western trauma system models is not feasible in low-resource communities with long prehospital transit times. The aims of the study were to evaluate to which extent a low-cost prehospital trauma system reduces trauma deaths where prehospital transit times are long, and to identify specific life support interventions that contributed to survival. Methods In the study period from 1997 to 2006, 2,788 patients injured by land mines, war, and traffic accidents were managed by a chain-of-survival trauma system where non-graduate paramedics were the key care providers. The study was conducted with a time-period cohort design. Results 37% of the study patients had serious injuries with Injury Severity Score ≥ 9. The mean prehospital transport time was 2.5 hours (95% CI 1.9 - 3.2. During the ten-year study period trauma mortality was reduced from 17% (95% CI 15 -19 to 4% (95% CI 3.5 - 5, survival especially improving in major trauma victims. In most patients with airway problems, in chest injured, and in patients with external hemorrhage, simple life support measures were sufficient to improve physiological severity indicators. Conclusion In case of long prehospital transit times simple life support measures by paramedics and lay first responders reduce trauma mortality in major injuries. Delegating life-saving skills to paramedics and lay people is a key factor for efficient prehospital trauma systems in low-resource communities.

Simultaneous Determination of Ten Constituents in Chaiqin Qingning Capsule by High-performance Liquid Chromatography Coupled with Triple-quadrupole Mass Spectrometry.

Science.gov (United States)

Li, Ting Yu; Huo, Xiao Kui; Zheng, Lu; Wang, Chao; Cong, Hai Jian; Xiang, Ting; Zhang, Lin; Zhang, Bao Jing; Huang, Shan Shan; Wu, Bin; Li, Xin Yu

2017-01-01

Chaiqin Qingning Capsule (CQQNC) was a prescription of Traditional Chinese Medicine with the effects of clearing away heat and removing toxin, harmonizing the exterior and interior, it was widely used in Asian, for example, China and Japan, different batches of the raws materials and different processing time may be the vital factor which raised a challenge to control the quality of the CQQNC. In this experiment, a high-performance liquid chromatography-mass spectrometry/MS (HPLC-MS/MS) method was developed to simultaneously determine ten bioactive components for the quality control of CQQNC. Chromatographic separation was achieved using an XBridge BEH C18 column (150 mm × 4.6 mm, 2.5 μm) with a mobile phase composed of 10 mm aqueous ammonium acetate and acetonitrile using a gradient elution in 20 min. This study was conducted by multiple reaction monitoring mode through electrospray ionization resource with a negative ionization mode. The established method was validated with good performance of precision, accuracy, stability, and reproducibility and was utilized to simultaneously quantify ten constituents of CQQNC obtained from seven different batches. It is the first time to report the rapid and simultaneous analysis of the ten compounds in CQQNC by HPLC-MS/MS and apply to determine 10 constituents in 7 batches of CQQNC bought from drug store in china. This method could be considered as good quality criteria to control the quality of CQQNC. In this paper, a simple, specific, and rapid high-performance liquid chromatogram coupled with triple-quadrupole mass spectrometry method for simultaneous quantification of ten constituents in Chaiqin Qingning Capsule has been developed for the first time. This method could be considered as good quality criteria to control the quality of CQQNC. Abbreviations used: CHM: Chinese herbal medicine; TCM: Traditional Chinese Medicine; CQQNC: Triple-quadrupole mass spectrometry Chaiqin Qingning Capsules; HPLC-MS/MS: High liquid

Ten per cent more grain

Energy Technology Data Exchange (ETDEWEB)

NONE

1967-08-15

At a low estimate, ten per cent of stored grain is lost every year to insect pests. In this article, based on a lecture given earlier this year in Switzerland, Dr. Harry E. Goresline, Food Radiation Specialist of the Food and Agriculture Organisation, now assisting the Joint FAO/IAEA Division of Atomic Energy in Food and Agriculture, explains how use of radiation can help to prevent losses and the research which has taken place to ensure its safety

Multielemental determination in ten maize plant fragment using neutron activation analysis

International Nuclear Information System (INIS)

Spiridon, S.

1993-01-01

An instrumental activation technique has been developed for simultaneous analysis in dry ash maize plant samples of 18 elements: Al, Au, Ca, Ce, Co, Cr, Cs, Eu, Fe, La, Lu, K, Mg, Mn, Na, Rb, Sc, and Zn. Ten fragments of maize plants (dry ash) were analysed: leaves sheaths, beads, stumps, peduncles, spikes, unfruitfuls, interknots, knots, and corn husks, with a content distribution of the elements from percent to ppm. A precision of 5-7 % has been achieved on the basis of replicate analysis. The method is relatively simple and suitable for the analysis of biological samples. (Author)

Investigation of Monnose-Binding Lectin gene Polymorphism in Patients with Erythema Multiforme, Stevens-Johnson Syndrome and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Overlap Syndrome

Directory of Open Access Journals (Sweden)

Sevil Toka

2012-09-01

Full Text Available Objective: Monnose-Binding lectin (MBL appears to play an important role in the immune system. The genetic polymorphisms in the MBL2 gene can result in a reduction of serum levels, leading to a predisposition to recurrent infection. The aim of this study is to investigate the influence of a polymorphism in codon 54 of the MBL2 gene on the susceptibility to Erythema Multiforme, Stevens-Johnson Syndrome and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Overlap Syndrome (EM, SJS and SJS/TEN overlap syndrome. Material and Methods: Our study included 64 patients who were clinically and/or histopathologically diagnosed with EM, SJS, and SJS/TEN overlap syndrome and 66 healthy control subjects who were genotyped for the MBL2 gene codon 54 polymorphism using the PCR-RFLP method. For all statistical analyses, the level of significance was set at p<0.05. Results: The prevalence of the B allele was 18% in the EM, SJS and SJS/TEN patient groups and 13% in the control group. No significant differences in allele frequencies of any polymorphism were observed between the patient and control groups, although the B allele was more frequent in the patient groups (p=0.328.Conclusion: Our results provide no evidence of a relationship between MBL2 gene codon 54 polymorphism and the susceptibility to EM, SJS and SJS/TEN overlap syndrome. However, these findings should be confirmed in studies with a larger sample size.

Transcutaneous Electrical Nerve Stimulation (TENS) reduces pain, fatigue, and hyperalgesia while restoring central inhibition in primary fibromyalgia

Science.gov (United States)

Dailey, Dana L; Rakel, Barbara A; Vance, Carol GT; Liebano, Richard E; Anand, Amrit S; Bush, Heather M; Lee, Kyoung S; Lee, Jennifer E; Sluka, Kathleen A

2014-01-01

Because TENS works by reducing central excitability and activating central inhibition pathways, we tested the hypothesis that TENS would reduce pain and fatigue and improve function and hyperalgesia in people with fibromyalgia who have enhanced central excitability and reduced inhibition. The current study used a double-blinded randomized, placebo controlled cross-over design to test effects of a single treatment of TENS in people with fibromyalgia. Three treatments were assessed in random order: active TENS, placebo TENS, no TENS. The following measures were assessed before and after each TENS treatment: pain and fatigue at rest and movement, pressure pain thresholds (PPTs), 6 minute walk test (6MWT), range of motion (ROM), five time sit to stand test (FTSTS), and single leg stance (SLS). Conditioned pain modulation (CPM) was completed at end of testing. There was a significant decrease in pain and fatigue with movement for active TENS compared to placebo and no TENS. PPTs increased at site of TENS (spine) and outside site of TENS (leg) when compared to placebo TENS or no TENS. During Active TENS CPM was significantly stronger compared to placebo TENS and no TENS. No changes in functional tasks were observed with TENS. Thus, the current study suggests TENS has short-term efficacy in relieving symptoms of fibromyalgia while the stimulator is active. Future clinical trials should examine the effects of repeated daily delivery of TENS, similar to how TENS is used clinically, on pain, fatigue, function and quality of life in individuals with fibromyalgia. PMID:23900134

Ten key issues in modern flow chemistry.

Science.gov (United States)

Wegner, Jens; Ceylan, Sascha; Kirschning, Andreas

2011-04-28

Ten essentials of synthesis in the flow mode, a new enabling technology in organic chemistry, are highlighted as flashlighted providing an insight into current and future issues and developments in this field. © The Royal Society of Chemistry 2011

Ten Leading Causes of Death and Injury

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... Overdose Traumatic Brain Injury Violence Prevention Ten Leading Causes of Death and Injury Recommend on Facebook Tweet Share Compartir ... in Hospital Emergency Departments, United States – 2014 Leading Causes of Death Charts Causes of Death by Age Group 2016 [ ...

Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain.

Science.gov (United States)

Simon, Corey B; Riley, Joseph L; Fillingim, Roger B; Bishop, Mark D; George, Steven Z

2015-12-01

Chronic low back pain (CLBP) is a highly prevalent and disabling musculoskeletal pain condition among older adults. Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat CLBP, however response to TENS in older adults compared with younger adults is untested. In a dose-response study stratified by age, 60 participants with axial CLBP (20 young, 20 middle-aged, 20 older) received four 20-minute sessions of high-frequency high-intensity TENS over a 2- to 3-week period in a laboratory-controlled setting. Experimental measures of pain sensitivity (mechanical pressure pain detection threshold) and central pain excitability (phasic heat temporal summation and heat aftersensations) were assessed before and after TENS. Episodic or immediate axial CLBP relief was assessed after TENS via measures of resting pain, movement-evoked-pain, and self-reported disability. Cumulative or prolonged axial CLBP relief was assessed by comparing daily pain reports across sessions. Independent of age, individuals experienced episodic increase in the pressure pain detection threshold and reduction in aftersensation after TENS application. Similarly, all groups, on average, experienced episodic axial CLBP relief via improved resting pain, movement-evoked pain, and disability report. Under this design, no cumulative effect was observed as daily pain did not improve for any age group across the 4 sessions. However, older adults received higher TENS amplitude across all sessions to achieve TENS responses similar to those in younger adults. These findings suggest that older adults experience similar episodic axial CLBP relief to that of younger individuals after high-frequency, high-intensity TENS when higher dose parameters are used. This study examined age group differences in experimental and axial CLBP response to TENS, delivered under the current recommended parameters of strong, but tolerable amplitude. Older adults had comparable TENS response although at higher TENS

Systems Analysis of Ten Supply Chains for Whole Tree Chips

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Helmer Belbo

2014-09-01

Full Text Available Whole trees from energy thinnings constitute one of many forest fuel sources, yet ten widely applied supply chains could be defined for this feedstock alone. These ten represent only a subset of the real possibilities, as felling method was held constant and only a single market (combustion of whole tree chips was considered. Stages included in-field, roadside landing, terminal, and conversion plant, and biomass states at each of these included loose whole trees, bundled whole trees or chipped material. Assumptions on prices, performances, and conversion rates were based on field trials and published literature in similar boreal forest conditions. The economic outcome was calculated on the basis of production, handling, treatment and storage costs and losses. Outcomes were tested for robustness on a range of object volumes (50–350 m3solid, extraction distances (50–550 m and transport distances (10–70 km using simulation across a set of discrete values. Transport was calculated for both a standard 19.5 m and an extended 24 m timber truck. Results showed that the most expensive chain (roadside bundling, roadside storage, terminal storage and delivery using a 19.5 m timber truck at 158 € td−1 was 23% more costly than the cheapest chain (roadside chipping and direct transport to conversion plant with container truck, at 128 € td−1. Outcomes vary at specific object volumes and transport distances, highlighting the need to verify assumptions, although standard deviations around mean supply costs for each chain were small (6%–9%. Losses at all stages were modelled, with the largest losses (23 € td−1 occurring in the chains including bundles. The study makes all methods and assumptions explicit and can assist the procurement manager in understanding the mechanisms at work.

Serotype distribution of Streptococcus pneumoniae isolated from patients with invasive pneumococcal disease in Brazil before and after ten-pneumococcal conjugate vaccine implementation.

Science.gov (United States)

dos Santos, Silvia R; Passadore, Lilian F; Takagi, Elizabeth H; Fujii, Cristiane M; Yoshioka, Cristina R M; Gilio, Alfredo E; Martinez, Marina B

2013-12-09

The ten-pneumococcal conjugate vaccine (PCV10) was introduced into the national immunization program for childhood vaccination schedules by the Brazilian Health Public Service in March 2010. The aim of this study was to compare Streptococcus pneumoniae serotype distribution, antibiotic resistance patterns, and potential coverage before (January 2006-June 2010) and after (July 2010-September 2012) PCV10 introduction. The incidence of invasive pneumococcal disease (IPD), patient demographics, and disease characteristics were recorded. This study was conducted at the University Hospital of Sao Paulo University in Brazil from January 2006 to September 2012. Serotyping was performed using multiplex PCR typing, and antimicrobial sensitivity by Clinical and Laboratory Standards Institute (CLSI). A total of 259 S. pneumoniae strains were isolated from patients with IPD. The ages of the patients ranged from 3 months to 95 years old. The strains were isolated from cerebrospinal fluid, pleural fluid, and blood. The incidence of IPD among patients at HU-USP changed after the introduction of PCV10. The overall incidence of IPD was 3.42 cases per 1000 admissions in the vaccine pre- implementation period and of 2.99 cases per 1000 admissions in the vaccine post-implementation period. The incidence of IPD among children<2 y.o. attended at HU-USP changed significantly after the introduction of PCV10, from 20.30 to 3.97 of incidence. The incidence of PCV10- serotypes decrease from 16.47 to 0.44 in the same age, before and after PC10 implementation, respectively. Moreover, it was possible to realize the sensitivity to penicillin among isolates increased significantly in the post-vaccine period. Data from this study suggest that PCV10 contributed to decrease with PID rate among children less than 2 y.o. The resistance rate among pneumococcal isolates also could be observed since serotypes with greater resistance to beta lactam antibiotics were not easily isolated after vaccination

Automated patient and medication payment method for clinical trials

Directory of Open Access Journals (Sweden)

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

Radiology now. The ten day rule - principles and practice

Energy Technology Data Exchange (ETDEWEB)

Carmichael, J H.E. [Broadgreen Hospital, Liverpool (UK); Warrick, C K

1978-11-01

The ten day rule recommends that non-urgent diagnostic radiography of the abdomen in women of child-bearing capacity should be confined to the pre-ovulatory phase of the menstrual cycle. Arguments for and against this rule are reviewed. The attitudes and organization of radiographic practice in the UK differ from those in the USA. Assessment of the evidence for the hazards involved leads to the conclusion that the continued application of the ten day rule should be strongly recommended as an essential part of good radiological and radiographic practice.

How green are the TEN-T core network corridors?

DEFF Research Database (Denmark)

Panagakos, George; Psaraftis, Harilaos N.

defining this concept, identified the characteristics that distinguish a green corridor from an otherwise efficient one. The main thesis of this paper is that the „core network corridors‟ of the new TEN-T guidelines exhibit all these qualities and the vision of a green corridor network in Europe is close...... to reality. To support this thesis, and in continuation of the work of SuperGreen, the paper examines the proposed new „guidelines‟ for the development of the TEN-T after presenting a brief history of transport network development in Europe....

Czech, Slovak science ten years after split

CERN Multimedia

2003-01-01

Ten years after the split of Czechoslovakia Czech and Slovak science are facing the same difficulties: shortage of money for research, poor salaries, obsolete equipment and brain drain, especially of the young, according to a feature in the Daily Lidove Noviny (1 page).

TENS and low-level laser therapy in the management of temporomandibular disorders Aplicação de TENS e laser de baixa freqüência no tratamento das disfunções temporomandibulares

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Melissa Thiemi Kato

2006-04-01

Full Text Available Pain relief and reestablishment of normal jaw function are the main goals of conservative management of Temporomandibular Disorders (TMD. Transcutaneous electrical nerve stimulation (TENS and laser therapy are part of these modalities, although little is known about their real efficacy in controlled studies. This research compared these two treatments in a sample of 18 patients with chronic TMD of muscular origin, divided into two groups (LASER and TENS. Treatment consisted of ten sessions, in a period of 30 days. Active range of motion (AROM, visual analogue scale (VAS of pain and muscle (masseter and anterior temporalis palpation were used for follow-up analysis. Data were analyzed by Friedman test and ANOVA for repeated measurements. Results showed decrease in pain and increase in AROM for both groups (pO tratamento das Disfunções Temporomandibulares (DTM objetiva ser conservador e reversível para alívio da dor e restauração da função normal. Sendo assim, tratamentos como a estimulação neural elétrica transcutânea (TENS e o laser de baixa freqüência têm sido utilizados. Portanto, foi premissa deste trabalho a comparação do TENS com o a terapia com laser de baixa freqüência no tratamento de pacientes com DTM. Foram selecionados dezoito pacientes com sinais e sintomas de DTM crônica de origem muscular. O grupo LASER recebeu aplicação de laser e o grupo TENS, estimulação elétrica, totalizando 10 sessões, três vezes por semana, durante um mês. A avaliação foi feita imediatamente antes e 5 minutos após cada sessão terapêutica, por meio da escala de análise visual (EAV para o registro da sensação de dor mensuração de abertura máxima e palpação muscular ( masseter e temporal anterior. Para análise estatística foram utilizados o teste de Friedman e ANOVA para mensurações repetidas. Os resultados demonstraram decréscimo na EAV e aumento da abertura bucal máxima de ambos os grupos (p<0,05. A palpa

Simultaneous determination of ten compounds in two main ...

African Journals Online (AJOL)

Simultaneous determination of ten compounds in two main medicinal plant parts of Tibetan herb, Pterocephalus hookeri (CB Clarke) Höeck, by ultra-high performance liquid chromatography-photodiode array.

Methods to improve patient recruitment and retention in stroke trials

DEFF Research Database (Denmark)

Berge, Eivind; Stapf, Christian; Al-Shahi Salman, Rustam

2016-01-01

Background: The success of randomized-controlled stroke trials is dependent on the recruitment and retention of a sufficient number of patients, but fewer than half of all trials meet their target number of patients. Methods: We performed a search and review of the literature, and conducted...... a survey and workshop among 56 European stroke trialists, to identify barriers, suggest methods to improve recruitment and retention, and make a priority list of interventions that merit further evaluation. Results: The survey and workshop identified a number of barriers to patient recruitment...... and retention, from patients’ incapacity to consent, to handicaps that prevent patients from participation in trial-specific follow-up. Methods to improve recruitment and retention may include simple interventions with individual participants, funding of research networks, and reimbursement of new treatments...

Evaluation of the Leishmanicidal and Cytotoxic Potential of Essential Oils Derived from Ten Colombian Plants

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JF Sanchez-Suarez

2013-03-01

Full Text Available Background: The leishmanicidal and cytotoxic activity of ten essential oils obtained from ten plant specimens were evaluated.Methods: Essential oils were obtained by the steam distillation of plant leaves without any prior processing. Cytotoxicity was tested on J774 macrophages and leishmanicidal activity was assessed against four species of Leishmania associated with cutaneous leishmaniasis. Results: Seven essential oils exhibited activity against Leishmania parasites, five of which were toxic against J774 macrophages. Selectivity indices of >6 and 13 were calculated for the essential oils of Ocimum basilicum and Origanum vulgare, respectively.Conclusion: The essential oil of Ocimum basilicum was active against promastigotes of Leishmania and innocuous to J774 macrophages at concentrations up to 1600 µg/mL and should be further investi­gated for leishmanicidal activity in others in vitro and in vivo experimental models.

Defects in α-Cell Function in Patients With Diabetes Due to Chronic Pancreatitis Compared With Patients With Type 2 Diabetes and Healthy Individuals

DEFF Research Database (Denmark)

Mumme, Lena; Breuer, Thomas G K; Rohrer, Stephan

2017-01-01

.0002) but not in patients with chronic pancreatitis. CONCLUSIONS: α-Cell responses to oral glucose ingestion and to hypoglycemia are disturbed in patients with diabetes and chronic pancreatitis and in patients with type 2 diabetes. The similarities between these defects suggest a common etiology.......OBJECTIVE: Diabetes frequently develops in patients with chronic pancreatitis. We examined the alterations in the glucagon response to hypoglycemia and to oral glucose administration in patients with diabetes due to chronic pancreatitis. RESEARCH DESIGN AND METHODS: Ten patients with diabetes...... secondary to chronic pancreatitis were compared with 13 patients with type 2 diabetes and 10 healthy control subjects. A stepwise hypoglycemic clamp and an oral glucose tolerance test (OGTT) were performed. RESULTS: Glucose levels during the OGTT were higher in patients with diabetes and chronic...

At-Risk Phenotype of Neurofibromatose-1 Patients: A Multicentre Case-Control Study

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Ferkal Salah

2011-07-01

Full Text Available Abstract Objectives To assess associations between subcutaneous neurofibromas (SC-NFs and internal neurofibromas in patients with neurofibromatosis type 1 (NF-1 and to determine whether the association between SC-NFs and peripheral neuropathy was ascribable to internal neurofibromas. Patients and methods Prospective multicentre case-control study. Between 2005 and 2008, 110 NF-1 adults having two or more SC-NFs were individually matched for age, sex and hospital with 110 controls who had no SC-NF. Patients underwent standardized MRI of the spinal cord, nerve roots and sciatic nerves and an electrophysiological study. Analyses used adjusted multinomial logistic regression (ORa to estimate the risk of the presence of internal neurofibromas or peripheral neuropathies associated with patients presented 2 to 9 SC-NFs, at least 10 SC-NFs as compared to patients without any (referential category. Results Cases had a mean age of 41 (± 13 years; 85 (80% had two to nine SC-NFs and 21 (19% at least ten SC-NFs. SC-NFs were more strongly associated with internal neurofibromas in patients with ten or more SC-NFs than in patients with fewer NF-SCs (e.g., sciatic nerve, aOR = 29.1 [8.5 to 100] vs. 4.3 [2.1 to 9.0]. The association with SC-NFs was stronger for diffuse, intradural, and > 3 cm internal neurofibromas than with other internal neurofibromas. Axonal neuropathy with slowed conduction velocities (SCV was more strongly associated with having at least ten SC-NFs (aOR = 29.9, 5.5 to 162.3 than with having fewer SC-NFs (aOR = 4.4, 0.9 to 22.0. Bivariate analyses showed that the association between axonal neuropathy with SCV and sciatic neurofibromas was mediated by the association between SC-NFs and sciatic neurofibromas. Conclusion The at-risk phenotype of NF-1 patients (i.e. NF-1 patients with SC-NFs is ascribable to associations linking SC-NFs to internal neurofibromas at risk for malignant transformation and to axonal neuropathies with slowed

Lipid profile in adult patients with Fabry disease - Ten-year follow up

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Karolina M. Stepien

2017-12-01

Conclusion: Adult patients with Fabry disease have remarkably elevated HDL-cholesterol and as a result, elevated total cholesterol. It is possible that elevated HDL-cholesterol has a cardioprotective effect in patients with this condition. Long term ERT does not have a significant impact on lipid profile in female and male population with Fabry disease.

Top Ten Concerns for Trustees in 1988.

Science.gov (United States)

Meyerson, Joel W.

1988-01-01

Ten issues most likely to influence institutions this year include tuition policy and financing, capital renewal and replacement, charitable giving, scientific equipment and laboratories, endowment management and spending policy, research funding, corporate contributions, minority enrollment and hiring, debt financing and debt capacity, and cost…

Dose-specific effects of transcutaneous electrical nerve stimulation (TENS) on experimental pain: a systematic review.

Science.gov (United States)

Claydon, Leica S; Chesterton, Linda S; Barlas, Panos; Sim, Julius

2011-09-01

To determine the hypoalgesic effects of transcutaneous electrical nerve stimulation (TENS) parameter combinations on experimental models in healthy humans. Searches were performed using the electronic databases Ovid MEDLINE, CINAHL, AMED, and Web of Science (from inception to December 2009). Manual searches of journals and reference lists of retrieved trials were also performed. Randomized controlled trials (RCTs) were included in the review if they compared the hypoalgesic effect of TENS relative with placebo and control, using an experimental pain model in healthy human participants. Two reviewers independently selected the trials, assessed their methodologic quality and extracted data. Forty-three RCTs were eligible for inclusion. A best evidence synthesis revealed: Overall "conflicting" (inconsistent findings in multiple RCTs) evidence of TENS efficacy on experimental pain irrespective of TENS parameters used. Overall intense TENS has "moderate" evidence of efficacy (1 high-quality and 2 low-quality trials). Conventional TENS has overall conflicting evidence of efficacy, this is derived from "strong" evidence of efficacy (generally consistent findings in multiple high-quality RCTs) on pressure pain but strong evidence of inefficacy on other pain models. "Limited" evidence (positive findings from 1 RCT) of hypoalgesia exists for some novel parameters. Low-intensity, low-frequency, local TENS has strong evidence of inefficacy. Inappropriate TENS (using "barely perceptible" intensities) has moderate evidence of inefficacy. The level of hypoalgesic efficacy of TENS is clearly dependent on TENS parameter combination selection (defined in terms of intensity, frequency, and stimulation site) and experimental pain model. Future clinical RCTs may consider these TENS dose responses.

Patients' Experiences of Nurse-Led Screening for Cardiovascular Risk in Rheumatoid Arthritis

DEFF Research Database (Denmark)

Frølund, Jannie Christina; Primdahl, Jette

2015-01-01

organization of screening programmes. METHODS: Three qualitative focus group interviews were carried out with 14 outpatients diagnosed with RA. The participants were stratified into groups, depending on whether they had a low-to-moderate or high ten-year risk of cardiovascular death according to the European...... screening programmes for CVD for patients with RA, it is important that the screening consultation is individualized and tailored to patients' needs and their RA. Copyright © 2015 John Wiley & Sons, Ltd....

Multifractal detrended cross-correlations between crude oil market and Chinese ten sector stock markets

Science.gov (United States)

Yang, Liansheng; Zhu, Yingming; Wang, Yudong; Wang, Yiqi

2016-11-01

Based on the daily price data of spot prices of West Texas Intermediate (WTI) crude oil and ten CSI300 sector indices in China, we apply multifractal detrended cross-correlation analysis (MF-DCCA) method to investigate the cross-correlations between crude oil and Chinese sector stock markets. We find that the strength of multifractality between WTI crude oil and energy sector stock market is the highest, followed by the strength of multifractality between WTI crude oil and financial sector market, which reflects a close connection between energy and financial market. Then we do vector autoregression (VAR) analysis to capture the interdependencies among the multiple time series. By comparing the strength of multifractality for original data and residual errors of VAR model, we get a conclusion that vector auto-regression (VAR) model could not be used to describe the dynamics of the cross-correlations between WTI crude oil and the ten sector stock markets.

Hepatitis C prevalence among HIV-infected patients in Guinea-Bissau

DEFF Research Database (Denmark)

Hønge, Bo Langhoff; Jespersen, Sanne; Medina, Candida

2014-01-01

Objectives: To estimate the prevalence and determine the clinical presentation of risk factors of hepatitis C virus (HCV) among HIV-infected patients in Bissau, Guinea-Bissau. Methods: In this cross-sectional study, we included individuals who had a routine blood analysis performed during...... the period April 28 to September 30, 2011. Patient samples were tested for HCV antibodies (anti-HCV) with a chemiluminescence test (Architect, Abbott, USA) and INNO-LIA HCV Score (Innogenetics, Belgium). HCV viral load and genotype were analyzed using an in-house real-time PCR method. Results: In total, 576...... patients were included (417 HIV-1, 104 HIV-2, and 55 HIV-1/2). Ten (1.7%) patients were anti-HCV-positive and eight (1.4%) patients had detectable HCV RNA; all were genotype 2. In a multivariable logistic regression analysis, age >50 years was associated with anti-HCV reactivity (p

Is it possible to diagnose idiopathic chondropathia of the patella by radiological methods

International Nuclear Information System (INIS)

Kaufmann, J.; Langlotz, M.; Zurich Univ.

1984-01-01

In a retrospective study of 47 cases of chondromalacia proved by operation, a correct diagnosis had been made by arthrography in three cases. In 44 patients a false negative finding had been obtained. A prospective study was carried out comparing single and double contrast arthrography as well as double contrast arthrotomography and scintigraphy in ten patients with typical chondropathia. It was confirmed by arthroscopy in nine cases. Only two patients with severe chondromalacia showed abnormal findings by arthrography or scintigraphy. Our investigation has led to the conclusion that arthrography is not a suitable method for demonstrating idiopathic chondropathia of the patella. (orig.) [de

Is it possible to diagnose idiopathic chondropathia of the patella by radiological methods

Energy Technology Data Exchange (ETDEWEB)

Kaufmann, J.; Langlotz, M.

1984-10-01

In a retrospective study of 47 cases of chondromalacia proved by operation, a correct diagnosis had been made by arthrography in three cases. In 44 patients a false negative finding had been obtained. A prospective study was carried out comparing single and double contrast arthrography as well as double contrast arthrotomography and scintigraphy in ten patients with typical chondropathia. It was confirmed by arthroscopy in nine cases. Only two patients with severe chondromalacia showed abnormal findings by arthrography or scintigraphy. Our investigation has led to the conclusion that arthrography is not a suitable method for demonstrating idiopathic chondropathia of the patella.

Ten good reasons why everybody can and should perform cardiac ultrasound in the ICU.

Science.gov (United States)

Charron, Cyril; Repessé, Xavier; Bodson, Laurent; Au, Siu-Ming; Vieillard-Baron, Antoine

2014-01-01

Critical care ultrasonography (CCUS) has been defined as an ultrasound evaluation of the heart, abdomen, pleura and lungs at the bedside by the intensivist, 24/7. Within CCUS, critical care echocardiography (CCE) is used to assess cardiac function and more generally haemodynamics. Experts in haemodynamics have published a 'consensus of 16' regarding an update on haemodynamic monitoring. They reported the ten key properties of an 'ideal' haemodynamic monitoring system, which perfectly match the ten good reasons we describe here for performing CCE in critically ill patients. Even though unfortunately no evidence-based medicine study is available to support this review, especially regarding CCE-related improvement of outcome, many clinical studies have demonstrated that CCE provides measurements of relevant, accurate, reproducible and interpretable variables, is easy to use, readily available, has a rapid response time, causes no harm, and is cost-effective. Whether it is operator-independent is obviously more debatable and is discussed in this review. All these characteristics are arguments for the extensive use of CCE by intensivists. This is why experts in the field have recommended that a basic level of CCE should be included in the training of all intensivists.

Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

Directory of Open Access Journals (Sweden)

Coluccia A

2014-09-01

Full Text Available Anna Coluccia, Fabio Ferretti, Andrea PozzaDepartment of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital, University of Siena, Siena, ItalyPurpose: The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methods: The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26 receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.Results: Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95. Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No

Astrophysical parameters of ten poorly studied open star clusters

International Nuclear Information System (INIS)

Tadross, Ashraf Latif; El-Bendary, Reda; Osman, Anas; Ismail, Nader; Bakry, Abdel Aziz

2012-01-01

We present the fundamental parameters of ten open star clusters, nominated from Kronberger et al. who presented some newly discovered stellar groups on the basis of the Two Micron All Sky Survey photometry and Digitized Sky Survey visual images. Star counts and photometric parameters (radius, membership, distance, color excess, age, luminosity function, mass function, total mass, and dynamical relaxation time) have been determined for these ten clusters for the first time. In order to calibrate our procedures, the main parameters (distance, age, and color excess) have been re-estimated for another five clusters, which are also studied by Kronberger et al. (research papers)

CYP2C19*2 status in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis

Directory of Open Access Journals (Sweden)

Laska AJ

2017-05-01

Full Text Available Amanda J Laska,1 Marie J Han,1 Josh A Lospinoso,2 Patrick J Brown,1 Thomas M Beachkofsky1 1Department of Dermatology, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, 2780th Military Intelligence Brigade, Ft Meade, MD, USA Purpose: Genetic polymorphisms have been linked to an increased predisposition to developing certain diseases. For example, patients of Han-Chinese descent carrying the HLA-B*1502 allele are at an increased risk of developing Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN if given carbamazepine. Given the complexity of in vivo drug metabolism, it is plausible that the activity of enzyme systems unrelated to specific drug metabolism may be important. Although multiple biomarkers have been identified in unique ethnic groups, there has yet to be a study investigating the presence of the slow metabolizing allele of CYP2C19, denoted CYP2C19*2, in diverse groups and the risk of developing SJS/TEN. Patients and methods: This study looked into the carrier status of CYP2C19*2, a poor metabolizing variant of CYP2C19, in patients diagnosed with SJS/TEN. We looked at its status in our series as a whole and when patients were divided by ethnicity. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissue of patients with biopsy-proven SJS/TEN and real-time polymerase chain reaction was used to assess for the presence of CYP2C19*2. Results: CYP2C19*2 status was determined in 47 patients. Twenty-nine of these 47 patients had a single medication implicated as causing their disease, and eight of these patients were heterozygous or homozygous for CYP2C19*2. There was insufficient evidence to conclude that the presence of CYP2C19*2 is an independent predictor of risk for developing SJS/TEN in our series as a whole. This analysis also confirmed that the frequency of the CYP2C19*2 polymorphism within the different ethnicities in our series did not vary statistically from reported ethnic

East Lancashire Hospital Trust creates an open culture paving the way for service improvement 'Below ten thousand'.

Science.gov (United States)

Tomlinson, Robert

2018-05-01

Reacting to a never event is difficult and often embarrassing for staff involved. East Lancashire Hospitals NHS Trust has demonstrated that treating staff with respect after a never event, creates an open culture that encourages problem solving and service improvement. The approach has allowed learning to be shared and paved the way for the trust to be the first in the UK to launch the patient centric behavioural noise reduction strategy 'Below ten thousand'.

Ten-Competence: Life-Long Competence Development and Learning

NARCIS (Netherlands)

Koper, Rob; Specht, Marcus

2006-01-01

Koper, R., & Specht, M. (2008). Ten-Competence: Life-Long Competence Development and Learning. In M-A. Cicilia (Ed.), Competencies in Organizational e-learning: concepts and tools (pp. 234-252). Hershey: IGI-Global.

Ten colour photometry of twelve Ap-stars

International Nuclear Information System (INIS)

Musielok, B.; Lange, D.; Schoeneich, W.; Hildebrandt, G.; Zelwanowa, E.; Hempelmann, A.; Salmanov, G.

1980-01-01

Ten-colour photoelectric observations are presented for twelve Ap-stars. Improved ephemeris for seven of them is given. Phase relations between the light curves and line intensity variations are discussed. The problem of the electromagnetic flux conctancy of IOTA Cas is approached from a qualitative point of view. (author)

Electrostimulation, response of the pelvic floor muscles, and urinary incontinence in elderly patients post prostatectomy

OpenAIRE

Zaidan,Patrícia; Silva,Elirez Bezerra da

2014-01-01

Objective to investigate the response of the pelvic floor muscles (PFM), and urinary incontinence (UI), in patients having undergone a prostatectomy, after treatment using electrical stimulation. Materials and methods this observational study was conducted in an outpatient urogynecologic physical therapy clinic of Hospital dos Servidores in Rio de Janeiro, Brazil from August to September 2012. Ten patients (aged, 64 ± 7 years) with urinary incontinence resulting from radical prostatectom...

Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan.

Science.gov (United States)

Jalil, Aisha; Zakar, Rubeena; Zakar, Muhammad Zakria; Fischer, Florian

2017-02-21

Patient satisfaction with doctor-patient interactions is an indicator of physicians' competence. The satisfaction of diabetes patients is rarely studied in public diabetes clinics of Pakistan. Thus, this study aims to analyse the association between patient satisfaction and five dimensions of medical interaction: technical expertise, interpersonal aspects, communication, consultation time, and access/availability. A cross-sectional mixed methods study was conducted during July and August 2015 in the largest public diabetes outpatient clinic in Punjab province. We used the criterion sampling method to identify 1164 patients who: (i) were adult (18 years and above), (ii) had diabetes mellitus, (iii) had made at least three previous visits to the same clinic. The data was collected through face-to-face interviews. The structured part of the questionnaire was based on demographic characteristics and the Patient Satisfaction Questionnaire (PSQ-III). We translated the questionnaire into Urdu and pretested it with 25 patients in a similar context. Data storage and analysis were carried out using SPSS (version 22.0). Bivariate analyses and multinomial logistic regression model were used to generate the quantitative findings. Out of the 1164 eligible patients approached for interviews, 1095 patients completed the structured questionnaire and 186 respondents provided qualitative information in comments section. We conducted a thematic content analysis of qualitative responses in order to explain the quantitative findings. Demographic characteristics such as gender, education and occupation were significantly associated with the levels of patient satisfaction. The dimensions of doctor-patient interaction were significantly associated with patient satisfaction: technical expertise (OR = .87; 95% CI = .84-.91), interpersonal aspects (OR = .82; 95% CI = .77-.87), communication (OR = .83; 95% CI = .78-.89), time dimension (OR = .90; 95% CI = .81

A method to quantify the "cone of economy".

Science.gov (United States)

Haddas, Ram; Lieberman, Isador H

2018-05-01

A non-randomized, prospective, concurrent control cohort study. The purpose of this study is to develop and evaluate a method to quantify the dimensions of the cone of economy (COE) and the energy expenditure associated with maintaining a balanced posture within the COE, scoliosis patients and compare them to matched non-scoliotic controls in a group of adult degenerative. Balance is defined as the ability of the human body to maintain its center of mass (COM) within the base of support with minimal postural sway. The cone of economy refers to the stable region of upright standing posture. The underlying assumption is that deviating outside one's individual cone challenges the balance mechanisms. Adult degenerative scoliosis (ADS) patients exhibit a variety of postural changes within their COE, involving the spine, pelvis and lower extremities, in their effort to compensate for the altered posture. Ten ADS patients and ten non-scoliotic volunteers performed a series of functional balance tests. The dimensions of the COE and the energy expenditure related to maintaining balance within the COE were measured using a human motion video capture system and dynamic surface electromyography. ADS patients presented more COM sway in the sagittal (ADS: 1.59 cm vs. H: 0.61 cm; p = 0.049) and coronal (ADS: 2.84 cm vs. H: 1.72 cm; p = 0.046) directions in comparison to the non-scoliotic control. ADS patients presented with more COM (ADS: 33.30 cm vs. H: 19.13 cm; p = 0.039) and head (ADS: 31.06 cm vs. H: 19.13 cm; p = 0.013) displacements in comparison to the non-scoliotic controls. Scoliosis patients expended more muscle activity to maintain static standing, as manifest by increased muscle activity in their erector spinae (ADS: 37.16 mV vs. H: 20.31 mV; p = 0.050), and gluteus maximus (ADS: 33.12 mV vs. H: 12.09 mV; p = 0.001) muscles. We were able to develop and evaluate a method that quantifies the COE boundaries, COM displacement, and amount of sway within the COE

Reactor dosimetry calibrations in the Big Ten critical assembly

International Nuclear Information System (INIS)

Barr, D.W.; Hansen, G.E.

1977-01-01

Eleven irradiations of foil packs located in the central region of Big Ten were made for the Interlaboratory Reaction Rate Program. Each irradiation was at a nominal 10 15 fluence and the principal fluence monitor was the National Bureau of Standards' double fission chamber containing 235 U and 238 U deposits and located at the center of Big Ten. Secondary monitors consisted of three external fission chambers and two internal foil sets containing Au, In, and Al. Activities of one set were counted at the LASL and the other at the Hanford Engineering Developement Laboratory. The uncertainty in relative fluence for each irradiation was +-0.3%

Paravertebral Block: An Improved Method of Pain Control in Percutaneous Transhepatic Biliary Drainage

International Nuclear Information System (INIS)

Culp, William C.; McCowan, Timothy C.; DeValdenebro, Miguel; Wright, Lonnie B.; Workman, James L.; Culp, William C.

2006-01-01

Background and Purpose. Percutaneous transhepatic biliary drainage remains a painful procedure in many cases despite the routine use of large amounts of intravenous sedation. We present a feasibility study of thoracic paravertebral blocks in an effort to reduce pain during and following the procedure and reduce requirements for intravenous sedation. Methods. Ten consecutive patients undergoing biliary drainage procedures received fluoroscopically guided paravertebral blocks and then had supplemental intravenous sedation as required to maintain patient comfort. Levels T8-T9 and T9-T10 on the right were targeted with 10-20 ml of 0.5% bupivacaine. Sedation requirements and pain levels were recorded. Results. Ten biliary drainage procedures in 8 patients were performed for malignancy in 8 cases and for stones in 2. The mean midazolam use was 1.13 mg IV, and the mean fentanyl requirement was 60.0 μg IV in the block patients. Two episodes of hypotension, which responded promptly to volume replacement, may have been related to the block. No serious complications were encountered. The mean pain score when traversing the chest wall, liver capsule, and upon entering the bile ducts was 0.1 on a scale of 0 to 10, with 1 patient reporting a pain level of 1 and 9 reporting 0. The mean peak pain score, encountered when manipulating at the common bile duct level or when addressing stones there, was 5.4 and ranged from 0 to 10. Conclusions. Thoracic paravertebral block with intravenous sedation supplementation appears to be a feasible method of pain control during biliary interventions

Giant multipole resonances: perspectives after ten years

International Nuclear Information System (INIS)

Bertrand, F.E.

1980-01-01

Nearly ten years ago evidence was published for the first of the so-called giant multipole resonances, the giant quadrupole resonance. During the ensuing years research in this field has spread to many nuclear physics laboratories throughout the world. The present status of electric giant multipole resonances is reviewed. 24 figures, 1 table

Intensive Care in a Patient with Toxic Epidermal Necrolysis

Directory of Open Access Journals (Sweden)

J. Wallenborn

2017-01-01

Full Text Available Toxic epidermal necrolysis (TEN is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose. This prevented further progression of the TEN. Despite marked improvement in skin findings, the ICU stay was prolonged by a complex analgosedation, transient kidney failure, volume management, positioning therapy, and vegetatively impeded weaning. Moreover, there was colonization with multiresistant bacteria (MRSA and VRE. Nonetheless, the patient could be restored to health and was released after four weeks. Infliximab seems to be effective in the treatment of TEN, especially in cases of rapid progression. Moreover, patients with TEN are difficult to handle in intensive-medical care, whereby attention should especially be paid to sufficient pain therapy, and the positioning of the patient is a particular challenge.

Which alternative communication methods are effective for voiceless patients in Intensive Care Units? A systematic review.

Science.gov (United States)

Carruthers, Helen; Astin, Felicity; Munro, Wendy

2017-10-01

To assess the effectiveness of Augmentative and Alternative Communication (AAC) strategies to enable people who are temporarily voiceless due to medical intervention, to communicate. A systematic review informed by a protocol published on an international register. Ten databases were searched from January 2004 to January 2017. Included studies assessed the effect of using AAC strategies on patient related outcomes and barriers to their use. All included studies were quality appraised. Due to the heterogeneity of interventions and outcome measures findings were narratively reviewed. Twelve studies met the inclusion criteria and were included in the review reporting outcomes from 1981 patient and 454 health professional participants. The quality of included studies were moderate to weak. AAC communication strategies increased the number of communication interactions, improved patient satisfaction with communication and reduced communication difficulties. Barriers to usage were device characteristics, the clinical condition of the patient, lack of timeliness in communication and staff constraints. There is preliminary, but inconsistent evidence that AAC strategies are effective in improving patient satisfaction with communication and reducing difficulties in communication. A lack of comparable studies precluded the identification of the most effective AAC strategy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sjuksköterskor och skötares upplevelser av möten i psykiatrisk öppenvård : En intervjustudie

OpenAIRE

Bäckman, Jenny; Nyman, Nyman

2016-01-01

Syftet med studien var att undersöka sjuksköterskors och skötares upplevelser av möten med patienter i psykiatrisk öppenvård.   Bakgrund – I psykiatrisk öppenvård möter sjuksköterskor och skötare många olika människor med individuella behov. Sedan tidigare forskning har det framkommit att patienters känsla av trygghet uppkommer genom faktorer som personalens inställning och empati. Relationen mellan personal och patient är viktig för patientens känsla av att bli tagen på allvar samt att bli b...

Ten Things Parents Can Do to Prevent Suicide

Science.gov (United States)

... Ribbon Commands Skip to main content Turn off Animations Turn on Animations Our Sponsors Log in | Register Menu Log in | ... teen at risk for suicide . Spend some time reading these ten ways you can help prevent a ...

Modification of the 'ten-day rule'

International Nuclear Information System (INIS)

Klempfner, G.

1985-01-01

In a 1964 decision the National Health and Medical Research Council recommended that radiological examinations of the lower abdomen and pelvis of women of childbearing age should be confined to the 10-day interval following the onset of menstruation. Recent evidence suggests that the first four weeks from the first day of the last menstrual period is not a critically radiosensitive period and consequently strict adherence to the ten-day rule is no longer indicated

A review of patient and carer participation and the use of qualitative research in the development of core outcome sets.

Science.gov (United States)

Jones, Janet E; Jones, Laura L; Keeley, Thomas J H; Calvert, Melanie J; Mathers, Jonathan

2017-01-01

To be meaningful, a core outcome set (COS) should be relevant to all stakeholders including patients and carers. This review aimed to explore the methods by which patients and carers have been included as participants in COS development exercises and, in particular, the use and reporting of qualitative methods. In August 2015, a search of the Core Outcomes Measures in Effectiveness Trials (COMET) database was undertaken to identify papers involving patients and carers in COS development. Data were extracted to identify the data collection methods used in COS development, the number of health professionals, patients and carers participating in these, and the reported details of qualitative research undertaken. Fifty-nine papers reporting patient and carer participation were included in the review, ten of which reported using qualitative methods. Although patients and carers participated in outcome elicitation for inclusion in COS processes, health professionals tended to dominate the prioritisation exercises. Of the ten qualitative papers, only three were reported as a clear pre-designed part of a COS process. Qualitative data were collected using interviews, focus groups or a combination of these. None of the qualitative papers reported an underpinning methodological framework and details regarding data saturation, reflexivity and resource use associated with data collection were often poorly reported. Five papers reported difficulty in achieving a diverse sample of participants and two reported that a large and varied range of outcomes were often identified by participants making subsequent rating and ranking difficult. Consideration of the best way to include patients and carers throughout the COS development process is needed. Additionally, further work is required to assess the potential role of qualitative methods in COS, to explore the knowledge produced by different qualitative data collection methods, and to evaluate the time and resources required to

Pulmonary arteriography by digital subtraction angiographic method in cyanotic heart disease with pulmonary stenosis or pulmonary atresia

International Nuclear Information System (INIS)

Kobayashi, Junjiro; Hirose, Hajime; Nakano, Susumu

1985-01-01

Pulmonary arteriography was performed by digital subtraction angiographic (DSA) method in 10 patients with cyanotic heart disease associated with pulmonary stenosis or pulmonary atresia. Ten patients consisted of five patients with tetralogy of Fallot, three with single ventricle and pulmonary stenosis, and two with pseudotruncus arteriosus. Hepato-clavicular position was taken in four patients. Pulmonary artery and its main branches were opacified and recognized clearly, and their diameter could be measured accurately with a small amount of contrast medium. There was a good correlation between the diameter of pulmonary artery measured by DSA and that measured by conventional pulmonary arteriography. DSA is a useful method for evaluating the size and the stenosis of pulmonary artery especially in small cyanotic infants. (author)

Ten questions about systems biology

DEFF Research Database (Denmark)

Joyner, Michael J; Pedersen, Bente K

2011-01-01

to understand how whole animals adapt to the real world. We argue that a lack of fluency in these concepts is a major stumbling block for what has been narrowly defined as 'systems biology' by some of its leading advocates. We also point out that it is a failure of regulation at multiple levels that causes many......In this paper we raise 'ten questions' broadly related to 'omics', the term systems biology, and why the new biology has failed to deliver major therapeutic advances for many common diseases, especially diabetes and cardiovascular disease. We argue that a fundamentally narrow and reductionist...

Ten questions about systems biology

DEFF Research Database (Denmark)

Joyner, Michael J; Pedersen, Bente K

2011-01-01

In this paper we raise 'ten questions' broadly related to 'omics', the term systems biology, and why the new biology has failed to deliver major therapeutic advances for many common diseases, especially diabetes and cardiovascular disease. We argue that a fundamentally narrow and reductionist...... to understand how whole animals adapt to the real world. We argue that a lack of fluency in these concepts is a major stumbling block for what has been narrowly defined as 'systems biology' by some of its leading advocates. We also point out that it is a failure of regulation at multiple levels that causes many...

Ten-year Survival and Its Associated Factors in the Patients Undergoing Pacemaker Implantation in Hospitals Affiliated to Shiraz University of Medical Sciences During 2002 - 2012

Science.gov (United States)

Rajaeefard, Abdolreza; Ghorbani, Mohammad; Babaee Baigi, Mohammad Ali; Tabatabae, Hamidreza

2015-01-01

Background: Heart failure is a prevalent disease affecting about 4.9 million people in the U.S. and more than 22 million individuals worldwide. Using electric pacemaker is the most common treatment for the patients with heart conduction problems. The present study aimed to determine the factors affecting survival in the patients undergoing pacemaker implantation in the hospitals affiliated to Shiraz University of Medical Sciences. Objectives: The aim of the present study was to identify the factors affecting the survival of the patients suffering from arrhythmia. Patients and Methods: This retrospective survival analysis was conducted on all 1207 patients with heart failure who had undergone permanent pacemaker implantation in the hospitals affiliated to Shiraz University of Medical Sciences from 2002 to 2012. The data were analyzed using non-parametric methods such as Kaplan-Meier method, life table, and Cox regression model. The risk factors of mortality were determined using multivariate Cox proportional hazards method. Results: Survival data were available for 1030 (80%) patients (median age = 71 years [5th to 95th percentile range: 26 - 86 years]) and follow-up was completed for 84.28% of them. According to the results, 56% of the patients had received dual-chamber systems, while 44% had been implanted by single-chamber ventricular systems. Moreover, sick sinus syndrome and pacemaker mode were independent predictors of increased mortality. Conclusions: In this study, sick sinus syndrome and pacemaker mode followed by syncope were independently associated with increased mortality. PMID:26734484

Genotype-environment interaction and stability in ten-year height growth of Norway spruce Clones (Picea abies Karst.).

Science.gov (United States)

J.B. St. Clair; J. Kleinschmit

1986-01-01

Norway spruce cuttings of 40 clones were tested on seven contrasting sites in northern Germany. Analysis of variance for ten-year height growth indicate a highly significant clone x site interaction. This interaction may be reduced by selection of stable clones. Several measures of stability were calculated and discussed. Characterization of sites by the method of...

Top ten pitfalls to avoid when performing musculoskeletal sonography: What you should know before entering the examination room

International Nuclear Information System (INIS)

Arend, Carlos Frederico

2013-01-01

Sonography has been used successfully to evaluate a number of musculoskeletal disorders. The method is operator dependent and familiarity with sonographic pitfalls greatly improves diagnostic accuracy and helps to optimize management. In this article, we discuss ten common pitfalls which can become a source of confusion and misdiagnosis in musculoskeletal sonography

Elliot Lake uranium mine reclamation, the first ten years

International Nuclear Information System (INIS)

Payne, R.A.

2000-01-01

In 1989, Rio Algom Limited finalized its plans for the closure and subsequent decommissioning of two of its then three operating mines in Elliot Lake as a result of market conditions. These two mines closed in August 1990. These mine closures had significant impacts. The principal mining operations of Rio Algom at that time were still in Elliot Lake and had been the very foundation of the company for about 40 years. The business impact on the Corporation was regarded as possibly severe. The resultant layoff of over 1,500 long-term, highly qualified, skilled and well-paid employees, a devastating blow to the affected employees and their families, would have a significant financial impact on the municipal economy, particularly as this announcement was seen as the first step in the early closure of all four operating mines in the region. At that time there was little precedence for such a high profile mine closure program and consequently the many unknowns relating to the mine decommissioning process, legislative requirements and society's expectations resulted in a perception of a significant yet ill-defined liability. In this atmosphere of understandable company, stakeholder and public concern, Rio Algom Limited embarked on what has turned out to be a long, rigorous, challenging yet ultimately reasonable and rewarding process of progressive reclamation of all its Elliot Lake mines, some ten in total (nine uranium, one copper). Over the past ten years, reclamation of all ten mines has been successfully completed, some $70 m plus has been expended in direct site reclamation works and the workforce has been reduced from over 2,500 to just 4. After ten years, the focus of attention is now on the long-term care, maintenance, monitoring and reporting required for the decommissioned mine sites, and the accomplishment of this in the best interests of all the stakeholders. (author)

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)

Field experiments on seed dispersal by wind in ten umbelliferous species (Apiaceae)

NARCIS (Netherlands)

Jongejans, E.; Telenius, A.

2001-01-01

This report presents data from experiments on seed dispersal by wind for ten species of the family Apiaceae. Seed shadows were obtained in the field under natural conditions, using wind speeds between four and ten m/s. The flight of individual seeds was followed by eye, and seed shadows were

Are intra-articular corticosteroid injections better than conventional TENS in treatment of rotator cuff tendinitis in the short run? A randomized study.

Science.gov (United States)

Eyigor, C; Eyigor, S; Kivilcim Korkmaz, O

2010-09-01

Rotator cuff problems are common causes of pain and restriction of movement in shoulder. The aim of this study to compare the effect of intra-articular injection of corticosteroid and conventional transcutaneous electrical nerve stimulator (TENS) treatment in treatment of rotator cuff tendinitis. Subjects were randomly allocated into Group 1 (intra-articular injection of corticosteroid) and Group 2 (conventional transcutaneous electrical nerve stimulation-TENS). Outcome measurements were performed using the Visual Analogue Scale (VAS) for pain, range of motion (ROM), the Shoulder Disability Questionnaire (SDQ), the Short Form-36 (SF-36), and Beck Depression Scale (BDS) questionnaires and paracetamol consumption. In both groups, significant improvement was observed in all weeks in VAS, ROM and SDQ scores (P0.05). In both treatment groups, paracetamol consumption decreased in time (Protator cuff tendinitis. When two treatments are compared, it may be concluded that intra-articular steroid injection was more effective especially in the first weeks regarding pain, ROM and disability. Otherwise, use of TENS allow to patients to increase activity level, improve function and quality of life like that in our study. TENS, as it is cheaper, non-invasive, more easily performed and efficient, may be preferable for the treatment of shoulder pain. Further studies are needed to include these results in the prospective treatment guidelines.

Peritonitis related to percutaneous endoscopic gastrostomy using the direct method for cancer patients.

Science.gov (United States)

Osera, Shozo; Yano, Tomonori; Odagaki, Tomoyuki; Oono, Yasuhiro; Ikematsu, Hiroaki; Ohtsu, Atsushi; Kaneko, Kazuhiro

2015-10-01

Percutaneous endoscopic gastrostomy (PEG) using the direct method is generally indicated for cancer patients. However, there are little available data about peritonitis related to this method. The aim of this retrospective analysis was to assess peritonitis related to PEG using the direct method in patients with cancer. We assessed the prevalence of peritonitis and the relationship between peritonitis and patients' backgrounds, as well as the clinical course after peritonitis. Between December 2008 and December 2011, peritonitis was found in 9 (2.1 %) of 421 patients. Of the 9 patients with peritonitis, 4 had received PEG prior to chemoradiotherapy. Emergency surgical drainage was required in 1 patient, and the remaining 8 recovered with conservative treatment. Peritonitis occurred within 8 days of PEG for 8 of the 9 patients and occurred within 2 days of suture removal for 4 of the 9 patients. Peritonitis related to PEG using the direct method was less frequent for cancer patients. Peritonitis tended to occur within a few days after removal of securing suture and in patients with palliative stage.

Considering social ergonomics: the effects of HIT on interpersonal relationships between patients and clinicians.

Science.gov (United States)

Montague, Enid; Asan, Onur

2012-01-01

This study explored physicians' interactions with EHRs to understand the qualities that contribute to patient satisfaction with their use of the technologies and patient satisfaction with physician. Video-taped observations of 100 medical consultations were used to distinguish interaction patterns between physicians and EHRs. Quantified observational methods were used to contribute to ecological validity. Ten primary care physicians and 100 patients from five clinics participated in the study. Visits were videotaped and coded using an objective coding methodology to understand how physicians interacted with electronic health records. Results indicate, a variety of EHR interaction styles may be effective in providing patient-centered care.

Do Elementary Science Methods Textbooks Promote Understanding of Shadows?

Directory of Open Access Journals (Sweden)

Lloyd H. Barrow

2016-02-01

Full Text Available Elementary science methods textbooks can be an important resource for future elementary teachers of science. Since shadows are a common topic in elementary school and Next Generation Science Standards (NGSS Lead States, 2013. A series of ten shadows concepts were formed into a learning progression by Wizman and Fortus (2007. For this research, ten science methods textbook were read and analyzed about how each of the shadow concepts were addressed. These methods textbooks focused on a limited number of shadow concepts. Consequently, as a future reference, they are very limited in addressing all ten shadow concepts.

Novitäten im Breslauer Stadttheater

OpenAIRE

Zduniak, Maria

2017-01-01

Am Anfang des 20. Jahrhunderts zählte das Breslauer Stadttheater, obwohl mit nur einer kleinen Orchester-Besetzung ausgestattet, zu den bemerkenswerten europäischen Opernbühnen. Es war aufgeschlossen für musikalische Novitäten. Als Beweis dafür sind u.a. die Breslauer Premieren Salome (1906) von Richard Strauss, L\\'Orfeo (1913) von Claudio Monteverdi und die Uraufführung der Oper Eros und Psyche (1917) von Ludomir Różycki zu nennen.

Clinical Presentation And Outcome Of Snake-Bite Patients At Zamko ...

African Journals Online (AJOL)

About eight out of every ten patients (81.6%) use a first aid measure and nine out of every ten patients that used a first aid measure used a tourniquet either alone or combined with other measures such as traditional medicine, incision of site. About 13% of those that employed first aid measures used the black stone.

Ten-a affects the fusion of central complex primordia in Drosophila.

Directory of Open Access Journals (Sweden)

Xuebo Cheng

Full Text Available The central complex of Drosophila melanogaster plays important functions in various behaviors, such as visual and olfactory memory, visual orientation, sleep, and movement control. However little is known about the genes regulating the development of the central complex. Here we report that a mutant gene affecting central complex morphology, cbd (central brain defect, was mapped to ten-a, a type II trans-membrane protein coding gene. Down-regulation of ten-a in pan-neural cells contributed to abnormal morphology of central complex. Over-expression of ten-a by C767-Gal4 was able to partially restore the abnormal central complex morphology in the cbd mutant. Tracking the development of FB primordia revealed that C767-Gal4 labeled interhemispheric junction that separated fan-shaped body precursors at larval stage withdrew to allow the fusion of the precursors. While the C767-Gal4 labeled structure did not withdraw properly and detached from FB primordia, the two fan-shaped body precursors failed to fuse in the cbd mutant. We propose that the withdrawal of C767-Gal4 labeled structure is related to the formation of the fan-shaped body. Our result revealed the function of ten-a in central brain development, and possible cellular mechanism underlying Drosophila fan-shaped body formation.

Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease

Directory of Open Access Journals (Sweden)

Marianne J. Middelveen

2018-04-01

Full Text Available Introduction: Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi, in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms. Methods: In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner. Results: Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borrelia burgdorferi by three distinct polymerase chain reaction (PCR-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods. Conclusions: Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined.

The Olson method for detection of acute myocardial ischemia in patients with coronary occlusion.

Science.gov (United States)

Lindow, Thomas; Olson, Charles W; Swenne, Cees A; Man, Sumche; Pahlm, Olle

An automated ECG-based method may provide diagnostic support in the management of patients with acute coronary syndrome. The Olson method has previously proved to accurately identify the culprit artery in patients with acute coronary occlusion. The Olson method was applied to 360 patients without acute myocardial ischemia and 52 patients with acute coronary occlusion. This study establishes the normal variation of the Olson wall scores in patients without acute myocardial ischemia, which provides the basis for implementation of the Olson method for triage of patients with acute coronary syndrome. All patients with acute occlusion had Olson wall scores above the upper limit of normal. The Olson method can be used for ischemia detection with very high sensitivity. Future studies are needed to explore specificity in patients with non-ischemic ST elevation. Copyright © 2016 Elsevier Inc. All rights reserved.

Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

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Bruennler, T.; Langgartner, J.; Lang, S.; Salzberger, B.; Schoelmerich, J. [University Hospital of Regensburg, Department of Internal Medicine 1, Regensburg (Germany); Zorger, N.; Herold, T.; Feuerbach, S.; Hamer, O.W. [University Hospital of Regensburg, Department of Radiology, Regensburg (Germany)

2008-08-15

The objective of this retrospective study was to evaluate the outcome of patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy. By searching the radiological, surgical and internal medicine databases, all patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy between 1992 and 2004 were identified. Demographic, laboratory, and clinical data, and details about invasive procedures were collected by reviewing patient charts, radiological and surgical reports. The computed tomography severity index (CTSI) scores were determined by reviewing CT images. Eighteen patients were identified. Median Ranson score on admission was 2. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was median 22. Median CTSI score was 7. Initially all patients were treated with CT-guided drainage placement. Because passive drainage proved not to be effective, subsequent minimally invasive, percutaneous necrosectomy was performed. Eight out of 18 patients recovered fully without the need for surgery. Ten of 18 patients required additional surgical necrosectomy. For one of ten patients, percutaneous necrosectomy allowed postponing surgery by 39 days. Four of ten surgically treated patients died: three from septic multiorgan failure, one from pulmonary embolism. Percutaneous minimally invasive necrosectomy can be regarded as a safe and effective complementary treatment modality in patients with necrotizing pancreatitis. It is suitable for a subset of patients to avoid or delay surgery. (orig.)

Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

International Nuclear Information System (INIS)

Bruennler, T.; Langgartner, J.; Lang, S.; Salzberger, B.; Schoelmerich, J.; Zorger, N.; Herold, T.; Feuerbach, S.; Hamer, O.W.

2008-01-01

The objective of this retrospective study was to evaluate the outcome of patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy. By searching the radiological, surgical and internal medicine databases, all patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy between 1992 and 2004 were identified. Demographic, laboratory, and clinical data, and details about invasive procedures were collected by reviewing patient charts, radiological and surgical reports. The computed tomography severity index (CTSI) scores were determined by reviewing CT images. Eighteen patients were identified. Median Ranson score on admission was 2. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was median 22. Median CTSI score was 7. Initially all patients were treated with CT-guided drainage placement. Because passive drainage proved not to be effective, subsequent minimally invasive, percutaneous necrosectomy was performed. Eight out of 18 patients recovered fully without the need for surgery. Ten of 18 patients required additional surgical necrosectomy. For one of ten patients, percutaneous necrosectomy allowed postponing surgery by 39 days. Four of ten surgically treated patients died: three from septic multiorgan failure, one from pulmonary embolism. Percutaneous minimally invasive necrosectomy can be regarded as a safe and effective complementary treatment modality in patients with necrotizing pancreatitis. It is suitable for a subset of patients to avoid or delay surgery. (orig.)

Methods for teaching effective patient communication techniques to radiography students.

Science.gov (United States)

Makely, S

1990-07-01

Teaching students to communicate effectively with patients has always been part of the radiography curriculum in the USA. However, developing these skills has become even more important in recent times due to several factors. Patients who have been well versed in what to expect from the examination being conducted are in a better position to co-operate with the radiographer. This increases the chances of producing optimal results from an examination at the first attempt, thus reducing radiation exposure, patient discomfort and the overall cost of conducting the procedure. Also, increased competition among health care providers has resulted in more emphasis being placed on patient, or customer, satisfaction. Radiographers are in the 'front line' of patient care. Patients often have more interaction with radiographers than with physicians or other medical specialists. Radiographers who practise effective communication techniques with their patients can alleviate anxiety and make an important contribution to the overall satisfaction of the patient with respect to the quality of service and care they receive. This article describes instructional methods being used in the USA to help develop effective patient communication techniques, and reports the findings of a study among radiography educators as to which of these methods are thought to be most successful.

The influence of transcutaneous electrical neurostimulation (TENS) on human cerebral blood flow velocities

NARCIS (Netherlands)

ter Laan, Mark; van Dijk, J. Marc C.; Elting, Jan-Willem J.; Fidler, Vaclav; Staal, Michiel J.

It has been shown that transcutaneous electrical neurostimulation (TENS) reduces sympathetic tone. Spinal cord stimulation (SCS) has proven qualities to improve coronary, peripheral, and cerebral blood circulation. Therefore, we postulate that TENS and SCS affect the autonomic nervous system in

Awareness about “Ten Steps for Successful Breastfeeding” among Medical and Nursing Students

Science.gov (United States)

Kakrani, Vandana A.; Rathod (Waghela), Hetal K.; Mammulwar, Megha S.; Bhawalkar, Jitendra S.

2015-01-01

Background: Baby-friendly Hospital Initiative (BFHI) is a vital intervention supported by World Health Organization and UNICEF to reduce infant mortality and has been included as a part of the curriculum in nursing and medical courses. To know the extent of knowledge of students about BFHI along with its understanding and to find out the gap in their knowledge about BFHI steps. Methods: A descriptive cross sectional study was carried out among the nursing (4th year) and medical students (3rd year MBBS) about ten steps of BFHI by a pretested and predesigned questionnaire. After ethical clearance, information was collected about their awareness and correct understanding concerning ten steps. Results: A total of 102 (51.6%) medical and 96 (48.4%) nursing students comprising of 57 (28.8%) males and 141 (71.2%) females were interviewed, had similar mean score about the ten steps of BFHI. Female respondents 82.3% had best understood the step 2 (training), as compared to males 80.7%. About step 6 (no supplements) 94.3% females and 86% males had well understood the step. Step 7 (rooming in) was known to 85.8% females and 54.4% males respectively. Step 9 (no pacifiers) was known to 80.1% females while among males 56.1% were aware. There was statistically significant difference in their knowledge about the steps 2 and 4 (skin to skin), 5 (counseling), 7, and 9 as females were more aware about these steps than males. The least understood steps in medical and nursing students were step 1 (written policy) (15.7%, 15.6%), step 3 (prenatal education) (27.5%, 29.2%), step 8 (cues) (10.8%, 24%) and step ten (community support) (8.8%, 11.5%) respectively. Conclusions: BFHI is one of the successful international efforts undertaken to promote, protect and support breast feeding. Acquiring knowledge about the same by medical and nursing students is most crucial tool for better practices by them in the future. Continued medical education, workshops and seminars by lactation specialists

Ten Thousand Years of Solitude

Energy Technology Data Exchange (ETDEWEB)

Benford, G. (Los Alamos National Lab., NM (USA) California Univ., Irvine, CA (USA). Dept. of Physics); Kirkwood, C.W. (Los Alamos National Lab., NM (USA) Arizona State Univ., Tempe, AZ (USA). Coll. of Business Administration); Harry, O. (Los Alamos National Lab., NM (USA)); Pasqualetti, M.J. (Los Alamos National Lab., NM (USA) Arizona State Univ., Tempe, AZ (USA))

1991-03-01

This report documents the authors work as an expert team advising the US Department of Energy on modes of inadvertent intrusion over the next 10,000 years into the Waste Isolation Pilot Project (WIPP) nuclear waste repository. Credible types of potential future accidental intrusion into the WIPP are estimated as a basis for creating warning markers to prevent inadvertent intrusion. A six-step process is used to structure possible scenarios for such intrusion, and it is concluded that the probability of inadvertent intrusion into the WIPP repository over the next ten thousand years lies between one and twenty-five percent. 3 figs., 5 tabs.

Ten Thousand Years of Solitude?

International Nuclear Information System (INIS)

Benford, G.; Pasqualetti, M.J.

1991-03-01

This report documents the authors work as an expert team advising the US Department of Energy on modes of inadvertent intrusion over the next 10,000 years into the Waste Isolation Pilot Project (WIPP) nuclear waste repository. Credible types of potential future accidental intrusion into the WIPP are estimated as a basis for creating warning markers to prevent inadvertent intrusion. A six-step process is used to structure possible scenarios for such intrusion, and it is concluded that the probability of inadvertent intrusion into the WIPP repository over the next ten thousand years lies between one and twenty-five percent. 3 figs., 5 tabs

Ten questions on nuclear wastes

International Nuclear Information System (INIS)

Guillaumont, R.; Bacher, P.

2004-01-01

The authors give explanations and answers to ten issues related to nuclear wastes: when a radioactive material becomes a waste, how radioactive wastes are classified and particularly nuclear wastes in France, what are the risks associated with radioactive wastes, whether the present management of radioactive wastes is well controlled in France, which wastes are raising actual problems and what are the solutions, whether amounts and radio-toxicity of wastes can be reduced, whether all long life radionuclides or part of them can be transmuted, whether geologic storage of final wastes is inescapable, whether radioactive material can be warehoused over long durations, and how the information on radioactive waste management is organised

Ten recommendations for software engineering in research.

Science.gov (United States)

Hastings, Janna; Haug, Kenneth; Steinbeck, Christoph

2014-01-01

Research in the context of data-driven science requires a backbone of well-written software, but scientific researchers are typically not trained at length in software engineering, the principles for creating better software products. To address this gap, in particular for young researchers new to programming, we give ten recommendations to ensure the usability, sustainability and practicality of research software.

VINKA, ten years on. Main scientific results

International Nuclear Information System (INIS)

1979-01-01

The VINKA facility in the TRITON swimming-pool reactor at Fontenay-aux-Roses allows the irradiation of solids at low temperatures in order to study crystalline defects. After ten years of operation the main scientific results obtained in the fields of creep and growth (chapter I), point defects (chapter II), amorphisation (chapter III) and dechanneling of particles (chapter IV) are summarised [fr

Experiences of patients with multiple sclerosis from group counseling.

Science.gov (United States)

Mazaheri, Mina; Fanian, Nasrin; Zargham-Boroujeni, Ali

2011-01-01

Group counseling is one of the most important methods in somatic and psychological rehabilitation of the multiple sclerosis (M.S.) patients. Knowing these patients' experiences, feelings, believes and emotion based on learning in group is necessary to indicate the importance of group discussion on quality of life of the patients. This study was done to achieve experiences of M.S. patients from group training. This was a qualitative study using phenomenological method. The samples were selected using purposeful sampling. Ten patients from M.S. society who had passed group training were included in the study. The group training was done through seven sessions weekly and voluntarily. The participants were interviewed using in-depth interview. The average time of each interview was between 30-50 minutes which has been recorded digitally and moved to a compact disc to transcribe and analysis. The data analyzed using 7-step Colaizzi method. The data were transformed into 158 codes, 12 sub-concepts and 4 main concepts including emotional consequences, communication, quality of life and needs. M.S can lead to multiple problems in patients such as somatic, behavioral, emotional and social disorders. Group psychotherapy is one of the methods which can decrease these problems and improve rehabilitation of the patients. Group discussion helps patients to overcome adverse feelings, behaviors and thoughts and guides them to move in a meaningful life. It also can improve quality of life and mental health of the patients.

The Ten-Minute Neighbourhood Is [not] a Basic Planning Unit for Happiness in Egypt

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Abeer Mohamed Elshater

2016-04-01

Full Text Available This paper investigates the relationship between inhabitants’ happiness and the right to the city in the status quo of Egyptian neighborhoods. Although services are easily accessible, by ten-minute walks in a suitable ambience, happiness is not achieved. The research aims to, first, review the literature that provides a guideline for ten-minute neighborhoods. Second, this study conducts a comparative content analysis of recent online articles on the right to the city. Third, the study tests findings from Egyptian neighborhood settings. The idea of a ten-minute neighborhood is manageable. The hypothesis concerns a compliant design. It is a logical assumption that people who live within ten minutes walking distance of essential facilities in their area can minimize several problems and maximize a healthy lifestyle. The supposed issue causes the right to the city to affect the relationship between ten-minute neighborhoods and citizens’ happiness. This assumption can be established through site observation and oriented questionnaires. This paper contributes by presenting new planning units that suit the current context of the old cities in the Middle East and North Africa region, based on walking distances of ten minutes or less with reference to the right to the city. This planning unit can result in citizens’ happiness.

A critical comparison of ten disposable cup LCAs

NARCIS (Netherlands)

Harst, van der E.J.M.; Potting, J.

2013-01-01

Disposable cups can be made from conventional petro-plastics, bioplastics, or paperboard (coated with petro-plastics or bioplastics). This study compared ten life cycle assessment (LCA) studies of disposable cups with the aim to evaluate the robustness of their results. The selected studies have

[Proposal of a conceptual method of supportive care for co-active patients].

Science.gov (United States)

Abidli, Yamine; Piette, Danielle; Casini, Annalisa

2015-01-01

There is a broad consensus on the importance for health professionals to support co-active patients. However, in practice, very few "patient care partnership" approaches have been developed. We hypothesized that the lack of investment in supporting patient care partnerships is due to the lack of interest in the skills needed by caregivers to provide such support. This paper intends to address thisgap. The patient care partnership method is studied, adapted and developed from existing models. It complements, harmonizes and integrates various schools of thought arising from the need to place the patient at the center of care and life in general. The patient care partnership method includes 7 stages during which the professional accompanies the patient through the process of care. The methodological approach for training professionals is designed to ensure that professionals experience the change as well as its difficulties of the change they expect from the patient in the care relationship. This method now needs to be validated by the experience of other professionals in order define the limits of application and to allow further development.

Maternity Nurses' Perceptions of Implementation of the Ten Steps to Successful Breastfeeding.

Science.gov (United States)

Cunningham, Emilie M; Doyle, Eva I; Bowden, Rodney G

The purpose of this study was to determine maternity nurses' perceptions of implementing the Ten Steps to Successful Breastfeeding. An online survey and a focus group were used to evaluate perceptions of maternity nurses of implementing the Ten Steps to Successful Breastfeeding in an urban Texas hospital at the onset of the project initiation. Responses were transcribed and coded using Nvivo software. Thematic analysis was conducted and consensus was reached among the research team to validate themes. Twenty-eight maternity nurses participated. Nurses perceived a number of barriers to implementing the Ten Steps to Successful Breastfeeding including nurse staffing shortages, variations in practice among nurses, different levels of nurse education and knowledge about breastfeeding, lack of parental awareness and knowledge about breastfeeding, culture, and postpartum issues such as maternal fatigue, visitors, and routine required procedures during recovery care that interfered with skin-to-skin positioning. Maternity nurses desired more education about breastfeeding; specifically, a hands-on approach, rather than formal classroom instruction, to be able to promote successful implementation of the Ten Steps. More education on breastfeeding for new mothers, their families, and healthcare providers was recommended. Nurse staffing should be adequate to support nurses in their efforts to promote breastfeeding. Skin-to-skin positioning should be integrated into the recovery period. Hospital leadership support for full implementation and policy adherence is essential. Challenges in implementing the Ten Steps were identified along with potential solutions.

Time in powers of ten natural phenomena and their timescales

CERN Document Server

't Hooft, Gerard

2014-01-01

In this richly illustrated book, Nobel Laureate Gerard 't Hooft and Theoretical Physicist Stefan Vandoren describe the enormous diversity of natural phenomena that take place at different time scales. In the tradition of the bestseller Powers of Ten , the authors zoom in and out in time, each step with a factor of ten. Starting from one second, time scales are enlarged until processes are reached that take much longer than the age of the universe. After the largest possible eternities, the reader is treated to the shortest and fastest phenomena known. Then the authors increase with powers of t

Ten- to 15-year results of the Oxford Phase III mobile unicompartmental knee arthroplasty: a prospective study from a non-designer group.

Science.gov (United States)

Lisowski, L A; Meijer, L I; Bekerom, M P J van den; Pilot, P; Lisowski, A E

2016-10-01

The interest in unicompartmental knee arthroplasty (UKA) for medial osteoarthritis has increased rapidly but the long-term follow-up of the Oxford UKAs has yet to be analysed in non-designer centres. We have examined our ten- to 15-year clinical and radiological follow-up data for the Oxford Phase III UKAs. Between January 1999 and January 2005 a total of 138 consecutive Oxford Phase III arthroplasties were performed by a single surgeon in 129 patients for medial compartment osteoarthritis (71 right and 67 left knees, mean age 72.0 years (47 to 91), mean body mass index 28.2 (20.7 to 52.2)). Both clinical data and radiographs were prospectively recorded and obtained at intervals. Of the 129 patients, 32 patients (32 knees) died, ten patients (12 knees) were not able to take part in the final clinical and radiological assessment due to physical and mental conditions, but via telephone interview it was confirmed that none of these ten patients (12 knees) had a revision of the knee arthroplasty. One patient (two knees) was lost to follow-up. The mean follow-up was 11.7 years (10 to 15). A total of 11 knees (8%) were revised. The survival at 15 years with revision for any reason as the endpoint was 90.6% (95% confidence interval (CI) 85.2 to 96.0) and revision related to the prosthesis was 99.3% (95% CI 97.9 to 100). The mean total Knee Society Score was 47 (0 to 80) pre-operatively and 81 (30 to 100) at latest follow-up. The mean Oxford Knee Score was 19 (12 to 40) pre-operatively and 42 (28 to 55) at final follow-up. Radiolucency beneath the tibial component occurred in 22 of 81 prostheses (27.2%) without evidence of loosening. This study supports the use of UKA in medial compartment osteoarthritis with excellent long-term functional and radiological outcomes with an excellent 15-year survival rate. Cite this article: Bone Joint J 2016;98-B(10 Suppl B):41-7. ©2016 Lisowski et al.

Ten-year statistics of the electric power supply. Status and tendencies

International Nuclear Information System (INIS)

2001-12-01

The ten-year statistics of the electric power supply in Denmark for 1991-2000 presents in tables and figures the trend of the electric power supply sector during the last ten years. The tables and figures present information on total energy consumption, combined heat and power generation, fuel consumption and the environment, the technical systems, economy and pricing, organization of the electricity supply, and information on electricity prices and taxes for households and industry in various countries. (LN)

A study on the evaluation of pneumothorax by imaging methods in patients presenting to the emergency department for blunt thoracic trauma.

Science.gov (United States)

Kaya, Şeyhmus; Çevik, Arif Alper; Acar, Nurdan; Döner, Egemen; Sivrikoz, Cumhur; Özkan, Ragıp

2015-09-01

Pneumothorax (PNX) is the collection of air between parietal and visceral pleura, and collapsed lung develops as a complication of the trapped air. PNX is likely to develop spontaneously in people with risk factors. However, it is mostly seen with blunt or penetrating trauma. Diagnosis is generally confirmed by chest radiography [posteroanterior chest radiography (PACR)]. Chest ultrasound (US) is also a promising technique for the detection of PNX in trauma patients. There is not much literature on the evaluation of blunt thoracic trauma (BTT) and pneumothorax (PNX) in the emergency department (ED). The aim of this study was to investigate the effectiveness of chest US for the diagnosis of PNX in patients presenting to ED with BTT. This study was carried out for a period of nine months in the ED of a university hospital. The chest US of patients was performed by emergency physicians trained in the field. The results were compared with anteroposterior chest radiography and/or CT scan of the chest. The APCR and chest CT results were evaluated by a radiology specialist blind to US findings. The evaluation of the radiology specialist was taken as the gold standard for diagnosis by imaging methods. Clinical follow-up was taken into consideration for the diagnosis of PNX in patients on whom CT scan was not performed. Chest US was performed on all two hundred and twelve patients (144 female and 68 male patients; mean age 45.8) who participated in this study. The supine APCR was performed on two hundred and ten (99%) patients and chest CT was performed on one hundred and twenty (56.6%). Out of the twenty-five (11.8%) diagnosed cases of PNX, 22 (88%) were diagnosed by chest US and 8 were diagnosed by APCR. For the detection of PNX, compared to clinical follow-up and chest CT, the sensitivity of chest US was 88%, specificity 99.5%, positive predictive value 95.7% and negative predictive value 98.4%. Chest US has not superseded supine and standing chest radiography for PNX

Patients' experiences of NPWT in an outpatient setting in Denmark

DEFF Research Database (Denmark)

Ottosen, B; Pedersen, B D

2013-01-01

qualitative interviews regarding their NPWT treatment. The French philosopher, Ricoeur's,theory of interpretation guided the data analysis, which included three levels: naive reading, structural analysis and critical interpretation and discussion. RESULTS: The patients experienced a high level of dependency......OBJECTIVE: To study patients' experiences of negative pressure wound therapy (NPWT) used for wounds of various aetiologies in the outpatient setting and the influences on daily life. METHOD: In this qualitative study, a phenomenological-hermeneutic approach was used. Ten patients underwent......, and they experienced embarrassment about odour,anxiety and uneasiness in relation to complications, a need for relatives' support and other social relation issues. It was important to include relatives as a resource and make use of the opportunity they presented to assist patients during information sessions about...

Pelvic radiation therapy for gynecologic malignancy in geriatric patients

International Nuclear Information System (INIS)

Grant, P.T.; Jeffrey, J.F.; Fraser, R.C.; Tompkins, M.G.; Filbee, J.F.; Wong, O.S.

1989-01-01

Thirty-one patients, aged 75 years or older, who received pelvic radiation therapy as part of primary treatment for a gynecologic malignancy, were reviewed. Ten patients (32%) failed to complete their treatment and 4 patients (13%) died of treatment-related complications. The treatment-related complications were independent of increasing age, but did correlate closely with the patients' pretreatment ECOG performance status. Ten patients with performance levels of 2 or higher had a mortality rate of 30%, while 70% failed to complete treatment. Treatment fractions of greater than 220 cGy per day also resulted in unacceptably high complication rates. Alternative treatment formats should be considered in geriatric patients with poor initial performance levels

The usefulness of percutaneous transluminal angioplasty of the middle cerebral artery stenosis in patients with transient ischemic attack

Energy Technology Data Exchange (ETDEWEB)

Lee, Young Chul; Lim, Hyo Soon; Kim, Jae Kyu; Seo, Jeong Jin; Jeong, Gwang Woo; Kang, Heoung Keun [Chonnam National Univ. Medical School, Kwangju (Korea, Republic of)

2001-06-01

To determine the effectiveness of percutaneous transluminal angioplasty(PTA) of atherosclerotic middle cerebral artery(MCA) stenosis in patients with transient ischemic attack (TIA). Ten patients with TIA who had undergone PTA were retrospectively investigated. In all ten, angiography revealed stenosis of the MCA. Mechanical dilatation was performed at the stenotic portion, and the angiographic findings after PTA, as well as peri/post-angioplastic complications, were evaluated. Four to 64 (mean, 23.5) months later, neurologic symptoms and the nature and timing of recurrent attacks were also assessed. The degree of stenosis before PTA was 50-75% in six patients and greater than 75% in four. Complete or partial angiographic recanalization of the stenotic segment occurred in nine patients (90%). During follow-up, seven patients recovered without recurrent TIA or cerebral stroke; one reported a tingling sensation and one experienced vertebrobasilar insufficiency. Motor aphasia developed in one patient after PTA, but after systemic heparinization, improved within 24 hours. One patient who suffered intracranial hemorrhage due to vascular rupture during PTA did three days later. PTA for atherosclerotic MCA stenosis in patients with TIA is an effective therapeutic method.

The usefulness of percutaneous transluminal angioplasty of the middle cerebral artery stenosis in patients with transient ischemic attack

International Nuclear Information System (INIS)

Lee, Young Chul; Lim, Hyo Soon; Kim, Jae Kyu; Seo, Jeong Jin; Jeong, Gwang Woo; Kang, Heoung Keun

2001-01-01

To determine the effectiveness of percutaneous transluminal angioplasty(PTA) of atherosclerotic middle cerebral artery(MCA) stenosis in patients with transient ischemic attack (TIA). Ten patients with TIA who had undergone PTA were retrospectively investigated. In all ten, angiography revealed stenosis of the MCA. Mechanical dilatation was performed at the stenotic portion, and the angiographic findings after PTA, as well as peri/post-angioplastic complications, were evaluated. Four to 64 (mean, 23.5) months later, neurologic symptoms and the nature and timing of recurrent attacks were also assessed. The degree of stenosis before PTA was 50-75% in six patients and greater than 75% in four. Complete or partial angiographic recanalization of the stenotic segment occurred in nine patients (90%). During follow-up, seven patients recovered without recurrent TIA or cerebral stroke; one reported a tingling sensation and one experienced vertebrobasilar insufficiency. Motor aphasia developed in one patient after PTA, but after systemic heparinization, improved within 24 hours. One patient who suffered intracranial hemorrhage due to vascular rupture during PTA did three days later. PTA for atherosclerotic MCA stenosis in patients with TIA is an effective therapeutic method

Clinical study of Atopic Dermatitis patient treated with Poison Extraction Method

Directory of Open Access Journals (Sweden)

Park Chi-young

2007-06-01

Full Text Available Objectives : This study is desinged in order to evaluate the Poison extraction method for the Atopic dermatitis. Methods : The authors observed the two cases of Atopic dermatitis patients who previously used steroid-based ointment. for treating the Poison Extraction Method. Conclusions : 1. In case 1, the patient with mild case of Atopic dermatitis in face is treated with the Poison extraction method. Rash symptoms intensed for first few days. As sweating appeared in the local area from the seventh day, all the symptoms was disappeared rapidly. No recurrence was found. 2. In case 2, the patient with severe case of Atopic dermatitis in whole body is treated with the Poison extraction method. The symptoms intensed after two months and all the symptoms of itchiness, rash, scaly letter dissapeared in the third and fourth months. No recurrence was found. 3. In both cases of mild and severe cases of Atopic dermatitis. all the symptoms were disappeared and no recurrence was found with the Poison Extraction Method.

Transcutaneous Electrical Nerve Stimulation (TENS) and Laryngeal Manual Therapy (LMT): Immediate Effects in Women With Dysphonia.

Science.gov (United States)

Conde, Mariana de Cásisa Macedo; Siqueira, Larissa Thaís Donalonso; Vendramini, José Eduardo; Brasolotto, Alcione Ghedini; Guirro, Rinaldo Roberto de Jesus; Silverio, Kelly Cristina Alves

2018-05-01

This study aimed to verify the immediate effect of low-frequency transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) in musculoskeletal pain, voice quality, and self-reported signs in women with dysphonia. Thirty women with behavioral dysphonia were randomly divided into the TENS group and the LMT group. All participants fulfilled the pain survey and had their voices recorded to posterior perceptual and acoustic analysis before and after intervention. The TENS group received a unique low-frequency TENS session (20 minutes). The LMT group received LMT (20 minutes) with soft and superficial massage in the sternocleidomastoid muscle, suprahyoid muscles, and larynx. Afterward, the volunteers reported their voice, larynx, breathing, and articulatory signs. Pre and post data were compared by parametric and nonparametric tests. After TENS, a decrease in pain intensity in the posterior or anterior region of the neck, shoulders, upper or lower back, and masseter was observed. After LMT, a decrease in pain intensity in the neck anterior region, shoulders, lower back, and temporal region was observed. Also, after TENS, there was an improvement in vowel /a/ instability; after LMT, there was a general improvement in voice quality, decrease in tension, and decrease in breathiness in speech. Positive voice and laryngeal signs were reported after TENS, and positive laryngeal signs and articulation were reported after LMT. TENS and LMT may be used in voice treatment of women with behavioral dysphonia, and both may be considered important therapy resources that reduce musculoskeletal pain and cause positive laryngeal signs. Both TENS and LMT are able to partially improve voice quality, but TENS presented better results. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Percutaneous Method of Management of Simple Bone Cyst

Directory of Open Access Journals (Sweden)

O. P. Lakhwani

2013-01-01

Full Text Available Introduction. Simple bone cyst or unicameral bone cysts are benign osteolytic lesions seen in metadiaphysis of long bones in growing children. Various treatment modalities with variable outcomes have been described in the literature. The case report illustrates the surgical technique of minimally invasive method of treatment. Case Study. A 14-year-old boy was diagnosed as active simple bone cyst proximal humerus with pathological fracture. The patient was treated by minimally invasive percutaneous curettage with titanium elastic nail (TENS and allogenic bone grafting mixed with bone marrow under image intensifier guidance. Results. Pathological fracture was healed and allograft filled in the cavity was well taken up. The patient achieved full range of motion with successful outcome. Conclusion. Minimally invasive percutaneous method using elastic intramedullary nail gives benefit of curettage cyst decompression and stabilization of fracture. Allogenic bone graft fills the cavity and healing of lesion by osteointegration. This method may be considered with advantage of minimally invasive technique in treatment of benign cystic lesions of bone, and the level of evidence was therapeutic level V.

Percutaneous Method of Management of Simple Bone Cyst

Science.gov (United States)

Lakhwani, O. P.

2013-01-01

Introduction. Simple bone cyst or unicameral bone cysts are benign osteolytic lesions seen in metadiaphysis of long bones in growing children. Various treatment modalities with variable outcomes have been described in the literature. The case report illustrates the surgical technique of minimally invasive method of treatment. Case Study. A 14-year-old boy was diagnosed as active simple bone cyst proximal humerus with pathological fracture. The patient was treated by minimally invasive percutaneous curettage with titanium elastic nail (TENS) and allogenic bone grafting mixed with bone marrow under image intensifier guidance. Results. Pathological fracture was healed and allograft filled in the cavity was well taken up. The patient achieved full range of motion with successful outcome. Conclusion. Minimally invasive percutaneous method using elastic intramedullary nail gives benefit of curettage cyst decompression and stabilization of fracture. Allogenic bone graft fills the cavity and healing of lesion by osteointegration. This method may be considered with advantage of minimally invasive technique in treatment of benign cystic lesions of bone, and the level of evidence was therapeutic level V. PMID:23819089

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.

Age Group Comparisons of TENS Response among Individuals with Chronic Axial Low Back Pain

OpenAIRE

Simon, Corey B.; Riley, Joseph L.; Fillingim, Roger B.; Bishop, Mark D.; George, Steven Z.

2015-01-01

Chronic low back pain (CLBP) is a highly prevalent and disabling musculoskeletal pain condition among older adults. Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat CLBP, however, TENS response for older adults compared to younger adults is untested. In a dose-response study stratified by age, sixty participants with axial CLBP (20 young, 20 middle-aged, 20 older) received four 20-minute sessions of high frequency, high intensity TENS over a two to three-week perio...

Ten-year statistics of the electric power supply. Status and tendencies

International Nuclear Information System (INIS)

2000-12-01

The ten-year statistics of the electric power supply in Denmark for 1990-1999 presents in tables and figures the trend of the electric power supply sector during the last ten years. The tables and figures present information on total energy consumption, combined heat and power generation, fuel consumption and the environment, the technical systems, economy and pricing, organization of the electricity supply, auto-production of electricity and information on electricity prices and taxes for households and industry in various countries. (LN)

Methods for interpreting change over time in patient-reported outcome measures.

Science.gov (United States)

Wyrwich, K W; Norquist, J M; Lenderking, W R; Acaster, S

2013-04-01

Interpretation guidelines are needed for patient-reported outcome (PRO) measures' change scores to evaluate efficacy of an intervention and to communicate PRO results to regulators, patients, physicians, and providers. The 2009 Food and Drug Administration (FDA) Guidance for Industry Patient-Reported Outcomes (PRO) Measures: Use in Medical Product Development to Support Labeling Claims (hereafter referred to as the final FDA PRO Guidance) provides some recommendations for the interpretation of change in PRO scores as evidence of treatment efficacy. This article reviews the evolution of the methods and the terminology used to describe and aid in the communication of meaningful PRO change score thresholds. Anchor- and distribution-based methods have played important roles, and the FDA has recently stressed the importance of cross-sectional patient global assessments of concept as anchor-based methods for estimation of the responder definition, which describes an individual-level treatment benefit. The final FDA PRO Guidance proposes the cumulative distribution function (CDF) of responses as a useful method to depict the effect of treatments across the study population. While CDFs serve an important role, they should not be a replacement for the careful investigation of a PRO's relevant responder definition using anchor-based methods and providing stakeholders with a relevant threshold for the interpretation of change over time.

Sampling for Patient Exit Interviews: Assessment of Methods Using Mathematical Derivation and Computer Simulations.

Science.gov (United States)

Geldsetzer, Pascal; Fink, Günther; Vaikath, Maria; Bärnighausen, Till

2018-02-01

(1) To evaluate the operational efficiency of various sampling methods for patient exit interviews; (2) to discuss under what circumstances each method yields an unbiased sample; and (3) to propose a new, operationally efficient, and unbiased sampling method. Literature review, mathematical derivation, and Monte Carlo simulations. Our simulations show that in patient exit interviews it is most operationally efficient if the interviewer, after completing an interview, selects the next patient exiting the clinical consultation. We demonstrate mathematically that this method yields a biased sample: patients who spend a longer time with the clinician are overrepresented. This bias can be removed by selecting the next patient who enters, rather than exits, the consultation room. We show that this sampling method is operationally more efficient than alternative methods (systematic and simple random sampling) in most primary health care settings. Under the assumption that the order in which patients enter the consultation room is unrelated to the length of time spent with the clinician and the interviewer, selecting the next patient entering the consultation room tends to be the operationally most efficient unbiased sampling method for patient exit interviews. © 2016 The Authors. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust.

Clinical way method in treatment of out-patients with ischemic heart disease after cardiosurgery

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Vardosanidze S.L.

2010-12-01

Full Text Available 158 patients with ischemic heart disease (IHD have been understudy during the period of 12 months in out-patient conditions. After completion of the primary examination all the patients of basic group (118 patients received clinical way method of treatment. Patients of the comparison group (40 patients after provided treatment were cared by their local therapeutists (cardiologists. The findings proved the fact that treatment of patients after cardiosurgery by clinical way method in out-patient conditions enabled to raise patient motivation to treatment, thereby assisting them to feel better, promoting normalization of arterial pressure data. The research results stated that clinical way method of treatment may be considered as rational and effective

Investigation on Carbohydrate Counting Method in Type 1 Diabetic Patients

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Osman Son

2014-01-01

Full Text Available Objective. The results from Diabetes Control and Complications Trial (DCCT have propounded the importance of the approach of treatment by medical nutrition when treating diabetes mellitus (DM. During this study, we tried to inquire carbohydrate (Kh count method’s positive effects on the type 1 DM treatment’s success as well as on the life quality of the patients. Methods. 22 of 37 type 1 DM patients who applied to Eskişehir Osmangazi University, Faculty of Medicine Hospital, Department of Endocrinology and Metabolism, had been treated by Kh count method and 15 of them are treated by multiple dosage intensive insulin treatment with applying standard diabetic diet as a control group and both of groups were under close follow-up for 6 months. Required approval was taken from the Ethical Committee of Eskişehir Osmangazi University, Medical Faculty, as well as informed consent from the patients. The body weight of patients who are treated by carbohydrate count method and multiple dosage intensive insulin treatment during the study beginning and after 6-month term, body mass index, and body compositions are analyzed. A short life quality and medical research survey applied. At statistical analysis, t-test, chi-squared test, and Mann-Whitney U test were used. Results. There had been no significant change determined at glycemic control indicators between the Kh counting group and the standard diabetic diet and multiple dosage insulin treatment group in our study. Conclusion. As a result, Kh counting method which offers a flexible nutrition plan to diabetic individuals is a functional method.

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)

Clinical characteristics of patients with conjunctivochalasis

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Balci O

2014-08-01

Full Text Available Ozlem Balci Ophthalmology Department, Kolan Hospitalium Group, Istanbul, Turkey Purpose: To evaluate the clinical characteristics of patients with conjunctivochalasis (CCh. Methods and materials: This retrospective study enrolled 30 subjects diagnosed with conjunctivochalasis. Complete ophthalmic examination, including visual acuity assessment, slit-lamp examination, applanation tonometry, dilated funduscopy, tear break-up time, Schirmer 1 test, and fluorescein staining were performed in all patients. Age, sex, laterality, ocular history, symptoms, and clinical findings were recorded. Results: The study included 50 eyes from 30 cases. Ages ranged from 45 to 80 years, with a mean age of 65±10 years. CChs grading were as follows: 30 (60% eyes with grade 1 CCh; 15 (30% eyes with grade 2 CCh; and five (10% eyes with grade 3 CCh. CCh was located in the inferior bulbar conjunctiva in 45 (90% eyes, and in the remaining five (10% CCh was located in the superior bulbar conjunctiva. Ten (33.3% patients had no symptoms. Dryness, eye pain, redness, blurry vision, tired eye feeling, and epiphora were the symptoms encountered in the remaining twenty (63.6% patients. Altered tear meniscus was noted in all cases. The mean tear break-up time was 7.6 seconds. The mean Schirmer 1 test score was 7 mm. Pinguecula was found in ten patients. Conclusion: Dryness, eye pain, redness, blurry vision, and epiphora were the main symptoms in patients with CCh. Dryness, eye pain, and blurry vision were worsened during downgaze and blinking. So CCh should be taken into consideration in the differential diagnosis of chronic ocular irritation and epiphora. Keywords: ocular irritation, epiphora, dryness, eye pain, blurry vision

Comparing Exercise Prescription Methods in Knee Osteoarthritis Patients in Malaysia

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D’Gasper Dineesha

2018-03-01

Full Text Available Aim: This study was a qualitative study that investigated the exercise prescription method in knee osteoarthritis patients in Malaysia. It purposed to find out the most common and effective method used by physiotherapist in prescribing exercises for knee osteoarthritis patients in Malaysia. Method: This study used a self-administered survey questionnaire. The subjects recruited for this study were diagnosed with knee osteoarthritis, age range of between 50 to 80 years old.The methods of delivery were divided into three categories, which include only verbal instructions, verbal instruction together with demonstration and lastly a combination of all three methods including verbal instruction, demonstration and handouts with diagrams. Results: The results showed that 52% received their exercise prescription with verbal instruction and together with demonstration, about 43% of them received all three types of methods which included the verbal instruction, demonstration and take home handouts and 5% of them only received verbal instruction. Out of 5% who received verbal instruction alone, only 1% understood the exercises and the remaining 4% did not and 45% out of 52% who received verbal and demonstration method understood the exercises and the remaining 7% did not. 5% who received only verbal instruction did not seem to continue the exercises at home. 52% received verbal instruction together with demonstration, with about 44% of them having continued their exercises but the remaining 8% did not. 43% who received all three methods reported to continue. Conclusion: The best method of delivering exercises to knee osteoarthritis patients was proven to be the method with a combination of verbal instruction, demonstration together with a take home handout. This method showed very positive outcome and should be implemented and emphasized more in both the government and private sectors of physiotherapy departments.

Ten questions about radiant heating and cooling systems

DEFF Research Database (Denmark)

Rhee, Kyu-Nam; Olesen, Bjarne W.; Kim, Kwang Woo

2017-01-01

to extend the applicability of the RHC system are providing the continuous impetus for research on RHC systems. This paper summarizes the important issues involved in the research on RHC system, whereby ten questions and answers concerning the RHC system are discussed, which will help researchers to conduct...

Development of the rate of employment and unemployment of males and females in ten associated countries of EU

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Jan Klíma

2004-01-01

Full Text Available The paper is focused on the evaluation the rates of employment and unemployment of women, men and as a whole in ten associated countries of EU. Rates of employment were evaluated in the period 1996-2002. Rates of unemployment were evaluated in the period 1996-2003. Employment of males in all ten associated countries of EU is higher then employment of females. Unemployment of females in the Czech Republic, Cyprus, Malta, Poland, Slovakia and Slovenia is higher than unemployment of males and in opposite unemployment of females in Estonia, Hungary, Lithuania and Latvia is lower than unemployment of males. Trends of rates of male, female and total employment and unemployment are evaluated. Methods of regression and correlation analysis, development trends and cluster analysis were applied for the mathematical-statistical analysis.

Using the modified Delphi method to establish clinical consensus for the diagnosis and treatment of patients with rotator cuff pathology

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Breda H. Eubank

2016-05-01

Full Text Available Abstract Background Patients presenting to the healthcare system with rotator cuff pathology do not always receive high quality care. High quality care occurs when a patient receives care that is accessible, appropriate, acceptable, effective, efficient, and safe. The aim of this study was twofold: 1 to develop a clinical pathway algorithm that sets forth a stepwise process for making decisions about the diagnosis and treatment of rotator cuff pathology presenting to primary, secondary, and tertiary healthcare settings; and 2 to establish clinical practice guidelines for the diagnosis and treatment of rotator cuff pathology to inform decision-making processes within the algorithm. Methods A three-step modified Delphi method was used to establish consensus. Fourteen experts representing athletic therapy, physiotherapy, sport medicine, and orthopaedic surgery were invited to participate as the expert panel. In round 1, 123 best practice statements were distributed to the panel. Panel members were asked to mark “agree” or “disagree” beside each statement, and provide comments. The same voting method was again used for round 2. Round 3 consisted of a final face-to-face meeting. Results In round 1, statements were grouped and reduced to 44 statements that met consensus. In round 2, five statements reached consensus. In round 3, ten statements reached consensus. Consensus was reached for 59 statements representing five domains: screening, diagnosis, physical examination, investigations, and treatment. The final face-to-face meeting was also used to develop clinical pathway algorithms (i.e., clinical care pathways for three types of rotator cuff pathology: acute, chronic, and acute-on-chronic. Conclusion This consensus guideline will help to standardize care, provide guidance on the diagnosis and treatment of rotator cuff pathology, and assist in clinical decision-making for all healthcare professionals.

Clinical presentation and treatment outcome of molar pregnancy: Ten years experience at a Tertiary Care Hospital in Dammam, Saudi Arabia

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Ayman A Al-Talib

2016-01-01

Full Text Available Objectives: To study the clinical presentation and treatment outcome of molar pregnancy at a Tertiary Care Hospital in Dammam, Saudi Arabia. Materials and Methods: Reviewed medical records of all molar pregnancy cases among all the deliveries at a tertiary care hospital in Dammam from 2005 to 2014, after approval by institutional ethical review committee. Data abstracted included patient′s age, parity, presenting symptoms, gestational age at diagnosis, uterine size, ultrasonographic findings, BhCG level at the time of diagnosis and at follow-up after evacuation, and blood loss during evacuation. Data was entered and analyzed using Excel; frequency distribution for categorical variables and descriptive statistics for continuous variables were computed. Results: Of a total of 25,000 deliveries in ten years, 22 cases of complete molar pregnancy were encountered: 0.9 cases of molar pregnancy per 1000 pregnancies. Majority of patients (63.7% were older than 35 years, and were nulliparous (45.5%. The commonest symptom was vaginal bleeding (86.4% followed by hyperemesis gravidarum (41.0%; Hyperthyroidism was seen in 1 patient (4.5%. Ovarian enlargement by theca-lutin cyst was seen in 3 patients (13.6%. The majority of patients (63.6% had normal BhCG within 9 weeks (63 days after suction curettage. The majority of the cases followed a benign course. Conclusion: Aged older than 35 years seems a risk factor and vaginal bleeding is the commonest presenting symptom. Early booking of pregnant women to antenatal care clinics and routine first trimester ultrasound made diagnosis easier and earlier before complications appear.

A Method for Developing Standard Patient Education Program.

Science.gov (United States)

Lura, Carolina Bryne; Hauch, Sophie Misser Pallesgaard; Gøeg, Kirstine Rosenbeck; Pape-Haugaard, Louise

2018-01-01

In Denmark, patients being treated on Haematology Outpatients Departments get instructed to self-manage their blood sample collection from Central Venous Catheter (CVC). However, this is a complex and risky procedure, which can jeopardize patient safety. The aim of the study was to suggest a method for developing standard digital patient education programs for patients in self-administration of blood samples drawn from CVC. The Design Science Research Paradigm was used to develop a digital patient education program, called PAVIOSY, to increase patient safety during execution of the blood sample collection procedure by using videos for teaching as well as procedural support. A step-by-step guide was developed and used as basis for making the videos. Quality assurance through evaluation with a nurse was conducted on both the step-by-step guide and the videos. The quality assurance evaluation of the videos showed; 1) Errors due to the order of the procedure can be determined by reviewing the videos despite that the guide was followed. 2) Videos can be used to identify errors - important for patient safety - in the procedure, which are not identifiable in a written script. To ensure correct clinical content of the educational patient system, health professionals must be engaged early in the development of content and design phase.

Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease.

Science.gov (United States)

Middelveen, Marianne J; Sapi, Eva; Burke, Jennie; Filush, Katherine R; Franco, Agustin; Fesler, Melissa C; Stricker, Raphael B

2018-04-14

Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi , in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms. In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner. Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borrelia burgdorferi by three distinct polymerase chain reaction (PCR)-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods. Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined.

Relevance of 123I-BMIPP delayed scintigraphic imaging for patients with angina pectoris ? a pilot study

OpenAIRE

Koyama, Kohei; Akashi, Yoshihiro J.; Kida, Keisuke; Suzuki, Kengo; Ishibashi, Yuki; Musha, Haruki; Banach, Maciej

2011-01-01

Introduction The study was designed to clarify the role of 123I-?-methyl-iodophenylpentadecanoic acid (123I-BMIPP) in the evaluation of myocardial fatty acid metabolism in patients with stable angina pectoris (AP) before and after percutaneous coronary intervention (PCI). Material and methods Ten controls (mean age: 70.4 ?10.5 years) and 12 patients with AP (mean age: 67.4 ?11.6 years) and single vessel coronary artery disease participated in the radionuclide cardiac study. Scintigraphic imag...

Research on pinch devices of tens of kA to MA

Energy Technology Data Exchange (ETDEWEB)

Soto, L.; Silva, P.; Moreno, J.; Silvester, G.; Zambra, M. [Comision Chilena de Energia Nuclear, Santiago (Chile); Pavez, C.; Saavedra, R. [Univ. de Concepcion (Chile); Bruzzone, H. [Pladema (Antiqua and Barbuda)]|[Univ. de Mar del Plata and CONICET (Argentina); Barbaglia, M. [Pladema (Antiqua and Barbuda); Mayer, R. [Pladema (Antiqua and Barbuda)]|[Inst. Balseiro, Bariloche, CNEA and CONICET (Argentina); Sidelnikov, Y.; Kies, W. [Heinrich-Heine-Univ., Duesseldorf (Germany)

2004-07-01

At present the Plasma Physics and Plasma Technology Group of the Comision Chilena de Energia Nuclear (CCHEN) has the experimental facilities in order to study dense transient discharges in a wide range of energy and current, namely: (I) energy from tens of joules to hundred of kilojoules, (II) current from tens of kiloamperes to some mega-amperes. Also several diagnostics have been implemented. An overview of the work being carried out on dense pinch discharges at the Comision Chilena de Energia Nuclear is presented. (orig.)

Research on pinch devices of tens of kA to MA

International Nuclear Information System (INIS)

Soto, L.; Silva, P.; Moreno, J.; Silvester, G.; Zambra, M.; Pavez, C.; Saavedra, R.; Bruzzone, H.; Barbaglia, M.; Mayer, R.; Sidelnikov, Y.; Kies, W.

2004-01-01

At present the Plasma Physics and Plasma Technology Group of the Comision Chilena de Energia Nuclear (CCHEN) has the experimental facilities in order to study dense transient discharges in a wide range of energy and current, namely: (I) energy from tens of joules to hundred of kilojoules, (II) current from tens of kiloamperes to some mega-amperes. Also several diagnostics have been implemented. An overview of the work being carried out on dense pinch discharges at the Comision Chilena de Energia Nuclear is presented. (orig.)

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.

Antihypertensive effect of low-frequency transcutaneous electrical nerve stimulation (TENS) in comparison with drug treatment.

Science.gov (United States)

Silverdal, Jonas; Mourtzinis, Georgios; Stener-Victorin, Elisabet; Mannheimer, Clas; Manhem, Karin

2012-10-01

Hypertension is a major risk factor for vascular disease, yet blood pressure (BP) control is unsatisfactory low, partly due to side-effects. Transcutaneous electrical nerve stimulation (TENS) is well tolerated and studies have demonstrated BP reduction. In this study, we compared the BP lowering effect of 2.5 mg felodipin once daily with 30 min of bidaily low-frequency TENS in 32 adult hypertensive subjects (mean office BP 152.7/90.0 mmHg) in a randomized, crossover design. Office BP and 24-h ambulatory BP monitoring (ABPM) were performed at baseline and at the end of each 4-week treatment and washout period. Felodipin reduced office BP by 10/6 mmHg (p TENS reduced office BP by 5/1.5 mmHg (p TENS washout, BP was further reduced and significantly lower than at baseline, but at levels similar to BP after felodipin washout and therefore reasonably caused by factors other than the treatment per se. ABPM revealed a significant systolic reduction of 3 mmHg by felodipin, but no significant changes were noted after TENS. We conclude that our study does not present any solid evidence of BP reduction of TENS.

Optical spectroscopy of ten extragalactic radiosources

International Nuclear Information System (INIS)

Rawlings, S.; Riley, J.M.; Saunders, R.

1989-01-01

We present optical spectroscopy of ten objects associated with extra-galactic radiosources, using the University of Hawaii 2.2-m telescope. Redshifts are measured for four radiogalaxies (B20217 + 36A + B, 3C73, 0648 + 19A, 0648 + 19B) and for a galaxy which is probably associated with a double radio-source with highly unusual properties (0951 + 37); existing redshifts are confirmed for two radiogalaxies (4C39.04, 4C40.08); and a tentative redshift of z=2.87 measured for the quasar 3C82. (author)

Ten essential skills for electrical engineers

CERN Document Server

Dorr, Barry

2014-01-01

Engineers know that, as in any other discipline, getting a good job requires practical, up-to-date skills. An engineering degree provides a broad set of fundamentals. Ten Essential Skills applies those fundamentals to practical tasks required by employers. Written in a user-friendly, no-nonsense format, the book reviews practical skills using the latest tools and techniques, and features a companion website with interview practice problems and advanced material for readers wishing to pursue additional skills. With this book, aspiring and current engineers may approach job interviews confident

Hippocampus and amygdala volumes in patients with vaginismus.

Science.gov (United States)

Atmaca, Murad; Baykara, Sema; Ozer, Omer; Korkmaz, Sevda; Akaslan, Unsal; Yildirim, Hanefi

2016-06-22

To compare hippocampus and amygdala volumes of patients with vaginismus with those of healthy control subjects. Magnetic resonance imaging was performed on ten patients with vaginismus and ten control subjects matched for age and gender. Volumes of the hippocampus and amygdala were blindly measured. We found that the mean right amygdala volume of patients with vaginismus were smaller than that of the healthy controls. With regard to hippocampus volumes, the mean left and right hippocampus volumes were smaller than those of the healthy controls. Our present findings suggest that there have been hippocampus and amygdala structural abnormalities in patients with vaginismus. These changes provide the notion that vaginismus may be a fear-related condition.

Ten years summary: FDG-PET on irradiated brain tumour

International Nuclear Information System (INIS)

Wang Shuxia; Boethius, J.

2004-01-01

Purpose: To retrospectively evaluate FDG-PET in differentiation of post-radiotherapy status: recurrence, radiation necrosis, malignant regression of low grade primary brain tumour, and to evaluate PET in terms of survival prediction. Material and methods: 117 irradiated patients (156 PET) were consecutively included. PET results were judged by a set of rigid follow-up standards. Brain metastases from lung carcinoma were further studied. Survival time was analysed with Kaplan-Meier method. Results: There were 61 true-positive, 2 false-positive, 15 false-negative, 51 true-negative PET; leaving 5 positive and 22 negative PET results indeterminate. PET positive predictive value was 96% in all and 100% in brain metastasis from lung carcinoma. PET negative predictive value was 55.6% among surgically selected cases. Survival time was significantly longer in patient's with negative PET, both brain metastasis and primary brain tumour. Conclusions: FDG-PET was a good method to pick up tumour recurrence from radiation necrosis, especially metastasis from lung carcinoma. FDG uptake could be used as a non-invasive parameter to predict patient's prognosis. (authors)

School Psychologists' Job Satisfaction: Ten Years Later

OpenAIRE

Worrell, Travis G.

2004-01-01

School Psychologistsâ Job Satisfaction: Ten Years Later (ABSTRACT) This study was designed to replicate nationwide surveys completed in 1982 and 1992. The purpose was to examine and describe the levels of job satisfaction and the relationship between the variables in a national sample of school psychologists belonging to the National Association of School Psychologists (NASP). The sample for this study consisted of respondents who reported being full-time school practitioners. ...

Os efeitos do método Ai Chi em pacientes portadoras da síndrome fibromiálgica The effect of Ai Chi method in fybromialgic patients

Directory of Open Access Journals (Sweden)

Jacqueline Soares de Santana

2010-06-01

Full Text Available O objetivo do estudo é demonstrar os efeitos do método Ai Chi como forma alternativa de abordagem hidroterapêutica em pacientes portadoras da síndrome fibromiálgica. Foram estudados dez pacientes; quatro fizeram parte do grupo experimento e cinco, do grupo controle, com uma desistência. As pacientes foram avaliadas através do Questionário de Impacto da Fibromialgia (QIF e da Escala de Intensidade e Índice de dor nos Pontos Sensíveis. Foram realizadas duas avaliações, uma antes e outra após o tratamento. As pacientes foram submetidas a dez sessões do método Ai Chi, com duração de quarenta minutos. Houve melhora na intensidade da dor, de acordo com a escala da intensidade de dor nos pontos sensíveis, após a intervenção; já a qualidade de vida manteve-se sem alteração. Na qualidade de vida, observou-se que os grupos obtiveram resultados semelhantes; isso se deve ao fato que as pacientes não apresentaram melhora no seu estado depressivo. No índice dos pontos sensíveis, verificou-se diferença entre os grupos. A explicação para essa diferença deve-se possivelmente aos benefícios da imersão em água aquecida e aos efeitos do método Ai Chi. Não houve diferença significativa entre os grupos, o que pode ser atribuído às limitações do estudo. Desta forma, torna-se relevante a realização de novos estudos referentes à aplicação do método Ai Chi em pacientes portadoras da síndrome fibromiálgica.The objective of this article is to show the effect of the Ai Chi method, as an alternative form of hydrotherapeutic approach in fibromyalgia syndrome patients. Ten patients were studied, four were part of the experiment group and five of the control group, with one desistance. The patients were evaluated through the Fibromyalgia Impact Questionnaire (QIF and Scale of Intensity and Index of pain in Sensible Points. Two evaluations were performed, before and after the treatment. The patients were submitted to ten sessions

Note: Making tens of centimeter long uniform microfluidic channels using commercial glass pipette

Science.gov (United States)

Ou, Neil; Lee, Huang-Ming; Wu, Jong-Ching

2018-03-01

Producing microchannels with diameters between 10 and 20 μm and with lengths in the tens of centimeters is reported. The method can be modified to obtain diameters as narrow as 350 nm. Length-to-diameter aspect ratios that surpass 104 can be produced for a fraction of current production costs. The controllable channel is produced by applying a flame to the narrow end of a commercial pipette that is made from a soda-lime silicate. In combination with a pulling mechanism, applying heat to the composite material lengthens the pipette in a highly uniform way. Given that the materials and methods in this research are cost-effective when compared to femtosecond laser micromachining on 2D silicon-based surfaces, further research into producing microchannels from soda-lime silicates may revolutionize access to 3D controllable microchannels.

Fulfilling the atomic promise: Ten years history gives pointers for the future

International Nuclear Information System (INIS)

1967-01-01

Ten years is a short period in human history, and a short period in the life of an international organization. Nevertheless the ten years now completed by the International Atomic Energy Agency has seen much work accomplished and has brought greater realization than ever before of the promise held out by the atom for peaceful benefits leading to the promotion of peace, health and prosperity throughout the world

Breastfeeding Practices and Barriers to Implementing the Ten Steps to Successful Breastfeeding in Mississippi Hospitals.

Science.gov (United States)

Alakaam, Amir; Lemacks, Jennifer; Yadrick, Kathleen; Connell, Carol; Choi, Hwanseok Winston; Newman, Ray G

2018-05-01

Mississippi has the lowest rates of breastfeeding in the United States at 6 and 12 months. There is growing evidence that the rates and duration of infant breastfeeding improve after hospitals implement the Ten Steps to Successful Breastfeeding; moreover, the Ten Steps approach is considered the standard model for evaluation of breastfeeding practices in birthplaces. Research aim: This study aimed to examine the implementation level of the Ten Steps and identify barriers to implementing the Ten Steps in Mississippi hospitals. A cross-sectional self-report survey was used to answer the research aim. Nurse managers of the birthing and maternity units of all 43 Mississippi hospitals that provided birthing and maternity care were recruited. A response rate of 72% ( N = 31) was obtained. Implementation of the Ten Steps in these hospitals was categorized as low, partial, moderate, or high. The researcher classified implementation in 29% of hospitals as moderate and in 71% as partial. The hospital level of implementation was significantly positively associated with the hospital delivery rate along with the hospital cesarean section rate per year. The main barriers for the implementation process of the Ten Steps reported were resistance to new policies, limited financial and human resources, and lack of support from national and state governments. Breastfeeding practices in Mississippi hospitals need to be improved. New policies need to be established in Mississippi to encourage hospitals to adopt the Ten Steps policies and practice in the maternity and birthing units.

Video elicitation interviews: a qualitative research method for investigating physician-patient interactions.

Science.gov (United States)

Henry, Stephen G; Fetters, Michael D

2012-01-01

We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants' associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specific events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, high-quality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care.

Video Elicitation Interviews: A Qualitative Research Method for Investigating Physician-Patient Interactions

Science.gov (United States)

Henry, Stephen G.; Fetters, Michael D.

2012-01-01

We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants’ associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specific events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, high-quality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care. PMID:22412003

Acute hyperinsulinemia is followed by increased serum concentrations of fibroblast growth factor 23 in type 2 diabetes patients

DEFF Research Database (Denmark)

Winther, Kristian; Nybo, Mads; Vind, Birgitte

2012-01-01

Background. Phosphate homeostasis is connected to glucose metabolism and is influenced by insulin, but the role of fibroblast growth factor 23 (FGF23) is unknown in this relation. Therefore, the levels of FGF23 and phosphate were investigated during a euglycemic-hyperinsulinemic clamp in healthy...... and type 2 diabetic individuals. Methods. The study population consisted of ten type 2 diabetic patients, ten weight-matched glucose-tolerant obese subjects, and ten healthy lean subjects. All subjects underwent a 4-h euglycemic-hyperinsulinemic clamp using physiological hyperinsulinemia (40 mU/min per m(2...... the groups. Conclusions. Physiological hyperinsulinemia is under euglycemic conditions followed by a significant increase in serum FGF23 concentrations in diabetic individuals, which correlated with change in insulin level. The interplay between insulin effects and FGF23 may be important...

Effects of transcutaneous electrical nerve stimulation on pain intensity during application of carboxytherapy in patients with cellulite: A randomized placebo-controlled trial.

Science.gov (United States)

Sadala, Adria Y; Machado, Aline F P; Liebano, Richard E

2018-01-16

Carboxytherapy may generate local pain that is considered the main limiting factor in clinical practice. Transcutaneous electric nerve stimulation (TENS) is widely used in the control of acute pain; however, the effect of TENS on pain relief during carboxytherapy has not been studied to date. To assess the effect of TENS on pain intensity during carboxytherapy in patients with cellulite in the gluteal region. This randomized clinical trial was conducted with 84 patients, 18-44 years of age, who had moderate cellulite in the gluteal region, according to Cellulite Severity Scale, but never received carboxytherapy. Patients were randomized into 3 groups: active TENS, placebo TENS, and control group. For the intervention, skin depressions with cellulite were outlined, and the gluteal area to be treated was defined. The subcutaneous injection of CO 2 was performed using 0.30 × 13 mm-needles at a 45° angle, with a controlled flow rate of 100 mL/min maintained for 1 minute at each puncture site. The parameters for TENS were as follows: frequency of 100 Hz and pulse duration of 200 μs; TENS intensity was adjusted until the patient reported strong paresthesia. The visual numeric pain rating scale was used to assess pain intensity after each puncture. The active TENS group reported lower pain intensity compared to the placebo TENS (P TENS) was effective in reducing pain intensity during carboxytherapy in patients with cellulite in the gluteal region. © 2018 Wiley Periodicals, Inc.

Amplifying Each Patient's Voice: A Systematic Review of Multi-criteria Decision Analyses Involving Patients.

Science.gov (United States)

Marsh, Kevin; Caro, J Jaime; Hamed, Alaa; Zaiser, Erica

2017-04-01

Qualitative methods tend to be used to incorporate patient preferences into healthcare decision making. However, for patient preferences to be given adequate consideration by decision makers they need to be quantified. Multi-criteria decision analysis (MCDA) is one way to quantify and capture the patient voice. The objective of this review was to report on existing MCDAs involving patients to support the future use of MCDA to capture the patient voice. MEDLINE and EMBASE were searched in June 2014 for English-language papers with no date restriction. The following search terms were used: 'multi-criteria decision*', 'multiple criteria decision*', 'MCDA', 'benefit risk assessment*', 'risk benefit assessment*', 'multicriteri* decision*', 'MCDM', 'multi-criteri* decision*'. Abstracts were included if they reported the application of MCDA to assess healthcare interventions where patients were the source of weights. Abstracts were excluded if they did not apply MCDA, such as discussions of how MCDA could be used; or did not evaluate healthcare interventions, such as MCDAs to assess the level of health need in a locality. Data were extracted on weighting method, variation in patient and expert preferences, and discussion on different weighting techniques. The review identified ten English-language studies that reported an MCDA to assess healthcare interventions and involved patients as a source of weights. These studies reported 12 applications of MCDA. Different methods of preference elicitation were employed: direct weighting in workshops; discrete choice experiment surveys; and the analytical hierarchy process using both workshops and surveys. There was significant heterogeneity in patient responses and differences between patients, who put greater weight on disease characteristics and treatment convenience, and experts, who put more weight on efficacy. The studies highlighted cognitive challenges associated with some weighting methods, though patients' views on their