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

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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.

Parathyroid autotransplantation in forty-four patients with primary hyperparathyroidism: the role of thallium scanning

International Nuclear Information System (INIS)

McCall, A.R.; Calandra, D.; Lawrence, A.M.; Henkin, R.; Paloyan, E.

1986-01-01

Forty-four patients with primary hyperparathyroidism were followed for 18 to 126 months after subtotal or total parathyroidectomy and parathyroid autotransplantation. Indications for autotransplantation included the devascularization of parathyroid glands during concomitant thyroid lobectomy or total thyroidectomy and the excision of the only remaining parathyroid tissue in patients with persistent hyperparathyroidism after previous unsuccessful parathyroidectomies. Before implantation, all parathyroid tissue was histologically evaluated by frozen-section light microscopy with hematoxylin and eosin stain. Fifteen patients had histologically normal implants; to date none of these patients have developed recurrent hyperparathyroidism. Twenty-nine patients had either adenomatous or hyperplastic parathyroid tissue used for implants; two of these patients developed graft-dependent recurrent hyperparathyroidism 4 and 7 years later. In both patients the grafts were preoperatively localized by thallium scanning and their resection restored eucalcemia. One hundred thirty-one patients from 11 series in the current literature had a cumulative incidence of 17.5% for presumed graft-dependent recurrence and a 9.2% incidence of graft excision followed by eucalcemia. In comparison, in the present series the incidence of graft-dependent recurrent hyperparathyroidism in patients with either adenomatous or hyperplastic implants stands at 6.9%. In contrast, in 15 patients with normal parathyroid tissue implants, the incidence was zero

CRT-D Therapy in Patients with Decompensated NYHA Class-Four CHF

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Faisal Zaeem

2012-01-01

Full Text Available Background. ACC-HRS Guidelines for Cardiac Resynchronization Therapy ICD implantation (CRT-D do not include patients with advanced nonambulatory NYHA class-four CHF due to an expectation of limited survival. There is little data available from these large multicenter randomized studies to support or refute this claim. Purpose. We evaluated the outcomes of patients with advanced nonambulatory NYHA class-four CHF who received CRT-D devices as an attempt to improve the clinical status and promote hospital discharge. Methods. Sixteen (of our six hundred and seventy CRT-D patients were classified as advanced nonambulatory NYHA Class four inotrope/vasodilator/diuretic-dependent patients. These patients were analyzed retrospectively for weaning success to oral medications, hospital discharge, hemodynamic stability, and survival over eighteen months. Results. Thirteen of sixteen patients were discharged to home within two weeks of implantation. The survival to hospital discharge, as well as at six, twelve, and eighteen months was positive (ninety-four percent, seventy-five percent, sixty-nine percent, sixty-nine percent, resp.. The groups showed significant improvements in systolic blood pressure, renal function, left ventricular ejection fraction, and CHF class. Conclusion. CRT-D in advanced nonambulatory NYHA four patients proved feasible and beneficial. These findings suggest that the strategy merits further study.

Thirty Days without a Bite: Wernicke's Encephalopathy in a Patient with Paranoid Schizophrenia.

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Langlois, Mélanie; Doré, Marie-Claire; Laforce, Robert

2014-09-25

Wernicke's Encephalopathy (WE) is a preventable neurologic condition characterized by altered mental status, ophthalmoplegia, and ataxia. Although historically associated with alcoholism, a few authors have described WE in patients with non-alcohol related psychiatric disorders. We report herein the case of a 36-year-old young man with paranoid schizophrenia who was brought to hospital for confusion and difficulties with his vision. His roommate said he had gone about thirty days without eating '…because he was on a slimming cure'. History and physical examination suggested WE as a result of isolation and poor diet leading to nutritional deficiency. This was confirmed by brain magnetic resonance imaging showing classic thalamic, mammillary bodies and brainstem lesions. Of note, his cognitive profile was far more heterogeneous than what had classically been described in the literature and involved both cortical and subcortical pathology, generating memory but also significant executive deficits. Intravenous treatment with thiamine was given and our patient showed mild improvements in visual acuity and nystagmus. However, persistent cognitive and physical disabilities consistent with Korsakoff syndrome remained, and he now lives in a supervised home. This case illustrates the tragic consequences of nutritional deficiencies in a patient with paranoid schizophrenia. The threshold to suspect WE in schizophrenic patients should be lowered and in doubt prophylactic parenteral thiamine should be administered.

Function protection of the parotid gland after intensity modulated radiotherapy for thirty-six patients of nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Xiao Zemin; Liao Yuping; Jiang Wuzhong; Wu Tao

2008-01-01

Objective: To study the parotid gland function protection of intensity modulated radiotherapy (IMRT) for patients with nasopharyngeal carcinoma (NPC) Methods: Thirty-six NPC patients were divided into IMRT group (therapy group) and conventional fraction (CF) group (control group) by random balanced design. Each group had 18 patients. The planning gross tumor volume (pGTV) of nasopharyngeal was treated with a total dose of 72.0 in therapy group, with a total dose of 70.0 Gy in control group (with daily 2.0 Gy/fraction and 5 times/week). Before treatment and at 3, 6, and 9 months, 1 and 2 years after therapy, all patients performed parotid imaging and both uptake index (UI) and excretion index (EI) after acid stimulation were calculated. The dose-volume histogram (DVH) was used to analyse the dose of parotid. Results: The values of UI were 77.6% and 96.2% at the end of therapy and after tow years in therapy group and 56.8% and 7.0% in contrast group. The values of EI were 64.1% and 95.3% at the end of therapy and after tow years in therapy group and 19.4% and 0 in control group. The mean doses of normal side and the trouble side of parotid gland were 20.0 Gy and 31.0 Gy in therapy group and 61.0 Gy and 68.2 Gy in control group. Conclusions: IMRT can reduce radiation dose of parotid glands compared with CF distinctly and thus protect parotid function effectively. (authors)

A Delphi Method Analysis to Create an Emergency Medicine Educational Patient Satisfaction Survey

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Kory S. London

2015-12-01

Full Text Available Introduction: Feedback on patient satisfaction (PS as a means to monitor and improve performance in patient communication is lacking in residency training. A physician’s promotion, compensation and job satisfaction may be impacted by his individual PS scores, once he is in practice. Many communication and satisfaction surveys exist but none focus on the emergency department setting for educational purposes. The goal of this project was to create an emergency medicine-based educational PS survey with strong evidence for content validity. Methods: We used the Delphi Method (DM to obtain expert opinion via an iterative process of surveying. Questions were mined from four PS surveys as well as from group suggestion. The DM analysis determined the structure, content and appropriate use of the tool. The group used four-point Likert-type scales and Lynn’s criteria for content validity to determine relevant questions from the stated goals. Results: Twelve recruited experts participated in a series of seven surveys to achieve consensus. A 10-question, single-page survey with an additional page of qualitative questions and demographic questions was selected. Thirty one questions were judged to be relevant from an original 48-question list. Of these, the final 10 questions were chosen. Response rates for individual survey items was 99.5%. Conclusion: The DM produced a consensus survey with content validity evidence. Future work will be needed to obtain evidence for response process, internal structure and construct validity.

Determination of aluminum by four analytical methods

International Nuclear Information System (INIS)

Hanson, T.J.; Smetana, K.M.

1975-11-01

Four procedures have been developed for determining the aluminum concentration in basic matrices. Atomic Absorption Spectroscopy (AAS) was the routine method of analysis. Citrate was required to complex the aluminum and eliminate matrix effects. AAS was the least accurate of the four methods studied and was adversely affected by high aluminum concentrations. The Fluoride Electrode Method was the most accurate and precise of the four methods. A Gran's Plot determination was used to determine the end point and average standard recovery was 100% +- 2%. The Thermometric Titration Method was the fastest method for determining aluminum and could also determine hydroxide concentration at the same time. Standard recoveries were 100% +- 5%. The pH Electrode Method also measures aluminum and hydroxide content simultaneously, but is less accurate and more time consuming that the thermal titration. Samples were analyzed using all four methods and results were compared to determine the strengths and weaknesses of each. On the basis of these comparisons, conclusions were drawn concerning the application of each method to our laboratory needs

A randomized trial of endoscopic balloon dilation and endoscopic sphincterotomy for removal of bile duct stones in patients with a prior Billroth II gastrectomy

NARCIS (Netherlands)

Bergman, J. J.; van Berkel, A. M.; Bruno, M. J.; Fockens, P.; Rauws, E. A.; Tijssen, J. G.; Tytgat, G. N.; Huibregtse, K.

2001-01-01

BACKGROUND: A prior Billroth II gastrectomy renders endoscopic sphincterotomy (EST) more difficult in patients with bile duct stones. Endoscopic balloon dilation (EBD) is a relatively easy procedure that potentially reduces the risk of bleeding and perforation. METHODS: Thirty-four patients with

Usefulness of computerized method for lung nodule detection on digital chest radiographs using similar subtraction images from different patients

International Nuclear Information System (INIS)

Aoki, Takatoshi; Oda, Nobuhiro; Yamashita, Yoshiko; Yamamoto, Keiji; Korogi, Yukunori

2012-01-01

Purpose: The purpose of this study is to evaluate the usefulness of a novel computerized method to select automatically the similar chest radiograph for image subtraction in the patients who have no previous chest radiographs and to assist the radiologists’ interpretation by presenting the “similar subtraction image” from different patients. Materials and methods: Institutional review board approval was obtained, and the requirement for informed patient consent was waived. A large database of approximately 15,000 normal chest radiographs was used for searching similar images of different patients. One hundred images of candidates were selected according to two clinical parameters and similarity of the lung field in the target image. We used the correlation value of chest region in the 100 images for searching the most similar image. The similar subtraction images were obtained by subtracting the similar image selected from the target image. Thirty cases with lung nodules and 30 cases without lung nodules were used for an observer performance test. Four attending radiologists and four radiology residents participated in this observer performance test. Results: The AUC for all radiologists increased significantly from 0.925 to 0.974 with the CAD (P = .004). When the computer output images were available, the average AUC for the residents was more improved (0.960 vs. 0.890) than for the attending radiologists (0.987 vs. 0.960). Conclusion: The novel computerized method for lung nodule detection using similar subtraction images from different patients would be useful to detect lung nodules on digital chest radiographs, especially for less experienced readers.

The Effect of Four-Week Period of Aerobic Exercise with Cinnamon Consumption on Lipoprotein Indicates and Blood sugar in Diabetic Female Patients (Type 2

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M Dastani

2013-01-01

Full Text Available Introduction: Cinnamon as an herbal medicine has the ability to reduce blood glucose and lipoproteins in diabetic patients. Based on the positive effects of exercise on diabetic patients, the present study was conducted to investigate the effect of Four weeks Period aerobic exercise alongside using cinnamon on lipoprotein parameters and blood glucose in women with type 2 diabetes. Methods: Thirty diabetic women were voluntarily selected and were randomly divided into three groups: 1 aerobic exercise group; 2 aerobic exercise alongside using cinnamon; and 3 control group. Aerobic exercise took four weeks with 60 percent of maximum heart rate. Blood samples were collected at the beginning and end of the study. Results: Blood glucose, the fat percentage and HDL, and the ratio of LDL to HDL in the first group significantly decreased and in the second group increased (P<0.05. Also the first group showed a significant reduction in triglyceride. The only significant change observed in the control group was a significant increase in the level of LDL. Comparing the first and second group, it was observed that in the second group the level of total cholesterol decreased and the ratio of LDL to HDL increased (P<0.05. Conclusion: Using cinnamon alongside aerobic exercise is likely to be beneficial in regulating the concentration of blood glucose and lipids in diabetic patients.

Twenty-four-hour ambulatory blood pressure monitoring in very elderly patients

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Cappelleri, Claudia; Janoschka, Alin; Berli, Reto; Kohler, Sibylle; Braun-Dullaeus, Ruediger C.; Heuss, Ludwig T.; Wolfrum, Mathias

2017-01-01

Abstract Elevated blood pressure (BP) is frequently diagnosed in very elderly hospitalized patients. Accurate diagnosis of hypertension is challenging in the hospital environment, due to the “white coat effect,” and both overtreatment and undertreatment can adversely affect clinical outcome. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) has the potential to avoid the “white coat effect” and accurately guide the management of hypertension. However, effects of the hospital environment on ABPM are unknown in the very elderly. We set out to enroll 45 patients, age ≥70 years, with elevated conventional BP during hospitalization in this observational study. It was prespecified by protocol to assess initially the difference between 24-hour BP during hospital-admission and home follow-up. Subsequent analysis should investigate the change in anxiety (Hospital Anxiety and Depression Scale-A [HADS-A]) after discharge, the correlation with change in 24-hour BP after discharge, and the prevalence of orthostatic hypertension. Thirty-one patients were included in the final analysis (age 83.5 ± 4.4 years; 71% female). Twenty-four-hour BP decreased significantly after hospital discharge (systolic from 133.5 ± 15.6 to 126.2 ± 14.4 mm Hg [millimeter of mercury], P = .008; diastolic from 71.0 ± 9.0 to 68.3 ± 8.6 mm Hg, P = .046). Anxiety level (HADS-A) decreased significantly after discharge, from 7.5 (interquartile range [IQR]: 4.0–13.8) to 5.0 (IQR: 4.0–8.0, P = .012). The change in anxiety was a predictor of change in systolic BP after discharge (F[1,20] = 5.9, P = .025). Sixty-one percent of the patients had significant orthostatic hypotension during hospital stay. In conclusion, 24-hour BP in very elderly patients is lower in the home environment than during hospitalization. This phenomenon seems to be directly linked to a lower anxiety-level at home. Reassessing hypertension at home may decrease the

Validation of the FOUR Score (Spanish Version) in acute stroke: an interobserver variability study.

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Idrovo, Luis; Fuentes, Blanca; Medina, Josmarlin; Gabaldón, Laura; Ruiz-Ares, Gerardo; Abenza, María José; Aguilar-Amat, María José; Martínez-Sánchez, Patricia; Rodríguez, Luis; Cazorla, Rubén; Martínez, Marta; Tafur, Alfonso; Wijdicks, Eelco F M; Diez-Tejedor, Exuperio

2010-01-01

Methods to assess impaired consciousness in acute stroke typically include the Glasgow Coma Scale (GCS), but the verbal component has limitations in aphasic or intubated patients. The FOUR (Full Outline of UnResponsiveness) score, a new coma scale, evaluates 4 components: eye and motor responses, brainstem reflexes and respiration. We aimed to study the interobserver variability of the FOUR score in acute stroke patients. We prospectively enrolled consecutive patients with acute stroke admitted from February to July 2008 to the stroke unit of our Neurology Department. Patients were evaluated by neurology residents and nurses using the FOUR score and the GCS. For both scales, we obtained paired and total weighted kappa values (Kw) and intraclass correlation coefficients (ICC). NIH stroke scale was also recorded on admission. We obtained a total of 75 paired evaluations in 60 patients (41 cerebral infarctions, 15 cerebral hemorrhages and 4 transient ischemic attacks). Thirty-three (55%) patients were alert, 17 (28.3%) drowsy and 10 (16.7%) stuporous or comatose. The overall rater agreement was excellent in the FOUR score (Kw 0.93; 95% CI 0.89-0.97) with an ICC of 0.94 (95% CI 0.91-0.96) and in the GCS (Kw 0.96; 95% CI 0.94-0.98) with an ICC of 0.96 (95% CI 0.93-0.97). A good correlation was found between the FOUR score and the GCS (rho 0.83; p FOUR score and the NIH stroke scale (rho -0.78; p FOUR score is a reliable scale for evaluating the level of consciousness in acute stroke patients, showing a good correlation with the GCS and the NIH stroke scale. Copyright 2010 S. Karger AG, Basel.

An improved Four-Russians method and sparsified Four-Russians algorithm for RNA folding.

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Frid, Yelena; Gusfield, Dan

2016-01-01

The basic RNA secondary structure prediction problem or single sequence folding problem (SSF) was solved 35 years ago by a now well-known [Formula: see text]-time dynamic programming method. Recently three methodologies-Valiant, Four-Russians, and Sparsification-have been applied to speedup RNA secondary structure prediction. The sparsification method exploits two properties of the input: the number of subsequence Z with the endpoints belonging to the optimal folding set and the maximum number base-pairs L. These sparsity properties satisfy [Formula: see text] and [Formula: see text], and the method reduces the algorithmic running time to O(LZ). While the Four-Russians method utilizes tabling partial results. In this paper, we explore three different algorithmic speedups. We first expand the reformulate the single sequence folding Four-Russians [Formula: see text]-time algorithm, to utilize an on-demand lookup table. Second, we create a framework that combines the fastest Sparsification and new fastest on-demand Four-Russians methods. This combined method has worst-case running time of [Formula: see text], where [Formula: see text] and [Formula: see text]. Third we update the Four-Russians formulation to achieve an on-demand [Formula: see text]-time parallel algorithm. This then leads to an asymptotic speedup of [Formula: see text] where [Formula: see text] and [Formula: see text] the number of subsequence with the endpoint j belonging to the optimal folding set. The on-demand formulation not only removes all extraneous computation and allows us to incorporate more realistic scoring schemes, but leads us to take advantage of the sparsity properties. Through asymptotic analysis and empirical testing on the base-pair maximization variant and a more biologically informative scoring scheme, we show that this Sparse Four-Russians framework is able to achieve a speedup on every problem instance, that is asymptotically never worse, and empirically better than achieved by

Retrospective analysis of two hundred thirty-five pediatric mandibular fracture cases.

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Eskitascioglu, Teoman; Ozyazgan, Irfan; Coruh, Atilla; Gunay, Galip K; Yuksel, Esabil

2009-11-01

Maxillofacial fractures are encountered less commonly during childhood period due to anatomic, social, cultural, and environmental factors. Although the incidence of all maxillofacial fractures is 1% to 15% among pediatric and adolescent patients, this rate drops to less than 1% in children below 5 years age. Two hundred thirty-five cases (mandibular fracture were evaluated retrospectively. Patients records were examined in terms of age, gender, cause of fracture, fracture localization, number of fractures, fracture pattern, accompanying injuries, applied treatment methods, and complications. Mean age of cases was 9.2 years and 165 cases were male, 70 were female. Traffic accidents as the most common etiologic cause in all ages. Falls is the second most common cause which particularly affects children above age of 2 years. All cases had 333 fractures and the most common fracture localization was parasymphysis region (34%). The other most common fracture localizations were as follows: condyle (19%), corpus (13%), dentoalveolar region (12%), angulus (11%), symphysis region (9%), and ramus (2%). There was only a single fracture line in 145 cases, 40 cases had unilateral multiple and 50 cases had bilateral fracture lines. We applied symptomatic (conservative) treatment in 20 (8%) of our cases; fracture fixation with interdental wires or closed reduction methods were employed in 122 patients. Internal fixation with open reduction (OR) was performed on 51 (22%) patients. Both closed and OR techniques were carried out in 30 (13%) patients. Pediatric mandibular fractures, which are seen less frequently compared with those of adults, require a specific and different treatment. Although mostly less invasive methods are preferred, we believe that ORs should be considered when required.

Treatment strategy for trigeminal neuralgia: a thirty years experience.

Science.gov (United States)

Broggi, Giovanni; Ferroli, Paolo; Franzini, Angelo

2008-05-01

Trigeminal neuralgia is an invalidating disease when become drug-resistant. The only possible treatment is surgery with different modalities, percutaneous, open surgery or radiosurgery. The thirty years experience at the Fondazione Istituto Neurologico C. Besta, Milano, Italy suggests that these surgical strategies are successful in pain control in short and long term period in more than 90% of cases, with a low rate of side effects and high improvement of quality of life. The type of surgery should be tailored on the particular patient considering age, general physical condition, neuroradiological assessment in which MRI with dedicated sequences are mandatory, and also patient's attitude.

Mathematical omnibus thirty lectures on classic mathematics

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Fuchs, Dmitry; Fuchs, Dmitry

2007-01-01

The book consists of thirty lectures on diverse topics, covering much of the mathematical landscape rather than focusing on one area. The reader will learn numerous results that often belong to neither the standard undergraduate nor graduate curriculum and will discover connections between classical and contemporary ideas in algebra, combinatorics, geometry, and topology. The reader's effort will be rewarded in seeing the harmony of each subject. The common thread in the selected subjects is their illustration of the unity and beauty of mathematics. Most lectures contain exercises, and solutions or answers are given to selected exercises. A special feature of the book is an abundance of drawings (more than four hundred), artwork by an accomplished artist, and about a hundred portraits of mathematicians. Almost every lecture contains surprises for even the seasoned researcher.

Patient satisfaction and efficacy of vacuum-assisted excision biopsy of fibroadenomas

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Thurley, P. [Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham (United Kingdom)], E-mail: pthurley@doctors.org.uk; Evans, A.; Hamilton, L.; James, J.; Wilson, R. [Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham (United Kingdom)

2009-04-15

Aim: To establish the efficacy, complications, and patient satisfaction for vacuum-assisted biopsy (VAB) excision of fibroadenomas. Materials and methods: All patients referred for VAB of benign lesions from 11 December 2002 to 30 November 2006 were identified prospectively, and the following data were recorded: age, histology, lesion size, and completeness of excision. A questionnaire was sent at least a year after the procedure to assess pain, complications, residual palpable lesions, and cosmetic result. Results: One hundred and thirty-four patients were referred for VAB, 81 had fibroadenomas. Fifty-nine percent replied to the questionnaire. Fifty-four percent of patients reported no pain during the procedure, 8% rated their pain at {>=}3/10. Thirty-two percent had no pain the week after the procedure, 55% had pain {>=}3/10. Seventy-nine percent had no palpable mass at the site of the original lesion. Ninety-four percent would recommend the procedure to others and would prefer further VAB to surgery. Bruising was common, one patient required aspiration of a haematoma. Six percent developed infections, all resolved with antibiotic therapy. Eighty-five percent of patients were completely satisfied with the cosmetic result. Interval ultrasound was performed in 36 patients. A palpable mass was present in 11%, a non-palpable mass in 19%, and no mass in 70%. Conclusion: VAB excision is well-tolerated, safe, and popular with a high initial success rate for fibroadenomas. Bruising and pain are common the week after the procedure.

Patient satisfaction and efficacy of vacuum-assisted excision biopsy of fibroadenomas

International Nuclear Information System (INIS)

Thurley, P.; Evans, A.; Hamilton, L.; James, J.; Wilson, R.

2009-01-01

Aim: To establish the efficacy, complications, and patient satisfaction for vacuum-assisted biopsy (VAB) excision of fibroadenomas. Materials and methods: All patients referred for VAB of benign lesions from 11 December 2002 to 30 November 2006 were identified prospectively, and the following data were recorded: age, histology, lesion size, and completeness of excision. A questionnaire was sent at least a year after the procedure to assess pain, complications, residual palpable lesions, and cosmetic result. Results: One hundred and thirty-four patients were referred for VAB, 81 had fibroadenomas. Fifty-nine percent replied to the questionnaire. Fifty-four percent of patients reported no pain during the procedure, 8% rated their pain at ≥3/10. Thirty-two percent had no pain the week after the procedure, 55% had pain ≥3/10. Seventy-nine percent had no palpable mass at the site of the original lesion. Ninety-four percent would recommend the procedure to others and would prefer further VAB to surgery. Bruising was common, one patient required aspiration of a haematoma. Six percent developed infections, all resolved with antibiotic therapy. Eighty-five percent of patients were completely satisfied with the cosmetic result. Interval ultrasound was performed in 36 patients. A palpable mass was present in 11%, a non-palpable mass in 19%, and no mass in 70%. Conclusion: VAB excision is well-tolerated, safe, and popular with a high initial success rate for fibroadenomas. Bruising and pain are common the week after the procedure

Quantification of Artifact Reduction With Real-Time Cine Four-Dimensional Computed Tomography Acquisition Methods

International Nuclear Information System (INIS)

Langner, Ulrich W.; Keall, Paul J.

2010-01-01

Purpose: To quantify the magnitude and frequency of artifacts in simulated four-dimensional computed tomography (4D CT) images using three real-time acquisition methods- direction-dependent displacement acquisition, simultaneous displacement and phase acquisition, and simultaneous displacement and velocity acquisition- and to compare these methods with commonly used retrospective phase sorting. Methods and Materials: Image acquisition for the four 4D CT methods was simulated with different displacement and velocity tolerances for spheres with radii of 0.5 cm, 1.5 cm, and 2.5 cm, using 58 patient-measured tumors and respiratory motion traces. The magnitude and frequency of artifacts, CT doses, and acquisition times were computed for each method. Results: The mean artifact magnitude was 50% smaller for the three real-time methods than for retrospective phase sorting. The dose was ∼50% lower, but the acquisition time was 20% to 100% longer for the real-time methods than for retrospective phase sorting. Conclusions: Real-time acquisition methods can reduce the frequency and magnitude of artifacts in 4D CT images, as well as the imaging dose, but they increase the image acquisition time. The results suggest that direction-dependent displacement acquisition is the preferred real-time 4D CT acquisition method, because on average, the lowest dose is delivered to the patient and the acquisition time is the shortest for the resulting number and magnitude of artifacts.

Unusual Neuroimaging Presentation of Cerebral Venus Sinus Thrombosis in 40 Patients

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Gh. Bakhshandepour; H. Abdolhusseinpour; S. Shahbaygi; J. Jalal Shokouki

2008-01-01

Background/Objective: This study has been per-formed to investigate the unusual imaging presenta-tion of the cerebral venous sinus thrombosis."nPatients and Methods: The data was analyzed retro-spectively from all patients with evidences of dural vein thrombosis in MRI, referred to two medical im-aging centers in Tehran during four years period (2002 to 2006)."nResults: Thirty-three women and seven men (22 to 70 years old) with imaging findings of Dural vein thrombosis were relative...

Liposuction-assisted four pedicle-based breast reduction (LAFPBR): A new safer technique of breast reduction for elderly patients.

Science.gov (United States)

La Padula, Simone; Hersant, Barbara; Noel, Warren; Meningaud, Jean Paul

2018-05-01

As older people increasingly care for their body image and remain active longer, the demand for reduction mammaplasty is increasing in this population. Only a few studies of reduction mammaplasty have specifically focussed on the outcomes in elderly women. We developed a new breast reduction technique: the Liposuction-Assisted Four Pedicle-Based Breast Reduction (LAFPBR) that is especially indicated for elderly patients. The aim of this paper was to describe the LAFPBR technique and to determine whether it could be considered a safer option for elderly patients compared to the superomedial pedicle (SMP) technique. A retrospective study included sixty-two women aged 60 years and over who underwent bilateral breast reduction mammaplasty. Thirty-one patients underwent LAFPBR and 31 patients were operated using the SMP technique. Complications and patient satisfaction in both groups were analysed. Patient satisfaction was measured using a validated questionnaire: the client satisfaction questionnaire 8 (CSQ-8). The LAFPBR technique required less operating time, and avoided significant blood loss. Six minor complications were observed in SMP patients. No LAFPBR women developed a procedure-related complication. Patient satisfaction was high with a mean score of 29.65 in LAFPBR patients and 28.68 in SMP patients. The LAFPBR is an easy procedure that appears safer than SMP and results in a high satisfaction rate in elderly women. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Taylor-series method for four-nucleon wave functions

International Nuclear Information System (INIS)

Sandulescu, A.; Tarnoveanu, I.; Rizea, M.

1977-09-01

Taylor-series method for transforming the infinite or finite well two-nucleon wave functions from individual coordinates to relative and c.m. coordinates, by expanding the single particle shell model wave functions around c.m. of the system, is generalized to four-nucleon wave functions. Also the connections with the Talmi-Moshinsky method for two and four harmonic oscillator wave functions are deduced. For both methods Fortran IV programs for the expansion coefficients have been written and the equivalence of corresponding expressions numerically proved. (author)

Waardenburg syndrome in four Mexican patients.

Science.gov (United States)

Aguilar Caso, Sandra I; Ortiz Nieva, Gabriela

2009-01-01

Waardenburg syndrome is a hereditary auditory-pigmentary syndrome. The major features include pigmentary disturbances and congenital deafness. Clinical findings are extremely variable, not only at the authors' institution but also in the literature. The authors describe four patients who presented with various clinical features and different genetic pedigree penetration.

3-year results of transvaginal cystocele repair with transobturator four-arm mesh: A prospective study of 105 patients

OpenAIRE

Kdous, Moez; Zhioua, Fethi

2014-01-01

Objectives To evaluate the long-term efficacy and safety of transobturator four-arm mesh for treating cystoceles. Patients and methods In this prospective study, 105 patients had a cystocele corrected between January 2004 and December 2008. All patients had a symptomatic cystocele of stage ?2 according to the Baden?Walker halfway stratification. We used only the transobturator four-arm mesh kit (Surgimesh?, Aspide Medical, France). All surgical procedures were carried out by the same experien...

Patients' satisfaction with the Nuss procedure

International Nuclear Information System (INIS)

Ishimaru, Tetsuya; Iwanaka, Tadashi; Uchida, Hiroo; Kawashima, Hiroshi; Gotoh, Chikashi; Satoh, Kaori; Yoshida, Mariko; Kitano, Yoshihiro

2009-01-01

The purpose of this study is to investigate the satisfaction of patients who have already finished bar removal. Fifty-four patients with pectus excavatum underwent the Nuss procedure between July 2000 and December 2007 and the bar was removed in 41 of them at our hospital. A telephone questionnaire was administered to their parents or the patients (12 years old or older). The questions were as follows: self-assessment of the present thoracic form on a 5-point scale, whether it was good to have undergone the Nuss procedure (Y/N), whether the patient will recommend this procedure to another patient (Y/N). Thirty-nine patients responded to the questionnaire. Median age at the bar insertion was 83 months (range: 63-189 months). The bar was removed about 2 years after the initial operation. The median period after removal was 29 months ( range: 2-65 months). The mean point for the thoracic form was 4.2 (5 points: 20, 4 points: 11, 3 points: 5, 2 points: 3). Thirty-eight patients answered that they were satisfied with this procedure. Thirty-four patients answered that they would recommend this procedure to another patient. Eight patients reported that redepression occurred after bar removal. Six of them are under observation because their thoracic deformity is mild. Patients' satisfaction with the Nuss procedure was high. However, our study shows the possibility of post-removal recurrence. There seems to be a tendency for patients to assess their thoracic form more strictly than the doctors. (author)

The effect of modified trampoline training on balance, gait, and falls efficacy of stroke patients

OpenAIRE

Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

2015-01-01

[Purpose] This research was conducted to investigate the effects of modified trampoline training on the balance, gait, and falls efficacy of stroke patients. [Subjects] Twenty-four stroke patients participated in this study. The subjects were randomly allocated to one of two groups: the trampoline group (n=12) or the control group (n=12). [Methods] Both groups participated in conventional physical therapy for thirty minutes per day, three times a week for six weeks. The trampoline group also ...

COMPARISON OF FOUR METHODS TO DETECT ADVERSE EVENTS IN HOSPITAL

Directory of Open Access Journals (Sweden)

Inge Dhamanti

2015-09-01

Full Text Available AbstrakDeteksi terjadinya kejadian yang tidak diharapkan (KTD telah menjadi salah satu tantangan dalam keselamatan pasien oleh karena itu metode untuk mendeteksi terjadinya KTD sangatlah penting untuk meningkatkan keselamatan pasien. Tujuan dari artikel ini adalah untuk membandingkan kelebihan dan kekurangan dari beberapa metode untuk mendeteksi terjadinya KTD di rumah sakit, meliputi review rekam medis, pelaporan insiden secara mandiri, teknologi informasi, dan pelaporan oleh pasien. Studi ini merupakan kajian literatur untuk membandingkan dan menganalisa metode terbaik untuk mendeteksi KTD yang dapat diimplementasikan oleh rumah sakit. Semua dari empat metode telah terbukti mampu untuk mendeteksi terjadinya KTD di rumah sakit, tetapi masing-masing metode mempunyai kelebihan dan kekurangan yang perlu diatasi. Tidak ada satu metode terbaik yang akan memberikan hasil terbaik untuk mendeteksi KTD di rumah sakit. Sehingga untuk mendeteksi lebih banyak KTD yang seharusnya dapat dicegah, atau KTD yang telah terjadi, rumah sakit seharusnya mengkombinasikan lebih dari satu metode untuk mendeteksi, karena masing-masing metode mempunyai sensitivitas berbeda-beda.AbstractDetecting adverse events has become one of the challenges in patient safety thus methods to detect adverse events become critical for improving patient safety. The purpose of this paper is to compare the strengths and weaknesses of several methods of identifying adverse events in hospital, including medical records reviews, self-reported incidents, information technology, and patient self-reports. This study is a literature review to compared and analyzed to determine the best method implemented by the hospital. All of four methods have been proved in their ability in detecting adverse events in hospitals, but each method had strengths and limitations to be overcome. There is no ‘best’ single method that will give the best results for adverse events detection in hospital. Thus to

The Thirty-Meter Telescope

Indian Academy of Sciences (India)

2016-01-27

Jan 27, 2016 ... The Thirty-Meter Telescope international observatory will enable transformational observations over the full cosmic timeline all the way from the first luminous objects in the Universe to the planets and moons of our own solar system. To realize its full scientific potential, TMT will be equipped with a powerful ...

[Anesthetic management of four patients with Fournier syndrome].

Science.gov (United States)

Sato, Rui; Tomioka, Toshiya; Orii, Ryo; Yamada, Yoshitsugu

2008-03-01

We experienced anesthetic managements of four patients with Fournier syndrome. In the anesthetic management of the patients with Fournier syndrome the following three points should be kept in mind; (a) the necessity of careful preoperative examination, (b) the better anesthesia, and (c) the careful postoperative care.

Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation

Science.gov (United States)

Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna

2011-01-01

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (Porganisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296

Large scale organisational intervention to improve patient safety in four UK hospitals: mixed method evaluation.

Science.gov (United States)

Benning, Amirta; Ghaleb, Maisoon; Suokas, Anu; Dixon-Woods, Mary; Dawson, Jeremy; Barber, Nick; Franklin, Bryony Dean; Girling, Alan; Hemming, Karla; Carmalt, Martin; Rudge, Gavin; Naicker, Thirumalai; Nwulu, Ugochi; Choudhury, Sopna; Lilford, Richard

2011-02-03

To conduct an independent evaluation of the first phase of the Health Foundation's Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Mixed method evaluation involving five substudies, before and after design. NHS hospitals in the United Kingdom. Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. The SPI1 was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration--monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)--there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for "difference in difference" 2

Decision-making of older patients in context of the doctor-patient relationship: a typology ranging from "self-determined" to "doctor-trusting" patients.

Science.gov (United States)

Wrede-Sach, Jennifer; Voigt, Isabel; Diederichs-Egidi, Heike; Hummers-Pradier, Eva; Dierks, Marie-Luise; Junius-Walker, Ulrike

2013-01-01

Background. This qualitative study aims to gain insight into the perceptions and experiences of older patients with regard to sharing health care decisions with their general practitioners. Patients and Methods. Thirty-four general practice patients (≥70 years) were asked about their preferences and experiences concerning shared decision making with their doctors using qualitative semistructured interviews. All interviews were analysed according to principles of content analysis. The resulting categories were then arranged into a classification grid to develop a typology of preferences for participating in decision-making processes. Results. Older patients generally preferred to make decisions concerning everyday life rather than medical decisions, which they preferred to leave to their doctors. We characterised eight different patient types based on four interdependent positions (self-determination, adherence, information seeking, and trust). Experiences of a good doctor-patient relationship were associated with trust, reliance on the doctor for information and decision making, and adherence. Conclusion. Owing to the varied patient decision-making types, it is not easy for doctors to anticipate the desired level of patient involvement. However, the decision matter and the self-determination of patients provide good starting points in preparing the ground for shared decision making. A good relationship with the doctor facilitates satisfying decision-making experiences.

The Comparison of Four Different Methods of Perioperative Eye Protection under General Anesthesia in Prone Position

OpenAIRE

Özlem Kocatürk; Tolga Kocatürk; Nil Kaan; Volkan Dayanır

2012-01-01

Aim: The purpose of this study was to compare and assess the efficacy of hypoallergen adhesive tape, antibiotic ointment, artificial tear liquid gel and ocular lubricant pomade for perioperative protection of eyes under general anesthesia in prone position. Material and Method: One hundred and eighty four patients (368 eyes) undergoing general anesthesia for >90 min for spinal procedures were divided randomly into four groups. Hypoallergen adhesive tape, antibiotic ointment, artificial tea...

Tacrolimus-induced thrombotic microangiopathy in orthotopic liver transplant patients: case series of four patients.

Science.gov (United States)

Nwaba, A; MacQuillan, G; Adams, L A; Garas, G; Delriviere, L; Augustson, B; DeBoer, B; Moody, H; Jeffrey, G P

2013-03-01

Thrombotic microangiopathy (TMA) is a potentially fatal complication in solid organ and bone marrow transplant patients, with reported incidence of 0.5-3% and mortality of about 75%. To emphasise the importance of early diagnosis and prompt commencement of therapy results in improved clinical outcomes. A retrospective study of all patients who underwent orthotopic liver transplantation (OLTX) at the Western Australian Liver Transplantation Service from May 1994 to December 2010 was conducted to identify patients who developed tacrolimus-induced TMA. We identified four patients with tacrolimus-induced TMA post-OLTX, derived from a cohort of 104 patients treated with tacrolimus in our institution. The mean age at diagnosis was 40 years, and the mean time of onset was 63 ± 7.5 weeks after OLTX. The indications for OLTX in the four patients were fulminant hepatic failure in three (Wilson disease, paracetamol overdose and post-partum thrombotic thrombocytopenic purpura) and hepatitis C virus-related cirrhosis. All patients had tacrolimus post-OLTX. At diagnosis, tacrolimus was discontinued in all patients, and three of the four patients underwent plasma exchange and all patients improved clinically. Mean duration of follow up was 15 ± 7.5 months. There was no mortality 6 months post-TMA. Early diagnosis with immediate discontinuation or conversion of calcineurin inhibitors and plasma exchange should be offered to OLTX patients with TMA as it results in good outcomes. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

The comparison between two different methods of radiotherapy in palliation and survival of patients with esophageal cancer

Directory of Open Access Journals (Sweden)

Keshvary M

2001-10-01

Full Text Available Esophageal cancer is one of the most common malignancies in our country. Patients often seek medical advice in advanced and inoperable stages or with cervical esophageal cancer, in which operation is accompanied by sever morbidity. In this conditions many of them cannot tolerate chemo-radiation, or refuse it. Therefore radiotherapy is applied as a single modality in palliation of many patients with esophageal cancer. One of the palliative radio therapeutic methods is application of 5000 CGY in 20 fractions (Long Course; but considering the great number of our patients and limited capacity of radiotherapy centers, as well as emphasis of literature on palliation with 4000 CGY in 13 fractions (short course, we decided to compare these two methods (which are both used in our departments. In this retrospective analytic study, the files of 283 patients with esophageal cancer referred to cancer institute of Imam Khomeini Hospital from 1989-1999 were studied. Patients were between 27-97 years old (mean age=58.3 and most of them were male (53.7 percent. The mean length of lesion was 8.5 cm. The most common site of lesion was middle third at esophagus (48.1 percent and the most common pathology was squamous cell carcinoma (99.6 percent. Fifty-four percent of patients were hot tea drinkers habitually. From the mentioned variables, only length of lesion had significant relationship with overall survival (P=0.04. Thirty-eight of 283 patients were excluded from analytic study because of incomplete follow-up. The number of patients had been treated by long course (5000 CGY in 20 fractions was 137 and the remainder (108 patients by short course (4000 CGY in 13 fractions. No significant difference was seen statistically between these two groups in overall and dysphagia-free survival (Kaplan-Meyer test. Also total dosage of spinal cord is lower in the short course. Thus regarding to less required time in short course and comparable palliation and survival between

Thirty Years Later: Evolution of Treatment for Acute Left Main Coronary Artery Occlusion

Directory of Open Access Journals (Sweden)

Moshe Y. Flugelman

2016-01-01

Full Text Available Acute occlusion of left main coronary artery is a catastrophic event. We describe two patients with acute occlusion of the left main coronary artery treated thirty years apart. The first patient was treated in 1982 and survived the event without revascularization but developed severe heart failure. His survival was so unusual that it merited a case report at that time. The second patient was treated at the end of 2015. Early revascularization resulted in myocardial reperfusion and near normal left ventricular function. These patients exemplify the progress in therapeutic cardiology over the last 30 years.

Time to Surgery Is Associated with Thirty-Day and Ninety-Day Mortality After Proximal Femoral Fracture

DEFF Research Database (Denmark)

Nyholm, Anne Marie; Gromov, Kirill; Palm, Henrik

2015-01-01

than twenty-four hours (odds ratio, 1.23; p = 0.04). An education level of the surgeon below that of an attending surgeon increased the risk of thirty-day mortality (odds ratio, 1.28; p = 0.035) and ninety-day mortality (odds ratio, 1.26; p = 0.016). Increasing American Society of Anesthesiologists...

Anaphylactic reactions in anaesthetised patients - four cases of chlorhexidine allergy

DEFF Research Database (Denmark)

Garvey, L H; Roed-Petersen, J; Husum, B

2001-01-01

Chlorhexidine is widely used all over the world in many different preparations. In Denmark chlorhexidine is the standard skin disinfectant used before surgery or invasive procedures and it is widely used in the general population in mouthwash or for disinfection of minor scratches etc. The potent......Chlorhexidine is widely used all over the world in many different preparations. In Denmark chlorhexidine is the standard skin disinfectant used before surgery or invasive procedures and it is widely used in the general population in mouthwash or for disinfection of minor scratches etc....... The potential for developing allergy to chlorhexidine is thus great, especially in surgical patients. We have identified four patients with serious allergic reactions in connection with surgery and general anaesthesia, who on subsequent skin testing tested positive for chlorhexidine. Symptoms appeared 20-40 min...... into the operation and all four patients required treatment with adrenaline. All four patients had a history of minor symptoms like rashes or faints in connection with previous surgery/invasive procedures. Allergy to chlorhexidine may be more prevalent in surgical patients and cases may have been overlooked due...

Decision-Making of Older Patients in Context of the Doctor-Patient Relationship: A Typology Ranging from “Self-Determined” to “Doctor-Trusting” Patients

Science.gov (United States)

Voigt, Isabel; Diederichs-Egidi, Heike; Hummers-Pradier, Eva; Dierks, Marie-Luise; Junius-Walker, Ulrike

2013-01-01

Background. This qualitative study aims to gain insight into the perceptions and experiences of older patients with regard to sharing health care decisions with their general practitioners. Patients and Methods. Thirty-four general practice patients (≥70 years) were asked about their preferences and experiences concerning shared decision making with their doctors using qualitative semistructured interviews. All interviews were analysed according to principles of content analysis. The resulting categories were then arranged into a classification grid to develop a typology of preferences for participating in decision-making processes. Results. Older patients generally preferred to make decisions concerning everyday life rather than medical decisions, which they preferred to leave to their doctors. We characterised eight different patient types based on four interdependent positions (self-determination, adherence, information seeking, and trust). Experiences of a good doctor-patient relationship were associated with trust, reliance on the doctor for information and decision making, and adherence. Conclusion. Owing to the varied patient decision-making types, it is not easy for doctors to anticipate the desired level of patient involvement. However, the decision matter and the self-determination of patients provide good starting points in preparing the ground for shared decision making. A good relationship with the doctor facilitates satisfying decision-making experiences. PMID:23691317

Charactering lidar optical subsystem using four quadrants method

Science.gov (United States)

Tian, Xiaomin; Liu, Dong; Xu, Jiwei; Wang, Zhenzhu; Wang, Bangxin; Wu, Decheng; Zhong, Zhiqing; Xie, Chenbo; Wang, Yingjian

2018-02-01

Lidar is a kind of active optical remote sensing instruments , can be applied to sound atmosphere with a high spatial and temporal resolution. Many parameter of atmosphere can be get by using different inverse algorithm with lidar backscatter signal. The basic setup of a lidar consist of a transmitter and a receiver. To make sure the quality of lidar signal data, the lidar must be calibrated before being used to measure the atmospheric variables. It is really significant to character and analyze lidar optical subsystem because a well equiped lidar optical subsystem contributes to high quality lidar signal data. we pay close attention to telecover test to character and analyze lidar optical subsystem.The telecover test is called four quadrants method consisting in dividing the telescope aperture in four quarants. when a lidar is well configured with lidar optical subsystem, the normalized signal from four qudrants will agree with each other on some level. Testing our WARL-II lidar by four quadrants method ,we find the signals of the four basically consistent with each other both in near range and in far range. But in detail, the signals in near range have some slight distinctions resulting from overlap function, some signals distinctions are induced by atmospheric instability.

Prospective Study on Noninvasive Assessment of Intracranial Pressure in Traumatic Brain-Injured Patients: Comparison of Four Methods.

Science.gov (United States)

Cardim, Danilo; Robba, Chiara; Donnelly, Joseph; Bohdanowicz, Michal; Schmidt, Bernhard; Damian, Maxwell; Varsos, Georgios V; Liu, Xiuyun; Cabeleira, Manuel; Frigieri, Gustavo; Cabella, Brenno; Smielewski, Peter; Mascarenhas, Sergio; Czosnyka, Marek

2016-04-15

Elevation of intracranial pressure (ICP) may occur in many diseases, and therefore the ability to measure it noninvasively would be useful. Flow velocity signals from transcranial Doppler (TCD) have been used to estimate ICP; however, the relative accuracy of these methods is unclear. This study aimed to compare four previously described TCD-based methods with directly measured ICP in a prospective cohort of traumatic brain-injured patients. Noninvasive ICP (nICP) was obtained using the following methods: 1) a mathematical "black-box" model based on interaction between TCD and arterial blood pressure (nICP_BB); 2) based on diastolic flow velocity (nICP_FVd); 3) based on critical closing pressure (nICP_CrCP); and 4) based on TCD-derived pulsatility index (nICP_PI). In time domain, for recordings including spontaneous changes in ICP greater than 7 mm Hg, nICP_PI showed the best correlation with measured ICP (R = 0.61). Considering every TCD recording as an independent event, nICP_BB generally showed to be the best estimator of measured ICP (R = 0.39; p area under the curve [AUC] = 0.66; p AUC (0.70; p AUC = 0.64; p > 0.05). nICP_PI was not related to measured ICP using any of the above statistical indicators. We also introduced a new estimator (nICP_Av) based on the average of three methods (nICP_BB, nICP_FVd, and nICP_CrCP), which overall presented improved statistical indicators (R = 0.47; p AUC = 0.73; p < 0.05). nICP_PI appeared to reflect changes in ICP in time most accurately. nICP_BB was the best estimator for ICP "as a number." nICP_Av demonstrated to improve the accuracy of measured ICP estimation.

Long term follow-up in patients with four or more positive lymph nodes treated with conservative surgery and radiation therapy

Energy Technology Data Exchange (ETDEWEB)

Mehta, Kiran; Haffty, Bruce G

1995-07-01

Purpose: The purpose of this study was to review management strategies with respect to systemic therapy and radiation treatment techniques, and to assess patient outcome (local regional control, distant metastases and overall survival) in breast cancer patients undergoing conservative surgery and radiation therapy (CS+RT) who had four or more lymph nodes involved at the time of diagnosis. Methods and Materials: Of 1,040 patients undergoing CS+RT at our institution prior to 12/89, 579 patients underwent axillary lymph node dissection, 167 of whom had positive nodes. Fifty-one of these patients had four or more positive lymph nodes involved and serve as the patient population base for this study. The median age was 51 years (range 33-80), median number of nodes sampled was 16, and the median number of positive nodes was 7 (range 4-21). All patients received radiation therapy to the intact breast using tangential fields with electron beam boost to a total median dose of 6400 cGy. The majority of patients received regional nodal RT as follows: 40 patients received RT to the supraclav without axilla to a median dose of 4600 cGy, 10 patients received radiation to the supraclav and axilla to a median dose of 4600 cGy. Thirty-five of the 51 patients received a separate internal mammary port with a mixed beam of photons and electrons. One patient received radiation to the tangents alone without regional nodal irradiation. Adjuvant systemic therapy was employed in 49 of the 51 patients (96%) with 36 patients receiving chemotherapy (CTX) alone, six receiving tamoxifen alone and nine patients receiving both CTX and tamoxifen. Of 45 patients receiving CTX, 12 (27%) received RT prior to CTX, 22 (48%) received RT concurrently with CTX, 6 (14%) received RT sandwiched with CTX and 5 (11%) received RT following all systemic CTX (RT delay > 16 weeks). Results: As of 12/94, there have been 18 distant relapses, two nodal relapses and five breast relapses resulting in a 10-year distant

A four-probe thermal transport measurement method for nanostructures

Energy Technology Data Exchange (ETDEWEB)

Kim, Jaehyun; Ou, Eric; Sellan, Daniel P.; Shi, Li, E-mail: lishi@mail.utexas.edu [Department of Mechanical Engineering, The University of Texas at Austin, Austin, Texas 78712 (United States)

2015-04-15

Several experimental techniques reported in recent years have enabled the measurement of thermal transport properties of nanostructures. However, eliminating the contact thermal resistance error from the measurement results has remained a critical challenge. Here, we report a different four-probe measurement method that can separately obtain both the intrinsic thermal conductance and the contact thermal resistance of individual nanostructures. The measurement device consists of four microfabricated, suspended metal lines that act as resistive heaters and thermometers, across which the nanostructure sample is assembled. The method takes advantage of the variation in the heat flow along the suspended nanostructure and across its contacts to the four suspended heater and thermometer lines, and uses sixteen sets of temperature and heat flow measurements to obtain nine of the thermal resistances in the measurement device and the nanostructure sample, including the intrinsic thermal resistance and the two contact thermal resistances to the middle suspended segment of the nanostructure. Two single crystalline Si nanowires with different cross sections are measured in this work to demonstrate the effectiveness of the method. This four-probe thermal transport measurement method can lead to future discoveries of unique size-dependent thermal transport phenomena in nanostructures and low-dimensional materials, in addition to providing reliable experimental data for calibrating theoretical models.

A four-probe thermal transport measurement method for nanostructures

International Nuclear Information System (INIS)

Kim, Jaehyun; Ou, Eric; Sellan, Daniel P.; Shi, Li

2015-01-01

Several experimental techniques reported in recent years have enabled the measurement of thermal transport properties of nanostructures. However, eliminating the contact thermal resistance error from the measurement results has remained a critical challenge. Here, we report a different four-probe measurement method that can separately obtain both the intrinsic thermal conductance and the contact thermal resistance of individual nanostructures. The measurement device consists of four microfabricated, suspended metal lines that act as resistive heaters and thermometers, across which the nanostructure sample is assembled. The method takes advantage of the variation in the heat flow along the suspended nanostructure and across its contacts to the four suspended heater and thermometer lines, and uses sixteen sets of temperature and heat flow measurements to obtain nine of the thermal resistances in the measurement device and the nanostructure sample, including the intrinsic thermal resistance and the two contact thermal resistances to the middle suspended segment of the nanostructure. Two single crystalline Si nanowires with different cross sections are measured in this work to demonstrate the effectiveness of the method. This four-probe thermal transport measurement method can lead to future discoveries of unique size-dependent thermal transport phenomena in nanostructures and low-dimensional materials, in addition to providing reliable experimental data for calibrating theoretical models

A comparison of the quality assurance of four dosimetric tools for intensity modulated radiation therapy

International Nuclear Information System (INIS)

Son, Jaeman; Baek, Taesung; Lee, Boram; Shin, Dongho; Park, Sung Yong; Park, Jeonghoon; Lim, Young Kyung; Lee, Se Byeong; Kim, Jooyoung; Yoon, Myonggeun

2015-01-01

This study was designed to compare the quality assurance (QA) results of four dosimetric tools used for intensity modulated radiation therapy (IMRT) and to suggest universal criteria for the passing rate in QA, irrespective of the dosimetric tool used. Thirty fields of IMRT plans from five patients were selected, followed by irradiation onto radiochromic film, a diode array (Mapcheck), an ion chamber array (MatriXX) and an electronic portal imaging device (EPID) for patient-specific QA. The measured doses from the four dosimetric tools were compared with the dose calculated by the treatment planning system. The passing rates of the four dosimetric tools were calculated using the gamma index method, using as criteria a dose difference of 3% and a distance-to-agreement of 3 mm. The QA results based on Mapcheck, MatriXX and EPID showed good agreement, with average passing rates of 99.61%, 99.04% and 99.29%, respectively. However, the average passing rate based on film measurement was significantly lower, 95.88%. The average uncertainty (1 standard deviation) of passing rates for 6 intensity modulated fields was around 0.31 for film measurement, larger than those of the other three dosimetric tools. QA results and consistencies depend on the choice of dosimetric tool. Universal passing rates should depend on the normalization or inter-comparisons of dosimetric tools if more than one dosimetric tool is used for patient specific QA

A comparison of the quality assurance of four dosimetric tools for intensity modulated radiation therapy.

Science.gov (United States)

Son, Jaeman; Baek, Taesung; Lee, Boram; Shin, Dongho; Park, Sung Yong; Park, Jeonghoon; Lim, Young Kyung; Lee, Se Byeong; Kim, Jooyoung; Yoon, Myonggeun

2015-09-01

This study was designed to compare the quality assurance (QA) results of four dosimetric tools used for intensity modulated radiation therapy (IMRT) and to suggest universal criteria for the passing rate in QA, irrespective of the dosimetric tool used. Thirty fields of IMRT plans from five patients were selected, followed by irradiation onto radiochromic film, a diode array (Mapcheck), an ion chamber array (MatriXX) and an electronic portal imaging device (EPID) for patient-specific QA. The measured doses from the four dosimetric tools were compared with the dose calculated by the treatment planning system. The passing rates of the four dosimetric tools were calculated using the gamma index method, using as criteria a dose difference of 3% and a distance-to-agreement of 3 mm. The QA results based on Mapcheck, MatriXX and EPID showed good agreement, with average passing rates of 99.61%, 99.04% and 99.29%, respectively. However, the average passing rate based on film measurement was significantly lower, 95.88%. The average uncertainty (1 standard deviation) of passing rates for 6 intensity modulated fields was around 0.31 for film measurement, larger than those of the other three dosimetric tools. QA results and consistencies depend on the choice of dosimetric tool. Universal passing rates should depend on the normalization or inter-comparisons of dosimetric tools if more than one dosimetric tool is used for patient specific QA.

Effect of intra-hepatic arterial infusion chemotherapy for patients with liver metastasis from breast cancer

International Nuclear Information System (INIS)

Liu Dezhong; Li Huai; Zeng Huiying; Yang Ling

2001-01-01

Objective: To evaluate the efficacy of intra-hepatic arterial infusion chemotherapy for patients with liver metastasis from breast cancer. Methods: 1993-1998 years, Thirty four patients with liver metastasis from breast cancer had received epi-adriamycin, cisplatin, mitomycin and 5-fluorouracil by intrahepatic arterial infusion chemotherapy. Twelve patients had received embolization. Results: Six patients (17.65%) had a complete response, 12 patients (35.29%) had a partial response. The overall response rate was 52.94%. Cumulative survival rates at 1, 2, 3 and 4 years were 56.90%, 25.00%, 5.00% and 5.00% respectively (Kaplan-Meier method). The median overall survival time was 11.5 months. Conclusion: Intra-hepatic arterial infusion chemotherapy is safe and effective for liver metastasis from breast cancer and should be the first choice of treatment for these patients

Comparison of four DNA extraction methods for the detection of Mycobacterium leprae from Ziehl-Neelsen-stained microscopic slides.

Science.gov (United States)

Ruiz-Fuentes, Jenny Laura; Díaz, Alexis; Entenza, Anayma Elena; Frión, Yahima; Suárez, Odelaisy; Torres, Pedro; de Armas, Yaxsier; Acosta, Lucrecia

2015-12-01

The diagnosis of leprosy has been a challenge due to the low sensibility of the conventional methods and the impossibility of culturing the causative organism. In this study, four methods for Mycobacterium leprae nucleic-acid extraction from Ziehl-Neelsen-stained slides (ZNS slides) were compared: Phenol/chloroform, Chelex 100 resin, and two commercial kits (Wizard Genomic DNA Purification Kit and QIAamp DNA Mini Kit). DNA was extracted from four groups of slides: a high-codification-slide group (bacteriological index [BI]⩾4), a low-codification-slide group (BI=1), a negative-slide group (BI=0), and a negative-control-slide group (BI=0). Quality DNA was evidenced by the amplification of specific repetitive element present in M. leprae genomic DNA (RLEP) using a nested polymerase chain reaction. This is the first report comparing four different extraction methods for obtaining M. leprae DNA from ZNS slides in Cuban patients, and applied in molecular diagnosis. Good-quality DNA and positive amplification were detected in the high-codification-slide group with the four methods, while from the low-codification-slide group only the QIAGEN and phenol-chloroform methods obtained amplification of M. leprae. In the negative-slide group, only the QIAGEN method was able to obtain DNA with sufficient quality for positive amplification of the RLEP region. No amplification was observed in the negative-control-slide group by any method. Patients with ZNS negative slides can still transmit the infection, and molecular methods can help identify and treat them, interrupting the chain of transmission and preventing the onset of disabilities. The ZNS slides can be sent easily to reference laboratories for later molecular analysis that can be useful not only to improve the diagnosis, but also for the application of other molecular techniques. Copyright © 2015 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

Comparison of impact of four surgical methods on surgical outcomes in endoscopic dacryocystorhinostomy.

Science.gov (United States)

Roh, Hyun Cheol; Baek, Sehyun; Lee, Hwa; Chang, Minwook

2016-06-01

To evaluate differences in the surgical outcomes of endoscopic dacryocystorhinostomy (DCR) according to four different surgical methods. This retrospective study included 222 patients who underwent endoscopic DCR from 2011 to 2013. All patients were assigned to one of four groups according to instruments for incision of nasal mucosa and the formation of mucosal flap: group 1, a sickle knife with mucosal flap; group 2, a sickle knife without mucosal flap; group 3, electrocautery with mucosal flap; and group 4, electrocautery without mucosal flap. The follow up period was at least 6 months. There were 33 eyes in group 1, 44 eyes in group 2, 49 eyes in group 3, and 97 eyes in group 4. There were no significant differences in success rate between groups (P = 0.878). Wound healing time was significantly different between groups (P knife may be more helpful and effective for shortening wound healing time rather than making mucosal flaps in endoscopic DCR. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The Effects of VR-based Wii Fit Yoga on Physical Function in Middle-aged Female LBP Patients

OpenAIRE

Kim, Seong-Sik; Min, Won-Kyu; Kim, Jung-Hee; Lee, Byoung-Hee

2014-01-01

[Purpose] The purpose of this research was to determine the effects of a virtual reality-based yoga program on middle-aged female low back pain patients. [Subjects and Methods] Thirty middle-aged female patients who suffered from low back pain were assigned to either a physical therapy program or a virtual reality-based yoga program for a period of four weeks. Participants could check their posture and weight bearing on a monitor as they shifted their weight or changed their postures on a Wii...

Gastroscopic screening in 80 patients with pernicious anaemia.

OpenAIRE

Stockbrügger, R W; Menon, G G; Beilby, J O; Mason, R R; Cotton, P B

1983-01-01

We have studied 80 patients with pernicious anaemia. Upper gastrointestinal endoscopy (with biopsy and cytology) showed no lesion other than atrophic gastritis in 34 patients. Thirty three patients, however, had varying degrees of gastric mucosal dysplasia, which was detected more frequently by histology than by cytology. The endoscopic appearance of the mucosa was abnormal in four of the six patients with moderate dysplasia, and in all three patients with severe dysplasia. One patient was fo...

Improving a newly developed patient-reported outcome for thyroid patients, using cognitive interviewing

DEFF Research Database (Denmark)

Watt, Torquil; Rasmussen, Ase Krogh; Groenvold, Mogens

2008-01-01

Objective To improve a newly developed patient-reported outcome measure for thyroid patients using cognitive interviewing. Methods Thirty-one interviews using immediate retrospective and expansive probing were conducted among patients with non-toxic goiter (n = 4), nodular toxic goiter (n = 5) Gr...

Experience with polyclonal immunoglobulin therapy in poly trauma patients with severe sepsis

International Nuclear Information System (INIS)

Janjua, S.K.; Hussain, R.M.; Mohsin, S.T.; Iqbal, A.; Mishwani, A.H.

2011-01-01

To evaluate the effects of intravenous immunoglobulin therapy on progression of severe sepsis in patients of poly trauma. Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Peshawar from June 2008 to Dec 2009. Patients and Methods: Forty six patients of poly trauma with severe sepsis were included. Along with the standard management i.e., surgical management, fluid resuscitation, antibiotics, analgesics, ionotropic, ventilatory and nutritional support, IVIG 5% (intravenous immunoglobulin) was infused over a period of 6 hours and repeated for three consecutive days. Sequential Organ Failure Assessment (SOFA) score was used to assess the progress in all the patients. Results: At the time of enrolment mean SOFA score was 5.41+- 1.127 and on the 15 day it was 1.62 +- 2.24, mean age was 39.21+10.26 years. Thirty four patients (73.91%) developed gram negative sepsis and eighteen patients (39.13%) developed septic shock. Mean duration of stay in ICU and on ventilatory support was 20.80+9.61 and 10.52 + 5.52 days respectively. Thirty five days mortality rate of these patients was 30.43%. Conclusion: The IVIG administration, when used along with the standard management appears to improve significantly the prognosis in patients of poly trauma with severe sepsis. (author)

ePatients on YouTube: Analysis of Four Experiences From the Patients' Perspective

Science.gov (United States)

Gómez-Zúñiga, Beni; Pousada, Modesta; Hernández-Encuentra, Eulàlia; Armayones, Manuel

2012-01-01

Background Many patients share their personal experiences and opinions using online video platforms. These videos are watched by millions of health consumers and health care professionals. Although it has become a popular phenomenon, little is known about patients who share videos online and why they do so. Objective We aimed to explore the motivations and challenges faced by patients who share videos about their health and experiences on YouTube. As part of a conference discussion, we asked several patients actively engaged on YouTube to make a video explaining their motivations. This paper discusses these videos. Methods In this qualitative study, we performed an analysis of the videos created by 4 patients about their self-reported motivations and challenges they face as YouTube users. First, two judges compared the transcriptions and decided the exact wording when confusing content was found. Second, two judges categorized the content of the videos to identify the major themes. Results Four main categories emerged: (1) the origin or cause for making the first video, (2) the objectives that they achieve by continuing to make videos, (3) the perception of community, and (4) the negative consequences of the experience. Conclusions The main reason for making videos was to bridge the gap between traditional health information about their diseases and everyday life. The first consequence of sharing their life on YouTube was a loss of privacy. However, they also experienced the positive effects of expressing their feelings, being part of a large community of peers, and helping others to deal with a chronic condition. PMID:25075229

Effects of intensive arm training with the rehabilitation robot ARMin II in chronic stroke patients: four single-cases

Directory of Open Access Journals (Sweden)

Nef Tobias

2009-12-01

Full Text Available Abstract Background Robot-assisted therapy offers a promising approach to neurorehabilitation, particularly for severely to moderately impaired stroke patients. The objective of this study was to investigate the effects of intensive arm training on motor performance in four chronic stroke patients using the robot ARMin II. Methods ARMin II is an exoskeleton robot with six degrees of freedom (DOF moving shoulder, elbow and wrist joints. Four volunteers with chronic (≥ 12 months post-stroke left side hemi-paresis and different levels of motor severity were enrolled in the study. They received robot-assisted therapy over a period of eight weeks, three to four therapy sessions per week, each session of one hour. Patients 1 and 4 had four one-hour training sessions per week and patients 2 and 3 had three one-hour training sessions per week. Primary outcome variable was the Fugl-Meyer Score of the upper extremity Assessment (FMA, secondary outcomes were the Wolf Motor Function Test (WMFT, the Catherine Bergego Scale (CBS, the Maximal Voluntary Torques (MVTs and a questionnaire about ADL-tasks, progress, changes, motivation etc. Results Three out of four patients showed significant improvements (p Conclusion Data clearly indicate that intensive arm therapy with the robot ARMin II can significantly improve motor function of the paretic arm in some stroke patients, even those in a chronic state. The findings of the study provide a basis for a subsequent controlled randomized clinical trial.

The Comparison of Four Different Methods of Perioperative Eye Protection under General Anesthesia in Prone Position

Directory of Open Access Journals (Sweden)

Özlem Kocatürk

2012-04-01

Full Text Available Aim: The purpose of this study was to compare and assess the efficacy of hypoallergen adhesive tape, antibiotic ointment, artificial tear liquid gel and ocular lubricant pomade for perioperative protection of eyes under general anesthesia in prone position. Material and Method: One hundred and eighty four patients (368 eyes undergoing general anesthesia for >90 min for spinal procedures were divided randomly into four groups. Hypoallergen adhesive tape, antibiotic ointment, artificial tear liquid gel or ocular lubricant pomade was applied into the eyes. The patients underwent complete ophthalmic examination, including corrected visual acuity measurement, basal tear production, corneal and conjunctival staining both before and after surgery. Results: Basal tear production was reduced in all groups compared to preoperative values (P0.05. There was no difference between pre and postoperative visual acuity. Discussion: All of the methods are suitable for protecting corneal injuries. But none of them is good enough to avoid temporary symptoms in postoperative period. During general anesthesia eyes need protection either by tape, gel, ointment or pomade to reduce the incidence of corneal injuries.

Application of the four formula of software ECToolbox for the assessment of left ventricular ejection fraction in myocardial perfusion SPECT

International Nuclear Information System (INIS)

Xia Wei; Ni Jing; Zhuang Juhua; Hu Cuihua

2014-01-01

Objective: To compare the four formula of software programs ECToolbox for the assessment of left ventricular ejection fraction (LVEF) with equilibrium radionuclide ventriculography. And to calculate the normal cutoff values for the four formula. Methods: A total of 103 patients (59 men, 44 women) were recruited into the study. Thirty-eight patients had known CAD and sixty-five were referred with suspicion of CAD. All the patients underwent equilibrium radionuclide ventriculograph (ERNV) and ECG-gated myocardial perfusion SPECT (GMPS) as the standard protocol. LVEF values were separately calculated with formula R_0, R_1, R_2, R_3 of ECToolbox software, and the results were compared with LVEF values from ERNV. The normal cutoff values for the four formula were calculated by using normal cutoff values greater than or equal to 50% in ERNV as the classifying variable. Results: The mean LVEF on ERNV was 54.6% ± 17.5%. The mean LVEF values for formula R_0, R_1, R_2, R_3 were 64.1% ± 15.7%, 56.3% ± 15.1%, 69.9% ± 17.9%, 56.3% ± 13.6%, respectively. On correlation analysis, a very strong positive correlation was observed between LVEF values derived by ERNV and those derived by the four formula (all of r values were greater than 0.85, P O.05). Normal cutoff values for LVEF on R_0, R_1, R_2, R_3 were 56.5%, 51.5%, 64.5%, 52.5%, respectively, using a 50% or more cutoff value on ERNV. Conclusion: A strong correlation was observed among the four formula of ECToolbox software programs when compared with ERNV. However, there are subtle differences in the objective values of LVEF generated by individual calculation methods, which must be taken into account for clinical studies. (authors)

Radiology findings in adult patients with vocal fold paralysis

Energy Technology Data Exchange (ETDEWEB)

Robinson, S. [Helsinki Medical Imaging Centre, University of Helsinki, Haartmaninkatu, Helsinki (Finland)]. E-mail: s.robinson@dzu.at; Pitkaeranta, A. [Department of Otorhinolaryngology, Haartmaninkatu, Helsinki (Finland)

2006-10-15

Aim: To compile imaging findings in patients with vocal fold paralysis. Materials and methods: A retrospective analysis of the medical charts of 100 consecutive patients, admitted to our department with vocal fold paralysis was undertaken. After laryngoscopy, patients were referred for radiological work-up depending on their clinical history and clinical findings. Ultrasound of the neck and/or contrast-enhanced spiral computed tomography (CT) of the neck and mediastinum was performed, extending to include the whole chest if necessary. In one patient, CT of the brain and in two patients, magnetic resonance angiography was undertaken. Analysis of the clinical and radiological data was performed to assess the most frequent causes for vocal fold paralysis. Results: In 66% of patients, the paralysis was related to previous surgery. Thirty-four percent of cases were labelled idiopathic after clinical examination. After imaging and follow-up, only 8% remained unexplained. Nine patients suffered from neoplasms, four from vascular disease, and 12 from infections. One patient developed encephalomyelitis disseminata on follow-up. Conclusion: Thorough radiological work-up helps to reduce the amount of idiopathic cases of vocal fold paralysis and guides appropriate therapy.

Radiology findings in adult patients with vocal fold paralysis

International Nuclear Information System (INIS)

Robinson, S.; Pitkaeranta, A.

2006-01-01

Aim: To compile imaging findings in patients with vocal fold paralysis. Materials and methods: A retrospective analysis of the medical charts of 100 consecutive patients, admitted to our department with vocal fold paralysis was undertaken. After laryngoscopy, patients were referred for radiological work-up depending on their clinical history and clinical findings. Ultrasound of the neck and/or contrast-enhanced spiral computed tomography (CT) of the neck and mediastinum was performed, extending to include the whole chest if necessary. In one patient, CT of the brain and in two patients, magnetic resonance angiography was undertaken. Analysis of the clinical and radiological data was performed to assess the most frequent causes for vocal fold paralysis. Results: In 66% of patients, the paralysis was related to previous surgery. Thirty-four percent of cases were labelled idiopathic after clinical examination. After imaging and follow-up, only 8% remained unexplained. Nine patients suffered from neoplasms, four from vascular disease, and 12 from infections. One patient developed encephalomyelitis disseminata on follow-up. Conclusion: Thorough radiological work-up helps to reduce the amount of idiopathic cases of vocal fold paralysis and guides appropriate therapy

Preventing errors in administration of parenteral drugs: the results of a four-year national patient safety program.

NARCIS (Netherlands)

Blok, C. de; Schilp, J.; Wagner, C.

2013-01-01

Objectives: To evaluate the implementation of a four-year national patient safety program concerning the parenteral drug administration process in the Netherlands. Methods: Structuring the preparation and administration process of parenteral drugs reduces the number of medication errors. A

Comparison of four surgical methods for eyebrow reconstruction

Directory of Open Access Journals (Sweden)

Omranifard Mahmood

2007-01-01

Full Text Available Background: The eyebrow plays an important role in facial harmony and eye protection. Eyebrows can be injured by burn, trauma, tumour, tattooing and alopecia. Eyebrow reconstructions have been done via several techniques. Here, our experience with a fairly new method for eyebrow reconstruction is presented. Materials and Methods: This is a descriptive-analytical study which was done on 76 patients at the Al-Zahra and Imam Mousa Kazem hospitals at Isfahan University of Medical University, Isfahan, Iran, from 1994 to 2004. Totally 86 eyebrows were reconstructed. All patients were examined before and after the operation. Methods which are commonly applied in eyebrow reconstruction are as follows: 1. Superficial Temporal Artery Flap (Island, 2. Interpolitation Scalp Flap, 3. Graft. Our method which is named Forehead Facial Island Flap with inferior pedicle provides an easier approach for the surgeon and more ideal hair growth direction for the patient. Results: Significantly lower rates of complication along with greater patient satisfaction were obtained with Forehead Facial Island Flap. Conclusions: According to the acquired results, this method seems to be more technically practical and aesthetically favourable when compared to others.

Negating Four Color Theorem with Neutrosophy and Quadstage Method

Directory of Open Access Journals (Sweden)

Fu Yuhua

2015-03-01

Full Text Available With the help of Neutrosophy and Quad-stage Method, the proof for negation of “the four color theorem” is given. In which the key issue is to consider the color of the boundary, thus “the two color theorem” and “the five color theorem” are derived to replace "the four color theorem".

Intra-operative computer navigation guided cervical pedicle screw insertion in thirty-three complex cervical spine deformities

Directory of Open Access Journals (Sweden)

S Rajasekaran

2010-01-01

Full Text Available Background: Cervical pedicle screw fixation is challenging due to the small osseous morphometrics and the close proximity of neurovascular elements. Computer navigation has been reported to improve the accuracy of pedicle screw placement. There are very few studies assessing its efficacy in the presence of deformity. Also cervical pedicle screw insertion in children has not been described before. We evaluated the safety and accuracy of Iso-C 3D-navigated pedicle screws in the deformed cervical spine. Materials and Methods: Thirty-three patients including 15 children formed the study group. One hundred and forty-five cervical pedicle screws were inserted using Iso-C 3D-based computer navigation in patients undergoing cervical spine stabilization for craniovertebral junction anomalies, cervico-thoracic deformities and cervical instabilities due to trauma, post-surgery and degenerative disorders. The accuracy and containment of screw placement was assessed from postoperative computerized tomography scans. Results: One hundred and thirty (89.7% screws were well contained inside the pedicles. Nine (6.1% Type A and six (4.2% Type B pedicle breaches were observed. In 136 levels, the screws were inserted in the classical description of pedicle screw application and in nine deformed vertebra, the screws were inserted in a non-classical fashion, taking purchase of the best bone stock. None of them had a critical breach. No patient had any neurovascular complications. Conclusion: Iso-C navigation improves the safety and accuracy of pedicle screw insertion and is not only successful in achieving secure pedicle fixation but also in identifying the best available bone stock for three-column bone fixation in altered anatomy. The advantages conferred by cervical pedicle screws can be extended to the pediatric population also.

Contextual factors affecting autonomy for patients in Iranian hospitals: A qualitative study

Science.gov (United States)

Ebrahimi, Hossein; Sadeghian, Efat; Seyedfatemi, Naeimeh; Mohammadi, Eesa; Crowley, Maureen

2016-01-01

Background: Consideration of patient autonomy is an essential element in individualized, patient-centered, ethical care. Internal and external factors associated with patient autonomy are related to culture and it is not clear what they are in Iran. The aim of this study was to explore contextual factors affecting the autonomy of patients in Iranian hospitals. Materials and Methods: This was a qualitative study using conventional content analysis methods. Thirty-four participants (23 patients, 9 nurses, and 2 doctors) from three Iranian teaching hospitals, selected using purposive sampling, participated in semi-structured interviews. Unstructured observation and filed notes were other methods for data collection. The data were subjected to qualitative content analysis and analyzed using the MAXQDA-10 software. Results: Five categories and sixteen subcategories were identified. The five main categories related to patient autonomy were: Intrapersonal factors, physical health status, supportive family and friends, communication style, and organizational constraints. Conclusions: In summary, this study uncovered contextual factors that the care team, managers, and planners in the health field should target in order to improve patient autonomy in Iranian hospitals. PMID:27186203

The Effects of Exercise with TENS on Spasticity, Balance, and Gait in Patients with Chronic Stroke: A Randomized Controlled Trial

OpenAIRE

Park, Junhyuck; Seo, Dongkwon; Choi, Wonjae; Lee, Seungwon

2014-01-01

Background Transcutaneous electrical nerve stimulation (TENS) is a useful modality for pain control. TENS has recently been applied to decrease spasticity. The purpose of this study is to determine whether the addition of TENS to an exercise program reduces spasticity and improves balance and gait in chronic stroke patients. Material/Methods This was a single-blinded, multicenter, randomized controlled trial. Thirty-four ambulatory individuals with chronic stroke participated and were randoml...

Would you Find Thirty online? Website use in a Western Australian physical activity campaign.

Science.gov (United States)

Leavy, J E; Rosenberg, M; Barnes, R; Bauman, A; Bull, F C

2013-08-01

Mass media campaigns have used a range of traditional media (television, radio and print) to communicate health messages. In the past decade the Internet has added to these traditional methods with Web 2.0, smart phone technology and interactive media. 'Find Thirty every day(®)', a Western Australia population-wide mass media campaign delivered over 2 years, used a combination of traditional mass media, a website, online resources and banner advertising. The aim of the present study is to describe the use of the Find Thirty every day(®) website during the campaign media activities of May 2008-June 2010. Cross-sectional self-reported survey data were collected from a random sample of adults using a computer-assisted telephone interview over the period February-March 2010. Objective online analytical measures of unique visits to the Find Thirty every day(®) website were collected between June 2008 and June 2010. Monthly visitors to the Find Thirty every day(®) website increased from 3193 in 2009 to 4374 in 2010. During the last two media waves (October 2009 and February 2010), site visits were 5388 and 5272 per month, respectively. The impact of the Find Thirty every day(®) website was a positive outcome, considering the minimal online presence. SO WHAT? Health communication campaign planners should maximise the potential synergy of traditional mass media and new social media in future campaigns. Accordingly, a multidisciplinary approach that includes communication researchers, experts in information systems and a creative team experienced in online environments will need to be the way forward.

Electroclinical findings in four patients with karyotype 47,XYY.

Science.gov (United States)

Torniero, Claudia; Bernardina, Bernardo Dalla; Fontana, Elena; Darra, Francesca; Danesino, Cesare; Elia, Maurizio

2011-05-01

47,XYY karyotype is a Y chromosome aneuploidy characterized by an extra copy of the Y chromosome in each of the male cells, with an incidence of 1/1000 males. Most studies about 47,XYY have focused on growth, cognitive development, academic performance, behavioural problems, speech and language skills and neuromuscular status. Up-to-date reports on seizures and EEG characteristics concerning 47,XYY men have been sporadic and poorly detailed. The aim of this study is to describe the particular electroclinical patterns in a group of four subjects with 47,XYY karyotype. We performed neurological examinations, psychometric tests, brain MRIs, prolonged EEG recordings during awake and sleep on four unselected males 47,XYY. All four patients presented various degrees of neuropsychological impairment. An incidence of familial antecedents for epilepsy was confirmed by three families. When present, seizures were very similar to that of benign epilepsy with central-temporal spikes, (BECTS), for age of onset, clinical picture, evolution and good response to antiepileptic drugs. EEG recordings in all four subjects showed normal background activity and sleep organization, particular focal spikes and sharp-waves localized mostly over the vertex and/or central-temporal regions, which increased during sleep. In our opinion, these 47,XYY patients present a particular electroclinical pattern. Copyright © 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Four-port bimanual 23-gauge vitrectomy for diabetic tractional retinal detachment.

Science.gov (United States)

Wang, Zhao-Yang; Zhao, Ke-Ke; Li, Jia-Kai; Rossmiller, Brian; Zhao, Pei-Quan

2016-06-01

Four-port bimanual vitrectomy is a surgical technique that facilitates removal of epiretinal membranes in severe proliferative diabetic retinopathy (PDR). As the illumination is held by the assistant through the fourth scleral incision, fibrovascular membranes are removed by bimanual manipulation techniques. The objective of this study was to evaluate the safety and efficacy of four-port bimanual 23-gauge vitrectomy for patients with tractional retinal detachment (TRD) in severe PDR. Retrospective, comparative, consecutive, interventional case series. Sixty-six eyes of 58 consecutive patients who underwent primary vitrectomy for severe diabetic TRD. Thirty-six eyes of 31 cases that were treated with four-port 23-gauge vitrectomy were compared with 30 eyes of 27 cases that were treated with 23-gauge pars plana vitrectomy (PPV). Main outcome measures were best-corrected visual acuity (BCVA), retinal status, intraocular pressure, and incidence of intraoperative and postoperative complications with at least 6 months of follow-up. The primary and ultimate anatomic success rates (94.4% versus 93.3%, and 100% in both groups, respectively) and the mean BCVA changes did not differ significantly between groups. The whole surgical time and the membrane removal time were significantly (p four-port 23-gauge group than in the 23-gauge group. There was no difference in the incidence of intraoperative and postoperative complications in both groups. Four-port bimanual 23-gauge vitrectomy offers comparable anatomic success and shortens the surgical time compared with conventional 23-gauge PPV in patients with TRD resulting from severe PDR. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

What Faces Reveal: A Novel Method to Identify Patients at Risk of Deterioration Using Facial Expressions.

Science.gov (United States)

Madrigal-Garcia, Maria Isabel; Rodrigues, Marcos; Shenfield, Alex; Singer, Mervyn; Moreno-Cuesta, Jeronimo

2018-07-01

To identify facial expressions occurring in patients at risk of deterioration in hospital wards. Prospective observational feasibility study. General ward patients in a London Community Hospital, United Kingdom. Thirty-four patients at risk of clinical deterioration. A 5-minute video (25 frames/s; 7,500 images) was recorded, encrypted, and subsequently analyzed for action units by a trained facial action coding system psychologist blinded to outcome. Action units of the upper face, head position, eyes position, lips and jaw position, and lower face were analyzed in conjunction with clinical measures collected within the National Early Warning Score. The most frequently detected action units were action unit 43 (73%) for upper face, action unit 51 (11.7%) for head position, action unit 62 (5.8%) for eyes position, action unit 25 (44.1%) for lips and jaw, and action unit 15 (67.6%) for lower face. The presence of certain combined face displays was increased in patients requiring admission to intensive care, namely, action units 43 + 15 + 25 (face display 1, p facial expressions can be identified in deteriorating general ward patients. This tool may potentially augment risk prediction of current scoring systems.

Intensive Nutritional Counselling And Support And Clinical Outcomes In Hemodialysis Patients

OpenAIRE

Alessio Molfino; Alessandro Laviano; Maria Grazia Chiappini; Thomas Amman; Filippo Rossi Fanelli; Maurizio Muscaritoli

2012-01-01

Protein-energy wasting is frequently found in haemodialysis (HD) patients. Anorexia and hypophagia contribute to malnutrition, increased morbidity and mortality, but the clinical impact of correcting hypophagia remains uncertain. We evaluated whether correction of hypophagia influences morbidity and mortality in anorexic HD patients. Thirty-four HD patients were enrolled in a 2-year follow-up programme including regular nutritional assessment. Patients not meeting nutritional requirements dur...

[The Need of a New Integral Approach to the Care of Patient with Severe Mental Disorder Thirty Years after the Psychiatric Reform].

Science.gov (United States)

Madoz-Gúrpide, Agustín; Ballesteros Martín, Juan Carlos; Leira Sanmartín, Mónica; García Yagüe, Ernesto

2017-01-18

More than thirty years have passed since the beginning of the psychiatric reform, a period of intense and relevant social, scientific and cultural changes which have directly impacted on mental disorders and their management. Improvement in psychopharmacological treatment, a new model of physician-patient relationship, patient´s empowerment as a key issue and the fight against social stigma related to mental health disorders, changes in clinical governance and health policy, the assistential burden derived from the treatment of less severe pathology in mental health community centers, improvements in teamwork and coordination with other resources involved… are some of the relevant changes which determine the scene of community-based mental health assistance. We think this is a right time to check the state of the community-based care programmes for severe mental disorders, and the role of mental health center. We propose to have a reflexion about two relevant topics: where we are and where we are heading.

Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina

International Nuclear Information System (INIS)

Hacker, Marcus; Hack, Nicolas; Hahn, Klaus; Tiling, Reinhold; Jakobs, Tobias; Nikolaou, Konstantin; Becker, Christoph; Reiser, Maximilian; Ziegler, Franz von; Knez, Andreas; Koenig, Andreas; Klauss, Volker

2007-01-01

The aim of this study was to evaluate spiral multidetector computed tomography (MDCT) angiography using 64-slice technique in the detection of functionally relevant coronary artery stenoses (CAS). Thirty-eight patients (62±11 years, 28 men) with stable angina (26 with suspected and 12 with known coronary artery disease) were investigated using 64-slice MDCT angiography and gated myocardial perfusion SPECT (gated SPECT); a subgroup of 30 patients had additional invasive coronary angiography (ICA). Stenoses with luminal narrowing of ≥50% were defined as ''significant'' in MDCT angiography and ICA. MDCT angiography was compared with gated SPECT and the combination of gated SPECT plus ICA with respect to the detection of functionally relevant CAS. The sensitivity, specificity and negative and positive predictive values of MDCT angiography in detecting reversible perfusion defects on gated SPECT were 63%, 80%, 94% and 32%, respectively, in vessel-based analysis and 71%, 62%, 72% and 60%, respectively, in patient-based analysis. If only reversible perfusion defects on gated SPECT with CAS ≥50% on ICA were considered, the sensitivity, specificity and negative and positive predictive values were, respectively, 85%, 79%, 98% and 33% for vessel-based analysis and 85%, 59%, 83% and 61% for patient-based analysis. Sixty-four slice MDCT angiography failed to predict the functional relevance of CAS, but had a high negative predictive value in the exclusion of functionally relevant CAS in symptomatic patients. (orig.)

Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina

Energy Technology Data Exchange (ETDEWEB)

Hacker, Marcus; Hack, Nicolas; Hahn, Klaus; Tiling, Reinhold [Ludwig-Maximilians-University, Department of Nuclear Medicine, Munich (Germany); Jakobs, Tobias; Nikolaou, Konstantin; Becker, Christoph; Reiser, Maximilian [Ludwig-Maximilians-University, Department of Clinical Radiology, Munich (Germany); Ziegler, Franz von; Knez, Andreas [Ludwig-Maximilians-University, Department of Cardiology, Klinikum Grosshadern, Munich (Germany); Koenig, Andreas; Klauss, Volker [Ludwig-Maximilians-University, Department of Cardiology, Medizinische Poliklinik-Innenstadt, Munich (Germany)

2007-01-15

The aim of this study was to evaluate spiral multidetector computed tomography (MDCT) angiography using 64-slice technique in the detection of functionally relevant coronary artery stenoses (CAS). Thirty-eight patients (62{+-}11 years, 28 men) with stable angina (26 with suspected and 12 with known coronary artery disease) were investigated using 64-slice MDCT angiography and gated myocardial perfusion SPECT (gated SPECT); a subgroup of 30 patients had additional invasive coronary angiography (ICA). Stenoses with luminal narrowing of {>=}50% were defined as ''significant'' in MDCT angiography and ICA. MDCT angiography was compared with gated SPECT and the combination of gated SPECT plus ICA with respect to the detection of functionally relevant CAS. The sensitivity, specificity and negative and positive predictive values of MDCT angiography in detecting reversible perfusion defects on gated SPECT were 63%, 80%, 94% and 32%, respectively, in vessel-based analysis and 71%, 62%, 72% and 60%, respectively, in patient-based analysis. If only reversible perfusion defects on gated SPECT with CAS {>=}50% on ICA were considered, the sensitivity, specificity and negative and positive predictive values were, respectively, 85%, 79%, 98% and 33% for vessel-based analysis and 85%, 59%, 83% and 61% for patient-based analysis. Sixty-four slice MDCT angiography failed to predict the functional relevance of CAS, but had a high negative predictive value in the exclusion of functionally relevant CAS in symptomatic patients. (orig.)

The quadrant method measuring four points is as a reliable and accurate as the quadrant method in the evaluation after anatomical double-bundle ACL reconstruction.

Science.gov (United States)

Mochizuki, Yuta; Kaneko, Takao; Kawahara, Keisuke; Toyoda, Shinya; Kono, Norihiko; Hada, Masaru; Ikegami, Hiroyasu; Musha, Yoshiro

2017-11-20

The quadrant method was described by Bernard et al. and it has been widely used for postoperative evaluation of anterior cruciate ligament (ACL) reconstruction. The purpose of this research is to further develop the quadrant method measuring four points, which we named four-point quadrant method, and to compare with the quadrant method. Three-dimensional computed tomography (3D-CT) analyses were performed in 25 patients who underwent double-bundle ACL reconstruction using the outside-in technique. The four points in this study's quadrant method were defined as point1-highest, point2-deepest, point3-lowest, and point4-shallowest, in femoral tunnel position. Value of depth and height in each point was measured. Antero-medial (AM) tunnel is (depth1, height2) and postero-lateral (PL) tunnel is (depth3, height4) in this four-point quadrant method. The 3D-CT images were evaluated independently by 2 orthopaedic surgeons. A second measurement was performed by both observers after a 4-week interval. Intra- and inter-observer reliability was calculated by means of intra-class correlation coefficient (ICC). Also, the accuracy of the method was evaluated against the quadrant method. Intra-observer reliability was almost perfect for both AM and PL tunnel (ICC > 0.81). Inter-observer reliability of AM tunnel was substantial (ICC > 0.61) and that of PL tunnel was almost perfect (ICC > 0.81). The AM tunnel position was 0.13% deep, 0.58% high and PL tunnel position was 0.01% shallow, 0.13% low compared to quadrant method. The four-point quadrant method was found to have high intra- and inter-observer reliability and accuracy. This method can evaluate the tunnel position regardless of the shape and morphology of the bone tunnel aperture for use of comparison and can provide measurement that can be compared with various reconstruction methods. The four-point quadrant method of this study is considered to have clinical relevance in that it is a detailed and accurate tool for

Double-blind, placebo-controlled cross-over study of intravenous S-adenosyl-L-methionine in patients with fibromyalgia

DEFF Research Database (Denmark)

Volkmann, H; Nørregaard, J; Jacobsen, Søren

1997-01-01

The objective of this study was to test the efficacy of intravenously administered S-adenosyl-L-methionine (SAMe) in patients with fibromyalgia (FM). Thirty-four out-patients with fibromyalgia symptoms received SAMe 600 mg i.v. or placebo daily for 10 days in a cross-over trial. There was no sign......The objective of this study was to test the efficacy of intravenously administered S-adenosyl-L-methionine (SAMe) in patients with fibromyalgia (FM). Thirty-four out-patients with fibromyalgia symptoms received SAMe 600 mg i.v. or placebo daily for 10 days in a cross-over trial.......17) and slight improvement only on fatigue, quality of sleep, morning stiffness, and on the Fibromyalgia Impact Questionnaire for pain. No effect could be observed on isokinetic muscle strength, Zerrsen self-assessment questionnaire, and the face scale. No effect of SAMe in patients with FM was found...

Assessment of Seed Germination and Dormancy of Thirty Seeds Lots of

Directory of Open Access Journals (Sweden)

H.R Ehyaee

2012-06-01

Full Text Available Most seeds of medicinal plants due to ecological adaptation to environmental conditions have several types of dormancy. Hence, it's necessary to recognize ecological factors that affect dormancy and provide optimum conditions for germination in medicinal plant species. Thirty seed lots were used to estimate germination and dormancy of medicinal plants. Treatments were KNO3, (2% and scarification of seeds by sand paper, hypochlorite sodium and removing the seed coat with four replicates of 25 seeds. Maximum and minimum germination observed in H2O for Digitalis purpure 100% and Saponaria officinalis 0%. In KNO3 treatment, Portulaca oleracea had the highest germination of 91% and Hyocyamus niger had no any germinated seeds. In sand paper treatment, the Saponaria officinalis and Datura stramonium had maximum, 33% and minimum 0% germination respectively.

Comparison among four proposed direct blood culture microbial identification methods using MALDI-TOF MS.

Science.gov (United States)

Bazzi, Ali M; Rabaan, Ali A; El Edaily, Zeyad; John, Susan; Fawarah, Mahmoud M; Al-Tawfiq, Jaffar A

Matrix-assisted laser desorption-ionization time-of-flight (MALDI-TOF) mass spectrometry facilitates rapid and accurate identification of pathogens, which is critical for sepsis patients. In this study, we assessed the accuracy in identification of both Gram-negative and Gram-positive bacteria, except for Streptococcus viridans, using four rapid blood culture methods with Vitek MALDI-TOF-MS. We compared our proposed lysis centrifugation followed by washing and 30% acetic acid treatment method (method 2) with two other lysis centrifugation methods (washing and 30% formic acid treatment (method 1); 100% ethanol treatment (method 3)), and picking colonies from 90 to 180min subculture plates (method 4). Methods 1 and 2 identified all organisms down to species level with 100% accuracy, except for Streptococcus viridans, Streptococcus pyogenes, Enterobacter cloacae and Proteus vulgaris. The latter two were identified to genus level with 100% accuracy. Each method exhibited excellent accuracy and precision in terms of identification to genus level with certain limitations. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Comparison among four proposed direct blood culture microbial identification methods using MALDI-TOF MS

Directory of Open Access Journals (Sweden)

Ali M. Bazzi

2017-05-01

Full Text Available Summary: Matrix-assisted laser desorption-ionization time-of-flight (MALDI-TOF mass spectrometry facilitates rapid and accurate identification of pathogens, which is critical for sepsis patients.In this study, we assessed the accuracy in identification of both Gram-negative and Gram-positive bacteria, except for Streptococcus viridans, using four rapid blood culture methods with Vitek MALDI-TOF-MS. We compared our proposed lysis centrifugation followed by washing and 30% acetic acid treatment method (method 2 with two other lysis centrifugation methods (washing and 30% formic acid treatment (method 1; 100% ethanol treatment (method 3, and picking colonies from 90 to 180 min subculture plates (method 4. Methods 1 and 2 identified all organisms down to species level with 100% accuracy, except for Streptococcus viridans, Streptococcus pyogenes, Enterobacter cloacae and Proteus vulgaris. The latter two were identified to genus level with 100% accuracy. Each method exhibited excellent accuracy and precision in terms of identification to genus level with certain limitations. Keywords: MALDI-TOF, Gram-negative, Gram-positive, Sepsis, Blood culture

Methods to score vertebral deformities in patients with rheumatoid arthritis

NARCIS (Netherlands)

Lems, W. F.; Jahangier, Z. N.; Raymakers, J. A.; Jacobs, J. W.; Bijlsma, J. W.

1997-01-01

The objective was to compare four different scoring methods for vertebral deformities: the semiquantitative Kleerekoper score and three quantitative scores (according to Minne, Melton and Raymakers) in patients with rheumatoid arthritis (RA). Lateral radiographs of the thoracic and lumbar vertebral

Cognitive Function and Depression in Symptom Resolution in Schizophrenia Patients Treated with an Atypical Antipsychotic

Science.gov (United States)

Stip, Emmanuel; Mancini-Marie, Adham

2004-01-01

Objective: To investigate which cognitive and affective features contribute most to responder/non-responder group separation during a switching trial with atypical antipsychotic. Design: A prospective open trial with an atypical antipsychotic (olanzapine). Patients: One hundred and thirty-four patients meeting diagnostic criteria for…

Effects of Find Thirty every day(R): cross-sectional findings from a Western Australian population-wide mass media campaign, 2008-2010.

Science.gov (United States)

Leavy, Justine E; Rosenberg, Michael; Bauman, Adrian E; Bull, Fiona C; Giles-Corti, Billie; Shilton, Trevor; Maitland, Clover; Barnes, Rosanne

2013-08-01

Internationally, over the last four decades large-scale mass media campaigns have been delivered to promote physical activity and its associated health benefits. In 2002-2005, the first Western Australian statewide adult physical activity campaign Find Thirty. It's Not a Big Exercise was launched. In 2007, a new iteration of the campaign was proposed with new objectives, executions, and tag line Find Thirty every day(®). This article reports on the population-level effects of the Find Thirty every day (®) campaign from 2008 to 2010, with a focus on changes in awareness, intention, and physical activity. Evaluation of the campaign involved pre- and posttest serial cross-sectional surveys. Baseline data were collected in May 2008, and subsequent surveys in 2009 and 2010. Samples sizes were as follows: baseline (n = 972), first follow-up (n = 938), and second follow-up (n = 937). Data were derived from self-reported responses to a random-sample computer-assisted telephone interview. Total awareness increased from 30.4% at baseline to 48.5% at second follow-up. Total awareness was higher in women and low socioeconomic status adults. Intention was 21.0%, double that reported at baseline. There were positive significant changes from baseline to first follow-up across all four categories: walking, moderate, vigorous, and total physical activity. There also were positive significant changes for self-reported walking from baseline to second follow-up. Find Thirty every day (®) resulted in an increase in awareness, intention, walking, vigorous intensity, and total level of physical activity in priority target groups. Campaign effects should be further examined by subgroups to identify the most receptive population segments.

Calculating regional tissue volume for hyperthermic isolated limb perfusion: Four methods compared.

Science.gov (United States)

Cecchin, D; Negri, A; Frigo, A C; Bui, F; Zucchetta, P; Bodanza, V; Gregianin, M; Campana, L G; Rossi, C R; Rastrelli, M

2016-12-01

Hyperthermic isolated limb perfusion (HILP) can be performed as an alternative to amputation for soft tissue sarcomas and melanomas of the extremities. Melphalan and tumor necrosis factor-alpha are used at a dosage that depends on the volume of the limb. Regional tissue volume is traditionally measured for the purposes of HILP using water displacement volumetry (WDV). Although this technique is considered the gold standard, it is time-consuming and complicated to implement, especially in obese and elderly patients. The aim of the present study was to compare the different methods described in the literature for calculating regional tissue volume in the HILP setting, and to validate an open source software. We reviewed the charts of 22 patients (11 males and 11 females) who had non-disseminated melanoma with in-transit metastases or sarcoma of the lower limb. We calculated the volume of the limb using four different methods: WDV, tape measurements and segmentation of computed tomography images using Osirix and Oncentra Masterplan softwares. The overall comparison provided a concordance correlation coefficient (CCC) of 0.92 for the calculations of whole limb volume. In particular, when Osirix was compared with Oncentra (validated for volume measures and used in radiotherapy), the concordance was near-perfect for the calculation of the whole limb volume (CCC = 0.99). With methods based on CT the user can choose a reliable plane for segmentation purposes. CT-based methods also provides the opportunity to separate the whole limb volume into defined tissue volumes (cortical bone, fat and water). Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparison of four methods for determining aluminum in highly radioactive solutions

International Nuclear Information System (INIS)

Hanson, T.J.

1976-06-01

Four methods for the accurate determination of aluminum in highly alkaline nuclear waste solutions were developed and the results were compared to determine the strengths and weaknesses of each. The solutions of interest contain aluminum in concentrations of 0.5 to 3.5 M and the hydroxide (OH - ) concentrations were greater than 1.0 M. The normal atomic absorption determination was highly inaccurate for these samples so citrate was used as a complexant to improve the results. A fluoride titration was carried out in an ethanol-water matrix using a fluoride ion-selective electrode. A thermometric titration proved successful in determining both the OH - and aluminum concentrations of the samples. Finally, a titrimetric method using a pH electrode to determine OH - d aluminum was checked and compared with the other methods. Samples were analyzed using all four methods and the agreement of the results was very good. For all four methods the accuracy was around 100 percent and the precision varied from approximately +-2 percent for the fluoride electrode determination to approximately +-10 percent for the atomic absorption determination. On the basis of the work performed, conclusions were drawn about the strengths and weaknesses of each method and whether or not the method was suitable for routine use in analytical laboratories

Comparative Evaluations of Four Specification Methods for Real-Time Systems

Science.gov (United States)

1989-12-01

December 1989 Comparative Evaluations of Four Specification Methods for Real - Time Systems David P. Wood William G. Wood Specification and Design Methods...Methods for Real - Time Systems Abstract: A number of methods have been proposed in the last decade for the specification of system and software requirements...and software specification for real - time systems . Our process for the identification of methods that meet the above criteria is described in greater

Four novel ELANE mutations in patients with congenital neutropenia.

Science.gov (United States)

Kurnikova, Maria; Maschan, Michael; Dinova, Evgeniya; Shagina, Irina; Finogenova, Natalia; Mamedova, Elena; Polovtseva, Tatyana; Shagin, Dmitry; Shcherbina, Anna

2011-08-01

Congenital neutropenia is a heterogeneous bone marrow failure syndrome characterized by a maturation arrest of myelopoesis at the promyelocyte/myelocyte stage. Cyclic neutropenia (CyN) and severe congenital neutropenia (SCN) are two main forms of congenital neutropenia. Genetic analysis has shown that heterozygous mutations in the ELANE gene encoding the neutrophil elastase are the major cause of these disorders. We investigated the prevalence of ELANE mutations in a group of 16 patients from 14 families with congenital neutropenia. Five patients had typical manifestations of CyN, and 11 patients had SCN. Seven different heterozygous ELANE mutations were found, including four novel mutations. Copyright © 2011 Wiley-Liss, Inc.

A comparison of four patient immobilization devices in the treatment of prostate cancer patients with three dimensional conformal radiotherapy

International Nuclear Information System (INIS)

Song, Paul Y.; Washington, Maxine; Vaida, Florin; Hamilton, Russell; Spelbring, Danny; Wyman, Brenda; Harrison, Joanne; Chen, George T. Y.; Vijayakumar, Srinivasan

1996-01-01

Purpose: To determine the variability of patient positioning during three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer treated with no immobilization or one of four immobilization devices, and to determine the effects of patient body habitus and pelvic circumference on patient movement with each individual immobilization technique. Methods and Materials: To see whether our immobilization techniques have improved day-to-day patient movement, a retrospective analysis was carried out. A total of 62 patients treated at one facility on a single machine with 3D-CRT via a four-field box technique (anterior-posterior and opposed laterals) in the supine position with either no immobilization or one of four immobilization devices. Five groups of patients were compared: (a) group 1-no immobilization; (b) group 2-alpha cradle from the waist to upper thigh; (c) group 3-alpha cradle from waist to below the knees; (d) group 4-styrofoam leg immobilizer (below knees); and (e) group 5-aquaplast cast encompassing the entire abdomen and pelvis to midthigh with alpha cradle immobilization to their lower legs and feet. Prior to starting radiotherapy, portal films of all four treatment fields were obtained 1 day before treatment. Subsequently, portal films were then obtained at least once a week. Portal films were compared with the simulation films and appropriate changes were made and verified on the next day prior to treatment. A deviation of greater than 0.5 cm or greater was considered to be clinically significant in our analysis. We studied the difference among the types of immobilization and no immobilization by looking at the frequency of movements (overall, and on each of the three axes) that a patient had during the course of his treatment. Using a logistic regression model, the probability of overall and individual directional movement for each group was obtained. In addition, the effects of patient body habitus and pelvic circumference on movement were

Contextual factors affecting autonomy for patients in Iranian hospitals: A qualitative study.

Science.gov (United States)

Ebrahimi, Hossein; Sadeghian, Efat; Seyedfatemi, Naeimeh; Mohammadi, Eesa; Crowley, Maureen

2016-01-01

Consideration of patient autonomy is an essential element in individualized, patient-centered, ethical care. Internal and external factors associated with patient autonomy are related to culture and it is not clear what they are in Iran. The aim of this study was to explore contextual factors affecting the autonomy of patients in Iranian hospitals. This was a qualitative study using conventional content analysis methods. Thirty-four participants (23 patients, 9 nurses, and 2 doctors) from three Iranian teaching hospitals, selected using purposive sampling, participated in semi-structured interviews. Unstructured observation and filed notes were other methods for data collection. The data were subjected to qualitative content analysis and analyzed using the MAXQDA-10 software. Five categories and sixteen subcategories were identified. The five main categories related to patient autonomy were: Intrapersonal factors, physical health status, supportive family and friends, communication style, and organizational constraints. In summary, this study uncovered contextual factors that the care team, managers, and planners in the health field should target in order to improve patient autonomy in Iranian hospitals.

Prognostic value of FOUR and GCS scores in determining mortality in patients with traumatic brain injury.

Science.gov (United States)

Saika, Amrit; Bansal, Sonia; Philip, Mariamma; Devi, Bhagavatula Indira; Shukla, Dhaval P

2015-09-01

The Glasgow Coma Scale (GCS) is considered the gold standard for assessment of unconsciousness in patients with traumatic brain injury (TBI) against which other scales are compared. To overcome the disadvantages of GCS, the Full Outline Of Unresponsiveness (FOUR) score was proposed. We aimed to compare the predictability of FOUR score and GCS for early mortality, after moderate and severe TBI. This is a prospective observational study of patients with moderate and severe TBI. Both FOUR and GCS scores were determined at admission. The primary outcome was mortality at the end of 2 weeks of injury. A total of 138 (117 males) patients were included in the study. Out of these, 17 (12.3 %) patients died within 2 weeks of injury. The mean GCS and FOUR scores were 9.5 (range, 3-13) and 11 (0-16), respectively. The total GCS and FOUR scores were significantly lower in patients who did not survive. At a cut-off score of 7 for FOUR score, the AUC was 0.97, with sensitivity of 97.5 and specificity of 88.2 % (p FOUR scores. The predictive value of the FOUR score on admission of patients with TBI is no better than the GCS score.

Effects of "Find Thirty Every Day [R]": Cross-Sectional Findings from a Western Australian Population-Wide Mass Media Campaign, 2008-2010

Science.gov (United States)

Leavy, Justine E.; Rosenberg, Michael; Bauman, Adrian E.; Bull, Fiona C.; Giles-Corti, Billie; Shilton, Trevor; Maitland, Clover; Barnes, Rosanne

2013-01-01

Background: Internationally, over the last four decades large-scale mass media campaigns have been delivered to promote physical activity and its associated health benefits. In 2002-2005, the first Western Australian statewide adult physical activity campaign "Find Thirty. It's Not a Big Exercise" was launched. In 2007, a new iteration…

Thirty Years with EoS/G^E Models - What Have We Learned?

DEFF Research Database (Denmark)

Kontogeorgis, Georgios M.; Coutsikos, Philippos

2012-01-01

Thirty years of research and the use of EoS/GE mixing rules in cubic equations of state are reviewed. The most popular approaches are presented both from the derivation and application points of view and they are compared to each other. It is shown that all methods have significant capabilities b...

17. The Thirty Years War

OpenAIRE

Blamires, David

2013-01-01

Without any question the period of the Thirty Years War, from 1618 to 1648, was one of the most horrifying in the history of Germany. Not only were huge numbers of soldiers killed in battle in virtually every part of the Holy Roman Empire, but even greater numbers of the civilian population died in the conflict or through starvation or disease. Houses, churches, villages and towns were burnt and destroyed, and by the end of the war the population had been reduced from about sixteen millions t...

Prospective and Retrospective Studies of Substance Abuse Treatment Outcomes: Methods and Results of Four Large-Scale Follow-Up Studies.

Science.gov (United States)

Gerstein, Dean R.; Johnson, Robert A.

This report compares the research methods, provider and patient characteristics, and outcome results from four large-scale followup studies of drug treatment during the 1990s: (1) the California Drug and Alcohol Treatment Assessment (CALDATA); (2) Services Research Outcomes Study (SROS); (3) National Treatment Improvement Evaluation Study (NTIES);…

Evaluation of four methods for platelet compatibility testing

International Nuclear Information System (INIS)

McFarland, J.G.; Aster, R.H.

1987-01-01

Four platelet compatibility assays were performed on serum and platelet or lymphocyte samples from 38 closely HLA-matched donor/recipient pairs involved in 55 single-donor platelet transfusions. The 22 patients studied were refractory to transfusions of pooled random-donor platelets. Of the four assays (platelet suspension immunofluorescence, PSIFT; 51 Cr release; microlymphocytotoxicity; and a monoclonal anti-IgG assay, MAIA), the MAIA was most predictive of platelet transfusion outcome (predictability, 74% for one-hour posttransfusion platelet recovery and 76% for 24-hour recovery). The only other assay to reach statistical significance was the PSIFT (63% predictability for one-hour posttransfusion recovery). The degree of HLA compatibility between donor and recipient (exact matches v those utilizing cross-reactive associations) was unrelated to the ability of the MAIA to predict transfusion results. The MAIA may be capable of differentiating HLA antibodies, ABO antibodies, and platelet-specific antibodies responsible for failure of HLA-matched and selectively mismatched single-donor platelet transfusions

Predicting Likelihood of Having Four or More Positive Nodes in Patient With Sentinel Lymph Node-Positive Breast Cancer: A Nomogram Validation Study

International Nuclear Information System (INIS)

Unal, Bulent; Gur, Akif Serhat; Beriwal, Sushil; Tang Gong; Johnson, Ronald; Ahrendt, Gretchen; Bonaventura, Marguerite; Soran, Atilla

2009-01-01

Purpose: Katz suggested a nomogram for predicting having four or more positive nodes in sentinel lymph node (SLN)-positive breast cancer patients. The findings from this formula might influence adjuvant radiotherapy decisions. Our goal was to validate the accuracy of the Katz nomogram. Methods and Materials: We reviewed the records of 309 patients with breast cancer who had undergone completion axillary lymph node dissection. The factors associated with the likelihood of having four or more positive axillary nodes were evaluated in patients with one to three positive SLNs. The nomogram developed by Katz was applied to our data set. The area under the curve of the corresponding receiver operating characteristics curve was calculated for the nomogram. Results: Of the 309 patients, 80 (25.9%) had four or more positive axillary lymph nodes. On multivariate analysis, the number of positive SLNs (p < .0001), overall metastasis size (p = .019), primary tumor size (p = .0001), and extracapsular extension (p = .01) were significant factors predicting for four or more positive nodes. For patients with <5% probability, 90.3% had fewer than four positive nodes and 9.7% had four or more positive nodes. The negative predictive value was 91.7%, and sensitivity was 80%. The nomogram was accurate and discriminating (area under the curve, .801). Conclusion: The probability of four or more involved nodes is significantly greater in patients who have an increased number of positive SLNs, increased overall metastasis size, increased tumor size, and extracapsular extension. The Katz nomogram was validated in our patients. This nomogram will be helpful to clinicians making adjuvant treatment recommendations to their patients.

Simple methods of aligning four-circle diffractometers with crystal reflections

Energy Technology Data Exchange (ETDEWEB)

Mitsui, Y [Tokyo Univ. (Japan). Faculty of Pharmaceutical Sciences

1979-08-01

Simple methods of aligning four-circle diffractometers with crystal reflections are devised. They provide the methods to check (1) perpendicularity of chi plane to the incident beam, (2) zero point of 2theta and linearity of focus-chi center-receiving aperture and (3) zero point of chi.

Comparison of eight degree-days estimation methods in four agroecological regions in Colombia

Directory of Open Access Journals (Sweden)

Daniel Rodríguez Caicedo

2012-01-01

Full Text Available Eight methods were used to estimate degree-days in four Colombian localities. Four methods have been previously proposed in literature: Simple Sine, Double Sine, Simple Triangle, and Double Triangle methods. The other four methods are proposed in this research: Simple Logistic, Double Logistic, Simple Normal, and Double Normal. The estimation of the degree-days through hourly temperature values was used as the reference standard method, and the four localities from where the temperature values were taken were the municipalities of Cajicá (Cundinamarca, Santa Elena (Antioquia, Carepa (Urabá Antioqueño, and Ciudad Bolivar (Zona cafetera Antioqueña. Degree-days obtained by all methods under study were compared through linear regression to those obtained by the reference standard method. There were differences in the correlation of each method to the reference when compared within each region and among regions. The Simple Logistic and Double Logistic methods showed the best performance with acceptable R² values and considerably lower bias than the other methods. The poorest fit was found in Cajicá, where the average R² was 0.571. For the regions of Santa Elena and Carepa, the average R² was 0.756 and 0.733. The best fit was found in Ciudad Bolivar, with an average R² of 0.826.

Control for the Three-Phase Four-Wire Four-Leg APF Based on SVPWM and Average Current Method

Directory of Open Access Journals (Sweden)

Xiangshun Li

2015-01-01

Full Text Available A novel control method is proposed for the three-phase four-wire four-leg active power filter (APF to realize the accurate and real-time compensation of harmonic of power system, which combines space vector pulse width modulation (SVPWM with triangle modulation strategy. Firstly, the basic principle of the APF is briefly described. Then the harmonic and reactive currents are derived by the instantaneous reactive power theory. Finally simulation and experiment are built to verify the validity and effectiveness of the proposed method. The simulation results show that the response time for compensation is about 0.025 sec and the total harmonic distortion (THD of the source current of phase A is reduced from 33.38% before compensation to 3.05% with APF.

Ethical case deliberation on the ward. A comparison of four methods.

NARCIS (Netherlands)

Steinkamp, N.L.; Gordijn, B.

2003-01-01

The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the

Breast conservation in the setting of contemporary multimodality treatment provides excellent outcomes for patients with occult primary breast cancer.

Science.gov (United States)

Rueth, Natasha M; Black, Dalliah M; Limmer, Angela R; Gabriel, Emmanuel; Huo, Lei; Fornage, Bruno D; Dogan, Basak E; Chavez-MacGregor, Mariana; Yi, Min; Hunt, Kelly K; Strom, Eric A

2015-01-01

To evaluate recurrence and survival for patients with occult (T0N+) breast cancer who underwent contemporary treatment, assessing outcomes for breast conservation and mastectomy. We performed a single-institution review of women with occult breast cancer presenting with axillary metastasis without identifiable breast tumor or distant metastasis. We excluded patients with tumors in the axillary tail or mastectomy specimen, patients with additional nonbreast cancer diagnoses, and patients with a history of breast cancer. Breast conservation was defined as axillary node dissection with radiation therapy, without breast surgery. We evaluated patient, tumor, treatment, and outcome variables. Patients were assessed for local, regional, and distant recurrences. Overall survival was calculated using the Kaplan-Meier method. Thirty-six patients met criteria for occult breast cancer. Most of these patients (77.8 %) had N1 disease. Fifty percent of cancers (n = 18) were estrogen receptor-positive; 12 (33.3 %) were triple-negative. All patients were evaluated with mammography. Thirty-five patients had breast ultrasound (97.2 %) and 33 (91.7 %) had an MRI. Thirty-four patients (94.4 %) were treated with chemotherapy and 33 (91.7 %) with radiotherapy. Twenty-seven patients (75.0 %) were treated with breast conservation. The median follow-up was 64 months. There were no local or regional failures. One distant recurrence occurred >5 years after diagnosis, resulting in a 5-years overall survival rate of 100 %. There were no significant survival differences between patients receiving breast conservation versus mastectomy (p = 0.7). Breast conservation-performed with contemporary imaging and multimodality treatment-provides excellent local control and survival for women with T0N+ breast cancer and can be safely offered instead of mastectomy.

Padma-28, et urtepraeparat, øger gangdistancen hos patienter med claudicatio intermittens

DEFF Research Database (Denmark)

Drabaek, H; Mehlsen, J; Petersen, J R

1994-01-01

Thirty-six patients with stable intermittent claudication were randomized in a doubleblind study either to treatment with two tablets of Padma-28 twice daily (containing 340 mg dried herbal mixture composed according to an ancient lamaistic prescription) or placebo for four months. Effect...

Dynamic thiol/disulphide homeostasis in patients with basal cell carcinoma.

Science.gov (United States)

Demirseren, Duriye Deniz; Cicek, Cagla; Alisik, Murat; Demirseren, Mustafa Erol; Aktaş, Akın; Erel, Ozcan

2017-09-01

The aim of this study is to measure and compare the dynamic thiol/disulphide homeostasis of patients with basal cell carcinoma and healthy subjects with a newly developed and original method. Thirty four patients attending our outpatient clinic and clinically and histopathologically diagnosed as nodular basal cell carcinoma, and age and gender matched 30 healthy individuals have been involved in the study. Thiol/disulphide homeostasis tests have been measured with a novel automatic spectrophotometric method developed and the results have been compared statistically. Serum native thiol and disulphide levels in the patient and control group show a considerable variance statistically (p = 0.028, 0.039, respectively). Total thiol levels do not reveal a considerable variation (p = 0.094). Disulphide/native thiol ratios and native thiol/total thiol ratios also show a considerable variance statistically (p = 0.012, 0.013, 0.010, respectively). Thiol disulphide homeostasis in patients with basal cell carcinoma alters in the way that disulphide gets lower and thiols get higher. Thiol/disulphide level is likely to have a role in basal cell carcinoma pathogenesis.

Risk calculation for hyperkalaemia in heart failure patients.

NARCIS (Netherlands)

Vereijken, T.L.; Bellersen, L.; Groenewoud, J.M.M.; Knubben, L.; Baltussen, L.; Kramers, C.

2007-01-01

BACKGROUND: We aimed to develop a model to estimate the risk of hyperkalaemia in patients treated for heart failure in a tertiary reference hospital and to identify precipitating factors. METHODS: 125 congestive heart failure (CHF) patients were studied retrospectively. Thirty of these patients

Assessment of myocardial viability in patients with myocardial infarction using twenty-four hour thallium-201 late redistribution imaging

International Nuclear Information System (INIS)

Yang Xiangjun; He Yongming; Zhang Bin; Wu Yiwei; Hui Jie; Jiang Tingbo; Song Jianping; Liu Zhihua; Jiang Wenping

2006-01-01

Rest thallium-201 ( 201 Tl) myocardial perfusion imaging has been widely used for evaluation of myocardial ischemia/viability after myocardial infarction, but the ideal timing for imaging after injection to maximally estimate viability is not well established. Thirty-six patients with myocardial infarction underwent the initial, 3 h, and 24 h redistribution imaging after intravenous injection of 148-185 MBq 201 Tl. The initial and 3 h images, the initial and 24 h images, and the 3 and 24 h images were compared double-blinded. Out of the 184 abnormal segments based on the initial imaging, 56 (30%) segments improved by at least 1 grade on the 3 h imaging while 78 (42%) segments improved by at least 1 grade on the 24 h imaging. The 24 h late imaging detected more viable myocardium than the 3 h imaging did, with a significant difference (χ 2 =5.680, p=0.017). There were 158 abnormal segments on the 3 h imaging, with average 28% (44) segments improved by at least 1 grade on the 24 h imaging. There were 128 initial abnormal segments with no improvement on the 3 h imaging. Out of these segments, the 24 h late redistribution imaging detected additional redistribution in 26 segments, taking up 20%. Twenty-four hour late 201 Tl imaging will demonstrated additional redistribution in patients who have incompletely reversible defects on early redistribution imaging at 3 h. (author)

Experiences from Auditory Brainstem Implantation (ABIs) in four paediatric patients.

Science.gov (United States)

Lundin, Karin; Stillesjö, Fredrik; Nyberg, Gunnar; Rask-Andersen, Helge

2016-01-01

Indications for auditory brainstem implants (ABIs) have been widened from patients with neurofibromatosis type 2 (NF2) to paediatric patients with congenital cochlear malformations, cochlear nerve hypoplasia/aplasia, or cochlear ossification after meningitis. We present four ABI surgeries performed in children at Uppsala University Hospital in Sweden since 2009. Three children were implanted with implants from Cochlear Ltd. (Lane Cove, Australia) and one child with an implant from MedEl GMBH (Innsbruck, Austria). A boy with Goldenhar syndrome was implanted with a Cochlear Nucleus ABI24M at age 2 years (patient 1). Another boy with CHARGE syndrome was implanted with a Cochlear Nucleus ABI541 at age 2.5 years (patient 2). Another boy with post-ossification meningitis was implanted with a Cochlear Nucleus ABI24M at age 4 years (patient 3). A girl with cochlear aplasia was implanted with a MedEl Synchrony ABI at age 3 years (patient 4). In patients 1, 2, and 3, the trans-labyrinthine approach was used, and in patient 4 the retro-sigmoid approach was used. Three of the four children benefited from their ABIs and use it full time. Two of the full time users had categories of auditory performance (CAP) score of 4 at their last follow up visit (6 and 2.5 years postoperative) which means they can discriminate consistently any combination of two of Ling's sounds. One child has not been fully evaluated yet, but is a full time user and had CAP 2 (responds to speech sounds) after 3 months of ABI use. No severe side or unpleasant stimulation effects have been observed so far. There was one case of immediate electrode migration and one case of implant device failure after 6.5 years. ABI should be considered as an option in the rehabilitation of children with similar diagnoses.

Four quadrant transversus abdominis plane block and continuous transversus abdominis plane analgesia: a 3-year prospective audit in 124 patients.

Science.gov (United States)

Niraj, G; Kelkar, Aditi; Hart, Elaine; Kaushik, Vipul; Fleet, Danny; Jameson, John

2015-11-01

Transversus abdominis plane (TAP) blocks have been reported to be an effective method of providing analgesia after abdominal surgery. To perform a prospective audit on the effectiveness of a novel technique of providing continuous transversus abdominis plane (TAP) analgesia in patients undergoing emergency and elective abdominal surgery. Prospective single center audit over a 3-year period. University hospital. One hundred twenty-four American Society of Anesthesiologists I to IV adult patients presenting for elective as well as emergency abdominal surgery in whom epidural analgesia was contraindicated or refused. Four quadrant TAP blocks and continuous TAP analgesia. Numerical rating scale pain scores at rest and on coughing, nausea scores, satisfaction scores, complications, frequency of analgesia failure, therapeutic failure with continuous TAP analgesia and opioid consumption. One hundred twenty-four patients who received continuous TAP analgesia were audited. This included 34 patients for elective open surgery, 36 patients for emergency laparotomy, and 54 patients who underwent elective laparoscopic colorectal surgery. Surgical incision was within the dermatomal limit of the block in 70% of the patients (88/124). Therapeutic failure with the technique was 10%. Frequency of analgesic failure over the 48-hour period was none in 39% and below 5 episodes in 57%. Four quadrant transversus abdominis plane blocks and continuous TAP analgesia is an effective technique for providing postoperative analgesia after abdominal surgery. It has the potential to be used as a sole analgesic technique when the surgical incision is within its dermatomal limit. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of Relative Resistance in Thirty Dwarf Mahaleb Genotypes to Four Phytophthora Species in the Greenhouse and Garden

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mohammad hajian

2018-01-01

Full Text Available Introduction: The best cherry rootstock for Iranian nurseries and orchards is Prunus mahaleb (L. Mill. Mahaleb is tolerant to lime-induced iron chlorosis and zinc deficiency. It is a good rootstock on light, calcareous soils and arid climates in Iran but sensitive to Phytophthora. Iran represents a significant source of germplasm of different fruit species, especially for those from the genus Prunus. Collection and research on P.mahaleb was initiated at the Horticultural Department of Khorasan Razavi Agriculture and Natural Resources Research and Education Center in 1997 for mahaleb cherry rootstock. Some researchers have reported pathogenicity of Phytophthora species (Banihashemi and Sartipi, 2004; Wilcox and Mircetich, 1985; Exadaktylou and Thomidis, 2005; Tomidis et al., 2008. This study was conducted to evaluate the susceptibility of 30 selected dwarf Mahaleb genotypes to P.nicotianae, P.citricola, P.cactorum and P. citrophthora under greenhouse and orchard conditions. Material and methods: In this study, the response of 30 selected dwarf Mahaleb genotypes (188, 171, 165, 162, 161, 155, 139, 136, 131, 120, 106, 104, 101, 100, 90, 194, 195, 199, 200, 224, 228, 247 , 249, 265, 266, 267, 268, 270, 272, 277 to disease caused by four species of the fungus Phytophthora root and crown rot were investigated under greenhouse and orchard conditions. Greenhouse experiments were performed based on Ribeiro and Baumer, 1977 and modified it by Feichtenberger et al., 1984. For evaluation the index disease was performed based on the method of Broadbent and Gollnow 1992. Orchard terials was laid out in the Toragh research station in Mashhad. Evaluation of genotypes and contamination based on Tomidis, 2001 was performed by measuring the area of necrosis. Results and discussion: In evaluating the reaction of young seedling dwarf mahaleb genotypes to four Phytophthora species under greenhouse conditions, results showed that four species of Phytophthora pathogens

Extension of the analytic nodal method to four energy groups

International Nuclear Information System (INIS)

Parsons, D.K.; Nigg, D.W.

1985-01-01

The Analytic Nodal Method is one of several recently-developed coarse mesh numerical methods for efficiently and accurately solving the multidimensional static and transient neutron diffusion equations. This summary describes a mathematically rigorous extension of the Analytic Nodal Method to the frequently more physically realistic four-group case. A few general theoretical considerations are discussed, followed by some calculated results for a typical steady-state two-dimensional PWR quarter core application. 8 refs

Estimated Glomerular Filtration Rate Correlates Poorly with Four-Hour Creatinine Clearance in Critically Ill Patients with Acute Kidney Injury

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Christopher J. Kirwan

2013-01-01

Full Text Available Introduction. RIFLE and AKIN provide a standardised classification of acute kidney injury (AKI, but their categorical rather than continuous nature restricts their use to a research tool. A more accurate real-time description of renal function in AKI is needed, and some published data suggest that equations based on serum creatinine that estimate glomerular filtration rate (eGFR can provide this. In addition, incorporating serum cystatin C concentration into estimates of GFR may improve their accuracy, but no eGFR equations are validated in critically ill patients with AKI. Aim. This study tests whether creatinine or cystatin-C-based eGFR equations, used in patients with CKD, offer an accurate representation of 4-hour creatinine clearance (4CrCl in critically ill patients with AKI. Methods. Fifty-one critically ill patients with AKI were recruited. Thirty-seven met inclusion criteria, and the performance of eGFR equations was compared to 4CrCl. Results. eGFR equations were better than creatinine alone at predicting 4CrCl. Adding cystatin C to estimates did not improve the bias or add accuracy. The MDRD 7 eGFR had the best combination of correlation, bias, percentage error and accuracy. None were near acceptable standards quoted in patients with chronic kidney disease (CKD. Conclusions. eGFR equations are not sufficiently accurate for use in critically ill patients with AKI. Incorporating serum cystatin C does not improve estimates. eGFR should not be used to describe renal function in patients with AKI. Standards of accuracy for validating eGFR need to be set.

The effects of posterior talar glide with dorsiflexion of the ankle on mobility, muscle strength and balance in stroke patients: a randomised controlled trial

OpenAIRE

Lee, Jin; Kim, Ju-O; Lee, Byoung-Hee

2017-01-01

[Purpose] The purpose of this study was to examine the effectiveness of posterior talar glide (PTG) with dorsiflexion of the ankle on stroke patients ankle mobility, muscle strength, and balance ability. [Subjects and Methods] Thirty-four subjects were randomly assigned to either a PTG with dorsiflexion group (PTG; n=17), or a weight-bearing with placebo PTG group (control; n=17). Subjects in the PTG group performed PTG with dorsiflexion, designed to improve ankle mobility, muscle strength an...

Development of thirty-four novel polymorphic microsatellite markers ...

Indian Academy of Sciences (India)

This work was supported by the Special Research Fund for national nonprofit institutes (East ... by Pierre Louis Juoy at Shanghai and Hong Kong, China. Proc. U. S. Nat. Mus. ... bionts in 'stress-tolerant' clade D Symbiodinium. Mol. Ecol. Res.

Primary radiotherapy in progressive optic nerve sheath meningiomas: a long-term follow-up study

NARCIS (Netherlands)

Saeed, P.; Blank, L.; Selva, D.; Wolbers, J.G.; Nowak, P.J.C.M.; Geskus, R.B.; Weis, E.; Mourits, M.P.; Rootman, J.

2010-01-01

Background/aims To report the outcome of primary radiotherapy in patients with progressive optic nerve sheath meningioma (ONSM). Methods The clinical records of all patients were reviewed in a retrospective, observational, multicentre study. Results Thirty-four consecutive patients were included.

Photodynamic Therapy in Patients with Advanced Hilar Cholangiocarcinoma: Percutaneous Cholangioscopic Versus Peroral Transpapillary Approach.

Science.gov (United States)

Lee, Tae Yoon; Cheon, Young Koog; Shim, Chan Sup

2016-04-01

This study aimed to compare the clinical outcomes of patients with advanced hilar cholangiocarcinoma (CC) who underwent photodynamic therapy (PDT) with either percutaneous transhepatic cholangioscopy (PTCS) or endoscopic retrograde cholangiopancreatography (ERCP). PDT has been proposed as a promising therapy for treatment of unresectable hilar CC that is resistant to conventional standard treatment. However, few studies have compared the delivery methods of PDT in unresectable hilar CC patients. Thirty-seven adult patients with advanced hilar CC were included in this study. Twenty-four patients treated with PTCS-directed PDT and 13 patients treated with ERCP-directed PDT were analyzed retrospectively. The PTCS- and ERCP-directed PDT groups were comparable with respect to age, gender, health status, pretreatment bilirubin levels, Bismuth type, and hilar CC stage. The length of hospital stay differed significantly (p hilar CC. Lower pre-PDT bilirubin levels were associated with longer survival in all patients.

Comparison of Four Human Papillomavirus Genotyping Methods: Next-generation Sequencing, INNO-LiPA, Electrochemical DNA Chip, and Nested-PCR.

Science.gov (United States)

Nilyanimit, Pornjarim; Chansaenroj, Jira; Poomipak, Witthaya; Praianantathavorn, Kesmanee; Payungporn, Sunchai; Poovorawan, Yong

2018-03-01

Human papillomavirus (HPV) infection causes cervical cancer, thus necessitating early detection by screening. Rapid and accurate HPV genotyping is crucial both for the assessment of patients with HPV infection and for surveillance studies. Fifty-eight cervicovaginal samples were tested for HPV genotypes using four methods in parallel: nested-PCR followed by conventional sequencing, INNO-LiPA, electrochemical DNA chip, and next-generation sequencing (NGS). Seven HPV genotypes (16, 18, 31, 33, 45, 56, and 58) were identified by all four methods. Nineteen HPV genotypes were detected by NGS, but not by nested-PCR, INNO-LiPA, or electrochemical DNA chip. Although NGS is relatively expensive and complex, it may serve as a sensitive HPV genotyping method. Because of its highly sensitive detection of multiple HPV genotypes, NGS may serve as an alternative for diagnostic HPV genotyping in certain situations. © The Korean Society for Laboratory Medicine

Patient safety competency and educational needs of nursing educators in South Korea

Science.gov (United States)

2017-01-01

Background Nursing educators must be qualified to teach patient safety to nursing students to ensure patient safety in the clinical field. The purpose of this study was to assess nursing educators’ competencies and educational needs for patient safety in hospitals and nursing schools. Method A mixed-methods sequential explanatory design employed a survey and focus group interview with nursing educators (school clinical instructors and hospital nurse preceptors). Thirty-eight questionnaires filled out by clinical instructors from six four-year nursing universities and 106 questionnaires from nurse preceptors from three high-level general hospitals in the Seoul metropolitan area were analyzed to obtain quantitative data. Focus group interviews were conducted among six clinical instructors from one nursing school and four nurse preceptors from one high-level general hospital in Seoul. Results Nursing educators had higher levels of attitude compared with relatively lower levels of skill and knowledge regarding patient safety. They reported educational needs of “medication” and “infection prevention” as being higher and “human factors” and “complexity of systems” as being lower. Nursing educators desired different types of education for patient safety. Conclusion It is necessary to enhance nursing educators’ patient safety skills and knowledge by developing and providing an integrated program of patient safety, with various teaching methods to meet their educational needs. The findings of this study provide the basic information needed to reform patient safety education programs appropriately to fit nursing educators' needs and their patient safety competencies in both clinical practice and academia. Furthermore, the findings have revealed the importance of effective communication between clinical and academic settings in making patient safety education seamless. PMID:28873099

Nano-material and method of fabrication

Science.gov (United States)

Menchhofer, Paul A; Seals, Roland D; Howe, Jane Y; Wang, Wei

2015-02-03

A fluffy nano-material and method of manufacture are described. At 2000.times. magnification the fluffy nanomaterial has the appearance of raw, uncarded wool, with individual fiber lengths ranging from approximately four microns to twenty microns. Powder-based nanocatalysts are dispersed in the fluffy nanomaterial. The production of fluffy nanomaterial typically involves flowing about 125 cc/min of organic vapor at a pressure of about 400 torr over powder-based nano-catalysts for a period of time that may range from approximately thirty minutes to twenty-four hours.

Methanol poisoning: brain computed tomography scan findings in four patients

International Nuclear Information System (INIS)

Patankar, T.; Prasad, S.; Rathod, K.; Bichile, L.; Karnad, D.

1999-01-01

Methanol, through its chief metabolite, formate, causes irreversible neurological damage. Methanol intoxication produces classic neuropathological changes and characteristic imaging findings. Computed tomography was performed on four patients who presented with a history of methanol poisoning. Prominent, hypodense lesions in the lentilform nuclei and peripheral white matter, sometimes with haemorrhage, were the characteristic imaging findings in the present patients. It was noted that the severity and extent of necrosis of the lentilform nuclei do not necessarily correlate with the clinical outcome. Copyright (1999) Blackwell Science Pty Ltd

Comparison of four techniques of nasogastric tube insertion in anaesthetised, intubated patients: A randomized controlled trial

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Mohan Chandra Mandal

2014-01-01

Full Text Available Background and Aims: Insertion of nasogastric tubes (NGTs in anaesthetised, intubated patients with a conventional method is sometimes difficult. Different techniques of NGT insertion have been tried with varying degree of success. The aim of this prospective, randomised, open-label study was to evaluate three modified techniques of NGT insertion comparing with the conventional method in respect of success rate, time taken for insertion and the adverse events. Methods: In the operation theatre of general surgery, the patients were randomly allocated into four groups: Group C (control group, n = 54, Group W (ureteral guide wire group, n = 54, Group F (neck flexion with lateral pressure, n = 54 and Group R (reverse Sellick′s manoeuvre, n = 54. The number of attempts for successful NGT insertion, time taken for insertion and adverse events were noted. Results: All the three modified techniques were found more successful than the conventional method on the first attempt. The least time taken for insertion was noted in the reverse Sellick′s method. However, on intergroup analysis, neck flexion and reverse Sellick′s methods were comparable but significantly faster than the other two methods with respect to time taken for insertion. Conclusion: Reverse Sellick′s manoeuver, neck flexion with lateral neck pressure and guide wire-assisted techniques are all better alternatives to the conventional method for successful, quick and reliable NGT insertion with permissible adverse events in anaesthetised, intubated adult patients. Further studies after eliminating major limitations of the present study are warranted to establish the superiority of any one of these modified techniques.

Late morbidity profiles in prostate cancer patients treated to 79-84 Gy by a simple four-field coplanar beam arrangement

International Nuclear Information System (INIS)

Chism, Derek B.; Horwitz, Eric M.; Hanlon, Alexandra L.; Pinover, Wayne H.; Mitra, Raj K.; Hanks, Gerald E.

2003-01-01

Purpose: To describe the frequency and magnitude of late GI and GU morbidity in prostate cancer patients treated to high dose levels with a simple three-dimensional conformal technique. Methods and Materials: A total of 156 intermediate- and high-risk patients were treated between January 1, 1992 and February 28, 1999 with a simple four-field three-dimensional conformal technique to 79-84 Gy. All patients were treated with a four-field conformal technique; the prostate received 82 Gy and the seminal vesicles and periprostatic tissue 46 Gy. GI and GU toxicity was scored according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Morbidity Grading Scale and compared using Kaplan-Meier estimates. Results: The late Grade 2 GI complication rate was 9% and 38% at 3 years for patients treated with and without rectal blocking, respectively (p=0.0004). No Grade 3 late GI complications developed. The rate of Grade 2 late GU complications was 5%, 8%, and 12% at 12, 24, and 36 months, respectively. The Grade 3 late GU complication rate was 2% at 36 months. These differences were not statistically significant. Conclusion: The treatment method described is a simple four-field conformal technique that can be easily implemented in the general radiation community. A dose of 79-84 Gy can be safely delivered to the prostate, with a 9% rate of late Grade 2 GI, 12% rate of late Grade 2 GU, and 2% rate of late Grade 3 GU complications

Optimal synthesis of a four-bar linkage by method of controlled deviation

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Bulatović Radovan R.

2004-01-01

Full Text Available This paper considers optimal synthesis of a four-bar linkage by method of controlled deviations. The advantage of this approximate method is that it allows control of motion of the coupler in the four-bar linkage so that the path of the coupler is in the prescribed environment around the given path on the segment observed. The Hooke-Jeeves’s optimization algorithm has been used in the optimization process. Calculation expressions are not used as the method of direct searching, i.e. individual comparison of the calculated value of the objective function is made in each iteration and the moving is done in the direction of decreasing the value of the objective function. This algorithm does not depend on the initial selection of the projected variables. All this is illustrated on an example of synthesis of a four-bar linkage whose coupler point traces a straight line, i.e. passes through sixteen prescribed points lying on one straight line. .

Risks of bleeding and thrombosis in intensive care unit patients with haematological malignancies

DEFF Research Database (Denmark)

Russell, Lene; Holst, Lars Broksø; Kjeldsen, Lars

2017-01-01

products and risk factors for bleeding in an adult population of ICU patients with haematological malignancies. METHODS: We screened all patients with acute leukaemia and myelodysplastic syndrome admitted to a university hospital ICU during 2008-2012. Bleeding in ICU was scored according to the WHO grading...... lower and upper airways and upper GI tract. Thirty-nine (59%) of the 66 patients had severe or debilitating (WHO grade 3 or 4) bleeding. The median platelet count on the day of grade 3 or 4 bleeding was 23 × 109 per litre (IQR 13-39). Nine patients (8%) died in ICU following a bleeding episode; five...... was the cause of death in four patients. The median platelet count was 20 × 109 per litre (15-48) at the time of thrombosis. The patients received a median of 6 units of red blood cells, 1 unit of fresh frozen plasma and 8 units of platelet concentrates in ICU. CONCLUSIONS: Severe and debilitating bleeding...

Intercultural communication through the eyes of patients: experiences and preferences.

NARCIS (Netherlands)

Paternotte, E.; Dulmen, S. van; Bank, L.; Seeleman, C.M.; Scheele, F.

2017-01-01

Objectives: To explore patients’ preferences and experiences regarding intercultural communication which could influence the development of intercultural patient-centred communication training. Methods: This qualitative study is based on interviews with non-native patients. Thirty non-native

Macrodystrophia lipomatosa: four case reports

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Ahmad Ibne

2010-10-01

Full Text Available Abstract Aim Macrodystrophia lipomatosa is a rare cause of gigantism of limb which can be confused with other common causes like congenital lymphedema. It presents usually with loss of function and cosmetic problems. Four cases are described with emphasis on clinical presentation, differential diagnoses, imaging and treatment options. Methods & Results Four patients of macrodystrophia lipomatosa were thoroughly examined and subjected to investigations. Conclusion Besides diligent clinical examination, imaging and histopathology are crucial in clinching the diagnosis.

Macrodystrophia lipomatosa: four case reports

Science.gov (United States)

2010-01-01

Aim Macrodystrophia lipomatosa is a rare cause of gigantism of limb which can be confused with other common causes like congenital lymphedema. It presents usually with loss of function and cosmetic problems. Four cases are described with emphasis on clinical presentation, differential diagnoses, imaging and treatment options. Methods & Results Four patients of macrodystrophia lipomatosa were thoroughly examined and subjected to investigations. Conclusion Besides diligent clinical examination, imaging and histopathology are crucial in clinching the diagnosis. PMID:20969776

When antithyroid drugs must be started in patients with hyperemesis gravidarum

International Nuclear Information System (INIS)

Farzad, N.; Akbar, A.; Naser, A.; Majid, M.

2009-01-01

To find out role of anti-thyroid drugs in patients with Hyperemesis gravidarum and thyroid dysfunction. One hundred thirty five patients with hyperemesis gravidarum who were admitted to obstetric and gynecology hospital were enrolled in this study. Thirty two patients were excluded because of diabetes mellitus and thyroid diseases. Hence, one hundred three patients underwent investigations including thyroid function test and beta-hCG (Human chorionic gonadotropin). Thirty five women were found with abnormal thyroid function test with FT4I (Free Thyroxin Index) 4.74 +- 0.54 and in another group (68 women) was 2.9 +- 0.39 (P<0.0001). B-hCG in first group was 59406 +-14899 miu/ml and in second group was 6750 +- m 3476 miu/mL (P<0.0001). In five patients PTU (propylthiouracil) was started due to severe sign and symptoms of hyperthyroidism. Thyroid function test was rechecked for all of 35 patients after four weeks routine therapy for hyperemesis gravidarum. Thyroid function test was normalized in 11 patients with hyperemesis graridarum but remained abnormal in 22 patients. In our study thyroid dysfunction in hyperemesis gravidarum was 35% and, 20% of patients needed anti-thyroid therapy. Routine assessment of thyroid function is necessary for women with hyperemesis gravidarum especially in patients with clinical features of hyperthyroidism. We must consider PTU (propylthouracil) in hyperemesis gravidarum with severe weight loss, vomiting and biochemical hyperthyroidism. (author)

Gross tumor volume dependency on phase sorting methods of four-dimensional computed tomography images for lung cancer

Energy Technology Data Exchange (ETDEWEB)

Lee, Soo Yong; Lim, Sang Wook; Ma, Sun Young; Yu, Je Sang [Dept. of Radiation Oncology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan (Korea, Republic of)

2017-09-15

To see the gross tumor volume (GTV) dependency according to the phase selection and reconstruction methods, we measured and analyzed the changes of tumor volume and motion at each phase in 20 cases with lung cancer patients who underwent image-guided radiotherapy. We retrospectively analyzed four-dimensional computed tomography (4D-CT) images in 20 cases of 19 patients who underwent image-guided radiotherapy. The 4D-CT images were reconstructed by the maximum intensity projection (MIP) and the minimum intensity projection (Min-IP) method after sorting phase as 40%–60%, 30%–70%, and 0%–90%. We analyzed the relationship between the range of motion and the change of GTV according to the reconstruction method. The motion ranges of GTVs are statistically significant only for the tumor motion in craniocaudal direction. The discrepancies of GTV volume and motion between MIP and Min-IP increased rapidly as the wider ranges of duty cycles are selected. As narrow as possible duty cycle such as 40%–60% and MIP reconstruction was suitable for lung cancer if the respiration was stable. Selecting the reconstruction methods and duty cycle is important for small size and for large motion range tumors.

Four Methods for Completing the Conceptual Development Phase of Applied Theory Building Research in HRD

Science.gov (United States)

Storberg-Walker, Julia; Chermack, Thomas J.

2007-01-01

The purpose of this article is to describe four methods for completing the conceptual development phase of theory building research for single or multiparadigm research. The four methods selected for this review are (1) Weick's method of "theorizing as disciplined imagination" (1989); (2) Whetten's method of "modeling as theorizing" (2002); (3)…

Analysis of chest image performance in patients with acute chlorine poisoning

International Nuclear Information System (INIS)

Liu Liangqing; Zheng Jiangang; Yang Keyu; Wu Honglin; Tang Qingfang; Wu Huiming

2012-01-01

Objective: To explore chest image features of patients with acute chlorine poisoning and their clinical values. Methods: A retrospective analysis was performed by chest image features of 117 patients with acute chlorine poisoning. All the patients were classified according to Chinese management of occupational acute chlorine poisoning diagnosis standard. Results: Sixty-five patients presented with stimulus response, and normal or both lungs had a little more white on their chest images. Thirty-one cases presented with minor poisoning, and without or the texture of both lungs was increased, and grew hazy and coarse.seventeen cases were moderate, and small sample vague shadows or single or multiple limitations lamellar shadow. Four cases were serious,and two lungs had extensive and density homogeneous consolidation shadow. Conclusions: It would make the diagnosis and assessment of chlorine poisoning more easier based on the combination of chest image features, the clear history of acute chlorine poisoning and relevant clinical performance. (authors)

Migraine patients consistently show abnormal vestibular bedside tests

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Eliana Teixeira Maranhão

2015-01-01

Full Text Available Migraine and vertigo are common disorders, with lifetime prevalences of 16% and 7% respectively, and co-morbidity around 3.2%. Vestibular syndromes and dizziness occur more frequently in migraine patients. We investigated bedside clinical signs indicative of vestibular dysfunction in migraineurs.Objective To test the hypothesis that vestibulo-ocular reflex, vestibulo-spinal reflex and fall risk (FR responses as measured by 14 bedside tests are abnormal in migraineurs without vertigo, as compared with controls.Method Cross-sectional study including sixty individuals – thirty migraineurs, 25 women, 19-60 y-o; and 30 gender/age healthy paired controls.Results Migraineurs showed a tendency to perform worse in almost all tests, albeit only the Romberg tandem test was statistically different from controls. A combination of four abnormal tests better discriminated the two groups (93.3% specificity.Conclusion Migraine patients consistently showed abnormal vestibular bedside tests when compared with controls.

Comparison of prosthetic models produced by traditional and additive manufacturing methods.

Science.gov (United States)

Park, Jin-Young; Kim, Hae-Young; Kim, Ji-Hwan; Kim, Jae-Hong; Kim, Woong-Chul

2015-08-01

The purpose of this study was to verify the clinical-feasibility of additive manufacturing by comparing the accuracy of four different manufacturing methods for metal coping: the conventional lost wax technique (CLWT); subtractive methods with wax blank milling (WBM); and two additive methods, multi jet modeling (MJM), and micro-stereolithography (Micro-SLA). Thirty study models were created using an acrylic model with the maxillary upper right canine, first premolar, and first molar teeth. Based on the scan files from a non-contact blue light scanner (Identica; Medit Co. Ltd., Seoul, Korea), thirty cores were produced using the WBM, MJM, and Micro-SLA methods, respectively, and another thirty frameworks were produced using the CLWT method. To measure the marginal and internal gap, the silicone replica method was adopted, and the silicone images obtained were evaluated using a digital microscope (KH-7700; Hirox, Tokyo, Japan) at 140X magnification. Analyses were performed using two-way analysis of variance (ANOVA) and Tukey post hoc test (α=.05). The mean marginal gaps and internal gaps showed significant differences according to tooth type (Pmanufacturing method (Pmanufacturing methods were within a clinically allowable range, and, thus, the clinical use of additive manufacturing methods is acceptable as an alternative to the traditional lost wax-technique and subtractive manufacturing.

Seven novel mutations of the SMPD1 gene in four Chinese patients with Niemann-Pick disease type A and prenatal diagnosis for four fetuses.

Science.gov (United States)

Ding, Yuan; Li, Xiyuan; Liu, Yupeng; Hua, Ying; Song, Jinqing; Wang, Liwen; Li, Mengqiu; Qin, Yaping; Yang, Yanling

2016-04-01

Niemann-Pick disease type A (NPD-A) is a rare autosomal recessive lysosomal storage disorder caused by acid sphingomyelinase deficiency. Only a few cases have been documented in mainland China, and prenatal diagnosis has not been performed to date. In this study, the clinical and laboratory features of four Chinese patients with early-onset NPD-A were summarized. Four patients with NPD-A were the firstborns of non-consanguineous parents from four unrelated Chinese families. Bone marrow analysis, acid sphingomyelinase assay and genetic studies were performed. SMPD1 gene studies on amniocytes were performed for the prenatal diagnosis of four fetuses from three families. Four patients were admitted at the age of 1-10 months due to jaundice, hepatosplenomegaly and psychomotor retardation. Liver histopathological analysis revealed glucolipid accumulation. Massive foamy histiocytes were found in the bone marrow. Acid sphingomyelinase activities of peripheral blood leukocytes were significantly decreased (4.05-21.9 nmol/h/mg protein, normal range 216.1-950.9 nmol/h/mg protein). Seven novel mutations (c.518-519insT, c.562_563insC, c.792Gdel, c.949G>A, c.1487_1499delACCGTGTGTACCA, c.1495T>C and c.1670T>C) of the SMPD1 gene were identified in four patients. Only one fetus had two mutations of the SMPD1 gene of amniocytes. The results suggested that the fetus was affected by NPD-A. The mother chose artificial abortion. The other three fetuses were not affected by NPD-A. No mutation of the SMPD1 gene was detected in the cultured amniocytes from the mothers. Postnatal genetic analysis and normal development of the three infants confirmed the prenatal diagnosis. Seven novel mutations associated with NPD-A were identified in the Chinese population. Prenatal diagnosis for four fetuses of three families was successfully performed by amniocyte gene analysis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Transfer matrix method for four-flux radiative transfer.

Science.gov (United States)

Slovick, Brian; Flom, Zachary; Zipp, Lucas; Krishnamurthy, Srini

2017-07-20

We develop a transfer matrix method for four-flux radiative transfer, which is ideally suited for studying transport through multiple scattering layers. The model predicts the specular and diffuse reflection and transmission of multilayer composite films, including interface reflections, for diffuse or collimated incidence. For spherical particles in the diffusion approximation, we derive closed-form expressions for the matrix coefficients and show remarkable agreement with numerical Monte Carlo simulations for a range of absorption values and film thicknesses, and for an example multilayer slab.

Continuous intraperitoneal insulin infusion in patients with 'brittle' diabetes

DEFF Research Database (Denmark)

DeVries, J H; Eskes, S A; Snoek, Frank J

2002-01-01

AIMS: To evaluate the effects of continuous intraperitoneal insulin infusion (CIPII) using implantable pumps on glycaemic control and duration of hospital stay in poorly controlled 'brittle' Dutch diabetes patients, and to assess their current quality of life. METHODS: Thirty-three patients were...

Train-of-four recovery precedes twitch recovery during reversal with sugammadex in pediatric patients: A retrospective analysis.

Science.gov (United States)

Vieira Carlos, Ricardo; Luis Abramides Torres, Marcelo; de Boer, Hans Donald

2018-04-01

After reversal of a rocuronium-induced neuromuscular blockade with sugammadex, the recovery of train-of-four ratio to 0.9 is faster than recovery of first twitch of the train-of-four to 90% in adults. These findings after reversal of neuromuscular blockade with sugammadex have not yet been investigated in pediatric patients. The aim of this retrospective analysis was to investigate the relationship of the recovery of first twitch of the train-of-four height and train-of-four ratio after reversal of rocuronium-induced neuromuscular blockade with sugammadex in pediatric patients. Patients ASA I-III, aged 2-11 years, and who underwent abdominal and/or perineal surgery were included in the analysis. After extracting the necessary data from the hospital database, the patients were divided into 2 groups based on the dose of sugammadex received: group A: 2 mg.kg -1 for reversal of moderate neuromuscular blockade and group B: 4 mg.kg -1 for reversal of deep neuromuscular blockade. The relationship of the recovery of first twitch of the train-of-four height and train-of-four ratio in these 2 groups were analyzed. Data from 43 pediatric patients aged 2-11 years could be analyzed. The first twitch of the train-of-four height at the recovery of train-of-four ratio to 0.9 in group B was statistically significantly lower compared with group A. This height 3 and 5 minutes after the train-of-four ratio reached 0.9 showed no statistically significant differences between groups. The results were in line with the results found in adults and showed that the train-of-four ratio recovered to 0.9 was faster than first twitch of the train-of-four height recovered to the same level. © 2018 John Wiley & Sons Ltd.

Dentoalveolar growth of patients with complete unilateral cleft lip and palate by early two-stage furlow and push-back method: preliminary results.

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Kitagawa, Taiji; Kohara, Hiroshi; Sohmura, Taiji; Takahashi, Junzo; Tachimura, Takashi; Wada, Takeshi; Kogo, Mikihiko

2004-09-01

This study examined dentoalveolar growth changes prior to the time of palatoplasty up to 3 years of age by the early two-stage Furlow and push-back methods. Thirty-four Japanese patients with complete unilateral cleft lip and palate (UCLP) treated with either a two-stage Furlow procedure (Furlow group: seven boys, eight girls) from 1998 to 2002 or a push-back procedure (push-back group; 12 boys, 7 girls) from 1993 to 1997. Consecutive plaster models were measured by three-dimensional laser scanner, before primary palatoplasty, before hard palate closure (Furlow group only), and at 3 years of age. Bite measures were taken at 3 years of age. In the Furlow group, arch length, canine width, first and second deciduous molar width and cross-sectional area, and depth and volume at midpoint showed greater growth than in the push-back group. In the Furlow group, the crossbite score was also better than in the push-back group at 3 years of age. In comparison with the push-back group, inhibition of growth impediment in the anterior region was observed in the horizontal direction in the Furlow group. In the midregion, it was observed in the horizontal and vertical directions, and in the posterior region it was observed in the horizontal direction. The results demonstrate that the early two-stage Furlow method showed progressive alveolar growth. Therefore, the early two-stage Furlow method is a more beneficial procedure than the push-back method.

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

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Wan, Rui; Pang, Xingyuan; Ren, Jun

2018-02-01

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

Prognostic analysis of patients with epilepsy according to time of relapse after withdrawal of antiepileptic drugs following four seizure-free years.

Science.gov (United States)

Park, Soochul; Lee, Dong Hyun; Kim, Seung Woo; Roh, Yun Ho

2017-01-01

We performed a retrospective, prognostic analysis of a cohort of patients with epilepsy according to time of relapse after four seizure-free years. Planned withdrawal of antiepileptic drugs (AEDs) and at least 3 years of follow-up after AED discontinuation were performed. The following two groups were assessed: (1) an early relapse (ER) group of patients who experienced recurrence during AED withdrawal and (2) a late relapse (LR) group of patients who experienced recurrence after completion of the AED discontinuation process. After dichotomization, the relapse rate, prognostic factors, and their impacts for each group were compared with those of a group of patients who continued to be seizure-free after AED withdrawal (SF group) using multiple logistic regression analysis. The AED intake mode was also analyzed. Two hundred seventeen (64.6%) of the 336 total patients experienced relapse. One hundred thirty-nine patients (41.4%) and 78 patients (23.2%) were included in the LR and ER groups, respectively. Symptom duration >120 months showed the strongest negative prognostic impact as demonstrated by the 4.7-fold higher risk of recurrence in the ER group compared with the SF group. Additional factors with a negative prognostic impact included an age at epilepsy onset of ≤20 years and the presence of localization-related epilepsy. No reliable predictor between the SF and LR groups was revealed. After exclusion of the SF group, post hoc analysis according to age at epilepsy onset and symptom duration showed that the above-mentioned negative prognostic factors significantly affected the relapse patterns of the LR and ER groups. The results suggest that longer symptom duration, which could be associated with intrinsic reactivation of epilepsy, is the strongest negative prognostic factor for relapse. Relapse after AED withdrawal in prolonged follow-up of seizure-free patients is one aspect of the natural history of epilepsy. © 2016 The Authors. Epilepsia published by

Fluorescence In Situ Hybridization and Immunohistochemistry as Diagnostic Methods for ALK Positive Non-Small Cell Lung Cancer Patients

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Martinez, Pablo; Hernández-Losa, Javier; Cedrés, Susana; Castellví, Josep; Martinez-Marti, Alex; Tallada, Natalia; Murtra-Garrell, Nuria; Navarro-Mendivill, Alejandro; Rodriguez-Freixinos, Victor; Canela, Mercedes; Ramon y Cajal, Santiago; Felip, Enriqueta

2013-01-01

Background Anaplastic Lymphoma Kinase (ALK) positivity represents a novel molecular target in a subset of Non-Small Cell Lung Cancers (NSCLC). We explore Fluorescence in situ Hybridization (FISH) and Immunohistochemistry (IHC) as diagnostic methods for ALK positive patients and to describe its prevalence and outcomes in a population of NSCLC patients. Methods NSCLC patients previously screened for Epidermal Growth Factor Receptor (EGFR) at our institution were selected. ALK positive patients were identified by FISH and the value of IHC (D5F3) was explored. Results ninety-nine patients were identified. Median age was 61.5 years (range 35–83), all were caucasians, eighty percent were adenocarcinomas, fifty-one percent were male and thirty-eight percent were current smokers. Seven (7.1%) patients were ALK positive by FISH, thirteen (13.1%) were EGFR mutant, and 65 (65.6%) were negative/Wild Type (WT) for both ALK and EGFR. ALK positivity and EGFR mutations were mutually exclusive. ALK positive patients tend to be younger than EGFR mutated or wt patients. ALK positive patients were predominantly never smokers (71.4%) and adenocarcinoma (71.4%). ALK positive and EGFR mutant patients have a better outcome than negative/WT. All patients with ALK FISH negative tumours were negative for ALK IHC. Out of 6 patients positive for ALK FISH with more tissue available, 5 were positive for ALK IHC and 1 negative. Conclusions ALK positive patients represent 7.1% of a population of selected NSCLC. ALK positive patients have different clinical features and a better outcome than EGFR WT and ALK negative patients. IHC is a promising method for detecting ALK positive NSCLC patients. PMID:23359795

The Danish version of the questionnaire on pain communication: preliminary validation in cancer patients

DEFF Research Database (Denmark)

Jacobsen, Ramune; Møldrup, Claus; Christrup, Lona Louring

2009-01-01

of the shortened Danish version of the M-PICS (SDM-PICS). METHODS: The validated English version of the M-PICS was translated into Danish following the repeated back-translation procedure. Cancer patients were recruited for the study from specialized pain management facilities. RESULTS: Thirty-three patients...... shared information with his/her health care provider, and Factor two, health care provider information, consisted of four items measuring the degree to which a health care provider was perceived as the one who shares information. Two separate items addressed the perceived level of information exchange...... between the patient and the health care provider. The SDM-PICS total had an internal consistency of 0.88. The SDM-PICS scores were positively related to pain relief and inversely related to the measures of cognitive pain management barriers, anxiety, and reported pain levels. CONCLUSION: The SDM...

The effect of modified trampoline training on balance, gait, and falls efficacy of stroke patients.

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Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

2015-11-01

[Purpose] This research was conducted to investigate the effects of modified trampoline training on the balance, gait, and falls efficacy of stroke patients. [Subjects] Twenty-four stroke patients participated in this study. The subjects were randomly allocated to one of two groups: the trampoline group (n=12) or the control group (n=12). [Methods] Both groups participated in conventional physical therapy for thirty minutes per day, three times a week for six weeks. The trampoline group also took part in trampoline training for thirty minutes per day, three times a week for six weeks. We evaluated balance (Berg balance scale, timed up and go test), gait (dynamic gait index), and falls efficacy (falls efficacy scale-K) to confirm the effects of the intervention. [Results] Both the trampoline and the control group showed significant improvements in balance, gait, and falls efficacy compared to before the intervention, and the improvements were significantly greater in the trampoline group than in the control group. [Conclusion] Modified trampoline training resulted in significantly improved balance, dynamic gait, and falls efficacy of stroke patients compared to the control group. These results suggest that modified trampoline training is feasible and effective at improving balance, dynamic gait, and falls efficacy after stroke.

A patient's view on the location of the temporomandibular joint.

Science.gov (United States)

Koole, Paul; Zonnenberg, Adriaan J J; Mulder, Jan

2018-03-25

Objective A survey was held to establish whether laypeople knew the location of their temporomandibular joint. Methods A sample of 61 participants, visiting their dental office for a routine check-up, was given a three-question survey of whether they knew the location of their temporomandibular joint and could point to this location. Results Thirty-eight participants answered the question affirmatively. Only 13 pointed to the correct location. Of these, six participants received consultation for TMD in the past, three participants were healthcare providers, and four participants actually had knowledge of the exact location. Out of 23 participants who did not know the location, one accidently designated the correct position. Conclusion The location of the temporomandibular joint is not a well-known site for many patients. In the presence of orofacial pain, it seems advisable to let the patient designate and record the site of the pain on a drawing on the patient chart.

Change of patients' perceptions of telemedicine after brief use

NARCIS (Netherlands)

Cranen, Karlijn; Cranen, Karlijn; Huis in 't Veld, M.H.A.; IJzerman, Maarten Joost; Vollenbroek-Hutten, Miriam Marie Rosé

Objective: This study aims to investigate whether patients' perceptions regarding a Web-based telemedicine service, for instruction and monitoring of an exercise program, change after brief use. Materials and Methods: Thirty patients were allocated, matched on gender and age, to a control group (10)

Development of a decision aid for the treatment of benign prostatic hyperplasia: A four stage method using a Delphi consensus study.

Science.gov (United States)

Lamers, Romy E D; Cuypers, Maarten; Garvelink, Mirjam M; de Vries, Marieke; Bosch, J L H Ruud; Kil, Paul J M

2016-07-01

To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2: Identifying patients' needs and expectations, 3: Development of DA content and structure, 4: Usability testing with LUTS/BPH patients. 1 (N=15): Dutch urologists reached consensus on 61% of the statements concerning users' criteria, decision options, structure, and medical content. 2 (N=24): Consensus was reached in 69% on statements concerning the need for improvement of information provision, the need for DA development and that the DA should clarify patients' preferences. 3: DA development based on results from stage 1 and stage 2. 4 (N=10): Pros of the DA were clear information provision, systematic design and easy to read and re-read. A LUTS/BPH DA containing VCEs(**) was developed in cooperation with urologists and patients following a structured 4 stage method and was stated to be well accepted. This method can be adopted for the development of DAs to support other medical decision issues. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Empirical comparison of four baseline covariate adjustment methods in analysis of continuous outcomes in randomized controlled trials

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Zhang S

2014-07-01

Full Text Available Shiyuan Zhang,1 James Paul,2 Manyat Nantha-Aree,2 Norman Buckley,2 Uswa Shahzad,2 Ji Cheng,2 Justin DeBeer,5 Mitchell Winemaker,5 David Wismer,5 Dinshaw Punthakee,5 Victoria Avram,5 Lehana Thabane1–41Department of Clinical Epidemiology and Biostatistics, 2Department of Anesthesia, McMaster University, Hamilton, ON, Canada; 3Biostatistics Unit/Centre for Evaluation of Medicines, St Joseph's Healthcare - Hamilton, Hamilton, ON, Canada; 4Population Health Research Institute, Hamilton Health Science/McMaster University, 5Department of Surgery, Division of Orthopaedics, McMaster University, Hamilton, ON, CanadaBackground: Although seemingly straightforward, the statistical comparison of a continuous variable in a randomized controlled trial that has both a pre- and posttreatment score presents an interesting challenge for trialists. We present here empirical application of four statistical methods (posttreatment scores with analysis of variance, analysis of covariance, change in scores, and percent change in scores, using data from a randomized controlled trial of postoperative pain in patients following total joint arthroplasty (the Morphine COnsumption in Joint Replacement Patients, With and Without GaBapentin Treatment, a RandomIzed ControlLEd Study [MOBILE] trials.Methods: Analysis of covariance (ANCOVA was used to adjust for baseline measures and to provide an unbiased estimate of the mean group difference of the 1-year postoperative knee flexion scores in knee arthroplasty patients. Robustness tests were done by comparing ANCOVA with three comparative methods: the posttreatment scores, change in scores, and percentage change from baseline.Results: All four methods showed similar direction of effect; however, ANCOVA (-3.9; 95% confidence interval [CI]: -9.5, 1.6; P=0.15 and the posttreatment score (-4.3; 95% CI: -9.8, 1.2; P=0.12 method provided the highest precision of estimate compared with the change score (-3.0; 95% CI: -9.9, 3.8; P=0

Double-blind, placebo-controlled cross-over study of intravenous S-adenosyl-L-methionine in patients with fibromyalgia

DEFF Research Database (Denmark)

Volkmann, H; Nørregaard, J; Jacobsen, Søren

1997-01-01

The objective of this study was to test the efficacy of intravenously administered S-adenosyl-L-methionine (SAMe) in patients with fibromyalgia (FM). Thirty-four out-patients with fibromyalgia symptoms received SAMe 600 mg i.v. or placebo daily for 10 days in a cross-over trial. There was no sign......The objective of this study was to test the efficacy of intravenously administered S-adenosyl-L-methionine (SAMe) in patients with fibromyalgia (FM). Thirty-four out-patients with fibromyalgia symptoms received SAMe 600 mg i.v. or placebo daily for 10 days in a cross-over trial....... There was no significant difference in improvement in the primary outcome: tender point change between the two treatment groups. There was a tendency towards statistical significance in favour of SAMe on subjective perception of pain at rest (p = 0.08), pain on movement (p = 0.11), and overall well-being (p = 0.......17) and slight improvement only on fatigue, quality of sleep, morning stiffness, and on the Fibromyalgia Impact Questionnaire for pain. No effect could be observed on isokinetic muscle strength, Zerrsen self-assessment questionnaire, and the face scale. No effect of SAMe in patients with FM was found...

Study of Attention Deficit in Patients with Schizophrenia and Bipolar Disorder

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SM Kafi

2013-05-01

Full Text Available Abstract Background & aim: Attention deficit has significant effect on the life of patients suffering from schizophrenia and bipolar disorder. The aim of this study was to assess the attention deficit in patients with schizophrenia. Methods: In the present post-hoc study, 132 patients with schizophrenia and bipolar disorder were selected via non-randomized sampling at Shafa Hospital (Rasht, Iran and then divided into four equal groups: chronic schizophrenia patients, first-episode patients, chronic bipolar patients, and first-episode bipolar patients. Thirty-three healthy individuals were selected as the control group. Subjects were evaluated by Stroop color-word test. The gathered Data were analyzed by one-way ANOVA. Results: Attention deficit among chronic schizophrenics and patients suffering from bipolar disease was higher than the control group (p <1. Chronic schizophrenic patients compared with schizophrenia bipolar disease and first round schizophrenia showed more attention deficit. There was no significant difference among the first bipolar disease and schizophrenia, bipolar disorder, as well as the first round schizophrenia (p<0.05. Conclusion: Attention deficit is more severe in schizophrenic patients than bipolar disorder, and chronicity is more effective in schizophrenic patients. Key words: Attention, Schizophrenia, Chronicity

TOLERANCE SENSITIVITY ANALYSIS: THIRTY YEARS LATER

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Richard E. Wendell

2010-12-01

Full Text Available Tolerance sensitivity analysis was conceived in 1980 as a pragmatic approach to effectively characterize a parametric region over which objective function coefficients and right-hand-side terms in linear programming could vary simultaneously and independently while maintaining the same optimal basis. As originally proposed, the tolerance region corresponds to the maximum percentage by which coefficients or terms could vary from their estimated values. Over the last thirty years the original results have been extended in a number of ways and applied in a variety of applications. This paper is a critical review of tolerance sensitivity analysis, including extensions and applications.

Validating the Danish adaptation of the World Health Organization's International Classification for Patient Safety classification of patient safety incident types

DEFF Research Database (Denmark)

Mikkelsen, Kim Lyngby; Thommesen, Jacob; Andersen, Henning Boje

2013-01-01

Objectives Validation of a Danish patient safety incident classification adapted from the World Health Organizaton's International Classification for Patient Safety (ICPS-WHO). Design Thirty-three hospital safety management experts classified 58 safety incident cases selected to represent all types.......513 (range: 0.193–0.804). Kappa and ICC showed high correlation (r = 0.99). An inverse correlation was found between the prevalence of type and inter-rater reliability. Results are discussed according to four factors known to determine the inter-rater agreement: skill and motivation of raters; clarity...

[Comparative study on four kinds of assessment methods of post-marketing safety of Danhong injection].

Science.gov (United States)

Li, Xuelin; Tang, Jinfa; Meng, Fei; Li, Chunxiao; Xie, Yanming

2011-10-01

To study the adverse reaction of Danhong injection with four kinds of methods, central monitoring method, chart review method, literature study method and spontaneous reporting method, and to compare the differences between them, explore an appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection. Set down the adverse reactions' questionnaire of four kinds of methods, central monitoring method, chart review method, literature study method and collect the information on adverse reactions in a certain period. Danhong injection adverse reaction information from Henan Province spontaneous reporting system was collected with spontaneous reporting method. Carry on data summary and descriptive analysis. Study the adverse reaction of Danhong injection with four methods of central monitoring method, chart review method, literature study method and spontaneous reporting method, the rates of adverse events were 0.993%, 0.336%, 0.515%, 0.067%, respectively. Cyanosis, arrhythmia, hypotension, sweating, erythema, hemorrhage dermatitis, rash, irritability, bleeding gums, toothache, tinnitus, asthma, elevated aminotransferases, constipation, pain are new discovered adverse reactions. The central monitoring method is the appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection, which could objectively reflect the real world of clinical usage.

Resistance Training With Ankle Weight Cuffs Is Feasible in Patients With Acute Exacerbation of COPD

DEFF Research Database (Denmark)

Kofod, Linette Marie; Døssing, Martin; Steentoft, Johnna

2017-01-01

-extension strength training. During training, the patients were seated on the bedside and performed 3 sets of 10-repetition maximum loads, using ankle weight cuffs. The primary outcome was the change in load from the first to last training sessions. The secondary outcomes were changes in maximal isometric knee......-extension strength improved by a mean of 12% (P = .02), whereas the TUG and STS test performances improved by 11% (P = .001) and 19% (P = .03), respectively. Ninety-eight percent of the planned training sessions were completed with no side effects. CONCLUSIONS: Progressive resistance training with ankle weight cuffs...... of progressive knee-extension resistance training, using ankle weight cuffs on patients with AECOPD, based on prespecified criteria for feasibility. METHODS: Thirty-four patients (18 men, mean age 74 years, forced expiratory volume in 1 second = 33% predicted) with AECOPD participated in daily knee...

Patient safety competency and educational needs of nursing educators in South Korea.

Directory of Open Access Journals (Sweden)

Haena Jang

Full Text Available Nursing educators must be qualified to teach patient safety to nursing students to ensure patient safety in the clinical field. The purpose of this study was to assess nursing educators' competencies and educational needs for patient safety in hospitals and nursing schools.A mixed-methods sequential explanatory design employed a survey and focus group interview with nursing educators (school clinical instructors and hospital nurse preceptors. Thirty-eight questionnaires filled out by clinical instructors from six four-year nursing universities and 106 questionnaires from nurse preceptors from three high-level general hospitals in the Seoul metropolitan area were analyzed to obtain quantitative data. Focus group interviews were conducted among six clinical instructors from one nursing school and four nurse preceptors from one high-level general hospital in Seoul.Nursing educators had higher levels of attitude compared with relatively lower levels of skill and knowledge regarding patient safety. They reported educational needs of "medication" and "infection prevention" as being higher and "human factors" and "complexity of systems" as being lower. Nursing educators desired different types of education for patient safety.It is necessary to enhance nursing educators' patient safety skills and knowledge by developing and providing an integrated program of patient safety, with various teaching methods to meet their educational needs. The findings of this study provide the basic information needed to reform patient safety education programs appropriately to fit nursing educators' needs and their patient safety competencies in both clinical practice and academia. Furthermore, the findings have revealed the importance of effective communication between clinical and academic settings in making patient safety education seamless.

Individual Experiences in Four Cancer Patients Following Psilocybin-Assisted Psychotherapy.

Science.gov (United States)

Malone, Tara C; Mennenga, Sarah E; Guss, Jeffrey; Podrebarac, Samantha K; Owens, Lindsey T; Bossis, Anthony P; Belser, Alexander B; Agin-Liebes, Gabrielle; Bogenschutz, Michael P; Ross, Stephen

2018-01-01

A growing body of evidence shows that existential and spiritual well-being in cancer patients is associated with better medical outcomes, improved quality of life, and serves as a buffer against depression, hopelessness, and desire for hastened death. Historical and recent research suggests a role for psilocybin-assisted psychotherapy in treating cancer-related anxiety and depression. A double-blind controlled trial was performed, where 29 patients with cancer-related anxiety and depression were randomly assigned to treatment with single-dose psilocybin (0.3 mg/kg) or niacin in conjunction with psychotherapy. Previously published results of this trial demonstrated that, in conjunction with psychotherapy, moderate-dose psilocybin produced rapid, robust, and enduring anxiolytic, and anti-depressant effects. Here, we illustrate unique clinical courses described by four participants using quantitative measures of acute and persisting effects of psilocybin, anxiety, depression, quality of life, and spiritual well-being, as well as qualitative interviews, written narratives, and clinician notes. Although the content of each psilocybin-assisted experience was unique to each participant, several thematic similarities and differences across the various sessions stood out. These four participants' personal narratives extended beyond the cancer diagnosis itself, frequently revolving around themes of self-compassion and love, acceptance of death, and memories of past trauma, though the specific details or narrative content differ substantially. The results presented here demonstrate the personalized nature of the subjective experiences elicited through treatment with psilocybin, particularly with respect to the spiritual and/or psychological needs of each patient.

Faster algorithms for RNA-folding using the Four-Russians method.

Science.gov (United States)

Venkatachalam, Balaji; Gusfield, Dan; Frid, Yelena

2014-03-06

The secondary structure that maximizes the number of non-crossing matchings between complimentary bases of an RNA sequence of length n can be computed in O(n3) time using Nussinov's dynamic programming algorithm. The Four-Russians method is a technique that reduces the running time for certain dynamic programming algorithms by a multiplicative factor after a preprocessing step where solutions to all smaller subproblems of a fixed size are exhaustively enumerated and solved. Frid and Gusfield designed an O(n3logn) algorithm for RNA folding using the Four-Russians technique. In their algorithm the preprocessing is interleaved with the algorithm computation. We simplify the algorithm and the analysis by doing the preprocessing once prior to the algorithm computation. We call this the two-vector method. We also show variants where instead of exhaustive preprocessing, we only solve the subproblems encountered in the main algorithm once and memoize the results. We give a simple proof of correctness and explore the practical advantages over the earlier method.The Nussinov algorithm admits an O(n2) time parallel algorithm. We show a parallel algorithm using the two-vector idea that improves the time bound to O(n2logn). We have implemented the parallel algorithm on graphics processing units using the CUDA platform. We discuss the organization of the data structures to exploit coalesced memory access for fast running times. The ideas to organize the data structures also help in improving the running time of the serial algorithms. For sequences of length up to 6000 bases the parallel algorithm takes only about 2.5 seconds and the two-vector serial method takes about 57 seconds on a desktop and 15 seconds on a server. Among the serial algorithms, the two-vector and memoized versions are faster than the Frid-Gusfield algorithm by a factor of 3, and are faster than Nussinov by up to a factor of 20. The source-code for the algorithms is available at http://github.com/ijalabv/FourRussiansRNAFolding.

Attentional Avoidance is Associated with Increased Pain Sensitivity in Patients with Chronic Posttraumatic Pain and Comorbid Posttraumatic Stress

DEFF Research Database (Denmark)

Harvold, Mathea; MacLeod, Colin; Vaegter, Henrik Bjarke

2018-01-01

posttraumatic pain patients is unknown. This study investigated AB for linguistic pain- and trauma-related stimuli, and clinical and thermal sensitivity in patients with chronic posttraumatic pain with and without PTSD. METHODS: Thirty-four patients with chronic posttraumatic cervical pain performed the visual......OBJECTIVES: Posttraumatic stress disorder (PTSD) is common in chronic posttraumatic pain. Theoretical models suggest that attentional biases (AB) contribute to the development and maintenance of chronic pain and PTSD, however, the influence of AB on clinical and heat pain sensitivity in chronic...... attentional probe task assessing patterns of selective attentional responding to trauma cues and to pain cues. The task used short (500 ms) and long (1250 ms) stimulus exposure durations to ensure sensitivity to both the orienting and maintenance of attention. Heat pain threshold (HPT) was assessed at the non-painful...

SU-F-T-202: An Evaluation Method of Lifetime Attributable Risk for Comparing Between Proton Beam Therapy and Intensity Modulated X-Ray Therapy for Pediatric Cancer Patients by Averaging Four Dose-Response Models for Carcinoma Induction

Energy Technology Data Exchange (ETDEWEB)

Tamura, M; Shirato, H [Department of Radiation Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido (Japan); Ito, Y [Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido (Japan); Sakurai, H; Mizumoto, M; Kamizawa, S [Proton Medical Research Center, University of Tsukuba, Tsukuba, Ibaraki (Japan); Murayama, S; Yamashita, H [Proton Therapy Division, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka (Japan); Takao, S; Suzuki, R [Department of Medical Physics, Hokkaido University Hospital, Sapporo, Hokkaido (Japan)

2016-06-15

Purpose: To examine how much lifetime attributable risk (LAR) as an in silico surrogate marker of radiation-induced secondary cancer would be lowered by using proton beam therapy (PBT) in place of intensity modulated x-ray therapy (IMXT) in pediatric patients. Methods: From 242 pediatric patients with cancers who were treated with PBT, 26 patients were selected by random sampling after stratification into four categories: a) brain, head, and neck, b) thoracic, c) abdominal, and d) whole craniospinal (WCNS) irradiation. IMXT was re-planned using the same computed tomography and region of interest. Using dose volume histogram (DVH) of PBT and IMXT, the LAR of Schneider et al. was calculated for the same patient. The published four dose-response models for carcinoma induction: i) full model, ii) bell-shaped model, iii) plateau model, and ix) linear model were tested for organs at risk. In the case that more than one dose-response model was available, the LAR for this patient was calculated by averaging LAR for each dose-response model. Results: Calculation of the LARs of PBT and IMXT based on DVH was feasible for all patients. The mean±standard deviation of the cumulative LAR difference between PBT and IMXT for the four categories was a) 0.77±0.44% (n=7, p=0.0037), b) 23.1±17.2%,(n=8, p=0.0067), c) 16.4±19.8% (n=8, p=0.0525), and d) 49.9±21.2% (n=3, p=0.0275, one tailed t-test), respectively. The LAR was significantly lower by PBT than IMXT for the the brain, head, and neck region, thoracic region, and whole craniospinal irradiation. Conclusion: In pediatric patients who had undergone PBT, the LAR of PBT was significantly lower than the LAR of IMXT estimated by in silico modeling. This method was suggested to be useful as an in silico surrogate marker of secondary cancer induced by different radiotherapy techniques. This research was supported by the Translational Research Network Program, JSPS KAKENHI Grant No. 15H04768 and the Global Institution for

SU-F-T-202: An Evaluation Method of Lifetime Attributable Risk for Comparing Between Proton Beam Therapy and Intensity Modulated X-Ray Therapy for Pediatric Cancer Patients by Averaging Four Dose-Response Models for Carcinoma Induction

International Nuclear Information System (INIS)

Tamura, M; Shirato, H; Ito, Y; Sakurai, H; Mizumoto, M; Kamizawa, S; Murayama, S; Yamashita, H; Takao, S; Suzuki, R

2016-01-01

Purpose: To examine how much lifetime attributable risk (LAR) as an in silico surrogate marker of radiation-induced secondary cancer would be lowered by using proton beam therapy (PBT) in place of intensity modulated x-ray therapy (IMXT) in pediatric patients. Methods: From 242 pediatric patients with cancers who were treated with PBT, 26 patients were selected by random sampling after stratification into four categories: a) brain, head, and neck, b) thoracic, c) abdominal, and d) whole craniospinal (WCNS) irradiation. IMXT was re-planned using the same computed tomography and region of interest. Using dose volume histogram (DVH) of PBT and IMXT, the LAR of Schneider et al. was calculated for the same patient. The published four dose-response models for carcinoma induction: i) full model, ii) bell-shaped model, iii) plateau model, and ix) linear model were tested for organs at risk. In the case that more than one dose-response model was available, the LAR for this patient was calculated by averaging LAR for each dose-response model. Results: Calculation of the LARs of PBT and IMXT based on DVH was feasible for all patients. The mean±standard deviation of the cumulative LAR difference between PBT and IMXT for the four categories was a) 0.77±0.44% (n=7, p=0.0037), b) 23.1±17.2%,(n=8, p=0.0067), c) 16.4±19.8% (n=8, p=0.0525), and d) 49.9±21.2% (n=3, p=0.0275, one tailed t-test), respectively. The LAR was significantly lower by PBT than IMXT for the the brain, head, and neck region, thoracic region, and whole craniospinal irradiation. Conclusion: In pediatric patients who had undergone PBT, the LAR of PBT was significantly lower than the LAR of IMXT estimated by in silico modeling. This method was suggested to be useful as an in silico surrogate marker of secondary cancer induced by different radiotherapy techniques. This research was supported by the Translational Research Network Program, JSPS KAKENHI Grant No. 15H04768 and the Global Institution for

Comarison of Four Methods for Teaching Phases of the Moon

Science.gov (United States)

Upton, Brianna; Cid, Ximena; Lopez, Ramon

2008-03-01

Previous studies have shown that many students have misconceptions about basic concepts in astronomy. As a consequence, various interactive engagement methods have been developed for introductory astronomy. We will present the results of a study that compares four different teaching methods for the subject of the phases of the Moon, which is well known to produce student difficulties. We compare a fairly traditional didactic approach, the use of manipulatives (moonballs) in lecture, the University of Arizona Lecture Tutorials, and an interactive computer program used in a didactic fashion. We use pre- and post-testing with the Lunar Phase Concept Inventory to determine the relative effectiveness of these methods.

Four Methods for LIDAR Retrieval of Microscale Wind Fields

Directory of Open Access Journals (Sweden)

Thomas Naini

2012-08-01

Full Text Available This paper evaluates four wind retrieval methods for micro-scale meteorology applications with volume and time resolution in the order of 30m³ and 5 s. Wind field vectors are estimated using sequential time-lapse volume images of aerosol density fluctuations. Suitably designed mono-static scanning backscatter LIDAR systems, which are sensitive to atmospheric density aerosol fluctuations, are expected to be ideal for this purpose. An important application is wind farm siting and evaluation. In this case, it is necessary to look at the complicated region between the earth’s surface and the boundary layer, where wind can be turbulent and fractal scaling from millimeter to kilometer. The methods are demonstrated using first a simple randomized moving hard target, and then with a physics based stochastic space-time dynamic turbulence model. In the latter case the actual vector wind field is known, allowing complete space-time error analysis. Two of the methods, the semblance method and the spatio-temporal method, are found to be most suitable for wind field estimation.

Variable pathogenicity of exon 43del (FAA) in four Fanconi anaemia patients within a consanguineous family.

Science.gov (United States)

Koc, A; Pronk, J C; Alikasifoglu, M; Joenje, H; Altay, C

1999-01-01

Four Fanconi anaemia group A (FAA) patients within two related consanguineous families are presented: the propositus (male, 13 years, transplanted at age 10), and his three cousins (one male, 8 years, and two female newborns). Assignment of the patients to FAA was based on the functional complementation analysis by somatic cell hybridization and confirmed by mutation screening showing a homozygous deletion of exon 43 (4267-4404del) in the FAA gene to be present in all four patients. The newborn patients had been diagnosed prenatally by DNA analysis. In spite of identical molecular pathology and close familial relationship the clinical phenotypes of the four patients were not concordant. Discordant symptoms included birthweight, pigmentation abnormalities, skeletal, renal and genital abnormalities, whereas microcephaly and possibly the haematological course were concordant. Differences in environmental conditions and/or genetic make-up along with chance effects during development may explain discordant phenotypes despite identical molecular pathology in these patients. However, our results do not rule out the possibility that the exon 43del mutation may have prognostic value for the haematological course of the disease.

Correlation between fatigue and self-esteem in patients with multiple sclerosis

OpenAIRE

Fragoso,Yára Dadalti; Silva,Érika Oliveira da; Finkelsztejn,Alessandro

2009-01-01

OBJECTIVE: To assess the possible association of fatigue with self-esteem in multiple sclerosis (MS) patients. METHOD: Thirty patients were prospectively assessed. None of them presented moderate or severe depression or anxiety and their degree of disability was low (EDSS

Resistivity Correction Factor for the Four-Probe Method: Experiment I

Science.gov (United States)

Yamashita, Masato; Yamaguchi, Shoji; Enjoji, Hideo

1988-05-01

Experimental verification of the theoretically derived resistivity correction factor (RCF) is presented. Resistivity and sheet resistance measurements by the four-probe method are made on three samples: isotropic graphite, ITO film and Au film. It is indicated that the RCF can correct the apparent variations of experimental data to yield reasonable resistivities and sheet resistances.

Melody pulmonary valve bacterial endocarditis: experience in four pediatric patients and a review of the literature.

Science.gov (United States)

Villafañe, Juan; Baker, George Hamilton; Austin, Erle H; Miller, Stephen; Peng, Lynn; Beekman, Robert

2014-08-01

The objectives of this manuscript are two-fold: (a) to describe the clinical characteristics and management of four pediatric patients with bacterial endocarditis (BE) after Melody pulmonary valve implantation (MPVI); and (b) to review the literature regarding Melody pulmonary valve endocarditis. There are several reports of BE following MPVI. The clinical course, BE management and outcome remain poorly defined. This is a multi-center report of four pediatric patients with repaired tetralogy of Fallot (TOF) and BE after MPVI. Clinical presentation, echocardiogram findings, infecting organism, BE management, and follow-up assessment are described. We review available literature on Melody pulmonary valve endocarditis and discuss the prognosis and challenges in the management of these patients. Of our four BE patients, two had documented vegetations and three showed worsening pulmonary stenosis. All patients remain asymptomatic after medical treatment (4) and surgical prosthesis replacement (3) at follow-up of 17 to 40 months. Analysis of published data shows that over half of patients undergo bioprosthesis explantation and that there is a 13% overall mortality. The most common BE pathogens are the Staphylococcus and Streptococcus species. Our case series of four pediatric patients with repaired TOF confirms a risk for BE after MPVI. A high index of suspicion for BE should be observed after MPVI. All patients should be advised to follow lifelong BE prophylaxis after MPVI. In case of BE, surgery should be considered for valve dysfunction or no clinical improvement in spite of medical treatment. © 2014 Wiley Periodicals, Inc.

Medulloblastoma: Long-term follow-up of patients treated with electron irradiation of the spinal field

International Nuclear Information System (INIS)

Gaspar, L.E.; Dawson, D.J.; Tilley-Gulliford, S.A.; Banerjee, P.

1991-01-01

Thirty-two patients with posterior fossa medulloblastoma underwent treatment with electron irradiation to the spinal field. The 5- and 10-year actuarial survival rates were 57% and 50%, respectively. Late complications observed in the 15 patients followed up for more than 5 years were short stature (six patients), decreased sitting-standing height ratio (four patients), scoliosis (two patients), poor school performance (seven patients), xerostomia (one patient), esophageal stricture (one patient), pituitary dysfunction (four patients), primary hypothyroidism (one patient), bilateral eighth-nerve deafness (one patient), and carcinoma of the thyroid (one patient). Complications following treatment with electrons to a spinal field are compared with reported complications following treatment with photons to the spinal field. Although short-term reactions were minimal, the authors found no difference in late complications. More sophisticated treatment planning may show such a long-term benefit in the future

Analgesic, anti-inflammatory and immuno-modulatory effects of ...

African Journals Online (AJOL)

modulatory effects of dezocine-propofol, and fentanyl-propofol combinations in colonoscopy. Methods: One hundred and thirty-four patients who received painless colonoscopy in Eastern Medical District of Linyi People's Hospital, Linyi City, ...

Thirty-seven transcription factor genes differentially respond to a ...

Indian Academy of Sciences (India)

Plant transcription factors and insect defence si. Thirty-seven transcription factor genes differentially respond to a harpin protein and affect resistance to the green peach aphid in Arabidopsis. HUNLIN. PIN. RUOXUE LIŲ, BEIBEI LÜ, XIAOMENG WANG, CHUNLING ZHANG, SHUPING ZHANG, JUN QIAN, LEI CHEN,.

Effects of a tailor-made exercise program on exercise adherence and health outcomes in patients with knee osteoarthritis: a mixed-methods pilot study.

Science.gov (United States)

Lee, Fung-Kam Iris; Lee, Tze-Fan Diana; So, Winnie Kwok-Wei

2016-01-01

Previous studies showed that exercise intervention was effective in symptoms control of knee osteoarthritis (OA) but poor intervention adherence reduced the exercise effect. It has been suspected that the design of exercise intervention mainly from the health care professionals' perspective could not address the patients' barriers to exercise. Therefore, a tailor-made exercise program which incorporated the patient's perspective in the design was developed and ready for evaluation. This pilot study estimated the effects of a tailor-made exercise program on exercise adherence and health outcomes, and explored the participants' perception and experience of the program. The intervention of this study was a 4-week community-based group exercise program, which required the participants to attend a 1-hour session each week. Thirty-four older people with knee OA were recruited to the program. Mixed-methods study design was used to estimate the effects of this program and explore the participants' perception and experience of the program. Exercise adherence and performance in return-demonstration of the exercise were assessed at 12 weeks after the program. Disease-specific health status (Western Ontario and McMaster Universities Osteoarthritis Index), general health status (12-item Short Form of the Medical Outcome Study Questionnaire), knee range of motion, muscle strength, and endurance of the lower extremities (Timed-Stands Test) were measured at the beginning of the program and 12 weeks after. Six participants were interviewed individually on the 12th week. Thirty-three participants (75.0±7.3 years) completed the one-group pretest and post-test study. The participants' exercise adherence was 91.4%±14.54%, and their correct performance in return-demonstration was 76.7%±21.75%. Most of the participants' health outcomes significantly improved at posttests except the 12-item Short Form of the Medical Outcome Study Questionnaire physical health summary score. The

Individual Experiences in Four Cancer Patients Following Psilocybin-Assisted Psychotherapy

Directory of Open Access Journals (Sweden)

Tara C. Malone

2018-04-01

Full Text Available A growing body of evidence shows that existential and spiritual well-being in cancer patients is associated with better medical outcomes, improved quality of life, and serves as a buffer against depression, hopelessness, and desire for hastened death. Historical and recent research suggests a role for psilocybin-assisted psychotherapy in treating cancer-related anxiety and depression. A double-blind controlled trial was performed, where 29 patients with cancer-related anxiety and depression were randomly assigned to treatment with single-dose psilocybin (0.3 mg/kg or niacin in conjunction with psychotherapy. Previously published results of this trial demonstrated that, in conjunction with psychotherapy, moderate-dose psilocybin produced rapid, robust, and enduring anxiolytic, and anti-depressant effects. Here, we illustrate unique clinical courses described by four participants using quantitative measures of acute and persisting effects of psilocybin, anxiety, depression, quality of life, and spiritual well-being, as well as qualitative interviews, written narratives, and clinician notes. Although the content of each psilocybin-assisted experience was unique to each participant, several thematic similarities and differences across the various sessions stood out. These four participants’ personal narratives extended beyond the cancer diagnosis itself, frequently revolving around themes of self-compassion and love, acceptance of death, and memories of past trauma, though the specific details or narrative content differ substantially. The results presented here demonstrate the personalized nature of the subjective experiences elicited through treatment with psilocybin, particularly with respect to the spiritual and/or psychological needs of each patient.

Helicobacter pylori detection in chronic gastritis: a comparison of staining methods

International Nuclear Information System (INIS)

Ahmad, F.; Khan, I.

2011-01-01

Background: Helicobacter pylori is an important cause of chronic gastritis, gastric ulceration and gastric malignancies as gastric carcinoma and MALT lymphoma. Its definitive diagnosis is based on histopathology. Routine H and E stain is not very effective in its detection, immune-stains and fluorescent stains are costly. Need for simple cheap and sensitive stain has always been a topic of hot debate and extensive research. Method: paraffin embedded blocks of all adult patients diagnosed as chronic gastritis/gastric ulceration with no accompanying gastric pathology as hypertrophic gastropathys, and neoplasias were taken into study. Three sections of 4 micron were cut and stained with routine H and E, Giemsa, and Cresyl fast violet. Results: Total number of patients was 50. Out of these 37 (74%) were males and 13 (26%) were females. Mean age of the patients was 50.4 years. Thirty-four percent (34%) were positive in normal H and E stain, 68% were positive in Giemsa and 76% were positive in Cresyl fast violet. Conclusion: Cresyl fast violet is a good stain for diagnosis of H. pylori gastritis. (author)

The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: a mixed methods study.

Science.gov (United States)

Bradt, Joke; Potvin, Noah; Kesslick, Amy; Shim, Minjung; Radl, Donna; Schriver, Emily; Gracely, Edward J; Komarnicky-Kocher, Lydia T

2015-05-01

The purpose of this study was to compare the impact of music therapy (MT) versus music medicine (MM) interventions on psychological outcomes and pain in cancer patients and to enhance understanding of patients' experiences of these two types of music interventions. This study employed a mixed methods intervention design in which qualitative data were embedded within a randomized cross-over trial. Thirty-one adult cancer patients participated in two sessions that involved interactive music making with a music therapist (MT) and two sessions in which they listened to pre-recorded music without the presence of a therapist (MM). Before and after each session, participants reported on their mood, anxiety, relaxation, and pain by means of visual analogue and numeric rating scales. Thirty participants completed an exit interview. The quantitative data suggest that both interventions were equally effective in enhancing target outcomes. However, 77.4 % of participants expressed a preference for MT sessions. The qualitative data indicate that music improves symptom management, embodies hope for survival, and helps connect to a pre-illness self, but may also access memories of loss and trauma. MT sessions helped participants tap into inner resources such as playfulness and creativity. Interactive music making also allowed for emotional expression. Some participants preferred the familiarity and predictability of listening to pre-recorded music. The findings of this study advocate for the use of music in cancer care. Treatment benefits may depend on patient characteristics such as outlook on life and readiness to explore emotions related to the cancer experience.

Planning Target Margin Calculations for Prostate Radiotherapy Based on Intrafraction and Interfraction Motion Using Four Localization Methods

International Nuclear Information System (INIS)

Beltran, Chris; Herman, Michael G.; Davis, Brian J.

2008-01-01

Purpose: To determine planning target volume (PTV) margins for prostate radiotherapy based on the internal margin (IM) (intrafractional motion) and the setup margin (SM) (interfractional motion) for four daily localization methods: skin marks (tattoo), pelvic bony anatomy (bone), intraprostatic gold seeds using a 5-mm action threshold, and using no threshold. Methods and Materials: Forty prostate cancer patients were treated with external radiotherapy according to an online localization protocol using four intraprostatic gold seeds and electronic portal images (EPIs). Daily localization and treatment EPIs were obtained. These data allowed inter- and intrafractional analysis of prostate motion. The SM for the four daily localization methods and the IM were determined. Results: A total of 1532 fractions were analyzed. Tattoo localization requires a SM of 6.8 mm left-right (LR), 7.2 mm inferior-superior (IS), and 9.8 mm anterior-posterior (AP). Bone localization requires 3.1, 8.9, and 10.7 mm, respectively. The 5-mm threshold localization requires 4.0, 3.9, and 3.7 mm. No threshold localization requires 3.4, 3.2, and 3.2 mm. The intrafractional prostate motion requires an IM of 2.4 mm LR, 3.4 mm IS and AP. The PTV margin using the 5-mm threshold, including interobserver uncertainty, IM, and SM, is 4.8 mm LR, 5.4 mm IS, and 5.2 mm AP. Conclusions: Localization based on EPI with implanted gold seeds allows a large PTV margin reduction when compared with tattoo localization. Except for the LR direction, bony anatomy localization does not decrease the margins compared with tattoo localization. Intrafractional prostate motion is a limiting factor on margin reduction

Evaluation of early and late complications in patients with congenital lobar emphysema: A 12 year experience

Directory of Open Access Journals (Sweden)

Nazem Masood

2010-01-01

Full Text Available Background: Congenital lobar emphysema (CLE is characterised by over distension of one lobe and pressure on the adjacent lobe and mediastinum. In this study, we review the pathological results of our paediatric patients with CLE, highlighting the early and late complications that occurred in these patients. Patients and Methods: In a prospective study from 1996 to 2008, we evaluated 30 patients with CLE diagnosis. Variables collected included sex, age at the time of diagnosis, radiological diagnostic method, type of treatment, pathological analysis, surgical findings and early postoperative complications. Parents were asked to refer to our clinic for follow-up and evaluation of late complications. Results: Thirty patients and males accounted for majority of the study population (n = 20, 67%. The mean age of male and female patients (at admission was 7.2 ± 2.3 and 4.7 ± 1.2 months respectively (P = not significant. The main diagnostic method was chest x-ray (CXR in all patients. Abnormal bronchial cartilage was found in 71% of patients. The most affected lobe was left upper lobe (50%. Associated anomalies were seen in four patients. Early postoperative periodhadtwo cases of pneumothoraces. At six month follow up, five (25% males and four females (40% had delayed weight gain. Permanent oxygen dependency was seen in two patients. Twenty- six patients underwent thoracotomy. Mortality rate was 13%. Base deficit at the time of admission was greater in those patients who eventually died, (-8.6 ± 1.2 versus -3.1 ± 0.4 (P = 0.0003. There were two deaths in the bilobar involvement group and two in the unilobar involvement group (P = 0.07, near significant. Conclusion: This study confirms that the number of affected lobes and base deficit at the time of admission were associated with significantly increased mortality.

Potentiality if Rb-Sr method for dating the argillous sedimentary rocks

International Nuclear Information System (INIS)

Thomaz Filho, A.

1976-01-01

The potentiality of application Rb-Sr method in argillous sediments, using samples from paleozoic and mesozoic formation in brazilian sedimentaries basin was tested. Physical, chemistry and isotopic analysis of thirty eight samples were made in the laboratories of geochronology Research Center from the University of Sao Paulo. Four isochronic diagrams for the argillous sedimentary rocks were also proposed. (author)

Thirty-four years' experience with biliary atresia in Denmark

DEFF Research Database (Denmark)

Kvist, N; Davenport, M

2011-01-01

Biliary atresia (BA) is a rare disease in Denmark (population ∼ 5.5 million) and there has been some controversy on how smaller countries should manage such conditions to obtain the best possible outcomes. The aim of this study was to evaluate the efficacy of primary surgery (i. e., Kasai portoen...

Posterior Mandibular Residual Ridge Resorption in Patients with Overdentures Supported by Two or Four Endosseous Implants in a 10-year Prospective Comparative Study

NARCIS (Netherlands)

de Jong, Marjolein H. M.; Wright, Paul S.; Meijer, Henny J. A.; Tymstra, Nynke

2010-01-01

Purpose The aim of this study was to evaluate the effect of treatment with either two or four mandibular endosseous implants with an overdenture on mandibular posterior residual ridge resorption over a 10 year period Materials and Methods Sixty edentulous patients with residual mandibular height

Detection and monitoring of invasive exotic plants: a comparison of four sampling methods

Science.gov (United States)

Cynthia D. Huebner

2007-01-01

The ability to detect and monitor exotic invasive plants is likely to vary depending on the sampling method employed. Methods with strong qualitative thoroughness for species detection often lack the intensity necessary to monitor vegetation change. Four sampling methods (systematic plot, stratified-random plot, modified Whittaker, and timed meander) in hemlock and red...

Rapid identification of pathogens directly from blood culture bottles by Bruker matrix-assisted laser desorption laser ionization-time of flight mass spectrometry versus routine methods.

Science.gov (United States)

Jamal, Wafaa; Saleem, Rola; Rotimi, Vincent O

2013-08-01

The use of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) for identification of microorganisms directly from blood culture is an exciting dimension to the microbiologists. We evaluated the performance of Bruker SepsiTyper kit™ (STK) for direct identification of bacteria from positive blood culture. This was done in parallel with conventional methods. Nonrepetitive positive blood cultures from 160 consecutive patients were prospectively evaluated by both methods. Of 160 positive blood cultures, the STK identified 114 (75.6%) isolates and routine conventional method 150 (93%). Thirty-six isolates were misidentified or not identified by the kit. Of these, 5 had score of >2.000 and 31 had an unreliable low score of <1.7. Four of 8 yeasts were identified correctly. The average turnaround time using the STK was 35 min, including extraction steps and 30:12 to 36:12 h with routine method. The STK holds promise for timely management of bacteremic patients. Copyright © 2013 Elsevier Inc. All rights reserved.

A Stakeholder Analysis of the Navy's Thirty-Year Shipbuilding Plan

National Research Council Canada - National Science Library

O'Loughlin, Patrick R

2007-01-01

Using a stakeholder management approach, this thesis helps the U.S. Navy understand who the external stakeholders are with respect to the Thirty-Year Shipbuilding Plan, the priority of differing stakeholder claims, and the nature...

Limb/trunk lean mass ratio as a risk factor for mortality in peritoneal dialysis patients

OpenAIRE

Hui Kang, Seok; Hyang Cho, Kyu; Won Park, Jong; Woo Yoon, Kyung; Young Do, Jun

2012-01-01

Protein energy wasting (PEW) is a common problem in dialysis patients. There have been few reports on the effects of regional lean mass distribution for peritoneal dialysis (PD) patients. We reviewed the medical records and identified all adults who received PD between May 2001 and May 2011. Five hundred thirty four patients were enrolled. The clinical and laboratory data were collected at 1 and 12 months. Regional lean masses were measured by dual-energy X-ray absorptiometry. The limb/trunk ...

Comparative evaluation of four different sterilization methods on contaminated endodontic files

Directory of Open Access Journals (Sweden)

Malathi Yenni

2017-01-01

Full Text Available Background: The reuse of instruments in the field of endodontics leads to cross infection due to contamination with microbes as the instruments come into direct contact with saliva, blood, and infected tissues. Since microbes are considered to be the major cause of endodontic failures, sterilization of endodontic instruments is mandatory for maintaining asepsis to prevent cross-contamination from one person to other. Hence, the present study was conducted to compare the effectiveness of four different methods of sterilizing contaminated endodontic files. Materials and Methods: A total of 48 stainless steel K files were divided into four groups based on the sterilization method followed – Group A: Autoclave, Group B: Glass bead sterilization, Group C: Glutaraldehyde, and Group D: Quitanet Plus (aldehyde-free solution. In all the tested groups, half of the files were contaminated with Escherichia coli and remaining with Enterococcus faecalis. Then, presterilization colony counts were recorded, followed by sterilization through respective methods. Later, the sterilized files were rinsed with distilled water and 100 ul of the diluted concentration was transferred and cultured onto the respective agar plates to determine the total microbial reduction. Results: Autoclave showed complete effectiveness in reducing the microbial count followed by Quitanet Plus, glass bead sterilizer, and glutaraldehyde. Conclusion: Autoclave is considered to be the best sterilization technique to prevent cross infection in endodontic therapy.

Oral Health-Related Quality of Life in Edentulous Patients with Two- vs Four-Locator-Retained Mandibular Overdentures: A Prospective, Randomized, Crossover Study.

Science.gov (United States)

Karbach, Julia; Hartmann, Sinsa; Jahn-Eimermacher, Antje; Wagner, Wilfried

2015-01-01

To compare the oral health-related quality of life (OHRQoL) in a prospective, randomized crossover trial in patients with mandibular overdentures retained with two or four locators. In 30 patients with edentulous mandibles, four implants (ICX-plus implants [Medentis Medical]) were placed in the intraforaminal area. Eight weeks after transgingival healing, patients were randomly assigned to have two or four implants incorporated in the prosthesis. After 3 months, the retention concepts were switched. The patients with a two-implant-supported overdenture had four implants incorporated, whereas patients with a four-implant-supported overdenture had two retention locators taken out. After 3 more months, all four implants were retained in the implant-supported overdenture in every patient. To measure OHRQoL of the patients, the Oral Health Impact Profile 14, German version (OHIP-14 G), was used. A considerable increase in OHRQoL could be seen in all patients after the prosthesis was placed on the implants. Also, a statistically significant difference of OHRQoL could be seen in the OHIP-14 G scores between two-implant and four-implant overdentures. Patients had a higher OHRQoL after incorporation of four implants in the overdenture compared with only two implants. Patients with implant-retained overdentures had better OHRQoL compared with those with conventional dentures. The number of incorporated implants in the locator-retained overdenture also influenced the increase in OHRQoL, with four implants having a statistically significant advantage over two implants.

Small-bowel capsule endoscopy in patients with suspected Crohn's disease-diagnostic value and complications.

Science.gov (United States)

Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos

2010-01-01

The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy.

Four quadrant parallel peripheral screw fixation for displaced femoral neck fractures in elderly patients

Directory of Open Access Journals (Sweden)

Bhava RJ Satish

2013-01-01

Conclusion: Closed reduction and cannulated cancellous screw fixation gives satisfactory functional results in large group of elderly patients. The four quadrant parallel peripheral (FQPP screw fixation technique gives good stability, allows controlled collapse, avoids fixation failure and achieves predictable bone healing in displaced femoral neck fracture in patients ≥50 years of age.

Constructing solvable groups with derived length four and four character degrees

OpenAIRE

Lewis, Mark L.

2018-01-01

In this paper, we present a new method to construct solvable groups with derived length four and four character degrees. We then use this method to present a number of new families of groups with derived length four and four character degrees.

The pedicled omentoplasty and split skin graft (POSSG) for reconstruction of large chest wall defects. A validity study of 34 patients

NARCIS (Netherlands)

C.M.E. Contant; A.N. van Geel (Albert); B. van der Holt (Bronno); T. Wiggers (Theo)

1996-01-01

textabstractThe aim of this study was to evaluate retrospectively the results of pedicled omentoplasty and split skin graft (POSSG) in reconstructing (full thickness) chest wall defects, and to define its role as a palliative procedure for local symptom control. Thirty-four patients with recurrent

Psychological well-being in obese in-patients with ischemic heart disease at entry and at discharge from a four-week cardiac rehabilitation program

Directory of Open Access Journals (Sweden)

Gian Mauro Manzoni

2010-08-01

Full Text Available The purposes of this observational pre-post study were twofold: 1- to evaluate psychological health in obese patients with ischemic heart disease (IHD at admission to cardiac rehabilitation (CR and 2 - to examine the effectiveness of a four-week CR residential program in improving obese patients’ psychological well-being at discharge from CR. A sample of 177 obese patients completed the Psychological General Well-Being Inventory (PGWBI at admission to the CR program and at discharge. The equivalence testing method with normative comparisons was used to determine the clinical significance of improvements after having established that baseline mean scores on the PGWBI scales were significantly lower than normal means. Results show that patients scored equally or better than norms on many PGWBI dimensions at admission to CR but scored significantly worse on Global Score, Vitality and Self-control. At discharge, mean scores that were impaired at baseline returned to normal levels at the more conservative equivalence interval. A four-week CR program was thus effective in improving obese patients’ psychological well-being. The equivalence testing method allowed to establish the clinical significance of such improvement.

Comparison of four methods to evaluate the modifications of the cerebral perfusion in tomo-scintigraphy; Comparaison de quatre methodes d'evaluation des modifications de la perfusion cerebrale en tomoscintigraphie

Energy Technology Data Exchange (ETDEWEB)

Daboussi, A.; Julian, A. [Universite Paul-Sabatier, EA 3033, Radiopharmaceutiques et Traitement de l' Image, 31 - Toulouse (France); Daboussi, A.; Fourcade, O. [Centre Hospitalier Universitaire Purpan, GRC 48 Coordination Anesthesie-Reanimation, 31 - Toulouse (France); Julian, A.; Ouhayoun, E.; Esquerre, J.P.; Payoux, P. [Centre Hospitalier Universitaire Purpan, Service de Medecine Nucleaire, 31 - Toulouse (France); Tremoulet, M. [Centre Hospitalier Universitaire Purpan, Service de Neurochirurgie, 31 - Toulouse (France)

2007-02-15

Introduction: We compared four different methods to assess changes in cerebral blood flow in patients with normal pressure hydrocephalus using cerebral ECD SPECT before and after injection of acetazolamide. Material and methods: Eleven patients underwent cerebral SPECT before and after injection of 1 g of acetazolamide using a {sup 99m}Tc-ECD split-dose protocol with a first injection of 370 MBq and a second of 1 100 MBq. After reconstruction of volumes with Neurogam (Segami) software. we compared visual analysis to semi quantitative analysis provided by Neurogam software. ratios methods and parametric analysis under SPM99 and SPM2. Results: Visual analysis is immediate but frequently misleading. The contribution of Neurogam depends on the reader's skill and may be significant for non expert readers. The manual semi-automatic method is tedious and its results depend on the choice of the areas of interest and reference necessary for activity normalization. At last, the automatic method carried out by SPM is reliable for population analysis, but its efficiency for individual analysis remains to be evaluated. (authors)

Identification of mechanisms enabling integrated care for patients with chronic diseases: a literature review

Directory of Open Access Journals (Sweden)

Denise van der Klauw

2014-07-01

Full Text Available Introduction: Notwithstanding care for chronically ill patients requires a shift towards care that is well coordinated and focused on prevention and self-care, the concept of integrated care lacks specificity and clarity. This article presents a literature review to identify mechanisms for achieving integrated care objectives.Theory and methods: Existing models often present a large variety of dimensions, archetypes and categories of integration without specifying them. Models and programmes describing integrated care for chronic diseases were reviewed. Data were extracted related to objectives and clusters of mechanisms of integration.Results: Thirty-four studies presented four objectives: functional, organisational, professional and service integration. We categorised approaches and interventions to achieve these objectives by strategy and clusters of ‘mechanisms of integration’: degree, patient centredness and normative aspects.Conclusions and discussion: The clarification of mechanisms to achieve objectives of integrated care as presented may be used as starting point for the development and refinement of integrated care programmes, including methodological grounding of their evaluation. Given that most studies reviewed lack both empirical data and descriptions of the methods used, future research needs to close these gaps. Validation of the findings by a large panel of experts is suggested as recommendation to work towards a grounded framework.

Analysis of 2014's Thirty Best Undergraduate Accounting Programs

Science.gov (United States)

Adkins, Darlene A.; Geddie, Mary F.; Moore, Paula Hearn; Griffin, Richard B.

2016-01-01

This paper examines primarily the courses in the accounting major and a portion of the business core of the best thirty accounting programs in the United States as identified by the Accounting Degree Review. A thorough examination of each school's web site has been conducted to gather current (2014) information concerning the requirements for a…

Acute fascioliasis--clinical and epidemiological features of four patients in Chile.

Science.gov (United States)

Fica, A; Dabanch, J; Farias, C; Castro, M; Jercic, M I; Weitzel, T

2012-01-01

Because of its infrequent and protean presentation and the lack of clinical data, the management of acute infections with the foodborne trematode Fasciola hepatica is challenging. We report four serologically confirmed cases that illustrate our experience with this parasitic infection in Chile. All patients were adults presenting with upper abdominal pain. Other symptoms included fever, nausea/vomiting, and cutaneous manifestations. In all cases, marked eosinophilia was present. All patients lived in an urban environment, and three reported the consumption of raw watercress. Computed tomography (CT) scans showed hypodense hepatic lesions, whereas ultrasonography findings were unremarkable. One patient suffered portal vein thrombosis, which might be a rare complication of acute fascioliasis. All patients were successfully treated with triclabendazole. Our case series demonstrates that patients with acute fascioliasis typically present with a combination of upper abdominal pain, marked eosinophilia, and hypodense hepatic lesions on CT imaging. Diagnosis should be confirmed by serological investigation. A history of recent consumption of raw watercress is an important finding, but in some patients the source of infection remains obscure. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

The Instrumentation Program for the Thirty Meter Telescope

OpenAIRE

Simard, Luc; Crampton, David; Ellerbroek, Brent; Boyer, Corinne

2012-01-01

An overview of the current status of the Thirty Meter Telescope (TMT) instrumentation program is presented. Science cases and operational concepts as well as their links to the instruments are continually revisited and updated through a series of workshops and conferences. Work on the three first-light instruments (WFOS IRIS, and IRMS) has made significant progress, and many groups in TMT partner communities are developing future instrument concepts. Other instrument-related subsystems are al...

Overt hypoadrenalism is uncommon in patients with stage 3 and 4 ...

African Journals Online (AJOL)

Our study aimed to determine the prevalence of primary hypoadrenalism, as defined by a subnormal cortisol response to the 250 µg adrenocorticotrophic hormone (ACTH) stimulation test, in patients with stage 3 and 4 lung cancer. Methods. Thirty patients with stage 3 and 4 bronchogenic carcinoma were prospectively ...

Structure of Symmetry Groups via Cartan's Method: Survey of Four Approaches

Directory of Open Access Journals (Sweden)

Oleg I. Morozov

2005-10-01

Full Text Available In this review article we discuss four recent methods for computing Maurer-Cartan structure equations of symmetry groups of differential equations. Examples include solution of the contact equivalence problem for linear hyperbolic equations and finding a contact transformation between the generalized Hunter-Saxton equation and the Euler-Poisson equation.

A new method to evaluate patient characteristic response to ultrafiltration during hemodialysis.

Science.gov (United States)

Casagrande, G; Teatini, U; Romei Longhena, G; Miglietta, F; Fumero, R; Costantino, M L

2007-05-01

Several factors are involved in the pathogenesis of dialysis discomfort interfering with optimal fluid removal and reducing the efficacy of the treatment; the most important one is a decrease in blood volume caused by an imbalance between ultrafiltration (UF) and plasmarefilling (PR) rates. This study is aimed at devising a method to tailor the dialysis therapy to each individual patient, by analyzing the relationship between PR and UF during the sessions in stable patients and widening the knowledge of fluid exchanges during the treatment. Thirty stable patients undergoing maintenance hemodialysis were enrolled. Three dialysis sessions were monitored for each patient; systemic pressure, blood composition, blood volume % variation, weight loss and conductivity were recorded repeatedly. A Plasma Refilling Index (PRI), defined and calculated by means of parameters measured throughout the dialysis, was introduced as a novel instrument to study plasma refilling phenomena. Results. The PRI provides understanding of patient response (in terms of plasma refilling) to the set UF. In the monitored sessions, the PRI trend is found to be characteristic of each patient; a PRI course that is at variance with the characteristic trend is a signal of inadequate or unusual dialysis scheduling. Moreover, statistical analysis highlights two different PRI trends during the first hour and during the rest of the treatment, suggesting the presence of different treatment phases. The main advantage of the PRI index is that it is non-invasive peculiar to each patient and easy to compute in a dialysis routine based on online data recorded by the monitor. A deviation from the characteristic trend may be a warning for the clinician. The analysis of the PRI trend also suggests how to modulate UF as a function of interstitial to intravascular fluid removal balance during dialysis.

Clinical effects of blood transfusion during the immediate postoperative period in cardiac surgery patients

Directory of Open Access Journals (Sweden)

Vasilis Hatzitolias

2015-09-01

Full Text Available Introduction: Blood transfusion is common in patients undergoing cardiac surgery. Aim: Our goal was to investigate the association between blood transfusions in the early postoperative period and complications during Cardiac Intensive Care Unit (CICU stay. Methods: Retrospectively analysis in 874 patients who underwent isolated coronary artery bypass grafting, valve surgery or combined procedures. Patients were allocated to two groups according to the presence (Group A or absence (Group B of blood transfusion during extracorporeal circulation, surgery and CICU stay. Two hundred thirty four patients with preexisting hepatic or blood diseases, atrial fibrillation, emergent surgery or those received autologous blood transfusions were excluded prior to the study. Morbidity was defined as prolonged postoperative mechanical ventilation, mechanical ventilation>7hours, reintubation, use of non-invasive ventilation, postoperative atrial fibrillation and length of hospital stay. Statistical analysis was carried out using Chi-square, Student’s t-test, Relative Risk (RR and logistic regression with statistical significance set at p7 hours (p 7 hours (p<0.01. Conclusions: Blood transfusions seem to associate with certain complications in cardiac surgery patients.

Dynamic contrast-enhanced MRI in patients with luminal Crohn's disease

International Nuclear Information System (INIS)

Ziech, M.L.W.; Lavini, C.; Caan, M.W.A.; Nio, C.Y.; Stokkers, P.C.F.; Bipat, S.; Ponsioen, C.Y.; Nederveen, A.J.; Stoker, J.

2012-01-01

Objectives: To prospectively assess dynamic contrast-enhanced (DCE-)MRI as compared to conventional sequences in patients with luminal Crohn's disease. Methods: Patients with Crohn's disease undergoing MRI and ileocolonoscopy within 1 month had DCE-MRI (3T) during intravenous contrast injection of gadobutrol, single shot fast spin echo sequence and 3D T1-weighted spoiled gradient echo sequence, a dynamic coronal 3D T1-weighted fast spoiled gradient were performed before and after gadobutrol. Maximum enhancement (ME) and initial slope of increase (ISI) were calculated for four colon segments (ascending colon + coecum, transverse colon, descending colon + sigmoid, rectum) and (neo)terminal ileum. C-reactive protein (CRP), Crohn's disease activity index (CDAI), per patient and per segment Crohn's disease endoscopic index of severity (CDEIS) and disease duration were determined. Mean values of the (DCE-)MRI parameters in each segment from each patient were compared between four disease activity groups (normal mucosa, non-ulcerative lesions, mild ulcerative and severe ulcerative disease) with Mann–Whitney test with Bonferroni adjustment. Spearman correlation coefficients were calculated for continuous variables. Results: Thirty-three patients were included (mean age 37 years; 23 females, median CDEIS 4.4). ME and ISI correlated weakly with segmental CDEIS (r = 0.485 and r = 0.206) and ME per patient correlated moderately with CDEIS (r = 0.551). ME was significantly higher in segments with mild (0.378) or severe (0.388) ulcerative disease compared to normal mucosa (0.304) (p < 0.001). No ulcerations were identified at conventional sequences. ME correlated with disease duration in diseased segments (r = 0.492), not with CDAI and CRP. Conclusions: DCE-MRI can be used as a method for detecting Crohn's disease ulcerative lesions.

Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates.

LENUS (Irish Health Repository)

O'Sullivan, S T

2012-02-03

Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.

A portable borehole temperature logging system using the four-wire resistance method

Science.gov (United States)

Erkan, Kamil; Akkoyunlu, Bülent; Balkan, Elif; Tayanç, Mete

2017-12-01

High-quality temperature-depth information from boreholes with a depth of 100 m or more is used in geothermal studies and in studies of climate change. Electrical wireline tools with thermistor sensors are capable of measuring borehole temperatures with millikelvin resolution. The use of a surface readout mode allows analysis of the thermally conductive state of a borehole, which is especially important for climatic and regional heat flow studies. In this study we describe the design of a portable temperature logging tool that uses the four-wire resistance measurement method. The four-wire method enables the elimination of cable resistance effects, thus allowing millikelvin resolution of temperature data at depth. A preliminary two-wire model of the system is also described. The portability of the tool enables one to collect data from boreholes down to 300 m, even in locations with limited accessibility.

Thirty years of nuclear fission in Yugoslavia

Energy Technology Data Exchange (ETDEWEB)

Pesic, M; Stefanovic, D [Boris Kidric Institute of Nuclear Sciences VINCA, Belgrade (Yugoslavia)

1989-07-01

Experimental nuclear reactor 'RB' in Boris Kidric Institute in Vinca is the first nuclear facility built in Yugoslavia in which the first Yugoslav controlled nuclear fission was achieved thirty years ago on April 26, 1958. Designed by Yugoslav scientist as a bare, natural uranium-heavy water critical assembly, the 'RB' reactor has survived a series of modifications trying to follow directions of contemporary nuclear research. The actual 'RB' reactor technical characteristics and experimental possibilities are described. The modifications are underlined, the experience gained and plans for future are presented. A brief review of reactor operation and experiments performed is shown. (author)

Simple method of detecting sarcoptes scabiei var hominis mites among bedridden elderly patients suffering from severe scabies infestation using an adhesive-tape.

Science.gov (United States)

Katsumata, Kazuo; Katsumata, Kazumi

2006-01-01

Scabies infestation is very common among bedridden elderly patients. The standard method of diagnosis for scabies by scraping the skin requires some skill. Therefore, dermatologists employ this method. However, dermatologists are usually not present in most long-term nursing units. Thus, we tried to catch mites using a strong transparent adhesive tape commercially available for packing use as an alternative method for the diagnosis of severe scabies infestation. After firmly applying the adhesive side of the tape onto an appropriate skin lesion of patients, the tape was pulled off and transferred directly onto a slide for microscopy, affixing the adhered separated part of the corneal skin. When a massive outbreak of scabies infestation occurred in May 2004 at the nursing unit of K hospital with thirty-one bedridden elderly patients, we tried to detect scabies mite using an adhesive tape. We could detect mites from six patients using this tape method. The diagnosis was confirmed by the standard scraping method. By the tape method we could observe some mites moving around and also could see a striated structure with dark red or weak red color or gray color granule-like constitution on the body of some mites. We found mites only on the skin of the fingers and toes where the skin of a patient is thin. Recently, massive scabies infestation in elderly long-term residents has been reported elsewhere. This tape method is simple and useful for diagnosis of severe scabies infestation in long-term nursing units.

Thirty years of transport package development for spent fuels

International Nuclear Information System (INIS)

Cory, A.R.

2005-01-01

By June 2005, when shipments of spent fuel for reprocessing from Germany are concluded, BNFL flask types will have been responsible for transporting more than 2000 tonnes of heavy metal in Europe in the form of spent fuel. Several thousand more tonnes of spent fuel have been transported by sea from Japan over the last thirty years. The design of spent fuel packages has not stood still for that time. In order to anticipate the changing needs of the nuclear power generation industry, advances have been made both in package design and analysis. Thirty years ago spent fuel burnup and initial enrichment were considerably lower, which was reflected in the different demands placed on the shielding design of packages, and in the design of the internal basket to separate the fuel assemblies. Technical development of both 'wet' (water-filled cavity) and 'dry' packages has progressed in parallel, and the relative merits and peculiarities of each type is explored. BNFL has considerable experience in the operation of both types, and is well placed to comment on practical and functional issues associated with both types. While there have been certain evolutionary changes affecting package design, there have also been more significant changes in the Design Safety Case. These have sometimes been necessary to meet changes in IAEA Regulations, or the challenges posed by the regulators themselves. In other cases advantage has been taken of improvements in analytical techniques to demonstrate increased margins of operational safety. Where possible these margins have also been increased by other means, such as taking advantage of commercial trends to reduce package thermal loads. A key factor over the last thirty years has been the increasing influence of the Regulating Authorities and the development of the IAEA Regulations. The various Competent Authorities now tend to have a higher proportion of technical experts, often recruited from the nuclear industry, and are thus more able to

MYO7A and USH2A gene sequence variants in Italian patients with Usher syndrome.

Science.gov (United States)

Sodi, Andrea; Mariottini, Alessandro; Passerini, Ilaria; Murro, Vittoria; Tachyla, Iryna; Bianchi, Benedetta; Menchini, Ugo; Torricelli, Francesca

2014-01-01

To analyze the spectrum of sequence variants in the MYO7A and USH2A genes in a group of Italian patients affected by Usher syndrome (USH). Thirty-six Italian patients with a diagnosis of USH were recruited. They received a standard ophthalmologic examination, visual field testing, optical coherence tomography (OCT) scan, and electrophysiological tests. Fluorescein angiography and fundus autofluorescence imaging were performed in selected cases. All the patients underwent an audiologic examination for the 0.25-8,000 Hz frequencies. Vestibular function was evaluated with specific tests. DNA samples were analyzed for sequence variants of the MYO7A gene (for USH1) and the USH2A gene (for USH2) with direct sequencing techniques. A few patients were analyzed for both genes. In the MYO7A gene, ten missense variants were found; three patients were compound heterozygous, and two were homozygous. Thirty-four USH2A gene variants were detected, including eight missense variants, nine nonsense variants, six splicing variants, and 11 duplications/deletions; 19 patients were compound heterozygous, and three were homozygous. Four MYO7A and 17 USH2A variants have already been described in the literature. Among the novel mutations there are four USH2A large deletions, detected with multiplex ligation dependent probe amplification (MLPA) technology. Two potentially pathogenic variants were found in 27 patients (75%). Affected patients showed variable clinical pictures without a clear genotype-phenotype correlation. Ten variants in the MYO7A gene and 34 variants in the USH2A gene were detected in Italian patients with USH at a high detection rate. A selective analysis of these genes may be valuable for molecular analysis, combining diagnostic efficiency with little time wastage and less resource consumption.

Analysis of four serum biomarkers in rheumatoid arthritis: association with extra articular manifestations in patients and arthralgia in relatives

Directory of Open Access Journals (Sweden)

Flávia R. Nass

Full Text Available ABSTRACT Objectives: To evaluate the frequency of four serum biomarkers in RA patients and their relatives and identify possible associations with clinical findings of the disease. Methods: This was a transversal analytical study. Anti-cyclic citrullinated peptide (anti-CCP, anti-mutated citrullinated vimentin (anti-MCV and IgA-rheumatoid factor (RF were determined by ELISA and IgM-RF by latex agglutination in 210 RA patients, 198 relatives and 92 healthy controls from Southern Brazil. Clinical and demographic data were obtained through charts review and questionnaires. Results: A higher positivity for all antibodies was observed in RA patients when compared to relatives and controls (p < 0.0001. IgA-RF was more frequent in relatives compared to controls (14.6% vs. 5.4%, p = 0.03, OR = 2.98; 95% CI = 1.11-7.98 whereas anti-CCP was the most common biomarker among RA patients (75.6%. Concomitant positivity for the four biomarkers was more common in patients (46.2%, p < 0.0001. Relatives and controls were mostly positive for just one biomarker (20.2%, p < 0.0001 and 15.2%, p = 0.016, respectively. No association was observed between the number of positive biomarkers and age of disease onset, functional class or tobacco exposure. In seronegative patients predominate absence of extra articular manifestations (EAMs (p = 0.01; OR = 3.25; 95% CI = 1.16-10.66. Arthralgia was present in positive relatives, regardless the type of biomarker. Conclusions: A higher number of biomarkers was present in RA patients with EAMs. Positivity of biomarkers was related to arthralgia in relatives. These findings reinforce the link between distinct biomarkers and the pathophysiologic mechanisms of AR.

Intraoperative irradiation for locally recurrent colorectal cancer in previously irradiated patients

International Nuclear Information System (INIS)

Haddock, Michael G.; Gunderson, Leonard L.; Nelson, Heidi; Cha, Stephen S.; Devine, Richard M.; Dozois, Roger R.; Wolff, Bruce G.

2001-01-01

Purpose: Information in the literature regarding salvage treatment for patients with locally recurrent colorectal cancer who have previously been treated with high or moderate dose external beam irradiation (EBRT) is scarce. A retrospective review was therefore performed in our institution to determine disease control, survival, and tolerance in patients treated aggressively with surgical resection and intraoperative electron irradiation (IOERT) ± additional EBRT and chemotherapy. Methods and Materials: From 1981 through 1994, 51 previously irradiated patients with recurrent locally advanced colorectal cancer without evidence of distant metastatic disease were treated at Mayo Clinic Rochester with surgical resection and IOERT ± additional EBRT. An attempt was made to achieve a gross total resection before IOERT if it could be safely accomplished. The median IOERT dose was 20 Gy (range, 10-30 Gy). Thirty-seven patients received additional EBRT either pre- or postoperatively with doses ranging from 5 to 50.4 Gy (median 25.2 Gy). Twenty patients received 5-fluorouracil ± leucovorin during EBRT. Three patients received additional cycles of 5-fluorouracil ± leucovorin as maintenance chemotherapy. Results: Thirty males and 21 females with a median age of 55 years (range 31-73 years) were treated. Thirty-four patients have died; the median follow-up in surviving patients is 21 months. The median, 2-yr, and 5-yr actuarial overall survivals are 23 months, 48% and 12%, respectively. The 2-yr actuarial central control (within IOERT field) is 72%. Local control at 2 years has been maintained in 60% of patients. There is a trend toward improved local control in patients who received ≥30 Gy EBRT in addition to IOERT as compared to those who received no EBRT or <30 Gy with 2-yr local control rates of 81% vs. 54%. Distant metastatic disease has developed in 25 patients, and the actuarial rate of distant progression at 2 and 4 years is 56% and 76%, respectively. Peripheral

Gas emission during laparoscopic colorectal surgery using a bipolar vessel sealing device: A pilot study on four patients

Directory of Open Access Journals (Sweden)

Gianella Michele

2008-09-01

Full Text Available Abstract Background Dissection during laparoscopic surgery produces smoke containing potentially toxic substances. The aim of the present study was to analyze smoke samples produced during laparoscopic colon surgery using a bipolar vessel sealing device (LigaSure™. Methods Four consecutive patients undergoing left-sided colectomy were enrolled in this pilot study. Smoke was produced by the use of LigaSure™. Samples (5,5l were evacuated from the pneumoperitoneum in a closed system into a reservoir. Analysis was performed with CO2-laser-based photoacoustic spectroscopy and confirmed by a Fourier-transform infrared spectrum. The detected spectra were compared to the available spectra of known toxins. Results Samples from four laparoscopic sigmoid resections were analyzed. No relevant differences were noted regarding patient and operation characteristics. The gas samples were stable over time proven by congruent control measurements as late as 24 h after sampling. The absorption spectra differed considerably between the patients. One broad absorption line at 100 ppm indicating H2O and several unknown molecules were detected. With a sensitivity of alpha min ca 10-5 cm-1 no known toxic substances like phenol or indole were identified. Conclusion The use of a vessel sealing device during laparoscopic surgery does not produce known toxic substances in relevant quantity. Further studies are needed to identify unknown molecules and to analyze gas emission under various conditions.

MRI abnormalities and related risk factors of the brain in patients with neuromyelitis optica

International Nuclear Information System (INIS)

Xiao Hui; Ma Lin; Lou Xin; Cai Youquan; Wang Yulin; Wang Yan; Wu Lei; Wu Weiping

2011-01-01

Objective: To investigate the MRI features of the brain in patients with neuromyelitis optica (NMO), and to evaluate the correlation between the brain abnormalities and related risk factors. Methods: Fifty-four patients with definite NMO according to 2006 Wingerchuk diagnosis criteria were enrolled in this study. MRI scanning of the brain was performed in these patients. Distribution and signal features of all the lesions were analyzed. A Logistic regression analysis was used to evaluate the risk factors of brain abnormalities. Results: Twenty-four NMO patients (44.4%) showed unremarkable findings and thirty (55.6%) showed abnormalities on brain MRI. Multiple and non-specific small lesions in the subcortical white matter and grey-white matter junction were the most frequent abnormalities on brain MRI (13/30, 43.3%). Typical lesion locations included corpus callosum, subependyma of ventricles, hypothalamus and brain stem. The lesions showed punctate, patchy and linear abnormal signals. Post-contrast MRI showed no abnormal enhancement in 16 cases. Logistic regression analysis showed that coexisting autoimmune disease or infection. history had correlations with abnormalities of the brain on MRI (OR=3.519, P<0.05). Conclusions: There was a high incidence of brain abnormalities in NMO. Subependymal white matter, corpus callosum, hypothalamus and brain stem were often involved in NMO. NMO patients with coexisting autoimmune disease and infection history had higher risk of brain abnormalities. (authors)

A comparison among four tract dilation methods of percutaneous nephrolithotomy: a systematic review and meta-analysis.

Science.gov (United States)

Dehong, Cao; Liangren, Liu; Huawei, Liu; Qiang, Wei

2013-11-01

The purpose of this study was to evaluate the efficacy and safety of the Amplatz dilation (AD), metal telescopic dilation (MTD), balloon dilation (BD), and one-shot dilation (OSD) methods for tract dilation during percutaneous nephrolithotomy (PCNL). Relevant eligible studies were identified using three electronic databases (Medline, EMBASE, and Cochrane CENTRAL). Database acquisition and quality evaluation were independently performed by two reviewers. Efficacy (stone-free rate, surgical duration, and tract dilatation fluoroscopy time) and safety (transfusion rate and hemoglobin decrease) were evaluated using Review Manager 5.2. Four randomized controlled trials and eight clinical controlled trials involving 6,820 patients met the inclusion criteria. The pooled result from a meta-analysis showed statistically significant differences in tract dilatation fluoroscopy time and hemoglobin decrease between the OSD and MTD groups, which showed comparable stone-free and transfusion rates. Significant differences in transfusion rate were found between the BD and MTD groups. Among patients without previous open renal surgery, those who underwent BD exhibited a lower blood transfusion rate and a shorter surgical duration compared with those who underwent AD. The OSD technique is safer and more efficient than the MTD technique for tract dilation during PCNL, particularly in patients with previous open renal surgery, resulting in a shorter tract dilatation fluoroscopy time and a lesser decrease in hemoglobin. The efficacy and safety of BD are better than AD in patients without previous open renal surgery. The OSD technique should be considered for most patients who undergo PCNL therapy.

Investigating the Effectiveness of Teaching Methods Based on a Four-Step Constructivist Strategy

Science.gov (United States)

Çalik, Muammer; Ayas, Alipaşa; Coll, Richard K.

2010-02-01

This paper reports on an investigation of the effectiveness an intervention using several different methods for teaching solution chemistry. The teaching strategy comprised a four-step approach derived from a constructivist view of learning. A sample consisting of 44 students (18 boys and 26 girls) was selected purposively from two different Grade 9 classes in the city of Trabzon, Turkey. Data collection employed a purpose-designed `solution chemistry concept test', consisting of 17 items, with the quantitative data from the survey supported by qualitative interview data. The findings suggest that using different methods embedded within the four-step constructivist-based teaching strategy enables students to refute some alternative conceptions, but does not completely eliminate student alternative conceptions for solution chemistry.

Post-operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

DEFF Research Database (Denmark)

Jensen, K; Kehlet, H; Lund, Claus

2007-01-01

functions. We investigated the feasibility and efficacy of a standardized, evidence-based anaesthesia/analgesic regime to identify residual problems in the early post-operative phase. METHODS: One hundred and thirty-four consecutive patients admitted for elective laparoscopic cholecystectomy at Hvidovre...

Noninvasive detection of coronary abnormalities in pediatric patients with Kawassaki disease using multi-slice spiral CT

International Nuclear Information System (INIS)

Hou Yang; Guo Wenli; Yue Yong; Chen Liying; Guo Qiyong; Yu Xianyi; Wang Hong

2006-01-01

Objective: To evaluate the feasibility and value of detecting coronary artery lesions in Kawasaki disease using multi-slice computed tomography (MSCT). Methods: Thirty-four pediatric patients underwent 16-slice or 64-slice CT coronary, angiography. 18 patients were also examined with 2 dimension echocardiography (2DE). In all cases, visibility of coronary artery segment was recorded. The diameter of the LCA, RCA were measured in MSCTA and compared with 2DE. Correlation coefficient of dimension and coincidence rate of two methods were calculated. Results: Coronary artery lesions were found in 14 patients (22 branches) of the 34 cases with KD on MSCT. Six cases were dialated, 3 cases were dialated with aneurysms, 2 cases had aneurysms without dialation. Coronary artery stenosis in 1 eases, calcification in 2 cases. Three cases had multiple aneurysms with the presence of alternate stenosis that made the artery a bead-like appearance. CC of LM and RCA were 0.85, 0.91, respectively (P>0.05). Three coronary artery aneurysm in the distal RCA was missed by 2DE. MSCT could not detect slight or moderate mitral regurgitation in 2 patients and artery wall thickening in 5 patients. Conclusion: MSCT would be an effective complementary or alternative method for CDEC to evaluate coronary artery lesions non-invasively in pediatric patients with Kawasaki disease. (authors)

Quantifying clutter: A comparison of four methods and their relationship to bat detection

Science.gov (United States)

Joy M. O’Keefe; Susan C. Loeb; Hoke S. Hill Jr.; J. Drew Lanham

2014-01-01

The degree of spatial complexity in the environment, or clutter, affects the quality of foraging habitats for bats and their detection with acoustic systems. Clutter has been assessed in a variety of ways but there are no standardized methods for measuring clutter. We compared four methods (Visual Clutter, Cluster, Single Variable, and Clutter Index) and related these...

Case series

African Journals Online (AJOL)

ebutamanya

2015-01-20

Jan 20, 2015 ... The brainstem, cerebral white matter, basal ganglia, internal capsule, thalamus and spinal cord were involved in forty four, thirty one, thirty, twenty nine, seventeen and four patients, respectively. The cerebral peduncle was the brainstem structure mainly involved with thirty cases followed by the pons with, ...

Nicholas Kaldor after Thirty Years

Directory of Open Access Journals (Sweden)

John Edward King

2016-06-01

Full Text Available The article analyses Kaldor’s ideas on economic policy, his interest in policy issues, and his contribution on specific policies. It underlines Kaldor’s strong and cogent views on three main topics: monetary and fiscal policy, the control of cost inflation, and the stabilisation of commodity prices. The author suggests how Kaldor might have reacted to the most important economic policy questions that still face Britain and the European Union, thirty years after his death. Kaldor was a prominent opponent of Britain’s entry into the then Common Market in the 1970s: not on the basis of any emotive English nationalism, but rather because he believed that the British economy would be damaged by an exposure to unlimited competition from more successful European industries. Perhaps he would have argued that, by 2016, the damage has already been done, and that Britain should now remain in the Union to continue the fight for more sensible macroeconomic policies. He would certainly have been pleased that his adoptive country had refused to join the Eurozone. JEL: B31; E61; E52

Determination of moderate-to-severe postoperative pain on the numeric rating scale: a cut-off point analysis applying four different methods.

Science.gov (United States)

Gerbershagen, H J; Rothaug, J; Kalkman, C J; Meissner, W

2011-10-01

Cut-off points (CPs) of the numeric rating scale (NRS 0-10) are regularly used in postoperative pain treatment. However, there is insufficient evidence to identify the optimal CP between mild and moderate pain. A total of 435 patients undergoing general, trauma, or oral and maxillofacial surgery were studied. To determine the optimal CP for pain treatment, four approaches were used: first, patients estimated their tolerable postoperative pain intensity before operation; secondly, 24 h after surgery, they indicated if they would have preferred to receive more analgesics; thirdly, satisfaction with pain treatment was analysed, and fourthly, multivariate analysis was used to calculate the optimal CP for pain intensities in relation to pain-related interference with movement, breathing, sleep, and mood. The estimated tolerable postoperative pain before operation was median (range) NRS 4.0 (0-10). Patients who would have liked more analgesics reported significantly higher average pain since surgery [median NRS 5.0 (0-9)] compared with those without this request [NRS 3.0 (0-8)]. Patients satisfied with pain treatment reported an average pain intensity of median NRS 3.0 (0-8) compared with less satisfied patients with NRS 5.0 (2-9). Analysis of average postoperative pain in relation to pain-related interference with mood and activity indicated pain categories of NRS 0-2, mild; 3-4, moderate; and 5-10, severe pain. Three of the four methods identified a treatment threshold of average pain of NRS≥4. This was considered to identify patients with pain of moderate-to-severe intensity. This cut-off was indentified as the tolerable pain threshold.

CASE REPORT Thirty years old lady with nephrotic syndrome: a ...

African Journals Online (AJOL)

CASE REPORT. Thirty years old lady with nephrotic syndrome: a case of biopsy proven lupus nephritis in Tanzania. FRANCIS FREDRICK1,2*, PASCHAL J. RUGGAJO2,3,GYAVIIRA MAKANGA3, CHARLES K. SHIJA3, MIKAEL. AMDEMARIAM3, BELSON RUGWIZAGONGA4 and JAMES N. KITINYA4. 1Department of ...

Four-Dimensional Data Assimilation Using the Adjoint Method

Science.gov (United States)

Bao, Jian-Wen

The calculus of variations is used to confirm that variational four-dimensional data assimilation (FDDA) using the adjoint method can be implemented when the numerical model equations have a finite number of first-order discontinuous points. These points represent the on/off switches associated with physical processes, for which the Jacobian matrix of the model equation does not exist. Numerical evidence suggests that, in some situations when the adjoint method is used for FDDA, the temperature field retrieved using horizontal wind data is numerically not unique. A physical interpretation of this type of non-uniqueness of the retrieval is proposed in terms of energetics. The adjoint equations of a numerical model can also be used for model-parameter estimation. A general computational procedure is developed to determine the size and distribution of any internal model parameter. The procedure is then applied to a one-dimensional shallow -fluid model in the context of analysis-nudging FDDA: the weighting coefficients used by the Newtonian nudging technique are determined. The sensitivity of these nudging coefficients to the optimal objectives and constraints is investigated. Experiments of FDDA using the adjoint method are conducted using the dry version of the hydrostatic Penn State/NCAR mesoscale model (MM4) and its adjoint. The minimization procedure converges and the initialization experiment is successful. Temperature-retrieval experiments involving an assimilation of the horizontal wind are also carried out using the adjoint of MM4.

Clinical outcome of percutaneous RF-ablation of non-operable patients with liver metastasis from breast cancer

DEFF Research Database (Denmark)

Kümler, Iben; Parner, Vibeke Kirk; Tuxen, Malgorzata K.

2015-01-01

PURPOSE: Despite improved anti-neoplastic treatment the prognosis for patients with liver metastases from metastatic breast cancer remains poor. MATERIALS AND METHODS: Thirty-two consecutive patients with metastatic breast cancer treated with radiofrequency ablation (RFA) at the Department of Onc...

Thirty ways to temporize on waste

International Nuclear Information System (INIS)

Marshall, E.

1987-01-01

Congress must decide in the coming weeks whether it should try to revive the civil nuclear waste program or yield to politics and apply an anesthetic for a couple of years. The program is in such poor shape that Congress may have to do something. Thirty proposals have been introduced; most would derail or postpone the present plan for disposing of nuclear waste. About 50 members of Congress would like to call a moratorium on field research at potential waste repository sites. They see this as the best way out of the present impasse-if a moratorium is a way out. But this decision would come as a blow to the nuclear utilities, already hard-pressed on several fronts. The last thing they want is a general review of the waste program. The options available for dispersing of nuclear wastes are discussed

[Phenotypic variability in 47, XXX patients: Clinical report of four new cases].

Science.gov (United States)

Goldschmidt, Ernesto; Márquez, Marisa; Solari, Andrea; Ziembar, María I; Laudicina, Alejandro

2010-08-01

The 47, XXX karyotype has a frequency of 1 in 1000 female newborns. However, this karyotype is not usually suspected at birth or childhood. These patients are usually diagnosed during adulthood when they develop premature ovarian failure or infertility, because the early phenotype doesn t have any specific features. The study describes four cases and the clinical variability of the 47, XXX karyotype.

Comparison of four test methods to measure damping properties of materials by using piezoelectric transducers

International Nuclear Information System (INIS)

Pereira, Roberto; Arenas, Jorge P.; Zumelzu, Ernesto

2011-01-01

Research highlights: → Contacting measuring methods produce high variability in the results of damping and stiffness. → Damping of a single metal layer may be accurately obtained through the Central Impedance Method. → The Simply-supported Method does not provide realistic results for multilayer beam samples. -- Abstract: This article presents the experimental results of damping loss factor and Young's modulus obtained for stiff and flexible materials through the use of four different methodologies: the Central Impedance Method, the Modified Oberst Method, the Seismic Response Method, and the simply supported beam method. The first three methods are based on the ASTM standard but using different experimental setting and different Frequency Response Functions. The fourth method corresponds to a non-resonant technique used in the characterization of materials at very low frequencies. In this work, the results of damping loss factor and Young's modulus obtained through these four methods are compared, the variability of results is studied and the sensitivity of each technique when facing controlled temperature variations is verified.

Psychosis among "healthy" siblings of schizophrenia patients

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Partonen Timo

2006-01-01

Full Text Available Abstract Background Schizophrenia aggregates in families and accurate diagnoses are essential for genetic studies of schizophrenia. In this study, we investigated whether siblings of patients with schizophrenia can be identified as free of any psychotic disorder using only register information. We also analyzed the emergence of psychotic disorders among siblings of patients with schizophrenia during seven to eleven years of follow-up. Methods A genetically homogenous population isolate in north-eastern Finland having 365 families with 446 patients with a diagnosis of schizophrenia was initially identified in 1991 using four nationwide registers. Between 1998 and 2002, 124 patients and 183 siblings in 110 families were contacted and interviewed using SCID-I, SCID-II and SANS. We also compared the frequency of mental disorders between siblings and a random population comparison group sample. Results Thirty (16% siblings received a diagnosis of psychotic disorder in the interview. 14 siblings had had psychotic symptoms already before 1991, while 16 developed psychotic symptoms during the follow-up. Over half of the siblings (n = 99, 54% had a lifetime diagnosis of any mental disorder in the interview. Conclusion Register information cannot be used to exclude psychotic disorders among siblings of patients with schizophrenia. The high rate of emergence of new psychotic disorders among initially healthy siblings should be taken into account in genetic analysis.

The Thirty Years War as a prototype of hybrid wars

OpenAIRE

A. V. Bagaeva

2015-01-01

The idea of the article is to show that the phenomenon of hybrid war, which confidently entered the scientific and official discourse, has a long history. In author’s opinion, the Thirty Years’ War in Central Europe can be characterized as one of the first historical examples of hybrid war.

Targeted methods for measuring patient satisfaction in a radiological center

International Nuclear Information System (INIS)

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

2010-01-01

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

Determination of trace elements in standard reference materials by the ko-standardization method

International Nuclear Information System (INIS)

Smodis, B.; Jacimovic, R.; Stegnar, P.; Jovanovic, S.

1990-01-01

The k o -standardization method is suitable for routine multielement determinations by reactor neutron activation analysis (NAA). Investigation of NIST standard reference materials SRM 1571 Orchard Leaves, SRM 1572 Citrus leaves, and SRM 1573 Tomato Leaves showed the systematic error of 12 certified elements determined to be less than 8%. Thirty-four elements were determined in NIST proposed SRM 1515 Apple Leaves

A method for the reconstruction of four-dimensional synchronized CT scans acquired during free breathing

International Nuclear Information System (INIS)

Low, Daniel A.; Nystrom, Michelle; Kalinin, Eugene; Parikh, Parag; Dempsey, James F.; Bradley, Jeffrey D.; Mutic, Sasa; Wahab, Sasha H.; Islam, Tareque; Christensen, Gary; Politte, David G.; Whiting, Bruce R.

2003-01-01

Breathing motion is a significant source of error in radiotherapy treatment planning for the thorax and upper abdomen. Accounting for breathing motion has a profound effect on the size of conformal radiation portals employed in these sites. Breathing motion also causes artifacts and distortions in treatment planning computed tomography (CT) scans acquired during free breathing and also causes a breakdown of the assumption of the superposition of radiation portals in intensity-modulated radiation therapy, possibly leading to significant dose delivery errors. Proposed voluntary and involuntary breath-hold techniques have the potential for reducing or eliminating the effects of breathing motion, however, they are limited in practice, by the fact that many lung cancer patients cannot tolerate holding their breath. We present an alternative solution to accounting for breathing motion in radiotherapy treatment planning, where multislice CT scans are collected simultaneously with digital spirometry over many free breathing cycles to create a four-dimensional (4-D) image set, where tidal lung volume is the additional dimension. An analysis of this 4-D data leads to methods for digital-spirometry, based elimination or accounting of breathing motion artifacts in radiotherapy treatment planning for free breathing patients. The 4-D image set is generated by sorting free-breathing multislice CT scans according to user-defined tidal-volume bins. A multislice CT scanner is operated in the cine mode, acquiring 15 scans per couch position, while the patient undergoes simultaneous digital-spirometry measurements. The spirometry is used to retrospectively sort the CT scans by their correlated tidal lung volume within the patient's normal breathing cycle. This method has been prototyped using data from three lung cancer patients. The actual tidal lung volumes agreed with the specified bin volumes within standard deviations ranging between 22 and 33 cm 3 . An analysis of sagittal and

Positive and negative aspects of colostomy irrigation: a patient and WOC nurse perspective.

Science.gov (United States)

Carlsson, Eva; Gylin, Meta; Nilsson, Laila; Svensson, Katarina; Alverslid, Ingrid; Persson, Eva

2010-01-01

Colostomy irrigation (CI) is an effective method to achieve fecal continence in selected persons with a colostomy. The primary aims of the study were to find out to what extent the WOC nurses used CI in their practice and what kind of information the WOC nurses gave patients if they provided explanations and potential solutions when irrigation was not successful in preserving continence. A further aim was to find out, from a patients' perspective, the positive and negative aspects of practicing CI and how they perform CI. The study employed a mixed quantitative and qualitative approach. Data from WOC nurses were obtained by means of a structured questionnaire and by means of structured telephone interviews with patients who performed CI. Questionnaires were sent out to 89 WOC nurses in Sweden, and 61 (69%) questionnaires were returned. Thirty-nine patients, median age 67 years, from 5 hospitals participated in the interview study. Sixty-four percent of the WOC nurse respondent always informed patients about CI. Forty-four percent of patients did not remember all the information they had been given by the WOC nurse regarding CI before starting with the procedure. Eighty-seven percent reported changing routines from how they initially performed CI over the years. Almost all (97%) of the respondents described positive aspects of CI. The 2 primary positive aspects described by participants were (1) feeling secure and (2) having an empty pouch. Persons living with a colostomy who regularly performed CI reported positive benefits associated with the procedure including a feeling of security and having an empty pouch. Despite these potential benefits, not all patients with a colostomy who are appropriate candidates for CI are offered information about the method from the WOC nurses.

Simultaneous determination of a binary mixture of pantoprazole sodium and itopride hydrochloride by four spectrophotometric methods

Science.gov (United States)

Ramadan, Nesrin K.; El-Ragehy, Nariman A.; Ragab, Mona T.; El-Zeany, Badr A.

2015-02-01

Four simple, sensitive, accurate and precise spectrophotometric methods were developed for the simultaneous determination of a binary mixture containing Pantoprazole Sodium Sesquihydrate (PAN) and Itopride Hydrochloride (ITH). Method (A) is the derivative ratio method (1DD), method (B) is the mean centering of ratio spectra method (MCR), method (C) is the ratio difference method (RD) and method (D) is the isoabsorptive point coupled with third derivative method (3D). Linear correlation was obtained in range 8-44 μg/mL for PAN by the four proposed methods, 8-40 μg/mL for ITH by methods A, B and C and 10-40 μg/mL for ITH by method D. The suggested methods were validated according to ICH guidelines. The obtained results were statistically compared with those obtained by the official and a reported method for PAN and ITH, respectively, showing no significant difference with respect to accuracy and precision.

Dynamic contrast-enhanced MRI in patients with luminal Crohn's disease

Energy Technology Data Exchange (ETDEWEB)

Ziech, M.L.W., E-mail: m.l.ziech@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Lavini, C., E-mail: c.lavini@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Caan, M.W.A., E-mail: m.w.a.caan@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Nio, C.Y., E-mail: C.Y.Nio@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Stokkers, P.C.F., E-mail: p.stokkers@slaz.nl [Academic Medical Center, Department of Gastroenterology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Sint Lucas Andreas Ziekenhuis, Department of Gastroenterology, Jan Tooropstraat 164, 1061 AE, Amsterdam (Netherlands); Bipat, S., E-mail: S.Bipat@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Ponsioen, C.Y., E-mail: c.y.ponsioen@amc.uva.nl [Academic Medical Center, Department of Gastroenterology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Nederveen, A.J., E-mail: a.j.nederveen@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Stoker, J., E-mail: j.stoker@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands)

2012-11-15

Objectives: To prospectively assess dynamic contrast-enhanced (DCE-)MRI as compared to conventional sequences in patients with luminal Crohn's disease. Methods: Patients with Crohn's disease undergoing MRI and ileocolonoscopy within 1 month had DCE-MRI (3T) during intravenous contrast injection of gadobutrol, single shot fast spin echo sequence and 3D T1-weighted spoiled gradient echo sequence, a dynamic coronal 3D T1-weighted fast spoiled gradient were performed before and after gadobutrol. Maximum enhancement (ME) and initial slope of increase (ISI) were calculated for four colon segments (ascending colon + coecum, transverse colon, descending colon + sigmoid, rectum) and (neo)terminal ileum. C-reactive protein (CRP), Crohn's disease activity index (CDAI), per patient and per segment Crohn's disease endoscopic index of severity (CDEIS) and disease duration were determined. Mean values of the (DCE-)MRI parameters in each segment from each patient were compared between four disease activity groups (normal mucosa, non-ulcerative lesions, mild ulcerative and severe ulcerative disease) with Mann-Whitney test with Bonferroni adjustment. Spearman correlation coefficients were calculated for continuous variables. Results: Thirty-three patients were included (mean age 37 years; 23 females, median CDEIS 4.4). ME and ISI correlated weakly with segmental CDEIS (r = 0.485 and r = 0.206) and ME per patient correlated moderately with CDEIS (r = 0.551). ME was significantly higher in segments with mild (0.378) or severe (0.388) ulcerative disease compared to normal mucosa (0.304) (p < 0.001). No ulcerations were identified at conventional sequences. ME correlated with disease duration in diseased segments (r = 0.492), not with CDAI and CRP. Conclusions: DCE-MRI can be used as a method for detecting Crohn's disease ulcerative lesions.

Gamma scintigraphic analysis of albumin flux in patients with acute respiratory distress syndrome

International Nuclear Information System (INIS)

Sugerman, H.J.; Tatum, J.L.; Burke, T.S.; Strash, A.M.; Glauser, F.L.

1984-01-01

Computerized gamma-scintigraphy provides a new method for the analysis of albumin flux in patients with pulmonary permeability edema. In this technique, 10 mCi of 99 mTc -tagged human serum albumin is administered and lung:heart radioactivity ratios are determined. This ratio remains constant unless there is a leak of albumin, when a rising ratio with time, called the ''slope index'' (SI), is seen. Thirty-five scintigraphic studies were obtained in 28 patients by means of a portable computerized gamma-camera. Thirteen of these patients had clinical evidence of the acute respiratory distress syndrome (ARDS) and six had or were recovering from left ventricular induced congestive heart failure (CHF). Five of the patients with CHF and pulmonary capillary wedge pressure (PCWP) below 30 mm Hg had normal scintigraphic studies. The patients with ARDS were found to have significantly higher SIs than patients who did not have, or had recovered from, ARDS. Positive SIs were present from 1 to 8 days following the apparent onset of ARDS in seven studies in five patients. Recovery of gas exchange was associated with a return to a normal SI in four patients. In conclusion, computerized gamma-scintigraphy was a sensitive, noninvasive tool for the detection of a pathologic increase in pulmonary protein flux. Positive scintigraphic findings were associated with significantly impaired gas exchange. The method documented that the leak of albumin in patients with ARDS may last for days but resolves with recovery

The Thirty Years War as a prototype of hybrid wars

Directory of Open Access Journals (Sweden)

A. V. Bagaeva

2015-01-01

Full Text Available The idea of the article is to show that the phenomenon of hybrid war, which confidently entered the scientific and official discourse, has a long history. In author’s opinion, the Thirty Years’ War in Central Europe can be characterized as one of the first historical examples of hybrid war.

A surfactant-thermal method to prepare four new three-dimensional heterometal-organic frameworks

KAUST Repository

Gao, Junkuo; He, Mi; Lee, Zhiyi; Cao, Wenfang; Xiong, Weiwei; Li, Yongxin; Ganguly, Rakesh; Wu, Tao; Zhang, Qichun

2013-01-01

Here, we report on a surfactant-thermal method to prepare four new 3-D crystalline heterometal-organic frameworks (HMOFs). The results indicate that our new strategy for growing crystalline materials in surfactant media has great potential

Pancreatitis aguda recidivante con enteropatía por gluten asociada: Características clínico-analíticas y evolutivas en 34 pacientes Relapsing acute pancreatitis associated with gluten enteropathy: Clinical, laboratory, and evolutive characteristics in thirty-four patients

Directory of Open Access Journals (Sweden)

L. Rodrigo

2008-12-01

Full Text Available Objetivos: describir la frecuencia y características clínico-analíticas de la pancreatitis aguda (PA recidivante con enteropatía por gluten (EG asociada. Pacientes y métodos: estudiamos de forma prospectiva los casos de pancreatitis agudas ingresados en nuestro Servicio durante el año 2006. Registramos un total de 185 pacientes. A las formas recurrentes que fueron 40 en total (22%, les aplicamos un protocolo clínico-analítico consistente en la determinación de marcadores serológicos, genéticos y biopsias duodenales, para descartar una EG asociada. Resultados: un total de 34 pacientes (18% cumplían criterios clínico-biológicos de EG asociada (grupo 1 y se compararon con el resto de las PA no-EG (n = 161 (grupo 2. La edad media en la EG fue de 54 ± 25 años, ligeramente inferior al grupo 2, (61 ± 14 (NS. Existía un ligero predominio de mujeres (50% en el grupo 1, respecto al grupo 2 (38,5% (NS. Siete pacientes del grupo 1 (20% presentaron una PA grave, frente a 27 (17% en el grupo 2 (NS. La presencia de colelitiasis en el grupo 1, fue de 6 casos (18%, significativamente inferior a la del grupo 2, de 72 casos (45% (p Objectives: to describe the frequency and the clinical and laboratory characteristics of relapsing acute pancreatitis (AP associated with gluten enteropathy (GE. Patients and methods: we prospectively examined all acute pancreatitis cases admitted to our Department in 2006. We recorded a total of 185 patients. With recurring forms, 40 (22% in all, we used a clinical-lab protocol including serologic and genetic markers, and duodenal biopsy to rule out GE. Results: a total of 34 patients (18% met clinical-biological criteria for GE (group 1, and were compared to the remaining non-GE AP cases (n = 161 (group 2. Mean age in the GE group was 54 ± 25 years, slightly younger than group 2 (61 ± 14 (NS. There was a mild predominance of women (50% in group 1 versus group 2 (38.5% (NS. Seven patients in group 1 (20% had severe

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.

Methods of assessing the functional status of patients with left ventricular systolic dysfunction in interventional studies: can brain natriuretic peptide measurement be used as surrogate for the traditional methods?

DEFF Research Database (Denmark)

Abdulla, Jawdat; Køber, Lars; Torp-Pedersen, Christian

2004-01-01

AIM: To review whether brain natriuretic peptides (BNP) can be used as a surrogate for the traditional methods of assessing functional status in interventional studies of patients with left ventricular systolic dysfunction (LVSD). METHODS AND RESULTS: The traditional methods for assessing...... functional status including New York Heart Association (NYHA) class, exercise intolerance and quality of life were reviewed in relation to BNP measurements in patients with LVSD. A meta-analysis of four studies evaluating BNP levels versus exercise peak oxygen uptake or 6-minute walking distance showed...

The development of a patient-specific method for physiotherapy goal setting: a user-centered design.

Science.gov (United States)

Stevens, Anita; Köke, Albère; van der Weijden, Trudy; Beurskens, Anna

2018-08-01

To deliver client-centered care, physiotherapists need to identify the patients' individual treatment goals. However, practical tools for involving patients in goal setting are lacking. The purpose of this study was to improve the frequently used Patient-Specific Complaints instrument in Dutch physiotherapy, and to develop it into a feasible method to improve physiotherapy goal setting. An iterative user-centered design was conducted in co-creation with the physiotherapists and patients, in three phases. Their needs and preferences were identified by means of group meetings and questionnaires. The new method was tested in several field tests in physiotherapy practices. Four main objectives for improvement were formulated: clear instructions for the administration procedure, targeted use across the physiotherapy process, client-activating communication skills, and a client-centered attitude of the physiotherapist. A theoretical goal-setting framework and elements of shared decision making were integrated into the new-called, Patient-Specific Goal-setting method, together with a practical training course. The user-centered approach resulted in a goal-setting method that is fully integrated in the physiotherapy process. The new goal-setting method contributes to a more structured approach to goal setting and enables patient participation and goal-oriented physiotherapy. Before large-scale implementation, its feasibility in physiotherapy practice needs to be investigated. Implications for rehabilitation Involving patients and physiotherapists in the development and testing of a goal-setting method, increases the likelihood of its feasibility in practice. The integration of a goal-setting method into the physiotherapy process offers the opportunity to focus more fully on the patient's goals. Patients should be informed about the aim of every step of the goal-setting process in order to increase their awareness and involvement. Training physiotherapists to use a patient

Meta-analysis of thirty-two case-control and two ecological radon studies of lung cancer.

Science.gov (United States)

Dobrzynski, Ludwik; Fornalski, Krzysztof W; Reszczynska, Joanna

2018-03-01

A re-analysis has been carried out of thirty-two case-control and two ecological studies concerning the influence of radon, a radioactive gas, on the risk of lung cancer. Three mathematically simplest dose-response relationships (models) were tested: constant (zero health effect), linear, and parabolic (linear-quadratic). Health effect end-points reported in the analysed studies are odds ratios or relative risk ratios, related either to morbidity or mortality. In our preliminary analysis, we show that the results of dose-response fitting are qualitatively (within uncertainties, given as error bars) the same, whichever of these health effect end-points are applied. Therefore, we deemed it reasonable to aggregate all response data into the so-called Relative Health Factor and jointly analysed such mixed data, to obtain better statistical power. In the second part of our analysis, robust Bayesian and classical methods of analysis were applied to this combined dataset. In this part of our analysis, we selected different subranges of radon concentrations. In view of substantial differences between the methodology used by the authors of case-control and ecological studies, the mathematical relationships (models) were applied mainly to the thirty-two case-control studies. The degree to which the two ecological studies, analysed separately, affect the overall results when combined with the thirty-two case-control studies, has also been evaluated. In all, as a result of our meta-analysis of the combined cohort, we conclude that the analysed data concerning radon concentrations below ~1000 Bq/m3 (~20 mSv/year of effective dose to the whole body) do not support the thesis that radon may be a cause of any statistically significant increase in lung cancer incidence.

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

Science.gov (United States)

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

2018-05-01

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

Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications

Science.gov (United States)

Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos

2010-01-01

Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy. PMID:20811612

Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications

Directory of Open Access Journals (Sweden)

Pedro Figueiredo

2010-01-01

Full Text Available Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD. Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%. The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy.

Coronary artery bypass grafting on the beating heart using the Octopus method

NARCIS (Netherlands)

Thijssens, K. M.; Rodrigus, I. E.; Amsel, B. J.; de Hert, S. G.; Moulijn, A. C.

2000-01-01

STUDY OBJECTIVE: To study the usefulness and effectiveness of off-pump coronary bypass grafting with the Octopus heart stabilizing device. METHOD: The files of thirty-one patients undergoing coronary artery bypass with the aid of the Octopus heart stabilizing device between April 1996 and October

Ectopic Pregnancy risk factors among the patients referred to Shariati hospital in Bandarabbas

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Minoo Rajaee

2011-08-01

Full Text Available Background: Ectopic pregnancy (EP is the most common cause of death related to pregnancy during the first trimester and its' incidence is increasing. Knowledge about the risk factors of EP can be helpful in diagnosis and also in prevention of EP, because some of these risk factors are preventable. The aim of this study is to assess the EP patients and the prevalence of EP risk factors among them in Bandarabbas.Methods: Eighty two patients with EP referred to Shariati hospital in Bandarabbas in 2009 were included in our descriptive study. Study was conducted using a questionnaire about demographic characteristics, EP risk factors, and information about treatment and duration of hospital stay. Data was collected using interview with patients by educated personnel and patients' records during hospitalization. After data collection we analysed the data using SPSS 17.0 software using descriptive statistics (Mean, Standard Deviation, and frequency.Results: Mean age of the participants was 27.46±5.98. Sixty four (78% patients were households and 18(22% were employees. Sixteen (19.5% had low socioeconomic status, 62(75.6% had intermediate socioeconomic status and 4 (4.9% had high socioeconomic status.Twenty one (25.6% of patients were using withdrawal method for contraception at the time of conception. Condom, Oral Contraceptive Pills (OCP, DMPA, and IUD was reported in 7 (8.5%, 13 (15.9%, 8 (9.8%, and 2 (2.4% respectively. Other 31 (37.8% patients weren’t using any method for contraception. Six (7.3% patients had previous history of EP. Also 4 (4.9% had history of previous EP in their near family members. One (1.2% patient was undergone surgery for Tubal Ligation (TL.Four (4.9% patient were using tobacco. EP location was in fallopian tube in 62 (75.6% and in other places in 20 (24.4% of patients. Thirty four (41.5% received drug therapy, 35 (42.7% undergone surgery and 13 (15.9% received both drug and surgery treatment. Mean duration of hospital

Ethical case deliberation on the ward. A comparison of four methods.

Science.gov (United States)

Steinkamp, Norbert; Gordijn, Bert

2003-01-01

The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the methods as well as the related protocols will be presented. Each method will then be evaluated against the background of those situations in which it is being used. The article aims to show that there is not one ideal method of ethical case deliberation, which fits to all possible kinds of moral problems. Rather, as each of the methods highlights a limited number of morally relevant aspects, each method has its strengths and weaknesses as well. These strengths and weaknesses should be evaluated in relation to different types of situations, for instance moral problems in treatment decisions, moral uneasiness and residue, and the like. The suggestion arrived at on the basis of the findings of this paper is a reasonable methodological plurality. This means that a method can be chosen depending on the type of moral problem to be deliberated upon. At the same time it means, that by means of a method, deliberation should be facilitated.

Thirty years of the new astronomy

International Nuclear Information System (INIS)

Rowan-Robinson, M.

1990-01-01

In an overview of advances in astrophysics over the last thirty years, the author expounds some of the important discoveries and how they have contributed to our understanding of star formation and evolution. The starting point for these new ideas has been exploring the non-visible radiations of the universe. Telescopes and observatories have been tuned to receive infrared, ultraviolet, x-ray, gamma ray and radiowave emissions. Radio astronomy revealed the existence of interstellar molecular clouds where stars are born. The discovery of the uniform microwave background radiation has suggested that the Universe started as a hot big bang. The inflationary model of cosmology provides answers to some problems of the big bang theory and predicts the existence of dark, nonluminous, matter which some infrared observations have confirmed. The author ends by providing a modern, astrophysical, description of the constellations so familiar to mediaeval astrologers. (UK)

Research with School Students: Four Innovative Methods Used to Explore Effective Teaching

Directory of Open Access Journals (Sweden)

Jessica Faye Heal

2015-03-01

Full Text Available This article outlines four research methods we’ve employed to enhance how students from low-income backgrounds engage in research exploring effective teaching. It firstly outlines the need to be innovative, drawing Article 12 of the United Nations Convention on the Rights of the Child, and then moves on to explain two methods that scaffold a semi-structured interview, one child-led classroom tour and finally a creative ‘draw and tell’ approach. It argues that these methods are successful because they disrupt the researcher-participant power imbalance using the following techniques: Familiarity to the student, empowering the student to be an expert, and giving the student choice.

LC-MSMS assays of urinary cortisol, a comparison between four in-house assays.

Science.gov (United States)

Brossaud, Julie; Leban, Monique; Corcuff, Jean-Benoit; Boux de Casson, Florence; Leloupp, Anne-Gaëlle; Masson, Damien; Moal, Valérie; Bach-Ngohou, Kalyane

2018-06-27

Twenty-four hour urinary free cortisol (UFC) determination can be used for screening and follow-up of Cushing syndrome (CS). As immunoassay methods lack specificity for UFC measurement, the use of high-performance liquid chromatography coupled to mass spectrometer (LC-MSMS) is recommended. The aim of our study was to compare UFC results using four LC-MSMS methods performed in four independent laboratories in order to evaluate interlaboratory agreement. Frozen aliquots of 24-h urine samples (78 healthy volunteers and 20 patients with CS) were sent to four different laboratories for analysis. Following liquid-liquid or solid-liquid extraction, UFC were determined using four different LC-MSMS assay. UFC intra- and interassays variation coefficients were lower than 10% for each centre. External quality control results were not significantly different. UFC normal ranges (established from healthy volunteers) were 17-126, 15-134, 12-118 and 27-157 nmol/day, respectively. Classification of UFC from healthy volunteers and patients with CS using a 95th percentile threshold was similar. However, for extreme UFC values (270 nmol/day), negative or positive bias was noted. Even for highly specific methods such as LC-MSMS, variations of results can be found depending on analytical process. Validation of LC-MSMS methods including determination of the reference range is essential.

Four-body calculation above four-body break-up threshold

International Nuclear Information System (INIS)

Uzu, E.; Kamada, H.; Koike, Y.

2005-01-01

The complex energy method [Prog. Theor. Phys. 109, 869L (2003)] is applied to the four body Faddeev-Yakubovsky equations in the four nucleon system. We obtain a well converged solution in all energy regions below and above the four nucleon break-up threshold

Wythenshawe boiler rig. Thirty years of support to the UK nuclear power industry

International Nuclear Information System (INIS)

Rudge, Andy; Woolsey, Ian S.; Moore, Andrew

2010-01-01

The Wythenshawe Boiler Rig in Manchester, UK, recently celebrated thirty years of operation in support of the UK nuclear power industry. The Boiler Rig, owned by EDF Energy and operated on EDF Energy's behalf by Serco plc, is a full scale once-through boiler test facility for the investigation of chemistry and corrosion related topics. This paper presents an overview of the design and operation of the Boiler Rig together with some of the technical highlights from its thirty years of operation, many of which have relevance to power plant operations beyond those plants for which the work was performed. (orig.)

Four-channel asymmetric Real-Time PCR hybridization probe assay: a rapid pre-screening method for critical BCR-ABL kinase domain mutations.

Science.gov (United States)

Martinez-Serra, Jordi; Gutiérrez, Antonio; Marcús, Toni F; Soverini, Simona; Amat, Juan Carlos; Navarro-Palou, María; Ros, Teresa; Bex, Teresa; Ballester, Carmen; Bauça, Josep Miquel; SanFelix, Sara; Novo, Andrés; Vidal, Carmen; Santos, Carmen; Besalduch, Joan

2012-03-01

Within the laboratory protocols, used for the study of BCR-ABL resistance mutations in chronic myeloid leukemia patients treated with Imatinib, direct sequencing remains the reference method. Since the incidence of patients with a mutation-related loss of response is not very high, it is very useful in the routine laboratory to perform a fast pre-screening method. With this in mind, we have designed a new technique, based on a single Real-Time FRET-based PCR, followed by a study of melting peaks. This new tool, developed in a LightCycler 2.0, combines four different fluorescence channels for the simultaneous detection, in a single close tube, of critical mutations within the ABL kinase domain. Assay evaluation performed on 33 samples, previously genotyped by sequentiation, resulted in full concordance of results. This new methodology detects in a few steps the presence of critical mutations associated to Imatinib resistance. Copyright © 2012 Elsevier Inc. All rights reserved.

A Status Report on the Thirty Meter Telescope Adaptive Optics

Indian Academy of Sciences (India)

2016-01-27

Jan 27, 2016 ... We provide an update on the recent development of the adaptive optics (AO) systems for the Thirty Meter Telescope (TMT) since mid-2011. The first light AO facility for TMT consists of the Narrow Field Infra-Red AO System (NFIRAOS) and the associated Laser Guide Star Facility (LGSF). This order 60 × 60 ...

Evaluation of the thermodynamics of a four level system using canonical density matrix method

Directory of Open Access Journals (Sweden)

Awoga Oladunjoye A.

2013-02-01

Full Text Available We consider a four-level system with two subsystems coupled by weak interaction. The system is in thermal equilibrium. The thermodynamics of the system, namely internal energy, free energy, entropy and heat capacity, are evaluated using the canonical density matrix by two methods. First by Kronecker product method and later by treating the subsystems separately and then adding the evaluated thermodynamic properties of each subsystem. It is discovered that both methods yield the same result, the results obey the laws of thermodynamics and are the same as earlier obtained results. The results also show that each level of the subsystems introduces a new degree of freedom and increases the entropy of the entire system. We also found that the four-level system predicts a linear relationship between heat capacity and temperature at very low temperatures just as in metals. Our numerical results show the same trend.

The Effect of Keyword Method on Vocabulary Retention of Senior High School EFL Learners in Iran

Science.gov (United States)

Davoudi, Mohammad; Yousefi, Dina

2016-01-01

This study aimed at investigating the effect of keyword method, as one of the mnemonic strategies, on vocabulary retention of Iranian senior high school EFL learners. Following a quasi-experimental design, the study used thirty eight (n = 38) female senior high school students in grade four from two intact classes at a public high school. The…

Comparison of four statistical and machine learning methods for crash severity prediction.

Science.gov (United States)

Iranitalab, Amirfarrokh; Khattak, Aemal

2017-11-01

Crash severity prediction models enable different agencies to predict the severity of a reported crash with unknown severity or the severity of crashes that may be expected to occur sometime in the future. This paper had three main objectives: comparison of the performance of four statistical and machine learning methods including Multinomial Logit (MNL), Nearest Neighbor Classification (NNC), Support Vector Machines (SVM) and Random Forests (RF), in predicting traffic crash severity; developing a crash costs-based approach for comparison of crash severity prediction methods; and investigating the effects of data clustering methods comprising K-means Clustering (KC) and Latent Class Clustering (LCC), on the performance of crash severity prediction models. The 2012-2015 reported crash data from Nebraska, United States was obtained and two-vehicle crashes were extracted as the analysis data. The dataset was split into training/estimation (2012-2014) and validation (2015) subsets. The four prediction methods were trained/estimated using the training/estimation dataset and the correct prediction rates for each crash severity level, overall correct prediction rate and a proposed crash costs-based accuracy measure were obtained for the validation dataset. The correct prediction rates and the proposed approach showed NNC had the best prediction performance in overall and in more severe crashes. RF and SVM had the next two sufficient performances and MNL was the weakest method. Data clustering did not affect the prediction results of SVM, but KC improved the prediction performance of MNL, NNC and RF, while LCC caused improvement in MNL and RF but weakened the performance of NNC. Overall correct prediction rate had almost the exact opposite results compared to the proposed approach, showing that neglecting the crash costs can lead to misjudgment in choosing the right prediction method. Copyright © 2017 Elsevier Ltd. All rights reserved.

Estimation of Cachexia among Cancer Patients Based on Four Definitions

Directory of Open Access Journals (Sweden)

Kathleen M. Fox

2009-01-01

Full Text Available Objectives. Estimate and compare the proportion of cancer patients with cachexia using different definitions from available clinical data. Methods. Electronic medical records were examined to estimate the proportion of cancer patients with cachexia using 4 definitions: (1 ICD-9 diagnostic code of 799.4 (cachexia, (2 ICD-9 diagnosis of cachexia, anorexia, abnormal weight loss, or feeding difficulties, (3 prescription for megestrol acetate, oxandrolone, somatropin, or dronabinol, and (4 ≥5% weight loss. Patients with cancer of the stomach, pancreas, lung, colon/rectum, head/neck, esophagus, prostate, breast, or liver diagnosed between 1999 and 2004 were followed for cachexia. Results. Of 8541 cancer patients (60% men and 55% Caucasian, cachexia was observed in 2.4% of patients using the cachexia diagnostic code, 5.5% expanded diagnoses, 6.4% prescription medication definition, and 14.7% with ≥5% weight loss. Conclusions. The proportion of patients with cachexia varied considerably depending upon the definition employed, indicating that a standard operational definition is needed.

Comparison of Rigid and Adaptive Methods of Propagating Gross Tumor Volume Through Respiratory Phases of Four-Dimensional Computed Tomography Image Data Set

International Nuclear Information System (INIS)

Ezhil, Muthuveni; Choi, Bum; Starkschall, George; Bucci, M. Kara; Vedam, Sastry; Balter, Peter

2008-01-01

Purpose: To compare three different methods of propagating the gross tumor volume (GTV) through the respiratory phases that constitute a four-dimensional computed tomography image data set. Methods and Materials: Four-dimensional computed tomography data sets of 20 patients who had undergone definitive hypofractionated radiotherapy to the lung were acquired. The GTV regions of interest (ROIs) were manually delineated on each phase of the four-dimensional computed tomography data set. The ROI from the end-expiration phase was propagated to the remaining nine phases of respiration using the following three techniques: (1) rigid-image registration using in-house software, (2) rigid image registration using research software from a commercial radiotherapy planning system vendor, and (3) rigid-image registration followed by deformable adaptation originally intended for organ-at-risk delineation using the same software. The internal GTVs generated from the various propagation methods were compared with the manual internal GTV using the normalized Dice similarity coefficient (DSC) index. Results: The normalized DSC index of 1.01 ± 0.06 (SD) for rigid propagation using the in-house software program was identical to the normalized DSC index of 1.01 ± 0.06 for rigid propagation achieved with the vendor's research software. Adaptive propagation yielded poorer results, with a normalized DSC index of 0.89 ± 0.10 (paired t test, p <0.001). Conclusion: Propagation of the GTV ROIs through the respiratory phases using rigid- body registration is an acceptable method within a 1-mm margin of uncertainty. The adaptive organ-at-risk propagation method was not applicable to propagating GTV ROIs, resulting in an unacceptable reduction of the volume and distortion of the ROIs

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

OpenAIRE

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

2014-01-01

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

The East Irish Sea Basin - from caterpillar to butterfly, a thirty-year metamorphosis

Energy Technology Data Exchange (ETDEWEB)

Colter, V.S.

1997-12-31

In the thirty years since the award of the first licenses, the East Irish Sea Basin has emerged as a significant hydrocarbon province. This paper first lists some of the occasionally almost arbitrary events that led to the first success in the basin, the discovery of the Morecambe Field, in 1974. An attempt is made to review progress over those thirty years in certain topics, namely (1) stratigraphy, (2) structure, (3) sedimentology, (4) diagenesis `The `Platy Illite problem`; and others, (5) uplift and inversion, (6) hydrocarbon sources and types, (7) East Irish Sea Basin analogues. The paper concludes by summarizing the current state of knowledge. (author)

Patient satisfaction of tooth supported overdentures utilizing ball attachments

OpenAIRE

Nassar, Hossam I.

2016-01-01

Statement of problem: Teeth retained overdenture therapy is an alternative treatment rarely used in cases with few remaining teeth. Purpose: The aim of this study was to evaluate the patient satisfaction associated with teeth retained maxillary and mandibular overdentures utilizing ready made ball attachment. Materials and methods: Thirty patients treated with teeth retained overdenture utilizing ready made ball attachment. Participants completed a series of questionnaires (OHIP-14 ques...

Identification of some human pathogenic fungi using four DNA ...

African Journals Online (AJOL)

Stocks from pathogenic fungi isolated from infected areas on different patients, around Lagos-Nigeria were analysed using molecular methods (DNA extraction, PCR-RFLP and DNA sequencing). Four DNA extraction protocols were employed in the identification of the fungal isolates. Sixteen different fungal isolates were ...

Resolutions and other decisions of the general conference. Thirty-ninth regular session. 18-22 September 1995

International Nuclear Information System (INIS)

1996-03-01

The twenty-four resolutions adopted and the seventeen other decisions taken by the General Conference at its thirty-ninth (1995) regular session are reproduced in this booklet. The resolutions are, for ease of reference, preceded by the agenda for the session. Before the title of each resolution a serial number is given by which it may be cited. Any footnotes to a resolution appear immediately after the text on the left side of the page; on the right side are given the date of the adoption of the resolution, the relevant agenda item and a reference to the record of the meeting at which the resolution was adopted. The other decisions taken by the Conference are presented similarly. This booklet should be read in conjunction with the summary records of the General Conference, where details of the proceedings, including voting results, are contained (GC(39)/OR.1-10)

Resolutions and other decisions of the general conference. Thirty-ninth regular session. 18-22 September 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-03-01

The twenty-four resolutions adopted and the seventeen other decisions taken by the General Conference at its thirty-ninth (1995) regular session are reproduced in this booklet. The resolutions are, for ease of reference, preceded by the agenda for the session. Before the title of each resolution a serial number is given by which it may be cited. Any footnotes to a resolution appear immediately after the text on the left side of the page; on the right side are given the date of the adoption of the resolution, the relevant agenda item and a reference to the record of the meeting at which the resolution was adopted. The other decisions taken by the Conference are presented similarly. This booklet should be read in conjunction with the summary records of the General Conference, where details of the proceedings, including voting results, are contained (GC(39)/OR.1-10).

Scintigraphy of sacroiliac joints in acute anterior uveitis. A study of thirty patients.

Science.gov (United States)

Russell, A S; Lentle, B C; Percy, J S; Jackson, F I

1976-11-01

HLA-B27 is a transplantation antigen found in a high proportion of patients with ankylosing spondylitis. Recently, an association has been shown to exist between HLA-B27 and acute uveitis, even in the absence of ankylosing spondylitis. We have examined the HLA antigen profile of 45 patients with acute nongranulomatous anterior uveitis and have confirmed this relation. In addition, using 90mtechnetium stannous pyrophosphate we have been able to demonstrate abnormal bone scan in 19 of 30 patients studied. Such abnormalities are limited to the sacroiliac joints but are otherwise the same as those seen in overt ankylosing spondylitis. Seven of the 19 patients did not have HLA-B27. These factors suggest that acute anterior uveitis may often represent a manifestation of a spondylitic diathesis even in the complete absence of any suggestive symptomatic or radiologic change and, in some cases, even though the antigenic marker HLA-B27 may be absent.

Scintigraphy of sacroliac joints in acute anterior uveitis. A study of thirty patients

International Nuclear Information System (INIS)

Russell, A.S.; Lentle, B.C.; Percy, J.S.; Jackson, F.I.

1976-01-01

HLA-B27 is a transplantation antigen found in a high proportion of patients with ankylosing spondylitis. Recently, an association has been shown to exist between HLA-B27 and acute uveitis, even in the absence of ankylosing spondylitis. We have examined the HLA antigen profile of 45 patients with acute nongranulomatous anterior uveitis and have confirmed this relation. In addition, using 90m technetium stannous pyrophosphate we have been able to demonstrate abnormal bone scan in 19 of 30 patients studied. Such abnormalities are limited to the sacroiliac joints but are otherwise the same as those seen in overt ankylosing spondylitis. Seven of the 19 patients did not have HLA-B27. These factors suggest that acute anterior uveitis may often represent a manifestation of a spondylitic diathesis even in the complete absence of any suggestive symptomatic or radiologic change and, in some cases, even through the antigenic marker HLA-B27 may be absent

Primary intestinal lymphangiectasia: four case reports and a review of the literature.

Science.gov (United States)

Wen, Jie; Tang, Qingya; Wu, Jiang; Wang, Ying; Cai, Wei

2010-12-01

Primary intestinal lymphangiectasia (PIL) is a rare digestive disease and most articles on this condition are isolated case reports. Our purpose is to investigate the clinical characteristics, therapeutic management, and outcome of PIL through case studies. We conducted a retrospective analysis and obtained detailed clinical information for four PIL patients treated at our institution. A MEDLINE database search was also performed using the search term "intestinal lymphangiectasia" and all pertinent literature was carefully reviewed. Four children treated in our department showed elevated IgE and a good response to diet intervention. After reviewing the literature, we conducted statistical analysis on the basis of all the cases, with a total of 84 cases. Thirty-eight cases have been reported with diet treatment, 24 (63%) of whom showed apparent improvement in clinical symptoms and laboratory parameters. Four cases (5%) had a malignant transformation of lymphoma, and the average time from PIL onset to lymphoma diagnosis was 31 years (range, 19-45 years). No difference was observed regarding the presence of major clinical manifestations among children and adults. Diet intervention in children was more effective than that in adults. Diet intervention is the cornerstone of PIL medical management, which was found to be more effective in children than in adults. Early diagnosis and treatment of IL is of great importance for effective diet therapy. An elevated IgE level should be monitored periodically since it could be an indication of malignant transformation-lymphoma.

Altered joint moment strategy during stair walking in diabetes patients with and without peripheral neuropathy.

Science.gov (United States)

Brown, Steven J; Handsaker, Joseph C; Maganaris, Constantinos N; Bowling, Frank L; Boulton, Andrew J M; Reeves, Neil D

2016-05-01

To investigate lower limb biomechanical strategy during stair walking in patients with diabetes and patients with diabetic peripheral neuropathy, a population known to exhibit lower limb muscular weakness. The peak lower limb joint moments of twenty-two patients with diabetic peripheral neuropathy and thirty-nine patients with diabetes and no neuropathy were compared during ascent and descent of a staircase to thirty-two healthy controls. Fifty-nine of the ninety-four participants also performed assessment of their maximum isokinetic ankle and knee joint moment (muscle strength) to assess the level of peak joint moments during the stair task relative to their maximal joint moment-generating capabilities (operating strengths). Both patient groups ascended and descended stairs slower than controls (pperipheral neuropathy were lower (pperipheral neuropathy compared to controls, and lower at knee only in patients without neuropathy. Operating strengths were higher (pneuropathy during stair descent compared to the controls, but not during stair ascent. Patients with diabetic peripheral neuropathy walk slower to alter gait strategy during stair walking and account for lower-limb muscular weakness, but still exhibit heightened operating strengths during stair descent, which may impact upon fatigue and the ability to recover a safe stance following postural instability. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Matrix metalloproteinase 2 and 9 activity in patients with colorectal cancer liver metastasis.

NARCIS (Netherlands)

Waas, E.T.; Wobbes, Th.; Lomme, R.M.L.M.; Groot, J.H. de; Ruers, T.J.M.; Hendriks, T.

2003-01-01

BACKGROUND: Matrix metalloproteinases (MMPs) have been reported to play an important role in tumour cell invasion and metastasis. The bioactivity of MMPs in liver metastasis from colorectal cancer was investigated and correlated with clinicopathological variables. METHOD: Thirty-two patients

Assessment of Quality of Life, Psychological and Functional Status and Disease Activity in Patients with Ankylosing Spondylitis and Fibromyalgia

Directory of Open Access Journals (Sweden)

Mehmet Caglayan

2016-03-01

Full Text Available Objective: Anxiety and depression are psychological dis­orders which frequently accompany and affect the course of rheumatic diseases. Quality of life is also affected by psychological status. In this study, we aimed to assess psychological status and quality of life in patients with an­kylosing spondylitis (AS and fibromyalgia (FM and in­vestigate their association with functional status, disease activity and physical limitation. Method: Thirty-seven patients with AS and thirty-four patients with FM were included in this study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI and Bath Ankylosing Spondylitis Functional Index (BAS­FI were used for assessment of disease activity and physical functions respectively. The Ankylosing Spondy­litis Quality of Life (ASQoL questionnaire was used for disease-related quality of life in AS patients. Fibromyalgia Impact Questionnaire (FIQ was used for assessment of functional status in FM patients. Nottingham Health Pro­file (NHP and the Hospital Anxiety and Depression Scale (HADS were, respectively, used for assessment of qual­ity of life and psychological status in groups. Results: There was no significant difference between the groups in HADS-total, HADS-depression and HADS-anxiety scores (p>0.05. However, patients with FM had significantly higher NHP-total and NHP-pain scores com­pared to patients with AS (p<0.05. Conclusion: There was no significant difference be­tween the two groups in psychological distress. Higher NHP-pain scores in patients with FM might have been caused by lower pain threshold in these patients. The generalizability of our findings is also limited because of the relatively small sample size. J Clin Exp Invest 2016; 7 (1: 41-46

Quantifying pCO2 in biological ocean acidification experiments: A comparison of four methods.

Science.gov (United States)

Watson, Sue-Ann; Fabricius, Katharina E; Munday, Philip L

2017-01-01

Quantifying the amount of carbon dioxide (CO2) in seawater is an essential component of ocean acidification research; however, equipment for measuring CO2 directly can be costly and involve complex, bulky apparatus. Consequently, other parameters of the carbonate system, such as pH and total alkalinity (AT), are often measured and used to calculate the partial pressure of CO2 (pCO2) in seawater, especially in biological CO2-manipulation studies, including large ecological experiments and those conducted at field sites. Here we compare four methods of pCO2 determination that have been used in biological ocean acidification experiments: 1) Versatile INstrument for the Determination of Total inorganic carbon and titration Alkalinity (VINDTA) measurement of dissolved inorganic carbon (CT) and AT, 2) spectrophotometric measurement of pHT and AT, 3) electrode measurement of pHNBS and AT, and 4) the direct measurement of CO2 using a portable CO2 equilibrator with a non-dispersive infrared (NDIR) gas analyser. In this study, we found these four methods can produce very similar pCO2 estimates, and the three methods often suited to field-based application (spectrophotometric pHT, electrode pHNBS and CO2 equilibrator) produced estimated measurement uncertainties of 3.5-4.6% for pCO2. Importantly, we are not advocating the replacement of established methods to measure seawater carbonate chemistry, particularly for high-accuracy quantification of carbonate parameters in seawater such as open ocean chemistry, for real-time measures of ocean change, nor for the measurement of small changes in seawater pCO2. However, for biological CO2-manipulation experiments measuring differences of over 100 μatm pCO2 among treatments, we find the four methods described here can produce similar results with careful use.

A retrospective clinical and radiographic study on healing of periradicular lesions in patients taking oral bisphosphonates.

Science.gov (United States)

Hsiao, Angela; Glickman, Gerald; He, Jianing

2009-11-01

Bisphosphonates have been related to impaired bone remodeling. The impact of oral bisphosphonates on periradicular healing has not been studied. The purpose of this study was to evaluate the healing of periradicular lesions in patients taking oral bisphosphonates after root canal therapy. Thirty-four teeth with preoperative periradicular radiolucencies were identified in patients undergoing oral bisphosphonate therapy. These cases were examined clinically and radiographically to determine treatment outcome. Thirty-eight control teeth were selected from a pool of patients not taking bisphosphonates. Nonsurgical root canal treatment and retreatment was performed by endodontic residents and undergraduate dental students at Baylor College of Dentistry using nonstandardized protocols. In the bisphosphonate group, 73.5% of the lesions healed, whereas the control cases had a healing rate of 81.6%. There was no statistically significant difference between the groups (p > 0.05). The results of this preliminary short-term study suggest that patients taking long-term oral bisphosphonates can expect a satisfactory outcome with evidence of periradicular healing after conventional root canal treatment. Thus, root canal treatment may be considered a safe and realistic alternative to extraction in patients on bisphosphonate therapy.

Flexor hallucis longus tendon rupture in RA-patients is associated with MTP 1 damage and pes planus

NARCIS (Netherlands)

Baan, H.; Baan, Henriette; Drossaers-Bakker, K.W.; Dubbeldam, Rosemary; Dubbeldam, Rosemary; Buurke, Jaap J.; Nene, A.V.; van de Laar, Mart A F J

2007-01-01

Background: To assess the prevalence of and relation between rupture or tenosynovitis of the Flexor Hallucis Longus (FHL) tendon and range of motion, deformities and joint damage of the forefoot in RA patients with foot complaints. Methods: Thirty RA patients with painful feet were analysed, their

Survey of Saccadic Parameters Using Videonystagmography in Patients with Idiopathic Parkinson's Disease and Normal Subjects

Directory of Open Access Journals (Sweden)

Reza Hosseinabadi

2008-06-01

Full Text Available Background and Aim: Patients with Parkinson’s disease manifest oculomotor abnormalities. This is the consequence of basal ganglia impairment. The most common abnormalities include increased saccade latency, hypometric saccades and decreased saccade velocity. The purpose of this study was comparison of saccadic parameters using videonystagmography in patients with idiopathic Parkinson’s disease and normal subjects.Materials and Methods: In this cross sectional study, saccadic movements were investigated in thirty patients with idiopathic Parkinson’s disease and thirty age matched subjects were 35-70 years old. Saccade latency, velocity and accuracy were quantitatively analyzed. Results: Results of this study indicated increased saccade latency, reduction of saccade velocity and accuracy in patients with Parkinson’s disease(P<0.001.Conclusion: This study showed that patients with Parkinson’s disease manifest saccadic deficits. This suggests dopaminergic control of these ocular movements.

Joint Coal Board. Thirty-eighth annual report 1984/1985. [New South Wales

Energy Technology Data Exchange (ETDEWEB)

1986-01-01

The thirty-eighth annual report of the Joint Coal Board is presented. Included are the major activities of the Board, general statistics of the New South Wales coal industry, an industry review and the Board's financial statements.

Which benefits and harms of preoperative radiotherapy should be addressed? A Delphi consensus study among rectal cancer patients and radiation oncologists

International Nuclear Information System (INIS)

Kunneman, Marleen; Pieterse, Arwen H.; Stiggelbout, Anne M.; Marijnen, Corrie A.M.

2015-01-01

Background and purpose: We previously found considerable variation in information provision on preoperative radiotherapy (PRT) in rectal cancer. Our aims were to reach consensus among patients and oncologists on which benefits/harms of PRT should be addressed during the consultation, and to assess congruence with daily clinical practice. Materials and methods: A four-round Delphi-study was conducted with two expert panels: (1) 31 treated rectal cancer patients and (2) 35 radiation oncologists. Thirty-seven possible benefits/harms were shown. Participants indicated whether addressing the benefit/harm was (1) essential, (2) desired, (3) not necessary, or (4) to be avoided. Consensus was assumed when ⩾80% of the panel agreed. Results were compared to 81 audio-taped consultations. Results: The panels reached consensus that six topics should be addressed in all patients (local control, survival, long term altered defecation pattern and faecal incontinence, perineal wound healing problems, advice to avoid pregnancy), three in male patients (erectile dysfunction, ejaculation disorder, infertility), and four in female patients (vaginal dryness, pain during intercourse, menopause, infertility). On average, less than half of these topics were addressed in daily clinical practice. Conclusions: This study showed substantial overlap between benefits/harms that patients and oncologists consider important to address during the consultation, and at the same time poor congruence with daily clinical practice

Determination of Respiratory Motion for Distal Esophagus Cancer Using Four-Dimensional Computed Tomography

International Nuclear Information System (INIS)

Yaremko, Brian P.; Guerrero, Thomas M.; McAleer, Mary F.; Bucci, M. Kara; Noyola-Martinez, Josue M.S.; Nguyen, Linda T. C.; Balter, Peter A.; Guerra, Rudy; Komaki, Ritsuko; Liao Zhongxing

2008-01-01

Purpose: To investigate the motion characteristics of distal esophagus cancer primary tumors using four-dimensional computed tomography (4D CT). Methods and Materials: Thirty-one consecutive patients treated for esophagus cancer who received respiratory-gated 4D CT imaging for treatment planning were selected. Deformable image registration was used to map the full expiratory motion gross tumor volume (GTV) to the full-inspiratory CT image, allowing quantitative assessment of each voxel's displacement. These displacements were correlated with patient tumor and respiratory characteristics. Results: The mean (SE) tidal volume was 608 (73) mL. The mean GTV volume was 64.3 (10.7) mL on expiration and 64.1 (10.7) mL on inspiration (no significant difference). The mean tumor motion in the x-direction was 0.13 (0.006) cm (average of absolute values), in the y-direction 0.23 (0.01) cm (anteriorly), and in the z-direction 0.71 (0.02) cm (inferiorly). Tumor motion correlated with tidal volume. Comparison of tumor motion above vs. below the diaphragm was significant for the average net displacement (p = 0.014), motion below the diaphragm was greater than above. From the cumulative distribution 95% of the tumors moved less than 0.80 cm radially and 1.75 cm inferiorly. Conclusions: Primary esophagus tumor motion was evaluated with 4D CT. According to the results of this study, when 4D CT is not available, a radial margin of 0.8 cm and axial margin of ±1.8 cm would provide tumor motion coverage for 95% of the cases in our study population

Frequency, and magnitude of anxiety and depression in patients with psoriasis vulgaris

International Nuclear Information System (INIS)

Nasreen, S.; Ahmed, I.; Effendi, S.

2008-01-01

To determine the frequency of anxiety and depression in patients with psoriasis. All patients presenting with psoriasis vulgaris above the age of 15 years, of either gender, fulfilling the selection criteria were included in the study. Clinical diagnosis was confirmed by biopsy and histopathology. Documentation of disease severity as mild, moderate and severe was done, using Psoriasis Area Severity Index (PASI). Patients were asked to fill AKUADS for their psychiatric assessment and scoring was done on this basis. Patients scoring equal to or above 19 were labeled as having anxiety or depression. There were 56 males (62%) and 33 females (38%), aged 20 to 65 years in the study. Out of those, 52 (58%) were married; while 37 (42%) were unmarried. The minimum duration of illness was 6 months and maximum 15 years. Thirty-four patients (38%) were suffering from mild disease, 31 (35%) from moderate and the remaining 24 (27%) from severe psoriasis. Twenty-four (27%) were on topical therapy while the other 65 (73%) were receiving systemic as well as topical therapy. Joint involvement was seen in 25 patients (28%) and nail changes in 31 (35%). Psychiatric illness was positive in 34 patients (38%, p<0.05) i.e. 20 males (59%) and 14 females (41%). Twenty-six patients (76%) were married (p<0.05). Anxiety and depression was seen irrespective of the disease duration. The mean AKUADS scores in accordance with disease severity were mild psoriasis 20, moderate psoriasis 22 and severe psoriasis 25. Twenty-one patients (62%, p=0.05) with joint involvement and another 23 (68%, p<0.05) with nail involvement had a score above 19. Thirty-one patients (91%) were receiving systemic as well as local therapy, while 3 patients (9%) were on topical treatment (p<0.05). There is an association of psoriasis vulgaris with anxiety and depression. The magnitude of this anxiety and depression can be influenced by variables of disease and life. (author)

Patient satisfaction with healthcare provided by family doctors: primary dimensions and an attempt at typology.

Science.gov (United States)

Marcinowicz, Ludmila; Chlabicz, Slawomir; Grebowski, Ryszard

2009-04-16

Patient satisfaction is a complex and difficult concept to measure, thus precluding the use of exclusively quantitative methods for its description. The purpose of this survey was firstly to identify particular healthcare dimensions that determine a patient's satisfaction or dissatisfaction; and secondly to attempt to typologise the patients' responses based on their evaluation of healthcare. Using a qualitative research design, thirty-six in-depth interviews with patients of family physicians were conducted: four patients from each of 9 family practices in different regions of Poland were interviewed. The main outcome measure was factors associated with patient satisfaction/dissatisfaction. In their evaluations of their contacts with family doctors, the patients cited mostly issues concerning interpersonal relationships with the doctor. Nearly 40% of the statements referred to this aspect of healthcare, with nearly equal proportions of positive and negative comments. The second most frequent category of responses concerned contextual factors (21%) that related to conditions of medical service, with two-thirds of the evaluations being negative. Statements concerning the doctor's competencies (12.9%) and personal qualities (10.5%) were less common. To improve the quality of healthcare, family doctors should take special care to ensure the quality of their interactions with patients.

Long-term results of patients with clinical stage C prostate cancer treated by photontherapy and early orchiectomy

International Nuclear Information System (INIS)

Wiegel, T.; Tepel, J.; Schmidt, R.; Klosterhalfen, H.; Arps, H.; Berger, P.; Franke, H.D.

1996-01-01

Background: To evaluate the value of radiotherapy and immediate hormonal therapy in the treatment of stage C prostate cancer. Patients and Method: From 1977 to 1986, 169 patients with clinically stage C prostate cancer underwent irradiation with curative intent following early orchiectomy. Sixty-four patients had a transurethral resection, 22 patients a prostatectomy and 83 patients had only a biopsy. In 38 patients a grade Ia/b tumor was found, in 78 patients a grade IIa/b tumor and in 43 patients a grade IIIa/b tumor using the German grade of malignancy. Treatment fields included the prostate, the seminal vesicles and the locoregional lymphatics. Until 1979 the dose was 60 Gy for the tumor encompassing isodose and from then on 65 Gy with a single dose of 2 Gy. Results: With a median follow-up of 98 months, the overall survival rate for 8 and 10 years was 51% and 37% and the cause-specific survival rate was 84% and 77%, respectively. Thirty-two patients (19%) developed distant metastases. Patients with local tumor control (n=148) had a significantly better overall survival rate of 45% for 10 years compared to patients with clinical local progression of disease (n=21) of 22% (p [de

A Comparison of Four Linear Equating Methods for the Common-Item Nonequivalent Groups Design Using Simulation Methods. ACT Research Report Series, 2013 (2)

Science.gov (United States)

Topczewski, Anna; Cui, Zhongmin; Woodruff, David; Chen, Hanwei; Fang, Yu

2013-01-01

This paper investigates four methods of linear equating under the common item nonequivalent groups design. Three of the methods are well known: Tucker, Angoff-Levine, and Congeneric-Levine. A fourth method is presented as a variant of the Congeneric-Levine method. Using simulation data generated from the three-parameter logistic IRT model we…

Four cycles of adriamycin and cyclophosphamide followed by four cycles of docetaxel (NSABP-B27 with concomitant trastuzumab as neoadjuvant therapy for high-risk, early-stage, HER2-positive breast cancer patients

Directory of Open Access Journals (Sweden)

Abdel-Razeq H

2018-04-01

Full Text Available Hikmat Abdel-Razeq,1,2 Salwa S Saadeh,1 Mahmoud Abu-Nasser,1 Hazem Abdulelah,1 Lina Marie,1 Murad Salam,1 Basel Al-Haj Ali,1 Mohammad Ibrahim,1 Dalia Rimawi3 1Department of Internal Medicine, Section of Hematology and Medical Oncology, King Hussein Cancer Center, Amman, Jordan; 2School of Medicine, University of Jordan, Amman, Jordan; 3Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan Background: The majority of breast cancer patients in Jordan are diagnosed at a young age and present with metastatic or locally advanced disease. The National Surgical Adjuvant Breast and Bowel Project Protocol B27 (NSABP-B27 (four cycles of adriamycin and cyclophosphamide [AC] followed by four cycles of docetaxel is a standard neoadjuvant regimen in our institution. In this study, we report the efficacy of adding trastuzumab to docetaxel in this regimen for high-risk human epidermal growth factor receptor 2 (HER2-positive early-stage disease. Patients and methods: Consecutive HER2-positive breast cancer patients treated with this regimen were included. Treatment was given at standard doses and schedules as reported in NSABP-B27. Trastuzumab was given with docetaxel and then continued for 1 year. Results: A total of 121 patients (mean age 45.4 years were included. The majority had high-risk features including large tumor size, positive axillary lymph nodes, and grade III disease. Three patients did not complete the planned cycles of AC due to a lack of response. Eight (6.6% patients missed at least one cycle of docetaxel. Following neoadjuvant therapy, 119 patients underwent surgery, of whom 59 (49.6% patients achieved pathological complete response. The response was higher in node-negative patients (64.0 vs 45.7%; P=0.03 and in hormone receptor-negative disease patients (69.7 vs 41.9%; P=0.018. Breast-conserving surgery was performed in 21.5% of the patients. The median disease-free survival (DFS for the whole group was not

Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients: Do the assessment methods measure the same outcome?

Science.gov (United States)

Mosmuller, David G M; Maal, Thomas J; Prahl, Charlotte; Tan, Robin A; Mulder, Frans J; Schwirtz, Roderic M F; de Vet, Henrica C W; Bergé, Stefaan J; Don Griot, J P W

2017-08-01

For the assessment of the nasolabial appearance in cleft patients, a widely accepted, reliable scoring system is not available. In this study four different methods of assessment are compared, including 2D and 3D asymmetry and aesthetic assessments. The data and ratings from an earlier study using the Asher-McDade aesthetic index on 3D photographs and the outcomes of 3D facial distance mapping were compared to a 2D aesthetic assessment, the Cleft Aesthetic Rating Scale, and to SymNose, a computerized 2D asymmetry assessment technique. The reliability and correlation between the four assessment techniques were tested using a sample of 79 patients. The 3D asymmetry assessment had the highest reliability and could be performed by just one observer (Intraclass correlation coefficient (ICC): 0.99). The 2D asymmetry assessment of the nose was highly reliable when performed by just one observer (ICC: 0.89). However, for the 2D asymmetry assessment of the lip more observers were needed. For the 2D aesthetic assessments 3 observers were needed. The 3D aesthetic assessment had the lowest single-observer reliability (ICC: 0.38-0.56) of all four techniques. The agreement between the different assessment methods is poor to very poor. The highest correlation (R: 0.48) was found between 2D and 3D aesthetic assessments. Remarkably, the lowest correlations were found between 2D and 3D asymmetry assessments (0.08-0.17). Different assessment methods are not in agreement and seem to measure different nasolabial aspects. More research is needed to establish exactly what each assessment technique measures and which measurements or outcomes are relevant for the patients. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Correlated, Static and Dynamic Polarizabilities of Small Molecules. Comparison of Four "Black Box" Methods

DEFF Research Database (Denmark)

Dalskov, Erik K.; Sauer, Stephan P. A.

1998-01-01

Molecular static and dynamic polarizabilities for thirteen small molecules have been calculated using four "black box" ab initio methods, the random phase approximation, RPA, the second-order polarization propagator approximation, SOPPA, the second-order polarization propagator approximation...

The meaning of pharmacological treatment for schizophrenic patients

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Kelly Graziani Giacchero Vedana

2014-08-01

Full Text Available OBJECTIVE: to understand the meaning of medication therapy for schizophrenic patients and formulate a theoretical model about the study phenomenon.METHOD: a qualitative approach was employed, using Symbolic Interactionism as the theoretical and Grounded Theory as the methodological framework. The research was developed between 2008 and 2010 at three community mental health services in the interior of the State of São Paulo - Brazil. Thirty-six patients and thirty-six family members were selected through theoretical sampling. The data were mainly collected through open interviews and observation and simultaneously analyzed through open, axial and selective coding.RESULTS: the meaning of the pharmacotherapy is centered on the phenomenon "Living with a help that bothers", which expresses the patients' ambivalence towards the medication and determines their decision making. The insight, access, limitations for self-administration of the drugs and interactions with family members and the health team influenced the patient's medication-related behavior.CONCLUSION: the theory presented in this study provides a comprehensive, contextualized, motivational and dynamic understanding of the relation the patient experiences and indicates potentials and barriers to follow the medication treatment.

Pattern of Serum Electrolytes Changes among Non Psychotic ...

African Journals Online (AJOL)

Method: Serum electrolytes, Na+, K+, Ca2+, Mg2+, were measured in 30 depressed patients at the Neuropsychiatric Hospital Rumuigbo, Port Harcourt before therapy commenced and after four (4) weeks of amitriptyline. Thirty (30) known non psychotic disordered subjects matched for age and sex were used as control.

Olfactory training in patients with Parkinson's disease.

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Antje Haehner

Full Text Available OBJECTIVE: Decrease of olfactory function in Parkinson's disease (PD is a well-investigated fact. Studies indicate that pharmacological treatment of PD fails to restore olfactory function in PD patients. The aim of this investigation was whether patients with PD would benefit from "training" with odors in terms of an improvement of their general olfactory function. It has been hypothesized that olfactory training should produce both an improved sensitivity towards the odors used in the training process and an overall increase of olfactory function. METHODS: We recruited 70 subjects with PD and olfactory loss into this single-center, prospective, controlled non-blinded study. Thirty-five patients were assigned to the olfactory training group and 35 subjects to the control group (no training. Olfactory training was performed over a period of 12 weeks while patients exposed themselves twice daily to four odors (phenyl ethyl alcohol: rose, eucalyptol: eucalyptus, citronellal: lemon, and eugenol: cloves. Olfactory testing was performed before and after training using the "Sniffin' Sticks" (thresholds for phenyl ethyl alcohol, tests for odor discrimination, and odor identification in addition to threshold tests for the odors used in the training process. RESULTS: Compared to baseline, trained PD patients experienced a significant increase in their olfactory function, which was observed for the Sniffin' Sticks test score and for thresholds for the odors used in the training process. Olfactory function was unchanged in PD patients who did not perform olfactory training. CONCLUSION: The present results indicate that olfactory training may increase olfactory sensitivity in PD patients.

The Complete Four-Loop Four-Point Amplitude in N

Energy Technology Data Exchange (ETDEWEB)

Bern, Z.; Carrasco, J.J.M.; /UCLA; Dixon, Lance J.; /SLAC /CERN; Johansson, H.; /Saclay, SPhT; Roiban, R.; /Penn State U.

2010-08-25

We present the complete four-loop four-point amplitude in N = 4 super-Yang-Mills theory, for a general gauge group and general D-dimensional covariant kinematics, and including all non-planar contributions. We use the method of maximal cuts - an efficient application of the unitarity method - to construct the result in terms of 50 four-loop integrals. We give graphical rules, valid in D-dimensions, for obtaining various non-planar contributions from previously-determined terms. We examine the ultraviolet behavior of the amplitude near D = 11/2. The non-planar terms are as well-behaved in the ultraviolet as the planar terms. However, in the color decomposition of the three- and four-loop amplitude for an SU(N{sub c}) gauge group, the coefficients of the double-trace terms are better behaved in the ultraviolet than are the single-trace terms. The results from this paper were an important step toward obtaining the corresponding amplitude in N = 8 supergravity, which confirmed the existence of cancellations beyond those needed for ultraviolet finiteness at four loops in four dimensions. Evaluation of the loop integrals near D = 4 would permit tests of recent conjectures and results concerning the infrared behavior of four-dimensional massless gauge theory.

SU-E-T-407: Evaluation of Four Commercial Dosimetry Systems for Routine Patient-Specific Tomotherapy Delivery Quality Assurance

International Nuclear Information System (INIS)

Xing, A; Arumugam, S; Deshpande, S; George, A; Holloway, L; Vial, P; Goozee, G

2014-01-01

Purpose: The purpose of this project was to evaluate the performance of four commercially available dosimetry systems for Tomotherapy delivery quality assurance (DQA). Methods: Eight clinical patient plans were chosen to represent a range of treatment sites and typical clinical plans. Four DQA plans for each patient plan were created using the TomoTherapy DQA Station (Hi-Art version 4.2.1) on CT images of the ScandiDose Delta4, IBA MatriXX Evolution, PTW Octavius 4D and Sun Nuclear ArcCHECK phantoms. Each detector was calibrated following the manufacture-provided procedure. No angular response correction was applied. All DQA plans for each detector were delivered on the Tomotherapy Hi-Art unit in a single measurement session but on different days. The measured results were loaded into the vendor supplied software for each QA system for comparison with the TPS-calculated dose. The Gamma index was calculated using 3%/3mm, 2%/2mm with 10% dose threshold of maximum TPS calculated dose. Results: Four detector systems showed comparable gamma pass rates for 3%/3m, which is recommended by AAPM TG119 and commonly used within the radiotherapy community. The averaged pass rates ± standard deviation for all DQA plans were (98.35±1.97)% for ArcCHECK, (99.9%±0.87)% for Matrix, (98.5%±5.09)% for Octavius 4D, (98.7%±1.27)% for Delata4. The rank of the gamma pass rate for individual plans was consistent between detectors. Using 2%/2mm Gamma criteria for analysis, the Gamma pass rate decreased on average by 9%, 8%, 6.6% and 5% respectively. Profile and Gamma failure map analysis using the software tools from each dosimetry system indicated that decreased passing rate is mainly due to the threading effect of Tomo plan. Conclusion: Despite the variation in detector type and resolution, phantom geometry and software implementation, the four systems demonstrated similar dosimetric performance, with the rank of the gamma pass rate consistent for the plans considered

Seizure threshold and the half-age method in bilateral electroconvulsive therapy in Japanese patients.

Science.gov (United States)

Yasuda, Kazuyuki; Kobayashi, Kaoru; Yamaguchi, Masayasu; Tanaka, Koichi; Fujii, Tomokazu; Kitahara, Yuichi; Tamaoki, Toshio; Matsushita, Yutaka; Nunomura, Akihiko; Motohashi, Nobutaka

2015-01-01

Seizure threshold (ST) in electroconvulsive therapy (ECT) has not been reported previously in Japanese patients. We investigated ST in bilateral ECT in Japanese patients using the dose-titration method. The associations between demographic and clinical characteristics and ST were analyzed to identify the predictors of ST. Finally, the validity of the half-age method for the stimulus dose was evaluated. Fifty-four Japanese patients with mood disorder, schizophrenia, and other psychotic disorders received an acute course of bilateral ECT using a brief-pulse device. ST was determined at the first session using a fixed titration schedule. ST was correlated with age, sex, body mass index, history of previous ECT, and psychotropic drugs on multiple regression analysis. Furthermore, the rate of accomplished seizures was calculated using the half-age method. Mean ST was 136 mC. ST was influenced by age, sex, history of previous ECT, and medication with benzodiazepines. The accomplished seizure rate using the half-age method was 72%, which was significantly lower in men and subjects on benzodiazepines. ST in Japanese patients was equal to or slightly higher than that previously reported in other ethnic groups, which might be attributable, at least in part, to high prevalence of and large-dose benzodiazepine prescription. Higher age, male gender, no history of ECT, and benzodiazepines were related to higher ST. The half-age method was especially useful in female patients and subjects without benzodiazepine medication. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

NARCIS (Netherlands)

Jongenelis, K; Eisses, AMH; Gerritsen, DL; Beekman, ATF; Kluiter, H; Ribbe, MW

2005-01-01

Objective To determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Method Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study

Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

NARCIS (Netherlands)

Jongenelis, K; Eisses, AMH; Gerritsen, DL; Beekman, ATF; Kluiter, H; Ribbe, MW

Objective To determine the diagnostic accuracy of the 30-item and shortened versions of the Geriatric Depression Scale (GDS) in diagnosing depression in older nursing home patients. Method Three hundred and thirty-three older nursing home patients participated in a prospective cross-sectional study

A surfactant-thermal method to prepare four new three-dimensional heterometal-organic frameworks

KAUST Repository

Gao, Junkuo

2013-01-01

Here, we report on a surfactant-thermal method to prepare four new 3-D crystalline heterometal-organic frameworks (HMOFs). The results indicate that our new strategy for growing crystalline materials in surfactant media has great potential for the synthesis of novel MOFs with various structures. © 2013 The Royal Society of Chemistry.

Placing wireless tablets in clinical settings for patient education

Directory of Open Access Journals (Sweden)

Judy C. Stribling, MA, MLS

2016-11-01

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

Use of multiple methods to determine factors affecting quality of care of patients with diabetes.

Science.gov (United States)

Khunti, K

1999-10-01

The process of care of patients with diabetes is complex; however, GPs are playing a greater role in its management. Despite the research evidence, the quality of care of patients with diabetes is variable. In order to improve care, information is required on the obstacles faced by practices in improving care. Qualitative and quantitative methods can be used for formation of hypotheses and the development of survey procedures. However, to date few examples exist in general practice research on the use of multiple methods using both quantitative and qualitative techniques for hypothesis generation. We aimed to determine information on all factors that may be associated with delivery of care to patients with diabetes. Factors for consideration on delivery of diabetes care were generated by multiple qualitative methods including brainstorming with health professionals and patients, a focus group and interviews with key informants which included GPs and practice nurses. Audit data showing variations in care of patients with diabetes were used to stimulate the brainstorming session. A systematic literature search focusing on quality of care of patients with diabetes in primary care was also conducted. Fifty-four potential factors were identified by multiple methods. Twenty (37.0%) were practice-related factors, 14 (25.9%) were patient-related factors and 20 (37.0%) were organizational factors. A combination of brainstorming and the literature review identified 51 (94.4%) factors. Patients did not identify factors in addition to those identified by other methods. The complexity of delivery of care to patients with diabetes is reflected in the large number of potential factors identified in this study. This study shows the feasibility of using multiple methods for hypothesis generation. Each evaluation method provided unique data which could not otherwise be easily obtained. This study highlights a way of combining various traditional methods in an attempt to overcome the

The effect of folate and vitamin B12 supplementation on homocysteine concentrations: a study in hemodialysis patients

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Azadibakhsh N.

2007-10-01

Full Text Available Background: Hyperhomocysteinemia is an independent risk factor for cardiovascular diseases. The frequency of hyperhomocysteinemia is higher in hemodialysis (HD patients than the general population. The objective of this study is to assess the efficacy of high-dose folic acid supplementation with and without vitamin B12 on lowering plasma total homocysteine (tHcy concentrations in HD patients. Methods: Thirty-six HD patients at Imam Hossein Hospital, Tehran, Iran, who had been given folic acid supplements (5 mg/d for at least 3 months before, were enrolled in this clinical trial. Subjects were also checked for other inclusion and exclusion criteria. The subjects were divided randomly into four groups and underwent two months of supplementation as follows: 5 mg/d oral folic acid + placebo in group one, 5 mg/d oral folic acid + vitamin B12 (1 mg/d orally in group two, 15 mg/d oral folic acid + placebo in group three and 15 mg/d oral folic acid + vitamin B12 (1 mg/d orally in group four. Concentrations of plasma tHcy and serum folic acid and vitamin B12 were measured at baseline and after the supplementation period. Dietary intake of patients was also determined during the supplementation period.Results: Of the folic acid supplemented patients, 27.8% had normal levels of tHcy at baseline and 72.2% had hyperhomocysteinemia. After the supplementation period, plasma tHcy increased by 1.35% in group one and decreased by 6.99%, 14.54% and 30.09% in groups two, three and four respectively. Changes in plasma tHcy and serum vitamin B12 were only significant in group four; however, no significant changes were seen for serum folic acid. The percentage of subjects reaching normal levels of plasma tHcy was 5.6 fold higher in group four than in the reference group. Conclusions: Supplementation with 15 mg/d folic acid together with 1 mg/d oral vitamin B12 is more effective in reducing tHcy levels in HD patients.

Impact of Mézières Rehabilitative Method in Patients with Parkinson’s Disease: A Randomized Controlled Trial

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Teresa Paolucci

2017-01-01

Full Text Available The aim of this study was to assess the efficacy of Mézières method in improving trunk flexibility of the back muscles and balance in patients with Parkinson’s disease (PD. Materials and Methods. Thirty-six patients were randomized into 2 groups: the Mézières treatment group and the control group (home exercise group. The primary outcome was the improvement in balance per the Berg Balance Scale (BBS and the trunk flexibility of the back for the anterior flexion trunk test. Also, we evaluated pain, gait balance for the Functional Gait Assessment (FGA, disease-related disability for the Modified Parkinson’s Activity Scale and the Unified Parkinson’s Disease Rating Scale (UPDRS, the quality of life, and the functional exercise capacity. All the measures were evaluated at baseline (T0, at the end of the rehabilitative program (T1, and at the 12-week follow-up (T2. Results. In the Mézières group, the BBS (p<.001 and trunk flexion test (p<.001 improved significantly at T1 and remained the same at T2. Between groups, significant changes were reported in FGA (p=.027 and UPDRS Total (p=.007 at T1 and in FGA (p=.03 at T2. Conclusion. The Mézières approach is efficacious in improving the flexibility of the trunk and balance in PD patients.

Vaginal vault recurrences of endometrial cancer in non-irradiated patients

DEFF Research Database (Denmark)

Hardarson, Hordur Alexander; Nyhøj Heidemann, Lene; Christensen, René dePont

2015-01-01

are few and limited to previously irradiated patients or patients with advanced disease. Investigation of surgical treatment for isolated vaginal vault recurrence is practically nonexistent. The aim of this study is to evaluate the efficacy of RT and ST in a non-irradiated group with recurrent endometrial...... cancer limited to the vaginal vault. METHODS: Patients treated for recurrent endometrial cancer at Odense University Hospital, Denmark between 2003 and 2012 were identified, n = 118. Thirty-three patients had an isolated vaginal vault recurrence and were treated with either RT, ST or both. Re...

Comparison of four bioindication methods for assessing the degree of environmental lead and cadmium pollution

International Nuclear Information System (INIS)

Dmuchowski, Wojciech; Gozdowski, Dariusz; Baczewska, Aneta Helena

2011-01-01

Highlights: ► In this study we examined level of contamination in extremely heavy polluted area. ► We examined four various bioindication methods. ► Results were presented in pollution maps. ► We evaluated relationships between examined bioindication methods. - Abstract: The purpose of this study was to assess the application of several bioindication methods for the monitoring of environmental pollution from Pb and Cd. The study area centered on the town of Olkusz, Poland, which is one of the oldest centers for the metallurgical industry in Europe. The assessment of environmental pollution due to metals was performed using four frequently used bioindication methods: moss-bag (Sphagnum fallax), determination of metal accumulation in Pleurozium schreberi, silver birch foliage, and Scots pine needles. The region of Olkusz, and especially the area surrounding the mining and metallurgical Bolesław complex, was extremely contaminated with Pb and Cd. The results of the investigations are presented as contamination deposition maps. Despite the application of various methods and the resulting diversity of the specific exposure periods for different biomonitors, the spatial distribution of contamination shown on the maps was similar, as confirmed by the statistical analysis of the results.

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

Science.gov (United States)

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

2002-12-01

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

Is DAS28-CRP with three and four variables interchangeable in individual patients selected for biological treatment in daily clinical practice?

DEFF Research Database (Denmark)

Madsen, Ole Rintek

2011-01-01

DAS28 is a widely used composite score for the assessment of disease activity in patients with rheumatoid arthritis (RA) and is often used as a treatment decision tool in the daily clinic. Different versions of DAS28 are available. DAS28-CRP(3) is calculated based on three variables: swollen...... and tender joint counts and CRP. DAS28-CRP(4) also includes patient global assessment. Thresholds for low and high disease activity are the same for the two scores. Based on the Bland-Altman method, the interchangeability between DAS28-CRP with three and four variables was examined in 319 RA patients...... selected for initiating biological treatment. Data were extracted from the Danish registry for biological treatment in rheumatology (DANBIO). Multiple regression analysis was used to assess the predictability of the DAS28 scores by several measures of disease activity. The overall mean DAS28-CRP was 4...

Direct method gas-phase oxygen abundances of four Lyman break analogs

Energy Technology Data Exchange (ETDEWEB)

Brown, Jonathan S.; Croxall, Kevin V.; Pogge, Richard W. [Department of Astronomy, The Ohio State University, Columbus, OH 43201 (United States)

2014-09-10

We measure the gas-phase oxygen abundances in four Lyman break analogs using auroral emission lines to derive direct abundances. The direct method oxygen abundances of these objects are generally consistent with the empirically derived strong-line method values, confirming that these objects are low oxygen abundance outliers from the mass-metallicity (MZ) relation defined by star forming Sloan Digital Sky Survey galaxies. We find slightly anomalous excitation conditions (Wolf-Rayet features) that could potentially bias the empirical estimates toward high values if caution is not exercised in the selection of the strong-line calibration. The high rate of star formation and low oxygen abundance of these objects is consistent with the predictions of the fundamental metallicity relation, in which the infall of relatively unenriched gas simultaneously triggers an episode of star formation and dilutes the interstellar medium of the host galaxy.

Symptom severity, quality of sleep, and treatment adherence among patients suffering from schizophrenia and depression

NARCIS (Netherlands)

Bosch, M.P.C.; Waberg, J.; Noort, M.W.M.L. van den; Staudte, H.; Lim, S.; Egger, J.I.M.

2016-01-01

Aim: Treatment non-adherence is a common problem in patients suffering from schizophrenia and depression. This study investigated the possible relationships between symptom severity, quality of sleep, and treatment adherence. Methods: Thirty outpatients with schizophrenia and 58 outpatients with

Quantitative computed tomography analysis of the airways in patients with cystic fibrosis using automated software: correlation with spirometry in the evaluation of severity

International Nuclear Information System (INIS)

Santos, Marcel Koenigkam; Cruvinel, Danilo Lemos; Menezes, Marcelo Bezerra de; Teixeira, Sara Reis; Vianna, Elcio de Oliveira; Elias Junior, Jorge; Martinez, Jose Antonio Baddini

2016-01-01

Objective: To perform a quantitative analysis of the airways using automated software, in computed tomography images of patients with cystic fibrosis, correlating the results with spirometric findings. Materials and methods: Thirty-four patients with cystic fibrosis were studied-20 males and 14 females; mean age 18 ± 9 years - divided into two groups according to the spirometry findings: group I (n = 21), without severe airflow obstruction (forced expiratory volume in first second [FEV1] > 50% predicted), and group II (n = 13), with severe obstruction (FEV1 ≤ 50% predicted). The following tracheobronchial tree parameters were obtained automatically: bronchial diameter, area, thickness, and wall attenuation. Results: On average, 52 bronchi per patient were studied. The number of bronchi analyzed was higher in group II. The correlation with spirometry findings, especially between the relative wall thickness of third to eighth bronchial generation and predicted FEV1, was better in group I. Conclusion: Quantitative analysis of the airways by computed tomography can be useful for assessing disease severity in cystic fibrosis patients. In patients with severe airflow obstruction, the number of bronchi studied by the method is higher, indicating more bronchiectasis. In patients without severe obstruction, the relative bronchial wall thickness showed a good correlation with the predicted FEV1. (author)

Quantitative computed tomography analysis of the airways in patients with cystic fibrosis using automated software: correlation with spirometry in the evaluation of severity

Energy Technology Data Exchange (ETDEWEB)

Santos, Marcel Koenigkam; Cruvinel, Danilo Lemos; Menezes, Marcelo Bezerra de; Teixeira, Sara Reis; Vianna, Elcio de Oliveira; Elias Junior, Jorge; Martinez, Jose Antonio Baddini, E-mail: marcelk46@yahoo.com.br [Universidade de Sao Paulo (HC/FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina

2016-11-15

Objective: To perform a quantitative analysis of the airways using automated software, in computed tomography images of patients with cystic fibrosis, correlating the results with spirometric findings. Materials and methods: Thirty-four patients with cystic fibrosis were studied-20 males and 14 females; mean age 18 ± 9 years - divided into two groups according to the spirometry findings: group I (n = 21), without severe airflow obstruction (forced expiratory volume in first second [FEV1] > 50% predicted), and group II (n = 13), with severe obstruction (FEV1 ≤ 50% predicted). The following tracheobronchial tree parameters were obtained automatically: bronchial diameter, area, thickness, and wall attenuation. Results: On average, 52 bronchi per patient were studied. The number of bronchi analyzed was higher in group II. The correlation with spirometry findings, especially between the relative wall thickness of third to eighth bronchial generation and predicted FEV1, was better in group I. Conclusion: Quantitative analysis of the airways by computed tomography can be useful for assessing disease severity in cystic fibrosis patients. In patients with severe airflow obstruction, the number of bronchi studied by the method is higher, indicating more bronchiectasis. In patients without severe obstruction, the relative bronchial wall thickness showed a good correlation with the predicted FEV1. (author)

Value of ultrasound in the determination of drainage methods in patients with tuberculous pleural effusion

International Nuclear Information System (INIS)

Kang, Eun Young; Suh, Bo Kyoung; Shim, Jae Jeong

1997-01-01

To evaluate the utility of ultrasonography (US) as a guide in deciding drainage methods and as a prognostic factor in the prediction of pleural fibrosis, and to compare the effects of drainage methods in patients with tuberculous pleural effusions. In 51 patients with tuberculous pleural effusion, US patterns of pleural effusion were classified according to degree of septa into three groups, as follows : anechoic (n=5), linear septa (n=15), and honeycomb septa (n=31). US-guided drainage methods, including thoracentesis (n=17), percutaneous catheter insertion (n=12), catheter insertion with urokinase instillation (n=22) were employed. Therapeutic effects were evaluated with follow-up chest radiographs after 3 and 6 months. Three months after the procedure, 43 of 51 effusions had drained effectively. US guided drainage failed in eight patients including two of six with linear septated effusion treated with thoracentesis, four of seven with honeycomb septated effusion treated with thoracentesis, and two of six with honeycomb septated effusion treated with catheter drainage. There was no drainage failure in patients with anechoic effusions and in patients with urokinase instillation. Late effects were assessed in 39 patients after 6 months. Follow-up radiographs available in 39 patients demonstrated pleural fibrosis with intercostal space narrowing in 7 patients with honeycomb septated effusion, 3 patients with linear septated effusion, and none of the patients with anechoic effusions. The pattern of septa seen on US could be a useful factor for determining drainage methods and predicting late results in tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation was a good drainage modality for patients with septated pleural effusions. Pleural fibrosis is more frequently induced by septated pleural effusion than by anechoic pleural effusion

Value of ultrasound in the determination of drainage methods in patients with tuberculous pleural effusion

Energy Technology Data Exchange (ETDEWEB)

Kang, Eun Young; Suh, Bo Kyoung; Shim, Jae Jeong [Korea Univ. College of Medicine, Seoul (Korea, Republic of)

1997-01-01

To evaluate the utility of ultrasonography (US) as a guide in deciding drainage methods and as a prognostic factor in the prediction of pleural fibrosis, and to compare the effects of drainage methods in patients with tuberculous pleural effusions. In 51 patients with tuberculous pleural effusion, US patterns of pleural effusion were classified according to degree of septa into three groups, as follows : anechoic (n=5), linear septa (n=15), and honeycomb septa (n=31). US-guided drainage methods, including thoracentesis (n=17), percutaneous catheter insertion (n=12), catheter insertion with urokinase instillation (n=22) were employed. Therapeutic effects were evaluated with follow-up chest radiographs after 3 and 6 months. Three months after the procedure, 43 of 51 effusions had drained effectively. US guided drainage failed in eight patients including two of six with linear septated effusion treated with thoracentesis, four of seven with honeycomb septated effusion treated with thoracentesis, and two of six with honeycomb septated effusion treated with catheter drainage. There was no drainage failure in patients with anechoic effusions and in patients with urokinase instillation. Late effects were assessed in 39 patients after 6 months. Follow-up radiographs available in 39 patients demonstrated pleural fibrosis with intercostal space narrowing in 7 patients with honeycomb septated effusion, 3 patients with linear septated effusion, and none of the patients with anechoic effusions. The pattern of septa seen on US could be a useful factor for determining drainage methods and predicting late results in tuberculous pleural effusion. Percutaneous catheter drainage with urokinase instillation was a good drainage modality for patients with septated pleural effusions. Pleural fibrosis is more frequently induced by septated pleural effusion than by anechoic pleural effusion.

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

Science.gov (United States)

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

2010-11-01

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

The meaning of pharmacological treatment for schizophrenic patients1

Science.gov (United States)

Vedana, Kelly Graziani Giacchero; Miasso, Adriana Inocenti

2014-01-01

OBJECTIVE: to understand the meaning of medication therapy for schizophrenic patients and formulate a theoretical model about the study phenomenon. METHOD: a qualitative approach was employed, using Symbolic Interactionism as the theoretical and Grounded Theory as the methodological framework. The research was developed between 2008 and 2010 at three community mental health services in the interior of the State of São Paulo - Brazil. Thirty-six patients and thirty-six family members were selected through theoretical sampling. The data were mainly collected through open interviews and observation and simultaneously analyzed through open, axial and selective coding. RESULTS: the meaning of the pharmacotherapy is centered on the phenomenon "Living with a help that bothers", which expresses the patients' ambivalence towards the medication and determines their decision making. The insight, access, limitations for self-administration of the drugs and interactions with family members and the health team influenced the patient's medication-related behavior. CONCLUSION: the theory presented in this study provides a comprehensive, contextualized, motivational and dynamic understanding of the relation the patient experiences and indicates potentials and barriers to follow the medication treatment. PMID:25296152

Comparison between refraction measured by Spot Vision ScreeningTM and subjective clinical refractometry

OpenAIRE

de Jesus, Daniela Lima; Villela, Fl?vio Fernandes; Orlandin, Luis Fernando; Eiji, Fernando Naves; Dantas, Daniel Oliveira; Alves, Milton Ruiz

2016-01-01

OBJECTIVE: The purpose of this study was to evaluate the accuracy of Spot Vision ScreeningTM as an autorefractor by comparing refraction measurements to subjective clinical refractometry results in children and adult patients. METHODS: One-hundred and thirty-four eyes of 134 patients were submitted to refractometry by Spot and clinical refractometry under cycloplegia. Patients, students, physicians, staff and children of staff from the Hospital das Clínicas (School of Medicine, University of...

Acute secondary effects in the esophagus in patients undergoing radiotherapy for carcinoma of the lung

Energy Technology Data Exchange (ETDEWEB)

Mascarenhas, F.; Silvestre, M.E.; Sa da Costa, M.; Grima, N.; Campos, C.; Chaves, P.

1989-02-01

The incidence and nature of acute secondary irradiation esophagitis was studied in a series of 38 patients undergoing 60Co teletherapy for carcinoma of the lung. Thirty-four patients were male and four female, with ages ranging from 38 to 78 years. The mediastinum being irradiated in the process, all the patients underwent endoscopy for signs of esophagitis and/or gastritis after a dose of 30-40 Gy was delivered to the esophagus. Eighteen patients complained of dysphagia, but only in 12 of them did endoscopy show esophagitis. Of the remaining patients without complaints five had endoscopic signs of esophagitis. Gastritis was found in 18 cases and confirmed histologically in 14. In 17 cases, esophagitis and/or gastritis were confirmed histologically. It is believed that there is a fairly close correlation among clinical, endoscopic, and histological findings to support the claim that esophagitis in these patients is radiation induced. However, the cause of gastritis is not well understood. Data in the literature suggest that nonsteroid anti-inflammatory agents can act as prophylactic means of preventing radiation esophagitis.

Acute secondary effects in the esophagus in patients undergoing radiotherapy for carcinoma of the lung

International Nuclear Information System (INIS)

Mascarenhas, F.; Silvestre, M.E.; Sa da Costa, M.; Grima, N.; Campos, C.; Chaves, P.

1989-01-01

The incidence and nature of acute secondary irradiation esophagitis was studied in a series of 38 patients undergoing 60Co teletherapy for carcinoma of the lung. Thirty-four patients were male and four female, with ages ranging from 38 to 78 years. The mediastinum being irradiated in the process, all the patients underwent endoscopy for signs of esophagitis and/or gastritis after a dose of 30-40 Gy was delivered to the esophagus. Eighteen patients complained of dysphagia, but only in 12 of them did endoscopy show esophagitis. Of the remaining patients without complaints five had endoscopic signs of esophagitis. Gastritis was found in 18 cases and confirmed histologically in 14. In 17 cases, esophagitis and/or gastritis were confirmed histologically. It is believed that there is a fairly close correlation among clinical, endoscopic, and histological findings to support the claim that esophagitis in these patients is radiation induced. However, the cause of gastritis is not well understood. Data in the literature suggest that nonsteroid anti-inflammatory agents can act as prophylactic means of preventing radiation esophagitis

Qualities of a good Singaporean psychiatrist: Qualitative differences between psychiatrists and patients.

Science.gov (United States)

Tor, Phern-Chern; Tan, Jacinta O A

2015-06-01

Pilot studies in Singapore established four themes (personal values, professional, relationship, academic-executive) relating to the qualities of a good psychiatrist, and suggested potential differences of opinion between patients and psychiatrists. We sought to explore differences between patients and psychiatrists regarding the qualities of a good psychiatrist. Qualitative analysis of interviews using a modified grounded theory approach with 21 voluntary psychiatric inpatients and 18 psychiatrists. One hundred thirty-one separate qualities emerged from the data. The qualities of a good psychiatrist were viewed in the context of motivations, functions, methods, and results obtained, mirroring the themes established in the pilot studies. Patients and psychiatrists mostly concurred on the qualities of a good psychiatrist, with 62.6% of the qualities emerging from both groups. However significant differences existed. Patient-specific qualities included proof of altruistic motives, diligence, clinical competence, and positive results. What the psychiatrist represented to patients in relation to gender, culture, and clinical prestige also mattered to patients. Psychiatrist-specific qualities related to societal (e.g. public protection) and professional concerns (e.g. boundary issues). The results of this study demonstrate that patients and psychiatrists have different views about the qualities of a good psychiatrist. Patients may expect proof of care, diligence, and competence from the psychiatrist, along with positive results. In addition, psychiatrists should be mindful of what they represent to patients and how that can impact the doctor-patient relationship. © 2014 Wiley Publishing Asia Pty Ltd.

Major depressive symptoms increase 3-year mortality rate in patients with mild dementia

DEFF Research Database (Denmark)

Petersen, Jindong Ding; Waldorff, Frans Boch; Siersma, Volkert Dirk

2017-01-01

Depression and dementia are commonly concurrent and are both associated with increased mortality among older people. However, little is known about whether home-dwelling patients newly diagnosed with mild dementia coexisting with depressive symptoms have excess mortality. We conducted a post hoc...... analysis based on data from the Danish Alzheimer's Intervention Study of 330 individuals who were diagnosed with mild dementia within the past 12 months. Thirty-four patients were identified with major depressive symptoms (MD-S) at baseline. During the 3-year follow-up period, 56 patients died, and, among...... mortality as compared to the patients without or with only few depressive symptoms. Our result revealed that depression is possibly associated with increased mortality in patients with mild dementia. Given that depression is treatable, screening for depression and treatment of depression can be important...

Determination of serum leptin and vascular endothelial growth factor (VEGF) contents in patients with breast cancer

International Nuclear Information System (INIS)

Huang Xudong; Jin Wentao; Pan Meizhen

2006-01-01

Objective: To investigate the serum expression of leptin and vascular endothelial growth factor (VEGF) in patients with breast cancer and assess its diagnostic significance. Methods: Thirty-six patients with breast cancer and thirty-one patients with benign breast disorders entered this study. Serum concentration of leptin (with RIA) and VEGF ( with ELISA) were determined in these patients before operation as well as in 56 controls. All the tested subjects were post-menopausal women. Results: The difference between the leptin levels in the controls and patients with benign breast disorders was significantly; 80 was the difference between the leptin levels in controls and patients with breast cancer. Significant difference also existed between the VEGF levels in controls and patients with cancer as well as between the levels in patients with benign breast disease and patients with cancer. Also, the serum leptin and VEGF levels in the cancerous patients with axillary metastasis were significantly higher than those in patients without metastasis. Conclusion: Serum leptin and VEGF might be taken as diagnostic tumor markers for malignanay and metastasis in patients with breast cancer. (authors)

Incidence of pulmonary embolism in patients with chronic obstructive pulmonary disease and indeterminate lung scans

International Nuclear Information System (INIS)

Perlmutt, L.M.; Blinder, R.A.; Newman, G.E.; Braun, S.D.; Coleman, R.E.

1987-01-01

Pulmonary embolism (PE) is commonly considered as a cause of acute excerbation of chronic obstructive pulmonary disease (COPD). These patients often have indeterminate lung scans. To determine the incidence of PE in this group of patients, the authors have retrospectively reviewed 157 consecutive patients who underwent pulmonary angiography. Forty (25%) had a diagnosis of COPD. Seven (18%) of these had PE compared with 57 (36%) in the total group. Thirty-seven of the 40 patients had a lung scan, of which 30 (81%) were indeterminate. Of these 30 patients, only four (13%) had PE. In conclusion, the prevalence of PE in patients with COPD is much lower than the prevalence of PE in the total population, and at this prevalence, an indeterminate scan in patients with COPD caries a low probability (13%) for PE

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.

Quantitative measurement of radiofrequency volumetric tissue reduction by multidetector CT in patients with inferior turbinate hypertrophy.

Science.gov (United States)

Bahadir, Osman; Kosucu, Polat

2012-12-01

To objectively assess the efficacy of radiofrequency thermal ablation of inferior turbinate hypertrophy. Thirty-five patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. Radiofrequency energy was delivered to four sites in each inferior turbinate. Patients were evaluated before and 8 weeks after intervention. Subjective evaluation of nasal obstruction was performed using a visual analogue scale (VAS), and objective evaluation of the turbinate volume reduction was calculated using multidetector CT. Volumetric measurements of the preoperative inferior turbinate were compared with postoperative values on both sides. The great majority of patients (91.4%) exhibited subjective postoperative improvement. Mean obstruction (VAS) improved significantly from 7.45±1.48 to 3.54±1.96. Significant turbinate volume reduction was achieved by the surgery on both right and left sides [(preoperative vs. postoperative, right: 6.55±1.62cm(3) vs. 5.10±1.47cm(3), (PRadiofrequency is a safe and effective surgical procedure in reducing turbinate volume in patients with inferior turbinate hypertrophy. Multidetector CT is an objective method of assessment in detecting radiofrequency turbinate volume reduction. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

State-Independent Proof of Kochen—Specker Theorem with Thirty Rank-Two Projectors

International Nuclear Information System (INIS)

Toh, S. P.

2013-01-01

The Kochen—Specker theorem states that noncontextual hidden variable theories are incompatible with quantum mechanics. We provide a state-independent proof of the Kochen—Specker theorem using the smallest number of projectors, i.e., thirty rank-2 projectors, associated with the Mermin pentagram for a three-qubit system

Effectiveness of Anonymization Methods in Preserving Patients' Privacy: A Systematic Literature Review.

Science.gov (United States)

Langarizadeh, Mostafa; Orooji, Azam; Sheikhtaheri, Abbas

2018-01-01

An ever growing for application of electronic health records (EHRs) has improved healthcare providers' communications, access to data for secondary use and promoted the quality of services. Patient's privacy has been changed to a great issue today since there are large loads of critical information in EHRs. Therefore, many privacy preservation techniques have been proposed and anonymization is a common one. This study aimed to investigate the effectiveness of anonymization in preserving patients' privacy. The articles published in the 2005-2016 were included. Pubmed, Cochrane, IEEE and ScienceDirect were searched with a variety of related keywords. Finally, 18 articles were included. In the present study, the relevant anonymization issues were investigated in four categories: secondary use of anonymized data, re-identification risk, anonymization effect on information extraction and inadequacy of current methods for different document types. The results revealed that though anonymization cannot reduce the risk of re-identification to zero, if implemented correctly, can manage to help preserve patient's privacy.

Patient-related barriers to cancer pain management: a systematic exploratory review

DEFF Research Database (Denmark)

Jacobsen, Ramune; Møldrup, Claus; Christrup, Lona Louring

2009-01-01

, carried out in Cochrane Library, Medline (through PubMed), Web of Science and EMBASE databases for the period 1994-2005. Thirty-seven studies, dealing with cognitive, sensory and affective patient-related barriers, as well as studies, describing patients' pain communication and their adherence......The aim of this review was to systemically explore the current evidence regarding patient-related barriers to cancer pain management to find new areas that might be important for better understanding of patient barriers' phenomenon. The method used in this study was a computerised literature search...

A method for total body irradiation

International Nuclear Information System (INIS)

Yasukochi, Hiroshi; Higashi, Shizuka; Okuhata, Yoshitaka; Lee, Keiichi; Ishioka, Kuniaki; Murakami, Koji; Nagai, Jun; Kuniyasu, Yoshio

1988-01-01

In these two years, we have treated four infant patients of acute leukemia by Cobalt-60 total body irradiation and bone marrow transplantation. During total body irradiation, thermoluminescence dosimeters were attached to the skin of patients. For four patients, nine dosimetries were performed. Reliability of this method was examined by phantom experiment. Every irradiation for the patient per fraction was 2.4 Gy, that is, 60 cGy for each four positions, right decubitus A-P and PA directions and left decubitus A-P and PA directions under aseptic circumstances. Radiation dose was uniform by this technique for each patient, and average determined dose for surface of the patients was between 87 % and 106 % compared with the air dose of the center of aseptic space (wagon). As the result, we suggest that this method is suitable for the total body irradiation of acute leukemia of infant. (author)

Three ports versus four ports laparoscopic cholecystectomy

International Nuclear Information System (INIS)

Shah, S.F.; Waqar, S.; Chaudry, M.A.; Hameed, S.

2017-01-01

To compare three ports laparoscopic cholecystectomy and four ports laparoscopic cholecystectomy in terms of complications, time taken to complete the procedure, hospital stay and cost effectiveness in local perspective. Methodology: This randomized control trial included 60 patients who underwent elective laparoscopic cholecystectomy at Department of Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from January 2013 to June 2013. These patients were randomized on computer generated table of random numbers into group A and Group B. In Group A patients four ports were passed to perform laparoscopic cholecystectomy and in Group B patients three ports were passed to perform the procedure. Results: The mean age in both groups was 44 years (range 18-72). Three ports laparoscopic cholecystectomy (43 min) took less time to complete than four ports laparoscopic cholecystectomy (51 min). Patients in three ports laparoscopic cholecystectomy experienced less pain as compared to four ports group. The total additional analgesia requirement in 24 hours calculated in milligrams was less in three port laparoscopic cholecystectomy group as compared four port laparoscopic cholecystectomy group. The mean hospital stay in three port laparoscopic cholecystectomy group is 25 hours while the mean hospital stay in the four port laparoscopic cholecystectomy group is 28 hours. Conclusion: Three ports laparoscopic cholecystectomy is safe and effective procedure and it did not compromise the patient safety. (author)

Holistic needs assessment in advanced, intensively treated multiple myeloma patients.

Science.gov (United States)

Boland, E G; Boland, J W; Ezaydi, Y; Greenfield, D M; Ahmedzai, S H; Snowden, J A

2014-10-01

It is recommended that patients with multiple myeloma should be assessed for unmet holistic needs at key times in their disease trajectory. The aim of this exploratory study was to characterise the holistic needs of advanced, intensively treated multiple myeloma using a structured assessment tool. Patients with multiple myeloma who had undergone a haematopoietic stem cell transplantation and subsequent treatment for at least one episode of progressive disease but were in stable plateau phase were included in the study. Patients' holistic needs were assessed using the self-reporting tool, Sheffield Profile for Assessment and Referral for Care (SPARC). Thirty-two patients with a median age of 60 years at assessment and a median of 5.5 years from diagnosis were recruited. Using the SPARC, half of the patients reported tiredness as 'quite a bit/very much,' while one third complained that daytime somnolence and insomnia were 'quite a bit/very much.' Forty-four percent of patients reported pain. One third of patients were bothered and distressed by the side effects from their treatment and were worried about long-term effects of their treatment. Thirty-one percent of patients felt that the effect of their condition had an impact on their sexual life, and 40 % were worried about the effect that their illness was having on their family or other people. This is the first study to use a self-reported holistic needs assessment tool in multiple myeloma. A multidimensional structured questionnaire like the SPARC could provide a useful first step in the effective delivery of supportive and palliative care for patients with multiple myeloma.

Feasibility of a combined aerobic and strength training program and its effects on cognitive and physical function in institutionalized dementia patients. A pilot study

NARCIS (Netherlands)

Bossers, Willem J R; Scherder, Erik J A; Boersma, Froukje; Hortobágyi, Tibor; van der Woude, Lucas H V; van Heuvelen, Marieke J G

2014-01-01

Objectives: We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. Methods: Thirty-three patients with dementia, recruited from one nursing home, participated in this

Feasibility of a Combined Aerobic and Strength Training Program and Its Effects on Cognitive and Physical Function in Institutionalized Dementia Patients. A Pilot Study

NARCIS (Netherlands)

Bossers, W.J.R; Scherder, E.J.A.; Boersma, F.; Hortobágyi, T.; van der Woude, L.H.V.; van Heuvelen, M.J.G.

2014-01-01

Objectives: We examined the feasibility of a combined aerobic and strength training program in institutionalized dementia patients and studied the effects on cognitive and physical function. Methods: Thirty-three patients with dementia, recruited from one nursing home, participated in this

[Operative treatment of proximal humeral four-part fractures in elderly patients: comparison of two angular-stable implant systems].

Science.gov (United States)

Kuhlmann, T; Hofmann, T; Seibert, O; Gundlach, G; Schmidt-Horlohé, K; Hoffmann, R

2012-04-01

Although being one of the most common fractures in elderly patients, there is still no standardised treatment protocol for four-part fractures of the proximal humerus. However, a wide variety of angular-stable implants is available. The present retrospective study compares the clinical and radiological outcome following operative treatment of four-part fractures of the proximal humerus with the Philos system (Philos, proximal humeral internal locking system, Synthes GmbH, Umkirch Germany) and the angular-stable Königsee plate system (Königsee Implantate GmbH, Allendorf, Germany) in patients older than 65 years. From July 2005 until December 2007 we identified 77 patients with a four-part fracture of the proximal humerus who were treated operatively with one of the two implant systems. Of the patients, 17 could not be located so that in total 60 patients (78 %) participated in this study. The mean age of the 30 patients (10 m, 20 f) in the Philos group was 69 years (65-92), whereas the mean age of the 30 patients (11 m, 19 f) in the Königsee group was 71 years (65-93). A comprehensive assessment was performed after a median of 17 months (12-24), including physical examination, radiographic examination and completion of the disabilities of the arm, shoulder and hand score (DASH) and the Constant score (CS) as patient-oriented, limb-specific questionnaires. Neither in the Philos nor in the Königsee group could excellent results be achieved. Using the CS 13 patients (43 %) of the Philos group achieved a good and 15 (50 %) a satisfactory result. Bad results were found in 2 patients (7 %). The mean CS was 61.53 points. In the Königsee group mean CS was 61.76 points. In detail, 14 patients (47 %) treated with the Königsee implant were rated as good and 15 (50 %) as satisfactory. Only 1 patient (3 %) was rated as poor. No significant statistical differences were found between the groups. Mean DASH score in the Philos group was 56.30 points and 55.37 points in the K�

Comparison of four bioindication methods for assessing the degree of environmental lead and cadmium pollution

Energy Technology Data Exchange (ETDEWEB)

Dmuchowski, Wojciech, E-mail: w.dmuchowski@obpan.pl [Botanical Garden-Center for Conservation of Biological Diversity, Polish Academy of Science, Prawdziwka 2, 02-973 Warsaw (Poland); Warsaw University of Life Sciences-SGGW, Faculty of Agriculture and Biology, 159 Nowoursynowska 159, 02-776 Warsaw (Poland); Gozdowski, Dariusz, E-mail: dariusz_gozdowski@sggw.pl [Warsaw University of Life Sciences-SGGW, Faculty of Agriculture and Biology, 159 Nowoursynowska 159, 02-776 Warsaw (Poland); Baczewska, Aneta Helena [Botanical Garden-Center for Conservation of Biological Diversity, Polish Academy of Science, Prawdziwka 2, 02-973 Warsaw (Poland)

2011-12-15

Highlights: Black-Right-Pointing-Pointer In this study we examined level of contamination in extremely heavy polluted area. Black-Right-Pointing-Pointer We examined four various bioindication methods. Black-Right-Pointing-Pointer Results were presented in pollution maps. Black-Right-Pointing-Pointer We evaluated relationships between examined bioindication methods. - Abstract: The purpose of this study was to assess the application of several bioindication methods for the monitoring of environmental pollution from Pb and Cd. The study area centered on the town of Olkusz, Poland, which is one of the oldest centers for the metallurgical industry in Europe. The assessment of environmental pollution due to metals was performed using four frequently used bioindication methods: moss-bag (Sphagnum fallax), determination of metal accumulation in Pleurozium schreberi, silver birch foliage, and Scots pine needles. The region of Olkusz, and especially the area surrounding the mining and metallurgical Boleslaw complex, was extremely contaminated with Pb and Cd. The results of the investigations are presented as contamination deposition maps. Despite the application of various methods and the resulting diversity of the specific exposure periods for different biomonitors, the spatial distribution of contamination shown on the maps was similar, as confirmed by the statistical analysis of the results.

A comparative study of occupancy and patient care quality in four different types of intensive care units in a children's hospital.

Science.gov (United States)

Smith, Thomas J

2012-01-01

This paper reports a comparative study of occupancy and patient care quality in four types of intensive care units in a children's hospital,: an Infant Care Center (ICC), a Medical/Surgical (Med/Surg) unit, a Neonatal Intensive Care Unit (NICU), and a Pediatric Intensive Care Unit (PICU), each featuring a mix of multi-bed and private room (PR) patient care environments. The project is prompted by interest by the project sponsor in a pre-occupancy analysis, before the units are upgraded to exclusive PR designs. Methods comprised, for each unit: (1) observations of ergonomic design features; (2) task activity analyses of job performance of selected staff; and (3) use of a survey to collect perceptions by unit nursing and house staff (HS) of indicators of occupancy and patient care quality. (1) the five most common task activities are interaction with patients, charting, and interaction with equipment, co-workers and family members; (2) job satisfaction, patient care, work environment, job, patient care team interaction, and general occupancy quality rankings by ICC and/or NICU respondents are significantly higher than those by other staff respondents; and (3) ergonomic design shortcomings noted are excess noise, problems with equipment, and work environment, job-related health, and patient care quality issues.

Expression of chemokine receptor CXCR3 in female patients with dry eye at perimenopause

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Hong Zhang

2013-09-01

Full Text Available AIM: To explore the expression and clinical significance of chemotactic factor receptor-3(CXCR3of female patients conjunctival with dry eye at perimenopause. METHODS: Thirty dry eye case(60 eyesin the patient at perimenopause of the First Affiliated Hospital of Xinjiang Medical University and thirty dry eye cases(60 eyesin patient at non-perimenopause were selected. The conjunctival epithelial cells at perimenopause and non-perimenopause in dry eye cases were obtained by impression cytology methods, and then immersed into the centrifugal tube with corresponding number respectively and the expression of CXCR3 in conjunctival epithelium of at perimenopause and non-perimenopause in dry eye cases were detected by flow cytometry. RESULTS: The break-up time(BUTand Schirmer Ⅰ test result of perimenopause was significantly lower than those of non-perimenopause(F=4.076, 5.023; PPr=-0.753, r=-0.684; PP>0.05.CONCLUSION: CXCR3 plays an inflammatory mediators role in dry eye mechanism and its expression level reflects the progress of dry eye at perimenopause.

Trialling computer touch-screen technology to assess psychological distress in patients with gynaecological cancer

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Georgia Halkett

2010-12-01

Full Text Available BackgroundCancer impacts on the psychological well-being of many cancer patients. Appropriate tools can be used to assist health professionals in identifying patient needs and psychological distress. Recent research suggests that touchscreen technology can be used to administer surveys. The aim of this study was to evaluate the use of a touchscreen system in comparison to written questionnaires in a large tertiary hospital in Western Australia (WA.Method Patients who were scheduled to commence treatment for gynaecological cancer participated in this study. Patients were assigned to complete either a written questionnaire or the same survey using the touchscreen technology. Both methods of survey contained the same scales. All participants were asked to complete a follow-up patient satisfaction survey. Semi-structured interviews were conducted with health professionals to elicit views about the implementation of the technology and the available referral pathways. Data was analysed using descriptive statistics and content analysis. ResultsThirty patients completed the touchscreen questionnaires and an equal number completed the survey on paper. Participants who used the touchscreens were not significantly more satisfied than other participants. Four themes were noted in the interviews with health professionals: usability of technology, patients’ acceptance of technology, advantages of psychological screening and the value of the instruments included.ConclusionAlthough previous studies report that computerised assessments are a feasible option for assessing cancer patients’ needs, the data collected in this study demonstrates that the technology was not reliable with significant practical problems. The technology did not serve these patients better than pen and paper.

A thirty million year-old inherited heteroplasmy.

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Vincent Doublet

Full Text Available Due to essentially maternal inheritance and a bottleneck effect during early oogenesis, newly arising mitochondrial DNA (mtDNA mutations segregate rapidly in metazoan female germlines. Consequently, heteroplasmy (i.e. the mixture of mtDNA genotypes within an organism is generally resolved to homoplasmy within a few generations. Here, we report an exceptional transpecific heteroplasmy (predicting an alanine/valine alloacceptor tRNA change that has been stably inherited in oniscid crustaceans for at least thirty million years. Our results suggest that this heteroplasmy is stably transmitted across generations because it occurs within mitochondria and therefore escapes the mtDNA bottleneck that usually erases heteroplasmy. Consistently, at least two oniscid species possess an atypical trimeric mitochondrial genome, which provides an adequate substrate for the emergence of a constitutive intra-mitochondrial heteroplasmy. Persistence of a mitochondrial polymorphism on such a deep evolutionary timescale suggests that balancing selection may be shaping mitochondrial sequence evolution in oniscid crustaceans.

Personal and Parents’ Life Stories in Patients with Borderline Personality Disorder

DEFF Research Database (Denmark)

Lind, Majse; Thomsen, Dorthe Kirkegaard; Bøye, Rikke

. Thirty patients with BPD and thirty matched control participants described and answered questions about their personal life stories and their parents’ life stories and completed measures of identity disturbance, alexithymia, empathy, and emotional intelligence. Compared to the control group, patients...

Planning Study Comparison of Real-Time Target Tracking and Four-Dimensional Inverse Planning for Managing Patient Respiratory Motion

International Nuclear Information System (INIS)

Zhang Peng; Hugo, Geoffrey D.; Yan Di

2008-01-01

Purpose: Real-time target tracking (RT-TT) and four-dimensional inverse planning (4D-IP) are two potential methods to manage respiratory target motion. In this study, we evaluated each method using the cumulative dose-volume criteria in lung cancer radiotherapy. Methods and Materials: Respiration-correlated computed tomography scans were acquired for 4 patients. Deformable image registration was applied to generate a displacement mapping for each phase image of the respiration-correlated computed tomography images. First, the dose distribution for the organs of interest obtained from an idealized RT-TT technique was evaluated, assuming perfect knowledge of organ motion and beam tracking. Inverse planning was performed on each phase image separately. The treatment dose to the organs of interest was then accumulated from the optimized plans. Second, 4D-IP was performed using the probability density function of respiratory motion. The beam arrangement, prescription dose, and objectives were consistent in both planning methods. The dose-volume and equivalent uniform dose in the target volume, lung, heart, and spinal cord were used for the evaluation. Results: The cumulative dose in the target was similar for both techniques. The equivalent uniform dose of the lung, heart, and spinal cord was 4.6 ± 2.2, 11 ± 4.4, and 11 ± 6.6 Gy for RT-TT with a 0-mm target margin, 5.2 ± 3.1, 12 ± 5.9, and 12 ± 7.8 Gy for RT-TT with a 2-mm target margin, and 5.3 ± 2.3, 11.9 ± 5.0, and 12 ± 5.6 Gy for 4D-IP, respectively. Conclusion: The results of our study have shown that 4D-IP can achieve plans similar to those achieved by RT-TT. Considering clinical implementation, 4D-IP could be a more reliable and practical method to manage patient respiration-induced motion

Thirty Years of Education in China: Between Change and No Change--A Comparative Analysis of Four Key Documents on Education Policy

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Wenbin, Hu

2012-01-01

This article reviews the education reform and development footprints in China by analyzing four key education policy documents in the past three decades. The conclusion is that the reform and development of China's educational establishment have provided excellent support for the operations of China's political and economic systems. The reality is…

Investigation of deletions at 7q11.23 in 44 patients referred for Williams-Beuren syndrome, using FISH and four DNA polymorphisms

DEFF Research Database (Denmark)

Brøndum-Nielsen, K; Beck, B; Gyftodimou, J

1997-01-01

Williams syndrome (WS) is associated with a submicroscopic deletion of the elastin gene (ELN) at 7q11.23. The deletion encompasses closely linked DNA markers. We have investigated 44 patients referred for possible WS using fluorescence in situ hybridization (FISH) analysis with a P1 clone...... containing an insert from the ELN, as well as performing genotype analysis of patients and parents with four DNA polymorphisms. Twenty-four patients were found to have deletions, 19 of whom were found clinically to have typical WS. The facial features were especially characteristic. None of the patients...

Supraclavicular failure after breast-conserving therapy in patients with four or more positive axillary lymph nodes when prophylactic supraclavicular irradiation is omitted

International Nuclear Information System (INIS)

Hamamoto, Yasushi; Kataoka, Masaaki; Semba, Takatoshi

2009-01-01

The incidence of supraclavicular metastasis as the initial failure and the failure patterns in patients with four or more positive axillary lymph nodes (PALNs) after breast-conserving therapy (BCT) without prophylactic supraclavicular irradiation were investigated. Between 1991 and 2002, a total of 48 women with four or more PALNs underwent BCT without prophylactic supraclavicular irradiation (33 patients with 4-9 PALNs; 15 patients with ≥10 PALNs). The median follow-up time was 50 months. Among the patients with 4-9 PALNs, 3% had isolated supraclavicular metastasis as the initial failure, and 30% had distant metastasis as the initial failure. Among patients with ≥10 PALNs, 7% had isolated supraclavicular metastasis as the initial failure, and 40% had distant metastasis as the initial failure. The 4-year isolated supraclavicular failure rates were 5% for all patients, 3% for patients with 4-9 PALNs, and 8% for patients with ≥10 PALNs. In patients who had undergone BCT and had had four or more PALNs, the major failure pattern was distant failure with or without locoregional failure; isolated supraclavicular failure as the initial failure comprised a less common failure pattern. Omission of prophylactic supraclavicular irradiation may be acceptable for this subset of patients. (author)

Retrospective cohort study of prognostic factors in patients with oral cavity and oropharyngeal squamous cell carcinoma.

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Carrillo, José F; Carrillo, Liliana C; Cano, Ana; Ramirez-Ortega, Margarita C; Chanona, Jorge G; Avilés, Alejandro; Herrera-Goepfert, Roberto; Corona-Rivera, Jaime; Ochoa-Carrillo, Francisco J; Oñate-Ocaña, Luis F

2016-04-01

Prognostic factors in oral cavity and oropharyngeal squamous cell carcinoma (SCC) are debated. The purpose of this study was to investigate the association of prognostic factors with oncologic outcomes. Patients with oral cavity and oropharyngeal SCC treated from 1997 to 2012 were included in this retrospective cohort study. Associations of prognostic factors with locoregional recurrence (LRR) or overall survival (OS) were analyzed using the logistic regression and the Cox models. Six hundred thirty-four patients were included in this study; tumor size, surgical margins, and N classification were associated with LRR (p oral cavity and oropharyngeal SCC. © 2015 Wiley Periodicals, Inc.

The role of gallium-67 tumour scintigraphy in patients with small, non-cleaved cell lymphoma

International Nuclear Information System (INIS)

Sandrock, D.; Lastoria, S.; Neumann, R.D.; Magrath, I.T.

1993-01-01

Two hundred and thirty-four scintigraphic studies were performed in 34 patients (27 men, 7 women, age 17.3±7.7 years) with small, non-cleaved cell lymphoma who had follow-up for 3-96 months (mean 21.6±21.7 months). Whole-body scintigraphy was performed 48-72 h following i.v. injection of 370 MBq gallium-67 citrate. 'Gold standards' for truth determinations were surgery, autopsy, histology, axial X-ray computed tomography, magnetic resonance imaging, ultrasonography and clinical follow-up. Overall, 181 of 234 studies were true negative. Eighty proven sites of disease had true positive 67 Ga uptake (in 21 patients/37 studies). Nineteen sites (in 12 patients/15 studies) were false positive. In addition, 31 benign lesions were detected and interpreted correctly in terms of non-malignancy. Ten lymphoma sites (in 6 patients/10 studies) were missed by scintigraphy. Overall, sensitivity of gallium scintigraphy was 89% when calculated by sites and 79% when calculated by studies. Corresponding specificities were 91% and 92%, respectively. Positive predictive values were 81% (sites) and 71% (studies), and negative predictive values 95% (sites and studies). Thus, gallium scintigraphy proved to be a sensitive and specific method for staging and follow-up in patients with small, non-cleaved cell lymphoma. (orig.)

Mammary analogue secretory carcinoma (MASC) of salivary gland in four Mexican patients.

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Serrano-Arévalo, Mónica L; Mosqueda-Taylor, Adalberto; Domínguez-Malagón, Hugo; Michal, Michal

2015-01-01

The Clinco-pathological, immunohistochemical and molecular findings of four cases of Mammary Analogue Secretory Carcinoma (MASC) of salivary glands found in Mexico are described. The cases were extracted from 253 salivary gland tumors from a single institution in Mexico City. The 85 Candidates for initial selection were: low grade mucoepidermoid carcinoma (MEC) (N=70 ), Acinic cell cancinoma (AciCC) (N=14), papillary cystadenocarcinoma (N=1), and adenocarcinoma NOS (N=0). Tumors with some histological features consistent with MASC (N= 17, 6.7%) were studied by immunohistochemistry for mammaglobin, STAT5, and S-100 protein and four cases were positive (1.5%), thus the diagnosis of MASC was established, and these were submitted for molecular studies for ETV6-NTRK3. Fusion gene was demonstrated in three cases, two had been erroneously diagnosed as poorly granulated AciCC, and one as low grade MEC with microcystic pattern. Female gender predominated (3:1); one occurred in the parotid, two in minor salivary glands and one in the submaxillary gland; infiltrating borders, atypical mitosis and lymph node metastases were seen in the parotideal tumor. Two patients with major salivary gland tumors are alive and well at 10 and 20 months respectively, the two patients with minor salivary gland tumors are lost. It can be concluded that is important to think in MASC in poorly granulated AciCC and low grade MEC with microcystic pattern. Immunohistochemisty studies confirm the diagnosis, preferentially supported by molecular studies. MASC may follow aggressive behavior or transform into a high grade neoplasm.

Weight stigma in physiotherapy practice: Patient perceptions of interactions with physiotherapists.

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Setchell, Jenny; Watson, Bernadette; Jones, Liz; Gard, Michael

2015-12-01

Weight management is increasingly considered part of physiotherapists' scope of practice in order to improve patient outcomes by, for example, reducing load on joints, or improving chronic pain. However, interactions with patients involving weight may result in patient perceptions of negative judgement from health professionals, which can result in poorer health outcomes. How physiotherapist/patient interactions involving weight are perceived by patients has not yet been investigated. To explore patients' perceptions of interactions with physiotherapists that involved weight, and investigate how these perceptions may inform physiotherapy practice. Face-to-face interviews with physiotherapy patients, with follow up interviews conducted by telephone. Data were analysed thematically. First interviews were held in a physiotherapy practice with follow up interviews conducted two weeks later. Interviews were audio recorded, transcribed and analysed using an inductive thematic method established by Braun and Clarke. Thirty interviews with 15 patients were analysed. Four main themes relevant to weight were identified: 1) perceptions of being 'in physiotherapy' including pre-conceptions, the physical environment, and exposing the body, 2) emphasis placed on weight in physiotherapy interactions, 3) communication styles, and 4) judgement perception. Some patients perceived negative weight judgements from elements of physiotherapy interactions and environments. Physiotherapists need to be aware of this perception because it may result in poorer patient outcomes and patients avoiding physiotherapy appointments. The results suggest strategies to counteract weight stigma include: adjusting the physical environment of the clinic, portraying an understanding of complex determinants of weight, and employing collaborative, non-judgemental communication styles. Copyright © 2015 Elsevier Ltd. All rights reserved.

Conventional and Molecular Epidemiology of Tuberculosis in Homeless Patients in Budapest, Hungary

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Lukács, Judit; Tubak, Vilmos; Mester, Judit; Dávid, Sándor; Bártfai, Zoltán; Kubica, Tanja; Niemann, Stefan; Somoskövi, Ákos

2004-01-01

In Hungary the incidence of tuberculosis among the homeless population was 676 per 100,000 in 2002. Sixty-nine percent (140 patients) of all homeless tuberculosis patients were notified in Budapest (the capital). Therefore, a retrospective study that included 66 homeless tuberculosis patients notified in Budapest in 2002 was conducted to determine the rate of recent transmission of the disease and medical risk factors and to identify transmission pathways by means of conventional and molecular epidemiologic methods. IS6110 DNA fingerprinting revealed that 71.2% of the isolates could be clustered. Thirty-four (51.5%) patients belonged to five major clusters (size, from 4 to 11 individuals), and 13 (19.7%) belonged to six smaller clusters. Additional analysis of patient records found that 2 (18%) of the 11 patients in cluster A, 3 (37.5%) of the 8 patients in cluster B, and 2 (33%) of the 6 patients in cluster C were residents of the same three homeless shelters during the diagnosis of tuberculosis. Review of the database of the National Tuberculosis Surveillance Center (NTSC) revealed that 21.2% of the cases have not been reported to the NTSC. These findings indicate that the screening and treatment of tuberculosis among the homeless need to be strengthened and also warrant the review of environmental control steps in public shelters. Improvement of adherence of clinicians to surveillance reporting regulations is also necessary. PMID:15583345

The medical food Souvenaid affects brain phospholipid metabolism in mild Alzheimer's disease: results from a randomized controlled trial

OpenAIRE

Rijpma, A.; Graaf, M. van der; Lansbergen, M.M.; Meulenbroek, O.V.; Cetinyurek-Yavuz, A.; Sijben, J.W.; Heerschap, A.; Olde Rikkert, M.G.M.

2017-01-01

Background Synaptic dysfunction contributes to cognitive impairment in Alzheimer?s disease and may be countered by increased intake of nutrients that target brain phospholipid metabolism. In this study, we explored whether the medical food Souvenaid affects brain phospholipid metabolism in patients with Alzheimer?s disease. Methods Thirty-four drug-naive patients with mild Alzheimer?s disease (Mini Mental State Examination score ?20) were enrolled in this exploratory, double-blind, randomized...

Full-Scale Turbofan Engine Noise-Source Separation Using a Four-Signal Method

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Hultgren, Lennart S.; Arechiga, Rene O.

2016-01-01

Contributions from the combustor to the overall propulsion noise of civilian transport aircraft are starting to become important due to turbofan design trends and expected advances in mitigation of other noise sources. During on-ground, static-engine acoustic tests, combustor noise is generally sub-dominant to other engine noise sources because of the absence of in-flight effects. Consequently, noise-source separation techniques are needed to extract combustor-noise information from the total noise signature in order to further progress. A novel four-signal source-separation method is applied to data from a static, full-scale engine test and compared to previous methods. The new method is, in a sense, a combination of two- and three-signal techniques and represents an attempt to alleviate some of the weaknesses of each of those approaches. This work is supported by the NASA Advanced Air Vehicles Program, Advanced Air Transport Technology Project, Aircraft Noise Reduction Subproject and the NASA Glenn Faculty Fellowship Program.

Comparison of four different preparation protocols to achieve bladder distension in patients with gross haematuria undergoing a CT urography

International Nuclear Information System (INIS)

Helenius, Malin; Segelsjo, Monica; Dahlman, Par; Magnusson, Anders

2012-01-01

Introduction: CT examination has been shown to be effective in detecting bladder cancer. Proper evaluation of the bladder requires it to be well distended. The purpose of the present study was to establish a preparation protocol to achieve satisfactory bladder distension without causing unacceptable patient discomfort. Material and method: We used four different preparation protocols (1: 0.5 L of fluid intake during a 1-h period, 2: Same as 1 with the addition of IV diuretics when the patient was examined, 3: 1 L of fluid intake during a 2-h period, 4: Same as 3 with the additional instruction to empty the bladder after 1 h. In protocols 1–3, the patients were asked not to empty their bladder during the preparation time). Bladder volume was calculated and bladder distension was judged as satisfactory or not by the radiologist. The patients answered questions about their ability to follow the preparation protocol and were requested to rate their need to empty the bladder pre-, during and post-examination. Results: Protocol 1 had the lowest bladder volume. Protocols 2, 3 and 4 were similar in bladder volume. However, Protocol 2 caused unacceptable patient discomfort, and the compliance was lowest in Protocol 4. Conclusion: Protocol 3, drinking 1 L of fluid during a 2-h period, gave satisfactory bladder distension, did not cause unacceptable discomfort in patients and did not have the lowest compliance.

Thirty years of the Spanish Novel (1980–2011

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Ángel Basanta

2012-12-01

Full Text Available The present paper surveys the Spanish novel over the past thirty years. Literary studies typically subdivide this period into generations: the 1936 Generation (writers who took part in the Spanish Civil War; writers “from the middle of the twentieth century” or “children of the war”; the 1968 Generation, marked by the transition to democracy; the 1980 Generation, known for their cosmopolitanism and critical engagement; Generation X, associated with urban realism; finally, the new millennium has brought with it the Generation “Nocilla”, ushering in new technology and the fragmentation of the textual narrative. In terms narrative approaches, the paper analyses eight of the most observable trends. A revival of narrativity breaks up with the excessive experimentation of the previous generation and the attention switches back to traditional elements of the novel; at the same time, the experimental novel continues to explore new narrative techniques. Part of this is also the metanovel, which is centred upon the process of writing, reading or on spoken discourse. Special attention is given to the autofictional novel in its numerous forms. In symbolic realism, universal mythical spaces and landscapes are created, in which the heroes are confronted with universal conflicts. The tradition of the existential novel is also maintained, where the heroes’ striving to accomplish their own life goals ends in failure as reality prevails over imagination. In the past few years, readers have favoured most the historical novel. In the latter, history is dealt with in four different ways: as a recreation of the past, as its retelling, as a projection of the past onto the present or as a springboard for various types of speculation. The paper also touches upon some authors of psychological novels, before moving on in turn to the crime novel, the detective novel and the roman noir and finally the action novel.

Radiotherapy of early breast cancer in scleroderma patients: our experience with four cases and a short review of the literature

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Kyrgias G

2012-01-01

Full Text Available George Kyrgias1,2, Kiki Theodorou3,4, Anna Zygogianni1, Konstantinos Tsanadis2, Stefanos Zervoudis5, John Tzitzikas6, Michael Koukourakis71Academic Radiotherapy, University of Thessaly, Medical School, Greece; 2Radiation Oncology Department, University Hospital of Larissa, Greece; 3Academic Medical Physics, University of Thessaly, Medical School, Greece; 4Medical Physics Department, University Hospital of Larissa, 5Breast Unit, REA Hospital, Athens, Greece; 6Radiation Oncology Department, AHEPA University Hospital of Thessaloniki, Greece; 7Radiotherapy-Oncology Department, University Hospital of Alexandroupolis, GreecePurpose: Connective vascular diseases (CVD, including scleroderma, are reported to represent for some researchers a relative contraindication and for others absolute contraindication for radiotherapy. The purpose of our study is to add four new cases to the existing body of international literature and to determine whether women with pre-existing scleroderma who have been surgically treated for early breast cancer could undergo postsurgical radiotherapy without serious early and late complications.Patients and methods: From May 1998 to November 2010, we irradiated for early breast cancer four patients suffering from pre-existing scleroderma; after conservative surgery, we performed whole breast postoperative radiotherapy of 50.4 Gy total dose to the whole breast plus a 9 Gy boost to the tumor bed. We reviewed the records of all four patients and evaluated the early and late reactions using acute radiation morbidity scoring criteria (Radiation Therapy Oncology Group [RTOG], American College of Radiology, Philadelphia, PA and late radiation morbidity scoring scheme (European Organisation for Research and Treatment of Cancer [EORTC], Brussels, Belgium and RTOG.Results: After a median follow-up of 105 months (range 12–155 months the early and late toxicity concerning the skin, the subcutaneous tissues, the lungs, and the heart have

Clinical analysis of 34 cases with glaucoma secondary to hypermature cataract

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Lin Jing

2016-03-01

Full Text Available AIM:To analyze the clinical symptoms, treatments and prognosis of the glaucoma secondary to hypermature cataract to offer some references for the diagnosis and the treatment.METHODS:Thirty four eyes with glaucoma secondary to hypermature cataract in 34 patients were collected from August 2011 to August 2014 in the West China Hospital, Sichuan University. Analyze different treatment methods selected according to different clinical symptoms, and corresponding prognosis.RESULTS:Thirty four patients were hospitalized in emergency, all the eyes had visual acuity of finger counting or worse, intraocular pressure(IOPwas 35～75mmHg. All patients received comprehensive IOP-lowering therapy before the surgery. Twenty-eight patients underwent phacoemulsification, 6 patients underwent extra-capsular cataract extraction(ECCEand 19 patients underwent primary or secondary IOL implantation. All the patients experienced pain relief after surgery, 30 of them had well-controlled postoperative IOP. One case underwent Ahmed glaucoma valve implant surgery, 3 cases gave up the treatment. Seventeen cases who had IOL implanted got great visual acuity improvement, the best postoperative visual acuity was 0.7.CONCLUSION:As long as we have proper and prompt diagnosis and positive control of IOP and inflammation before surgery, precise surgery skills, close observation after surgery and positive anti-inflammation therapy, most of the glaucoma secondary to hypermature cataract get satisfactory outcomes.

Serum homocystein level in patients with scleroderma.

Science.gov (United States)

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

2013-01-01

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

Efficacy and patient satisfaction with Essure hysteroscopic sterilisation

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Maja Rosič

2015-05-01

Full Text Available BACKGROUND: Essure is a permanent transcervical sterilisationprocedure. Three months after the procedure a confirmation test is performed to evaluate tubal occlusion or microinsert location. During this period the tubal lumen is occluded by benign tissue ingrowth stimulated by the microinsert. Since 2007, 169 procedures have been performed at University Medical Centre Maribor. The purpose of our study was to evaluate the efficacy, satisfaction, and complications of the procedure.METHODS: Thirty-eight consecutive patients were included in prospective study. All procedures were performed between August 2012 and March 2013 by the same experienced hysteroscopist in an outpatient setting. Transvaginal 2D ultrasound was performed 3 months after the procedure to asses the position of microinserts. Hysterosalpingo foam sonography (HyFoSy was performed in 5 cases and hysterosalpingography (HSG was performed once in a total of 6 cases with indeterminate position of microinserts.RESULTS: Thirty-eight patients with 75 Fallopian tubes were included. Essure microinsert was successfully placed in 73 of 75 Fallopian tubes in 37 patients (97,3%. Transvaginal ultrasound demonstrated a correct placement of 67 microinserts (67/73, 91,8%. Tubal occlusion was confirmed in all 6 cases with indeterminate position of microinserts. The overall patient satisfactory rate was 9,92 on a scale from 0 to 10.CONSCLUSION: Essure is a method for permanent female contraception that has a very high rate of success and patient satisfaction, a low rate of complications and is well tolerated. In cases of indeterminate position of microinserts on transvaginal ultrasound, HyFoSy could be an alternative to HSG.

Patient Adherence Predicts Outcome from Cognitive Behavioral Therapy in Obsessive-Compulsive Disorder

Science.gov (United States)

Simpson, Helen Blair; Maher, Michael J.; Wang, Yuanjia; Bao, Yuanyuan; Foa, Edna B.; Franklin, Martin

2011-01-01

Objective: To examine the effects of patient adherence on outcome from exposure and response prevention (EX/RP) therapy in adults with obsessive-compulsive disorder (OCD). Method: Thirty adults with OCD were randomized to EX/RP (n = 15) or EX/RP augmented by motivational interviewing strategies (n = 15). Both treatments included 3 introductory…

The twenty-four/four hour ratio (T/F ratio) of Tc-99m MDP uptake in patients with bone metastases and degenerative changes

International Nuclear Information System (INIS)

Israel, O.; Kleinhaus, U.; Keren, R.; Frankel, A.; Front, D.

1984-01-01

Normal and metastatic bone differ in their histological structure. Normal bone is mainly lamellar while metastatic bone formation is made in a large part out of new woven bone. The woven bone has a much larger surface area than the more stable lamellar bone and it is lined with metabolically active osteoblasts. The crystalline structures in the woven bone are smaller and have a larger surface area available for absorption. Uptake of bone seeking radiopharmaceuticals continues in new woven bone longer than in the lamellar bone. Bone scintigraphy was performed in 89 patients at four hours and 24 hours using a digital camera. The lesion to non lesion (L/N) ratio was determined using the camera computer. The T/F ratio was calculated: T/F=((L/N)-24)/((L/N)-4). Three groups were investigated. In 15 patients with metastatic bone carcinoma, T/F ratio was 1.46 +- 0.4. In 47 patients with degenerative joint disease the T/F ratio was 1.05 +- 0.06. In 27 patients with treated metastatic bone carcinoma the T/F ratio was 1.12 +- 0.13. The T/F ratio is significantly (p<0.001) different in patients with metastases compared to patients with benign degenerative disease. Chemotherapeutic and hormonal treatment cause significant (p<0.001) reduction in the T/F ratio. The T/F ratio may have a potential in differentiating degenerative from neoplastic diseases and in the evaluation of patients with bone metastases undergoing treatment

Dopaminergic influences on emotional decision making in euthymic bipolar patients.

Science.gov (United States)

Burdick, Katherine E; Braga, Raphael J; Gopin, Chaya B; Malhotra, Anil K

2014-01-01

We recently reported that the D2/D3 agonist pramipexole may have pro-cognitive effects in euthymic patients with bipolar disorder (BPD); however, the emergence of impulse-control disorders has been documented in Parkinson's disease (PD) after pramipexole treatment. Performance on reward-based tasks is altered in healthy subjects after a single dose of pramipexole, but its potential to induce abnormalities in BPD patients is unknown. We assessed reward-dependent decision making in euthymic BPD patients pre- and post 8 weeks of treatment with pramipexole or placebo by using the Iowa Gambling Task (IGT). The IGT requires subjects to choose among four card decks (two risky and two conservative) and is designed to promote learning to make advantageous (conservative) choices over time. Thirty-four BPD patients completed both assessments (18 placebo and 16 pramipexole). Baseline performance did not differ by treatment group (F=0.63; p=0.64); however, at week 8, BPD patients on pramipexole demonstrated a significantly greater tendency to make increasingly high-risk, high-reward choices across the five blocks, whereas the placebo group's pattern was similar to that reported in healthy individuals (treatment × time × block interaction, pinfluences risk-associated decision-making performance in euthymic BPD. The clinical implications remain unknown.

Prognosis and risk factors for deterioration in patients admitted to a medical emergency department

DEFF Research Database (Denmark)

Henriksen, Daniel Pilsgaard; Brabrand, Mikkel; Lassen, Annmarie Touborg

2014-01-01

vital signs at arrival to a medical emergency department (MED). DESIGN AND SETTING: Single-centre, retrospective cohort study of all patients admitted to the MED from September 2010-August 2011. SUBJECTS: Patients were included when their vital signs (systolic blood pressure, pulse rate, respiratory.......2-3.0%) among the non-deteriorating, hazard ratio 4.11 (95% CI: 2.38-7.10). CONCLUSIONS: Among acutely admitted medical patients who arrive with normal vital signs, 31.0% showed signs of deterioration within 24 hours. Risk factors included old age, Do-not-attempt-to-resuscitate order, admission from the open...... general ED. Thirty-day mortality among patients with deterioration was four times higher than among non-deteriorating patients. Further research is needed to determine whether intensified monitoring of vital signs can help to prevent deterioration or mortality among medical emergency patients....

Thirty-day outcomes of direct carotid artery stenting with cerebral protection in high-risk patients

International Nuclear Information System (INIS)

Veselka, J.; Cerna, D.; Zimolova, P.; Blasko, P.; Fiedler, J.; Hajek, P.; Maly, M.; Zemanek, D.; Duchonova, R.

2007-01-01

Implantation of a carotid artery stent after predilation is a standard approach in the endovascular treatment of carotid artery stenoses. Stenting without predilation may be an alternative approach in a certain subset of patients. The present prospective, single-center registry was designed to evaluate the feasibility and safety of direct carotid artery stenting (DCAS) in high-risk patients. Symptomatic patients with stenosis >50% and asymptomatic patients with stenosis >70% were eligible for enrolment. Criteria for high-risk patients included: need or history of open heart surgery, history of myocardial infarction, multivessel coronary artery disease, left ventricular dysfunction (ejection fraction ≤40%), severe pulmonary or renal disease, significant contralateral carotid disease, previous endarterectomy, and age ≥80 years. All procedures were performed using a filter protection device. Patients underwent complete clinical examination before and after DCAS and at 30-day follow-up. A total of 83 consecutive patients (45 males, 68±9 years, 33% symptomatic) underwent 100 procedures and 103 stents were deployed successfully. The technical success rate of stenting was 100%. Predilation of carotid stenosis was necessary in 1 (1%) procedure. Carotid-artery stenoses before and after DCAS were 80±9% and 7±9%, respectively. The median fluoroscopic time for DCAS was 7 min. The overall rate of in-hospital major adverse cerebrovascular events (death, stroke, myocardial infarction) was 5% (2 minor strokes, 3 transient attacks). There was 1 (1%) minor stroke within the 30-day follow-up. DCAS is feasible and can be performed with an acceptable risk in high-risk patients. (author)

Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty.

Science.gov (United States)

Yamamoto, Michiro; Murakami, Yukimi; Iwatsuki, Katsuyuki; Kurimoto, Shigeru; Hirata, Hitoshi

2016-04-02

Recent advances in imaging modalities have enabled three-dimensional preoperative simulation. A four-dimensional preoperative simulation system would be useful for debridement arthroplasty of primary degenerative elbow osteoarthritis because it would be able to detect the impingement lesions. We developed a four-dimensional simulation system by adding the anatomical axis to the three-dimensional computed tomography scan data of the affected arm in one position. Eleven patients with primary degenerative elbow osteoarthritis were included. A "two rings" method was used to calculate the flexion-extension axis of the elbow by converting the surface of the trochlea and capitellum into two rings. A four-dimensional simulation movie was created and showed the optimal range of motion and the impingement area requiring excision. To evaluate the reliability of the flexion-extension axis, interobserver and intraobserver reliabilities regarding the assessment of bony overlap volumes were calculated twice for each patient by two authors. Patients were treated by open or arthroscopic debridement arthroplasties. Pre- and postoperative examinations included elbow range of motion measurement, and completion of the patient-rated questionnaire Hand20, Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score, and the Mayo Elbow Performance Score. Measurement of the bony overlap volume showed an intraobserver intraclass correlation coefficient of 0.93 and 0.90, and an interobserver intraclass correlation coefficient of 0.94. The mean elbow flexion-extension arc significantly improved from 101° to 125°. The mean Hand20 score significantly improved from 52 to 22. The mean Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score significantly improved from 67 to 88. The mean Mayo Elbow Performance Score significantly improved from 71 to 91 at the final follow-up evaluation. We showed that four-dimensional, preoperative simulation can be generated by

Management of blunt liver trauma in 134 severely injured patients.

Science.gov (United States)

Hommes, Martijn; Navsaria, Pradeep H; Schipper, Inger B; Krige, J E J; Kahn, D; Nicol, Andrew John

2015-05-01

In haemodynamic stable patients without an acute abdomen, nonoperative management (NOM) of blunt liver injuries (BLI) has become the standard of care with a reported success rate of between 80 and 100%. Concern has been expressed about the potential overuse of NOM and the fact that failed NOM is associated with higher mortality rate. The aim of this study was to evaluate factors that might indicate the need for surgical intervention, and to assess the efficacy of NOM. A single centre prospective study between 2008 and 2013 in a level-1 Trauma Centre. One hundred thirty four patients with BLI were diagnosed on CT-scan or at laparotomy. The median ISS was 25 (range 16-34). Thirty five (26%) patients underwent an early exploratory laparotomy. The indication for surgery was haemodynamic instability in 11 (31%) patients, an acute abdomen in 16 (46%), and 8 (23%) patients had CT findings of intraabdominal injuries, other than the hepatic injury, that required surgical repair. NOM was initiated in 99 (74%) patients, 36 patients had associated intraabdominal solid organ injuries. Seven patients developed liver related complications. Five (5%) patients required a delayed laparotomy (liver related (3), splenic injury (2)). NOM failure was not related to the presence of shock on admission (p=1000), to the grade of liver injury (p=0.790) or associated intraabdominal injuries (p=0.866). Physiologic behaviour or CT findings dictated the need for operative intervention. NOM of BLI has a high success rate (95%). Nonoperative management of BLI should be considered in patients who respond to resuscitation, irrespective of the grade of liver trauma. Associated intraabdominal solid organ injuries do not exclude NOM. Copyright © 2014 Elsevier Ltd. All rights reserved.

Occult hepatitis B virus infection in immunocompromised patients

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Ruth Nogueira Cordeiro Moraes Jardim

Full Text Available Occult hepatitis B infection is characterized by hepatitis B virus (HBV DNA in the serum in the absence of hepatitis B surface antigen (HBsAg. We assessed occult HBV infection prevalence in two groups of immunocompromised patients (maintenance hemodialysis patients and HIV-positive patients presenting HBsAg-negative and anti-HBc positive serological patterns, co-infected or not by HCV. Thirty-four hemodialysis anti-HIV negative patients, 159 HIV-positive patients and 150 blood donors who were anti-HBc positive (control group were selected. HBV-DNA was detected by nested-PCR. Occult hepatitis B infection was not observed in the hemodialysis patients group but was found in 5% of the HIV-patients and in 4% of the blood donors. Immunosuppression in HIV positive patients was not a determining factor for occult HBV infection. In addition, no significant relationship between HBV-DNA and HCV co-infection in the HIV-positive patient group was found. A lack of significant associations was also observed between positivity for HBV-DNA and CD4 count, viral load and previous lamivudine treatment in these HIV-positive patients.

Evaluation of four non-invasive methods for examination and characterization of pressure ulcers

DEFF Research Database (Denmark)

Andersen, E.S.; Karlsmark, T.

2008-01-01

Background: Pressure ulcers are globally of major concern and there is need for research in the pathogenesis for early intervention. Early studies have suggested existence of a hypo-echogenic subepidermal layer at the location of pressure ulcers, visualized by ultrasound scans. As a continuation......, we here report on usability of four non-invasive techniques for evaluation of pressure ulcers. Methods: Fifteen pressure ulcers in stage 0-IV were examined using four different non-invasive techniques [redness index, skin temperature, skin elasticity (i.e. retraction time), and ultrasound scanning...... at all pressure ulcers, but none at the reference points. The skin retraction time was often higher at the location of a pressure ulcer than at the reference location. We found no correlation between the stage of the ulcers and temperature, redness index, subepidermal layer thickness, or retraction time...

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

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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.

Patients with first-episode, drug-naive schizophrenia and subjects at ultra-high risk of psychosis shared increased cerebellar-default mode network connectivity at rest.

Science.gov (United States)

Wang, Houliang; Guo, Wenbin; Liu, Feng; Wang, Guodong; Lyu, Hailong; Wu, Renrong; Chen, Jindong; Wang, Shuai; Li, Lehua; Zhao, Jingping

2016-05-18

Increased cerebellar-default mode network (DMN) connectivity has been observed in first-episode, drug-naive patients with schizophrenia. However, it remains unclear whether increased cerebellar-DMN connectivity starts earlier than disease onset. Thirty-four ultra-high risk (UHR) subjects, 31 first-episode, drug-naive patients with schizophrenia and 37 healthy controls were enrolled for a resting-state scan. The imaging data were analyzed using the seed-based functional connectivity (FC) method. Compared with the controls, UHR subjects and patients with schizophrenia shared increased connectivity between the right Crus I and bilateral posterior cingulate cortex/precuneus and between Lobule IX and the left superior medial prefrontal cortex. There are positive correlations between the right Crus I-bilateral precuneus connectivity and clinical variables (Structured Interview for Prodromal Syndromes/Positive and Negative Symptom Scale negative symptoms/total scores) in the UHR subjects. Increased cerebellar-DMN connectivity shared by the UHR subjects and the patients not only highlights the importance of the DMN in the pathophysiology of psychosis but also may be a trait alteration for psychosis.

Four factors of impulsivity differentiate antisocial and borderline personality disorders.

Science.gov (United States)

DeShong, Hilary L; Kurtz, John E

2013-04-01

Impulsivity is a shared criterion for the diagnosis of antisocial and borderline personality disorders, and this link may account for the high comorbidity rates between the two disorders. The current study aimed to differentiate between borderline and antisocial personality disorders using the four factors of impulsivity identified by Whiteside and Lynam (2001). Five hundred thirty-six undergraduate participants completed the personality assessment inventory (PAI; Morey, 1991) to assess borderline and antisocial personality features and the NEO personality inventory, third edition (NEO-PI-3; McCrae & Costa, 2010) to assess the four factors of impulsivity. Results indicate that negative urgency and lack of perseverance were significantly and uniquely related to borderline features, while sensation seeking and lack of premeditation were significantly and uniquely related to antisocial features. The implications of these results for improved differential diagnosis are discussed.

Elevated urine formaldehyde in elderly patients with primary open angle glaucoma

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Ying Cui

2016-03-01

Full Text Available AIM: To investigate the risk factor of primary open angle glaucoma (POAG, which is the leading cause of irreversible blindness worldwide. An abnormally high level of endogenous formaldehyde (FA has recently been found correlated with cell death and neurodegenerative disease, raising the possibility of a putative correlation of abnormal endogenous FA with POAG. METHODS: Thirty-four elderly patients with POAG and sixteen healthy controls were enrolled. Glaucomatous visual defects were present at both the functional (visual field and structural [retinal nerve fiber layer (RNFL thickness] levels. Morning urine samples were obtained and were analyzed by high-performance liquid chromatography (HPLC to detect the endogenous FA level in a double blind manner. RESULTS: Patients with POAG (P<0.05 had significantly higher urine FA levels. The urine FA level of patients with severe visual field defects [mean deviation (MD≥12 dB] was significantly (P<0.001 greater than that of patients with mild to moderate defects (MD<12 dB. By optical coherence tomography (OCT, the superior and inferior RNFL thickness of POAG group was significantly (P<0.001 thinner than in controls. Furthermore, the superior and inferior thinning of the RNFL was correlated with the elevation of urine FA concentration. CONCLUSION: Endogenous FA level is positively correlated with the neuronal defects of POAG.

Overall scores as an alternative to global ratings in patient experience surveys : A comparison of four methods

NARCIS (Netherlands)

Krol, M.W.; de Boer, D.; Rademakers, J.J.D.J.M.; Delnoij, D.

2013-01-01

Background Global ratings of healthcare by patients are a popular way of summarizing patients’ experiences. Summary scores can be used for comparing healthcare provider performance and provider rankings. As an alternative, overall scores from actual patient experiences can be constructed as summary

Clinical significance of sentinel lymph node detection in patients with invasive cervical cancer

Science.gov (United States)

Sinilkin, I. G.; Chernov, V. I.; Lyapunov, A. Yu.; Medvedeva, A. A.; Zelchan, R. V.; Chernyshova, A. L.; Kolomiets, L. A.; Bragina, O. D.

2017-09-01

The clinical significance of determining sentinel lymph nodes (SLN) in patients with invasive cervical cancer was studied. From 2013 to 2014, 30 cervical cancer patients (T1a1NxM0-T1b1NxM0) were treated at the Gynecological Oncology Department of the Cancer Research Institute. The day before surgery, four submucosal injections of 99mTc Al2O3 at a total dose of 80 MBq were made in each quadrant around the cervical tumor. Patients were submitted to preoperative lymphoscintigraphy and intraoperative SLN detection. The feasibility of preserving the reproductive potential in patients after radical abdominal trachelectomy was assessed. The 3-year, overall, disease-free and metastasis-free survival rates were analyzed. Thirty-four SLNs were detected by single-photon emission computed tomography (SPECT) and 42 SLNs were identified by intraoperative gamma probe. The sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 80% for SPECT image. The reproductive potential was preserved in 86% of patients. The 3-year overall and metastases-free survival rates were 100%. Recurrence occurred in 8.6% of cases.

Changes of FDG brain uptake in patients with abnormal thyroid function

International Nuclear Information System (INIS)

Huang, Wen-Sheng; Chang, Chih-Yung; Cheng, Cheng Yi

2009-01-01

Full text: Objective: To investigate FOG brain uptake in patients with hypo- and subclinical hyperthyroidism undergoing whole-body FOG PET/CT. Methods: Sixty-four patients who had received total thyroidectomy for thyroid carcinoma underwent whole-body FDG PETI CT. Thirty-two of them received imaging in subclinical hyperthyroid status (15 males; 17 females; mean age, 55 ± 14 years) while the other 32 age-matched patients underwent the scan 4 wk after thyroid hormone withdrawal (12 males; 20 females; mean age, 56 ± 13 years). Brain images were performed I h after 370 MBq intravenous injection using a dedicated PET/CT (Siemens Biograph BGO duo). FOG-uptake was quantified by the standardized uptake value (SUY), normalized to patient's body weight. The volume of brain was determined by PET with 40% maximum SUY threshold. The brain mean SUV (SUY mean) were calculated in each patient. Data were compared between the two groups. Results: The brain mean SUYs for the hypothyroid patients ranged between 3.11 and 6.35 (averaged SUY mean 5.13 ± 0.91) while those of the subclinical hyperthyroid patients varied from 3.53 to 8.29 (mean SUY mean 5.77 ± 1.04). There was a significant global reduction of brain FDG uptake in the hypothyroid group (II.] %, P < 0.0 I) but no significant changes in the sub-clinical hyperthyroid group compared to the controls. Conclusion: FDG brain uptake in subclinical hyperthyroid patients was significantly greater than that of patients with hypothyroidism, suggesting effects of thyroid hormone on cerebral glucose metabolism.

Incidence rate of falls and its risk factors in patients with rheumatoid arthritis compared to controls: Four years of the TOMORROW study.

Science.gov (United States)

Mamoto, Kenji; Inui, Kentaro; Okano, Tadashi; Sugioka, Yuko; Tada, Masahiro; Koike, Tatsuya; Nakamura, Hiroaki

2017-01-01

Patients with rheumatoid arthritis (RA) have been recognized to experience falls frequently due to functional disabilities. The aim of this study was to prospectively investigate factors influencing falls in patients with RA compared to controls. We compared the frequency of falls in 208 RA patients and 205 age- and sex-matched volunteers for four years and analyzed risk factors for falls in RA patients using multivariate regression analysis. No significant difference in the incidence rate of falls (/person-year) between patients with RA (median [interquartile range]: 0 [0, 0.5]) and controls (0 [0, 0.5]) was evident during four years. Logistic regression analysis identified age, sex, body mass index, history of falls, and lower limb implant at baseline as significant risk factors for falls. The highest quartile of anti-CCP antibody level (>300.6 U/ml) was the strongest predictor for multiple falls (odds ratio, 2.97; 95% confidence interval, 1.12-7.91, p = 0.029) among RA patients. During four years we could not observe the higher incidence rate of falls in RA patients compared to controls in our cohort. Subjects with a higher titer of anti-CCP antibody might be at higher risk of frequent falls among RA patients.

Investigation of four-dimensional computed tomography-based pulmonary ventilation imaging in patients with emphysematous lung regions

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Yamamoto, Tokihiro; Loo, Billy W Jr; Keall, Paul J [Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Dr, Stanford, CA 94305-5847 (United States); Kabus, Sven; Lorenz, Cristian; Von Berg, Jens; Blaffert, Thomas [Department of Digital Imaging, Philips Research Europe, Roentgenstrasse 24-26, D-22335 Hamburg (Germany); Klinder, Tobias, E-mail: Tokihiro@stanford.edu [Clinical Informatics, Interventional, and Translational Solutions, Philips Research North America, Briarcliff Manor, NY 10510 (United States)

2011-04-07

A pulmonary ventilation imaging technique based on four-dimensional (4D) computed tomography (CT) has advantages over existing techniques. However, physiologically accurate 4D-CT ventilation imaging has not been achieved in patients. The purpose of this study was to evaluate 4D-CT ventilation imaging by correlating ventilation with emphysema. Emphysematous lung regions are less ventilated and can be used as surrogates for low ventilation. We tested the hypothesis: 4D-CT ventilation in emphysematous lung regions is significantly lower than in non-emphysematous regions. Four-dimensional CT ventilation images were created for 12 patients with emphysematous lung regions as observed on CT, using a total of four combinations of two deformable image registration (DIR) algorithms: surface-based (DIR{sup sur}) and volumetric (DIR{sup vol}), and two metrics: Hounsfield unit (HU) change (V{sub HU}) and Jacobian determinant of deformation (V{sub Jac}), yielding four ventilation image sets per patient. Emphysematous lung regions were detected by density masking. We tested our hypothesis using the one-tailed t-test. Visually, different DIR algorithms and metrics yielded spatially variant 4D-CT ventilation images. The mean ventilation values in emphysematous lung regions were consistently lower than in non-emphysematous regions for all the combinations of DIR algorithms and metrics. V{sub HU} resulted in statistically significant differences for both DIR{sup sur} (0.14 {+-} 0.14 versus 0.29 {+-} 0.16, p = 0.01) and DIR{sup vol} (0.13 {+-} 0.13 versus 0.27 {+-} 0.15, p < 0.01). However, V{sub Jac} resulted in non-significant differences for both DIR{sup sur} (0.15 {+-} 0.07 versus 0.17 {+-} 0.08, p = 0.20) and DIR{sup vol} (0.17 {+-} 0.08 versus 0.19 {+-} 0.09, p = 0.30). This study demonstrated the strong correlation between the HU-based 4D-CT ventilation and emphysema, which indicates the potential for HU-based 4D-CT ventilation imaging to achieve high physiologic accuracy. A

Self-reported alcohol intake in pregnancy: comparison between four methods

DEFF Research Database (Denmark)

Kesmodel, U; Olsen, S F

2001-01-01

STUDY OBJECTIVE To assess the agreement between four different measures of alcohol intake in pregnancy. DESIGN AND SETTING Danish speaking pregnant women referred to the Midwife Centre in Aarhus, Denmark, for routine antenatal care were contacted at their first visit at approximately 15–16 weeks...... combining the methods. CONCLUSIONS When assessing the distribution of alcohol intake in pregnancy or when studying adverse pregnancy outcomes that are probably caused mainly by sustained exposure it seems that for pregnant women with low to moderate alcohol intake diaries or an average measure from...... gestation from October to December 1998. The women were interviewed about current average alcohol intake and intake within the previous week, and subsequently filled in a two week diary on alcohol intake. When booking for delivery at the end of the first trimester the women were also asked to complete...

Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position

NARCIS (Netherlands)

Jensen, Charlotte; Raghoebar, Gerry M.; Kerdijk, Wouter; Meijer, Henny J. A.; Cune, Marco S.

2016-01-01

Objectives: To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Methods: Thirty subjects with a bilateral

Mandibulary dental arch form differences between level four polynomial method and pentamorphic pattern for normal occlusion sample

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Y. Yuliana

2011-07-01

Full Text Available The aim of an orthodontic treatment is to achieve aesthetic, dental health and the surrounding tissues, occlusal functional relationship, and stability. The success of an orthodontic treatment is influenced by many factors, such as diagnosis and treatment plan. In order to do a diagnosis and a treatment plan, medical record, clinical examination, radiographic examination, extra oral and intra oral photos, as well as study model analysis are needed. The purpose of this study was to evaluate the differences in dental arch form between level four polynomial and pentamorphic arch form and to determine which one is best suitable for normal occlusion sample. This analytic comparative study was conducted at Faculty of Dentistry Universitas Padjadjaran on 13 models by comparing the dental arch form using the level four polynomial method based on mathematical calculations, the pattern of the pentamorphic arch and mandibular normal occlusion as a control. The results obtained were tested using statistical analysis T student test. The results indicate a significant difference both in the form of level four polynomial method and pentamorphic arch form when compared with mandibular normal occlusion dental arch form. Level four polynomial fits better, compare to pentamorphic arch form.

Seismic hazard analysis with PSHA method in four cities in Java

International Nuclear Information System (INIS)

Elistyawati, Y.; Palupi, I. R.; Suharsono

2016-01-01

In this study the tectonic earthquakes was observed through the peak ground acceleration through the PSHA method by dividing the area of the earthquake source. This study applied the earthquake data from 1965 - 2015 that has been analyzed the completeness of the data, location research was the entire Java with stressed in four large cities prone to earthquakes. The results were found to be a hazard map with a return period of 500 years, 2500 years return period, and the hazard curve were four major cities (Jakarta, Bandung, Yogyakarta, and the city of Banyuwangi). Results Java PGA hazard map 500 years had a peak ground acceleration within 0 g ≥ 0.5 g, while the return period of 2500 years had a value of 0 to ≥ 0.8 g. While, the PGA hazard curves on the city's most influential source of the earthquake was from sources such as fault Cimandiri backgroud, for the city of Bandung earthquake sources that influence the seismic source fault dent background form. In other side, the city of Yogyakarta earthquake hazard curve of the most influential was the source of the earthquake background of the Opak fault, and the most influential hazard curve of Banyuwangi earthquake was the source of Java and Sumba megatruts earthquake. (paper)

Treatment comfort, time perception, and preference for conventional and digital impression techniques : A comparative study in young patients

NARCIS (Netherlands)

Burhardt, Lukasz; Livas, Christos; Kerdijk, Wouter; van der Meer, Wicher Joerd; Ren, Yijin

INTRODUCTION: The aim of this crossover study was to assess perceptions and preferences for impression techniques in young orthodontic patients receiving alginate and 2 different digital impressions. METHODS: Thirty-eight subjects aged 10 to 17 years requiring impressions for orthodontic treatment

Clinical Manifestations and Outcomes of Rickettsia australis Infection: A 15-Year Retrospective Study of Hospitalized Patients

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Adam Stewart

2017-06-01

Full Text Available Queensland tick typhus (QTT; Rickettsia australis is an important cause of community-acquired acute febrile illness in eastern Australia. Cases of QTT were identified retrospectively from 2000 to 2015 at five sites in Northern Brisbane through a pathology database. Those included had a fourfold rise in spotted fever group (SFG-specific serology, a single SFG-specific serology ≥ 256 or SFG-specific serology ≥ 128 with a clinically consistent illness. Cases were excluded on the basis of clinical unlikelihood of QTT infection. Thirty-six cases were included. Fever was found in 34/36 (94% patients. Rash occurred in 83% of patients with maculopapular being the dominant morphology (70%. Thrombocytopenia, lymphopenia, and raised transaminases were common and occurred in 58%, 69%, and 89% of patients, respectively. Thirty-one of 36 (86% patients received antibiotic therapy (usually doxycycline and the time to correct antibiotic (from admission ranged from 3 to 120 h (mean 45.5 h. Four of 36 (11% required intensive care unit (ICU admission for severe sepsis and end-organ support. There were no deaths. QTT has a wide range of clinical and laboratory features. Early and appropriate antimicrobial therapy is important and may prevent severe disease. Further prospective studies are required to identify factors associated with severe infection and sepsis.

Self-Assembly of 3D Fennel-Like Co3O4 with Thirty-Six Surfaces for High Performance Supercapacitor

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Yanfang Li

2017-01-01

Full Text Available Three-dimensional (3D fennel-like cobalt oxide (II, III (Co3O4 particles with thirty-six surfaces on nickel foams were prepared via a simple hydrothermal synthesis method and its growth process was also researched. The crystalline structure and morphology were investigated by X-ray diffraction (XRD, scanning electron microscopy (SEM, and Raman spectroscopy. The Brunauer-Emmett-Teller (BET analysis revealed that 3D fennel-like Co3O4 particles have high specific surface area. Therefore, the special structure with thirty-six surfaces indicates the good electrochemical performance of the micron-nanometer material as electrode material for supercapacitors. The cyclic voltammetry (CV, galvanostatic charge-discharge, and electrochemical impedance spectroscopy (EIS were conducted to evaluate the electrochemical performances. Compared with other morphological materials of the similar sizes, the Co3O4 particles on nickel foam exhibit a high specific capacitance of 384.375 F·g−1 at the current density of 3 A·g−1 and excellent cycling stability of a capacitance retention of 96.54% after 1500 galvanostatic charge-discharge cycles in 6 M potassium hydroxide (KOH electrolyte.

An investigation of a possible relationship between olfactory identification deficits at first episode and four-year outcomes in patients with psychosis.

Science.gov (United States)

Good, Kimberley P; Tibbo, Philip; Milliken, Heather; Whitehorn, David; Alexiadis, Maria; Robertson, Nancy; Kopala, Lili C

2010-12-01

Olfactory identification deficits are found in a significant proportion of patients with schizophrenia spectrum psychotic disorders and appear to be predictive of incomplete remission of negative and cognitive symptoms. In the current study, we examined whether patients with first episode psychosis who have olfactory identification deficits (microsmic) have poorer functional outcome than those whose olfactory status is normal (normosmic). Sixty-six (66) first episode psychosis patients (46 M and 20 F) were assessed with the University of Pennsylvania Smell Identification Test (UPSIT) at baseline. UPSIT scores served to classify patients into subgroups. The patients' psychiatrists completed the Social and Occupational Functioning Assessment Scale (SOFAS) and the Levels of Functioning Scale (LOFS) after at least 6 months of treatment. The Premorbid Assessment Scale (PAS) was rated by a parent at baseline. Thirty-eight percent (38%) of the sample was identified as 'microsmic'. LOFS and SOFAS scores were significantly lower in the microsmic group than in the normosmic group. Symptoms were significantly worse in the microsmic group in comparison to the normosmic group. PAS scores did not differ between groups. First episode patients identified as microsmic at baseline assessment went on to demonstrate poorer functional outcome compared to normosmic patients despite no differences in premorbid adjustment. Olfactory identification deficits at first episode may provide a marker for poorer outcome. Testing olfaction is simple and inexpensive, and could provide clinically valuable information at first episode to identify those patients who might benefit from more intensive interventions promoting functional recovery. Copyright © 2010 Elsevier B.V. All rights reserved.

Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization

International Nuclear Information System (INIS)

Tian, Bing; Xu, Bing; Lu, Jianping; Liu, Qi; Wang, Li; Wang, Minjie

2015-01-01

Highlights: • 4D CTA showed excellent agreement with DSA with regard to identification of feeding arteries and drainage veins. • The most important finding was 4D CTA in determining the impact of DAVF treatment with transarterial embolization. • 4D CTA provides images similar to those obtained with DSA both before and after treatment. - Abstract: Purpose: This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Patients and Methods: Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Results: Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ = 1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Conclusion: Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings

New patient-controlled abdominal compression method in radiography: radiation dose and image quality.

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Piippo-Huotari, Oili; Norrman, Eva; Anderzén-Carlsson, Agneta; Geijer, Håkan

2018-05-01

The radiation dose for patients can be reduced with many methods and one way is to use abdominal compression. In this study, the radiation dose and image quality for a new patient-controlled compression device were compared with conventional compression and compression in the prone position . To compare radiation dose and image quality of patient-controlled compression compared with conventional and prone compression in general radiography. An experimental design with quantitative approach. After obtaining the approval of the ethics committee, a consecutive sample of 48 patients was examined with the standard clinical urography protocol. The radiation doses were measured as dose-area product and analyzed with a paired t-test. The image quality was evaluated by visual grading analysis. Four radiologists evaluated each image individually by scoring nine criteria modified from the European quality criteria for diagnostic radiographic images. There was no significant difference in radiation dose or image quality between conventional and patient-controlled compression. Prone position resulted in both higher dose and inferior image quality. Patient-controlled compression gave similar dose levels as conventional compression and lower than prone compression. Image quality was similar with both patient-controlled and conventional compression and was judged to be better than in the prone position.

Cardiac findings in 31 patients with Noonan's syndrome

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Bertola Débora Romeo

2000-01-01

Full Text Available OBJECTIVE: To evaluate cardiac findings in 31 Noonan syndrome patients. METHODS: Thirty-one (18 males and 13 femalespatients from 26 families affected with Noonan's syndrome were evaluated from the cardiac point of view with electrocardiography and echodopplercardiography. RESULTS: Twenty patients had some type of cardiac abnormality. The most frequent was pulmonary valve stenosis followed by hypertrophic myocardiopathy, commonly associated with valve defects. Upper deviation of the QRS axis was observed in 80% of these patients. CONCLUSION: In view of the high frequency and diversity of cardiac abnormalities present in Noonan syndrome, cardiac evaluation with electrocardiography and echocardiography should be performed in all patients diagnostically suspected of having this disease.

Synthesis method based on solution regions for planar four bar straight line linkages

International Nuclear Information System (INIS)

Lai Rong, Yin; Cong, Mao; Jian you, Han; Tong, Yang; Juan, Huang

2012-01-01

An analytical method for synthesizing and selecting desired four-bar straight line mechanisms based on solution regions is presented. Given two fixed pivots, the point position and direction of the target straight line, an infinite number of mechanism solutions can be produced by employing this method, both in the general case and all three special cases. Unifying the straight line direction and the displacement from the given point to the instant center into the same form with different angles as parameters, infinite mechanism solutions can be expressed with different solution region charts. The mechanism property graphs have been computed to enable the designers to find out the involved mechanism information more intuitively and avoid aimlessness in selecting optimal mechanisms

Comparison Between the Two-Injection Technique and the Four-Injection Technique in Axillary Brachial Plexus Block with Articaine.

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Ertikin, Aysun; Argun, Güldeniz; Mısırlıoğlu, Mesut; Aydın, Murat; Arıkan, Murat; Kadıoğulları, Nihal

2017-10-01

In this study, we aimed to compare axillary brachial plexus block using the two-injection and four-injection techniques assisted with ultrasonography (USG) and nerve stimulator in patients operated for carpal tunnel syndrome with articaine. To evaluate which technique is more effective, we compared the onset time, effectiveness, and duration of block procedures, patient satisfaction, adverse effect of the drug, and complication rates of the motor and sensory blocks. Sixty patients were randomly divided into two groups. A mixture of physiologic serum added to articain with NaHCO 3 (30 mL) was injected into the patients' axilla in both the groups. After the blockage of the musculocutaneous nerve in both the groups, the median nerve in the two-injection group and the median nerve, ulnar nerve, and radial nerve in the four-injection group were blocked. In brachial plexus nerves, sensorial blockage was evaluated with pinprick test, and motor block was evaluated by contraction of the muscles innervated by each nerve. The adverse effects and complications, visual analog scale (VAS) values during the operation, and post-operative patient satisfaction were recorded. Sufficient analgesia and anaesthesia were achieved with no need for an additional local anaesthetics in both the groups. Furthermore, additional sedation requirements were found to be similar in both the groups. A faster rate and a more effective complete block were achieved in more patients from the four-injection group. In the two-injection group, the block could not be achieved for N. radialis in one patient. All other nerves were successfully blocked. Whereas the blockage procedure lasted longer in the four-injection group, the VAS values recorded during the blockage procedure were higher in the four-injection group. No statistical difference was found with regard to patient satisfaction, and no adverse effects and complications were observed in any group. Although the multi-injection method takes more time

[Mental Health in the General Hospital: Results of the Patient Health Questionnaire (PHQ) in Four Hospital Services].

Science.gov (United States)

Castro-Camacho, Leonidas; Escobar, Juan Manuel; Sáenz-Moncaleano, Camilo; Delgado-Barrera, Lucía; Aparicio-Turbay, Soraya; Molano, Juan Carlos; Noguera, Efraín

2012-03-01

Few individuals have access to mental health services due in part to underdetection. As it is more likely to consult for medical conditions, primary care may be a useful gateway for early detection of mental health problems. Detection of the frequency of mental health problems in four hospital services at the Fundación Santa Fe de Bogotá: Outpatient unit, hospitalization, emergency department, and primary care through a brief detection questionnaire, the Patient Health Questionnaire (PHQ). Cross-sectional study of patients seen at the four services who answered a Demographic Data Questionnaire and the PHQ together with information gathered about current medical diagnosis, history of visits, and hospitalizations during the last year. 1094 patients seen at the four hospital services between September 2010 and May 2011 were selected at random. A mental health problem was detected in 36.7% of the total sample. Major depressive disorder (7.3%), alcohol abuse (14.4%), and any anxiety disorder (7.7%) showed the highest prevalence with the emergency department showing the highest frequency of detection. The usefulness of a brief detection questionnaire such as the PHQ in hospital settings is demonstrated and implications in the design of mental health programs in the general hospital are discussed. The need to replicate this study in other settings and to undertake further research is outlined. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

A single tube PCR assay for simultaneous amplification of HSV-1/-2, VZV, CMV, HHV-6A/-6B, and EBV DNAs in cerebrospinal fluid from patients with virus-related neurological diseases.

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Yamamoto, T; Nakamura, Y

2000-10-01

Cerebrospinal fluid (CSF) specimens from 27 patients with encephalitis, meningitis, and other neurological diseases were studied for the presence of herpes simplex virus types 1 and 2 (HSV-1/-2), varicella-zoster virus (VZV), cytomegalovirus (CMV), human herpesviruses 6A and 6B (HHV-6A/-6B) and Epstein-Barr virus (EBV) DNA using the polymerase chain reaction (PCR) method. The DNAs were amplified using two sets of consensus primer pairs in a single tube, bringing simultaneous amplification of the herpesviruses. The PCR products were analyzed by agarose gel electrophoresis, and Southern blot hybridization with virus-type specific probes, thus allowing discrimination between the different types of herpesviruses to be made. Each virus-specific probe was highly specific for identifying the PCR product. Thirty CSF specimens from 13 patients with encephalitis and 10 specimens from 10 patients with meningitis, respectively, were examined using this method. Eight patients with encephalitis and six with meningitis were positive for different herpesviruses, including patients with coinfections (HSV-1/-2 and VZV, VZV and CMV). Among four CSF specimens from four patients with other neurological disorders, dual amplification of CMV and EBV was present. Since identification of the types of herpesviruses in this system requires a very small amount of CSF, and is completed with one PCR, it is useful for routine diagnosis of herpesvirus infections in diagnostic laboratories. The viruses responsible for central nervous system infection are easily detected with various coinfection and serial patterns of herpesviruses, by this consensus primer-based PCR method. This may give an insight into the relationship between virus-related neurological diseases (VRNDS) and herpesvirus infections.

[Dent's syndrome. Nephrology follow-up of four patients of the same family].

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Coulibaly, G; Babinet, F; Champion, G

2012-04-01

Dent's syndrome is a rare inherited tubulopathy. Factors influencing renal function in this disease are not well known. The aim of our study is to investigate the evolution of the Dent's syndrome in renal plan. The study was retrospective and conducted in 2006, concerning four brothers. The genetic defect was a mutation S244L missense in exon 6 of gene CLCN5. Various parameters were studied. Patients were 8.5 to 21-years-old at the beginning of the follow-up. Two of them had chronic renal insufficiency (CRI) which evolved, at least 7 years of moderate to terminal stage. Tubular signs were made of hypokalemia, hypercalciuria, hypophosphatemia and proteinuria mostly β2 microglobulin. Improvement of these abnormalities was obtained with symptomatic treatment which has not always been well tolerated. A case of beginner nephrocalcinosis was observed. There was size and weight delay at the beginning of patient monitoring. Dent's syndrome may be complicated by CRI. It seems to appear in the second decade of life and hypercalciuria would contribute to it. Our CRI patients had significant bone disease. The hypercalciuria and proteinuria are factors over which we try to act. Clinical trials are needed to evaluate the efficacy of treatment on the reduction of CRI or its progression by reducing these factors in patients with Dent's syndrome. Copyright © 2011 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Traumatic abdominal wall hernia - four cases and a review of the ...

African Journals Online (AJOL)

Objective: To review blunt traumatic abdominal wall hernias (TAWHs) in our institution. Method: Retrospective review of blunt abdominal trauma cases over a 6-month period. Results: Four patients with TAWH were identified. The mean age was 36 years. Three had been involved in vehicular collisions, and 1 had been ...

Imaging features of isolated unilateral pulmonary artery agenesis presenting in adulthood: a review of four cases

International Nuclear Information System (INIS)

Griffin, N.; Mansfield, L.; Redmond, K.C.; Dusmet, M.; Goldstraw, P.; Mittal, T.K.; Padley, S.

2007-01-01

Aim: To highlight the variation in clinical manifestations, imaging and management of four cases of unilateral pulmonary artery agenesis presenting in adulthood. Method: Four patients with unilateral pulmonary artery agenesis were referred to our institution between 1995 and 2005. They underwent a series of investigations, including chest radiography, echocardiography, ventilation perfusion scintigraphy, angiography, computed tomography (CT) and magnetic resonance imaging (MRI). Results: Two of the four patients had absence of the right main pulmonary artery, whilst the remaining two patients had absence of the left main pulmonary artery. One patient showed a restrictive defect on pulmonary function tests. Two patients who had ventilation perfusion scintigraphy showed absent perfusion and reduced ventilation on the affected side. Angiography (where performed), CT and MRI confirmed the anatomy and the presence of multiple collaterals. Bronchiectasis was demonstrated on CT in two patients, with one also demonstrating a mosaic attenuation pattern. One patient had an incidental lung tumour on the side of the agenesis, which was diagnosed as a chondroid hamartoma on histology. Three of the four patients eventually underwent resection of the affected lung. Conclusion: Isolated unilateral pulmonary artery agenesis has a non-specific presentation. Awareness of this condition can lead to earlier diagnosis, with cross-sectional imaging making an important contribution

Imaging features of isolated unilateral pulmonary artery agenesis presenting in adulthood: a review of four cases

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Griffin, N. [Royal Brompton and Harefield NHS Trust, London (United Kingdom)]. E-mail: nyreegriffin@hotmail.com; Mansfield, L. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Redmond, K.C. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Dusmet, M. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Goldstraw, P. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Mittal, T.K. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Padley, S. [Royal Brompton and Harefield NHS Trust, London (United Kingdom)

2007-03-15

Aim: To highlight the variation in clinical manifestations, imaging and management of four cases of unilateral pulmonary artery agenesis presenting in adulthood. Method: Four patients with unilateral pulmonary artery agenesis were referred to our institution between 1995 and 2005. They underwent a series of investigations, including chest radiography, echocardiography, ventilation perfusion scintigraphy, angiography, computed tomography (CT) and magnetic resonance imaging (MRI). Results: Two of the four patients had absence of the right main pulmonary artery, whilst the remaining two patients had absence of the left main pulmonary artery. One patient showed a restrictive defect on pulmonary function tests. Two patients who had ventilation perfusion scintigraphy showed absent perfusion and reduced ventilation on the affected side. Angiography (where performed), CT and MRI confirmed the anatomy and the presence of multiple collaterals. Bronchiectasis was demonstrated on CT in two patients, with one also demonstrating a mosaic attenuation pattern. One patient had an incidental lung tumour on the side of the agenesis, which was diagnosed as a chondroid hamartoma on histology. Three of the four patients eventually underwent resection of the affected lung. Conclusion: Isolated unilateral pulmonary artery agenesis has a non-specific presentation. Awareness of this condition can lead to earlier diagnosis, with cross-sectional imaging making an important contribution.